WorldWideScience

Sample records for regulations effective fall

  1. Quantification of the probable effects of alternative in-river harvest regulations on recovery of Snake River fall chinook salmon. Final report

    International Nuclear Information System (INIS)

    Cramer, S.P.; Vigg, S.

    1996-03-01

    The goal of this study was to quantify the probable effects that alternative strategies for managing in-river harvest would have on recovery of Snake River fall chinook salmon. This report presents the analysis of existing data to quantify the way in which various in-river harvest strategies catch Snake River bright (SRB) fall chinook. Because there has been disagreement among experts regarding the magnitude of in-river harvest impacts on Snake River fall chinook, the authors compared the results from using the following three different methods to estimate in-river harvest rates: (1) use of run reconstruction through stock accounting of escapement and landings data to estimate harvest rate of SRB chinook in Zone 6 alone; (2) use of Coded Wire Tag (CWT) recoveries of fall chinook from Lyons Ferry Hatchery in a cohort analysis to estimate age and sex specific harvest rates for Zone 6 and for below Bonneville Dam; (3) comparison of harvest rates estimated for SRB chinook by the above methods to those estimated by the same methods for Upriver Bright (URB) fall chinook

  2. Quantifying Temperature Effects on Fall Chinook Salmon

    Energy Technology Data Exchange (ETDEWEB)

    Jager, Yetta [ORNL

    2011-11-01

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

  3. Effect of impact surface in equestrian falls

    OpenAIRE

    Clark, J. Michio; Post, Andrew; Connor, Thomas A.; Hoshizaki, Thomas Blaine; Gilchrist, M. D.

    2016-01-01

    This study examines the effect of impact surface on head kinematic response and maximum principal strain (MPS) for equestrian falls. A helmeted Hybrid III headform was dropped unrestrained onto three impact surfaces of different stiffness (steel, turf and sand) and three locations. Peak resultant linear acceleration, rotational acceleration and duration of the impact events were measured. A finite element brain model was used to calculate MPS. The results revealed that drops onto steel produc...

  4. Fall

    OpenAIRE

    Odundo, Magdalene

    2008-01-01

    The monoprint Fall, created in the artist-in-residence studio at Dartmouth College, Hanover, New England, represents a transient yet vivid memory of the season spent walking and re-walking a trail I took to the studio on a daily basis. The work arose spontaneously from a direct and instinctive wish to replicate the ghost imprints left on the trail by the wet and dry weather of that autumn. It also represented a sensationally hopeful political transition of what seemed to be the growth of hope...

  5. 78 FR 22423 - Drawbridge Operation Regulations; Taunton River, Fall River and Somerset, MA

    Science.gov (United States)

    2013-04-16

    ... Operation Regulations; Taunton River, Fall River and Somerset, MA AGENCY: Coast Guard, DHS. ACTION: Notice of temporary deviation from regulation. SUMMARY: The Coast Guard is issuing a temporary deviation from the regulation governing the operation of the Brightman Street Bridge across the Taunton River...

  6. 78 FR 1536 - Fall 2012 Semiannual Agenda of Regulations

    Science.gov (United States)

    2013-01-08

    ... for Regulation, Office of the Assistant General Counsel for Legislation and Regulation, U.S... and Atmospheric Administration, 7600 Sand Point Way NE., Seattle, WA 98115, Phone: 206 526-6142, Fax..., National Oceanic and Atmospheric Administration, 7600 Sand [[Page 1544

  7. The Effects of the A Matter of Balance Program on Falls and Physical Risk of Falls, Tampa, Florida, 2013

    OpenAIRE

    Chen, Tuo-Yu; Edwards, Jerri D.; Janke, Megan C.

    2015-01-01

    Introduction This study investigated the effects of the A Matter of Balance (MOB) program on falls and physical risk factors of falling among community-dwelling older adults living in Tampa, Florida, in 2013. Methods A total of 110 adults (52 MOB, 58 comparison) were enrolled in this prospective cohort study. Data on falls, physical risk of falling, and other known risk factors of falling were collected at baseline and at the end of the program. Multivariate analysis of covariance with repeat...

  8. 77 FR 7904 - Fall 2011 Semiannual Agenda of Regulations

    Science.gov (United States)

    2012-02-13

    ... ``Regulatory Planning and Review,'' and the Regulatory Flexibility Act, as amended, the Department of Commerce...-AS65 for Regulating Offshore Marine Aquaculture in the Gulf of Mexico (Reg Plan Seq No. 22). 206... Management Recommendations by the Atlantic States Marine Fisheries Commission. 207 Collection and Use of Tax...

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

    NARCIS (Netherlands)

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

    2015-01-01

    Recent trials have shown that multifactorial fall interventions vary in effectiveness, possibly due to lack of adherence to the interventions. The aim of this study was to examine what proportion of older adults recognize their falls risk and prioritize for fall-preventive care, and which factors

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

    NARCIS (Netherlands)

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

    2015-01-01

    Background: Recent trials have shown that multifactorial fall interventions vary in effectiveness, possibly due to lack of adherence to the interventions. The aim of this study was to examine what proportion of older adults recognize their falls risk and prioritize for fall-preventive care, and

  11. Cost-effectiveness in fall prevention for older women.

    Science.gov (United States)

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

    2009-08-01

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

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

    Science.gov (United States)

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

    2015-12-17

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  15. Cost-effectiveness in fall prevention for older women

    OpenAIRE

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2013-04-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

  19. Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling.

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Perdrizet, Johnna; Markle-Reid, Maureen; Hoch, Jeffrey S

    2017-09-01

    Falls among older adults can cause serious morbidity and pose economic burdens on society. Older age is a known risk factor for falls and age has been shown to influence the effectiveness of fall prevention programs. To our knowledge, no studies have explicitly investigated whether cost-effectiveness of a multifactorial fall prevention intervention (the intervention) is influenced by age. This economic evaluation explores: 1) the cost-effectiveness of a multifactorial fall prevention intervention compared to usual care for community-dwelling adults ≥ 75 years at risk of falling in Canada; and 2) the influence of age on the cost-effectiveness of the intervention. Net benefit regression was used to examine the cost-effectiveness of the intervention with willingness-to-pay values ranging from $0-$50,000. Effects were measured as change in the number of falls, from baseline to 6-month follow-up. Costs were measured using a societal perspective. The cost-effectiveness analysis was conducted for both the total sample and by age subgroups (75-84 and 85+ years). For the total sample, the intervention was not economically attractive. However, the intervention was cost-effective at higher willingness-to-pay (WTP) (≥ $25,000) for adults 75-84 years and at lower WTP (cost-effectiveness of the intervention depends on age and decision makers' WTP to prevent falls. Understanding the influence of age on the cost-effectiveness of an intervention may help to target resources to those who benefit most. Retrospectively registered. Clinicaltrials.gov identifier: NCT00463658 (18 April 2007).

  20. Effects of falls prevention interventions on falls outcomes for hospitalised adults: protocol for a systematic review with meta-analysis.

    Science.gov (United States)

    Slade, Susan C; Carey, David L; Hill, Anne-Marie; Morris, Meg E

    2017-11-12

    Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation. Published reviews have mainly evaluated community settings and residential care facilities. A better understanding of hospital falls and the most effective strategies to prevent them is vital to keeping people safe. To evaluate the effectiveness of falls prevention interventions on reducing falls in hospitalised adults (acute and subacute wards, rehabilitation, mental health, operating theatre and emergency departments). We also summarise components of effective falls prevention interventions. This protocol has been registered. The systematic review will be informed by Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis statement. randomised controlled trials, quasi-randomised trials or controlled clinical trials that evaluate falls prevention interventions for use by hospitalised adults or employees. Electronic databases will be searched using key terms including falls, accidental falls, prevention, hospital, rehabilitation, emergency, mental health, acute and subacute. Pairs of independent reviewers will conduct all review steps. Included studies will be evaluated for risk of bias. Data for variables such as age, participant characteristics, settings and interventions will be extracted and analysed with descriptive statistics and meta-analysis where possible. The results will be presented textually, with flow charts, summary tables, statistical analysis (and meta

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

    Science.gov (United States)

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

    2016-09-01

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

  2. TOWARD MORE EFFECTIVE REGULATION

    Energy Technology Data Exchange (ETDEWEB)

    J. GRAF

    2000-06-01

    This paper proposes a model relationship between the operator engaged in a hazardous activity, the regulator of that activity, and the general public. The roles and responsibilities of each entity are described in a way that allows effective communication flow. The role of the regulator is developed using the steam boiler as an example of a hazard subject to regulation; however, the model applies to any regulated activity. In this model the safety analyst has the extremely important role of communicating sometimes difficult technical information to the regulator in a way that the regulator can provide credible assurance to the general public as to the adequacy of the control of the hazardous activity. The conclusion asserts that acceptance of the model, understanding of the roles and responsibilities and definition of who communicates what information to whom will mitigate frustration on the part of each of the three entities.

  3. The Effectiveness of a Participatory Program on Fall Prevention in Oncology Patients

    Science.gov (United States)

    Huang, Li-Chi; Ma, Wei-Fen; Li, Tsai-Chung; Liang, Yia-Wun; Tsai, Li-Yun; Chang, Fy-Uan

    2015-01-01

    Falls are known to be one of the most common in patient adverse events. A high incidence of falls was reported on patients with cancer. The purpose of this study was to explore the effect of a participatory program on patient's knowledge and self-efficacy of fall prevention and fall incidence in an oncology ward. In this quasi-experimental study,…

  4. The Effect of Personalization on Smartphone-Based Fall Detectors

    Directory of Open Access Journals (Sweden)

    Carlos Medrano

    2016-01-01

    Full Text Available The risk of falling is high among different groups of people, such as older people, individuals with Parkinson's disease or patients in neuro-rehabilitation units. Developing robust fall detectors is important for acting promptly in case of a fall. Therefore, in this study we propose to personalize smartphone-based detectors to boost their performance as compared to a non-personalized system. Four algorithms were investigated using a public dataset: three novelty detection algorithms—Nearest Neighbor (NN, Local Outlier Factor (LOF and One-Class Support Vector Machine (OneClass-SVM—and a traditional supervised algorithm, Support Vector Machine (SVM. The effect of personalization was studied for each subject by considering two different training conditions: data coming only from that subject or data coming from the remaining subjects. The area under the receiver operating characteristic curve (AUC was selected as the primary figure of merit. The results show that there is a general trend towards the increase in performance by personalizing the detector, but the effect depends on the individual being considered. A personalized NN can reach the performance of a non-personalized SVM (average AUC of 0.9861 and 0.9795, respectively, which is remarkable since NN only uses activities of daily living for training.

  5. Effective detection method for falls according to the distance between two tri-axial accelerometers

    Science.gov (United States)

    Kim, Jae-Hyung; Park, Geun-Chul; Kim, Soo-Hong; Kim, Soo-Sung; Lee, Hae-Rim; Jeon, Gye-Rok

    2016-04-01

    Falls and fall-related injuries are a significant problem in the elderly population. A number of different approaches for detecting falls and activities of daily living (ADLs) have been conducted in recent years. However, distinguishing between real falls and certain fall-like ADL is often difficult. The aim of this study is to discriminate falls from fall-like ADLs such as jogging, jumping, and jumping down. The distance between two tri-axial accelerometers attached to the abdomen and the sternum was increased from 10 to 30 cm in 10-cm intervals. Experiments for falls and ADLs were performed to investigate the feasibility of the detection system for falls developed in this study. When the distances between the two tri-axial electrometers were 20 and 30 cm, fall-like ADLs were effectively distinguished from falls. The thresholds for three parameters — SVM, Diff Z, and Sum_diff_Z — were set; falls could be distinguished from ADL action sequences when the SVM value was larger than 4 g (TH1), the Diff_Z parameter was larger than 1.25 g (TH2), and the Sum_diff_Z parameter was larger than 15 m/s (TH3). In particular, when the SVM, Diff_Z, and Sum_diff_Z parameter were sequentially applied to thresholds (TH1, TH2, and TH3), fall-like ADL action sequences were accurately discriminated from falls.

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

    NARCIS (Netherlands)

    Hartholt, K.A.; van der Velde, N.; van Lieshout, E.M.M.; Polinder, S.; de Vries, O.J.; Boyé, N.D.A.; Kerver, A.J.H.; Ziere, G.; Bruijninckx, M.M.M.; de Vries, M.R.; Mattace-Raso, F.U.S.; Uitterlinden, A.G.; van Beeck, E.F.; Lips, P.T.A.M.; Patka, P.; van der Cammen, T.J.

    2011-01-01

    Background: Fall incidents represent an increasing public health problem in aging societies worldwide. A major risk factor for falls is the use of fall-risk increasing drugs. The primary aim of the study is to compare the effect of a structured medication assessment including the withdrawal of

  7. Effectiveness of medication withdrawal in older fallers: results from the Improving Medication Prescribing to reduce Risk Of FALLs (IMPROveFALL) trial

    NARCIS (Netherlands)

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

    2017-01-01

    To investigate the effect of withdrawal of fall-risk-increasing-drugs (FRIDs) versus ‘care as usual’ on reducing falls in community-dwelling older fallers. Randomised multicentre trial Six hundred and twelve older adults who visited an Emergency Department (ED) because of a fall. Withdrawal of

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

    Science.gov (United States)

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

    2013-10-29

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

  9. The effect anticoagulation status on geriatric fall trauma patients.

    Science.gov (United States)

    Coleman, Julia; Baldawi, Mustafa; Heidt, David

    2016-12-01

    This research study aims to identify the effect of anticoagulation status on hospital course, complications, and outcomes among geriatric fall trauma patients. The study design is a retrospective cohort study, looking at fall trauma among patients aged 60 to 80 years from 2009 to 2013 at a university hospital in the United States. The statistical analysis, conducted with SPSS software with a threshold for statistical significance of P patients included in this study was 1,121. Compared with patients not on anticoagulation, there was a higher LOS among patients on anticoagulation (6.3 ± 6.2 vs 4.9 ± 5.2, P = .001). A higher LOS (7.2 ± 6.8 vs 5.0 ± 5.3, P = .001) and days in the ICU (2.1 ± 5.4 vs 1.1 ± 3.8, P = .010) was observed in patients on warfarin. A higher mortality (7.1% vs 2.8%, P = .013), LOS (6.3 ± 6.2 vs 5.1 ± 5.396, P = .036), and complication rate (49.1 vs 36.7, P = .010) was observed among patients on clopidogrel. In this study, a higher mortality and complication rate were seen among clopidogrel, and a greater LOS and number of days in the ICU were seen in patients on warfarin. These differences are important, as they can serve as a screening tool for triaging the severity of a geriatric trauma patient's condition and complication risk. For patients on clopidogrel, it is essential that these patients are recognized early as high-risk patients who will need to be monitored more closely. For patients on clopidogrel or warfarin, bridging a patient's anticoagulation should be initiated as soon as possible to prevent unnecessary increased LOS. At last, these data also provide support against prescribing patients clopidogrel when other anticoagulation options are available. Published by Elsevier Inc.

  10. Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio: A qualitative study

    Directory of Open Access Journals (Sweden)

    Christina Brogårdh

    2017-08-01

    Full Text Available Objective: To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls. Design: A qualitative study with face-to-face interviews. Data were analysed by systematic text condensation. Participants: Fourteen ambulatory persons (7 women; mean age 70 years with late effects of polio. Results: Analysis resulted in one main theme, “Everyday life is a challenge to avoid the consequences of falls”, and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions. Conclusion: Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problem-focused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.

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

    OpenAIRE

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

    2011-01-01

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

  12. Effectiveness of an automatic manual wheelchair braking system in the prevention of falls.

    Science.gov (United States)

    Martorello, Laura; Swanson, Edward

    2006-01-01

    The purpose of this study was to evaluate the effectiveness of an automatic manual wheelchair braking system in the reduction of falls for patients at high risk of falls while transferring to and from a manual wheelchair. The study design was a normative survey carried out through the use of a written questionnaire sent to 60 skilled nursing facilities to collect data from the medical charts, which identified patients at high risk for falls who used an automatic wheelchair braking system. The facilities participating in the study identified a frequency of falls of high-risk patients while transferring to and from the wheelchair ranging from 2 to 10 per year, with a median fall rate per facility of 4 falls. One year after the installation of the automatic wheelchair braking system, participating facilities demonstrated a reduction of zero to three falls during transfers by high-risk patients, with a median fall rate of zero falls. This represents a statistically significant reduction of 78% in the fall rate of high-risk patients while transferring to and from the wheelchair, t (18) = 6.39, p braking system for manual wheelchairs was installed. The application of the automatic braking system allows clients, families/caregivers, and facility personnel an increased safety factor for the reduction of falls from the wheelchair.

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

    Science.gov (United States)

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

    2014-11-14

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

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

    Science.gov (United States)

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

    2011-08-21

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

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

    Directory of Open Access Journals (Sweden)

    Mattace-Raso Francesco US

    2011-08-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  17. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients.

    Science.gov (United States)

    van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W; Pols, Huibert A P; van der Cammen, Tischa J M

    2008-01-01

    Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.

  18. Effects of Linear Falling Ramp Reset Pulse on Addressing Operation in AC PDP

    International Nuclear Information System (INIS)

    Liu Zujun; Liang Zhihu; Liu Chunliang; Meng Lingguo

    2006-01-01

    The effects of linear falling ramp reset pulse related to addressing operation in an alternating current plasma display panel (AC PDP) were studied. The wall charge waveforms were measured by the electrode balance method in a 12-inch coplanar AC PDP. The wall charge waveforms show the relationship between the slope ratio of the falling ramp reset pulse and the wall charges at the end of the falling ramp reset pulse which influences the addressing stability. Then the effects of the slope ratio of the linear falling ramp reset pulse on the addressing voltage and addressing time were investigated. The experimental results show that the minimum addressing voltage increases with the increase of the slope ratio of the falling ramp reset pulse, and so does the minimum addressing time. Based on the experimental results, the optimization of the addressing time and the slope ratio of the falling ramp pulse is discussed

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

    Directory of Open Access Journals (Sweden)

    Sang Chul Kim

    2016-10-01

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

  20. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences

    OpenAIRE

    Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

    2017-01-01

    Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome me...

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

    Directory of Open Access Journals (Sweden)

    Chandran Manju

    2011-06-01

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

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

    Science.gov (United States)

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

    2011-06-18

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

  3. The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

    Directory of Open Access Journals (Sweden)

    Ohde Sachiko

    2012-07-01

    Full Text Available Abstract Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1 the fall risk assessment tool, 2 an intervention protocol to prevent in-patient falls, 3 specific environmental safety interventions, 4 staff education, and 5 multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331 in 2004 versus 1.53 falls per 1000 patient days (263/172325 in 2010, representing a significant decrease (p = 0.039. In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368, increasing to 97.6% in 2010 (10564/10828. The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective.

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

    Science.gov (United States)

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

    2015-10-01

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

  5. Effect evaluation of a multifactor community intervention to reduce falls among older persons

    NARCIS (Netherlands)

    Wijlhuizen, G.J.; Bois, P. du; Dommelen, P. van; Hopman-Rock, M.

    2007-01-01

    The objective of the study was to evaluate the effectiveness of a multifactor and multimethod community intervention programme to reduce falls among older persons by at least 20%. In a pre-test-post test design, self-reported falls were registered for 10 months in the intervention community and two

  6. Effect of eastern gamagrass on fall armyworm and corn earworm development

    Science.gov (United States)

    The fall armyworm, Spodoptera frugiperda (J.E. Smith) and the corn earworm, Helicoverpa zea (Boddie) are two important corn pests in the southern U.S. states. Effect of the leaves from the corn relative, the Eastern gamagrass (Tripsacum dactyloides L.) on fall armyworm and corn earworm development ...

  7. Effectiveness of medication withdrawal in older fallers: Results from the improving medication prescribing to reduce risk of falls (IMPROveFALL) trial

    NARCIS (Netherlands)

    N.D.A. Boyé (Nicole); N. van der Velde (Nathalie); De Vries, O.J. (Oscar J.); E.M.M. van Lieshout (Esther); Hartholt, K.A. (Klaas A.); Mattace-Raso, F.U.S. (Francesco U.S.); P. Lips (Paul); P. Patka (Peter); Van Beeck, E.F. (Ed F.); T.J.M. van der Cammen (Tischa); van der Cammen, T.J.M.; Patka, P.; E.F. van Beeck (Ed); van der Velde, N.; E.M.M. van Lieshout (Esther); S. Polinder (Suzanne); F.U.S. Mattace Raso (Francesco); K.A. Hartholt (Klaas); Boyé, N.D.A.; C.W.N. Looman (Caspar); Lips, P.; O.J. de Vries (Oscar); A.J.H. Kerver (Albert J.H.)

    2017-01-01

    textabstractObjectives: to investigate the effect of withdrawal of fall-risk-increasing-drugs (FRIDs) versus 'care as usual' on reducing falls in community-dwelling older fallers. Design: randomised multicentre trial. Participants: six hundred and twelve older adults who visited an Emergency

  8. Interactive effect between depression and chronic medical conditions on fall risk in community-dwelling elders.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Science.gov (United States)

    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.

  11. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences.

    Science.gov (United States)

    Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

    2017-02-01

    Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome measures of functional reach, perceived health status, fear of fall were included. Quality of the included articles was rated using Physiotherapy Evidence Database (PEDro) scale and the pooled effect of SSE was obtained by Review Manager (RevMan5) software. Significant effect of SSE was detected over walking or no treatment to improve balance as well to prevent fear of fall and improve perceived health status. The results of this systematic review proposed that SSE significantly better than walking or no treatment to prevent fall, prevent fear of fall and improve perceived health status.

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

    Science.gov (United States)

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

    2012-09-01

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

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

    Science.gov (United States)

    Oppewal, Alyt; Hilgenkamp, Thessa I M

    2017-09-03

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

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Kuptniratsaikul V

    2011-05-01

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

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

    Science.gov (United States)

    Park, Jin-Hyuck

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

  17. Sideways fall-induced impact force and its effect on hip fracture risk: a review.

    Science.gov (United States)

    Nasiri Sarvi, M; Luo, Y

    2017-10-01

    Osteoporotic hip fracture, mostly induced in falls among the elderly, is a major health burden over the world. The impact force applied to the hip is an important factor in determining the risk of hip fracture. However, biomechanical researches have yielded conflicting conclusions about whether the fall-induced impact force can be accurately predicted by the available models. It also has been debated whether or not the effect of impact force has been considered appropriately in hip fracture risk assessment tools. This study aimed to provide a state-of-the-art review of the available methods for predicting the impact force, investigate their strengths/limitations, and suggest further improvements in modeling of human body falling. We divided the effective parameters on impact force to two categories: (1) the parameters that can be determined subject-specifically and (2) the parameters that may significantly vary from fall to fall for an individual and cannot be considered subject-specifically. The parameters in the first category can be investigated in human body fall experiments. Video capture of real-life falls was reported as a valuable method to investigate the parameters in the second category that significantly affect the impact force and cannot be determined in human body fall experiments. The analysis of the gathered data revealed that there is a need to develop modified biomechanical models for more accurate prediction of the impact force and appropriately adopt them in hip fracture risk assessment tools in order to achieve a better precision in identifying high-risk patients. Graphical abstract Impact force to the hip induced in sideways falls is affected by many parameters and may remarkably vary from subject to subject.

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

    Science.gov (United States)

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

    2016-10-01

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

  19. Effectiveness of Videogames on Balance and Fear of Falling in Chronic Stroke Patient

    Directory of Open Access Journals (Sweden)

    Neshat Rahimi S.Monfared

    2015-03-01

    Full Text Available Objectives: Balance disorder is one of the most common problems after stroke causes falling and fear of falling in some patients. The balance based video games are newly used in people with motor problems. It is very important to use different interventions for balance issues. The aim of this study is to determine the effectiveness of videogame on balance and fear of falling in one participant. Methods: This experimental study was done in a single subject system, A-B design for one patient with chronic stroke. This method including repetitive measures conducted in two phases, baseline and then twelve intervention sessions. Berg Balance Scale, Timed up and go, Functional Reach, the maximum weight bearing in different directions and the deviation from center were conducted for balance assessing. Fear of falling questionnaire was used to assess fear of falling. Analysis of results was done by C-statistic, Bayesian factor, Mann Whitney U, and visual analysis graphs. Results: The results showed significant improvement for balance skills, the maximum force produced by lower extremities and reducing fear of falling parameters. But the deviation from center graphs did not showed distinct pattern. Discussion: All analysis confirmed the efficacy of videogames on balance skills and fear of falling improvement. However, the deviation from center did not show improvement and it seems to need more studies.

  20. Carotid sinus syndrome and cardiovagal regulation in elderly patients with suspected syncope-related falls

    DEFF Research Database (Denmark)

    Brinth, Louise; Latif, Tabassam; Pors, Kirsten

    2014-01-01

    ) positions. A hypersensitive response was defined by current guidelines. Results: In the supine position, heart rate (HR) and systolic blood pressure (SBP) decreased during CSM on the right side by 17.0 +/- 15.2 min-1 and 32.5 +/- 25.5 mmHg, and on the left side by 12.8 +/- 14.3 min-1 and 22.7 +/- 20.7 mm....... Conclusions: The hemodynamic response to CSM has a well-defined pattern and differs both with respect to the stimulus site and patient position. We suggest that CSS is not a distinct pathophysiological process or disease entity but rather an acquired cardiovascular instability due to age-related degeneration......Background: Falls and syncope in the elderly may be caused by hypersensitivity in the high-pressure baroreflex control - carotid sinus syndrome (CSS). The pathophysiological process causing CSS remains poorly understood. Methods: We studied the hemodynamic response to carotid sinus massage (CSM...

  1. Effect of Tree-Fall Gaps on Fruit-Feeding Nymphalidae Assemblages in a Peruvian Rainforest

    OpenAIRE

    Pardonnet, Sylvia

    2010-01-01

    Tropical rainforests are among the most complex and diverse ecosystems, composed of a mosaic of shady understory under the closed canopy and tree-fall gaps of varying sizes and age. The light reaching the forest floor favors the recruitment of fast growing plant species and provide food resources for other animal species including butterflies. The Nymphalidae are the most species rich butterfly family in the tropics, and are ideal bioindicators. We investigated the effect of the tree-fall gap...

  2. Effect of a program of multifactorial fall prevention on health-related quality of life, functional ability, fear of falling and psychological well-being. A randomized controlled trial

    DEFF Research Database (Denmark)

    Vind, Ane Bonnerup; Andersen, Hanne Elkjaer; Pedersen, Kirsten Damgaard

    2010-01-01

    Falls among older people are associated with injury, functional decline, fear of falling, and depression. This study aims to evaluate the effect of multifactorial fall prevention on function, fear of falling, health-related quality of life and psychological well-being....

  3. Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review.

    Science.gov (United States)

    Lipardo, Donald S; Aseron, Anne Marie C; Kwan, Marcella M; Tsang, William W

    2017-10-01

    To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI). Seven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, Digital Dissertation Consortium) and reference lists of pertinent articles were searched. Randomized controlled trials (RCTs) on the effect of exercise, cognitive training, or a combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait, and cognitive function among community-dwelling older adults with MCI were included. Data were extracted using the modified Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument. Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function, while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included. This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI. Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

    2015-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Daniel K. Y. Chan

    2008-10-01

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

  6. The effect of spasticity, sense and walking aids in falls of people after chronic stroke.

    Science.gov (United States)

    Soyuer, Ferhan; Oztürk, Ahmet

    2007-05-15

    To study the effects of spasticity, sensory impairment, and type of walking aid on falls in community dwellers with chronic stroke. Functional Independence Measure (FIM) Instrument, Joint Position Sense Evaluation (JPS), the Rivermead motor assessment scale (RMA), Ashworth Scale, Tinetti Assessment Tool were used to assess 100 cases. Fifty-three of the cases were grouped as nonfallers, 36 as one-time fallers and 11 as repeat fallers. These 3 groups were found to be different from each other in respect to FIM, Tinetti test and RMA (p cane, 41.9% high cane). According to Ordinal logistic regression analysis, it was found that the possibility of fall increased (p fall of the individuals with stroke decreased (p falls, spasticity is also an indicator for chronic stroke patients, as is motor impairment, functional situation, impairment of balance and walking. Sensory impairment, using a walking aid and the type were found to be ineffective.

  7. Effect of whole-body vibration exercise in preventing falls and fractures

    DEFF Research Database (Denmark)

    Jepsen, Ditte Beck; Thomsen, Katja; Hansen, Stinus

    2017-01-01

    OBJECTIVE: To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age. DESIGN: A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity...... of retrieved publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density......2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA. CONCLUSIONS: WBV reduces fall rate but seems to have no overall effect on BMD...

  8. Justification and crush tests compared with fall tests in relation to changes in existing regulations

    International Nuclear Information System (INIS)

    Chevalier, G.; Gilles, P.; Pouard, M.

    1983-05-01

    The I.A.E.A. regulations applied to validate type B packages in an accidental situation represent a perfectly logical simulation of what could happen during transport, for most packages: - collision at 47.8 km/h with a very rigid obstacle, - local damage of 9.8 times the mass in joules (150 mm diameter punch test). These accident levels are justified for packages weighing 1000 kg to 50000 kg (between the mass of a car and that of a very large loaded transport vehicles). Under 500 kg, the aggression level required by the regulations seems insufficient in comparison with possible accidents, and experience shows that the packages in service in France display a resistance capacity closer to probable accidents than the minimum requirements of the regulations. Above 50 tons and around 100 tons, it seems that the situation is reversed, the requirements of the regulations appear to be much more severe than the probable accidents, and when a large package is located, it would seem to be more important to be concerned with the damage that this package would cause to the civil works than the damage that it would itself suffer [fr

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

    Science.gov (United States)

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

    2004-12-01

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

  10. The effect of total knee arthroplasty on patients' balance and incidence of falls: a systematic review.

    Science.gov (United States)

    Moutzouri, M; Gleeson, N; Billis, E; Tsepis, E; Panoutsopoulou, I; Gliatis, J

    2017-11-01

    Despite the high incidence of falls in patients with OA, few studies have explored whether falls risk is affected after patients undergo total knee arthroplasty (TKA). Therefore, the aim of this systematic review was to identify the extent of the effects of TKA on balance and incidence of falls by critically reviewing the available literature. A systematic review of published literature sources was conducted up to March 2014. All studies assessing balance and incidence of falls after TKA (without physiotherapeutic intervention) were included. The methodological quality of each study was reviewed using the Critical Appraisal Skill Programme tool. Thirteen studies were included, comprising of ten cohort studies (Level II) and three studies with Level of evidence III. Findings provide evidence that TKA improves significantly single-limb standing balance (~60%) and dynamic balance up to 1-year following surgery (Level of evidence II). Moreover, TKA influences positively fear of falling and incidence of falls by switching 54.2 % of pre-operative fallers to post-operative non-fallers (Level of evidence II-III). It is highlighted that knee extension strength, proprioception and symmetrization of postural strategies have not fully recovered post-TKA and influence balance performance. Clinically, these persistent deficits need to be mitigated by physiotherapy even before TKA takes place.

  11. Effect of guided relaxation and imagery on falls self-efficacy: a randomized controlled trial.

    Science.gov (United States)

    Kim, Bang Hyun; Newton, Roberta A; Sachs, Michael L; Glutting, Joseph J; Glanz, Karen

    2012-06-01

    To examine the effects of guided relaxation and imagery (GRI) on improvement in falls self-efficacy in older adults who report having a fear of falling. Randomized, controlled trial with allocation to GRI or guided relaxation with music of choice. General community. Ninety-one men and women aged 60 to 92. Participants were randomized to listen to a GRI audio compact disk (intervention group) or a guided relaxation audio compact disk and music of choice (control group) twice a week for 6 weeks for 10 minutes per session. Primary outcome measure was the Short Falls Efficacy Scale-International (FES-I). Secondary outcome measures were the Leisure Time Exercise Questionnaire (LTEQ) and the Timed Up and Go (TUG) mobility test. GRI participants reported greater improvements on the Short FES-I (P = .002) and LTEQ (P = .001) scores and shorter time on the TUG (P = .002) than the guided relaxation and music-of-choice group. GRI was more effective at increasing falls self-efficacy and self-reported leisure time exercise and reducing times on a simple mobility test than was guided relaxation with music of choice. GRI is an effective, simple, low-cost tool for older adults to improve falls self-efficacy and leisure time exercise behaviors. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  12. THE EFFECTS OF OTAGO EXERCISE PROGRAMME FOR FALL PREVENTION IN ELDERLY PEOPLE

    Directory of Open Access Journals (Sweden)

    Nancy N. Patel

    2015-08-01

    Full Text Available Background: The ‘Otago exercise programme’ (OEP is a strength and balance retraining programme designed to prevent falls in older people living in the community. The aim of this study was to find the effects of Otago exercise programme for fall prevention in community dwelling elderly people. Method: The sample comprised 30 community dwelling elderly around sinhgad road, pune (out of 30, 4 were dropouts aged over 60 years both male and female falling under moderate fall risk measured by Tinetti Performance Oriented Mobility Assessment. The intervention consisted mainly strength and balance training. Intervention was done for 1 hr every day, 5 days per week for 6weeks. Outcome measure assessment was done pre, 3rd week and post intervention. Pre and post comparison of following three outcome measures was done. Outcome measures: Tinetti Performance Oriented Mobility Assessment, 10RM and Chair stand test. Result: Paired t-test was done. Results of p value for 10RM (p value = 0.00, Tinetti performance oriented mobility assessment (p value = 0.00 and chair stand test (p value = 0.01 was found to be highly significant. Out of 26 subjects with moderate risk of fall pre intervention, 24 subjects showed low risk of fall during post intervention assessment of Tinetti Performance Oriented Mobility Assessment. Conclusion: The Otago exercise programme is significantly effective increasing strength of lower limb and improving in balance, gait and therefore ultimately preventing fall in community dwelling Indian elder people. Hence, Otago exercise protocol can be used in day to day clinical practice and also as a home exercise program.

  13. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients

    NARCIS (Netherlands)

    van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W.; Pols, Huibert A. P.; van der Cammen, Tischa J. M.

    2008-01-01

    BACKGROUND: Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. METHOD: Within a common geriatric outpatient

  14. The Fall of Oil Prices and the Effects on Biofuels.

    Science.gov (United States)

    Reboredo, Fernando H; Lidon, Fernando; Pessoa, Fernanda; Ramalho, José C

    2016-01-01

    This analysis is focused on the effect of the abrupt decline of oil prices on biofuels, particularly second-generation ethanol. The efforts to decrease the production costs of biofuels, especially cellulosic ethanol (CE), will be greatly threatened if current oil prices remain low, especially since production is not slowing. Only huge state subsidies could alleviate this threat, but the challenge is to persuade citizens that this sacrifice is worthwhile. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Science.gov (United States)

    Park, Jin-Hyuck

    2018-03-28

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

  17. Liquid flow rate effects during partial evaporation in a falling film micro contactor

    NARCIS (Netherlands)

    Moschou, P.; Croon, de M.H.J.M.; Schaaf, van der J.; Schouten, J.C.

    2013-01-01

    The focus of this study is the investigation of the effect of liquid flow rate on partial evaporation, enhanced by convective nitrogen flow, in a falling film micro contactor. Experiments are performed at different flow rates and for a certain heating liquid temperature. The temperatures of the gas

  18. Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

    Science.gov (United States)

    Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

    2015-12-01

    Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  19. The effect of vacuum assisted socket suspension on prospective, community-based falls by users of lower limb prostheses.

    Science.gov (United States)

    Rosenblatt, Noah J; Ehrhardt, Tess

    2017-06-01

    Individuals with lower limb amputation are at increased risk of falling compared to age-matched peers. The purpose of this study was to quantify the effect of socket suspension on the risk of falling, by comparing prospectively tracked falls between a group of participants that used vacuum assisted socket suspension (VASS) and a group that did not use this system. Fifteen current users of VASS and 12 non-VASS users received an email every two weeks for one year, with a link to an online survey that asked whether they fell (i.e., "unintentionally came to rest on a lower surface") or stumbled (i.e., lost balance but did not fall) in the prior two weeks. A Chi-squared test was used to compare fall and stumble risk between groups, after stratifying by level of amputation, and the phi coefficient (φ) was used to quantify effect size. While the use of VASS did not affect the rate of falling (i.e., falls per person year) for either persons with transtibial amputation (TTA) or those with transfemoral amputation (TFA), the absolute risk of having multiple falls was reduced by nearly 75% in the former (φ=0.83), which is particularly important given that recurrent falls are associated with more severe injuries. There was no effect of VASS on the risk of falls in TFA. Further work is warranted to demonstrate the persistence of these effects in larger, more controlled samples. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The effects of Salsa dance on balance, gait, and fall risk in a sedentary patient with Alzheimer's dementia, multiple comorbidities, and recurrent falls.

    Science.gov (United States)

    Abreu, Mauro; Hartley, Greg

    2013-01-01

    Recent studies have looked at the effects of dance on functional outcomes for persons with balance, gait, and cognitive impairments. The purpose of this report is to quantify the effects of Salsa dance therapy on function, balance, and fall risk in a sedentary older patient with multiple comorbidities. CASE DESCRIPTION/INTERVENTION: The patient was an 84-year-old woman with functional decline due to Alzheimer's dementia, late effects of a cerebral hemorrhagic aneurysm with right hemiparesis in the lower extremity, arthritis, and recurrent falls. Intervention consisted largely of Salsa dancing activities for 24 sessions over 12 weeks. The patient showed improvements in range of motion, strength, balance, functional mobility, gait distance, and speed. During the course of therapy, 1 fall was reported with no significant injuries and 6 months postintervention the patient/caregiver reported no falls. This case describes the clinically meaningful effects of Salsa dance therapy as a primary intervention and its impact on functional recovery in a geriatric patient with multiple impairments.

  1. Rise and fall of nuclear power in the United States and the limits of regulation

    International Nuclear Information System (INIS)

    Del Sesto, S.L.

    1982-01-01

    This paper documents the rapid growth of nuclear power in the United States and its subsequent decline in the late 1970s. It demonstrates that the increase in numbers of new orders for nuclear plants created pressures for additional licensing complexity to insure safety and provide public intervenors with opportunities to participate in the regulatory process. The resulting protraction of the licensing process combined with increasing political opposition to nuclear power caused construction delays and bureaucratic bottlenecks at a time when soaring interest rates and double-digit inflation have pushed the cost of building new facilities out of the reach of the financially battered utility industry. Together with a downturn in demand for electricity and increasing uncertainty over nuclear power, no reactor orders have been placed since late 1978. It is argued that renewed growth of nuclear power in the United States is unlikely, especially in a regulatory environment which fosters increased costs of electricity to consumers and a simultaneous abrogation of the economies of scale. The consequences of the impending atrophication of the nuclear industry in America and its effects on future energy mixes and long-term national interests must be considered in future nuclear policies and reforms

  2. Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults.

    Science.gov (United States)

    Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

    2018-05-01

    Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults. In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions. High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor. The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Lays Cavallero Pagliosa

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

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

    Directory of Open Access Journals (Sweden)

    Fatih Celebi

    2017-01-01

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

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

    OpenAIRE

    Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

    2015-01-01

    [Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also ...

  6. Cost Effectiveness of Falls and Injury Prevention Strategies for Older Adults Living in Residential Aged Care Facilities.

    Science.gov (United States)

    Church, Jody L; Haas, Marion R; Goodall, Stephen

    2015-12-01

    To evaluate the cost effectiveness of interventions designed to prevent falls and fall-related injuries among older people living in residential aged care facilities (RACFs) from an Australian health care perspective. A decision analytic Markov model was developed that stratified individuals according to their risk of falling and accounted for the risk of injury following a fall. The effectiveness of the interventions was derived from two Cochrane reviews of randomized controlled trials for falls/fall-related injury prevention in RACFs. Interventions were considered effective if they reduced the risk of falling or reduced the risk of injury following a fall. The interventions that were modelled included vitamin D supplementation, annual medication review, multifactorial intervention (a combination of risk assessment, medication review, vision assessment and exercise) and hip protectors. The cost effectiveness was calculated as the incremental cost relative to the incremental benefit, in which the benefit was estimated using quality-adjusted life-years (QALYs). Uncertainty was explored using univariate and probabilistic sensitivity analysis. Vitamin D supplementation and medication review both dominated 'no intervention', as these interventions were both more effective and cost saving (because of healthcare costs avoided). Hip protectors are dominated (less effective and more costly) by vitamin D and medication review. The incremental cost-effectiveness ratio (ICER) for medication review relative to vitamin D supplementation is AU$2442 per QALY gained, and the ICER for multifactorial intervention relative to medication review is AU$1,112,500 per QALY gained. The model is most sensitive to the fear of falling and the cost of the interventions. The model suggests that vitamin D supplementation and medication review are cost-effective interventions that reduce falls, provide health benefits and reduce health care costs in older adults living in RACFs.

  7. Investigating the fall-injury reducing effect of impact absorbing flooring among female nursing home residents: initial results.

    Science.gov (United States)

    Gustavsson, Johanna; Bonander, Carl; Andersson, Ragnar; Nilson, Finn

    2015-10-01

    Fall-related injuries affect the lives of elderly to a substantial degree. This quasi-experimental study investigates the fall-injury reducing effect of impact absorbing flooring among female nursing home residents. The intervention site is a nursing home in Sweden where impact absorbing flooring was installed in parts of one of six wards (six out of 10 apartments (excluding bathrooms), the communal dining-room and parts of the corridor). The impact absorbing flooring is a 12 mm thick closed cell flexible polyurethane/polyurea composite tile (500×500 mm) with an exterior surface of polyurethane/polyurea. A generalised linear model (log-binomial) was used to calculate the RR of injury from falls on impact absorbing flooring compared to falls on regular flooring, adjusted for age, body mass index, visual and cognitive impairments. During the study period (1 October 2011 to 31 March 2014), 254 falls occurred on regular flooring and 77 falls on impact absorbing flooring. The injury/fall rate was 30.3% for falls on regular flooring and 16.9% for falls on impact absorbing flooring. Adjusted for covariates, the impact absorbing flooring significantly reduced the RR of injury in the event of a fall by 59% (RR 0.41 (95% Cl 0.20 to 0.80)). This is, to our knowledge, the first study evaluating the injury-reducing effect of impact absorbing flooring in a nursing home showing statistically significant effect. The results from this study are promising, indicating the considerable potential of impact absorbing flooring as a fall-related injury intervention among frail elderly. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. The effect of nurse manager turnover on patient fall and pressure ulcer rates.

    Science.gov (United States)

    Warshawsky, Nora; Rayens, Mary Kay; Stefaniak, Karen; Rahman, Rana

    2013-07-01

    The purpose of this study was to explore the effects of nurse manager turnover on the occurrence of adverse events. Nurse managers create professional nurse practice environments to support the provision of quality patient outcomes. Inconsistent findings were reported in the literature testing the relationship between nurse managers and patient outcomes. All prior studies assumed stable nursing management. A longitudinal quasi-experimental study of 23 nursing units in two hospitals was used to determine whether unit characteristics, including nurse manager turnover, have an effect on patient falls or pressure ulcers. Statistical analyses included repeated measures and hierarchical modelling. Patients in medical/surgical units experienced more falls than in intensive care units (F1,11 = 15.9, P = 0.002). Patients in units with a nurse manager turnover [odds ratio: 3.16; 95% confidence interval: 1.49-6.70] and intensive care units (odds ratio: 2.70; 95% confidence interval: 1.33-5.49) were more likely to develop pressure ulcers. Nurse manager turnover and intensive care unit status were associated with more pressure ulcers. Medical/surgical unit status was associated with more falls. The study was limited by a small sample size. Nurse manager turnover may negatively impact patient outcomes. Stable nursing management, strategic interim management and long-term succession planning may reduce adverse patient events. © 2013 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Kim, Do-Yeon; Lim, Chae-Gil

    2017-07-01

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

  10. The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients.

    Science.gov (United States)

    Subermaniam, Kogilavani; Welfred, Ridgwan; Subramanian, Pathmawathi; Chinna, Karuthan; Ibrahim, Fatimah; Mohktar, Mas S; Tan, Maw Pin

    2016-01-01

    Falls and fall-related injuries are increasingly serious issues among elderly inpatients due to population aging. The bed-exit alarm has only previously been evaluated in a handful of studies with mixed results. Therefore, we evaluated the effectiveness of a modular bed absence sensor device (M-BAS) in detecting bed exits among older inpatients in a middle income nation in East Asia. Patients aged ≥65 years on an acute geriatric ward who were able to mobilize with or without walking aids and physical assistance were recruited to the study. The total number of alarms and the numbers of true and false alarms were recorded by ward nurses. The M-BAS device is placed across the mattress of all consenting participants. Nurses' workload was assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score, while nurses' perceptions were surveyed. The sensitivity of the M-BAS was 100% with a positive predictive value of 68% and a nuisance alarm rate of 31%. There was a significant reduction in total NASA-TLX workload score (mean difference = 14.34 ± 13.96 SD, p  < 0.001) at the end of the intervention period. 83% of the nurses found the device useful for falls prevention, 97% found it user friendly, and 87% would use it in future. The M-BAS was able to accurately detect bed absence episodes among geriatric inpatients and alert nurses accordingly. The use of the device significantly reduced the total workload score, while the acceptability of the device was high among our nurses. A larger, cluster randomized study to measure actual falls outcome associated with the use of the device is now indicated.

  11. The medical effects of radioactive fall-out: role of stable end-products

    International Nuclear Information System (INIS)

    Burrows, B.A.; Cardarelli, J.C.; Boling, E.A.; Sinex, F.M.

    1980-01-01

    To summarize, from preliminary observations on the possible effects of radioactive fall-out, it may be inferred that in addition to the secondary products of ionizing irradiation per se, the stable end-products of the transmutation of certain radionuclides may adversely influence cellular metabolism, including mutagenesis. The discussion of the possible role of intracellular barium as an end-product of 137Cs decay is offered as an example of an unpredictable number of broad ecological, as well as the more limited medical, effects that may be of both clinical and climatological significance

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

    Science.gov (United States)

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

    2016-01-01

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

  13. The effects of a multicomponent intervention program on clinical outcomes associated with falls in healthy older adults.

    Science.gov (United States)

    Cho, Young-Hee; Mohamed, Olfat; White, Barbara; Singh-Carlson, Savitri; Krishnan, Vennila

    2018-01-25

    Multicomponent intervention programs have been shown to be effective in reducing risk factors associated with falls, but the primary target population of these interventions is often low-functioning older adults. The purpose of this study was to investigate the effectiveness of a multicomponent intervention program focusing on balance and muscle strength for independently functioning community-dwelling older adults. Fifty-three independently functioning older adults, aged 80.09 ± 6.62 years, participated in a group exercise class (conducted 2 times/week for 8 weeks) emphasizing balance. Outcome measures were balance performance using the Fullerton Advanced Balance (FAB) scale and muscle strength using the Senior Fitness Test (SFT). The intervention improved balance (P older adults who were classified as having high fall risks based on the FAB scores at pre-testing improved more than older adults who were classified as having low fall risks (P = 0.017). As a result, 22 participants transitioned from a high fall risk group at pre-testing to a low fall risk group at post-testing (P fall risk status. The multicomponent intervention conducted two times per week for 8 weeks was effective in improving balance and enhancing muscle strength of independently functioning older adults. The results underscore the importance of providing fall prevention interventions to healthy older adults, a population often not a target of balance interventions.

  14. Improved simulation of Antarctic sea ice due to the radiative effects of falling snow

    Science.gov (United States)

    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.

  15. Falling chains

    OpenAIRE

    Wong, Chun Wa; Yasui, Kosuke

    2005-01-01

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

  16. Bone-eating Osedax worms (Annelida: Siboglinidae) regulate biodiversity of deep-sea whale-fall communities

    Science.gov (United States)

    Alfaro-Lucas, Joan M.; Shimabukuro, Maurício; Ferreira, Giulia D.; Kitazato, Hiroshi; Fujiwara, Yoshihiro; Sumida, Paulo Y. G.

    2017-12-01

    Although it is well recognized the capital role of "bone-eating" Osedax worms in the degradation of vertebrate skeletons in the deep sea, very little is known about their effects on bone faunal assemblages. Here we aim to shed light on the bone colonization process and determine 1) whether Osedax degradation induces different bone epi/infaunal assemblages and 2) how biodiversity is affected by Osedax colonization. We describe and compare the epi/infaunal assemblage structures of caudal vertebrae colonized and not colonized by Osedax of an abyssal juvenile whale carcass serendipitously found at 4204 m depth in the SW Atlantic Ocean by HOV Shinkai 6500. Our results show that whale skeletons are very heterogeneous habitats that harbor specific and very rich assemblages and that contrasting epi/infaunal community patterns are found depending on the presence of Osedax. Vertebrae not colonized by Osedax were both well preserved and in a highly sulfophilic stage with chemosynthetic bacterial mats and numerous epifaunal organisms that fed on them. On the contrary, vertebrae colonized by Osedax were heavily degraded and did not exhibit evidence of a sulfophilic stage, harboring a distinct epifaunal assemblage. In general, bone infaunal assemblages were dominated by nematodes, especially in vertebrae without Osedax (ca. 77%) where organisms were only found in bone outer layers, showing a colonization pattern similar to that described for bacteria. Infauna in Osedax-colonized bones were present throughout the inner-matrices and were on average three times more abundant (ca. 1800 ind. 100 cm-3) and twice as rich in number of species (16 species). Here, bones had a relatively higher proportion of the polychaete Capitella iatapiuna (ca. 39%) in comparison with nematodes (ca. 52%). Besides, a higher number of rare species were present in bones with Osedax. We suggest that Osedax degradation increases water diffusion through matrices probably modifying reduced-compound fluxes and

  17. Effectiveness of a community-based multifaceted fall-prevention intervention in active and independent older Chinese adults

    OpenAIRE

    Xia, Q H; Jiang, Y; Niu, C J; Tang, C X; Xia, Z L

    2009-01-01

    Objective: To evaluate the effectiveness of an 18-month multifaceted intervention designed to reduce the incidence of falls in community-living older adults in China. Methods: A population-based community trial evaluated by before-and-after cross-sectional surveys. Four residential communities were randomised to either a multifaceted intervention or a control condition. Baseline information was collected from a sample of older adults in each community. A 1-year annual fall rate was calculated...

  18. Biomechanical analysis of effects of neuromusculoskeletal training for older adults on the likelihood of slip-induced falls.

    OpenAIRE

    Kim, Sukwon

    2006-01-01

    Overview of the Study Title Biomechanical Analysis for Effects of Neuromusculoskeletal Training for Older Adults on Outcomes of Slip-induced Falls. Research Objectives The objective of this study was to evaluate if neuromusculoskeletal training (i.e., weight and balance training) for older adults could reduce the likelihood of slip-induced fall accidents. The study focused on evaluating biomechanics among the elderly at pre- and post-training stages during processes associated w...

  19. Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Erika Y. Ishigaki

    2014-05-01

    Full Text Available Background: Falls are a geriatric syndrome that is considered a significant public health problem in terms of morbidity and mortality because they lead to a decline in functional capacity and an impaired quality of life in the elderly. Lower limb muscle strengthening seems to be an effective intervention for preventing falls; however, there is no consensus regarding the best method for increasing lower limb muscle strength. Objectives: To analyze the effectiveness of lower limb muscle strengthening and to investigate and describe the protocols used for preventing falls in elderly subjects. Method: We performed a systematic review of randomized and controlled clinical trials published between 2002 and 2012 in the databases PubMed, EMBASE, Scopus, Web of Science, and PEDro that cited some type of lower limb muscle strengthening protocol and that evaluated the incidence of falls as the primary outcome exclusively in elderly subjects. Twelve studies met the inclusion criteria. Qualitative analysis was performed by independent reviewers applying the PEDro scale. Results: The data obtained from the selected studies showed lower fall rates in the intervention groups compared to controls. Six studies described the lower limb muscle strengthening protocol in detail. High methodological quality was found in 6 studies (PEDro score ≥7/10 points. Conclusions: The methodological quality of the studies in this area appears to leave little doubt regarding the effectiveness of lower limb strengthening exercises for preventing falls in elderly subjects, however the interventions in these studies were poorly reported.

  20. Fatal falls in the US construction industry, 1990 to 1999.

    Science.gov (United States)

    Derr, J; Forst, L; Chen, H Y; Conroy, L

    2001-10-01

    The Occupational Safety and Health Administration's (OSHA's) Integrated Management Information System (IMIS) database allows for the detailed analysis of risk factors surrounding fatal occupational events. This study used IMIS data to (1) perform a risk factor analysis of fatal construction falls, and (2) assess the impact of the February 1995 29 CFR Part 1926 Subpart M OSHA fall protection regulations for construction by calculating trends in fatal fall rates. In addition, IMIS data on fatal construction falls were compared with data from other occupational fatality surveillance systems. For falls in construction, the study identified several demographic factors that may indicate increased risk. A statistically significant downward trend in fatal falls was evident in all construction and within several construction categories during the decade. Although the study failed to show a statistically significant intervention effect from the new OSHA regulations, it may have lacked the power to do so.

  1. Effects of an Ai Chi fall prevention programme for patients with Parkinson's disease.

    Science.gov (United States)

    Pérez-de la Cruz, S; García Luengo, A V; Lambeck, J

    2016-04-01

    One of the main symptoms of Parkinson's disease is the high incidence of falls occurring due to the decline of both static and dynamic balance. The aim of this study is to determine the effect of an Ai Chi programme designed to prevent falls in patients with Parkinson's disease by improving both functional independence and perception of physical pain. Fifteen patients diagnosed with Parkinson's disease (Hoehn and Yahr stages 1-3) participated in a 10-week Ai Chi programme consisting of 30 to 45-minute aquatic exercise sessions twice a week. The assessment measures used in this study were the pain visual analogue scale (VAS), the Tinetti gait and balance assessment tool, and the Timed Get up and Go test. The results were calculated by applying the Friedman test to 3 related measurements: patients at baseline, at post-treatment (at the end of the 10 week programme) and after one month of follow-up. The data obtained showed a significant improvement (p Parkinson's disease. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  2. numerical assessment of conventional regulation effectiveness

    African Journals Online (AJOL)

    Benkoussas B, Djedjig R, and Vauquelin O

    2016-05-01

    May 1, 2016 ... The effectiveness of an underground smoke control system mainly depends on fire safety engineering that is ... In the same context, this work aims firstly, at investigating the effectiveness of conventional regulation applied to .... 5a). Fig.4. Station smoke behavior for conventional ventilation regulation. Fig.5a.

  3. Clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for falls prevention in older people: a multicentre cohort randomised controlled trial (the REducing Falls with ORthoses and a Multifaceted podiatry intervention trial).

    Science.gov (United States)

    Cockayne, Sarah; Rodgers, Sara; Green, Lorraine; Fairhurst, Caroline; Adamson, Joy; Scantlebury, Arabella; Corbacho, Belen; Hewitt, Catherine E; Hicks, Kate; Hull, Robin; Keenan, Anne-Maree; Lamb, Sarah E; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony; Richardson, Zoe; Vernon, Wesley; Watson, Judith; Torgerson, David J

    2017-04-01

    Falls are a serious cause of morbidity and cost to individuals and society. Evidence suggests that foot problems and inappropriate footwear may increase the risk of falling. Podiatric interventions could help reduce falls; however, there is limited evidence regarding their clinical effectiveness and cost-effectiveness. To determine the clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for preventing falls in community-dwelling older people at risk of falling, relative to usual care. A pragmatic, multicentred, cohort randomised controlled trial with an economic evaluation and qualitative study. Nine NHS trusts in the UK and one site in Ireland. In total, 1010 participants aged ≥ 65 years were randomised (intervention, n  = 493; usual care, n  = 517) via a secure, remote service. Blinding was not possible. All participants received a falls prevention leaflet and routine care from their podiatrist and general practitioner. The intervention also consisted of footwear advice, footwear provision if required, foot orthoses and foot- and ankle-strengthening exercises. The primary outcome was the incidence rate of falls per participant in the 12 months following randomisation. The secondary outcomes included the proportion of fallers and multiple fallers, time to first fall, fear of falling, fracture rate, health-related quality of life (HRQoL) and cost-effectiveness. The primary analysis consisted of 484 (98.2%) intervention and 507 (98.1%) usual-care participants. There was a non-statistically significant reduction in the incidence rate of falls in the intervention group [adjusted incidence rate ratio 0.88, 95% confidence interval (CI) 0.73 to 1.05; p  = 0.16]. The proportion of participants experiencing a fall was lower (50% vs. 55%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00; p  = 0.05). No differences were observed in key secondary outcomes. No serious, unexpected and related adverse events were reported. The

  4. Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.

    Science.gov (United States)

    Steinman, Bernard A; Allen, Susan M; Chen, Jie; Pynoos, Jon

    2015-02-01

    To test whether limitations in mobility and large-muscle functioning mediate self-reported vision status to increase fall risk among respondents age 65 and above. This study used two waves from the Health and Retirement Study. We conducted binary logistic and negative binomial regression analyses to test indirect paths leading from self-reported vision status to falls, via indices of mobility and large-muscle functioning. Limited evidence was found for a mediating effect among women; however, large-muscle groups were implicated as partially mediating risk factors for falls among men with fair self-reported vision status. Implications of these findings are discussed including the need for prioritizing improved muscle strength of older men and women with poor vision as a preventive measure against falls. © The Author(s) 2014.

  5. Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors.

    Science.gov (United States)

    Taylor-Piliae, Ruth E; Hoke, Tiffany M; Hepworth, Joseph T; Latt, L Daniel; Najafi, Bijan; Coull, Bruce M

    2014-05-01

    To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Single-blind, randomized controlled trial. General community. Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke. Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, Pfall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. The effect of asymmetrical body orientation during simulated forward falls on the distal upper extremity impact response of healthy people.

    Science.gov (United States)

    Burkhart, Timothy A; Brydges, Evan; Stefanczyk, Jennifer; Andrews, David M

    2017-04-01

    The occurrence of distal upper extremity injuries resulting from forward falls (approximately 165,000 per year) has remained relatively constant for over 20years. Previous work has provided valuable insight into fall arrest strategies, but only symmetric falls in body postures that do not represent actual fall scenarios closely have been evaluated. This study quantified the effect of asymmetric loading and body postures on distal upper extremity response to simulated forward falls. Twenty participants were suspended from the Propelled Upper Limb fall ARest Impact System (PULARIS) in different torso and leg postures relative to the ground and to the sagittal plane (0°, 30° and 45°). When released from PULARIS (hands 10cm above surface, velocity 1m/s), participants landed on two force platforms, one for each hand. Right forearm impact response was measured with distal (radial styloid) and proximal (olecranon) tri-axial accelerometers and bipolar EMG from seven muscles. Overall, the relative height of the torso and legs had little effect on the forces, or forearm response variables. Muscle activation patterns consistently increased from the start to the peak activation levels after impact for all muscles, followed by a rapid decline after peak. The impact forces and accelerations suggest that the distal upper extremity is loaded more medial-laterally during asymmetric falls than symmetric falls. Altering the direction of the impact force in this way (volar-dorsal to medial-lateral) may help reduce distal extremity injuries caused when landing occurs symmetrically in the sagittal plane as it has been shown that volar-dorsal forces increase the risk of injury. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The Characteristics of an Effective Nuclear Regulator

    International Nuclear Information System (INIS)

    Cheok, Michael; Wertelaers, An; Lojk, Robert; Santini, Miguel; Alm-Lytz, Kirsi; Rigail, Anne-Cecile; Weidenbruck, Kai-Jochen; Stoppa, Gisela; Rainieri, Roberto; Aoki, Masahiro; Gonzalez-Mercado; Miroshnichenko, Mikhail; Kuznetsov, Nikolay; Kudryavtsev, Evgeny; Cid, Rafael; Franzen, Anna; Skanberg, Lars; Gibson, Steve; Golshan, Mina; Cheok, Michael; Nicic, Adriana; Salgado, Nancy; Creswell, Len

    2014-01-01

    Both national and international organisations agree that the fundamental objective of all nuclear safety regulatory bodies - the regulator's prime purpose - is to ensure that nuclear licensees operate their facilities at all times in a safe manner. Much has been written about ways to improve regulatory processes or to improve the effectiveness of a regulatory body, including in previous OECD/NEA regulatory guidance booklets. But until now, none have focused on the characteristics of an effective nuclear safety regulator. Effective organisations are those that have good leadership and are able to transform strategic direction into operational programmes. Effectiveness is about how well the organisation is achieving its fundamental purpose - in the case of a nuclear safety regulator, ensuring that licensees operate their facilities and discharge their obligations in a safe manner. This regulatory guidance booklet describes the characteristics of an effective nuclear safety regulator in terms of roles and responsibilities, principles and attributes. Each of the characteristics discussed in this report is a necessary feature of an effective nuclear safety regulator but no one characteristic is sufficient on its own. It is the combination of these characteristics that leads to the effectiveness of a nuclear regulatory body. The report provides a unique resource to countries with existing, mature regulators and can be used for benchmarking as well as training and developing staff. It will also be useful for new entrant countries in the process of developing and maintaining an effective nuclear safety regulator. (authors)

  8. Predictive effects of different clinical balance measures and the fear of falling on falls in postmenopausal women aged 50 years and over.

    Science.gov (United States)

    Ersoy, Yuksel; MacWalter, Ronald S; Durmus, Bekir; Altay, Zuhal E; Baysal, Ozlem

    2009-01-01

    Falls among the elderly are associated with a high morbidity and mortality and can involve high-cost medical interventions. The risk of falls often remains undiagnosed until an episode occurs but if the risk is high, preventative measures could be introduced. This 6-month prospective study investigated whether different postural clinical measures and fear of falling (FOF) itself can predict future falls in postmenopausal women aged > or =50 years. 125 postmenopausal women were studied comparing the outcome of fallers vs. non-fallers within the 6-month follow-up study period. Clinical measures, history of falls and FOF data were determined at baseline and the number of falls and FOF were ascertained at the final visit or by telephone interview at 6 months. Of the clinical measures investigated, the Falls Efficacy Scale International (FES-I) >26 points (OR = 7.28, per additional point, 95% CI 2.25-23.61, p = 0.001) and Berg Balance Scale (BBS) falls. Postmenopausal women aged > or =50 years who had FES-I scores >26 points and BBS risk factors of future falls and offered preventative measures.

  9. Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series

    Science.gov (United States)

    Rimland, Joseph M.; Abraha, Iosief; Dell’Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Soiza, Roy; Gudmusson, Adalsteinn; Petrovic, Mirko; O’Mahony, Denis; Todd, Chris; Cherubini, Antonio

    2016-01-01

    Background Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making. Objectives To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals. Methods We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions. Results Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis. Conclusions The aim of this overview of

  10. Effects of Combined exergame and conventional exercise to reduce and prevent fall risk among elderly people: A Hypothesis

    Directory of Open Access Journals (Sweden)

    Hassan Sadeghi

    2017-10-01

    Full Text Available Background: Falling among old individuals has provoked ceaseless discussion among gerontologists and physical therapists and it is still one of the greatest issues among this population. Loss of the balance and functional mobility is the main reason of falling. There have been numerous studies conducting the effect of the conventional balance exercise and exergame independently on balance and functional mobility of elderly. Previous studies lacked dealing with the effect of combined exergame and conventional exercise on the balance and functional mobility. Combined exercises are enjoyable and may have more effective to improve balance and performance to reduce risk of fall among elderly people. This package would be preferable for older people. Objective: We hypothesize that while conventional balance exercise and exergame improve balance and functional mobility, combined both types of exercise would superior improvements in elderly performance. Conclusion: Ultimately we expect that this hypothesis will provide a useful framework for facilitating combined exergame and conventional balance intervention in older people.

  11. Withdrawal of fall-risk-increasing drugs in older persons: Effect on mobility test outcomes

    NARCIS (Netherlands)

    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.

  12. Withdrawal of fall-risk-increasing drugs in older persons: effect on mobility test outcomes

    NARCIS (Netherlands)

    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

  13. Feeding deterrence and inhibitory effects of bee balm (Monarda didyma) leaves on fall armyworm

    Science.gov (United States)

    The fall armyworm [Spodoptera frugiperda (J.E. Smith)] is a serious pest of many field and horticulture crops. Because of the many advantages for the use of plant-derived pesticides, we tested whether bee balm (Monarda didyma L.) leaves could have feeding deterrence on fall armyworm. When S. frugipe...

  14. The Effect of Landscape Composition on the Abundance of Laodelphax striatellus Fallén in Fragmented Agricultural Landscapes

    Directory of Open Access Journals (Sweden)

    Zhanyu Liu

    2016-10-01

    Full Text Available The spatial distribution of crop and non-crop habitats over segmented agricultural landscapes could be used as a means to reduce insect pest populations. Seven land cover categories such as wheat, rapeseed, vegetable, water, built-up, paved road, and unsurfaced road were extracted from GeoEye satellite images dating from late May to late June of 2010. Three diversity metrics and three evenness metrics were estimated from the abovementioned land cover categories for quantifying the effect of landscape composition on nymphal and adult Laodelphax striatellus Fallén. The degree of correlation between the proportion of crop cover and adjacent spatial scales (r: 0.651–0.983 was higher than the correlation between the proportion of crop cover and nonadjacent spatial scales (r: −0.255–0.896. While the degree of correlation between diversity indices and abundance of L. striatellus decreased gradually when the spatial scales varied from large (>100 m radius buffer to small (<100 m. Our study suggests that when using natural biological pest control and ecological engineering practices in the rural-urban fringes, the crop field’s width should be less than 200 m and increasing vegetation diversity within such a scale will be helpful to regulate the insect pests under a certain density.

  15. Recombinant human erythropoietin in humans down-regulates proximal renal tubular reabsorption and causes a fall in glomerular filtration rate

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal; Aachmann-Andersen, Niels Jacob; Oturai, Peter

    2010-01-01

    HuEPO for 28 days in doses raising the hematocrit to 48.3 (4.1) %. Renal clearance studies with urine collections (N = 8) were done at baseline and at days 4, 11, 29, and 42. Glomerular filtration rate (GFR) was measured by (51)Cr-EDTA. Renal clearance of lithium (C(Li)) was used as an index of proximal...... tubular outflow and to assess segmental renal tubular handling of sodium and water. rHuEPO-induced increases in hematocrit occurred from day 10 onwards and was caused by both an increase in red cell volume and a fall in plasma volume. Well before that (from day 2 and throughout the treatment time), r...... and water (APR = GFR - C(Li), P

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

    Science.gov (United States)

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

    2015-01-01

    whole-body vibration training may improve neuromuscular function, falls risk and bone density, but previous studies have had conflicting findings. this study aimed to evaluate the influence of vertical vibration (VV) and side-alternating vibration (SV) on musculoskeletal health in older people at risk of falls. single-blind, randomised, controlled trial comparing vibration training to sham vibration (Sham) in addition to usual care. participants were 61 older people (37 women and 24 men), aged 80.2 + 6.5 years, referred to an outpatient falls prevention service. participants were randomly assigned to VV, SV or Sham in addition to the usual falls prevention programme. Participants were requested to attend three vibration sessions per week for 12 weeks, with sessions increasing to six, 1 min bouts of vibration. Falls risk factors and neuromuscular tests were assessed, and blood samples collected for determination of bone turnover, at baseline and following the intervention. chair stand time, timed-up-and-go time, fear of falling, NEADL index and postural sway with eyes open improved in the Sham group. There were significantly greater gains in leg power in the VV than in the Sham group and in bone formation in SV and VV compared with the Sham group. Conversely, body sway improved less in the VV than in the Sham group. Changes in falls risk factors did not differ between the groups. whole-body vibration increased leg power and bone formation, but it did not provide any additional benefits to balance or fall risk factors beyond a falls prevention programme in older people at risk of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Effects of combined-sewer overflows and urban runoff on the water quality of Fall Creek, Indianapolis, Indiana

    Science.gov (United States)

    Martin, Jeffrey D.

    1995-01-01

    In 1986, the U.S. Geological Survey and the Indianapolis Department of Public Works began a study to evaluate the effects of combined-sewer overflows and urban runoff discharging to Fall Geek on the White River. This report describes the effects of combined-sewer overflows and urban runoff on the water quality of Fall Creek during summer 1987 by comparing the water quality during base flow with that during storm runoff and by comparing water quality in the urbanized area with that in the less urbanized area upstream from the combined-sewer overflows. Data were collected at three streamflow-gaging stations located upstream from, downstream from, and in the middle of 27 combined-sewer overflows on Fall Creek. The most downstream station also was immediately downstream from the discharge of filter backwash from a water-treatment plant for public supply.

  18. Independent and Combined Effects of Exercise and Vitamin D on Muscle Morphology, Function and Falls in the Elderly

    Directory of Open Access Journals (Sweden)

    Robin M. Daly

    2010-09-01

    Full Text Available Regular exercise, particularly progressive resistance training (PRT, is recognized as one of the most effective strategies to prevent age-related muscle loss (sarcopenia, but its effects on muscle function are mixed. However, emerging data indicates that high velocity PRT (fast concentric muscle contractions is more effective for improving functional outcomes than traditional PRT. In terms of falls prevention, high-challenging balance training programs appear to be most effective. There is also compelling evidence that supplemental vitamin D is an effective therapeutic option for falls prevention. The findings from a recent meta-analysis revealed that supplemental vitamin D at a dose of at least 700–1,000 IU/d or an achieved serum 25(OHD level of at least 60 nmol/L was associated with reduced falls risk among older individuals. Based on these findings, it is possible that the combination of exercise and vitamin D could have a synergistic effect on muscle morphology and function, particularly since both interventions have been shown to have beneficial effects on type II “fast twitch” muscle fibers and systemic inflammation, which have both been linked to losses in muscle mass and function. Unfortunately however, the findings from the limited number of factorial 2 × 2 design RCTs indicate that additional vitamin D does not enhance the effects of exercise on measures of muscle morphology, function or falls risk. However, none of these trials were adequately powered to detect a “synergistic” effect between the two treatment strategies, but it is likely that if an exercise-by-vitamin D interaction does exist, it may be limited to situations when vitamin D deficiency/insufficiency is corrected. Further targeted research in “high risk” groups is still needed to address this question, and evaluate whether there is a threshold level of serum 25(OHD to maximize the effects of exercise on muscle and falls risk.

  19. Long-run effects of falling cellulosic ethanol production costs on the US agricultural economy

    International Nuclear Information System (INIS)

    Campiche, Jody L; Bryant, Henry L; Richardson, James W

    2010-01-01

    Renewable energy production has been expanding at a rapid pace. New advances in cellulosic ethanol technologies have the potential to displace the use of petroleum as a transportation fuel, and could have significant effects on both the agricultural economy and the environment. In this letter, the effects of falling cellulosic ethanol production costs on the mix of ethanol feedstocks employed and on the US agricultural economy are examined. Results indicate that, as expected, cellulosic ethanol production increases by a substantial amount as conversion technology improves. Corn production increases initially following the introduction of cellulosic technology, because producers enjoy new revenue from sales of corn stover. After cellulosic ethanol production becomes substantially cheaper, however, acres are shifted from corn production to all other agricultural commodities. Essentially, this new technology could facilitate the exploitation of a previously under-employed resource (corn stover), resulting in an improvement in overall welfare. In the most optimistic scenario considered, 68% of US ethanol is derived from cellulosic sources, coarse grain production is reduced by about 2%, and the prices of all food commodities are reduced modestly.

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

    Science.gov (United States)

    Brewin, Dorothy; Naninni, Angela

    2014-01-01

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

  1. The Effects of Fall-Risk-Increasing Drugs on Postural Control : A Literature Review

    NARCIS (Netherlands)

    de Groot, Maartje H.; van Campen, Jos P. C. M.; Moek, Marije A.; Tulner, Linda R.; Beijnen, Jos H.; Lamoth, Claudine J. C.

    Meta-analyses showed that psychotropic drugs (antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs) and some cardiac drugs (digoxin, type IA anti-arrhythmics, diuretics) are associated with increased fall risk. Because balance and gait disorders are the most consistent predictors of

  2. Effects of a complex intervention on fall risk in the general practitioner setting: a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Freiberger E

    2013-08-01

    Full Text Available Ellen Freiberger,1 Wolfgang A Blank,2 Johannes Salb,1 Barbara Geilhof,3 Christian Hentschke,1 Peter Landendoerfer,2 Martin Halle,3 Monika Siegrist31Institute of Sport Science and Sport Universität Erlangen-Nürnberg, Nuremberg, Germany; 2Institute of General Practice, Technische Universität München, Munich, Germany; 3Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Munich, GermanyPurpose: To study the feasibility of first, reaching functionally declined, but still independent older persons at risk of falls through their general practitioner (GP and second, to reduce their physiological and psychological fall risk factors with a complex exercise intervention. We investigated the effects of a 16-week exercise intervention on physiological (function, strength, and balance and psychological (fear of falling outcomes in community-dwelling older persons in comparison with usual care. In addition, we obtained data on adherence of the participants to the exercise program.Methods: Tests on physical and psychological fall risk were conducted at study inclusion, and after the 16-week intervention period in the GP office setting. The 16-week intervention included progressive and challenging balance, gait, and strength exercise as well as changes to behavioral aspects. To account for the hierarchical structure in the chosen study design, with patients nested in GPs and measurements nested in patients, a three-level linear mixed effects model was determined for analysis.Results: In total, 33 GPs recruited 378 participants (75.4% females. The mean age of the participants was 78.1 years (standard deviation 5.9 years. Patients in the intervention group showed an improvement in the Timed-Up-and-Go-test (TUG that was 1.5 seconds greater than that showed by the control group, equivalent to a small to moderate effect. For balance, a relative improvement of 0.8 seconds was accomplished, and anxiety about falls was

  3. Closing the gap: a research agenda to accelerate the adoption and effective use of proven older adult fall prevention strategies.

    Science.gov (United States)

    Noonan, Rita K; Sleet, David A; Stevens, Judy A

    2011-12-01

    To make an impact on the public's health, evidence-based interventions must be disseminated broadly, supported by training and technical assistance, adopted widely, and implemented as designed. Many effective older adult fall prevention interventions have been identified, but too few have gained wide community acceptance and little is known about the best ways to encourage their broader use. Therefore, as in many other fields, fall prevention suffers from a wide gap between scientific discoveries and their everyday use. This article articulates the key activities embedded in Step 4 of the public health model-specifically translation and dissemination to ensure widespread adoption and use-in order to illuminate critical research needs in older adult fall prevention. These needs, if addressed, will help close the gap between research and practice. Published by Elsevier Ltd.

  4. Effects of Antigravity Treadmill Training on Gait, Balance, and Fall Risk in Children With Diplegic Cerebral Palsy.

    Science.gov (United States)

    El-Shamy, Shamekh Mohamed

    2017-11-01

    The aim of this study was to investigate the effects of antigravity treadmill training on gait, balance, and fall risk in children with diplegic cerebral palsy. Thirty children with diplegic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received antigravity treadmill training (20 mins/d, 3 d/wk) together with traditional physical therapy for 3 successive mos and (2) a control group that received only traditional physical therapy program for the same period. Outcomes included selected gait parameters, postural stability, and fall risk. Outcomes were measured at baseline and after 3 mos of intervention. Children in both groups showed significant improvements in the mean values of all measured variables (P balance, and fall risk in children with diplegic cerebral palsy.

  5. An Effective Community?Academic Partnership to Extend the Reach of Screenings for Fall Risk

    OpenAIRE

    Schrodt, Lori A.; Garbe, Kathie C.; Chaplin, Rebecca; Busby-Whitehead, Jan; Shubert, Tiffany E.

    2013-01-01

    Older adults should be screened for fall risk annually. Community providers (people without formal medical training who work with older adults in senior centers or aging services) may be a viable group to expand the reach of screenings. Our community–academic partnership developed a program to increase and assess fall risk screenings by community providers. Community sites hosted training workshops and screening events. Community screenings were well attended and received by providers and old...

  6. Crop and livestock enterprise integration: Effects of annual crops used for fall forage production on livestock productivity

    Science.gov (United States)

    Diversification of farm enterprises is important to maintain sustainable production systems. Systems that integrate crops and livestock may prove beneficial to each enterprise. Our objectives were to determine the effects of annual crops grazed in the fall and early-winter period on cow and calf gro...

  7. The effect of Pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults.

    Science.gov (United States)

    Pata, Rachel W; Lord, Katrina; Lamb, Jamie

    2014-07-01

    Falls are a common problem in older adults. Impaired balance, mobility and postural stability are risk factors for falling. Limited research has been performed on Pilates exercise and the ability to decrease fall risk. In this quasi-experimental study, 35 adults (61-87 years old) participated in an 8-week Pilates based exercise program. Blind examiners conducted the Timed Up and Go (TUG), Forward Reach Test, and Turn 180 Test before and after the intervention. Number of falls, perception of Pilates, and fear of falling was also recorded. Thirty-two (91.4%) participants completed post-test measures. Significant improvements were seen in the TUG (p falling was shown. Results suggest a Pilates based exercise program may be effective in improving balance, mobility and postural stability to decrease fall risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Effects of gamma radiation on larvae of Spodoptera frugiperda (Smith, 1797) (Lepidoptera: Noctuidae) fall armyworm

    International Nuclear Information System (INIS)

    Arthur, Valter; Arthur, Paula B.; Silva, Lucia C.A.S.; Franco, Jose G.; Harder, Marcia N.C.; Franco, Suely S.H.; Machi, Andre R.

    2013-01-01

    One of the most harmful insects the corn culture is the Spodoptera frugiperda (J.E. Smith, 1797) (Lepidoptera: Noctuidae), known commonly as fall armyworm, it is would originate of the tropical and subtropical areas of the American continent; its economical importance is due polyphagism, attacking countless grassy, such as corn, sorghum, wheat, barley, rice and pastures. One of the methods more used in the moment is the chemical control that during several applications the insect can turn resistant, then news researches has been made to the control of the insects. Due what was exposed the objective of the research was evaluated the effects of gamma radiation on larvae of S. frugiperda. Insects were rear in artificial diet. Each treatment had 5 repetitions with 20 larvae with 15-20 days of age in the total of 100 larvae per treatment. The larvae were irradiated with doses of gamma radiation of: 0 (control), 50, 100, 200 and 300 Gy, in source of Cobalt-60, type Gammacell-220, at dose rate of 0,508 kGy/hour. After irradiation the insects were keep in room with climatic conditions of 25 ± 5 dec C and 70 ± 5% R.H. Were evaluated the emergence of adults. The results showed that the dose of 300 Gy was the lethal dose to larvae irradiated, and 200 Gy the sterilizing dose to adults. (author)

  9. Effects of gamma radiation on larvae of Spodoptera frugiperda (Smith, 1797) (Lepidoptera: Noctuidae) fall armyworm

    Energy Technology Data Exchange (ETDEWEB)

    Arthur, Valter; Arthur, Paula B.; Silva, Lucia C.A.S.; Franco, Jose G.; Harder, Marcia N.C., E-mail: arthur@cena.usp.br, E-mail: mnharder@terra.com.br [Centro de Energia Nuclear na Agricultura (CENA/USP), Piracicaba, SP (Brazil); Franco, Suely S.H.; Machi, Andre R., E-mail: gilmita@uol.com.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    One of the most harmful insects the corn culture is the Spodoptera frugiperda (J.E. Smith, 1797) (Lepidoptera: Noctuidae), known commonly as fall armyworm, it is would originate of the tropical and subtropical areas of the American continent; its economical importance is due polyphagism, attacking countless grassy, such as corn, sorghum, wheat, barley, rice and pastures. One of the methods more used in the moment is the chemical control that during several applications the insect can turn resistant, then news researches has been made to the control of the insects. Due what was exposed the objective of the research was evaluated the effects of gamma radiation on larvae of S. frugiperda. Insects were rear in artificial diet. Each treatment had 5 repetitions with 20 larvae with 15-20 days of age in the total of 100 larvae per treatment. The larvae were irradiated with doses of gamma radiation of: 0 (control), 50, 100, 200 and 300 Gy, in source of Cobalt-60, type Gammacell-220, at dose rate of 0,508 kGy/hour. After irradiation the insects were keep in room with climatic conditions of 25 ± 5 dec C and 70 ± 5% R.H. Were evaluated the emergence of adults. The results showed that the dose of 300 Gy was the lethal dose to larvae irradiated, and 200 Gy the sterilizing dose to adults. (author)

  10. Color indirect effects on melatonin regulation

    Science.gov (United States)

    Mian, Tian; Liu, Timon C.; Li, Yan

    2002-04-01

    Color indirect effect (CIE) is referred to as the physiological and psychological effects of color resulting from color vision. In previous papers, we have studied CIE from the viewpoints of the integrated western and Chinese traditional medicine, put forward the color-autonomic- nervous-subsystem model (CAM), and provided its time-theory foundation. In this paper, we applied it to study light effects on melatonin regulation in humans, and suggested that it is CIE that mediates light effects on melatonin suppression.

  11. Effect of Tai Chi Exercise on Fall Prevention in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

    OpenAIRE

    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...

  12. A spatial model to assess the effects of hydropower operations on Columbia River fall Chinook Salmon spawning habitat

    Science.gov (United States)

    Hatten, James R.; Tiffan, Kenneth F.; Anglin, Donald R.; Haeseker, Steven L.; Skalicky, Joseph J.; Schaller, Howard

    2009-01-01

    Priest Rapids Dam on the Columbia River produces large daily and hourly streamflow fluctuations throughout the Hanford Reach during the period when fall Chinook salmon Oncorhynchus tshawytscha are selecting spawning habitat, constructing redds, and actively engaged in spawning. Concern over the detrimental effects of these fluctuations prompted us to quantify the effects of variable flows on the amount and persistence of fall Chinook salmon spawning habitat in the Hanford Reach. Specifically, our goal was to develop a management tool capable of quantifying the effects of current and alternative hydrographs on predicted spawning habitat in a spatially explicit manner. Toward this goal, we modeled the water velocities and depths that fall Chinook salmon experienced during the 2004 spawning season, plus what they would probably have experienced under several alternative (i.e., synthetic) hydrographs, using both one- and two-dimensional hydrodynamic models. To estimate spawning habitat under existing or alternative hydrographs, we used cell-based modeling and logistic regression to construct and compare numerous spatial habitat models. We found that fall Chinook salmon were more likely to spawn at locations where velocities were persistently greater than 1 m/s and in areas where fluctuating water velocities were reduced. Simulations of alternative dam operations indicate that the quantity of spawning habitat is expected to increase as streamflow fluctuations are reduced during the spawning season. The spatial habitat models that we developed provide management agencies with a quantitative tool for predicting, in a spatially explicit manner, the effects of different flow regimes on fall Chinook salmon spawning habitat in the Hanford Reach. In addition to characterizing temporally varying habitat conditions, our research describes an analytical approach that could be applied in other highly variable aquatic systems.

  13. Systematic Review: The Effectiveness of Interventions to Reduce Falls and Improve Balance in Adults With Multiple Sclerosis.

    Science.gov (United States)

    Gunn, Hilary; Markevics, Sophie; Haas, Bernhard; Marsden, Jonathan; Freeman, Jennifer

    2015-10-01

    To evaluate the effectiveness of interventions in reducing falls and/or improving balance as a falls risk in multiple sclerosis (MS). Computer-based and manual searches included the following medical subject heading keywords: "Multiple Sclerosis AND accidental falls" OR "Multiple Sclerosis AND postural balance" OR "Multiple Sclerosis AND exercise" OR "Multiple Sclerosis AND physical/physio therapy" NOT animals. All literature published to November 2014 with available full-text details were included. Studies were reviewed against the PICO (participants, interventions, comparisons, outcomes) selection criteria: P, adults with MS; I, falls management/balance rehabilitation interventions; C, randomized/quasi-randomized studies comparing intervention with usual care or placebo control; O, falls outcomes and measures of balance. Fifteen articles of the original 529 search results were included. Two reviewers independently extracted data and assessed methodological quality using the Cochrane Risk of Bias tool. Random-effects meta-analysis indicated a small decrease in falls risk (risk ratio, .74), although the 95% confidence interval (CI) crossed 1 (95% CI, .12-4.38). The pooled standardized mean difference (SMD) for balance outcomes was .55 (95% CI, .35-.74). SMD varied significantly between exercise subgroupings; gait, balance, and functional training interventions yielded the greatest pooled effect size (ES) (SMD=.82; 95% CI, 0.55-1.10). There was a moderate positive correlation between program volume (min/wk) and ES (Cohen's d) (r=.70, P=.009), and a moderate negative correlation between program duration in weeks and ES (r=-.62, P=.03). Variations in interventions and outcomes and methodological limitations mean that results must be viewed with caution. This review suggests that balance may improve through exercise interventions, but that the magnitude of the improvements achieved in existing programs may not be sufficient to impact falls outcomes. Supporting

  14. The hard fall effect: high working memory capacity leads to a higher, but less robust short-term memory performance.

    Science.gov (United States)

    Thomassin, Noémylle; Gonthier, Corentin; Guerraz, Michel; Roulin, Jean-Luc

    2015-01-01

    Participants with a high working memory span tend to perform better than low spans in a variety of tasks. However, their performance is paradoxically more impaired when they have to perform two tasks at once, a phenomenon that could be labeled the "hard fall effect." The present study tested whether this effect exists in a short-term memory task, and investigated the proposal that the effect is due to high spans using efficient facilitative strategies under simple task conditions. Ninety-eight participants performed a spatial short-term memory task under simple and dual task conditions; stimuli presentation times either allowed for the use of complex facilitative strategies or not. High spans outperformed low spans only under simple task conditions when presentation times allowed for the use of facilitative strategies. These results indicate that the hard fall effect exists on a short-term memory task and may be caused by individual differences in strategy use.

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

    Science.gov (United States)

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

    2015-08-01

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

  16. Frequently observed risk factors for fall-related injuries and effective preventive interventions: a multihospital survey of nurses' perceptions.

    Science.gov (United States)

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2013-01-01

    There is an urgent need to prioritize the risk factors for injurious falls and effective interventions in nursing practice. Registered nurses perceived that the most frequently observed risk factors were confusion, gait problems, Alzheimer disease, disorientation, and inability to follow safety instructions. The most effective interventions were keeping hospital bed brakes locked, keeping floor surfaces clean/dry, using appropriate footwear for patients, maintaining a call light within reach, and reducing tripping hazards.

  17. Effects of cultivar and grazing initiation date on fall-grown oat for replacement dairy heifers.

    Science.gov (United States)

    Coblentz, W K; Brink, G E; Esser, N M; Cavadini, J S

    2015-09-01

    Fall-grown oat has shown promise for extending the grazing season in Wisconsin, but the optimum date for initiating grazing has not been evaluated. Our objectives for this project were (1) to assess the pasture productivity and nutritive value of 2 oat cultivars [Ogle and ForagePlus (OG and FP, respectively)] with late-September (EG) or mid-October (LG) grazing initiation dates; and (2) to evaluate growth performance by heifers grazing these oat forages compared with heifers reared in confinement (CON). A total of 160 gravid Holstein heifers (80 heifers/yr) were assigned to 10 research groups (8 heifers/group). Mean initial body weight was 509±40.5 kg in 2013 and 517±30.2 kg in 2014. Heifer groups were assigned to specific pastures arranged as a 2×2 factorial of oat cultivars and grazing initiation dates. Grazing heifer groups were allowed to strip-graze oat pastures for 6 h daily before returning to the barn, where they were offered a forage-based basal total mixed ration. Main effects of oat cultivar and sampling date interacted for forage characteristics in 2013, but not in 2014. During 2013, oat forage mass increased until early November before declining in response to freezing weather conditions, thereby exhibiting linear and quadratic effects of sampling date, regardless of oat cultivar. Similar trends over time were observed in 2014. For 2013, the maximum forage mass was 5,329 and 5,046 kg/ha for FP and OG, respectively, whereas the mean maximum forage mass for 2014 was 4,806 kg/ha. ForagePlus did not reach the boot stage of growth during either year of the trial; OG matured more rapidly, reaching the late-heading stage during 2013, but exhibited only minor maturity differences from FP in 2014. For 2013, average daily gain for CON did not differ from grazing heifer groups (overall mean=0.63 kg/d); however, average daily gain from FP was greater than OG (0.68 vs. 0.57 kg/d), and greater from EG compared with LG (0.82 vs. 0.43 kg/d). For 2013, advantages in

  18. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial

    NARCIS (Netherlands)

    Faber, M.J.; Bosscher, R.J.; Chin, A.P.M.J.; van Wieringen, P.C.W.

    2006-01-01

    Faber MJ, Bosscher RJ, Chin A Paw MJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Objectives: To determine the effects of moderate intensity group-exercise programs on falls, functional

  19. EFFECT OF SWISS BALL EXERCISE TOWARD THE BODY BALANCE TO LESS THE RISK FALL OF OLDER AT UPT SOCIAL

    Directory of Open Access Journals (Sweden)

    Henny Syapitri

    2017-02-01

    Full Text Available Abstract The balance of body is one of the main factor in doing fungsional activity. In every activity, the body always need control of the body balance, because basically every phisic activity right static or dinamic will take someone on unstable position with big risk to having fell. Swiss Ball exercise as support is believed on labile surface will make spine have big chance to stabling the muscle between vebra and increase the dinamic balance to restrain the repeats stability. The research object to know The Effect of Swiss Ball Exercise toward The Body Balance to Less The Risk Fall of Older at UPT Social Service of Older and Children Under Five district Binjai and Medan in Year 2016. The research type is Quasi Experiment with pre test-post test one group only design method. Population in this research all of older at UPT Social Service district Binjai as much as 172 older with number of man is 81 and woman is 91, with Purposive sampling Technique that is 15 respondences. Data collecting using observation sheet with analysis that used is univariat: respondence characteristics, the body balance of older before and after doing Swiss Ball practice, and bivariat with Paired t-Test. The research result showing the average of body balance before doing Swiss Ball as much (Mean 38,07 and after (Mean 46,33. Conclusion: there is the effect of Swiss Ball toward body balance to less the risk fall of older (p=0,000 ; p=< 0,05. Sugessted for older to practice the balance himself more steady so that not easy to have risk fall further. Influenced, and for the next researcher can research about another factor that foregrounded the risk fall of older. Keywords    : Swiss Ball, Balance Exercise, Risk Fall

  20. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Zhuang J

    2014-01-01

    Full Text Available Jie Zhuang,1,* Liang Huang,1,2,* Yanqiang Wu,3 Yanxin Zhang2 1School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China; 2Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand; 3Shanghai Municipal Center for Students' Physical Fitness and Health Surveillance, Shanghai, People's Republic of China *These authors contributed equally to this work Abstract: This study aimed to evaluate the effectiveness of an innovative exercise program on muscle strength, balance, and gait kinematics in elderly community-dwellers. The exercise program included strength and balance training and the 8-form Tai Chi Chuan. The measurements were carried out at baseline and 12 weeks, and consisted of four physical performance tests, joint isokinetic strength tests, and three-dimensional gait analysis. Fifty-six community-dwelling older adults aged 60–80 years old were randomly assigned to an intervention or control group. After 12 weeks, the intervention group showed a 17.6% improvement in the timed up and go test, accompanied by a 54.7% increase in the 30-second chair stand test score. Significant increases in the score of star excursion balance tests, and the strength of the extensor and flexor muscles at knee and ankle joints were also observed. In addition, the intervention group walked at a faster speed with a longer step length, shorter support phase, and a greater sagittal plane range of motion at the hip and ankle joints. No statistical improvements were seen in the control group. This study provided an effective, evidence-based falls prevention program that can be implemented in community settings to improve physical fitness and reduce fall risks among community-dwelling older adults. The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people. Keywords: Tai Chi Chuan, resistance training, balance, fall prevention, fall

  1. Effects of vibration training in reducing risk of slip-related falls among young adults with obesity.

    Science.gov (United States)

    Yang, Feng; Munoz, Jose; Han, Long-Zhu; Yang, Fei

    2017-05-24

    This study examined the effects of controlled whole-body vibration training on reducing risk of slip-related falls in people with obesity. Twenty-three young adults with obesity were randomly assigned into either the vibration or placebo group. The vibration and placebo groups respectively received 6-week vibration and placebo training on a side-alternating vibration platform. Before and after the training, the isometric knee extensors strength capacity was measured for the two groups. Both groups were also exposed to a standardized slip induced by a treadmill during gait prior to and following the training. Dynamic stability and fall incidences responding to the slip were also assessed. The results indicated that vibration training significantly increased the muscle strength and improved dynamic stability control at recovery touchdown after the slip occurrence. The improved dynamic stability could be resulted from the enhanced trunk segment movement control, which may be attributable to the strength increment caused by the vibration training. The decline of the fall rates from the pre-training slip to the post-training one was greater among the vibration group than the placebo group (45% vs. 25%). Vibration-based training could be a promising alternative or additional modality to active exercise-based fall prevention programs for people with obesity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Investigation of the effect of changes in muscle strength in gestational age upon fear of falling and quality of life.

    Science.gov (United States)

    Atay, Emrah; Başalan Iz, Fatma

    2015-01-01

    The aim of this study is the investigation of the effect of changes in muscle strength in gestational age upon fear of falling and quality of life. This longitudinal, descriptive study included a sample of 37 pregnant women who volunteered to participate. The research data were collected at 20 and 32 weeks of gestation. Data collection instruments included a newly developed questionnaire form, the Tinetti Falls Efficacy Scale, a visual analog scale, and the Turkish language version of the WHO Quality of Life Scale. Upper body flexibility was measured by the back scratch test, while muscle strength was measured by a handgrip dynamometer and balance by the unipedal stance test. It was found that, as pregnancy advanced, pregnant women had an increased fear of falling, as well as elevated systolic and diastolic blood pressure levels. Participants suffered significant impairments in their balance, handgrip strength, and quality of life within the physical, psychological, and environmental domains. As pregnancy advances, muscle strength decreases and the fear of falling experienced by pregnant women increases, which significantly impairs the quality of life in the domains of environment, physical, and mental health.

  3. The Procyclical Effects of Bank Capital Regulation

    NARCIS (Netherlands)

    Repullo, R.; Suarez, J.

    2010-01-01

    We assess the procyclical effects of bank capital regulation in a dynamic equilibrium model of relationship lending in which banks are unable to access the equity markets every period. Banks anticipate that shocks to their earnings as well as the cyclical position of the economy can impair their

  4. Environmental regulations and their effects on the nuclear regulator

    International Nuclear Information System (INIS)

    McManus, J.G.

    1994-01-01

    Environmental regulations are discussed from the point of view of the Canadian Atomic Energy Control Board (AECB). The AECB's mission includes the environment, namely 'to ensure that the use of nuclear energy in Canada does not pose any undue risk to health, safety, security or the environment'. The regulatory process was governed by the Atomic Energy Control Act, which at the time of the conference was outdated and due for replacement by a new version, and by the Environmental Assessment and Review Process Guidelines Order, which was due to be replaced by the Canadian Environmental Assessment Act, still not in force at the time of the conference. Through court decisions, the Guidelines Order had effectively acquired statutory authority. Public hearings and review can result in some considerable delay to the approval of a project, yet the AECB has no choice but to ensure that the requirements of the Guidelines Order are fulfilled. Collaboration between the federal and provincial governments is very evident in Saskatchewan. Of six mining projects being considered by the AECB, five were being reviewed by a joint federal provincial panel. For the future, it was hoped that the new Atomic Energy Control Act would increase fines and the powers of inspectors, require financial guarantees for decommissioning, regularize cooperation with the provinces, and empower the AECB to hold hearings that could effectively substitute for those prescribed by the Canadian Environmental Assessment Act

  5. A Review Study on Effective Factors in Prevention of Falling and Osteoporosis Fracture in Elderly People

    Directory of Open Access Journals (Sweden)

    Roghayeh Esmaieli

    2013-01-01

    Full Text Available Background and Aim The geriatric process consists of stages of progressive and unrevisable changes during the life. This change starts from the age of 35 to 40, but usually a person over 60 years old is considered as elderly. With regard to the geriatric physiopathology process, osteoporosis and the following bone fracture caused by a fall, is one of the most common and serious problems in elderly people. Other important factors responsible for old people`s bedridden at hospital are respectively as follow: femoral fractures, sub durra hemorrhage, and injury or damage of brain. Only after being involved in a problem or injury the elders notice the risk factors and the ways to prevent them. Therefore, the investigation and recognition of precaution measures are necessary in case of osteoporosis and falling in elder people. The primary prevention of falling in elderly people is the prevention of osteoporosis. Therefore, screening of peripheral and central bone density is necessary for those who are at risk.The present article is a review study which has been prepared by gathering and reviewing thirty articles about recognition of risk factors and preventing osteoporosis and falling down in elderly people. From review of literature it was concluded that the following measures should be taken in order to prevent the elderly people from any kind of injury:A - Identification and Assessment of elderly people with high risk exposure B - Decreasing or eliminating the risk factors by:- Body & physical exercise - Taking tablets - Appropriate diet- Multiple interventions

  6. Students fall for Fall Meeting

    Science.gov (United States)

    Smedley, Kara

    2012-02-01

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

  7. Identifying Balance and Fall Risk in Community-Dwelling Older Women: The Effect of Executive Function on Postural Control

    OpenAIRE

    Muir-Hunter, Susan W.; Clark, Jennifer; McLean, Stephanie; Pedlow, Sam; Van Hemmen, Alysia; Montero Odasso, Manuel; Overend, Tom

    2014-01-01

    Purpose: The mechanisms linking cognition, balance function, and fall risk among older adults are not fully understood. An evaluation of the effect of cognition on balance tests commonly used in clinical practice to assess community-dwelling older adults could enhance the identification of at-risk individuals. The study aimed to determine (1) the association between cognition and clinical tests of balance and (2) the relationship between executive function (EF) and balance under single- and d...

  8. The Method of Calculating the Shock Effect of Falling Rock Research

    Science.gov (United States)

    Guo, Kexuan; Chen, Hongkai; Chen, Tao

    2017-12-01

    The paper study on the process of rockfall falling, consider the air below the rockfall will be compressed, calculate the force of the compressed air to the rockfall; Set up theory mode and divide the process into n parts, using the theory of Aerodynamics, Conservation of energy theorem and Air moving theory to derive the method of calculate the rockfall impacts; The results have certain reference, it can be used in the theory study of disaster reduction and technical of rockfall.

  9. The effects of multidirectional stepping training on balance, gait ability, and falls efficacy following stroke

    OpenAIRE

    Park, Gi-Deok; Choi, Jin-Uk; Kim, Young-Min

    2016-01-01

    [Purpose] The purpose of this study was to determine whether a multidirectional stepping training improves balance, gait ability, and falls efficacy in stroke patients. [Subjects] Firty patients who met the selection criteria and agreed to participate in research at hospital N were randomly allocated and enrolled in this study. Twenty of the subjects were assigned to an experimental group that participated in combined stepping exercise, and the other twenty subjects were assigned to a control...

  10. Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety.

    Science.gov (United States)

    Lachance, Chantelle C; Jurkowski, Michal P; Dymarz, Ania C; Robinovitch, Stephen N; Feldman, Fabio; Laing, Andrew C; Mackey, Dawn C

    2017-01-01

    Compliant flooring, broadly defined as flooring systems or floor coverings with some level of shock absorbency, may reduce the incidence and severity of fall-related injuries in older adults; however, a lack of synthesized evidence may be limiting widespread uptake. Informed by the Arksey and O'Malley framework and guided by a Research Advisory Panel of knowledge users, we conducted a scoping review to answer: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries in healthcare settings? We searched academic and grey literature databases. Any record that discussed a compliant flooring system and at least one of biomechanical efficacy, clinical effectiveness, cost-effectiveness, or workplace safety was eligible for inclusion. Two independent reviewers screened and abstracted records, charted data, and summarized results. After screening 3611 titles and abstracts and 166 full-text articles, we included 84 records plus 56 companion (supplementary) reports. Biomechanical efficacy records (n = 50) demonstrate compliant flooring can reduce fall-related impact forces with minimal effects on standing and walking balance. Clinical effectiveness records (n = 20) suggest that compliant flooring may reduce injuries, but may increase risk for falls. Preliminary evidence suggests that compliant flooring may be a cost-effective strategy (n = 12), but may also result in increased physical demands for healthcare workers (n = 17). In summary, compliant flooring is a promising strategy for preventing fall-related injuries from a biomechanical perspective. Additional research is warranted to confirm whether compliant flooring (i) prevents fall-related injuries in real-world settings, (ii) is a cost-effective intervention strategy, and (iii) can be installed without negatively impacting workplace safety. Avenues for future research are

  11. Effect of fall wind on wind power generation; Furyoku hatsuden ni okeru dashikaze no koka

    Energy Technology Data Exchange (ETDEWEB)

    Nagai, H [Nihon University, Tokyo (Japan)

    1997-11-25

    Wind conditions in Arakawa Town, Niigata Prefecture, were surveyed by anemometers and anemoscopes installed at 3 different points, and the data are analyzed to develop the prediction model for investigating possibility of introduction of wind mills there. Outlined herein is power generated by fall wind by comparing predicted power availability with the actual results. In order to investigate possibility of power generation by fall wind, the wind conditions and power availability are simulated using the observed wind condition data. Predicted wind velocity involves a large error at a point where frequency of prevailing wind direction is high, and direction in which average wind velocity is high coincides with direction in which land is slanted at a high slope. Fall wind occurs locally for geographical reasons. Location of the wind mill must be carefully considered, because it is complex, although potentially gives a larger quantity of power. A wind mill of 400kW can produce power of around 600MWh annually, when it is located at the suited site confirmed by the wind condition analysis results. 6 refs., 5 figs., 6 tabs.

  12. Establishing the effectiveness, cost-effectiveness and student experience of a Simulation-based education Training program On the Prevention of Falls (STOP-Falls) among hospitalised inpatients: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Williams, Cylie; Bowles, Kelly-Ann; Kiegaldie, Debra; Maloney, Stephen; Nestel, Debra; Kaplonyi, Jessica; Haines, Terry

    2016-06-02

    Simulation-based education (SBE) is now commonly used across health professional disciplines to teach a range of skills. The evidence base supporting the effectiveness of this approach for improving patient health outcomes is relatively narrow, focused mainly on the development of procedural skills. However, there are other simulation approaches used to support non-procedure specific skills that are in need of further investigation. This cluster, cross-over randomised controlled trial with a concurrent economic evaluation (cost per fall prevented) trial will evaluate the effectiveness, cost-effectiveness and student experience of health professional students undertaking simulation training for the prevention of falls among hospitalised inpatients. This research will target the students within the established undergraduate student placements of Monash University medicine, nursing and allied health across Peninsula Health acute and subacute inpatient wards. The intervention will train the students in how to provide the Safe Recovery program, the only single intervention approach demonstrated to reduce falls in hospitals. This will involve redevelopment of the Safe Recovery program into a one-to-many participant SBE program, so that groups of students learn the communication skills and falls prevention knowledge necessary for delivery of the program. The primary outcome of this research will be patient falls across participating inpatient wards, with secondary outcomes including student satisfaction with the SBE and knowledge gain, ward-level practice change and cost of acute/rehabilitation care for each patient measured using clinical costing data. The Human Research Ethics Committees of Peninsula Health (LRR/15/PH/11) and Monash University (CF15/3523-2015001384) have approved this research. The participant information and consent forms provide information on privacy, storage of results and dissemination. Registration of this trial has been completed with the

  13. The Effect of Roll Waves on the Hydrodynamics of Falling Films Observed in Vertical Column Absorbers

    International Nuclear Information System (INIS)

    Miller, W.A.

    2001-01-01

    A thin falling film is well suited to simultaneous heat and mass transfer because of the small thermal resistance through the film and because of the large contact surface achievable at low flow rates. The film enters as a smooth laminar flow and quickly transitions into small-amplitude wavy flow. The waves grown in length and amplitude and are identified as roll waves. This flow regime is termed wavy-laminar flow, and modern heat and mass transfer equipment operate in this complicated transition regime. Research published in open literature has shown the mass flow rate in the rollwaves to be about 10 to 20 times greater than that in the laminar substrate. As the film fully develops, the waves grow in mass and the film substrate thins because fluid is swept from the substrate by the secondary flows of the roll wave. Many studies have been conducted to measure and correlate the film thickness of wavy-laminar flows. Literature data show that Nusselt's theory for smooth laminar flow can over predict the film thickness by as much as 20% for certain wavy-laminar flow conditions. The hydrodynamics of falling films were therefore studied to measure the film thickness of a free-surface falling film and to better understand the parameters that affect the variations of the film thickness. A flow loop was set up for measuring the thickness, wave amplitude,and frequency of a film during hydrodynamic flow. Decreasing the pipe diameter caused the amplitude of the wavy flow to diminish. Measurements monitored from stations along the falling film showed a thinning of film thickness. Fully developed flow required large starting lengths of about 0.5 m. The film thickness increases as the Reynolds number (Re) increases. Increasing the Kapitza number (Ka) causes a decrease in the film thickness. Regression analysis showed that the Re and Ka numbers described the data trends in wavy-laminar flow. Rather than correlating the Re number in discrete ranges of the Ka number as earlier

  14. [Effects of training on static and dynamic balance in elderly subjects who have had a fall or not].

    Science.gov (United States)

    Toulotte, C; Thévenon, A; Fabre, C

    2004-11-01

    To evaluate the effects of a physical training program on static and dynamic balance during single and dual task conditions in elderly subjects who have had a fall or not. Two groups, comprising a total of 33 elderly subjects, were trained: 16 who had a fall were 69.2 +/- 5.0 years old and 17 who had not had a fall were 67.3 +/- 3.8 years. All subjects underwent an unipedal test with eyes open and eyes closed, followed by gait assessment during single and dual motor task conditions, before and after a physical training program. All subjects showed a significant decrease, by six times for subjects who had fallen and four times by those who had not, in the number of touch-downs in the unipedal test with eyes open (P < 0.05), and by 2.5 and 2 times, respectively, with eyes closed (P < 0.05) after the training program. All subjects showed a significant increase in speed (P < 0.05), cadence (P < 0.05) and stride length (P < 0.05) and a significant decrease in the single support time (P < 0.05) and stride time (P < 0.05) in gait assessment during single and dual task conditions after the training program. During the training program, no subjects fell. The physical training program improved static balance and quality of gait in elderly subjects who had had a fall and those who had not, which could contribute to minimizing and/or retarding the effects of aging and maintaining physical independence.

  15. Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil).

    Science.gov (United States)

    de Negreiros Cabral, Kelem; Perracini, Monica Rodrigues; Soares, Aline Thomaz; de Cristo Stein, Francine; Sera, Celisa Tiemi Nakagawa; Tiedemann, Anne; Sherrington, Cathie; Filho, Wilson Jacob; Paschoal, Sérgio Márcio Pacheco

    2013-03-15

    Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle.The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression analysis. This study is the

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

    Science.gov (United States)

    Berry, Sarah D; Miller, Ram R

    2008-12-01

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

  17. New horizons in fall prevention.

    Science.gov (United States)

    Lord, Stephen R; Close, Jacqueline C T

    2018-04-25

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

  18. Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Peixia Cheng

    2018-03-01

    Full Text Available Background: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR and 95% credible interval (95% CrI were calculated. Results: A total of 49 trials involving 27,740 participants and 9271 fallers were included. Compared to usual care, multifactorial interventions (MFI demonstrated the greatest efficacy (OR: 0.64, 95% CrI: 0.53 to 0.77 followed by interventions combining education and exercise (EDU + EXC (OR: 0.65, 95% CrI: 0.38 to 1.00 and interventions combining exercise and hazard assessment and modification (EXC + HAM (OR: 0.66, 95% CrI: 0.40 to 1.04. The effect of medical care performed the worst (OR: 1.02, 95% CrI: 0.78 to 1.34. Model fit was good, inconsistency was low, and publication bias was considered absent. The overall quality of included trials was high. The pooled odds ratios and ranking probabilities remained relatively stable across all sensitivity analyses. Conclusions: MFI and exercise appear to be effective to reduce falls among older adults, and should be considered first as service delivery options. Further investigation is necessary to verify effectiveness and suitableness of the strategies to at-risk populations.

  19. Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy.

    Science.gov (United States)

    El-Shamy, Shamekh Mohamed; Abd El Kafy, Ehab Mohamed

    2014-01-01

    The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy. Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured. Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p control group (p postural balance control in children with diplegic cerebral palsy.

  20. The Effects of Augmented Reality-based Otago Exercise on Balance, Gait, and Falls Efficacy of Elderly Women.

    Science.gov (United States)

    Yoo, Ha-Na; Chung, Eunjung; Lee, Byoung-Hee

    2013-07-01

    [Purpose] The purpose of this study was to determine the effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. [Subjects] The subjects were 21 elderly women, who were randomly divided into two groups: an augmented reality-based Otago exercise group of 10 subjects and an Otago exercise group of 11 subjects. [Methods] All subjects were evaluated for balance (Berg Balance Scale, BBS), gait parameters (velocity, cadence, step length, and stride length), and falls efficacy. Within 12 weeks, Otago exercise for muscle strengthening and balance training was conducted three times, for a period of 60 minutes each, and subjects in the experimental group performed augmented reality-based Otago exercise. [Results] Following intervention, the augmented reality-based Otago exercise group showed significant increases in BBS, velocity, cadence, step length (right side), stride length (right side and left side) and falls efficacy. [Conclusion] The results of this study suggest the feasibility and suitability of this augmented reality-based Otago exercise for elderly women.

  1. Effects of Functional Training and Calf Stretching on Risk of Falls in Older People: A Pilot Study.

    Science.gov (United States)

    do Rosario, Jailton Thulher; da Fonseca Martins, Natalia Santos; Peixinho, Carolina Carneiro; Oliveira, Liliam Fernandes

    2017-04-01

    This study aimed to determine the effects of a functional training and ankle stretching program in triceps surae torque, passive stiffness index, and in the risk for fall indicators in older adults. Twenty women (73.4 ± 7.3 years) were allocated into an intervention or control group. The 12-week intervention consisted of functional training and calf stretching exercises performed twice a week. Measurements of peak passive and active torque, passive stiffness, maximum dorsiflexion angle, and indexes of risk for falls (Timed Up and Go, functional reach test, QuickScreen-test) were collected. There were no significant differences for all variables, except the maximum dorsiflexion angle, which increased in the intervention group from 33.78 ± 8.57° to 38.89 ± 7.52°. The exercise program was not sufficient to enhance performance on functional tests and decrease the risk for falls in older adults. The significant increase in the maximum dorsiflexion indicates a positive impact of stretching exercises.

  2. 29 CFR 1926.760 - Fall protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Fall protection. 1926.760 Section 1926.760 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Steel Erection § 1926.760 Fall protection. (a... protection from fall hazards in accordance with paragraph (a)(1) of this section. (c) Controlled Decking Zone...

  3. 29 CFR 1917.41 - House falls.

    Science.gov (United States)

    2010-07-01

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

  4. 7 CFR 1900.7 - Effect on other regulations.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Effect on other regulations. 1900.7 Section 1900.7 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... REGULATIONS GENERAL Delegations of Authority § 1900.7 Effect on other regulations. This subpart does not...

  5. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean; Tremblay-Boudreault, Valérie; Beaudoin, Audrée-Jeanne

    2012-01-01

    To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

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

    Science.gov (United States)

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

    2016-08-01

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

  7. Cost-effectiveness of vitamin D supplementation and exercise in preventing injurious falls among older home-dwelling women: findings from an RCT.

    Science.gov (United States)

    Patil, R; Kolu, P; Raitanen, J; Valvanne, J; Kannus, P; Karinkanta, S; Sievänen, H; Uusi-Rasi, K

    2016-01-01

    This study assessed the cost-effectiveness of vitamin D supplementation and exercise, separately and combined, in preventing medically attended injurious falls among older home-dwelling Finnish women. Given a willingness to pay of €3,000 per injurious fall prevented, the exercise intervention had an 86 % probability of being cost-effective in this population. The costs of falling in older persons are high, both to the individual and to society. Both vitamin D and exercise have been suggested to reduce the risk of falls. This study assessed the cost-effectiveness of vitamin D supplementation and exercise, separately and combined, in preventing medically attended injurious falls among older Finnish women. Economic evaluation was based on the results of a previously published 2-year randomized controlled trial (RCT) where 409 community-dwelling women aged 70 to 80 years were recruited into four groups: (1) no exercise + placebo (D-Ex-), (2) no exercise + vitamin D 800 IU/day (D+Ex-), (3) exercise + placebo (D-Ex+), and (4) exercise + vitamin D 800 IU/day (D+Ex+). The outcomes were medically attended injurious falls and fall-related health care utilization costs over the intervention period, the latter evaluated from a societal perspective based on 2011 unit costs. Incremental cost-effectiveness ratios (ICER) were calculated for the number of injurious falls per person-year prevented and uncertainty estimated using bootstrapping. Incidence rate ratios (95 % CI) for medically attended injurious falls were lower in both Ex+ groups compared with D-Ex-: 0.46 (0.22 to 0.95) for D-Ex+, 0.38 (0.17 to 0.81) for D+Ex+. Step-wise calculation of ICERs resulted in exclusion of D+Ex- as more expensive and less effective. Recalculated ICERs were €221 for D-Ex-, €708 for D-Ex+, and €3,820 for D+Ex+; bootstrapping indicated 93 % probability that each injurious fall avoided by D-Ex+ per person year costs €708. At a willingness to pay €3,000 per injurious fall prevented

  8. Effects of a simple home-based exercise program on fall prevention in older adults: A 12-month primary care setting, randomized controlled trial.

    Science.gov (United States)

    Boongird, Chitima; Keesukphan, Prasit; Phiphadthakusolkul, Soontraporn; Rattanasiri, Sasivimol; Thakkinstian, Ammarin

    2017-11-01

    To investigate the effects of a simple home-based exercise program on falls, physical functioning, fear of falling and quality of life in a primary care setting. Participants (n = 439), aged ≥65 years with mild-to-moderate balance dysfunction were randomly assigned to an exercise (n = 219) or control (n = 220) group. The program consisted of five combined exercises, which progressed in difficulty, and a walking plan. Controls received fall prevention education. Physical functioning and other outcomes were measured at 3- and 6-month follow-up visits. Falls were monitored with fall diaries and phone interviews at 3, 6, 9, and 12 months respectively. The 12 months of the home-based exercise program showed the incidence of falls was 0.30 falls per person year in the exercise group, compared with 0.40 in the control group. The estimated incidence rate ratio was 0.75 (95% CI 0.55-1.04), which was not statistically significant. The fear of falling (measured by the Thai fall efficacy scale) was significantly lower in the exercise than control group (24.7 vs 27.0, P = 0.003). Also, the trend of program adherence increased in the exercise group. (29.6% to 56.8%). This simple home-based exercise program showed a reduction in fear of falling and a positive trend towards exercise adherence. Further studies should focus on factors associated with exercise adherence, the benefits of increased home visits and should follow participants longer in order to evaluate the effects of the program. Geriatr Gerontol Int 2017; 17: 2157-2163. © 2017 Japan Geriatrics Society.

  9. The effects of high frequency subthalamic stimulation on balance performance and fear of falling in patients with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Jarnlo Gun-Britt

    2009-04-01

    Full Text Available Abstract Background Balance impairment is one of the most distressing symptoms in Parkinson's disease (PD even with pharmacological treatment (levodopa. A complementary treatment is high frequency stimulation in the subthalamic nucleus (STN. Whether STN stimulation improves postural control is under debate. The aim of this study was to explore the effects of STN stimulation alone on balance performance as assessed with clinical performance tests, subjective ratings of fear of falling and posturography. Methods Ten patients (median age 66, range 59–69 years with bilateral STN stimulation for a minimum of one year, had their anti-PD medications withdrawn overnight. Assessments were done both with the STN stimulation turned OFF and ON (start randomized. In both test conditions, the following were assessed: motor symptoms (descriptive purposes, clinical performance tests, fear of falling ratings, and posturography with and without vibratory proprioceptive disturbance. Results STN stimulation alone significantly (p = 0.002 increased the scores of the Berg balance scale, and the median increase was 6 points. The results of all timed performance tests, except for sharpened Romberg, were significantly (p ≤ 0.016 improved. The patients rated their fear of falling as less severe, and the total score of the Falls-Efficacy Scale(S increased (p = 0.002 in median with 54 points. All patients completed posturography when the STN stimulation was turned ON, but three patients were unable to do so when it was turned OFF. The seven patients with complete data showed no statistical significant difference (p values ≥ 0.109 in torque variance values when comparing the two test situations. This applied both during quiet stance and during the periods with vibratory stimulation, and it was irrespective of visual input and sway direction. Conclusion In this sample, STN stimulation alone significantly improved the results of the clinical performance tests that mimic

  10. Counterintuitive effect of fall mixed layer deepening on eukaryotic new production in the Sargasso Sea

    Science.gov (United States)

    Fawcett, S. E.; Lomas, M. W.; Ward, B. B.; Sigman, D. M.

    2012-12-01

    The Sargasso Sea is characterized by a short period of deep vertical mixing in the late winter and early spring, followed by strong thermal stratification during the summer. Stratification persists into the fall, impeding the upward flux of nitrate from depth so that recycled forms of nitrogen (N) such as ammonium are thought to support most primary production. We collected particles from surface waters during March, July, October, and December, used flow cytometry to separate the prokaryotic and eukaryotic phytoplankton, and analyzed their respective 15N/14N. In all months, the 15N/14N of the prokaryotic genera, Prochlorococcus and Synechococcus, was low, indicative of reliance on recycled N throughout the year. In July, the 15N/14N of eukaryotic phytoplankton was variable but consistently higher than that of the prokaryotes, reflecting eukaryotic consumption of subsurface nitrate. Two eukaryotic profiles from October and December were similar to those from July. In three other fall profiles, the eukaryotes had a 15N/14N similar to that of the prokaryotes, suggesting a switch toward greater reliance on recycled N. This change in the dominant N source supporting eukaryotic production appears to be driven by the density structure of the upper water column. The very shallow low-density surface "mixed layer" (≤20 m) that develops in early-to-mid summer does not contribute to stratification at the base of the euphotic zone, and subsurface nitrate can mix up into the lower euphotic zone, facilitating continued production. The deepening of the mixed layer into the fall, typically taken as an indication of weaker overall stratification, actually strengthens the isolation of the euphotic zone as a whole, reducing the upward supply of nitrate to the photosynthetically active layer. The same counterintuitive dynamic explains the latitudinal patterns in a set of three October depth profiles. Two northern stations (32°N and 27°N) were characterized by a thick, low

  11. Effect of Tai Chi Exercise on Fall Prevention in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Yu-Ning Hu

    2016-09-01

    Conclusion: Our findings demonstrate that Tai Chi exercise has a significant protective effect on fall risk among older adults. Further studies are warranted to develop optimal Tai Chi training programs (training intensity, duration, and frequency, etc. for older adults.

  12. Exercise and physical training improve physical function in older adults with visual impairments but their effect on falls is unclear: a systematic review

    Directory of Open Access Journals (Sweden)

    Michael Gleeson

    2014-09-01

    [Gleeson M, Sherrington C, Keay L (2014 Exercise and physical training improve physical function in older adults with visual impairments but their effect on falls is unclear: a systematic review. Journal of Physiotherapy 60: 130–135

  13. Effects of dancing on the risk of falling related factors of healthy older adults: a systematic review.

    Science.gov (United States)

    Fernández-Argüelles, Esther López; Rodríguez-Mansilla, Juan; Antunez, Luis Espejo; Garrido-Ardila, Elisa María; Muñoz, Rafael Perez

    2015-01-01

    Deficits of balance or postural control in persons of advanced age are one of the factors that influence the risk of falling. The most appropriate treatment approaches and their benefits are still unknown. The aim of this article is to systematically review the scientific literature to identify the therapeutic effects of dancing as a physical exercise modality on balance, flexibility, gait, muscle strength and physical performance in older adults. A systematic search of Pubmed, Cochrane Library Plus, PEDro, Science Direct, Dialnet and Academic Search Complete using the search terms "dance", "older", "dance therapy", "elderly", "balance", "gait" and "motor skills". The eligibility criteria were: studies written in English and Spanish, published from January 2000 to January 2013, studies which analyzed the effects of dance (ballroom dance and/or dance based exercise) in older adults over 60 years of age with no disabling disease and included the following variables of study: balance, gait, risk of falls, strength, functionality, flexibility and quality of life. 123 articles were found in the literature. A final selection of seven articles was used for the present manuscript. Although the selected studies showed positive effects on the risk of falling related to factors (balance, gait and dynamic mobility, strength and physical performance), there were some aspects of the studies such as the methodological quality, the small sample size, the lack of homogeneity in relation to the variables and the measurement tools, and the existing diversity regarding the study design and the type of dance, that do not enable us to confirm that dance has significant benefits on these factors based on the scientific evidence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Analysis and Compensation of Dead-Time Effect of a ZVT PWM Inverter Considering the Rise- and Fall-Times

    Directory of Open Access Journals (Sweden)

    Hailin Zhang

    2016-11-01

    Full Text Available The dead-time effect, as an intrinsic problem of the converters based on the half-bridge unit, leads to distortions in the converter output. Although several dead-time effect compensation or elimination methods have been proposed, they cannot fully remove the dead-time effect of blanking delay error, because the output current polarity is difficult detect accurately. This paper utilizes the zero-voltage-switching (ZVT technique to eliminate the blanking delay error, which is the main drawback of the hard-switching inverter, although the technique initially aims to improve the efficiency. A typical ZVT inverter—the auxiliary resonant snubber inverter (ARSI is analyzed. The blanking delay error is completely eliminated in the ARSI. Another error source caused by the finite rise- and fall-times of the voltage is analyzed, which was not considered in the hard-switching inverter. A compensation method based on the voltage error estimation is proposed to compensate the rise- and fall-error. A prototype was developed to verify the effectiveness of the proposed control. Both the simulation and experimental results demonstrate that the qualities of the output current and voltage in the ARSI are better than that in the hard-switching inverter due to the elimination of the blanking delay error. The total harmonic distortion (THD of the output is further reduced by using the proposed compensation method in the ARSI.

  15. Daily Bicycling in Older Adults May Be Effective to Reduce Fall Risks - A Case Control Study.

    Science.gov (United States)

    Batcir, Shani; Melzer, Itshak

    2018-01-18

    Older adults gain many health benefits from riding bicycles regularly. We aimed to explore whether older persons who ride bicycles regularly have better balance than controls. Balance control and voluntary stepping were assessed in 20 older adults aged 65 to 85 who live in an agricultural community village who regularly ride bicycles (BR), and 30 age- and gender-matched non-bicycle riders (NBR). Self-reported function and fear of fall were also assessed. Bicycle riders showed significantly better balance, faster voluntary stepping, and better self-reported advanced lower extremity function compared with NBR. The results might suggest that bicycling regularly preserves balance control and speed of voluntary stepping in older adults because bicycling might maintain specific balance coordination patterns. The results should be treated with caution since BR were older adults who selected an active life style (i.e., bicycling as well as living in an agricultural village) that may bias the results.

  16. Evaluation of the effect of patient education on rates of falls in older hospital patients: Description of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hoffmann Tammy

    2009-04-01

    This trial will examine the effect of a single intervention (specifically designed patient education on rates of falls in older patients in hospital and after discharge. The results will provide robust recommendations for clinicians and researchers about the role of patient education in this population. The study has the potential to identify a new intervention that may reduce rates of falls in older hospital patients and could be readily duplicated and applied in a wide range of clinical settings. Trial Registration ACTRN12608000015347

  17. Epidemiologic features and intervention effect of fall injury among rural school-aged children in southwest China: a short-term cohort study.

    Science.gov (United States)

    Shi, Xiuquan; Wang, Tao; Nie, Chan; Wang, Haiyan; Luo, Lirong; Qi, Yonghong; Jiang, Zhixia

    2018-05-24

    Falls are the top one type in all unintentional injuries. In this study, we aim to explore the epidemiological characteristics of falls and assess the intervention effect. Our research had interviewed 2854 rural children in southwest China. Then, we used School-Family-Individual (SFI) comprehensive education model to conduct an intervention among 1506 children and follow up them for one year. The changes in injury knowledge and incidence rate before and after intervention were compared. We found the fall injury was 37.32% (178/477) and ranked top one in the total injuries. After intervention, the children's fall-injuries-related knowledge was significantly increased by 15.29 percent (P < 0.001). While falls incidence significantly decreased after- intervention (6.24% vs. 3.93%; P < 0.001). From the results we concluded that the falls rate was high and was the prior reason of all injuries. SFI intervention model can effectively reduce the incidence of the fall injury.

  18. Effects of the visual-feedback-based force platform training with functional electric stimulation on the balance and prevention of falls in older adults: a randomized controlled trial.

    Science.gov (United States)

    Li, Zhen; Wang, Xiu-Xia; Liang, Yan-Yi; Chen, Shu-Yan; Sheng, Jing; Ma, Shao-Jun

    2018-01-01

    Force platform training with functional electric stimulation aimed at improving balance may be effective in fall prevention for older adults. Aim of the study is to evaluate the effects of the visual-feedback-based force platform balance training with functional electric stimulation on balance and fall prevention in older adults. A single-centre, unblinded, randomized controlled trial was conducted. One hundred and twenty older adults were randomly allocated to two groups: the control group ( n  = 60, one-leg standing balance exercise, 12 min/d) or the intervention group ( n  = 60, force platform training with functional electric stimulation, 12 min/d). The training was provided 15 days a month for 3 months by physical therapists. Medial-lateral and anterior-posterior maximal range of sway with eyes open and closed, the Berg Balance Scale, the Barthel Index, the Falls Efficacy scale-International were assessed at baseline and after the 3-month intervention. A fall diary was kept by each participant during the 6-month follow-up. On comparing the two groups, the intervention group showed significantly decreased ( p  Falls Efficacy Scale-International ( p  fall rates ( p  falls in older adults.

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

    Science.gov (United States)

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

    2017-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-09-24

    suggested that there was significant vertical hydrologic exchange during all time periods. The combined results of temperature monitoring and numerical modeling indicate that only two sites were significantly affected by short-term (hourly to daily) large magnitude changes in discharge. Although the two sites exhibited acute flux reversals between river water and hyporheic water resulting from short-term large magnitude changes in discharge, these flux reversals had minimal effect on emergence timing estimates. Indeed, the emergence timing estimates at all sites was largely unaffected by the changes in river stage resulting from hydropower operations at Hells Canyon Dam. Our results indicate that the range of emergence timing estimates due to differences among the eggs from different females can be as large as or larger than the emergence timing estimates due to site differences (i.e., bed temperatures within and among sites). We conclude that during the 2002-2003 fall chinook salmon incubation period, hydropower operations of Hells Canyon Dam had an insignificant effect on fry emergence timing at the study sites. It appears that short-term (i.e., hourly to daily) manipulations of discharge from the Hells Canyon Complex during the incubation period would not substantially alter egg pocket incubation temperatures, and thus would not affect fry emergence timing at the study sites. However, the use of hydropower operational manipulations at the Hells Canyon Complex to accelerate egg incubation and fry emergence should not be ruled out on the basis of only one water year's worth of study. Further investigation of the incubation environment of Snake River fall chinook salmon is warranted based on the complexity of hyporheic zone characteristics and the variability of surface/subsurface interactions among dry, normal, and wet water years.

  1. Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study.

    Science.gov (United States)

    van der Meulen, Erik; Zijlstra, G A Rixt; Ambergen, Ton; Kempen, Gertrudis I J M

    2014-12-01

    To determine the effect of fall-related concerns on physical, mental, and social function. Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial). Two municipalities in the south of the Netherlands. Community-dwelling older adults (N = 260). Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline. At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months. Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  2. The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson's Patients: A Report of Four Cases.

    Science.gov (United States)

    Balci, Nilay Çömük; Tonga, Eda; Gülşen, Mustafa

    2013-09-01

    This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson's disease. Four patients with Parkinson's disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson's Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson's patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson's disease patients.

  3. Clinical Effectiveness and Cost of a Hospital-Based Fall Prevention Intervention: The Importance of Time Nurses Spend on the Front Line of Implementation.

    Science.gov (United States)

    Nuckols, Teryl K; Needleman, Jack; Grogan, Tristan R; Liang, Li-Jung; Worobel-Luk, Pamela; Anderson, Laura; Czypinski, Linda; Coles, Courtney; Walsh, Catherine M

    2017-11-01

    The aim of this study is to evaluate the clinical effectiveness and incremental net cost of a fall prevention intervention that involved hourly rounding by RNs at 2 hospitals. Minimizing in-hospital falls is a priority, but little is known about the value of fall prevention interventions. We used an uncontrolled before-after design to evaluate changes in fall rates and time use by RNs. Using decision-analytical models, we estimated incremental net costs per hospital per year. Falls declined at 1 hospital (incidence rate ratio [IRR], 0.47; 95% confidence interval [CI], 0.26-0.87; P = .016), but not the other (IRR, 0.83; 95% CI, 0.59-1.17; P = .28). Cost analyses projected a 67.9% to 72.2% probability of net savings at both hospitals due to unexpected declines in the time that RNs spent in fall-related activities. Incorporating fall prevention into hourly rounds might improve value. Time that RNs invest in implementing quality improvement interventions can equate to sizable opportunity costs or savings.

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  5. 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.

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

    Science.gov (United States)

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

    2011-01-01

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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Lisa A Simpson

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

  9. Effect of Fear of Falling on Turning Performance in Parkinson's Disease in the Lab and at Home.

    Science.gov (United States)

    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.

  10. Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients.

    Science.gov (United States)

    Chen, Ying; Zhu, Ling-Ling; Zhou, Quan

    2014-01-01

    Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer's agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug-drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of FRIDs, pharmacist-conducted clinical medication

  11. Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

    Science.gov (United States)

    Chen, Ying; Zhu, Ling-Ling; Zhou, Quan

    2014-01-01

    Background Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Results Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer’s agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug–drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of

  12. The effect of Tai Chi Chuan in reducing falls among elderly people: design of a randomized clinical trial in the Netherlands [ISRCTN98840266

    Directory of Open Access Journals (Sweden)

    van Rossum Erik

    2006-03-01

    Full Text Available Abstract Background Falls are a significant public health problem. Thirty to fifty percent of the elderly of 65 years and older fall each year. Falls are the most common type of accident in this age group and can result in fractures and subsequent disabilities, increased fear of falling, social isolation, decreased mobility, and even an increased mortality. Several forms of exercise have been associated with a reduced risk of falling and with a wide range of physiological as well as psychosocial health benefits. Tai Chi Chuan seems to be the most promising form of exercise in the elderly, but the evidence is still controversial. In this article the design of a randomized clinical trial is presented. The trial evaluates the effect of Tai Chi Chuan on fall prevention and physical and psychological function in older adults. Methods/Design 270 people of seventy years and older living at home will be identified in the files of the participating general practitioners. People will be asked to participate when meeting the following inclusion criteria: have experienced a fall in the preceding year or suffer from two of the following risk factors: disturbed balance, mobility problems, dizziness, or the use of benzodiazepines or diuretics. People will be randomly allocated to either the Tai Chi Chuan group (13 weeks, twice a week or the no treatment control group. The primary outcome measure is the number of new falls, measured with a diary. The secondary outcome measures are balance, fear of falling, blood pressure, heart rate, lung function parameters, physical activity, functional status, quality of life, mental health, use of walking devices, medication, use of health care services, adjustments to the house, severity of fall incidents and subsequent injuries. Process parameters will be measured to evaluate the Tai Chi Chuan intervention. A cost-effectiveness analysis will be carried out alongside the evaluation of the clinical results. Follow

  13. Patient safety during assistant propelled wheelchair transfers: the effect of the seat cushion on risk of falling.

    Science.gov (United States)

    Okunribido, Olanrewaju O

    2013-01-01

    This article is a report of a study of the effect of the seat cushion on risk of falling from a wheelchair. Two laboratory studies and simulated assistant propelled wheelchair transfers were conducted with four healthy female participants. For the laboratory studies there were three independent variables: trunk posture (upright/flexed forward), seat cushion (flat polyurethane/propad low profile), and feet condition (dangling/supported), and two dependent variables: occupied wheelchair (wheelchair) center of gravity (CG), and stability. For the simulated transfers there was one independent variable: seat cushion (flat polyurethane/propad low profile), and one dependent variable: perception of safety (risk of falling). Results showed that the wheelchair CG was closer to the front wheels, and stability lower for the propad low profile cushion compared to the polyurethane cushion, when the participants sat with their feet dangling. During the simulated transfers, sitting on the propad low profile cushion caused participants to feel more apprehensive (anxious or uneasy) compared to sitting on the polyurethane cushion. The findings can contribute to the assessment of risk and care planning of non-ambulatory wheelchair users.

  14. The effect of pulmonary rehabilitation on mortality, balance, and risk of fall in stable patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Hakamy, Ali; Bolton, Charlotte E; McKeever, Tricia M

    2017-02-01

    The aim of this study is to conduct a systematic review of published studies that evaluate the impact of pulmonary rehabilitation (PR) on survival and fall (including balance) in patients with chronic obstructive pulmonary disease at stability. OVID, Medline, EMBASE, and Cochrane collaboration library were searched for literature dating from January 1980 up to November 2014 as well as an update in October 2015. Two reviewers screened titles, abstracts and full text records, extracted data, and assessed studies for risk of bias; any disagreements were resolved by a third member of the team, and consensus was always sought. Initial searches yielded 3216 records but after review only seven studies were included and there were no studies focused solely on falls. Two cohort studies found some positive benefits of PR on balance, but the results were inconsistent across the studies. Regarding survival, two randomized controlled trials were conducted; one study showed significant survival benefit at 1 year, while the other one showed nonsignificant survival benefit at 3 years. Neither were adequately powered and in both, survival was a secondary outcome. There was only limited inconclusive evidence to show that PR has a significant beneficial effect on balance or survival.

  15. Effects of foot and ankle devices on balance, gait and falls in adults with sensory perception loss: a systematic review.

    Science.gov (United States)

    Paton, Joanne; Hatton, Anna L; Rome, Keith; Kent, Bridie

    2016-12-01

    Foot and ankle devices are being developed as a method of preventing people with sensory perception loss sustaining a fall. Such devices are believed to work by reducing the likelihood of a fall by improving the balance and gait of the user. The objective of the review was to evaluate the effectiveness of foot and ankle devices for the prevention of falls and the improvement of balance and gait in adults with sensory perception loss. Participants were community-dwelling adults with bilateral pathological sensory perception loss. The current review evaluated any foot or ankle device, including but not restricted to, all types of footwear (therapeutic and retail), insoles (customized and prefabricated) and ankle-foot orthoses (AFOs). In the absence of randomized controlled trials (RCT), the review considered experimental and epidemiological study designs, except case series, individual case reports and descriptive cross-sectional studies. The primary outcome was number of falls. Secondary outcome measures were clinical or laboratory measures of balance or gait. A search for published and unpublished literature from inception to March 2015 written in the English language was conducted across a number of major electronic databases. A three-step search strategy was developed using MeSH terminology and keywords to ensure all that relevant materials are captured. Methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using standardized Joanna Briggs Institute (JBI) critical appraisal tools. Quantitative data were extracted from the studies that were identified as meeting the criteria for methodological quality using the standardized JBI data extraction tools. Due to the heterogeneity of populations, interventions and outcome measures, meta-analyses were not possible and results are presented in narrative form. Nine trials (from 10 papers) involving 238 participants, (14 with multiple sclerosis and 16 with

  16. 45 CFR 4.5 - Effect of regulations.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Effect of regulations. 4.5 Section 4.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION SERVICE OF PROCESS § 4.5 Effect of regulations. The regulations in this part are intended solely to identify Department officials who are...

  17. Effect of a multifactorial fall-and-fracture risk assessment and management program on gait and balance performances and disability in hospitalized older adults: a controlled study.

    Science.gov (United States)

    Trombetti, A; Hars, M; Herrmann, F; Rizzoli, R; Ferrari, S

    2013-03-01

    This controlled intervention study in hospitalized oldest old adults showed that a multifactorial fall-and-fracture risk assessment and management program, applied in a dedicated geriatric hospital unit, was effective in improving fall-related physical and functional performances and the level of independence in activities of daily living in high-risk patients. Hospitalization affords a major opportunity for interdisciplinary cooperation to manage fall-and-fracture risk factors in older adults. This study aimed at assessing the effects on physical performances and the level of independence in activities of daily living (ADL) of a multifactorial fall-and-fracture risk assessment and management program applied in a geriatric hospital setting. A controlled intervention study was conducted among 122 geriatric inpatients (mean ± SD age, 84 ± 7 years) admitted with a fall-related diagnosis. Among them, 92 were admitted to a dedicated unit and enrolled into a multifactorial intervention program, including intensive targeted exercise. Thirty patients who received standard usual care in a general geriatric unit formed the control group. Primary outcomes included gait and balance performances and the level of independence in ADL measured 12 ± 6 days apart. Secondary outcomes included length of stay, incidence of in-hospital falls, hospital readmission, and mortality rates. Compared to the usual care group, the intervention group had significant improvements in Timed Up and Go (adjusted mean difference [AMD] = -3.7s; 95 % CI = -6.8 to -0.7; P = 0.017), Tinetti (AMD = -1.4; 95 % CI = -2.1 to -0.8; P fall-and-fracture risk-based intervention program, applied in a dedicated geriatric hospital unit, was effective and more beneficial than usual care in improving physical parameters related to the risk of fall and disability among high-risk oldest old patients.

  18. Effects of a multimodal exercise program on balance, functional mobility and fall risk in older adults with cognitive impairment: a randomized controlled single-blind study.

    Science.gov (United States)

    Kovács, E; Sztruhár Jónásné, I; Karóczi, C K; Korpos, A; Gondos, T

    2013-10-01

    Exercise programs have important role in prevention of falls, but to date, there are conflicting findings about the effects of exercise programs on balance, functional performance and fall risk among cognitively impaired older adults. AIM. To investigate the effects of a multimodal exercise program on static and dynamic balance, and risk of falls in older adults with mild or moderate cognitive impairment. A randomized controlled study. A long-term care institute. Cognitively impaired individuals aged over 60 years. Eighty-six participants were randomized to an exercise group providing multimodal exercise program for 12 months or a control group which did not participate in any exercise program. The Performance Oriented Mobility Assessment scale, Timed Up and Go test, and incidence of falls were measured at baseline, at 6 months and at 12 months. There was a significant improvement in balance-related items of Performance Oriented Mobility Assessment scale in the exercise group both at 6 month and 12 month (Pfalls. Our results confirmed that a 12-month multimodal exercise program can improve the balance in cognitively impaired older adults. Based on our results, the multimodal exercise program may be a promising fall prevention exercise program for older adults with mild or moderate cognitive impairment improving static balance but it is supposed that more emphasis should be put on walking component of exercise program and environmental fall risk assessment.

  19. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review.

    Science.gov (United States)

    Cadore, Eduardo Lusa; Rodríguez-Mañas, Leocadio; Sinclair, Alan; Izquierdo, Mikel

    2013-04-01

    The aim of this review was to recommend training strategies that improve the functional capacity in physically frail older adults based on scientific literature, focusing specially in supervised exercise programs that improved muscle strength, fall risk, balance, and gait ability. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus, and ScienceDirect databases were searched from 1990 to 2012. Studies must have mentioned the effects of exercise training on at least one of the following four parameters: Incidence of falls, gait, balance, and lower-body strength. Twenty studies that investigated the effects of multi-component exercise training (10), resistance training (6), endurance training (1), and balance training (3) were included in the present revision. Ten trials investigated the effects of exercise on the incidence of falls in elderly with physical frailty. Seven of them have found a fewer falls incidence after physical training when compared with the control group. Eleven trials investigated the effects of exercise intervention on the gait ability. Six of them showed enhancements in the gait ability. Ten trials investigated the effects of exercise intervention on the balance performance and seven of them demonstrated enhanced balance. Thirteen trials investigated the effects of exercise intervention on the muscle strength and nine of them showed increases in the muscle strength. The multi-component exercise intervention composed by strength, endurance and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults.

  20. Effectiveness and implementation aspects of interventions for preventing falls in elderly people in long-term care facilities: a systematic review of RCTs.

    Science.gov (United States)

    Neyens, Jacques C; van Haastregt, Jolanda C; Dijcks, Béatrice P; Martens, Mark; van den Heuvel, Wim J; de Witte, Luc P; Schols, Jos M

    2011-07-01

    There is extensive literature on interventions to prevent or reduce falls in elderly people. These findings, however, were based mainly on studies of community-living persons. The primary aim of the present study was to report the effectiveness and implementation aspects of interventions aimed at reducing falls in elderly residents in long-term care facilities: a systematic review of randomized controlled trials (RCTs). MEDLINE, EMBASE, CINAHL, and hand searching of reference lists of included RCTs. RCTs that assessed fall incidents (falls, fallers, recurrent fallers, fall-related injuries) among elderly residents in long-term care facilities were included in this narrative review. Two independent reviewers abstracted data: general program characteristics (setting, population, intervention program) and outcomes, detailed program characteristics (assessment, intervention content, individually tailored, multidisciplinary), and implementation aspects (feasibility, implications for practice). The CONSORT Statement 2001 Checklist was used regarding the quality of reporting RCTs. Twenty trials met the inclusion criteria. Seven trials, 4 multifactorial and 3 monofactorial, showed a significant reduction in the fall rate, the percentage of recurrent fallers, or both the fall rate and the percentage of persons sustaining femoral fractures. The positive effective programs were as follows: a comprehensive structured individual assessment with specific safety recommendations; a multidisciplinary program including general strategies tailored to the setting and strategies tailored specifically to residents; a multifaceted intervention including education, environmental adaptation, balance, resistance training, and hip protector; calcium plus vitamin D supplementation; vitamin D supplementation; a clinical medication review; and a multifactorial intervention (fall risk evaluation, specific and general interventions). In general, because of the limited number of included trials

  1. Numerical assessment of conventional regulation effectiveness for ...

    African Journals Online (AJOL)

    ... depends on fire safety engineering that is provided, and which is generally established using smoke spread field and temperature distribution predictions. ... conventional regulation; ventilation strategies; smoke temperature; smoke barriers ...

  2. Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2008-09-01

    Full Text Available Abstract Background Cost of illness studies show that Parkinson disease (PD is costly for individuals, the healthcare system and society. The costs of PD include both direct and indirect costs associated with falls and related injuries. Methods This protocol describes a prospective economic analysis conducted alongside a randomised controlled trial (RCT. It evaluates whether physical therapy is more cost effective than usual care from the perspective of the health care system. Cost effectiveness will be evaluated using a three-way comparison of the cost per fall averted and the cost per quality adjusted life year saved across two physical therapy interventions and a control group. Conclusion This study has the potential to determine whether targetted physical therapy as an adjunct to standard care can be cost effective in reducing falls in people with PD. Trial Registration No: ACTRN12606000344594

  3. Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

    NARCIS (Netherlands)

    Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

    2018-01-01

    BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.

  4. [Effects of physical activity on cognitive functions, balance and risk of falls in elderly patients with Alzheimer's dementia].

    Science.gov (United States)

    Hernandez, Salma S S; Coelho, Flávia G M; Gobbi, Sebastião; Stella, Florindo

    2010-01-01

    To analyze the effects of regular, systematic and supervised activity on the cognitive functions, balance and risk of falls of elderly patients with Alzheimer's Dementia (AD). Sixteen elderly patients (mean age 78.5+/-6.8 years) were divided into two groups: intervention group (IG; n=9) and routine group (RG; n=7). The IG exercised systematically for six months, and both groups were submitted to the following tests: Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) and the agility/dynamic balance (AGIBAL) item of the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) test battery. There was a statistically significant interaction (two-way ANOVA; F1,14=32.07; p=0.01) between groups and moments for the AGIBAL. The Mann Whitney U test indicated significant differences between groups (p=0.03), only at the post-intervention moment for the TUG measured in steps and for BBS. Therefore, no significant intergroup differences were found for the TUG, BBS and MMSE at the pre-intervention moment or at post-intervention moment for the TUG measured in seconds and MMSE. The intragroup analysis by means of the Wilcoxon test showed a significant decline in the TUG, BBS and MMSE for the RG, but not for the IG. Spearman's coefficient showed a significant correlation between the results of the MMSE and AGIBAL. Physical activity may be an important non-pharmacological approach that can benefit cognitive functions and balance and reduce the risk of falls. Moreover, agility and balance are associated with cognitive functions in elderly patients with AD.

  5. Intrinsic factors associated with pregnancy falls.

    Science.gov (United States)

    Wu, Xuefang; Yeoh, Han T

    2014-10-01

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

  6. Pathways from fear of falling to quality of life: the mediating effect of the self-concept of health and physical independence.

    Science.gov (United States)

    Hsu, Yawen; Alfermann, Dorothee; Lu, Frank J H; Lin, Linda L

    2013-01-01

    Fear of falling leads to many adverse consequences and may compromise the quality of life of older adults. Psychological factors are potential mediators between the fear of falling and quality of life, but have yet to be explored in detail. This study presents results from examining the mediating effect of the self-concept of health and physical independence. Data from Western and Eastern countries were compared. Concerns about falling, the level of participation in physical activities, the self-concept of health and physical independence, and health-related quality of life were measured using samples from Taiwan (n = 193) and Germany (n = 182). Multiple regression models were used to test the mediating effects. The relationship between fear of falling and quality of life was partially mediated through participation in physical activities and the self-concept of health and physical independence in both the Taiwanese and German samples. In particular, the self-concept of health and physical independence of the Taiwanese sample resulted in the strongest mediating effect. Potential mediating mechanisms through both participation in physical activities and the self-concept of health and physical independence provide useful information for understanding related theories and for explicating interventions. Cultural factors should also be accounted for when conducting research and programs related to the fear of falling.

  7. Cost-effectiveness of combined oral bisphosphonate therapy and falls prevention exercise for fracture prevention in the USA.

    Science.gov (United States)

    Mori, T; Crandall, C J; Ganz, D A

    2017-02-01

    We developed a Markov microsimulation model among hypothetical cohorts of community-dwelling US white women without prior major osteoporotic fractures over a lifetime horizon. At ages 75 and 80, adding 1 year of exercise to 5 years of oral bisphosphonate therapy is cost-effective at a conventionally accepted threshold compared with bisphosphonates alone. The purpose of this study was to examine the cost-effectiveness of the combined strategy of oral bisphosphonate therapy for 5 years and falls prevention exercise for 1 year compared with either strategy in isolation. We calculated incremental cost-effectiveness ratios [ICERs] (2014 US dollars per quality-adjusted life year [QALY]), using a Markov microsimulation model among hypothetical cohorts of community-dwelling US white women with different starting ages (65, 70, 75, and 80) without prior history of hip, vertebral, or wrist fractures over a lifetime horizon from the societal perspective. At ages 65, 70, 75, and 80, the combined strategy had ICERs of $202,020, $118,460, $46,870, and $17,640 per QALY, respectively, compared with oral bisphosphonate therapy alone. The combined strategy provided better health at lower cost than falls prevention exercise alone at ages 70, 75, and 80. In deterministic sensitivity analyses, results were particularly sensitive to the change in the opportunity cost of participants' time spent exercising. In probabilistic sensitivity analyses, the probabilities of the combined strategy being cost-effective compared with the next best alternative increased with age, ranging from 35 % at age 65 to 48 % at age 80 at a willingness-to-pay of $100,000 per QALY. Among community-dwelling US white women ages 75 and 80, adding 1 year of exercise to 5 years of oral bisphosphonate therapy is cost-effective at a willingness-to-pay of $100,000 per QALY, compared with oral bisphosphonate therapy only. This analysis will help clinicians and policymakers make better decisions about treatment

  8. Effects of the visual-feedback-based force platform training with functional electric stimulation on the balance and prevention of falls in older adults: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zhen Li

    2018-01-01

    Full Text Available Background Force platform training with functional electric stimulation aimed at improving balance may be effective in fall prevention for older adults. Aim of the study is to evaluate the effects of the visual-feedback-based force platform balance training with functional electric stimulation on balance and fall prevention in older adults. Methods A single-centre, unblinded, randomized controlled trial was conducted. One hundred and twenty older adults were randomly allocated to two groups: the control group (n = 60, one-leg standing balance exercise, 12 min/d or the intervention group (n = 60, force platform training with functional electric stimulation, 12 min/d. The training was provided 15 days a month for 3 months by physical therapists. Medial–lateral and anterior–posterior maximal range of sway with eyes open and closed, the Berg Balance Scale, the Barthel Index, the Falls Efficacy scale-International were assessed at baseline and after the 3-month intervention. A fall diary was kept by each participant during the 6-month follow-up. Results On comparing the two groups, the intervention group showed significantly decreased (p < 0.01 medial–lateral and anterior–posterior maximal range of sway with eyes open and closed. There was significantly higher improvement in the Berg Balance Scale (p < 0.05, the Barthel Index (p < 0.05 and the Falls Efficacy Scale-International (p < 0.05, along with significantly lesser number of injurious fallers (p < 0.05, number of fallers (p < 0.05, and fall rates (p < 0.05 during the 6-month follow-up in the intervention group. Conclusion This study showed that the visual feedback-based force platform training with functional electric stimulation improved balance and prevented falls in older adults.

  9. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial.

    NARCIS (Netherlands)

    Faber, M.J.; Bosscher, R.J.; Chin A Paw, M.J.; Wieringen, P. van

    2006-01-01

    OBJECTIVES: To determine the effects of moderate intensity group-exercise programs on falls, functional performance, and disability in older adults; and to investigate the influence of frailty on these effects. DESIGN: A 20-week, multicenter randomized controlled trial, with 52-week follow-up.

  10. Preventing Falls in Older Persons.

    Science.gov (United States)

    Moncada, Lainie Van Voast; Mire, L Glen

    2017-08-15

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

  11. Effects of different foot progression angles and platform settings on postural stability and fall risk in healthy and medial knee osteoarthritic adults.

    Science.gov (United States)

    Khan, Saad Jawaid; Khan, Soobia Saad; Usman, Juliana; Mokhtar, Abdul Halim; Abu Osman, Noor Azuan

    2018-02-01

    This study aims to investigate the effects of varying toe angles at different platform settings on Overall Stability Index of postural stability and fall risk using Biodex Balance System in healthy participants and medial knee osteoarthritis patients. Biodex Balance System was employed to measure postural stability and fall risk at different foot progression angles (ranging from -20° to 40°, with 10° increments) on 20 healthy (control group) and 20 knee osteoarthritis patients (osteoarthritis group) randomly (age: 59.50 ± 7.33 years and 61.50 ± 8.63 years; body mass: 69.95 ± 9.86 kg and 70.45 ± 8.80 kg). Platform settings used were (1) static, (2) postural stability dynamic level 8 (PS8), (3) fall risk levels 12 to 8 (FR12) and (4) fall risk levels 8 to 2 (FR8). Data from the tests were analysed using three-way mixed repeated measures analysis of variance. The participant group, platform settings and toe angles all had a significant main effect on balance ( p ≤ 0.02). Platform settings had a significant interaction effect with participant group F(3, 144) = 6.97, p fall risk as compared to the healthy group. Changing platform settings has a more pronounced effect on balance in knee osteoarthritis group than in healthy participants. Changing toe angles produced similar effects in both the participant groups, with decreased stability and increased fall risk at extreme toe-in and toe-out angles.

  12. Fall prevention in the elderly.

    Science.gov (United States)

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

    2013-05-01

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

  13. Annual Report, Fall 2016: Identifying Cost Effective Tank Waste Characterization Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Reboul, S. H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); DiPrete, D. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-12-12

    This report documents the activities that were performed during the second year of a project undertaken to improve the cost effectiveness and timeliness of SRNL’s tank closure characterization practices. The activities performed during the first year of the project were previously reported in SRNL-STI-2015-00144. The scope of the second year activities was divided into the following three primary tasks: 1) develop a technical basis and strategy for improving the cost effectiveness and schedule of SRNL’s tank closure characterization program; 2) initiate the design and assembly of a new waste removal system for improving the throughput and reducing the personnel dose associated with extraction chromatography radiochemical separations; and 3) develop and perform feasibility testing of three alternative radiochemical separation protocols holding promise for improving high resource demand/time consuming tank closure sample analysis methods.

  14. Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation.

    Science.gov (United States)

    Ko, Dae-Sik; Jung, Dae-In; Jeong, Mi-Ae

    2014-11-01

    [Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessing physical performances. We evaluated depression and fear of falling for assessing psychological functions. [Results] Relative to the control group, the core stability training group showed statistically significant overall changes after the training session: an increase in POMA scores, faster CV, lower MVHC, and a decrease in knee flexion angle. Furthermore, depression and fear of falling decreased significantly. [Conclusion] CSE can have a positive effect on the improvement of physical and psychological performances of older women who are vulnerable to falls as they negotiate everyday obstacles.

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

    Directory of Open Access Journals (Sweden)

    Yan-Chiou Ku

    2013-06-01

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

  16. Effect of isolated vitamin D supplementation on the rate of falls and postural balance in postmenopausal women fallers: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Cangussu, Luciana Mendes; Nahas-Neto, Jorge; Orsatti, Claudio Lera; Poloni, Priscila Ferreira; Schmitt, Eneida Boteon; Almeida-Filho, Benedito; Nahas, Eliana Aguiar Petri

    2016-03-01

    To evaluate the effect of isolated vitamin D supplementation (VITD) on the rate of falls and postural balance in postmenopausal women fallers. In this double-blind, placebo-controlled trial, 160 Brazilian younger postmenopausal women were randomized into two groups: VITD group, vitamin D3 supplementation 1,000 IU/day/orally (n = 80) and placebo group (n = 80). Women with amenorrhea at least 12 months, age 50 to 65 years, and a history of falls (previous 12 months) were included. Those with neurological or musculoskeletal disorders, vestibulopathies, drugs use that could affect balance and osteoporosis were excluded. The intervention time was 9 months. Postural balance was assessed by stabilometry (computerized force platform) and investigation on the occurrence/recurrence of falls was performed by interviews. The plasma concentration of 25-hydroxyvitamin D [25(OH)D] was measured by high-performance liquid chromatography. Statistical analysis was achieved by intention-to-treat, using analysis of variance, Student's t test, Tukey test, chi-square, and logistic regression. After 9 months, mean values of 25(OH)D increased from 15.0 ± 7.5 ng/mL to 27.5 ± 10.4 ng/mL (+45.4%) in the VITD group, and decreased from 16.9 ± 6.7 ng/mL to 13.8 ± 6.0 ng/mL (-18.5%) in the placebo group (P falls was higher in the placebo group (+46.3%) with an adjusted risk of 1.95 (95% confidence interval [CI] 1.23-3.08) times more likely to fall and 2.80 (95% CI 1.43-5.50) times higher for recurrent falls compared to the VITD group (P falls and improvement in postural balance.

  17. Effects of WiiActive exercises on fear of falling and functional outcomes in community-dwelling older adults: a randomised control trial.

    Science.gov (United States)

    Kwok, Boon Chong; Pua, Yong Hao

    2016-09-01

    the study compares the effects of a Nintendo Wii exercise programme and a standard Gym-based exercise intervention on fear of falling, knee strength, physical function and falls rate in older adults. eighty community-dwelling adults aged 60 years and above with short physical performance battery score of 5-9 points and modified falls efficacy scale (MFES) score of ≤9 points participated in the parallel-group randomised trial. Each intervention arm involved an hour of intervention per week, totalling 12 sessions over 12 weeks. Besides 1-year fall incidence, the participants were evaluated on MFES, knee extensor strength (KES), timed-up-and-go test, gait speed, 6-minute walk test and narrow corridor walk test at weeks 13 and 24. at week 13, between interventions, the effect of MFES changes did not reach statistical significance (difference = -0.07 point, 95% CI -0.56 to 0.42, P = 0.78); at week 24, the Wii group showed statistically significant effects over the Gym group (difference = 0.8 point, 95% CI 0.27 to 1.29, P falling when compared to a standard Gym-based exercise intervention; however, post-intervention there was an apparent reduction in fear of falling in the group allocated to Wii training, despite knee strength apparently improving more in those allocated to the Gym. It is possible that long-term gains after using the Wii might be due to a carry-over effect. Australian New Zealand Clinical Trials Registry, ACTRN12610000576022. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2011-03-28

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

  19. Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

    Science.gov (United States)

    Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

    2016-01-01

    Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an

  20. The effect of plant growth regulators, explants and cultivars on ...

    African Journals Online (AJOL)

    To achieve the best explants and media for spinach tissue culture, the effects of two different plant growth regulators, two explants and cultivars on adventitious shoot regeneration were tested. The Analysis of Variance (ANOVA) showed that the effects of plant growth regulators on spinach tissue culture were significant; ...

  1. Fall Enrollment Report. 2014

    Science.gov (United States)

    Iowa Department of Education, 2014

    2014-01-01

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

  2. Causal effects of informal care and health on falls and other accidents among the elderly population in China.

    Science.gov (United States)

    Wu, Hong; Lu, Naiji; Wang, Chenguang; Tu, Xinming

    2018-03-01

    This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g., traffic accidents) among elderly people. We also examine if there are heterogeneous impacts on elderly of different gender, urban status, and past accident history. To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. We use longitudinal data from a representative national China Health and Retirement Longitudinal Study of people aged 45 and older in China. A total of 3935 respondents with two-wave data are included in our study. Each respondent is interviewed to measure health status and report their accident history. Mental health is assessed using CES-D questions. Our findings indicate that while informal care decreased the occurrence of accidents, poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history. Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care of elders into account. Second, ease of birth policy and postponed retirement policy are urgently needed to meet the demands of informal care. Third, medical policies should attach great importance not only to physical health but also mental health of elderly parents especially for older people with accident history.

  3. The effect of serum vitamin D level and bone mineral density on balance and the risk of falling in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Ayşegül Küçükali Türkyılmaz

    2013-01-01

    Full Text Available Objective: The aim of this study was to investigate the effect of bone mineral density and vitamin D level on the risk of falling and balance in postmenopausal women.Methods: The age ranged from 44 to 67 (57.25±7.27 years, 133 postmenopausal women were enrolled. Age, height, weight, socio-demographic information, history of falling and fracture in last year, risk factors for osteoporosis, and menopause duration were recorded. Serum 25OHD3 level and bone mineral density (BMD of participants were measured. Postural balance function and the risk of falling were evaluated by time-up and go test (TUG, and Berg balance scale (BBS. Patients were divided into 4 groups; group 1: low vitamin D and osteoporosis, group 2: only low vitamin D, group 3: only osteoporotic, group 4: normal. Results: There was significant difference between the groups according to TUG (p<0.001. There were significant differences between group 1 and 2, group 1 and 4, group 3 and 4 (each, p= 0.001. There was significant difference between the groups according to BBS (p<0.001. Significant differences were found between group 1 and 2, group 1 and 4, group 2 (each, p<0.001 and 3 (p= 0.002, group 3 and 4 (p<0.001. There were negative correlations between TUG, L1-L4 and femoral neck BMD (r=-0.488, p<0.001 and r =-0.462, p<0.001, respectively. There were positive correlations between BBS, L1-L4 and femoral neck BMD (r=-0.488, p<0.001 and r=-0.462, p<0.001, respectively. Conclusion: We concluded that whereas vitamin D level had no effect on balance and the risk of falling, whereas osteoporosis had effects both on balance and risk of falling. Key words: Vitamin D, bone mineral density, balance, risk of falling

  4. Investigating the effect of education based on need to prevent falling during activities of daily living among the elderlies referring to health centers of Isfahan

    Directory of Open Access Journals (Sweden)

    Marziyeh Ghasemi

    2016-01-01

    Full Text Available Background: Falling has a great importance among the elderlies. Even if no physical injury occurs, it can cause fear of falling down again and, consequently, reduce older adults′ activities. With regard to the prevalence of falling among older adults, its prevention is essential. Therefore, the present study was aimed to define the effect of need-based education on prevention of older adults′ falling during their everyday life activities. Materials and Methods: This is a quasi-experimental study. Study population comprised all the older adults of age 60 years and over referring to health care centers in Isfahan. Through multiple random sampling, 15 older adults were selected from four health care centers. Data collection tool in the present study was Daily Activity Questionnaire. Results: Results showed a significant difference between the mean of daily activity scores in the intervention group before, immediately after, and 1 month after the intervention (12, 13.6, and 13.5, respectively; P = 0.01. Meanwhile, there was no significant deference between the scores immediately after and 1 month after the intervention. There was no significant difference observed between the three time points in the control group (mean = 12.3; P = 0.907. Conclusion: Implementation of education concerning prevention of older adults′ falling led to improvement of their daily activity in the intervention group.

  5. Transfer effects of fall training on balance performance and spatiotemporal gait parameters in healthy community-dwelling older adults: a pilot study.

    Science.gov (United States)

    Donath, Lars; Faude, Oliver; Bridenbaugh, Stephanie A; Roth, Ralf; Soltermann, Martin; Kressig, Reto W; Zahner, Lukas

    2014-07-01

    This study examined transfer effects of fall training on fear of falling (Falls Efficacy Scale-International [FES-I]), balance performance, and spatiotemporal gait characteristics in older adults. Eighteen community-dwelling older adults (ages 65-85) were randomly assigned to an intervention or control group. The intervention group completed 12 training sessions (60 min, 6 weeks). During pre- and posttesting, we measured FES-I, balance performance (double limb, closed eyes; single limb, open eyes; double limb, open eyes with motor-interfered task), and gait parameters (e.g., velocity; cadence; stride time, stride width, and stride length; variability of stride time and stride length) under single- and motor-interfered tasks. Dual tasks were applied to appraise improvements of cognitive processing during balance and gait. FES-I (p = .33) and postural sway did not significantly change (0.36 Fall training did not sufficiently improve fear of falling, balance, or gait performance under single- or dual-task conditions in healthy older adults.

  6. Fall Prevention in a Primary Care Setting.

    Science.gov (United States)

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

    2016-05-27

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

  7. Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

    Directory of Open Access Journals (Sweden)

    Chen Y

    2014-06-01

    Full Text Available Ying Chen,1 Ling-Ling Zhu,2 Quan Zhou3 1Liaison Office of Geriatric VIP Patients, 2First Geriatric VIP Ward, Division of Nursing, 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China Background: Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods: Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Results: Fall-risk-increasing drugs (FRIDs include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer’s agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class and

  8. Withdrawal of fall-risk-increasing drugs in older persons: effect on tilt-table test outcomes

    NARCIS (Netherlands)

    van der Velde, Nathalie; van den Meiracker, Anton H.; Pols, Huibert A. P.; Stricker, Bruno H. Ch; van der Cammen, Tischa J. M.

    2007-01-01

    OBJECTIVES: To determine whether outcomes of tilt-table tests improved after withdrawal of fall-risk-increasing drugs (FRIDs). DESIGN: Prospective cohort study. SETTING: Geriatric outpatient clinic. PARTICIPANTS: Two hundred eleven new, consecutive outpatients, recruited from April 2003 until

  9. Rehabilitation after falls and fractures.

    Science.gov (United States)

    Dionyssiotis, Y; Dontas, I A; Economopoulos, D; Lyritis, G P

    2008-01-01

    Falls are one of the most common geriatric problems threatening the independence of older persons. Elderly patients tend to fall more often and have a greater tendency to fracture their bones. Fractures occur particularly in osteoporotic people due to increased bone fragility, resulting in considerable reduction of quality of life, morbidity, and mortality. This article provides information for the rehabilitation of osteoporotic fractures pertaining to the rehabilitation of the fractured patient, based on personal experience and literature. It also outlines a suggested effective and efficient clinical strategy approach for preventing falls in individual patients.

  10. Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial.

    Science.gov (United States)

    Spink, Martin J; Menz, Hylton B; Fotoohabadi, Mohammad R; Wee, Elin; Landorf, Karl B; Hill, Keith D; Lord, Stephen R

    2011-06-16

    To determine the effectiveness of a multifaceted podiatry intervention in preventing falls in community dwelling older people with disabling foot pain. Parallel group randomised controlled trial. University health sciences clinic in Melbourne, Australia. 305 community dwelling men and women (mean age 74 (SD 6) years) with disabling foot pain and an increased risk of falling. 153 were allocated to a multifaceted podiatry intervention and 152 to routine podiatry care, with 12 months' follow-up. Multifaceted podiatry intervention consisting of foot orthoses, advice on footwear, subsidy for footwear ($A100 voucher; £65; €74), a home based programme of foot and ankle exercises, a falls prevention education booklet, and routine podiatry care for 12 months. The control group received routine podiatry care for 12 months. Proportion of fallers and multiple fallers, falling rate, and injuries resulting from falls during follow-up. Overall, 264 falls occurred during the study. 296 participants returned all 12 calendars: 147 (96%) in the intervention group and 149 (98%) in the control group. Adherence was good, with 52% of the participants completing 75% or more of the requested three exercise sessions weekly, and 55% of those issued orthoses reporting wearing them most of the time. Participants in the intervention group (n=153) experienced 36% fewer falls than participants in the control group (incidence rate ratio 0.64, 95% confidence interval 0.45 to 0.91, P=0.01). The proportion of fallers and multiple fallers did not differ significantly between the groups (relative risk 0.85, 0.66 to 1.08, P=0.19 and 0.63, 0.38 to 1.04, P=0.07). One fracture occurred in the intervention group and seven in the control group (0.14, 0.02 to 1.15, P=0.07). Significant improvements in the intervention group compared with the control group were found for the domains of strength (ankle eversion), range of motion (ankle dorsiflexion and inversion/eversion), and balance (postural sway on the

  11. The Effects of Head Start on Children's Kindergarten Retention, Reading and Math Achievement in Fall Kindergarten--An Application of Propensity Score Method and Sensitivity Analysis

    Science.gov (United States)

    Dong, Nianbo

    2009-01-01

    Using data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), this paper applied optimal propensity score matching method to evaluate the effects of Head Start on children's kindergarten retention, reading and math achievement in fall kindergarten comparing with center-based care. Both parametric and nonparametric…

  12. Effect of comorbidity on relative survival following hospitalisation for fall-related hip fracture in older people.

    Science.gov (United States)

    Hindmarsh, Diane; Loh, Ming; Finch, Caroline F; Hayen, Andrew; Close, Jacqueline C T

    2014-09-01

    To assess the effect of comorbidity on relative survival after hip fracture. Relative survival analysis was undertaken in 16 838 fall-related hip fracture hospitalisations in New South Wales, Australia. Comorbidity was measured on the basis of additional diagnosis codes on the same hospital separation as the hip fracture using the Charlson Comorbidity Index (CCI). Interval-specific relative survival and relative excess risk of death were calculated. Comorbidity was more frequently documented in men than women across the age groups. Survival decreased with increasing age and increasing comorbidity, but the relative impact of comorbidity was greater in the younger-old age group (65-74 years). The excess mortality in men was not accounted for by age or comorbidities. This study demonstrates an association between increasing comorbidity and death particularly in the first 3 months post hip fracture. It also highlights a relative excess risk of death in men after hip fracture after adjusting for age and comorbidity. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

  13. Identifying balance and fall risk in community-dwelling older women: the effect of executive function on postural control.

    Science.gov (United States)

    Muir-Hunter, Susan W; Clark, Jennifer; McLean, Stephanie; Pedlow, Sam; Van Hemmen, Alysia; Montero Odasso, Manuel; Overend, Tom

    2014-01-01

    The mechanisms linking cognition, balance function, and fall risk among older adults are not fully understood. An evaluation of the effect of cognition on balance tests commonly used in clinical practice to assess community-dwelling older adults could enhance the identification of at-risk individuals. The study aimed to determine (1) the association between cognition and clinical tests of balance and (2) the relationship between executive function (EF) and balance under single- and dual-task testing. Participants (24 women, mean age of 76.18 [SD 16.45] years) completed six clinical balance tests, four cognitive tests, and two measures of physical function. Poor balance function was associated with poor performance on cognitive testing of EF. In addition, the association with EF was strongest under the dual-task timed up-and-go (TUG) test and the Fullerton Advanced Balance Scale. Measures of global cognition were associated only with the dual-task performance of the TUG. Postural sway measured with the Standing Balance Test, under single- or dual-task test conditions, was not associated with cognition. Decreased EF was associated with worse performance on functional measures of balance. The relationship between EF and balance was more pronounced with dual-task testing using a complex cognitive task combined with the TUG.

  14. Identifying Balance and Fall Risk in Community-Dwelling Older Women: The Effect of Executive Function on Postural Control

    Science.gov (United States)

    Clark, Jennifer; McLean, Stephanie; Pedlow, Sam; Van Hemmen, Alysia; Montero Odasso, Manuel; Overend, Tom

    2014-01-01

    ABSTRACT Purpose: The mechanisms linking cognition, balance function, and fall risk among older adults are not fully understood. An evaluation of the effect of cognition on balance tests commonly used in clinical practice to assess community-dwelling older adults could enhance the identification of at-risk individuals. The study aimed to determine (1) the association between cognition and clinical tests of balance and (2) the relationship between executive function (EF) and balance under single- and dual-task testing. Methods: Participants (24 women, mean age of 76.18 [SD 16.45] years) completed six clinical balance tests, four cognitive tests, and two measures of physical function. Results: Poor balance function was associated with poor performance on cognitive testing of EF. In addition, the association with EF was strongest under the dual-task timed up-and-go (TUG) test and the Fullerton Advanced Balance Scale. Measures of global cognition were associated only with the dual-task performance of the TUG. Postural sway measured with the Standing Balance Test, under single- or dual-task test conditions, was not associated with cognition. Conclusions: Decreased EF was associated with worse performance on functional measures of balance. The relationship between EF and balance was more pronounced with dual-task testing using a complex cognitive task combined with the TUG. PMID:24799756

  15. Comparison of the effects of virtual reality-based balance exercises and conventional exercises on balance and fall risk in older adults living in nursing homes in Turkey.

    Science.gov (United States)

    Yeşilyaprak, Sevgi Sevi; Yıldırım, Meriç Şenduran; Tomruk, Murat; Ertekin, Özge; Algun, Z Candan

    2016-01-01

    There is limited information on effective balance training techniques including virtual reality (VR)-based balance exercises in residential settings and no studies have been designed to compare the effects of VR-based balance exercises with conventional balance exercises in older adults living in nursing homes in Turkey. The objective of our study was to investigate the effects of VR-based balance exercises on balance and fall risk in comparison to conventional balance exercises in older adults living in nursing homes. A total sample of 18 subjects (65-82 years of age) with fall history who were randomly assigned to either the VR group (Group 1, n = 7) or the conventional exercise group (Group 2, n = 11) completed the exercise training. In both groups, Berg balance score (BBS), timed up & go duration, and left leg stance and tandem stance duration with eyes closed significantly improved with time (p 0.05) after training, indicating that neither the exercise method was superior. Similar improvements were found in balance and fall risk with VR-based balance training and conventional balance training in older adults living in the nursing home. Both exercise trainings can be preferable by health care professionals considering fall prevention. Appropriate patient selection is essential.

  16. Effects of supervised slackline training on postural instability, freezing of gait, and falls efficacy in people with Parkinson's disease.

    Science.gov (United States)

    Santos, Luis; Fernandez-Rio, Javier; Winge, Kristian; Barragán-Pérez, Beatriz; Rodríguez-Pérez, Vicente; González-Díez, Vicente; Blanco-Traba, Miguel; Suman, Oscar E; Philip Gabel, Charles; Rodríguez-Gómez, Javier

    2017-08-01

    The aim of this study was to assess whether supervised slackline training reduces the risk of falls in people with Parkinson's disease (PD). Twenty-two patients with idiopathic PD were randomized into experimental (EG, N = 11) and control (CG, N = 11) groups. Center of Pressure (CoP), Freezing of Gait (FOG), and Falls Efficacy Scale (FES) were assessed at pre-test, post-test and re-test. Rate perceived exertion (RPE, Borg's 6-20 scale) and local muscle perceived exertion (LRPE) were also assessed at the end of the training sessions. The EG group showed significant improvements in FOG and FES scores from pre-test to post-test. Both decreased at re-test, though they did not return to pre-test levels. No significant differences were detected in CoP parameters. Analysis of RPE and LRPE scores revealed that slackline was associated with minimal fatigue and involved the major lower limb and lumbar muscles. These findings suggest that slacklining is a simple, safe, and challenging training and rehabilitation tool for PD patients. It could be introduced into their physical activity routine to reduce the risk of falls and improve confidence related to fear of falling. Implications for Rehabilitation Individuals with Parkinson's disease (PD) are twice as likely to have falls compared to patients with other neurological conditions. This study support slackline as a simple, safe, and challenging training and rehabilitation tool for people with PD, which reduce their risk of falls and improve confidence related to fear of falling. Slackline in people with PD yields a low tiredness or fatigue impact and involves the major lower limb and lumbar muscles.

  17. Assessment of channel changes, model of historical floods, and effects of backwater on flood stage, and flood mitigation alternatives for the Wichita River at Wichita Falls, Texas

    Science.gov (United States)

    Winters, Karl E.; Baldys, Stanley

    2011-01-01

    In cooperation with the City of Wichita Falls, the U.S. Geological Survey assessed channel changes on the Wichita River at Wichita Falls, Texas, and modeled historical floods to investigate possible causes and potential mitigation alternatives to higher flood stages in recent (2007 and 2008) floods. Extreme flooding occurred on the Wichita River on June 30, 2007, inundating 167 homes in Wichita Falls. Although a record flood stage was reached in June 2007, the peak discharge was much less than some historical floods at Wichita Falls. Streamflow and stage data from two gages on the Wichita River and one on Holliday Creek were used to assess the interaction of the two streams. Changes in the Wichita River channel were evaluated using historical aerial and ground photography, comparison of recent and historical cross sections, and comparison of channel roughness coefficients with those from earlier studies. The floods of 2007 and 2008 were modeled using a one-dimensional step-backwater model. Calibrated channel roughness was larger for the 2007 flood compared to the 2008 flood, and the 2007 flood peaked about 4 feet higher than the 2008 flood. Calibration of the 1941 flood yielded a channel roughness coefficient (Manning's n) of 0.030, which represents a fairly clean natural channel. The step-backwater model was also used to evaluate the following potential mitigation alternatives: (1) increasing the capacity of the bypass channel near River Road in Wichita Falls, Texas; (2) removal of obstructions near the Scott Avenue and Martin Luther King Junior Boulevard bridges in Wichita Falls, Texas; (3) widening of aggraded channel banks in the reach between Martin Luther King Junior Boulevard and River Road; and (4) reducing channel bank and overbank roughness. Reductions in water-surface elevations ranged from 0.1 foot to as much as 3.0 feet for the different mitigation alternatives. The effects of implementing a combination of different flood-mitigation alternatives were

  18. Effectiveness and regulation in the Norwegian power supply

    International Nuclear Information System (INIS)

    Kittelsen, S.A.C.

    1994-03-01

    The report deals with the Norwegian research project dubbed ''Effectiveness in the power supply''. The aim of the project was to develop a methodology and a suitable tool (EDB-PC) to assess the cost effectiveness in the electric power distribution network in order to stipulate the average prices of power distribution in the different network levels. Topics cover as follow: Demand of regulation; measuring method and data; measured effectiveness; regulation of the Norwegian power distribution. 52 refs., 15 figs., 6 tabs

  19. Preventing falls and fractures.

    Science.gov (United States)

    Ulfarsson, J; Robinson, B E

    1994-11-01

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

  20. Effect Mechanism of Penstock on Stability and Regulation Quality of Turbine Regulating System

    Directory of Open Access Journals (Sweden)

    Wencheng Guo

    2014-01-01

    Full Text Available This paper studies the effect mechanism of water inertia and head loss of penstock on stability and regulation quality of turbine regulating system with surge tank or not and proposes the construction method of equivalent model of regulating system. Firstly, the complete linear mathematical model of regulating system is established. Then, the free oscillation equation and time response of the frequency that describe stability and regulation quality, respectively, are obtained. Finally, the effects of penstock are analysed by using stability region and response curves. The results indicate that the stability and regulation quality of system without surge tank are determined by time response of frequency which only depends on water hammer wave in penstock, while, for system with surge tank, the time response of frequency depending on water hammer wave in penstock and water-level fluctuation in surge tank jointly determines the stability and regulation quality. Water inertia of penstock mainly affects the stability and time response of frequency of system without surge tank as well as the stability and head wave of time response of frequency with surge tank. Head loss of penstock mainly affects the stability and tail wave of time response of frequency with surge tank.

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

    Science.gov (United States)

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

    2012-01-01

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

  2. Effectiveness of interventions aimed at improving physical and psychological outcomes of fall-related injuries in people with dementia: a narrative systematic review

    Directory of Open Access Journals (Sweden)

    Shannon Robalino

    2018-02-01

    Full Text Available Abstract Background The annual prevalence of falls in people with dementia ranges from 47 to 90%. Falls are a common reason for hospital admission in people with dementia, and there is limited research evidence regarding the care pathways experienced by this population. In addition to immediate management of an injury, prevention of further falls is likely to be an important part of any successful intervention. This review aims to assess the effectiveness of interventions for improving the physical and psychological wellbeing of people with dementia who have sustained a fall-related injury. Methods Systematic review methodologies were employed utilising searches across multiple databases (MEDLINE, CENTRAL, Health Management Information Consortium, EMBASE, CINAHL, Web of Science, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro and citation chaining. Studies including people with a known diagnosis of dementia living in the community and who present at health services with a fall, with or without injury, were included. Outcomes of interest included mobility, recurrent falls, activities of daily living, length of hospital stay, and post-discharge residence. Results were independently reviewed and quality assessed by two researchers, and data extracted using a customised form. A narrative synthesis was performed due to heterogeneity of the included studies. Results Seven studies were included. Interventions clustered into three broad categories: multidisciplinary in-hospital post-surgical geriatric assessment; pharmaceuticals; and multifactorial assessment. Multidisciplinary care and early mobilisation showed short-term improvements for some outcomes. Only an annual administration of zoledronic acid showed long-term reduction in recurrent falls. Conclusions Due to high heterogeneity across the studies, definitive conclusions could not be reached. Most post-fall interventions were not aimed at patients with

  3. Falls in multiple sclerosis.

    Science.gov (United States)

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

    2011-07-01

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

  4. Modelling synergistic effects of appetite regulating hormones

    DEFF Research Database (Denmark)

    Schmidt, Julie Berg; Ritz, Christian

    2016-01-01

    We briefly reviewed one definition of dose addition, which is applicable within the framework of generalized linear models. We established how this definition of dose addition corresponds to effect addition in case only two doses per compound are considered for evaluating synergistic effects. The....... The link between definitions was exemplified for an appetite study where two appetite hormones were studied....

  5. Cost-effectiveness and budget impact of Empirical vitamin D therapy on unintentional falls in older adults in the UK.

    Science.gov (United States)

    Poole, C D; Smith, J; Davies, J S

    2015-09-29

    To evaluate the health outcomes and economics associated with the current guidance relating to the prevention of falls in the elderly through vitamin D supplementation. UK. UK population aged 60 years and above. A Markov health state transition model simulated patient transitions between key fall-related outcomes using a 5-year horizon and annual cycles to assess the costs and benefits of empirical treatment with colecalciferol 800 iu daily. Costs and health outcomes attributable to fall prevention following vitamin D supplementation. Our model shows that treating the UK population aged 60 years and above with 800 iu colecalciferol would, over a 5-year period: (1) prevent in excess of 430,000 minor falls; (2) avoid 190,000 major falls; (3) prevent 1579 acute deaths; (4) avoid 84,000 person-years of long-term care and (5) prevent 8300 deaths associated with increased mortality in long-term care. The greatest gains are seen among those 75 years and older. Based on reduction in falls alone, the intervention in all adults aged 65+ is cost-saving and leads to increased quality adjusted life years. Treating all adults aged 60+ incurs an intervention cost of £2.70bn over 5 years, yet produces a -£3.12bn reduction in fall-related costs; a net saving of £420M. Increasing the lower bound age limit by 5-year increments increases budget impact to -£1.17bn, -£1.75bn, and -£2.06bn for adults 65+, 70+ and 75+, respectively. This study shows that treatment of the elderly UK population with colecalciferol 800 iu daily would be associated with reductions in mortality and substantial cost-savings through fall prevention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Coal marketability: Effects of deregulation and regulation

    International Nuclear Information System (INIS)

    Attanasi, E.

    2000-01-01

    Electrical utility deregulation will force power plants to compete for sales because they will not longer have captive markets. Market uncertainty and uncertainty about future environmental regulations have encouraged power plants to shift to low sulfur coal and/or to use emissions allowances to comply with Phase 2 of the 1990 Clean Air Act Amendments. Mines in Northern and Central Appalachia and the Illinois Basin shipped 240 million tons of non-compliance coal to power plants without scrubbers in 1997. Under Phase 2, this coal will be replaced by low sulfur coal and/or be used with emission permits. It is possible that Powder River Basin coal production will have to increase by over 200 million tons/year to meet new demand. The prices of emissions permits will impose penalties on non-compliance coal that will probably drive out marginal coal producers. For example, if the cost of an emission permit is $200, coal from the Pittsburgh bed could bear a sulfur penalty of $6.55 per ton and similarly, coal from the Herrinbed could bear a penalty of $8.64 per ton

  7. Home Improvements Prevent Falls

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2015-07-01

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

  9. Effect of a balance-training programme on postural balance, aerobic capacity and frequency of falls in women with osteoporosis: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ibolya Miko

    2018-05-01

    Full Text Available Objective: To investigate the effect of a 12-month complex balance-training programme on static and dynamic postural balance, aerobic capacity and frequency of falls in women with established osteoporosis. Design: Randomized controlled trial in which the intervention group was assigned a 12-month exercise programme (3 times a week for 30 min and the control group had no intervention. Subjects: A total of 100 osteoporotic women with at least one previous fracture. Methods: Performance-based Timed Up and Go (TUG, Berg Balance Scale (BBS and stabilometric platform tests were used to evaluate balance. Aerobic capacity was measured by bicycle ergometry. Frequency of falls was assessed using a falls diary. Results: After 1 year, there was a statistically significant difference between the improvement achieved in the intervention and control groups on the performance-based TUG, BBS and stabilometric platform tests (p < 0.05. Mean metabolic equivalent (MET value decreased in the intervention group, from 4.91 to 3.82 (a significant difference from the change achieved in the control group; p = 0.05. Relative risk of falls was 0.534 at 1 year (p = 0.17. Conclusion: The 12-month balance-training programme significantly improved postural balance and increased aerobic capacity in women with established osteoporosis.

  10. Effective regulation under conditions of scientific uncertainty: how collaborative networks contribute to occupational health and safety regulation for nanomaterials

    NARCIS (Netherlands)

    Reichow, Aline

    2015-01-01

    This thesis seeks to understand, and evaluate, the contribution of business associations within the United States (US) and German chemical sector, to the effective regulation of nanomaterials. In the effective regulation of new technologies characterized by high scientific uncertainty, with

  11. Falls in older people

    NARCIS (Netherlands)

    van Dieën, Jaap H.; Pijnappels, Mirjam

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

  12. Falls in Parkinson's disease.

    NARCIS (Netherlands)

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

    2004-01-01

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

  13. Effect of fall-applied nitrogen on growth, nitrogen storage, and frost hardiness of bareroot Larix olgensis seedlings

    Science.gov (United States)

    Guolei Li; Yong Liu; Yan Zhu; Qingmei Li; R. Kasten Dumroese

    2012-01-01

    Nursery response of evergreen trees to fall fertilization has been studied widely, but little attention has been given to deciduous trees. Bareroot Olga Bay larch (Larix olgensis Henry) seedlings were fertilized in the nursery with urea at four rates (0, 30, 60, 90 kg N ha-1), with half of each rate applied on two dates (September 16 and October 1, 2009). The seedlings...

  14. Proprioceptive impairments in high fall risk older adults: the effect of mechanical calf vibration on postural balance.

    Science.gov (United States)

    Toosizadeh, Nima; Ehsani, Hossein; Miramonte, Marco; Mohler, Jane

    2018-05-02

    Impairments in proprioceptive mechanism with aging has been observed and associated with fall risk. The purpose of the current study was to assess proprioceptive deficits among high fall risk individuals in comparison with healthy participants, when postural performance was disturbed using low-frequency mechanical gastrocnemius vibratory stimulation. Three groups of participants were recruited: healthy young (n = 10; age = 23 ± 2 years), healthy elders (n = 10; age = 73 ± 3 years), and high fall risk elders (n = 10; age = 84 ± 9 years). Eyes-open and eyes-closed upright standing balance performance was measured with no vibration, and 30 and 40 Hz vibration of both calves. Vibration-induced changes in balance behaviors, compared to baseline (no vibratory stimulation) were compared between three groups using multivariable repeated measures analysis of variance models. Overall, similar results were observed for two vibration frequencies. However, changes in body sway due to vibration were more obvious within the eyes-closed condition, and in the medial-lateral direction. Within the eyes-closed condition high fall risk participants showed 83% less vibration-induced change in medial-lateral body sway, and 58% less sway velocity, when compared to healthy participants (p balance performance may be explained by reduced sensitivity in peripheral nervous system among older adults with impaired balance.

  15. Kinematic effect of Nintendo Wii(TM) sports program exercise on obstacle gait in elderly women with falling risk.

    Science.gov (United States)

    Jung, Dae-In; Ko, Dae-Sik; Jeong, Mi-Ae

    2015-05-01

    [Purpose] This study evaluated the changes in balance ability and obstacle gait after lumbar stabilization exercise and Nintendo Wii(TM) Sports in elderly at risk for falls. [Subjects and Methods] Twenty-four elderly women with at risk for falls were randomly divided into the control, lumbar stabilization exercise, and Nintendo Wii Sports groups. Static balance was measured by the Berg Balance Scale and functional reach test, dynamic balance by the timed up-and-go test, and obstacle negotiation function by crossing velocity and maximum vertical heel clearance. [Results] Both the lumbar stabilization exercise and Nintendo Wii Sports groups showed significant improvements in obstacle negotiation function after the exercise compared to the control group. Berg Balance Scale and functional reach test scores were greater in the lumbar stabilization exercise group, while the timed up-and-go test time was significantly better in the Nintendo Wii Sports groups. [Conclusion] Lumbar stabilization exercises and Nintendo Wii Sports improve falling related balance and obstacle negotiation function in elderly women at risk for falls.

  16. Kinematic effect of Nintendo WiiTM sports program exercise on obstacle gait in elderly women with falling risk

    Science.gov (United States)

    Jung, Dae-In; Ko, Dae-Sik; Jeong, Mi-Ae

    2015-01-01

    [Purpose] This study evaluated the changes in balance ability and obstacle gait after lumbar stabilization exercise and Nintendo WiiTM Sports in elderly at risk for falls. [Subjects and Methods] Twenty-four elderly women with at risk for falls were randomly divided into the control, lumbar stabilization exercise, and Nintendo Wii Sports groups. Static balance was measured by the Berg Balance Scale and functional reach test, dynamic balance by the timed up-and-go test, and obstacle negotiation function by crossing velocity and maximum vertical heel clearance. [Results] Both the lumbar stabilization exercise and Nintendo Wii Sports groups showed significant improvements in obstacle negotiation function after the exercise compared to the control group. Berg Balance Scale and functional reach test scores were greater in the lumbar stabilization exercise group, while the timed up-and-go test time was significantly better in the Nintendo Wii Sports groups. [Conclusion] Lumbar stabilization exercises and Nintendo Wii Sports improve falling related balance and obstacle negotiation function in elderly women at risk for falls. PMID:26157228

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-09-01

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

  18. Capital Allocation Effects of Financial Reporting Regulation

    NARCIS (Netherlands)

    Koenigsgruber, R.

    2012-01-01

    This paper analyses the effects of stricter financial reporting enforcement on capital allocation and reporting quality in a game-theoretic model and derives conclusions about optimal enforcement strictness. Analysis of the model shows that reporting quality strictly increases with tighter

  19. Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period.

    Science.gov (United States)

    Fraser, Lisa-Ann; Adachi, Jonathan D; Leslie, William D; Goltzman, David; Josse, Robert; Prior, Jerilynn; Kaiser, Stephanie; Kreiger, Nancy; Kovacs, Christopher S; Anastassiades, Tassos P; Papaioannou, Alexandra

    2014-08-01

    Many medications used in older adults have strong anticholinergic (ACH) properties, which may increase the risk of falls and fractures. Use of these medications was identified in a population-based Canadian cohort. To identify the fall and fracture risk associated with ACH medication use. Data collection and analysis were conducted at baseline, year 5, and year 10. Cross-sectional analyses were performed to examine associations between ACH medication use and falls. Time-dependent Cox regression was used to examine time to first nontraumatic fracture. Finally, change in bone mineral density (BMD) over 10 years was compared in ACH medication users versus nonusers. Strongly ACH medications were used by 618 of 7753 participants (8.0%) at study baseline, 592 (9.5%) at year 5, and 334 (7.7%) at year 10. Unadjusted ACH medication use was associated with falls at baseline (odds ratio = 1.50; 95% CI = 1.14-1.98; P = 0.004), but the association was no longer significant after covariate adjustment. Similar results occurred at years 5 and 10. ACH medication use was associated with increased incident fracture risk before (hazard ratio = 1.22; CI = 1.13-1.32; P < 0.001) but not after covariate adjustment. Mean (SD) change in femoral neck BMD T-score over 10 years, in those using ACH medications at both years 0 and 5, was -0.60 (0.63) in ACH users versus -0.49 (0.45) in nonusers (P = 0.041), but this was not significant after covariate adjustment. ACH medications were not found to be independently associated with an increased risk of falling, fractures, or BMD loss. Rather, factors associated with ACH medication use explained the apparent associations. © The Author(s) 2014.

  20. Fall Prevention: Simple Tips to Prevent Falls

    Science.gov (United States)

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

  1. Effect of forearm axially rotated posture on shoulder load and shoulder abduction / flexion angles in one-armed arrest of forward falls.

    Science.gov (United States)

    Hsu, Hsiu-Hao; Chou, You-Li; Lou, Shu-Zon; Huang, Ming-Jer; Chou, Paul Pei-Hsi

    2011-03-01

    Falling onto the outstretched hand is the most common cause of upper extremity injury. This study develops an experimental model for evaluating the shoulder load during a simulated forward fall onto one hand with three different forearm axially rotated postures, and examines the shoulder abduction angle and shoulder flexion angle in each case. Fifteen healthy young male subjects with an average age of 23.7 years performed a series of one-armed arrests from a height of 5 cm onto a force plate. The kinematics and kinetics of the upper extremity were analyzed for three different forearm postures, namely 45° externally rotated, non-rotated, and 45° internally rotated. The shoulder joint load and shoulder abduction/flexion angles were significantly dependent on the rotational posture of the forearm. The shoulder medio-lateral shear forces in the externally rotated group were found to be 1.61 and 2.94 times higher than those in the non-rotated and internally rotated groups, respectively. The shoulder flexion angles in the externally rotated, non-rotated and internally rotated groups were 0.6°, 8.0° and 19.2°, respectively, while the corresponding shoulder abduction angles were 6.1°, 34.1° and 46.3°, respectively. In falls onto the outstretched hand, an externally rotated forearm posture should be avoided in order to reduce the medio-lateral shear force acting on the shoulder joint. In falls of this type, a 45° internally rotated forearm posture represents the most effective fall strategy in terms of minimizing the risk of upper extremity injuries. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Heat transfer analysis and effects of feeding tubes arrangement, falling film behavior and backsplash on ice formation around horizontal tubes bundles

    International Nuclear Information System (INIS)

    Sait, Hani Hussain

    2013-01-01

    Highlights: • Ice shape around the tubes. • Effects of accumulation of ice around the tubes. • Effects of parallel and series tubes arrangements. • Effects of ice accumulated around the tube surfaces. • Effects of backsplash on ice formation. - Abstract: Excessive electrical load has recently get a lot of attention from electric companies specially in hot countries like Saudi Arabia, where air-conditioning load represents about 75% from the total electrical load. Energy storage by freezing is one of the methods that used to tackle this issue. Ice is formed around horizontal cold tubes that are subjected to falling film of water. Ice quantity is measured, photographed and studied. In this studied the coolant inside the tubes flows in series tube arrangement. The results are compared with previous study in which parallel arrangement was used. In addition the falling film behavior and the resulted backsplash are also investigated. A mathematical model to predict ice formation around the tube is proposed. Comparison of the results of the model with that of the experiments showed that the agreement between the two is acceptable. The results also show a quite reasonable quantity of ice is formed in a short time and the series arrangement is more efficient than parallel one. The falling film shapes and its backsplash has also affected the ice formation

  3. Exergames for women with fibromyalgia: a randomised controlled trial to evaluate the effects on mobility skills, balance and fear of falling

    Directory of Open Access Journals (Sweden)

    Daniel Collado-Mateo

    2017-04-01

    Full Text Available Background Exergames are a new form of rehabilitation that combine the characteristics of physical exercise and the benefits of non-immersive virtual reality (VR. Effects of this novel therapy in women fibromyalgia are still unknown. The objective was to evaluate the effects of exergame-based intervention on mobility skills, balance and fear of falling in women with fibromyalgia. Methods This study was a randomized controlled trial with concealed allocation. Seventy-six women with fibromyalgia were divided into two groups: the exercise group received an eight week intervention based on exergames, while the control group continued their usual activities. Mobility skills were evaluated using the timed up and go test, while balance was assessed using the functional reach test, and the CTSIB protocol. Fear of falling was evaluated on a scale of 0–100 (0, no fear; 100, extreme fear. Measurements were performed before and after the intervention. A repeated-measures linear mixed model was used to compare the effects of the intervention between the two groups. Results The exercise group was significantly quicker than the control group in the timed up and go test (MD, −0.71; 95% CI [−1.09–0.32]; p < 0.001. There were also significant improvements in functional reach and a reduced fear of falling (MD, 4.34; 95% CI [1.39–7.30]; p = 0.005 and MD, −9.85; 95% CI [−0.19–−0.08]; p = 0.048, respectively. Discussion The improved TUG observed herein was better than the smallest real difference. Based on the results on mobility skills, balance and fear of falling, exergames may be an effective tool as a therapy for women with fibromyalgia.

  4. Effectiveness of Senior Dance on risk factors for falls in older adults (DanSE): a study protocol for a randomised controlled trial

    Science.gov (United States)

    Franco, Marcia R; Sherrington, Catherine; Tiedemann, Anne; Pereira, Leani S; Perracini, Monica R; Faria, Claudia R S; Pinto, Rafael Z; Pastre, Carlos M

    2016-01-01

    Introduction Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. Methods and analysis This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. Ethics and dissemination Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be

  5. The effect of enhanced trunk control on balance and falls through bilateral upper extremity exercises among chronic stroke patients in a standing position

    OpenAIRE

    Shin, Ji Won; Don Kim, Kyoung

    2016-01-01

    [Purpose] This study examined the effects of bilateral upper extremity exercises on trunk control, balance, and risk of falls in stroke patients. [Subjects and Methods] A total of 30 study subjects were selected and randomly divided into experimental and control groups containing 15 subjects each, who received bilateral upper extremity activities and conventional rehabilitation treatment, respectively. [Results] There were statistically significant differences between groups in all sub-items ...

  6. Effects of Different Exercise Interventions on Risk of Falls, Gait Ability, and Balance in Physically Frail Older Adults: A Systematic Review

    OpenAIRE

    Cadore, Eduardo Lusa; Rodriguez-Manas, Leocadio; Sinclair, Alan; Izquierdo, Mikel

    2013-01-01

    The aim of this review was to recommend training strategies that improve the functional capacity in physically frail older adults based on scientific literature, focusing specially in supervised exercise programs that improved muscle strength, fall risk, balance, and gait ability. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus, and ScienceDirect databases were searched from 1990 to 2012. Studies must have mentioned the effects of exercise training on at least one of the followi...

  7. Community-based osteoporosis prevention: Physical activity in relation to bone density, fall prevention, and the effect of training programmes : The Vadstena Osteoporosis Prevention Project

    OpenAIRE

    Grahn Kronhed, Ann-Charlotte

    2003-01-01

    This thesis is based on studies of the ten-year community-based intervention programme entitled, the Vadstena Osteoporosis Prevention Project (VOPP). The specific aims of the research were to describe the effects of physical activity and training programmes on bone mass and balance performance in adults, to determine whether a fall risk prevention programme could motivate personal actions among the elderly, to ascertain whether the intervention programme could reduce the incidence of forearm ...

  8. Fall prevention in the elderly

    Science.gov (United States)

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

    2013-01-01

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

  9. The Effects of the Pilates Training Method on Balance and Falls of Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Moreno-Segura, Noemi; Igual-Camacho, Celedonia; Ballester-Gil, Yéntel; Blasco-Igual, María Clara; Blasco, Jose María

    2018-04-01

    Exercising with the Pilates method may be a beneficial treatment to improve balance and decrease the number of falls. To ascertain this, our search in 7 databases included 15 randomized controlled trials in which Pilates was the primary intervention. Participants were over 60 years of age; the outcomes were related to balance and falls. The Cochrane tool and PEDro scale were used to assess risk of bias and quality of individual studies. Current evidence supported the view that exercising with the Pilates method improves the balance of older adults with a high practical effect in terms of the dynamic (SMD = 0.75 [0.17;1.32]), static (SMD = 1.33 [0.53;2.13]), and overall balance (SMD = 0.96[0.00;1.91]). Pilates also produced greater improvements with a moderate effect in terms of the dynamic (SMD = 0.37[-0.36;1.11]) and overall balance (SMD = 0.58[0.19;0.96]) compared to other training approaches oriented to the same end. Literature evaluating the effects on falls is scarce, and results were not conclusive.

  10. The Effects of Liquidity Regulation on Bank Assets and Liabilities

    OpenAIRE

    Patty Duijm; Peter Wierts

    2014-01-01

    Under Basel III rules, banks become subject to a liquidity coverage ratio (LCR) from 2015 onwards, to promote short-term resilience. We investigate the effects of such liquidity regulation on bank liquid assets and liabilities. Results indicate co-integration of liquid assets and liabilities, to maintain a minimum short-term liquidity buffer. Still, microprudential regulation has not prevented an aggregate liquidity cycle characterised by a pro-cyclical pattern in the size of balance sheets a...

  11. Effects of risk-based multifactorial fall prevention on health-related quality of life among the community-dwelling aged: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Isoaho Raimo

    2007-04-01

    Full Text Available Abstract Background This study aimed to assess the effects of a risk-based, multifactorial fall prevention programme on health-related quality of life among the community-dwelling aged who had fallen at least once during the previous 12 months. Methods The study is a part of a single-centre, risk-based, multifactorial randomised controlled trial. The intervention lasted for 12 months and consisted of a geriatric assessment, guidance and treatment, individual instruction in fall prevention, group exercise, lectures on themes related to falling, psychosocial group activities and home exercise. Of the total study population (n = 591, 97% of eligible subjects, 513(251 in the intervention group and 262 in the control group participated in this study. The effect of the intervention on quality of life was measured using the 15D health-related quality of life instrument consisting of 15 dimensions. The data were analysed using the chi-square test or Fisher's exact test, the Mann-Whitney U-test and logistic regression. Results In men, the results showed significant differences in the changes between the intervention and control groups in depression (p = 0.017 and distress (p = 0.029 and marginally significant differences in usual activities (p = 0.058 and sexual activity (p = 0.051. In women, significant differences in the changes between the groups were found in usual activities (p = 0.005 and discomfort/symptoms (p = 0.047. For the subjects aged 65 to 74 years, significant differences in the changes between the groups were seen in distress (p = 0.037 among men and in usual activities (p = 0.011 among women. All improvements were in favour of the intervention group. Conclusion Fall prevention produced positive effects on some dimensions of health-related quality of life in the community-dwelling aged. Men benefited more than women.

  12. Effects of fall and spring seeding date and other agronomic factors on infestations of root maggots, Delia spp. (Diptera: Anthomyiidae), in canola.

    Science.gov (United States)

    Dosdall, L M; Clayton, G W; Harker, K N; O'Donovan, J T; Stevenson, F C

    2006-10-01

    Several agronomic benefits can result from fall seeding of canola (Brassica spp.), but extensive research data are lacking on the potential impact of this practice on infestations of root maggots (Delia spp.) (Diptera: Anthomyiidae), which are major pests of the crop in western Canada. Field experiments making up 13 location by year combinations were conducted in central Alberta, Canada, from 1998 to 2001 to determine the effect of fall versus spring seeding of canola on root maggot damage. Depending on the experiment, interactions with seeding rate, seed treatment, timing of weed removal, and canola species (cultivar) also were investigated. Root maggot damage declined with an increase in seeding rate for plots seeded in May but not in fall or April. Susceptibility to infestation was greater for plants of Brassica rapa L. than Brassica napus L., but seed treatment had no effect on damage by these pests. Combined analysis using data from all experiment by location by year combinations indicated that seeding date had no significant effect on root maggot damage. The extended emergence of Delia spp. adults, which spans the appearance of crop stages vulnerable to oviposition regardless of seeding date, prevented reduced root maggot attack. Covariance analysis demonstrated the importance of increasing seeding rate for reducing root maggot infestations, a practice that can be especially beneficial for May-seeded canola when growing conditions limit the ability of plants to compensate for root maggot damage. Results determined with the small plot studies described here should be validated in larger plots or on a commercial field scale, but both the combined and covariance analyses indicate that seeding canola in fall does not predispose plants to greater damage by larval root maggots than seeding in spring.

  13. The effect of perindopril on postural instability in older people with a history of falls-a randomised controlled trial.

    Science.gov (United States)

    Sumukadas, Deepa; Price, Rosemary; McMurdo, Marion E T; Rauchhaus, Petra; Struthers, Allan; McSwiggan, Stephen; Arnold, Graham; Abboud, Rami; Witham, Miles

    2018-01-01

    double-blind, parallel group, placebo-controlled randomised trial. we recruited people aged >65 years with at least one fall in the previous year. Participants received 4 mg perindopril or placebo daily for 15 weeks. The primary outcome was the between-group difference in force-plate measured anteroposterior (AP) sway at 15 weeks. Secondary outcomes included other measures of postural sway, limits of stability during maximal forward, right and left leaning, blood pressure, muscle strength, 6-min walk distance and falls. The primary outcome was assessed using two-way ANOVA, adjusted for baseline factors. we randomised 80 participants. Mean age was 78.0 (SD 7.4) years; 60 (75%) were female. About 77/80 (96%) completed the trial. At 15 weeks there were no significant between-group differences in AP sway with eyes open (mean difference 0 mm, 95% CI -8 to 7 mm, P = 0.91) or eyes closed (mean difference 2 mm, 95% CI -7 to 12 mm, P = 0.59); no differences in other measures of postural stability, muscle strength or function. About 16/40 (42%) of patients in each group had orthostatic hypotension at follow-up. The median number (IQR) of falls was 1 (0,4) in the perindopril versus 1 (0,2) in the placebo group (P = 0.24). perindopril did not improve postural sway in older people at risk of falls. ISRCTN58995463. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

  14. Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.

    Science.gov (United States)

    Sungkarat, Somporn; Boripuntakul, Sirinun; Chattipakorn, Nipon; Watcharasaksilp, Kanokwan; Lord, Stephen R

    2017-04-01

    To examine whether combined center- and home-based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment (a-MCI). Randomized controlled trial. Chiang Mai, Thailand. Adults aged 60 and older who met Petersen's criteria for multiple-domain a-MCI (N = 66). Three weeks center-based and 12 weeks home-based Tai Chi (50 minutes per session, 3 times per week). Cognitive tests, including Logical Memory (LM) delayed recall, Block Design, Digit Span forward and backward, and Trail-Making Test Part B-A (TMT B-A), and fall risk index using the Physiological Profile Assessment (PPA). At the end of the trial, performance on LM, Block Design, and TMT B-A were significantly better for the Tai Chi group than the control group after adjusting for baseline test performance. The Tai Chi group also had significantly better composite PPA score and PPA parameter scores: knee extension strength, reaction time, postural sway, and lower limb proprioception. Combined center- and home-based Tai Chi training three times per week for 15 weeks significantly improved cognitive function and moderately reduced physiological fall risk in older adults with multiple-domain a-MCI. Tai Chi may be particularly beneficial to older adults with this condition. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  15. The effect of Tai Chi Chuan in reducing falls among elderly people: design of a randomized clinical trial in the Netherlands [ISRCTN98840266].

    NARCIS (Netherlands)

    Zeeuwe, P.E.; Verhagen, A.P.; Bierma-Zeinstra, S.M.; Rossum, E. van; Faber, M.J.; Koes, B.W.

    2006-01-01

    BACKGROUND: Falls are a significant public health problem. Thirty to fifty percent of the elderly of 65 years and older fall each year. Falls are the most common type of accident in this age group and can result in fractures and subsequent disabilities, increased fear of falling, social isolation,

  16. The effect of Tai Chi Chuan in reducing falls among elderly people: design of a randomized clinical trial in the Netherlands [ISRCTN98840266].

    NARCIS (Netherlands)

    P.E. Zeeuwe (Petra); A.P. Verhagen (Arianne); S.M. Bierma-Zeinstra (Sita); E. van Rossum (Erik); M.J. Faber (Marjan); B.W. Koes (Bart)

    2006-01-01

    textabstractBACKGROUND: Falls are a significant public health problem. Thirty to fifty percent of the elderly of 65 years and older fall each year. Falls are the most common type of accident in this age group and can result in fractures and subsequent disabilities, increased fear of falling, social

  17. Sensory impairment in hip-fracture patients 65 years or older and effects of hearing/vision interventions on fall frequency

    Directory of Open Access Journals (Sweden)

    Else V Grue

    2008-11-01

    Full Text Available Else V Grue1, Marit Kirkevold2, Petter Mowinchel3, Anette H Ranhoff41Diakonhjemmet University College, Department of Research and Development, Oslo, Norway; 2University of Oslo, Department of Medisin, Institute of Nursing Sciences and Health Profession, Oslo, Norway; 3Department of Paediatrics, Woman-child division, Ullevål University Hospital Oslo, Norway; 4Diakonhjemmet Hospital, Geriatric Unit, Oslo, NorwayAim: Examine the effect of nursing interventions to improve vision and hearing, systematic assessment, and referral to sensory specialists on falling.Methods: Controlled intervention trial targeting hip fracture patients, 65 years and older, living at home and having problems seeing/reading regular print (VI or hearing normal speech (HI. Intervention group = 200, control group = 131. The InterRAI-AcuteCare (RAI-AC and the Combined-Serious-Sensory-Impairment interview guide (KAS-Screen were used. Follow-up telephone calls were done every third month for one year.Results: Mean age was 84.2 years, 79.8% were female, and 76.7% lived alone. HI was detected in 80.7% and VI in 59.8%. Falling was more frequent among the intervention group (P = 0.003 and they also more often moved to a nursing home (P < 0.001 and were dependent walking up stairs (P = 0.003.Conclusions: This study could not document the effect of intervention on falling, possibly because of different base line characteristics (more females, P = 0.018, and more living alone P = 0.011 in the intervention group, differences in nursing care between subjects, and different risk factors. Interventions to improve sensory function remain important in rehabilitation, but have to be studied further.Keywords: vision, hearing, hip fracture, falls, intervention, hospital

  18. Meteorite falls in Africa

    Science.gov (United States)

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

    2017-10-01

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

  19. Preventing falls in hospital.

    Science.gov (United States)

    Pearce, Lynne

    2017-02-27

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

  20. Effect of an aerobic exercise intervention on cardiac autonomic regulation

    DEFF Research Database (Denmark)

    Hallman, David M; Holtermann, Andreas; Søgaard, Karen

    2017-01-01

    obtained at baseline and at 4-month follow-up. Time and frequency domain indices of HRV were derived during work, leisure time and sleep to evaluate cardiac autonomic regulation. Linear mixed models were used to determine the effect of the intervention on HRV indices, with adjustment for age, gender...... and daily use of antihypertensive and/or heart medication. RESULTS: Compared with the reference group, the exercise group increased all HRV indices apart from a reduction in LF/HF ratio from baseline to follow-up both during work (psleep, the HRV indices......, but not during sleep. The health effect of this contrasting change in autonomic regulation needs further investigation....

  1. Effects of anger regulation and social anxiety on perceived stress

    Directory of Open Access Journals (Sweden)

    Ayano Yamaguchi

    2015-08-01

    Full Text Available The mediating role of social anxiety was explored within the effect of anger regulation on perceived stress in the national sample of American and Japanese older adults. Results indicated that anger suppression is a significant factor in perceived stress mediated by social anxiety. Anger suppression was also directly related to perceived stress. The correlation of anger suppression with social anxiety was stronger in Japan than in the United States. Understanding both universal and culture-specific aspects of emotion regulation and perceived stress will be essential for the development of sound theory, future research, and effective prevention and intervention efforts.

  2. Falls prevention for the elderly

    Directory of Open Access Journals (Sweden)

    Dagmar Lühmann

    2012-04-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  4. The Canadian Government perspective on cost-effective regulation

    Energy Technology Data Exchange (ETDEWEB)

    Martin, J K; Iwankow, C [Treasury Board of Canada Secretariat, Ottawa, ON (Canada)

    1997-12-31

    Fiscal constraint, globalization of markets, and accelerated technological change have resulted in a new focus on the cost-effectiveness of government activities and, in turn, on methods of policy evaluation. An exploration of regulatory problems, and the use of regulation as a public policy instrument, reveals a commonalty of experience in all industrialized countries. This paper provides a brief synopsis of the Government of Canada`s perspective on cost-effective regulation. To understand cost-effective regulation, this paper examines the principles of regulatory reform which underlie the current strategy of the federal government (collaborative decision-making mechanisms., methods of clear policy evaluation, and well defined lines of accountability). It discusses the nature of, and rationale for, government regulation, the reasons for regulatory reform in the economy, and the principal aims of Canadian regulatory reform and regulatory policy assessment. It does so by specifically addressing the role of cost-benefit analysis in the process of regulatory assessment - a method which involves systematically identifying, and quantifying where possible, the social benefits and costs associated with alternative public policy actions - with a particular focus on regulation which affects the Canadian nuclear industry. (author). 51 refs.

  5. The Canadian Government perspective on cost-effective regulation

    International Nuclear Information System (INIS)

    Martin, J.K.; Iwankow, C.

    1996-01-01

    Fiscal constraint, globalization of markets, and accelerated technological change have resulted in a new focus on the cost-effectiveness of government activities and, in turn, on methods of policy evaluation. An exploration of regulatory problems, and the use of regulation as a public policy instrument, reveals a commonalty of experience in all industrialized countries. This paper provides a brief synopsis of the Government of Canada's perspective on cost-effective regulation. To understand cost-effective regulation, this paper examines the principles of regulatory reform which underlie the current strategy of the federal government (collaborative decision-making mechanisms., methods of clear policy evaluation, and well defined lines of accountability). It discusses the nature of, and rationale for, government regulation, the reasons for regulatory reform in the economy, and the principal aims of Canadian regulatory reform and regulatory policy assessment. It does so by specifically addressing the role of cost-benefit analysis in the process of regulatory assessment - a method which involves systematically identifying, and quantifying where possible, the social benefits and costs associated with alternative public policy actions - with a particular focus on regulation which affects the Canadian nuclear industry. (author). 51 refs

  6. Effects of augmented reality-based Otago exercise on balance, gait, and physical factors in elderly women to prevent falls: a randomized controlled trial.

    Science.gov (United States)

    Lee, Jin; Yoo, Ha-Na; Lee, Byoung-Hee

    2017-09-01

    [Purpose] To determine the effect of augmented reality (AR)-based otago exercise on muscle strength, balance, and physical factors in falls of elderly women. [Subjects and Methods] Thirty subjects were randomly assigned to AR group (AR, n=10), yoga group (yoga, n=10), and self-exercise group (self, n=10). For 12 weeks, these groups were given lessons related to AR-based otago exercise including strengthening, balance training, or yoga three times a week (60 minutes each time) and self-exercise using elastic band exercise program. [Results] Knee flexion and ankle dorsiflexion strength were significantly improved in all three groups (AR, yoga, and self-exercise groups). Regarding balance, eye open center of pressure-x (EO CoP-x) was significantly decreased in AR group and yoga group. However, eye close CoP-x, eye open standard deviation-x (EO SD-x), and eye open height of ellipse (EO HoE) were only significantly decreased in AR group. AR group also showed meaningfully improved results in morse fall scale. [Conclusion] Augmented reality-based otago exercise can improve muscle strength, balance, and physical factors in elderly women to prevent falls.

  7. Effects of dual-task cognitive-gait intervention on memory and gait dynamics in older adults with a history of falls: a preliminary investigation.

    Science.gov (United States)

    You, Joshua H; Shetty, Anand; Jones, Tawaih; Shields, Kimberli; Belay, Yordanos; Brown, Deborah

    2009-01-01

    The present study highlights the effects of the dual-task cognitive-gait intervention (CGI) on working memory and gait functions in older adults with a history of falls. Thirteen older adults with a history of falls were recruited from local community centers and randomly stratified into either the control (n = 5) or experimental (n = 8) group. The experimental group received the dual-task cognitive-motor intervention involving simultaneous motor (walking) and cognitive (memory recall) task whereas the control group received a placebo treatment (walking with simple music). The intervention was provided 30 minutes per session, over a 6-week period. Memory measures included a combination of word recall and arithmetic task. Gait function measures included velocity and center of pressure (COP) stability. Non-parametric tests were used at p memory performance than the control (p long-term dual-task cognitive-motor intervention improved memory of older adults with a history of falls under the dual cognitive motor task condition.

  8. Effects of dance exergaming on depressive symptoms, fear of falling and musculoskeletal function in fallers and non-fallers community-dewlling older women.

    Science.gov (United States)

    Rodrigues, Elisângela Valevein; Gallo, Luiza Herminia; Guimarães, Ana Tereza Bittencourt; Melo Filho, Jarbas; Luna, Bruna Cavon; Gomes, Anna Raquel Silveira

    2018-04-19

    The aim of this study was to evaluate the effects of a pop dance exergaming protocol on fall risk factors-depressive symptoms, fear of falling and musculoskeletal function-in community-dwelling, older female fallers and non-fallers. There were 47 community-dwelling older women assigned to the Intervention Group [fallers (n=10, 69.8 ± 4.3 years); non-fallers (n = 12, 68.9 ± 3.3 years)] or the Control Group [fallers (n = 12, 73.6 ± 5.4 years); non-fallers (n = 13, 68.7 ± 4.8 years)]. The Control Group maintained their lifestyle and the Intervention Group performed a videogame dance training three times per week for 12 weeks. The Dance Central game for XBOX 360® and Kinect motion sensor was used. The primary outcomes were geriatric depressive symptoms, fear of falling, and concentric and eccentric isokinetic peak torque of quadriceps and hamstrings. Secondary outcomes included cross-sectional area of quadriceps and hamstrings muscles, functionality (Timed Up and Go test, gait speed, the Five Times Sit-to-Stand test) and a fall circumstances and outcomes inventory. The depressive symptoms decreased in the Intervention Fallers Group. The eccentric hamstrings peak torque at 180°/s increased in the Intervention Non-fallers Group. There were no significant differences between groups for the other variables analyzed. The training attendance was 83% for the Intervention Fallers Group and 88% for the Intervention Non-fallers Group. Dance exergaming can be indicated to decrease depressive symptoms in fallers and increase the peak torque in non-fallers among community-dwelling older women.

  9. The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall.

    Science.gov (United States)

    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.

  10. Environmental effects on hormonal regulation of testicular descent

    DEFF Research Database (Denmark)

    Toppari, J; Virtanen, H E; Skakkebaek, N E

    2006-01-01

    cause some cases of undescended testis. Similarly, androgen insensitivity or androgen deficiency can cause cryptorchidism. Estrogens have been shown to down regulate INSL3 and thereby cause maldescent. Thus, a reduced androgen-estrogen ratio may disturb testicular descent. Environmental effects changing......Regulation of testicular descent is hormonally regulated, but the reasons for maldescent remain unknown in most cases. The main regulatory hormones are Leydig cell-derived testosterone and insulin-like factor 3 (INSL3). Luteinizing hormone (LH) stimulates the secretion of these hormones...... hypothesize that an exposure to a mixture of chemicals with anti-androgenic or estrogenic properties (either their own activity or their effect on androgen-estrogen ratio) may be involved in cryptorchidism....

  11. Effect of regulating anger and sadness on decision-making.

    Science.gov (United States)

    Szasz, Paul Lucian; Hofmann, Stefan G; Heilman, Renata M; Curtiss, Joshua

    2016-11-01

    The aim of the current study was to investigate the effects of reappraisal, acceptance, and rumination for regulating anger and sadness on decision-making. Participants (N = 165) were asked to recall two autobiographical events in which they felt intense anger and sadness, respectively. Participants were then instructed to reappraise, accept, ruminate, or not use any strategies to regulate their feelings of anger and sadness. Following this manipulation, risk aversion, and decision-making strategies were measured using a computer-based measure of risk-taking and a simulated real-life decision-making task. Participants who were instructed to reappraise their emotions showed the least anger and sadness, the most adaptive decision-making strategies, but the least risk aversion as compared to the participants in the other conditions. These findings suggest that emotion regulation strategies of negative affective states have an immediate effect on decision-making and risk-taking behaviors.

  12. Effects of Social Isolation on Glucocorticoid Regulation in Social Mammals

    Science.gov (United States)

    Hawkley, Louise C.; Cole, Steve W.; Capitanio, John P.; Norman, Greg J.; Cacioppo, John T.

    2012-01-01

    The regulation and function of the hypothalamic-pituitary-adrenocortical (HPA) axis and glucocorticoids have been well conserved across vertebrate species. Glucocorticoids influence a wide range of physiological functions that include glucose regulation, metabolism, inflammatory control, as well as cardiovascular, reproductive, and neuronal effects. Some of these are relatively quick-acting non-genomic effects, but most are slower-acting genomic effects. Thus, any stimulus that affects HPA function has the potential to exert wide-ranging short-term and long-term effects on much of vertebrate physiology. Here, we review the effects of social isolation on the functioning of the HPA axis in social species, and on glucocorticoid physiology in social mammals in particular. Evidence indicates that objective and perceived social isolation alter HPA regulation, although the nature and direction of the HPA response differs among species and across age. The inconsistencies in the direction and nature of HPA effects have implications for drawing cross-species conclusions about the effects of social isolation, and are particularly problematic for understanding HPA-related physiological processes in humans. The animal and human data are incommensurate because, for example, animal studies of objective isolation have typically not been modeled on, or for comparability with, the subjective experience of isolation in humans. An animal model of human isolation must be taken more seriously if we want to advance our understanding of the mechanisms for the effects of objective and perceived isolation in humans. PMID:22663934

  13. Geriatric falls: prevention strategies for the staff.

    Science.gov (United States)

    Brady, R; Chester, F R; Pierce, L L; Salter, J P; Schreck, S; Radziewicz, R

    1993-09-01

    1. Multiple falls and injuries are more prevalent among elderly over the age of 75 and are the second leading cause of accidental death in the elderly. The risk for falling is noted to be significantly greater in the hospitalized elderly. 2. Review of retrospective quality improvement chart audits revealed that peak fall times were associated with the patient's need for toileting, rest, and obtaining nutrition and hydration. 3. The MetroHealth Falls Prevention Program is based on simple proactive measures to prevent falls in the elderly. 4. An effective falls prevention program has several implications for gerontological nursing practice, including less restraint use, increased patient autonomy, and decreased loss of self-esteem. There is also a sense of increased nursing control over patient safety and time management, as well as implications for further nursing research.

  14. Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults.

    Science.gov (United States)

    Donoghue, Orna A; Cronin, Hilary; Savva, George M; O'Regan, Claire; Kenny, Rose Anne

    2013-05-01

    Fear of falling (FOF) is associated with poor physical and psychosocial health and can have debilitating consequences especially when it leads to activity restriction. This study examined whether normal and dual task gait disruptions were independently associated with FOF and activity restriction or if they were fully explained by impaired health status. Data was obtained from The Irish Longitudinal Study on Ageing (TILDA). Community dwelling adults ≥65 years, with a Mini-Mental State Examination score ≥18 and who completed a gait assessment (n=1307) were divided into three groups: no FOF, FOF but no activity restriction (FOF-NAR), FOF with activity restriction (FOF-AR). Physical, psychosocial and cognitive measures were obtained and gait characteristics were assessed using a GAITRite(®) mat during normal and dual task (cognitive) walking. After adjusting for sociodemographics, physical, mental and cognitive health, FOF was associated with reduced gait speed and stride length and increased double support phase and step width in normal and dual task conditions; these changes were most pronounced in those who restrict activities as a result of FOF. These gait changes may be associated with an increased fall risk, however some changes especially increased step width may also reflect positive, compensatory adaptations to FOF. The results also highlight the importance of treating underlying health impairments and preventing the transition from FOF to activity restriction. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. The effect of costs and regulation on electricity prices

    International Nuclear Information System (INIS)

    Schlaf, E.P.

    1991-01-01

    Two distinct econometric tests were performed to determine if state price regulation of public utilities has had a measurable impact on retail electricity prices. The results of both tests agree that, during the 1971-1985 period, average national electricity prices in each of the three major consuming sectors and the four Census regions were below the level which would have been preferred by profit-maximizing monopolists. Electricity consumers received price benefits during the sample period as a result of regulation. The first test of the effectiveness of state price regulation used a 'revealed preference' approach by comparing the actual prices set by regulatory commissioners with prices and outcomes predicted by three competing theories of regulatory motivation. The second test of the effectiveness of price regulation combined traditional cost function inputs with regulatory variables in reduced-form price equations to determine whether the amount of regulatory intensity, as measured by the number of staff members per regulated utility, is associated with declining electricity prices and whether appointed commissioners allow higher prices than elected commissioners

  16. Regulation effects of exogenous gibberellin acid (GA 3 ) on the ...

    African Journals Online (AJOL)

    To fully understand the regulation effects of gibberellin on tomato (Solanum Lycoperscium) ovary locule formation and the fasciated transcription, two varieties: multi-locule 'MLK1' and few- locule 'FL1' which were highly different in locule number and fasciated transcriptional levels, were used in this study. By spraying GA3 ...

  17. Effect of plant growth regulators on regeneration of the endangered ...

    African Journals Online (AJOL)

    Development of an efficient in vitro regeneration protocol of Calligonum comosum is important and that has achieved to protect the endangered multipurpose medicinally important desert plant in the Kingdom of Bahrain. Nodal segments were used as explants source and the effect of various plant growth regulators (PGRs) ...

  18. Effect of plant growth regulators on callus induction and plant ...

    African Journals Online (AJOL)

    The present study was conducted to investigate the effects of different concentrations and combinations of growth regulators on callus induction and plant regeneration of potato (Solanum tuberosum L.) cultivar Diamant. The tuber segments were used as explants and cultured on Murashige and Skoog (MS) medium ...

  19. The effect of plant growth regulators, explants and cultivars on ...

    African Journals Online (AJOL)

    ONOS

    2010-07-05

    Jul 5, 2010 ... The effect of plant growth regulators, explants and cultivars on spinach (Spinacia oleracea L.) tissue culture. Taha Roodbar Shojaei1*, Vahid Salari2, Darioush Ramazan3, Mahdi Ehyaei1, Javad. Gharechahi4 and Roya Motallebi Chaleshtori5. 1Department of Agronomy and Plant Breeding, College of ...

  20. Effect of ghrelin on glucose regulation in mice

    NARCIS (Netherlands)

    Chacko, Shaji K.; Haymond, Morey W.; Sun, Yuxiang; Marini, Juan C.; Sauer, Pieter J. J.; Ma, Xiaojun; Sunehag, Agneta L.

    Chacko SK, Haymond MW, Sun Y, Marini JC, Sauer PJJ, Ma X, Sunehag AL. Effect of ghrelin on glucose regulation in mice. Am J Physiol Endocrinol Metab 302: E1055-E1062, 2012. First published February 14, 2011; doi:10.1152/ajpendo.00445.2011.-Improvement of glucose metabolism after bariatric surgery

  1. Falls and comorbidity

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  2. An update on falls

    NARCIS (Netherlands)

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

    2003-01-01

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

  3. An update on falls.

    NARCIS (Netherlands)

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

    2003-01-01

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

  4. First Aid: Falls

    Science.gov (United States)

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

  5. Falling-sphere radioactive viscometry

    International Nuclear Information System (INIS)

    Souza, R. de.

    1987-01-01

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

  6. Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Burton E

    2015-02-01

    Full Text Available Elissa Burton,1,2 Vinicius Cavalheri,1 Richard Adams,3 Colleen Oakley Browne,4 Petra Bovery-Spencer,4 Audra M Fenton,3 Bruce W Campbell,5 Keith D Hill1,6 1School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Community Services, West Gippsland Healthcare Group, Warragul, VIC, Australia; 4Falls Prevention for People Living with Dementia Project, Central West Gippsland Primary Care Partnership, Moe, VIC, Australia; 5Allied Health, Latrobe Regional Hospital, Traralgon, VIC, Australia; 6Preventive and Public Health Division, National Ageing Research Institute, Melbourne, VIC, Australia Objective: The objective of this systematic review and meta-analysis is to evaluate the effectiveness of exercise programs to reduce falls in older people with dementia who are living in the community.Method: Peer-reviewed articles (randomized controlled trials [RCTs] and quasi-experimental trials published in English between January 2000 and February 2014, retrieved from six electronic databases – Medline (ProQuest, CINAHL, PubMed, PsycInfo, EMBASE and Scopus – according to predefined inclusion criteria were included. Where possible, results were pooled and meta-analysis was conducted.Results: Four articles (three RCT and one single-group pre- and post-test pilot study were included. The study quality of the three RCTs was high; however, measurement outcomes, interventions, and follow-up time periods differed across studies. On completion of the intervention period, the mean number of falls was lower in the exercise group compared to the control group (mean difference [MD] [95% confidence interval {CI}] =-1.06 [-1.67 to -0.46] falls. Importantly, the exercise intervention reduced the risk of being a faller by 32% (risk ratio [95% CI] =0.68 [0.55–0.85]. Only two other outcomes were reported in two or more of the studies (step test and physiological profile assessment. No

  7. Effects of trochanteric soft tissue thickness and hip impact velocity on hip fracture in sideways fall through 3D finite element simulations.

    Science.gov (United States)

    Majumder, Santanu; Roychowdhury, Amit; Pal, Subrata

    2008-09-18

    A major worldwide health problem is hip fracture due to sideways fall among the elderly population. The effects of sideways fall on the hip are required to be investigated thoroughly. The objectives of this study are to evaluate the responses to trochanteric soft tissue thickness (T) variations and hip impact velocity (V) variations during sideways fall based on a previously developed CT scan derived 3D non-linear and non-homogeneous finite element model of pelvis-femur-soft tissue complex with simplified biomechanical representation of the whole body. This study is also aimed at quantifying the effects [peak impact force (F(max)), time to F(max), acceleration and peak principal compressive strain (epsilon(max))] of these variations (T,V) on hip fracture. It was found that under constant impact energy, for 81% decrease in T (26-5mm), F(max) and epsilon(max) increased by 38% and 97%, respectively. Hence, decrease in T (as in slimmer persons) strongly correlated to risk for hip fracture (phi) and strain ratio (SR) by 0.972 and 0.988, respectively. Also under same T and body weight, for 75% decrease in V (4.79-1.2m/s), F(max) and epsilon(max) decreased by 70% and 86%, respectively. Hence, increase in V (as in taller persons) strongly correlated to phi and SR by 0.995 and 0.984, respectively. For both variations in T and V, inter-trochanteric fracture situations were well demonstrated by phi as well as by SR and strain contours, similar to clinically observed fractures. These quantifications would be helpful for effective design of person-specific hip protective devices.

  8. Effect of gamma irradiation in the pupal stage on the fall armyworm parent and F1 generations reproduction

    International Nuclear Information System (INIS)

    Arthur, V.; Wiendl, F.M.; Duarte-Aguilar, J.A.; Wiendl, J.A.

    1994-01-01

    To induce sterilization into F 1 generation, pupae of the fall armyworm Spodoptera frugiperda (Smith, 1797) (Lepidoptera, Noctuidae) were irradiated at the age of five days. The radiation source was a Cobalt-60 panoramic irradiator. The pupae were irradiated at the dose-rate of 2.60 kGy/h with doses of 0 (control), 50, 75, 100 and 125 Gy. The hatching of the eggs laid by the adults originated from the irradiated pupae with dose of 125 Gy were 15.0 and 10.0 percent for males and females respectively. Crossing this irradiated parent generation, it could be found that the F 1 generation reached 93.0 percent of hatching for both sexes

  9. Effect of gamma radiation at pupal stage on fall army worm parent and F1 generation reproduction

    International Nuclear Information System (INIS)

    Arthur, V.; Maximiliano Wiendl, F.M.; Duarte Aguilar, J.A.; Domarco, R.E.

    1993-01-01

    To induce sterility in the F 1 generation, pupae of the fall army worm, Spodoptera frugiperda (J.E. Smith), were irradiated at the age of five days. The radiation source was a 60 Co panoramic irradiator. The pupae were irradiated at the dose rate of 2.60 kGy/h with doses of 0 (control), 50, 75, 100 and 125 Gy. The percentage hatch of eggs laid by adults that originated from pupae irradiated with 125 Gy was 15.0 and 10.0% for males and females, respectively. By crossing this irradiated parent generation, it was found that the egg hatch in the F 1 generation was 4% for descendants of treated males and 10% for descendants of treated females. (author). 12 refs, 2 figs, 2 tabs

  10. The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson?s Patients: A Report of Four Cases

    OpenAIRE

    BALCI, Nilay ??m?k; TONGA, Eda; G?L?EN, Mustafa

    2013-01-01

    This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson?s disease. Four patients with Parkinson?s disease between the ages of 56 and 70 years (61.25?6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson?s Disease Rating Sca...

  11. Effectiveness of Senior Dance on risk factors for falls in older adults (DanSE): a study protocol for a randomised controlled trial.

    Science.gov (United States)

    Franco, Marcia R; Sherrington, Catherine; Tiedemann, Anne; Pereira, Leani S; Perracini, Monica R; Faria, Claudia R S; Pinto, Rafael Z; Pastre, Carlos M

    2016-12-30

    Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be disseminated through publication in peer-reviewed journals and

  12. Ageing vision and falls: a review.

    Science.gov (United States)

    Saftari, Liana Nafisa; Kwon, Oh-Sang

    2018-04-23

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

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

    Science.gov (United States)

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

    2016-08-01

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

  14. [The biological effects of a nuclear explosion. Introduction of a new system on a colorimetric scale (black, grey, red, orange, yellow and white zone) to estimate the effects of fall-out on civilian populations].

    Science.gov (United States)

    Nacci, G

    2002-08-01

    Following September 11 the eventuality of terrorist attacks using bags containing nuclear devices is considered possible in western cities like New York, London, Paris, Rome, Berlin, Moscow etc. However, with a modern Civil Defence programme the effects of a catastrophe of this nature can be partially limited, at least as far as Fall-out is concerned. The present paper explains the medical reasons for building anti-fall-out shelters for the larger part of western populations: from the USA to Russia. The paper also sets out a new method for classifying levels of radioactive Fall-out based on a scale of colours (black, grey, red, orange, yellow and white) whatever kind of radioactivity is involved (total gamma levels, Cesium 137 levels, Strontium 90 levels). The arrival times for fall-out in each area of the scale are fixed, whatever the energy of the explosion and the speed of the wind might be. The radioactive decay in each area of the scale, from the time of arrival of the fall-out is described with precision. Also described are the acute radiation syndrome, tumours, miscarriages and genetic diseases. A nomogram is attached for civil defence purposes showing the leeward extension of these areas, easily measurable in just a few minutes, if four parameters are known: ground zero (locality) of the explosion, the energy of the explosion, the direction of the wind and the speed of the wind.

  15. Lethal and sublethal effects of methoxyphenozide on the development, survival and reproduction of the fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae)

    International Nuclear Information System (INIS)

    Zarate, N.; Diaz, O.; Martinez, A.M.; Figueroa, J.I.; Pineda, S.; Schneider, M.I.; Smagghe, G.; Vinuela, E.; Budia, F.

    2011-01-01

    The lethal and sublethal effects of the ecdysone agonist methoxyphenozide on the fall armyworm, Spodoptera frugiperda (J. E. Smith), were investigated by feeding a methoxyphenozide-treated diet to fifth instars until pupation in doses corresponding to the LC 10 and LC 25 for the compound. Larval mortality reached 8% and 26% in the low and high concentration groups, respectively, on the seventh day of the experiment. A progressive larval mortality of 12% for the LC 10 and 60% for the LC 25 was observed before pupation. Treated larvae exhibited lower pupal weights, higher pupal mortality, presence of deformed pupae, and more deformed adults than untreated larvae. The incorporation of methoxyfenozide into the diet had a significant effect on the timing of larval development. The development period for males and females was about seven days longer than the controls for both concentrations tested. In contrast, the compound affected neither pupae nor adult longevity. Finally, S. frugiperda adults that resulted from fifth instars treated with methoxyfenozide were not affected in their mean cumulative number of eggs laid per female (fecundity), nor percentages of eggs hatched (fertility), or the sex ratio. Our results suggest that the combination of lethal and sublethal effects of methoxyfenozide may have important implications for the population dynamics of the fall armyworm. (author)

  16. Lethal and sublethal effects of methoxyphenozide on the development, survival and reproduction of the fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae)

    Energy Technology Data Exchange (ETDEWEB)

    Zarate, N.; Diaz, O. [Universidad Autonoma de San Luis Potosi (Mexico). Facultad de Agronomia; Martinez, A.M.; Figueroa, J.I.; Pineda, S., E-mail: spineda_us@yahoo.co [Universidad Michoacana de San Nicolas de Hidalgo, Tarimbaro, Michoacan (Mexico). Inst. de Investigaciones Agropecuarias y Forestales; Schneider, M.I. [National Council of Scientific and Technical Research (CEPAVE/CCT/CONICET), La Plata (Argentina). Centro de Estudios Parasitologicos y de Vectores. Centro Cientifico Tecnologico; Smagghe, G. [Ghent University, Ghent (Belgium). Faculty of Bioscience Engineering. Lab of Agrozoology; Vinuela, E.; Budia, F. [Escuela Tecnica Superior de Ingenieros Agronomos, Madrid (Spain). Escuela Tecnica Superior de Ingenieros Agronomos. Proteccion de Cultivos

    2011-01-15

    The lethal and sublethal effects of the ecdysone agonist methoxyphenozide on the fall armyworm, Spodoptera frugiperda (J. E. Smith), were investigated by feeding a methoxyphenozide-treated diet to fifth instars until pupation in doses corresponding to the LC{sub 10} and LC{sub 25} for the compound. Larval mortality reached 8% and 26% in the low and high concentration groups, respectively, on the seventh day of the experiment. A progressive larval mortality of 12% for the LC{sub 10} and 60% for the LC{sub 25} was observed before pupation. Treated larvae exhibited lower pupal weights, higher pupal mortality, presence of deformed pupae, and more deformed adults than untreated larvae. The incorporation of methoxyfenozide into the diet had a significant effect on the timing of larval development. The development period for males and females was about seven days longer than the controls for both concentrations tested. In contrast, the compound affected neither pupae nor adult longevity. Finally, S. frugiperda adults that resulted from fifth instars treated with methoxyfenozide were not affected in their mean cumulative number of eggs laid per female (fecundity), nor percentages of eggs hatched (fertility), or the sex ratio. Our results suggest that the combination of lethal and sublethal effects of methoxyfenozide may have important implications for the population dynamics of the fall armyworm. (author)

  17. 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.

  18. Effect of demand management on regulated and deregulated electricity sectors

    International Nuclear Information System (INIS)

    Fahrioglu, Murat

    2016-01-01

    Our society derives a quantifiable benefit from electric power. In particular, forced outages or blackouts have enormous consequences on society, one of which is loss of economic surplus. The society relies on having a continuous supply of electrical energy. Some customers may willingly risk this continuous supply and participate in demand management programs for electrical power. If the power system grid is in trouble, electric utilities need to have demand relief. Customers willing to reduce their demand to help the system can receive an incentive fee for helping the utilities. Demand relief can be system wide or location specific. Sometimes it can be more effective to fix the electrical demand vs. supply imbalance from the demand side. The value of demand management contracts is greatly affected by customer location. Inclusion of locational attributes into the contract design procedure increases the effectiveness of the contracts by helping a utility get more value from its demand management programs. Independent System Operators and regulators, among others, can also benefit from effective demand management. This paper will investigate how this type of demand management contracts can help the electricity sector both in regulated and deregulated environments. - Highlights: • Demand management can help prevent forced electricity outages. • Both electric utilities and ISOs can use demand management. • Regulated and deregulated electricity sectors can benefit from demand management. • Demand management contracts can be effectively used in power system grids.

  19. Fall Bottom Trawl Survey

    Data.gov (United States)

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

  20. Catapults fall short

    Science.gov (United States)

    Gibson, Marcus

    2018-01-01

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

  1. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

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

  2. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

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

  3. Effect of business regulation on investment in emerging market economies

    Directory of Open Access Journals (Sweden)

    Birungi Korutaro

    2013-01-01

    Full Text Available This paper provides an empirical analysis of the business regulatory factors that influence investment in a selection of 29 emerging market economies. Both theoretical and empirical literature on the effect of the regulatory environment on investment is reviewed. A panel data analysis over the period 2003–2007 reveals that investment is influenced by secure property rights and the degree of business entry regulation. The results carry important policy implications for improving the investment climate of emerging market economies.

  4. Effects of supervised whole body vibration exercise on fall risk factors, functional dependence and health-related quality of life in nursing home residents aged 80+.

    Science.gov (United States)

    Álvarez-Barbosa, Francisco; del Pozo-Cruz, Jesús; del Pozo-Cruz, Borja; Alfonso-Rosa, Rosa M; Rogers, Michael E; Zhang, Yanxin

    2014-12-01

    To test the feasibility and effectiveness of whole-body vibration (WBV) therapy on fall risk, functional dependence and health-related quality of life in nursing home residents aged 80+ years. Twenty-nine 80-95 years old volunteers, nursing home residents were randomized to an eight-week WBV intervention group) (n=15) or control group (n=14). Functional mobility was assessed using the timed up and go (TUG) test. Lower limb performance was evaluated using the 30-s Chair Sit to Stand (30-s CSTS) test. Postural stability was measured using a force platform. The Barthel Index was used to assess functional dependence and the EuroQol (EQ-5D) was used to evaluate Health-Related Quality of Life. All outcome measures were assessed at baseline and at a follow-up after 8 weeks. At the 8-week follow up, TUG test (p<0.001), 30-s CSTS number of times (p=0.006), EQ-5Dmobility (p<0.001), EQ-5DVAS (p<0.014), EQ-5Dutility (p<0.001) and Barthel index (p=0.003) improved in the WBV intervention group when compared to the control group. An 8-week WBV-based intervention in a nursing home setting is effective in reducing fall risk factors and quality of life in nursing home residents aged 80+. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    1996-07-01

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

  6. Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss

    Directory of Open Access Journals (Sweden)

    Lacerda, Clara Fonseca

    2012-01-01

    Full Text Available Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI. The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36, Falls Efficacy International Scale- (FES-I and the test of Berg Balance Scale (BBS. After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS and Functional Capacity (CF and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. Conclusion: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss.

  7. Falls from height: A retrospective analysis.

    Science.gov (United States)

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

    2018-01-01

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

  8. Osteosarcopenic obesity and fall prevention strategies.

    Science.gov (United States)

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

    2015-02-01

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

  9. Effects of new environmental regulations on coal-fired generation

    International Nuclear Information System (INIS)

    LaCount, R.

    1999-01-01

    As restructuring of the electricity industry places downward pressure on power production costs, new environmental regulations are having the opposite effect. Although power plants may be subject to a variety of environmental regulations over the next ten years including reductions in mercury, toxics, and carbon dioxide, new regulations for sulfur dioxide (SO2) and nitrogen oxides (NOX) are poised to impact the electricity industry in the very short term. The cost for coal-fired power plants to comply with these new regulations has the potential to alter their competitive position. January 1, 2000 marks the beginning of Phase II for the Environmental Protection Agency's SO2 allowance market. Starting in January, all coal and oil plants above 25 MW will be required to comply with the federal SO2 provisions. Regulatory deadlines for NOX are also fast approaching; though the ultimate requirements are still subject to change. On May 1, 1999, a NOX allowance market began for states within the Northeast Ozone Transport Commission (OTC). A second phase of this program is scheduled to begin in 2003 that will lower the overall cap for allowable NOX emissions in the participating states. EPA is also working to expand the reach of regional NOX reductions in 2003 through its NOX SIP call. This program, which is currently subject to litigation, would require NOX reductions in 14 states outside of the OTC. A new study by Resource Data International (RDI), Coal-Fired Generation in Competitive Power Markets, assessed the potential impact that the new SO2 and NOX regulations may have on the competitiveness of coal-fired generation. Overall, the study shows that coal-fired generation will continue to grow despite significant environmental costs and competition from natural gas-fired units. The new environmental regulations have the effect of increasing the dispatch cost of coal-fired units from $0.65/MWh on average in the WSCC to $4.14/MWh on average in the MAAC region. The addition

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  11. The Impressionist Effect in Jean Epstein’s Film Discourse: ‘The Fall of the House of Usher’

    Directory of Open Access Journals (Sweden)

    Rafael Gómez Alonso

    2017-05-01

    Full Text Available This article aims to demonstrate how there is a parallelism between the figurative qualities of pictorial impressionism and the avant-garde aesthetics that Jean Epstein sets in his film The Fall of the House of Usher. In turn, it is a question of studying the process of adaptation of the literary universe of Edgar Allan Poe protected in the style of Gothic romanticism, with special emphasis on visual references. For this, it is a question of investigating how descriptive appreciations are conceived that concern an avant-garde visual representation. The methodology used for the analysis is based on using the aesthetic variables that allow to support how a model of different visual representation is created. Through the analysis of the images it is possible to study the traits that characterize the ascription to the Impressionist movement and the style that defines the author brand. To this end, it is intended to describe how a suitable targeting is recreated in the staging, in which different types of environments are recreated.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-09-01

    ) downstream to the upper end of Lower Granite Reservoir near rkm 240. We randomly selected 14 fall Chinook salmon spawning locations as study sites, which represents 25% of the most used spawning areas throughout the HCR. Interactions between river water and pore water within the riverbed (i.e., hyporheic zone) at each site were quantified through the use of self-contained temperature and water level data loggers suspended inside of piezometers. Surrounding the piezometer cluster at each site were 3 artificial egg pockets. In mid-November 2002, early-eyed stage fall Chinook salmon eggs were placed inside of perforated polyvinyl chloride (PVC) tubes, along with a temperature data logger, and buried within the egg pockets. Fall Chinook salmon eggs were also incubated in the laboratory for the purpose of developing growth curves that could be used as indicators of emergence timing. The effects of discharge on vertical hydrologic exchange between the river and riverbed were inferred from measured temperature gradients between the river and riverbed, and the application of a numerical model. The hydrologic regime during the 2002-2003 sampling period exhibited one of the lowest, most stable daily discharge patterns of any of the previous 12 water years. The vertical hydraulic gradients (VHG) between the river and the riverbed suggested the potential for predominantly small magnitude vertical exchange. The VHG also showed little relationship to changes in river discharge at most sites. Despite the relatively small vertical hydraulic gradients at most sites, results from the numerical modeling of riverbed pore water velocity and hyporheic zone temperatures suggested that there was significant vertical hydrologic exchange during all time periods. The combined results of temperature monitoring and numerical modeling indicate that only 2 of 14 sites were significantly affected by short-term (hourly to daily) large magnitude changes in discharge. Although the two sites exhibited acute

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

    Science.gov (United States)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-09-04

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

  16. Dance movement therapy and falls prevention.

    Science.gov (United States)

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

    2017-08-01

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

  17. Collective Fall Protection for Construction Workers

    Directory of Open Access Journals (Sweden)

    Sulowski, A. C.

    2014-03-01

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

  18. Effects of different plant growth regulators on blueberry fruit quality

    Science.gov (United States)

    Zhang, X. C.; Zhu, Y. Q.; Wang, Y. N.; Luo, C.; Wang, X.

    2017-08-01

    In order to understand the effects of different plant growth regulators (PGRs) on blueberry fruit growth, various concentrations of Abscisic acid (ABA), Methyl jasmonate (MJ), Brassinolide (BR), Melatonin (MT) were sprayed on blueberry cv. ‘Brigita’ fruits. The results showed that all the PGRs put into effect on improving the quality of blueberry fruit. Comparing with the control plants no PGR spraying,300 mg/L of MT treatment promoted effectively accumulation of the soluble sugar. ABA 20mg/L treatment in-creased effectively accumulation of anthocyanin, and significantly decreased titratable acid content. The treatment of MJ 10mg/L improved significantly the soluble solid content. The effect of the four PGRs treatments on appearance did not show obvious difference.

  19. 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

  20. Elements for regulating surrogacy arrangements with cross-border effects

    Directory of Open Access Journals (Sweden)

    Bordaš Bernadet

    2013-01-01

    Full Text Available Numerous cases of international surrogacy arrangements and their legal effects in different national legal frameworks have caused a need to weigh the possibility and necessity of regulating the issue on international level. The Hague Conference on Private International Law has been since 2011 involved in preliminary research activities of the issue, on the basis of which it will submit a final report in 2014 on the state of play and on the need to start drafting an international instrument. During the past three years two preliminary reports and four questionnaires have been submitted. Questionnaire 1 have been sent to the member states of the Conference and to other interested countries to collect data on crucial issues of surrogacy and its legal regulation in national legislations. Serbian law de lege lata prohibits surrogacy arrangements, but the 2011 Draft Civil Code introduces it to the domestic legal system as a tool of biomedically assisted fertilization. The present paper suggests that the regulation of surrogacy must also include surrogacy arrangements with cross-border effects for the sake of comprehensiveness of the future legal act on the issue. For this purpose, the paper indicates - based on the preliminary research conducted by the Hague Conference on Private International Law - those elements that should be included in future legislation of Serbia.

  1. Regulation of positive and negative emotion: Effects of sociocultural context

    Directory of Open Access Journals (Sweden)

    Sara A. Snyder

    2013-07-01

    Full Text Available Previous research has demonstrated that the use of emotion regulation strategies can vary by sociocultural context. In a previous study, we reported changes in the use of two different emotion regulation strategies at an annual alternative cultural event, Burning Man (McRae, Heller, John, & Gross, 2011. In this sociocultural context, as compared to home, participants reported less use of expressive suppression (a strategy generally associated with maladaptive outcomes, and greater use of cognitive reappraisal (a strategy associated with adaptive outcomes. What remained unclear was whether these changes in self-reported emotion regulation strategy use were characterized by changes in the regulation of positive emotion, negative emotion, or both. We addressed this issue in the current study by asking Burning Man participants separate questions about positive and negative emotion. Using multiple datasets, we not only replicated our previous findings, but also found that the decreased use of suppression is primarily driven by reports of decreased suppression of positive emotion at Burning Man. By contrast, the reported increased use of reappraisal is not characterized by differential reappraisal of positive and negative emotion at Burning Man. Moreover, we observed novel individual differences in the magnitude of these effects. The contextual changes in self-reported suppression that we report are strongest for men and younger participants. For those who had previously attended Burning Man, we observed lower levels of self-reported suppression in both sociocultural contexts: Burning Man and home. These findings have implications for understanding the ways in which certain sociocultural contexts may decrease suppression, and possibly minimize its associated maladaptive effects.

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

    Science.gov (United States)

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

    2017-09-01

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

  3. The neurobiology of falls.

    Science.gov (United States)

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

    2012-12-01

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

  4. 25 CFR 518.6 - When will a certificate of self-regulation become effective?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false When will a certificate of self-regulation become... PROVISIONS SELF REGULATION OF CLASS II GAMING § 518.6 When will a certificate of self-regulation become effective? A certificate of self-regulation shall become effective on January 1 of the year following the...

  5. Effects of empathic paraphrasing - Extrinsic emotion regulation in social conflict

    Directory of Open Access Journals (Sweden)

    Maria eSeehausen

    2012-11-01

    Full Text Available In the present study, we investigated the effects of empathic paraphrasing as an extrinsic emotion regulation technique in social conflict. We hypothesized that negative emotions elicited by social conflict can be regulated extrinsically in a conversation by a listener following the narrator’s perspective and verbally expressing cognitive empathy.20 participants were interviewed on an ongoing or recently self-experienced social conflict. The interviewer utilized ten standardized open questions inviting participants to describe their perception of the conflict. After each of the ten descriptions, the interviewer responded by either paraphrasing or taking notes (control condition. Valence ratings pertaining to the current emotional state were assessed during the interview along with psychophysiological and voice recordings.Participants reported feeling less negative after hearing the interviewer paraphrase what they had said. In addition, we found a lower sound intensity of participants' voices when answering to questions following a paraphrase. At the physiological level, skin conductance response, as well as heart rate, was higher during paraphrasing than during taking notes, while blood volume pulse amplitude was lower during paraphrasing, indicating higher autonomic arousal.The results show that demonstrating cognitive empathy through paraphrasing can extrinsically regulate negative emotion on a short-term basis. Paraphrasing led to enhanced autonomic activation in recipients, while at the same time influencing emotional valence in the direction of feeling better. A possible explanation for these results is that being treated in an empathic manner may stimulate a more intense emotion processing helping to transform and resolve the conflict.

  6. Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial.

    Science.gov (United States)

    El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline; Dargent-Molina, Patricia

    2015-07-22

    To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Pragmatic multicentre, two arm, parallel group, randomised controlled trial. 20 study sites in 16 medium to large cities throughout France. 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a "shared frailty" model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group sessions attended was 53 (interquartile range 16-71). Five injurious falls

  7. The effect of emotion regulation strategies on anger.

    Science.gov (United States)

    Szasz, Paul Lucian; Szentagotai, Aurora; Hofmann, Stefan G

    2011-02-01

    This study examined the effects of different emotion regulation strategies on the experience and expression of anger. Participants consisted of undergraduate students who endorsed at least a moderate level of state anger. As part of a laboratory experiment, they were instructed to reappraise (n = 24), suppress (n = 24), or accept (n = 25) their anger during a frustrating task. Reappraisal was more effective at reducing anger than attempts to suppress or accept it. Furthermore, participants in the reappraisal condition persisted significantly longer with the frustrating task than those who were instructed to suppress or accept their negative feelings. These findings suggest that reappraisal techniques are more effective than acceptance and suppression techniques for modulating the experience and expression of anger. Copyright © 2010 Elsevier Ltd. All rights reserved.

  8. Fall Prevention Hits Stumbling Blocks.

    Science.gov (United States)

    Huff, Charlotte

    2018-03-01

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

  9. First Results of Evaluation of a Falls Clinic

    Directory of Open Access Journals (Sweden)

    Christoph Bauer

    2010-09-01

    Conclusion: The results showed that a high-risk population attended our falls clinic. We presume that the falls clinic will have a beneficial effect in reducing the prevalence of falls in a high-risk population. Further studies are necessary to test this hypothesis.

  10. Fear of falling as seen in the Multidisciplinary falls consultation.

    Science.gov (United States)

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

    2011-06-01

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

  11. Fall Back Equilibrium

    NARCIS (Netherlands)

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

    2008-01-01

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

  12. Regulation

    International Nuclear Information System (INIS)

    Ballereau, P.

    1999-01-01

    The different regulations relative to nuclear energy since the first of January 1999 are given here. Two points deserve to be noticed: the decree of the third august 1999 authorizing the national Agency for the radioactive waste management to install and exploit on the commune of Bures (Meuse) an underground laboratory destined to study the deep geological formations where could be stored the radioactive waste. The second point is about the uranium residues and the waste notion. The judgment of the administrative tribunal of Limoges ( 9. july 1998) forbidding the exploitation of a storage installation of depleted uranium considered as final waste and qualifying it as an industrial waste storage facility has been annulled bu the Court of Appeal. It stipulated that, according to the law number 75663 of the 15. july 1965, no criteria below can be applied to depleted uranium: production residue (possibility of an ulterior enrichment), abandonment of a personal property or simple intention to do it ( future use aimed in the authorization request made in the Prefecture). This judgment has devoted the primacy of the waste notion on this one of final waste. (N.C.)

  13. The effect of the weight of cloves on the growth and the yield of fall-planted garlic

    Directory of Open Access Journals (Sweden)

    Renata Nurzyńska-Wierdak

    2013-12-01

    Full Text Available In three years trials (1990-1993 the effect of diameter of bulbilson growth and yield of local garlic ecotype R was studied. Nine size classes of bulbils were investigated. Significant effect of diameter of bulbils on biometric propeities and yield of local garlic was found out. The plants grown from big bulbils gave higher and better quality yield then those grown from smaller bulbils. There was no difference in yield of plants grown from big and medium bulbils.

  14. Effects of low dose radiation and epigenetic regulation

    International Nuclear Information System (INIS)

    Jiao Benzheng; Ma Shumei; Yi Heqing; Kong Dejuan; Zhao Guangtong; Gao Lin; Liu Xiaodong

    2010-01-01

    Purpose: To conclude the relationship between epigenetics regulation and radiation responses, especially in low-dose area. Methods: The literature was examined for papers related to the topics of DNA methylation, histone modifications, chromatin remodeling and non-coding RNA modulation in low-dose radiation responses. Results: DNA methylation and radiation can regulate reciprocally, especially in low-dose radiation responses. The relationship between histone methylation and radiation mainly exists in the high-dose radiation area; histone deacetylase (HDAC) inhibitors show a promising application to enhance radiation sensitivity, no matter whether in low-dose or high-dose areas; the connection between γ-H2AX and LDR has been remained unknown, although γ-H2AX has been shown no radiation sensitivities with 1-15 Gy irradiation; histone ubiquitination play an important role in DNA damage repair mechanism. Moreover, chromatin remodeling has an integral role in DSB repair and the chromatin response, in general, may be precede DNA end resection. Finally, the effect of radiation on miRNA expression seems to vary according to cell type, radiation dose, and post-irradiation time point. Conclusion: Although the advance of epigenetic regulation on radiation responses, which we are managing to elucidate in this review, has been concluded, there are many questions and blind blots deserved to investigated, especially in low-dose radiation area. However, as progress on epigenetics, we believe that many new elements will be identified in the low-dose radiation responses which may put new sights into the mechanisms of radiation responses and radiotherapy. (authors)

  15. Internship Progress Summary: Fall 2016

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-12-13

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

  16. Falls following discharge after an in-hospital fall

    Directory of Open Access Journals (Sweden)

    Kessler Lori A

    2009-12-01

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

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

    Science.gov (United States)

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

    2005-07-01

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

  18. The effects of Basel III liquidity regulations on banks’ profitability

    Directory of Open Access Journals (Sweden)

    Tafirei Mashamba

    2018-05-01

    Full Text Available The new Basel III Liquidity Coverage Ratio standard which encourages banks to maintain a diversified pool of high-quality liquid assets against their short-term expected net cash outflows although it appears to be noble from a theoretic perspective it may weigh down banks’ performance because liquid assets earn low returns. It is against this background that this study sought to evaluate the impact of the new Basel III liquidity regulations on the profitability of banks in emerging market economies. A sample of 40 banks operating in 11 emerging markets over the period 2011 to 2016 was used in the study. For estimation, system Generalized Method of Moments (GMM estimator was employed. Surprisingly, empirical results demonstrated that regulatory pressure stemming from Liquidity Coverage Ratio requirement increased instead of diminishing the profitability of banks in emerging markets. The plausible explanation given for this evidence was that banks in emerging markets managed their liquidity in a manner that is consistent with Liquidity Coverage Ratio rule hence the regulation had no detrimental effects on banks in emerging economies.

  19. Situation selection is a particularly effective emotion regulation strategy for people who need help regulating their emotions.

    Science.gov (United States)

    Webb, Thomas L; Lindquist, Kristen A; Jones, Katelyn; Avishai, Aya; Sheeran, Paschal

    2018-03-01

    Situation selection involves choosing situations based on their likely emotional impact and may be less cognitively taxing or challenging to implement compared to other strategies for regulating emotion, which require people to regulate their emotions "in the moment"; we thus predicted that individuals who chronically experience intense emotions or who are not particularly competent at employing other emotion regulation strategies would be especially likely to benefit from situation selection. Consistent with this idea, we found that the use of situation selection interacted with individual differences in emotional reactivity and competence at emotion regulation to predict emotional outcomes in both a correlational (Study 1; N = 301) and an experimental field study (Study 2; N = 125). Taken together, the findings suggest that situation selection is an effective strategy for regulating emotions, especially for individuals who otherwise struggle to do so.

  20. Health effects of air quality regulations in Delhi, India

    Science.gov (United States)

    Foster, Andrew; Kumar, Naresh

    2011-03-01

    This, the first systematic study, quantifies the health effects of air quality regulations in Delhi, which adopted radical measures to improve air quality, including, for example, the conversion of all commercial vehicles to compressed natural gas (CNG), and the closure of polluting industries in residential areas from 2000 to 2002. Air pollution data, collected at 113 sites (spread across Delhi and its neighboring areas) from July-December 2003, were used to compute exposure at the place of residence of 3989 subjects. A socio-economic and respiratory health survey was administered in 1576 households. This survey collected time-use, residence histories, demographic information, and direct measurements of lung function with subjects. The optimal interpolation methods were used to link air pollution and respiratory health data at the place of their residence. Resident histories, in combination with secondary data, were used to impute cumulative exposure prior to the air-quality interventions, and the effects of recent air quality measures on lung function were then evaluated. Three important findings emerge from the analysis. First, the interventions were associated with a significant improvement in respiratory health. Second, the effect of these interventions varied significantly by gender and income. Third, consistent with a causal interpretation of these results, effects were the strongest among those individuals who spend a disproportionate share of their time out-of-doors.

  1. What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals? Study protocol for a randomised controlled trial.

    Science.gov (United States)

    Tiedemann, Anne; Paul, Serene; Ramsay, Elisabeth; O'Rourke, Sandra D; Chamberlain, Kathryn; Kirkham, Catherine; Merom, Dafna; Fairhall, Nicola; Oliveira, Juliana S; Hassett, Leanne; Sherrington, Catherine

    2015-05-09

    Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60+. A randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer. Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation. General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2017-05-10

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

  4. How to identify patients with cancer at risk of falling: a review of the evidence.

    LENUS (Irish Health Repository)

    Stone, Carol A

    2011-02-01

    Clinical experience and a limited number of studies suggest that a cancer diagnosis confers a high risk of accidental falls. The negative sequelae of falls in older persons are well documented; risk factors for falls in this population have been extensively investigated and evidence for the efficacy of interventions to reduce falls is steadily emerging. It is not known whether the risk factors for falls and effective interventions for falls risk reduction in patients with cancer are different from those in older persons.

  5. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults

    OpenAIRE

    Zhuang J; Huang L; Wu Y; Zhang Y

    2014-01-01

    Jie Zhuang,1,* Liang Huang,1,2,* Yanqiang Wu,3 Yanxin Zhang2 1School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China; 2Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand; 3Shanghai Municipal Center for Students' Physical Fitness and Health Surveillance, Shanghai, People's Republic of China *These authors contributed equally to this work Abstract: This study aimed to evaluate the effectiveness ...

  6. Representing and Retrieving Patients' Falls Risk Factors and Risk for Falls among Adults in Acute Care through the Electronic Health Record

    Science.gov (United States)

    Pfaff, Jann

    2013-01-01

    Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care…

  7. The clinical practice guideline for falls and fall risk

    OpenAIRE

    Vance, Jacqueline

    2011-01-01

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

  8. Urban fall traps

    Directory of Open Access Journals (Sweden)

    Vera Lucia de Almeida Valsecchi

    2007-06-01

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

  9. Effect of three-dimensional deformations on local heat transfer to a nonuniformly heated falling film of liquid

    International Nuclear Information System (INIS)

    Chinnov, E.A.; Kabov, O.A.

    2004-01-01

    The experimental study on the heat transfer by the water film heated vertical flow is studied within the Reynolds number values from 1 to 45. The chart of the liquid film flow modes is plotted and the heat exchange areas are separated. The data on the dependence of the temperature of the heater walls and local heat flux at the heater symmetry axis on the longitudinal coordinate are obtained. The local heat exchange coefficients are measured. The comparison of the experimental data with the numerical calculations for the smooth film is carried out. The effect of the jet flow formation on the heat transfer to the liquid film is analyzed [ru

  10. The feasibility and positive effects of a customised videogame rehabilitation programme for freezing of gait and falls in Parkinson's disease patients: a pilot study.

    Science.gov (United States)

    Nuic, Dijana; Vinti, Maria; Karachi, Carine; Foulon, Pierre; Van Hamme, Angèle; Welter, Marie-Laure

    2018-04-10

    Freezing of gait and falls represent a major burden in patients with advanced forms of Parkinson's disease (PD). These axial motor signs are not fully alleviated by drug treatment or deep-brain stimulation. Recently, virtual reality has emerged as a rehabilitation option for these patients. In this pilot study, we aim to determine the feasibility and acceptability of rehabilitation with a customised videogame to treat gait and balance disorders in PD patients, and assess its effects on these disabling motor signs. We developed a customised videogame displayed on a screen using the Kinect system. To play, the patient had to perform large amplitude and fast movements of all four limbs, pelvis and trunk, in response to visual and auditory cueing, to displace an avatar to collect coins and avoid obstacles to gain points. We tested ten patients with advanced forms of PD (median disease duration = 16.5 years) suffering from freezing of gait and/or falls (Hoehn&Yahr score ≥ 3) resistant to antiparkinsonian treatment and deep brain stimulation. Patients performed 18 training sessions during a 6-9 week period. We measured the feasibility and acceptability of our rehabilitation programme and its effects on parkinsonian disability, gait and balance disorders (with clinical scales and kinematics recordings), positive and negative affects, and quality of life, after the 9th and 18th training sessions and 3 months later. All patients completed the 18 training sessions with high feasibility, acceptability and satisfaction scores. After training, the freezing-of-gait questionnaire, gait-and-balance scale and axial score significantly decreased by 39, 38 and 41%, respectively, and the activity-balance confidence scale increased by 35%. Kinematic gait parameters also significantly improved with increased step length and gait velocity and decreased double-stance time. Three months after the final session, no significant change persisted except decreased axial score and

  11. The Fort McMurray Demonstration Project in Social Marketing: no demonstrable effect on already falling injury rates following intensive community and workplace intervention.

    Science.gov (United States)

    Guidotti, Tee L; Deb, Pooja; Bertera, Robert; Ford, Lynda

    2009-10-01

    The Fort McMurray Demonstration Project in Social Marketing attempted to achieve mutually reinforcing effects from thematically coordinated educational and awareness efforts in the community as a whole and in the workplace and the inclusion of occupational safety within the framework of a community health promotion project. The study community was Fort McMurray, a small, industrial city in northern Alberta. The Mistahiai Health Region, several hundred kilometers to the west and also dominated by one city, Grande Prairie, served as the reference community. The intervention was based on media and events staged at public events, with supporting educational activities in schools and the community. It relied heavily on community-based partners and volunteers. Data on healthcare utilization of selected preventable injuries were obtained from Alberta Health for the time period 1990-1996 for the Regional Health Authorities of Northern Lights, where the only large population centre is Fort McMurray, and Mistahia. Age-adjusted aggregate injury rates were analyzed for evidence of an effect of the intervention. Severity was measured by proxy, using the number of diagnostic claims submitted for reimbursement for medical services in a given year. The communities differed in age-specific injury rates, with Fort McMurray showing higher rates for residents aged less than 55. Young adults and older adolescents showed higher levels of severity. Injury rates fell substantially and at similar rates in both communities over the five-year period. However, in both communities injury rates were already falling before the intervention in Fort McMurray began and continued to fall at about the same rate, slowing toward the end of the period. No evidence was found for an effect of the Project or for acceleration of the reduction in injury frequency in the intervention area. Over the period, fewer medical services were delivered in office settings and more in emergency rooms, in both

  12. Statistical evaluation of the effects of fall and winter flows on the spring condition of rainbow and brown trout in the green river downstream of Flaming Gorge Dam.

    Energy Technology Data Exchange (ETDEWEB)

    Magnusson, A. K.; LaGory, K. E.; Hayse, J. W.; Environmental Science Division

    2009-01-09

    Flaming Gorge Dam, a hydroelectric facility operated by the Bureau of Reclamation (Reclamation), is located on the Green River in Daggett County, northeastern Utah. In recent years, single peak releases each day or steady flows have been the operational pattern during the winter period. A double-peak pattern (two flow peaks each day) was implemented during the winter of 2006-2007 by Reclamation. Because there is no recent history of double-peaking at Flaming Gorge Dam, the potential effects of double-peaking operations on the body condition of trout in the dam's tailwater are not known. A study plan was developed that identified research activities to evaluate potential effects from double-peaking operations during winter months. Along with other tasks, the study plan identified the need to conduct a statistical analysis of existing data on trout condition and macroinvertebrate abundance to evaluate potential effects of hydropower operations. This report presents the results of this analysis. We analyzed historical data to (1) describe temporal patterns and relationships among flows, benthic macroinvertebrate abundance, and condition of brown trout (Salmo trutta) and rainbow trout (Oncorhynchus mykiss) in the tailwaters of Flaming Gorge Dam and (2) to evaluate the degree to which flow characteristics (i.e., flow volumes and flow variability) and benthic macroinvertebrate abundance affect the condition of trout in this area. This information, together with further analyses of size-stratified trout data, may also serve as baseline data to which the effects of potential future double-peaking flows can be compared. The condition (length, weight and/or relative weight) of rainbow trout (Oncorhynchus mykiss) at two sites in the Green River downstream of Flaming Gorge Dam (Tailrace and Little Hole) and weight of brown trout (Salmo trutta) at the Little Hole site has been decreasing since 1990 while the abundance of brown trout has been increasing at the two sites. At

  13. Statistical evaluation of the effects of fall and winter flows on the spring condition of rainbow and brown trout in the Green River downstream of Flaming Gorge Dam

    International Nuclear Information System (INIS)

    Magnusson, A. K.; LaGory, K. E.; Hayse, J. W.

    2009-01-01

    Flaming Gorge Dam, a hydroelectric facility operated by the Bureau of Reclamation (Reclamation), is located on the Green River in Daggett County, northeastern Utah. In recent years, single peak releases each day or steady flows have been the operational pattern during the winter period. A double-peak pattern (two flow peaks each day) was implemented during the winter of 2006-2007 by Reclamation. Because there is no recent history of double-peaking at Flaming Gorge Dam, the potential effects of double-peaking operations on the body condition of trout in the dam's tailwater are not known. A study plan was developed that identified research activities to evaluate potential effects from double-peaking operations during winter months. Along with other tasks, the study plan identified the need to conduct a statistical analysis of existing data on trout condition and macroinvertebrate abundance to evaluate potential effects of hydropower operations. This report presents the results of this analysis. We analyzed historical data to (1) describe temporal patterns and relationships among flows, benthic macroinvertebrate abundance, and condition of brown trout (Salmo trutta) and rainbow trout (Oncorhynchus mykiss) in the tailwaters of Flaming Gorge Dam and (2) to evaluate the degree to which flow characteristics (i.e., flow volumes and flow variability) and benthic macroinvertebrate abundance affect the condition of trout in this area. This information, together with further analyses of size-stratified trout data, may also serve as baseline data to which the effects of potential future double-peaking flows can be compared. The condition (length, weight and/or relative weight) of rainbow trout (Oncorhynchus mykiss) at two sites in the Green River downstream of Flaming Gorge Dam (Tailrace and Little Hole) and weight of brown trout (Salmo trutta) at the Little Hole site has been decreasing since 1990 while the abundance of brown trout has been increasing at the two sites. At the

  14. An investigation on the effect of cognitive emotion regulation strategies on job satisfaction

    Directory of Open Access Journals (Sweden)

    Somayeh Shahba

    2014-06-01

    Full Text Available This paper examined the effects of cognitive emotion regulation on employees’ job satisfaction. In this survey, Questionnaire and the questions were divided into two categories of cognitive emotion regulation and job satisfaction. To measure cognitive emotion regulation, including unadjusted emotion regulation strategies and adjusted strategies, 36 items questionnaire was used originally developed by Garnefski et al. (2001 [Garnefski, N., Kraaij, V., & Spinhoven, P. (2001. Negative life events, cognitive emotion regulation, and emotional problems. Personality and Individual Differences, 30, 1311–1327.]. The questionnaires were distributed among 340 staff employee of the Islamic Republic of Iran Customs Administration. The results revealed that the adjusted cognitive emotion regulation strategies increase job satisfaction of employees. However, unadjusted cognitive emotion regulation strategies reduce employees' job satisfaction. Moreover, among adjusted emotion regulation strategies, put in perspective strategy did not have significant effect on job satisfaction and rumination, had no significant effect on job satisfaction, which was one of the unadjusted strategies of cognitive emotion regulation.

  15. Fall prevention in older persons

    African Journals Online (AJOL)

    weak muscles, poor vision, psychotropic medications ... with increased risk of falls.[3]. Building on the .... [8] First eye cataract surgery has ... of users of bifocals in which half the subjects .... falls of providing single lens distance vision glasses.

  16. Fall prevention walker during rehabilitation

    Science.gov (United States)

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

    2017-09-01

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

  17. The sky is falling III: The effect of deposition from static solid rocket motor tests on juvenile crops.

    Science.gov (United States)

    Doucette, William J; Curry, Eric; McNeill, Laurie S; Heavilin, Justin

    2017-12-01

    A mixture of combustion products (mainly hydrogen chloride, aluminum oxide, and water) and entrained soil, referred to as Test Fire Soil (TFS), can be deposited on crops during static solid rocket motor tests. The impact of a reported worst-case event was previously evaluated by exposing corn and alfalfa to 3200-gTFS/m 2 at 54days after emergence. Exposures via soil and leaves were evaluated separately. Reduced growth (soil exposure) and leaf "scorch" (leaf exposure) were attributed mainly to the high chloride concentrations in the TFS (56,000mg/kg). A follow-up study was conducted to evaluate the effect of a typical deposition event (70-gTFS/m 2 , estimated by radar during several tests) and exposure (soil and leaves simultaneously) on juvenile corn, alfalfa, and winter wheat. Younger crops were used to examine potential age sensitivity differences. Impact was evaluated by comparing the growth, elemental composition, and leaf chlorophyll content of treated and untreated plants. The relationship between deposition exposure and response was also addressed. Growth of corn, alfalfa, and winter wheat exposed to a typical TFS loading was not impacted, although slightly elevated concentrations of aluminum and iron were found in the leaves. At the highest loadings used for the exposure-response experiment, concentrations of chloride and calcium were higher in TFS-exposed corn leaves than in the untreated leaves. Overall results indicate that exposure to a typical deposition event does not adversely impact juvenile crops and that younger plants may be less vulnerable to TFS. However, higher TFS loadings can cause leaf scorch and increase the leaf concentrations of some elements. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. The effective neutrino mass of neutrinoless double-beta decays: how possible to fall into a well

    Energy Technology Data Exchange (ETDEWEB)

    Xing, Zhi-zhong [University of Chinese Academy of Sciences, Institute of High Energy Physics and School of Physical Sciences, Beijing (China); Peking University, Center of High Energy Physics, Beijing (China); Zhao, Zhen-hua [Liaoning Normal University, Department of Physics, Dalian (China)

    2017-03-15

    The neutrinoless double-beta (0ν2β) decay is currently the only feasible process in particle and nuclear physics to probe whether massive neutrinos are the Majorana fermions. If they are of a Majorana nature and have a normal mass ordering, the effective neutrino mass term left angle m right angle {sub ee} of a 0ν2β decay may suffer significant cancellations among its three components and thus sink into a decline, resulting in a ''well'' in the three-dimensional graph of vertical stroke left angle m right angle {sub ee} vertical stroke against the smallest neutrino mass m{sub 1} and the relevant Majorana phase ρ. We present a new and complete analytical understanding of the fine issues inside such a well, and identify a novel threshold of vertical stroke left angle m right angle {sub ee} vertical stroke in terms of the neutrino masses and flavor mixing angles: vertical stroke left angle m right angle {sub ee} vertical stroke {sub *} = m{sub 3}sin{sup 2}θ{sub 13} in connection with tanθ{sub 12} = √(m{sub 1}/m{sub 2}) and ρ = π. This threshold point, which links the local minimum and maximum of vertical stroke left angle m right angle {sub ee} vertical stroke, can be used to signify observability or sensitivity of the future 0ν2β-decay experiments. Given current neutrino oscillation data, the possibility of vertical stroke left angle m right angle {sub ee} vertical stroke < vertical stroke left angle m right angle {sub ee} vertical stroke {sub *} is found to be very small. (orig.)

  19. Narp regulates long-term aversive effects of morphine withdrawal

    Science.gov (United States)

    Reti, Irving M.; Crombag, Hans S.; Takamiya, Kogo; Sutton, Jeffrey M.; Guo, Ning; Dinenna, Megan L.; Huganir, Richard L.; Holland, Peter C.; Baraban, Jay M.

    2008-01-01

    Although long-lasting effects of drug withdrawal are thought to play a key role in motivating continued drug use, the mechanisms mediating this type of drug-induced plasticity are unclear. As Narp is an immediate early gene product that is secreted at synaptic sites and binds to AMPA receptors, it has been implicated in mediating enduring forms of synaptic plasticity. In previous studies, we found that Narp is selectively induced by morphine withdrawal in the extended amygdala, a group of limbic nuclei that mediate aversive behavioral responses. Accordingly, in this study, we evaluated whether long-term aversive effects of morphine withdrawal are altered in Narp KO mice. We found that acute physical signs of morphine withdrawal are unaffected by Narp deletion. However, Narp KO mice acquire and sustain more aversive responses to the environment conditioned with morphine withdrawal than WT controls. Paradoxically, Narp KO mice undergo accelerated extinction of this heightened aversive response. Taken together, these studies suggest that Narp modulates both acquisition and extinction of aversive responses to morphine withdrawal and, therefore, may regulate plasticity processes underlying drug addiction. PMID:18729628

  20. The effect of default values in regulation matters

    International Nuclear Information System (INIS)

    Jang, Seung-cheol; Jung, Won-dea; Ha, Jae-joo; Jin, Young-ho

    1998-01-01

    Both performing and validating a detailed risk analysis of a complex system are costly and time-consuming undertakings. With the increased use of probabilistic risk analysis (PRA) in regulatory decision making, both PRA practitioners (usually, licensees) and regulators have generally favored the use of defaults because they can greatly facilitate the process of performing a PRA in the first place as well as the process of reviewing and verifying the PRA. The use of defaults can also ensure more uniform standards of PRA quality. However, different regulatory agencies differ in their approaches to the use of default values, and the implications of these differences are not yet widely understood. Moreover, large heterogeneity among licensees makes it difficult to set suitable defaults. This paper will focus on the effect of default values on estimates of risk. In particular, the following questions will be explored: ''How should defaults be set?''; and ''What are the implications of choosing different default values?'' Some insights on the effects of different levels of conservatism in setting defaults will be provided. This can help decision makers evaluate the levels of safety likely to result from regulatory decisions

  1. Preventing Falls and Related Fractures

    Science.gov (United States)

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

  2. Childhood Falls With Occipital Impacts

    NARCIS (Netherlands)

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

    2017-01-01

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

  3. 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.

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

    Science.gov (United States)

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

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

  5. Improving efficiency and effectiveness in natural gas regulation : discussion paper

    International Nuclear Information System (INIS)

    Rounding, M.C.

    2004-11-01

    Energy market liberalization is a world trend that has prompted the deregulation of natural gas and electricity over the past twenty years in North America. The Ontario Energy Board and the National Energy Board are conducting public hearings on natural gas regulation in response to the request by Canadian energy industries for better regulatory streamlining. The following 5 issues regarding natural gas regulation in Canada have been examined: (1) system gas in a regulated market, (2) natural gas infrastructure investments and capital renewal, (3) improving efficiency in gas regulation, (4) expectations of performance-based regulation (PBR) in the natural gas industry, and (5) the debate whether further deregulation of the natural gas industry is beneficial. This paper discusses the impact that natural gas regulation has had on the efficiency and competitiveness of the industry and its affect on customers and other stakeholders. It focuses on the efficiency of the regulatory process and examines regulatory objectives, best practices and performance indicators. The factors that determine the efficiency of natural gas regulation include alternative regulatory models, structure of the regulatory agency, regulatory framework approaches, and outcomes for the natural gas industry. The relationship between the government and the regulator was also examined in terms of their abilities to implement policy. A comparative evaluation between energy regulators in Canada, the United States, Australia and the United Kingdom was presented. The balancing of short-term and long-term objectives for gas supply and planning issues was also addressed. 17 refs

  6. The effect of a non-steroidal anti-inflammatory drug on two important predictors for accidental falls: postural balance and manual reaction time. A randomized, controlled pilot study.

    Science.gov (United States)

    Hegeman, Judith; Nienhuis, Bart; van den Bemt, Bart; Weerdesteyn, Vivian; van Limbeek, Jacques; Duysens, Jacques

    2011-04-01

    Accidental falls in older individuals are a major health and research topic. Increased reaction time and impaired postural balance have been determined as reliable predictors for those at risk of falling and are important functions of the central nervous system (CNS). An essential risk factor for falls is medication exposure. Amongst the medications related to accidental falls are the non-steroidal anti-inflammatory drugs (NSAIDs). About 1-10% of all users experience CNS side effects. These side effects, such as dizziness, headaches, drowsiness, mood alteration, and confusion, seem to be more common during treatment with indomethacin. Hence, it is possible that maintenance of (static) postural balance and swift reactions to stimuli are affected by exposure to NSAIDs, indomethacin in particular, consequently putting older individuals at a greater risk for accidental falls. The present study investigated the effect of a high indomethacin dose in healthy middle-aged individuals on two important predictors of falls: postural balance and reaction time. Twenty-two healthy middle-aged individuals (59.5 ± 4.7 years) participated in this double-blind, placebo-controlled, randomized crossover trial. Three measurements were conducted with a week interval each. A measurement consisted of postural balance as a single task and while concurrently performing a secondary cognitive task and reaction time tasks. For the first measurement indomethacin 75 mg (slow-release) or a visually identical placebo was randomly assigned. In total, five capsules were taken orally in the 2.5 days preceding assessment. The second measurement was without intervention, for the final one the first placebo group got indomethacin and vice versa. Repeated measures GLM revealed no significant differences between indomethacin, placebo, and baseline in any of the balance tasks. No differences in postural balance were found between the single and dual task conditions, or on the performance of the dual task

  7. 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.

  8. 29 CFR Appendix C to Subpart M of... - Personal Fall Arrest Systems

    Science.gov (United States)

    2010-07-01

    ..., DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Fall Protection Pt. 1926... fall distance should be supplied with the system, or in its absence, the least elastic lanyard or... considerations. (1) One of the most important aspects of personal fall protection systems is fully planning the...

  9. 1990 Fall Meeting Report

    Science.gov (United States)

    Chapman, David S.

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

  10. Falls and cerebellar ataxia

    Directory of Open Access Journals (Sweden)

    I. V. Damulin

    2015-01-01

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

  11. Falling Liquid Films

    CERN Document Server

    Kalliadasis, S; Scheid, B

    2012-01-01

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

  12. Does aging with a cortical lesion increase fall-risk: Examining effect of age versus stroke on intensity modulation of reactive balance responses from slip-like perturbations.

    Science.gov (United States)

    Patel, Prakruti J; Bhatt, Tanvi

    2016-10-01

    We examined whether aging with and without a cerebral lesion such as stroke affects modulation of reactive balance response for recovery from increasing intensity of sudden slip-like stance perturbations. Ten young adults, older age-match adults and older chronic stroke survivors were exposed to three different levels of slip-like perturbations, level 1 (7.75m/s(2)), Level II (12.00m/s(2)) and level III (16.75m/s(2)) in stance. The center of mass (COM) state stability was computed as the shortest distance of the instantaneous COM position and velocity relative to base of support (BOS) from a theoretical threshold for backward loss of balance (BLOB). The COM position (XCOM/BOS) and velocity (ẊCOM/BOS) relative to BOS at compensatory step touchdown, compensatory step length and trunk angle at touchdown were also recorded. At liftoff, stability reduced with increasing perturbation intensity across all groups (main effect of intensity pbalance control, potentially contributing toward a higher fall risk in older stroke survivors. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  13. Regulation of international energy markets: Economic effects of political actions

    Science.gov (United States)

    Shcherbakova, Anastasia V.

    's participation in a regulated market results in an average decline in its stock returns of up to 50 basis points per day, and a cumulative loss of more than 3.5% of its market value. Negative shocks to securities returns persist for at least two months. Participation in a regulated market, however, is not always unfavorable, as involved firms not directly targeted by regulatory action appear to gain sizable risk premiums. Additional evidence suggests that, although there is no direct linear relationship between firm size and effect magnitude, large firms tend to be hurt more in the short term, while small firms suffer bigger declines in returns over a longer time period. The last chapter turns to global electricity sectors to examine the development of Demand Response (DR) programs, which have become popular means of addressing the sector's central market failure of pricing below marginal generation cost. DR programs incorporate demand signals into retail electricity rates, and have the potential to effectively and inexpensively improve grid reliability and increase end-use efficiency. However, DR faces many challenges, arguably the most important of which is a general lack of information among consumers regarding usage levels and existence of alternative providers and rate plans. Financial considerations, lack of access to technological infrastructure, and misaligned producer incentives also play an important role in DR's limited success.

  14. Effects of Music on Emotion Regulation: A Systematic Literature Review

    NARCIS (Netherlands)

    Luck, Geoff; Brabant, Olivier; Uhlig, Sylka; Jaschke, Artur; Scherder, E.J.A.

    2013-01-01

    Music and its use for emotion regulation processes, to this day remains an unresolved question. Multiple experimental layouts encompassing its daily life use and clinical applications across different cultures and con-tinents have preserved music as a self-regulative tool. Therefore it is seen as a

  15. On distributive effects of optimal regulation for power grid expansion

    International Nuclear Information System (INIS)

    Herrera, Luis Ángel; Rosellón, Juan

    2014-01-01

    To date, the distributive implications of incentive regulation on electricity transmission networks have not been explicitly studied in the literature. More specifically, the parameters that a regulator might use to achieve distributive efficiency under price-cap regulation have not yet been identified. To discern these parameters is the motivation for the research presented in this paper. We study how different weight parameters affect the distributive characteristics of optimal price-cap incentive regulation for electricity transmission. We find that a regulator's use of ideal (Laspeyres) weights tends to be more beneficial for the Transco (consumers) than for consumers (the Transco). - Highlights: • Distributive implications of incentive regulation on transmission networks have not been studied in the literature. • The parameters that a regulator might use to achieve distributive efficiency have so far not been explicitly analyzed. • Analyze how different weights affect the distributive characteristics of price-cap regulation in electricity transmission. • Results: ideal (Laspeyres) weights tend to be more beneficial for the Transco (consumers) than for consumers (the Transco)

  16. When is public enforcement of insider trading regulations effective?

    NARCIS (Netherlands)

    Wielhouwer, J.L.

    2013-01-01

    In this paper we investigate when public enforcement of insider trading regulations reduces the amount of insider trading. We model a game between a potentially self-interested regulator enforcing insider trading laws and a trader who may be trading on inside information. We show that equilibrium

  17. The effect of energy performance regulations on energy consumption

    NARCIS (Netherlands)

    Guerra-Santin, O.; Itard, L.

    2012-01-01

    Governments have developed energy performance regulations in order to lower energy consumption in the housing stock. Most of these regulations are based on the thermal quality of the buildings. In the Netherlands, the energy efficiency for new buildings is expressed as the EPC (energy performance

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

    Science.gov (United States)

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

    2008-06-01

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

  19. [Can falls be prevented?].

    Science.gov (United States)

    Dubousset, Jean

    2014-06-01

    Most recommendations and measures intended to prevent falls focus on the elderly (see HAS guideline of April 2009) but, in our opinion, this isfar too late: prevention must begin much earlier, not only by identifying persons at risk, but also by providing personalized lifestyle advice adapted to each individual's biomechanical, somatic, neurological and biological characteristics. The first preventive measure is to identify a possible deterioration of balance, starting with a physical examination at the age of 45 and repeated regularly throughout life. Extrinsic preventive measures focusing on the domestic and external environments are clearly necessary. But what is most important is to detect and, if necessary, correct any degradation of intrinsic (intracorporeal or somatic) factors starting at the age of 45 years; these include vision, vestibular function and balance, proprioception, and psychological and neurological status. Chronic illnesses and their treatments must also be taken into account: treatment must be limited to indispensable drugs; sedative psychotropics must be avoided if possible; and polymedication must be tightly controlled, as it is a major risk factor for falls. Prevention also requires a diet sufficiently rich in protein, calcium and vitamin D3 (to prevent osteoporosis), and regular daily exercise adapted to the individual, if possible associated with a simultaneous cognitive task. The last key point is the absolute need for thorough functional rehabilitation after any accidental or medical trauma, regardless of age, with the aim of restoring functional status to that existing prior to the accident.

  20. Fall from grace

    International Nuclear Information System (INIS)

    Kelley, K.P.

    1988-01-01

    This paper reports that EPA issued the final rule for land disposal restrictions this summer, banning about one-third of all regulated hazardous wastes from landfills. Among the 861 million gallons of banned industrial wastes is 129 million gallons of electroplating sludges. fortunately, a group of researchers from industry and Northwestern University (Evanston, Ill.) has revived a metals recovery technology that could save some electroplating shops from both supply and disposal costs. Electroplating is one of the least expensive ways of protect an object from corrosion and wear resistance. Finishes are electroplated onto items ranging from jewelry to electronic equipment. It is also a $10 billion business with a value-added market that is an incredibly large number, says Varjian. The mostly small businesses that drive this industry have annual sales ranging around $1 million to $2 million, he adds. Now the managers of electroplating shops must figure out the most cost effective method of dealing with the hazardous sludges they produce that now are banned from landfills

  1. Interação silício com inseticida regulador de crescimento no manejo da lagarta-do-cartucho Spodoptera frugiperda (J. E. Smith, 1797 (Lepidoptera: Noctuidae em milho Interaction of silicon with growth regulating insecticide in the management of fall armyworm Spodoptera frugiperda (J. E. SMITH, 1797 (Lepidoptera: Noctuidae in corn plants

    Directory of Open Access Journals (Sweden)

    Danila Kelly Pereira Neri

    2005-12-01

    Full Text Available Com o objetivo de avaliar o efeito do silício aplicado via solo e foliar, bem como sua interação com o inseticida regulador de crescimento (lufenuron no manejo de Spodoptera frugiperda em plantas de milho, foi realizado um ensaio em casa-de-vegetação e em laboratório, constando de nove tratamentos com cinco repetições. No laboratório do Departamento de Entomologia da Universidade Federal de Lavras-MG, avaliou-se a preferência das lagartas por folhas destacadas de plantas de milho provenientes dos diferentes tratamentos, bem como o consumo e a mortalidade dessa praga. Em casa-de-vegetação, foram avaliadas a intensidade das injúrias provocadas pelas lagartas nas folhas, utilizando uma escala visual de danos proposta por Davis & Williams (1989, bem como o número e a biomassa das lagartas vivas. Pelos resultados pode-se concluir que os tratamentos não afetaram a preferência da lagarta-do-cartucho em teste de livre escolha. A interação silício e lufenuron no manejo de S. frugiperda é positiva em relação ao inseticida isolado, provavelmente devido a resistência mecânica conferida pelo silício as folhas.The objective of this work was to evaluate the effect of sprayed silicon via soil and leaf as well as its interaction with growth regulating insecticide (lufenuron in the management of Spodoptera frugiperda on corn plants. The trials were carried out in greenhouse and laboratory conditions and consisting of nine treatments with five replicates. In the laboratory, the preference of fall armyworms on detached leaves of corn plants from different treatments was evaluated, as well as the consumption and mortality of this pest. In the greenhouse, the damage caused by the insect on the leaves were evaluated by using a visual scale of injuries proposed by Davis & Williams (1989. In the greenhouse on the control treatment, both the number and weight of the larval were also determined. According to the results, silicon, the insecticide

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

    Science.gov (United States)

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

    2016-09-01

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

  3. Work place regulations - effects on power station construction

    International Nuclear Information System (INIS)

    Richter, E.

    1979-01-01

    The paper describes that the Workplace Order and Workplace Regulations cannot be applied in every area of a conventional power station or the conventional sections of nuclear power stations. In any case extensive regulations already exist for the hot regions of nuclear power stations. A proposal is made as to which areas of power stations should be developed in accordance with the Workplace Order and the Workplace Regulations and which areas are not deemed to be 'Workplaces'. This is illustrated with the aid of typical examples. (orig.) [de

  4. Effective self-regulation change techniques to promote mental wellbeing among adolescents: a meta-analysis

    NARCIS (Netherlands)

    Genugten, L. van; Dusseldorp, E.; Massey, E.K.; Empelen, P. van

    2017-01-01

    Mental wellbeing is influenced by self-regulation processes. However, little is known on the efficacy of change techniques based on self-regulation to promote mental wellbeing. The aim of this meta-analysis is to identify effective self-regulation techniques (SRTs) in primary and secondary

  5. Comparing welfare effects of different regulation schemes: An application to the electricity distribution industry

    International Nuclear Information System (INIS)

    Kopsakangas-Savolainen, Maria; Svento, Rauli

    2010-01-01

    We compare the welfare effects of different regulation schemes of electricity distribution utilities. The compared regulation schemes are Fixed Price regulation, Cost of Service regulation, Menu of Cost-Contingent Contracts and Simple Menu of Contracts. In our calculations we utilize the information of a firm's potential to improve cost efficiency. The firm-specific cost information of Finnish electricity distribution utilities is obtained by using various Stochastic Frontier models. Our basic result is that welfare can be improved by changing the Cost of Service regulation scheme to the Menu of Contracts regulation. Welfare also increases in the case of Fixed Price regulation and Simple Menu of Contract regulation. There is however, a significant difference among regulation regimes on how this improved welfare is distributed to consumers and producers.

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

    Science.gov (United States)

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

    2012-05-01

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

  7. Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial.

    Science.gov (United States)

    Oh, SeJun; Lim, Jong-Min; Kim, Yushin; Kim, MinSeock; Song, WoonGang; Yoon, BumChul

    2015-01-01

    The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life (QOL) in community-dwelling elderly people with history of falling. Participants were randomly assigned to the water-based exercise group (n=34) or land-based exercise groups (n=32). To identify the effects on physical functions, muscle strength, flexibility, and mobility were measured. QOL and fear of falling were evaluated using the Short Form 36-item questionnaire and the modified falls efficacy scale (M-FES). The measurements were performed before and after the 10-week training period. Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups (p=0.005; p=0.007). However, no statistically significant within-group differences were found in the back scratch test (p=0.766) and chair sit-and-reach test (p=0.870). QOL was significantly different in both groups (health transition: p=0.014, physical functioning: pwater-based exercises are beneficial to improve the QOL, as well as physical activities, of community-dwelling elderly compared with land-based exercise. Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Sposaro, Frank; Tyson, Gary

    2009-01-01

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

  9. Effect of plant growth regulators, explants type and efficient plantlet ...

    African Journals Online (AJOL)

    use

    2011-12-05

    Dec 5, 2011 ... Plant Pathology, Tissue Culture and Biotechnology Laboratory, Department of Botany,. University of ... variability in response to growth regulators. In vitro rooting ..... an adult tree Wrightia tomentosa through enhanced axillary.

  10. Effects of Plant Growth Regulators and Photoperiod on In

    African Journals Online (AJOL)

    Shahin

    using the combination of two plant growth regulators and same photoperiod. Key words: Tissue culture, ... they can be stored and transplanted directly into the field without an acclimatization ..... SAS user's guide. cary, NC: Statistical Analysis ...

  11. Issues in Geriatric Care: Falls.

    Science.gov (United States)

    Patel, Dipesh; Ackermann, Richard J

    2018-05-01

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

  12. An investigation on the effect of cognitive emotion regulation strategies on job satisfaction

    OpenAIRE

    Somayeh Shahba; Seyed Mehdi Alvani; Shams Alsadat Zahedi; Gholamreza Memarzadeh

    2014-01-01

    This paper examined the effects of cognitive emotion regulation on employees’ job satisfaction. In this survey, Questionnaire and the questions were divided into two categories of cognitive emotion regulation and job satisfaction. To measure cognitive emotion regulation, including unadjusted emotion regulation strategies and adjusted strategies, 36 items questionnaire was used originally developed by Garnefski et al. (2001) [Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life eve...

  13. The effect of sensor-based exercise at home on functional performance associated with fall risk in older people - a comparison of two exergame interventions.

    Science.gov (United States)

    Gschwind, Yves J; Schoene, Daniel; Lord, Stephen R; Ejupi, Andreas; Valenzuela, Trinidad; Aal, Konstantin; Woodbury, Ashley; Delbaere, Kim

    2015-01-01

    There is good evidence that balance challenging exercises can reduce falls in older people. However, older people often find it difficult to incorporate such programs in their daily life. Videogame technology has been proposed to promote enjoyable, balance-challenging exercise. As part of a larger analysis, we compared feasibility and efficacy of two exergame interventions: step-mat-training (SMT) and Microsoft-Kinect® (KIN) exergames. 148 community-dwelling people, aged 65+ years participated in two exergame studies in Sydney, Australia (KIN: n = 57, SMT: n = 91). Both interventions were delivered as unsupervised exercise programs in participants' homes for 16 weeks. Assessment measures included overall physiological fall risk, muscle strength, finger-press reaction time, proprioception, vision, balance and executive functioning. For participants allocated to the intervention arms, the median time played each week was 17 min (IQR 32) for KIN and 48 min (IQR 94) for SMT. Compared to the control group, SMT participants improved their fall risk score (p = 0.036), proprioception (p = 0.015), reaction time (p = 0.003), sit-to-stand performance (p = 0.011) and executive functioning (p = 0.001), while KIN participants improved their muscle strength (p = 0.032) and vision (p = 0.010), and showed a trend towards improved fall risk scores (p = 0.057). The findings suggest that it is feasible for older people to conduct an unsupervised exercise program at home using exergames. Both interventions reduced fall risk and SMT additionally improved specific cognitive functions. However, further refinement of the systems is required to improve adherence and maximise the benefits of exergames to deliver fall prevention programs in older people's homes. ACTRN12613000671763 (Step Mat Training RCT) ACTRN12614000096651 (MS Kinect RCT).

  14. Effectiveness of a combination of cognitive behavioral therapy and task-oriented balance training in reducing the fear of falling in patients with chronic stroke: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Liu, Tai-Wa; Ng, Gabriel Y F; Ng, Shamay S M

    2018-03-07

    The consequences of falls are devastating for patients with stroke. Balance problems and fear of falling are two major challenges, and recent systematic reviews have revealed that habitual physical exercise training alone cannot reduce the occurrence of falls in stroke survivors. However, recent trials with community-dwelling healthy older adults yielded the promising result that interventions with a cognitive behavioral therapy (CBT) component can simultaneously promote balance and reduce the fear of falling. Therefore, the aim of the proposed clinical trial is to evaluate the effectiveness of a combination of CBT and task-oriented balance training (TOBT) in promoting subjective balance confidence, and thereby reducing fear-avoidance behavior, improving balance ability, reducing fall risk, and promoting independent living, community reintegration, and health-related quality of life of patients with stroke. The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial in which patients are assessed immediately, at 3 months, and at 12 months. The selected participants will be randomly allocated into one of two parallel groups (the experimental group and the control group) with a 1:1 ratio. Both groups will receive 45 min of TOBT twice per week for 8 weeks. In addition, the experimental group will receive a 45-min CBT-based group intervention, and the control group will receive 45 min of general health education (GHE) twice per week for 8 weeks. The primary outcome measure is subjective balance confidence. The secondary outcome measures are fear-avoidance behavior, balance ability, fall risk, level of activities of daily living, community reintegration, and health-related quality of life. The proposed clinical trial will compare the effectiveness of CBT combined with TOBT and GHE combined with TOBT in promoting subjective balance confidence among chronic stroke patients. We hope our results will provide evidence of a safe

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-11-13

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

  16. Comparison of the effect of sevoflurane and halothane anesthesia on the fall in hear rate as a predictor of successful single shot caudal epidural in children

    International Nuclear Information System (INIS)

    Mercan, A.; Ture, H.; Sayin, Murat M.; Koner, O.; Aykac, B.; Sozubir, S.

    2009-01-01

    Objective was to investigate the effect of sevoflurane anesthesia on heart rate (HR) fall with the injection of the initial drug in caudal space to confirm the correct needle placement. After the ethical approval was obtained from the hospital's ethics committee, a prospective randomized, clinical study was designed in Yeditepe University Hospital, in 2007. Children aged 1-12 years, scheduled for infraumblical surgery under general anesthesia and caudal block were included in the study. Anesthesia was induced and maintained by sevoflurane in group S (n=8) and by halothane in group H (n=82). Baseline HR was recorded before the caudal block was performed. The HR changes during the initial dose and total drug injection was recorded followed by 2 more HR recordings taken 5 and 10 minutes after caudal injection. The success of the block was recorded by a blind observer. There were 167 children included in the study. Caudal block success was 96.5% in group S and 97.6% in group H. Basal HR was 110.9+-10.9 in group S and 105.9+-10.1 in group H. Following the initial drug injection, mean HR was 109.8+-10.9 in group S and 102.9+-9.9 in group H. It was significantly lower than the baseline in group. The only significant decrease in the HR of the patients in group S was at the tenth minute following caudal injection. The decrease in HR with drug injection has no value to predict the success of caudal block under sevoflurane anesthesia. (author)

  17. Meteoric calcite cementation: diagenetic response to relative fall in sea-level and effect on porosity and permeability, Las Negras area, southeastern Spain

    Science.gov (United States)

    Li, Zhaoqi; Goldstein, Robert H.; Franseen, Evan K.

    2017-03-01

    A dolomitized Upper Miocene carbonate system in southeast Spain contains extensive upper and lower zones of calcite cementation that cut across the stratigraphy. Cement textures including isopachous and circumgranular, which are consistent with phreatic-zone cementation. Cements in the upper cemented zone are non-luminescent, whereas those in the lower cemented zone exhibit multiple bands of luminescent and non-luminescent cements. In the upper cemented zone, isotopic data show two meteoric calcite lines (MCL) with mean δ18O at - 5.1‰ and - 5.8‰ VPDB, whereas no clear MCL is defined in the lower cemented zone where mean δ18O for calcite cement is at - 6.7‰ VPDB. δ13C values in both cement zones are predominantly negative, ranging from - 10 to + 2‰ VPDB, suggestive of carbon from soil gas or decayed organics. Measurements of Tm ice in primary fluid inclusions yield a mode of 0.0 °C in both zones, indicating calcite cementation from fresh water. These two zones define the positions of two different paleo-water tables that formed during a relative sea-level fall and erosional downcutting during the Plio-Pleistocene. The upper cemented zone pre-dated the lower cemented zone on the basis of known relative sea-level history. Meteoric calcite cementation reduced porosity and permeability, but measured values are inconsistent with simple filling of open pore space. Each texture, boundstone, grainstone, packstone, wackestone, produces a different relationship between percent calcite cement and porosity/permeability. Distribution of cements may be predictable on the basis of known sea-level history, and the effect of the cementation can be incorporated into subsurface geomodels by defining surfaces of rock boundaries that separate cemented zones from uncemented zones, and applying texture-specific relationships among cementation, porosity and permeability.

  18. 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...

  19. "The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis": Correction to Johnsen and Friborg (2015).

    Science.gov (United States)

    2016-03-01

    Reports an error in "The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis" by Tom J. Johnsen and Oddgeir Friborg (Psychological Bulletin, 2015[Jul], Vol 141[4], 747-768). There are several numerical errors in the flowchart summarizing the selection and exclusion of studies as contained in Figure 1. The correct number of titles not further investigated should be 27,381; abstracts rejected should be 1,181; Excluded, different treatment form should be (94). The errors do not affect the results or conclusions of the study as the final number of meta-analysable studies are the same as originally reported. (The following abstract of the original article appeared in record 2015-20361-001.) A meta-analysis examining temporal changes (time trends) in the effects of cognitive behavioral therapy (CBT) as a treatment for unipolar depression was conducted. A comprehensive search of psychotherapy trials yielded 70 eligible studies from 1977 to 2014. Effect sizes (ES) were quantified as Hedge's g based on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). Rates of remission were also registered. The publication year of each study was examined as a linear metaregression predictor of ES, and as part of a 2-way interaction with other moderators (Year × Moderator). The average ES of the BDI was 1.58 (95% CI [1.43, 1.74]), and 1.69 for the HRSD (95% CI [1.48, 1.89]). Subgroup analyses revealed that women profited more from therapy than did men (p < .05). Experienced psychologists (g = 1.55) achieved better results (p < .01) than less experienced student therapists (g = 0.98). The metaregressions examining the temporal trends indicated that the effects of CBT have declined linearly and steadily since its introduction, as measured by patients' self-reports (the BDI, p < .001), clinicians' ratings (the HRSD, p < .01) and rates of remission (p < .01). Subgroup analyses confirmed that the declining

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

    Science.gov (United States)

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

    2017-06-01

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

  1. Study on effects of environmental regulation on competitiveness

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Man Ok; Lim, Hyun Jeong [Korea Environment Institute, Seoul (Korea)

    1999-12-01

    For Korea, the claim that the enhancement of environmental regulation is worsening the international competitiveness of the business is dominant. However, it is too early to reestablish a relationship between environmental regulation and competitiveness with the above new aspect. In fact, the economic development, which is brought a quantitative growth, and the maintenance of environmental quality, which is brought a qualitative growth, are very important on decision making in economic and social policy. In this study, it represents the results of existing positive studies on the relationship between the enhancement of environmental regulation, trade and productivity. Moreover, the objective of this study is on applying it based on the data of Korea. 86 refs., 13 figs., 35 tabs.

  2. Direct and indirect effects in the regulation of overlapping promoters

    DEFF Research Database (Denmark)

    Bendtsen, Kristian Moss; Erdossy, Janos; Csiszovski, Zsolt

    2011-01-01

    promoter database we found that ~14% of the identified 'forward' promoters overlap with a promoter oriented in the opposite direction. In this article we combine a mathematical model with experimental analysis of synthetic regulatory regions to investigate interference of overlapping promoters. We find...... that promoter interference depends on the characteristics of overlapping promoters. The model predicts that promoter strength and interference can be regulated separately, which provides unique opportunities for regulation. Our experimental data suggest that in principle any DNA binding protein can be used......Optimal response to environmental stimuli often requires activation of certain genes and repression of others. Dual function regulatory proteins play a key role in the differential regulation of gene expression. While repression can be achieved by any DNA binding protein through steric occlusion...

  3. The effect of arousal on regulation of negative emotions using cognitive reappraisal: An ERP study.

    Science.gov (United States)

    Langeslag, Sandra J E; Surti, Kruti

    2017-08-01

    Because the effectiveness of the emotion regulation strategy cognitive reappraisal may vary with emotion intensity, we investigated how stimulus arousal affects reappraisal success. Participants up- and down-regulated emotional responses using cognitive reappraisal to low and high arousing unpleasant pictures while the electroencephalogram (EEG) was recorded. Up-regulation resulted in more negative self-reported valence, while down-regulation resulted in less negative self-reported valence regardless of stimulus arousal, suggesting that subjective reappraisal success does not vary with emotional intensity. Participants felt that down-regulation of emotional responses to low arousing unpleasant pictures was easiest, which is in line with previous findings that participants showed a greater preference for reappraisal in low than high arousing situations. The late positive potential (LPP) amplitude was enhanced by down-regulation of high arousing unpleasant pictures. Even though this effect was unexpected and is opposite to the typical effect of down-regulation on the LPP, it is in line with several previous studies. Potential explanations for LPP regulation effects in the unexpected direction, such as strategy selection and task design, are evaluated. Suggestions and recommendations for future research are discussed, including using trial-by-trial manipulation of regulation instructions and studying the effect of stimulus arousal on up- and down-regulation of positive emotions. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Comparison and Characterization of Android-Based Fall Detection Systems

    Directory of Open Access Journals (Sweden)

    Rafael Luque

    2014-10-01

    Full Text Available Falls are a foremost source of injuries and hospitalization for seniors. The adoption of automatic fall detection mechanisms can noticeably reduce the response time of the medical staff or caregivers when a fall takes place. Smartphones are being increasingly proposed as wearable, cost-effective and not-intrusive systems for fall detection. The exploitation of smartphones’ potential (and in particular, the Android Operating System can benefit from the wide implantation, the growing computational capabilities and the diversity of communication interfaces and embedded sensors of these personal devices. After revising the state-of-the-art on this matter, this study develops an experimental testbed to assess the performance of different fall detection algorithms that ground their decisions on the analysis of the inertial data registered by the accelerometer of the smartphone. Results obtained in a real testbed with diverse individuals indicate that the accuracy of the accelerometry-based techniques to identify the falls depends strongly on the fall pattern. The performed tests also show the difficulty to set detection acceleration thresholds that allow achieving a good trade-off between false negatives (falls that remain unnoticed and false positives (conventional movements that are erroneously classified as falls. In any case, the study of the evolution of the battery drain reveals that the extra power consumption introduced by the Android monitoring applications cannot be neglected when evaluating the autonomy and even the viability of fall detection systems.

  5. Comparison and characterization of Android-based fall detection systems.

    Science.gov (United States)

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

    2014-10-08

    Falls are a foremost source of injuries and hospitalization for seniors. The adoption of automatic fall detection mechanisms can noticeably reduce the response time of the medical staff or caregivers when a fall takes place. Smartphones are being increasingly proposed as wearable, cost-effective and not-intrusive systems for fall detection. The exploitation of smartphones' potential (and in particular, the Android Operating System) can benefit from the wide implantation, the growing computational capabilities and the diversity of communication interfaces and embedded sensors of these personal devices. After revising the state-of-the-art on this matter, this study develops an experimental testbed to assess the performance of different fall detection algorithms that ground their decisions on the analysis of the inertial data registered by the accelerometer of the smartphone. Results obtained in a real testbed with diverse individuals indicate that the accuracy of the accelerometry-based techniques to identify the falls depends strongly on the fall pattern. The performed tests also show the difficulty to set detection acceleration thresholds that allow achieving a good trade-off between false negatives (falls that remain unnoticed) and false positives (conventional movements that are erroneously classified as falls). In any case, the study of the evolution of the battery drain reveals that the extra power consumption introduced by the Android monitoring applications cannot be neglected when evaluating the autonomy and even the viability of fall detection systems.

  6. Comparison and Characterization of Android-Based Fall Detection Systems

    Science.gov (United States)

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

    2014-01-01

    Falls are a foremost source of injuries and hospitalization for seniors. The adoption of automatic fall detection mechanisms can noticeably reduce the response time of the medical staff or caregivers when a fall takes place. Smartphones are being increasingly proposed as wearable, cost-effective and not-intrusive systems for fall detection. The exploitation of smartphones' potential (and in particular, the Android Operating System) can benefit from the wide implantation, the growing computational capabilities and the diversity of communication interfaces and embedded sensors of these personal devices. After revising the state-of-the-art on this matter, this study develops an experimental testbed to assess the performance of different fall detection algorithms that ground their decisions on the analysis of the inertial data registered by the accelerometer of the smartphone. Results obtained in a real testbed with diverse individuals indicate that the accuracy of the accelerometry-based techniques to identify the falls depends strongly on the fall pattern. The performed tests also show the difficulty to set detection acceleration thresholds that allow achieving a good trade-off between false negatives (falls that remain unnoticed) and false positives (conventional movements that are erroneously classified as falls). In any case, the study of the evolution of the battery drain reveals that the extra power consumption introduced by the Android monitoring applications cannot be neglected when evaluating the autonomy and even the viability of fall detection systems. PMID:25299953

  7. The effects of different regulation strategies on Jiangsu's wind integration

    DEFF Research Database (Denmark)

    Hong, Lixuan; Lund, Henrik; Möller, Bernd

    This paper presents the influence of different regulation strategies on wind energy integration into existing Jiangsu’s energy system. The ability of wind integration is defined in terms of the ability to avoid excess electricity production, to conserve primary energy consumptions and to reduce CO2...... emissions in the system. Firstly, a reference model of Jiangsu’s energy system is built by using EnergyPLAN based on the year 2009. The model results then are compared to actual values from 2009 to validate its accuracy. Based on the reference model, different regulations of Jiangsu’s energy system...

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

    Science.gov (United States)

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

    2017-11-08

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

  9. 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.

  10. 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.

  11. Research on patient safety: falls and medications.

    Science.gov (United States)

    Boddice, Sandra Dawn; Kogan, Polina

    2009-10-01

    Below you will find summaries of published research describing investigations into patient safety issues related to falls and medications. The first summary provides details on the incidence of falls associated with the use of walkers and canes. This is followed by a summary of a fall-prevention intervention study that evaluated the effectiveness of widespread dissemination of evidence-based strategies in a community in Connecticut. The third write up provides information on three classes of medications that are associated with a significant number of emergency room visits. The last summary describes a pharmacist-managed medication reconciliation intervention pilot program. For additional details about the study findings and interventions, we encourage readers to review the original articles.

  12. Streamflow effects on spawning, rearing, and outmigration of fall-run chinook salmon (Oncorhynchus tshawytscha) predicted by a spatial and individual-based model

    International Nuclear Information System (INIS)

    Jager, H.I.; Sale, M.J.; Cardwell, H.E.; Deangelis, D.L.; Bevelhimer, M.J.; Coutant, C.C.

    1994-01-01

    The thread posed to Pacific salmon by competing water demands is a great concern to regulators of the hydropower industry. Finding the balance between fish resource and economic objectives depends on our ability to quantify flow effects on salmon production. Because field experiments are impractical, simulation models are needed to predict the effects of minimum flows on chinook salmon during their freshwater residence. We have developed a model to simulate the survival and development of eggs and alevins in redds and the growth, survival, and movement of juvenile chinook in response to local stream conditions (flow, temperature, chinook and predator density). Model results suggest that smolt production during dry years can be increased by raising spring minimum flows

  13. Reducing the fear of falling through a community evidence-based intervention.

    Science.gov (United States)

    Beauvais, Audrey; Beauvais, John E

    2014-02-01

    Falls and the fear of falling are major health concerns among older adults. The purpose of this study was to assess the effects of an evidence-based fall prevention program on the fear of falling and health-related quality of life among community-dwelling elders. The program consisted of 6 classes that covered topics such as risk factors for falls, balance exercises, medications, safe footwear, and home safety. Of those elders who were most fearful at baseline, the fall prevention program decreased their fear of falling and improved 1 dimension of their health-related quality of life.

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

    Science.gov (United States)

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

    2003-05-01

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

  15. The effect of manure management regulations on competitiveness

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou

    2003-01-01

    Significant differences in the competitiveness of pig production along with growing international competition in the pigmeat market have raised concerns about the cost impact of environmental regulations on producers, particularly those regarding the management of manure. There appears to be a U...

  16. Effects of season and regulated photoperiod on the reproductive ...

    African Journals Online (AJOL)

    user

    constant photoperiod (10 h light and 14 h darkness) and control sows (n = 187) ... Keywords: Season, regulated photoperiod, return to oestrus, farrowing rate, litter size .... were exposed to a minimum daylight cycle of 10.4 h during winter and a ...

  17. Personal Space Regulation in Williams Syndrome: The Effect of Familiarity

    Science.gov (United States)

    Lough, Emma; Flynn, Emma; Riby, Deborah M.

    2016-01-01

    Personal space refers to a protective barrier that we strive to maintain around our body. We examined personal space regulation in young people with Williams syndrome (WS) and their typically developing, chronological age-matched peers using a parent report questionnaire and a stop-distance paradigm. Individuals with WS were reported by their…

  18. The Effect of Turkish Students' Motivational Beliefs on Their Metacognitive Self-Regulation in Physics

    Science.gov (United States)

    Gurcay, Deniz; Balta, Ebru

    2013-01-01

    It is emphasized in several studies that both domain specific factors and cultural values and beliefs could have an effect on students' metacognitive self-regulation and motivational beliefs. The aim of this study was to investigate the effect of motivational beliefs on Turkish students' metacognitive self-regulation in physics courses. Therefore,…

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

    Science.gov (United States)

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

    2010-11-03

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

  20. Effective management of regulator RI/FS comments

    International Nuclear Information System (INIS)

    Wolinsky, S.M.; Lojek, D.; George, R.D.; Houser, S.M.; Strimbu, M.J.

    1995-01-01

    This paper describes a successful strategy that facilitates regulatory approval of CERCLA documents required by compliance agreement and CERCLA, based on the experience of Operable Unit 1, Waste Storage Area, of the Fernald Environmental Management Project (FEMP). This strategy, which has become the site standard at the FEMP, was instrumental in obtaining regulator approval of the OU1 RI and FS, and early approval of the Record of Decision during a very tight compliance agreement-driven schedule. This strategy can be applied at any DOE Superfund site, especially where there is need to recover lost schedule, an incentive to meet milestones early, a need to improve the relationship between the DOE and the regulators, or where the regulatory agencies have historically provided a large volume of comments on CERCLA documents. The strategy focuses on early identification and resolution of issues relating to draft RI/FS documents, as raised in regulatory agency review comments. This pro-active strategy has the potential for schedule and cost savings, as well as for improved communication between DOE and the regulators. The strategy includes preparation of a separate comment response document, integration of comment responses with RI/FS documents, development of a database of agency comments and their resolution, and sharing lessons learned with preparers of subsequent RI/FS documents. The paper provides background on the FEMP and describes the FEMP comment response strategy; DOE and regulator interface; the Sitewide Comment Database; networked electronic file management; the process for classifying, analyzing, and responding to comments; integration with base RI/FS documents; and a conclusion

  1. Effective management of regulator RI/FS comments

    Energy Technology Data Exchange (ETDEWEB)

    Wolinsky, S.M.; Lojek, D.; George, R.D.; Houser, S.M.; Strimbu, M.J.

    1995-12-31

    This paper describes a successful strategy that facilitates regulatory approval of CERCLA documents required by compliance agreement and CERCLA, based on the experience of Operable Unit 1, Waste Storage Area, of the Fernald Environmental Management Project (FEMP). This strategy, which has become the site standard at the FEMP, was instrumental in obtaining regulator approval of the OU1 RI and FS, and early approval of the Record of Decision during a very tight compliance agreement-driven schedule. This strategy can be applied at any DOE Superfund site, especially where there is need to recover lost schedule, an incentive to meet milestones early, a need to improve the relationship between the DOE and the regulators, or where the regulatory agencies have historically provided a large volume of comments on CERCLA documents. The strategy focuses on early identification and resolution of issues relating to draft RI/FS documents, as raised in regulatory agency review comments. This pro-active strategy has the potential for schedule and cost savings, as well as for improved communication between DOE and the regulators. The strategy includes preparation of a separate comment response document, integration of comment responses with RI/FS documents, development of a database of agency comments and their resolution, and sharing lessons learned with preparers of subsequent RI/FS documents. The paper provides background on the FEMP and describes the FEMP comment response strategy; DOE and regulator interface; the Sitewide Comment Database; networked electronic file management; the process for classifying, analyzing, and responding to comments; integration with base RI/FS documents; and a conclusion.

  2. Effect of Sleep/Wake Cycle on Autonomic Regulation

    International Nuclear Information System (INIS)

    Jabeen, S.

    2015-01-01

    Objective: To evaluate the association between irregular sleep/wake cycle in shift workers and autonomic regulation. Study Design: Cross-sectional, analytical study. Place and Duration of Study: Dow University Hospital, Karachi, from August to November 2013. Methodology: All health care providers working in rotating shifts making a total (n=104) were included. Instrument was an integrated questionnaire applied to assess autonomic regulation, taken from Kroz et al. on scoring criteria, ranging from 18 - 54, where higher rating signifies strong autonomic regulation, indicating a stable Autonomic Nervous System (ANS) and vice versa. Participants were interviewed and their response was recorded by the investigator. Influence of sleep misalignment was measured quantitatively to extract index of autonomic activity. Results: There was a reduced trend in autonomic strength amongst shift workers. The mean score obtained on the Autonomic Scale was 37.8 ± 5.9. Conclusion: Circadian misalignment has an injurious influence on ANS which might be valuable in controlling autonomic dysfunction that leads to fatal triggers in rotating shift workers. (author)

  3. Effects of late gestation distillers grains supplementation on fall-calving beef cow performance and steer calf growth and carcass characteristics.

    Science.gov (United States)

    Wilson, T B; Schroeder, A R; Ireland, F A; Faulkner, D B; Shike, D W

    2015-10-01

    Fall-calving, mature Angus and Simmental × Angus cows ( = 251 total) and their progeny were used to evaluate the effects of late gestation dried distillers grains plus solubles (DDGS) supplementation on cow performance and progeny growth and carcass characteristics. Cows were blocked by breed and allotted to 12 tall fescue pastures (6.8 ha average). Pastures were randomly assigned to 1 of 2 treatments: cows were offered 2.1 kg DM DDGS·cow·d (SUP; CP = 23%, fat = 7%; = 6 pastures) or were not offered a supplement (CON; = 6 pastures) 69 ± 9 d before expected calving date. Cows remained on treatments until calving. Once weekly, cows that had calved were removed from treatment pastures and were moved to new tall fescue pastures (21.6 ha average) where cows from both treatments were comingled without further supplementation. Cows ( = 74) were removed from study for calving more than 30 d after expected calving date, calf loss and injury, or euthanasia. Cow BW and BCS were recorded at the beginning of the supplementation period, after calving, and at breeding. Calf BW was taken at birth and early weaning (82 ± 14 d of age). After weaning, 71 steer progeny (representative of dam breed and treatment pastures) were transitioned to a common feedlot diet with individual feed intake monitored using the GrowSafe feeding system. Steers were slaughtered at 47 ± 4 d after a minimum 12th rib fat thickness (back fat) estimation of 0.6 cm, with cattle being shipped in 3 groups. Forage availability was not different between treatments ( = 0.69). Cows offered SUP gained more BW and BCS ( ≤ 0.02) during the supplementation period. There were no differences ( ≥ 0.12) in calving date, calf birth or weaning BW, or preweaning ADG. Cow BW at breeding was not different ( = 0.19); however, BCS at breeding was greater ( milk production, AI conception, or overall pregnancy rate were detected. For steer progeny, initial feedlot BW, final BW, and days on feed were not different ( ≥ 0

  4. Efectividad de las intervenciones para la prevención de caídas en ancianos: revisión sistemática Effectiveness of interventions for prevention falls in the elderly: systematic review

    Directory of Open Access Journals (Sweden)

    Juan Manuel Laguna-Parras

    2010-09-01

    Full Text Available Objetivos: identificar las principales causas por las que se producen las caídas y determinar qué medidas son efectivas y cuáles no en la prevención de caídas accidentales. Métodos: revisión sistemática sobre los diferentes estudios de caídas en el hospital. Esta revisión incluye ensayos clínicos, estudios de casos/controles, estudios de cohortes y estudios observacionales publicados desde la indexación de cada base de datos, hasta diciembre de 2009. Resultados: se revisó un total de 60 estudios, de los cuales 37 finalmente entraron en la revisión, previo examen de su calidad metodológica mediante el CASP. Las principales causas por las que se producen las caídas están relacionadas con la edad, patologías (Parkinson, demencias, Alzheimer, medicación y el pre/postoperatorio. De todos los estudios, hay diversas intervenciones que han demostrado ser efectivas y reducir el número de caídas. Conclusiones: todos los estudios, en general, han aplicado medidas de prevención en función del riesgo y/o enfermedad identificados por grupos de pacientes. Las medidas preventivas que han demostrado eficacia han sido el uso correcto de la colocación de medidas de protección, el establecimiento de unos parámetros para la identificación de los posibles factores de riesgo que puedan ocasionar una caída y evaluar la frecuencia de éstas, establecer una escala de atención de la dependencia y compararla con el modelo de factores de riesgo, analizar los factores de riesgo extrínsecos que las favorecen, realizar una puntuación para identificar a los pacientes con alto riesgo, establecer un programa de intervención de caídas y desarrollar estrategias para la prevención de éstas.Aims: to identify the main causes of falls and determine which interventions are effective to prevent accidental falls. Methods: Systematic review over studies of falls in the hospital. This review includes clinical trials, case/control, cohort and observational

  5. Influence of non-spatial working memory demands on reach-grasp responses to loss of balance: Effects of age and fall risk.

    Science.gov (United States)

    Westlake, Kelly P; Johnson, Brian P; Creath, Robert A; Neff, Rachel M; Rogers, Mark W

    2016-03-01

    Reactive balance recovery strategies following an unexpected loss of balance are crucial to the prevention of falls, head trauma and other major injuries in older adults. While a longstanding focus has been on understanding lower limb recovery responses, the upper limbs also play a critical role. However, when a fall occurs, little is known about the role of memory and attention shifting on the reach to grasp recovery strategy and what factors determine the speed and precision of this response beyond simple reaction time. The objective of this study was to compare response time and accuracy of a stabilizing grasp following a balance perturbation in older adult fallers compared to non-fallers and younger adults while loading the processing demands of non-spatial, verbal working memory. Working memory was engaged with a progressively challenging verb-generation task that was interrupted by an unexpected sideways platform perturbation and a pre-instructed reach to grasp response. Results revealed that the older adults, particularly those at high fall risk, demonstrated significantly increased movement time to handrail contact and grasping errors during conditions in which non-spatial memory was actively engaged. These findings provide preliminary evidence of the cognitive deficit in attention shifting away from an ongoing working memory task that underlies delayed and inaccurate protective reach to grasp responses in older adult fallers. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. The effects of bedtime writing on difficulty falling asleep: A polysomnographic study comparing to-do lists and completed activity lists.

    Science.gov (United States)

    Scullin, Michael K; Krueger, Madison L; Ballard, Hannah K; Pruett, Natalya; Bliwise, Donald L

    2018-01-01

    Bedtime worry, including worrying about incomplete future tasks, is a significant contributor to difficulty falling asleep. Previous research showed that writing about one's worries can help individuals fall asleep. We investigated whether the temporal focus of bedtime writing-writing a to-do list versus journaling about completed activities-affected sleep onset latency. Fifty-seven healthy young adults (18-30) completed a writing assignment for 5 min prior to overnight polysomnography recording in a controlled sleep laboratory. They were randomly assigned to write about tasks that they needed to remember to complete the next few days (to-do list) or about tasks they had completed the previous few days (completed list). Participants in the to-do list condition fell asleep significantly faster than those in the completed-list condition. The more specifically participants wrote their to-do list, the faster they subsequently fell asleep, whereas the opposite trend was observed when participants wrote about completed activities. Therefore, to facilitate falling asleep, individuals may derive benefit from writing a very specific to-do list for 5 min at bedtime rather than journaling about completed activities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

    Science.gov (United States)

    Reinsch, Sibylle; And Others

    1992-01-01

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

  8. 29 CFR 1915.159 - Personal fall arrest systems (PFAS).

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Personal fall arrest systems (PFAS). 1915.159 Section 1915... Protective Equipment (PPE) § 1915.159 Personal fall arrest systems (PFAS). The criteria of this section apply to PFAS and their use. Effective January 1, 1998, body belts and non-locking snaphooks are not...

  9. Mixed waste and waste minimization: The effect of regulations and waste minimization on the laboratory

    International Nuclear Information System (INIS)

    Dagan, E.B.; Selby, K.B.

    1993-08-01

    The Hanford Site is located in the State of Washington and is subject to state and federal environmental regulations that hamper waste minimization efforts. This paper addresses the negative effect of these regulations on waste minimization and mixed waste issues related to the Hanford Site. Also, issues are addressed concerning the regulations becoming more lenient. In addition to field operations, the Hanford Site is home to the Pacific Northwest Laboratory which has many ongoing waste minimization activities of particular interest to laboratories

  10. Geriatric fall-related injuries.

    Science.gov (United States)

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

    2016-06-01

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

  11. The effect of puberty on diurnal sodium regulation.

    Science.gov (United States)

    Mahler, B; Kamperis, K; Ankarberg-Lindgren, C; Djurhuus, J C; Rittig, S

    2015-11-15

    The aim of this study was to investigate the impact of sex and puberty stage on circadian changes in sodium excretion, sodium-regulating hormones, and hemodynamics. Thirty-nine healthy volunteers (9 prepuberty boys, 10 prepuberty girls, 10 puberty boys, and 10 puberty girls) were included. They all underwent a 24-h circadian in-patient study under standardized conditions regarding activity, diet, and fluid intake. Blood samples were drawn every 4 h, and the urine was collected in fractions. Blood pressure and heart rate were noninvasively monitored. Atrial natriuretic peptide (ANP), angiotensin II, aldosterone, and renin were measured in blood. Children in puberty had lower plasma levels of renin (Ppuberty group. There is a circadian rhythm of sodium excretion and sodium regulation in 7- to 15-yr-old children. This rhythm is similar in boys and girls. As an important new finding, puberty changes the plasma levels of renin and angiotensin II without changing the amount of sodium excreted or the day to night sodium excretion ratio. Copyright © 2015 the American Physiological Society.

  12. Cowlitz Falls fish passage

    International Nuclear Information System (INIS)

    1995-09-01

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

  13. Catching a Falling Star

    Science.gov (United States)

    2004-07-01

    apparent diameter of Mars in the evening sky! It is the same effect as when you try to photograph your children with a forest in the background. If you focus your camera on the distant forest, then (in most cases) your children will be out of focus. Or to put this in another way, the VLT is clearly not very suited to observe ships passing by on the Pacific Ocean, just 12 km from Paranal! No Trace of Carbon The meteor spectrum also provided a first view of such an object in the near-infrared window between wavelengths 900 and 1050 nm. This spectral region contains relatively strong lines of atomic carbon, but no such emissions were detected. "We calculated that these lines should have been visible if all atmospheric carbon dioxide in the meteor path was dissociated into carbon and oxygen atoms," says Jenniskens, "but they were conspicuously absent". This observation is important because it sets new constraints on the efficiency of meteor-induced atmospheric chemistry at the time when life began on our planet. Appendix: Cosmic showers Meteoroids are small grains of rocks orbiting the Sun. Far smaller than asteroids, they make their presence known to us in a dramatic and beautiful way when they enter earth's atmosphere and burn up, producing a short glowing trail in the night sky, rarely lasting more than a second or two - a meteor. Most meteoroids are completely destroyed at altitudes between 80 and 110 km, but some of the bigger ones make it to the ground. Here they may be collected as meteorites. Many meteoroids originate as fragments of asteroids and appear to be unaltered since the formation of the Solar System, some 4500 million years ago. Based on the peculiar composition of some meteorites, we know that a small fraction of meteoroids originate from the Moon, Mars or the large asteroid Vesta. They obviously result from major impacts on these bodies which blasted rock fragments into space. These fragments then orbit the Sun and may eventually collide with the Earth

  14. Community College Estimated Growth: Fall 2010

    Science.gov (United States)

    Phillippe, Kent; Mullin, Christopher M.

    2011-01-01

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

  15. Preventing falls in assisted living: Results of a quality improvement pilot study.

    Science.gov (United States)

    Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

    Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-03-01

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

  17. Effects of growth regulator herbicide on downy brome (Bromus tectorum) seed production

    Science.gov (United States)

    Previous research showed growth regulator herbicides, such as picloram and aminopyralid, have a sterilizing effect on Japanese brome (Bromus japonicus Thunb.) that can reduce this invasive annual grass’s seed production nearly 100%. This suggests growth regulators might be used to control invasive ...

  18. 31 CFR 100.2 - Scope of regulations; transactions effected through Federal Reserve banks and branches...

    Science.gov (United States)

    2010-07-01

    ... branches; distribution of coin and currencies. The regulations in this part govern the exchange of the coin... effected through Federal Reserve banks and branches; distribution of coin and currencies. 100.2 Section 100.2 Money and Finance: Treasury Regulations Relating to Money and Finance EXCHANGE OF PAPER CURRENCY...

  19. The effect of regulation feedback in a computer-based formative assessment on information problem solving

    NARCIS (Netherlands)

    Timmers, Caroline; Walraven, Amber; Veldkamp, Bernard P.

    2015-01-01

    This study examines the effect of regulation feedback in a computer-based formative assessment in the context of searching for information online. Fifty 13-year-old students completed two randomly selected assessment tasks, receiving automated regulation feedback between them. Student performance

  20. Telephone Care Management of Fall Risk:: A Feasibility Study.

    Science.gov (United States)

    Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

    2017-03-01

    Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Schuster Tibor

    2011-02-01

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

  2. The role of exercise for fall prevention in older age

    Directory of Open Access Journals (Sweden)

    Anne Tiedemann

    2013-09-01

    Full Text Available Falls are a common, costly and preventable consequence of sensorimotor impairments that increase in prevalence with advancing age. A fall occurs when the physical ability of the individual is unable to match the immediate demands of the environment and/or of the activity being undertaken. Targeted exercise aimed at improving the physical ability of the individual, such as balance and strength training, is crucial for promoting functional independence and mobility and reducing the risk of falling in older age. Exercise programs that provide a high challenge to balance, have a high dose, include progression of intensity over time and are ongoing are most effective for preventing falls. This paper provides guidance to health professionals involved with the prescription of physical activity and exercise to older people regarding the safe and effective provision of programs aimed at improving strength and balance and preventing falls in older age.

  3. Effect of Government Regulation on the Evolution of Sports Nutrition

    Science.gov (United States)

    Collins, Rick; Kalman, Douglas

    The sports nutrition segment of the dietary supplement industry enjoyed nearly a decade of unfettered growth under federal legislation passed in 1994. A series of breakthroughs in the dietary supplement field led to the development and marketing of innovative products designed to enhance performance, build muscle, or lose excess fat. As the popularity of these products soared and evolved into a multi-billion dollar industry, the sports nutrition supplement market drew the attention of federal and state regulatory bodies and sports antidoping authorities. Growing concerns over potential health risks and unfair athletic advantages have spurred government regulators and legislators to heighten the scrutiny of this market, leading to recent legislative amendments and increased government enforcement action.

  4. Synergistic effect of CART (cocaine- and amphetamine-regulated transcript peptide and cholecystokinin on food intake regulation in lean mice

    Directory of Open Access Journals (Sweden)

    Kiss Alexander

    2008-10-01

    Full Text Available Abstract Background CART (cocaine- and amphetamine-regulated transcript peptide and cholecystokinin (CCK are neuromodulators involved in feeding behavior. This study is based on previously found synergistic effect of leptin and CCK on food intake and our hypothesis on a co-operation of the CART peptide and CCK in food intake regulation and Fos activation in their common targets, the nucleus tractus solitarii of the brainstem (NTS, the paraventricular nucleus (PVN, and the dorsomedial nucleus (DMH of the hypothalamus. Results In fasted C57BL/6 mice, the anorexigenic effect of CART(61-102 in the doses of 0.1 or 0.5 μg/mouse was significantly enhanced by low doses of CCK-8 of 0.4 or 4 μg/kg, while 1 mg/kg dose of CCK-A receptor antagonist devazepide blocked the effect of CART(61-102 on food intake. After simultaneous administration of 0.1 μg/mouse CART(61-102 and of 4 μg/kg of CCK-8, the number of Fos-positive neurons in NTS, PVN, and DMH was significantly higher than after administration of each particular peptide. Besides, CART(61-102 and CCK-8 showed an additive effect on inhibition of the locomotor activity of mice in an open field test. Conclusion The synergistic and long-lasting effect of the CART peptide and CCK on food intake and their additive effect on Fos immunoreactivity in their common targets suggest a co-operative action of CART peptide and CCK which could be related to synergistic effect of leptin on CCK satiety.

  5. Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.

    Science.gov (United States)

    Aldao, Amelia; Mennin, Douglas S

    2012-02-01

    Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or were not given specific regulation instructions. Implementation of adaptive regulation strategies produced differential effects in the physiological (but not subjective) domain across diagnostic groups. Whereas participants with GAD demonstrated lower cardiac flexibility when implementing adaptive regulation strategies than when not given specific instructions on how to regulate, healthy controls showed the opposite pattern, suggesting they benefited from the use of adaptive regulation strategies. We discuss the implications of these findings for the delineation of emotion regulation deficits in psychopathology. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    1987-04-01

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

  7. [Association between depression and fall risk among elderly community residents].

    Science.gov (United States)

    Tanaka, Mika; Kusaga, Mari; Ushijima, Kayo; Watanabe, Chiho

    2012-01-01

    To investigate the relationship between depression and fall risk in the elderly. Residents of a village in Kumamoto Prefecture, Japan (563 people), aged ≥65 years were given a self-administered questionnaire survey between June and July 2010. To evaluate depression status and fall risk, the Geriatric Depression Scale--Short Form and the Simple Screening Test for Risk of Falls were administered. Adjustment factors assessed were age, sex, medical history for diseases associated with falls, usage of hypnotics, and cognitive dysfunction. We examined the relationship between depression and fall risk using multiple logistic regression analysis. Given that some degree of correlation was expected among adjustment factors in the model, we constructed a model that introduced the adjustment factors stepwise to confirm the robustness of the model and any effect of multicollinearity. Overall (n=395), after excluding data from participants with significant cognitive disturbance or severe physical problems from among valid responders, a significant relationship was found between depression and fall risk in all models. The odds ratio was 2.28 (95% confidence interval: 1.31-3.96) in the final model, controlling for all adjustment factors. Our findings suggest a significant relationship between depression and fall risk in the elderly. This relationship implies that the improvement of depression could be an effective measure to decrease fall risk in the elderly.

  8. Transient model for free fall effect during cementing operations in oil wells; Modelo transiente para o efeito de queda livre durante operacoes de cimentacao em pocos de petroleo

    Energy Technology Data Exchange (ETDEWEB)

    Poggio, Junior, Ademar; Lage, Antonio Carlos V.M.; Campos, Wellington [PETROBRAS, Rio de Janeiro (Brazil). Centro de Pesquisas. Setor de Tecnologia de Perfuracao

    1990-12-31

    This paper presents a mathematical model for the simulation of cementing operations in oil wells. The downward flow of fluids in the casing and the upward flow of fluids in the annulus is further complicated by fluid free fall, which creates a vacuum at the well head. The basic equations were derived from the mass and momentum conservation laws by means of a macroscopic balance. The simulator is used to predict pressures and flow rates during the operation. (author) 6 refs., 6 figs., 1 tab.

  9. Transient model for free fall effect during cementing operations in oil wells; Modelo transiente para o efeito de queda livre durante operacoes de cimentacao em pocos de petroleo

    Energy Technology Data Exchange (ETDEWEB)

    Poggio Junior, Ademar; Lage, Antonio Carlos V.M.; Campos, Wellington [PETROBRAS, Rio de Janeiro (Brazil). Centro de Pesquisas. Setor de Tecnologia de Perfuracao

    1989-12-31

    This paper presents a mathematical model for the simulation of cementing operations in oil wells. The downward flow of fluids in the casing and the upward flow of fluids in the annulus is further complicated by fluid free fall, which creates a vacuum at the well head. The basic equations were derived from the mass and momentum conservation laws by means of a macroscopic balance. The simulator is used to predict pressures and flow rates during the operation. (author) 6 refs., 6 figs., 1 tab.

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

    Science.gov (United States)

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

    2012-10-01

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

  11. Effect of ghrelin on glucose regulation in mice

    Science.gov (United States)

    Improvement of glucose metabolism after bariatric surgery appears to be from the composite effect of the alterations in multiple circulating gut hormone concentrations. However, their individual effect on glucose metabolism during different conditions is not clear. The objective of this study was to...

  12. Free Falling in Stratified Fluids

    Science.gov (United States)

    Lam, Try; Vincent, Lionel; Kanso, Eva

    2017-11-01

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

  13. The effect of some growth regulators on enzyme systems in irradiated barley grain using disinfestation doses

    International Nuclear Information System (INIS)

    Bachman, S.

    1973-01-01

    Disinfestation doses of 20 to 100 krad may cause changes in the biological systems of barley grain and, therefore, may influence undesirably the technological quality of malted grain. The effect of some growth regulators on irradiated grain has been investigated. The experiments have been carried out on brewery barley var. Visa Breuns. Following growth-regulators were used: gibberellic acid (Polish preparation ''Gibrescol''), kinetin (6-furfurylo-aminopurin), CCC (2-chloroethyl trimethyl ammonium chloride), and betaine hydrochloride. By treating the irradiated barley with solutions of growth regulators it was possible to diminish the loss of enzyme activity. A ''regenerating'' effect of growth substances, mainly gibberellic acid and betain hydrochloride in 10 -4 M solutions, was observed. Amylolytic activity decreased immediately after irradiation but in samples treated with growth regulators it was higher than in those without regulators. The results may have a practical importance since gibberellic acid has just been introduced into the brewery industry. (F.J.)

  14. The effect of nonhuman’s external regulation on detecting the natural development process of young children’s self-regulation during learning tasks

    NARCIS (Netherlands)

    Agina, Adel Masaud; Agina, Adel M.; Kommers, Petrus A.M.; Steehouder, M.F.

    2011-01-01

    The present study explored the effect of nonhuman’s external regulation on children’s natural development of self-regulation and the effect of each natural developed class on children’s spontaneous thinking aloud and satisfaction. The Aginian’s methodology (Agina et al., 2011a) that relied on

  15. Effects of emotion regulation strategies on music-elicited emotions: An experimental study explaining individual differences

    NARCIS (Netherlands)

    Karreman, A.; Laceulle, O.M.; Hanser, Waldie; Vingerhoets, Ad

    This experimental study examined if emotional experience can be manipulated by applying an emotion regulation strategy during music listening and if individual differences in effects of strategies can be explained by person characteristics. Adults (N = 466) completed questionnaires and rated

  16. Effects of emotion regulation strategies on music elicited emotions : An experimental study explaining individual differences

    NARCIS (Netherlands)

    Karreman, A.; Laceulle, O.M.; Hanser, W.E.; Vingerhoets, A.J.J.M.

    2017-01-01

    This experimental study examined if emotional experience can be manipulated by applying an emotion regulation strategy during music listening and if individual differences in effects of strategies can be explained by person characteristics. Adults (N = 466) completed questionnaires and rated

  17. Impact of fall-related behaviors as risk factors for falls among the elderly patients with dementia in a geriatric facility in Japan.

    Science.gov (United States)

    Suzuki, Mizue; Kurata, Sadami; Yamamoto, Emiko; Makino, Kumiko; Kanamori, Masao

    2012-09-01

    The purpose of this study was to clarify potential fall-related behaviors as fall risk factors that may predict the potential for falls among the elderly patients with dementia at a geriatric facility in Japan. This study was conducted from April 2008 to May 2009. A baseline study was conducted in April 2008 to evaluate Mini-Mental State Examination, Physical Self-Maintenance Scale, fall-related behaviors, and other factors. For statistical analysis, paired t test and logistic analysis were used to compare each item between fallers and nonfallers. A total of 135 participants were followed up for 1 year; 50 participants (37.04%) fell during that period. Results of multiple logistic regression analysis showed that the total score for fall-related behaviors was significantly related to falls. It was suggested that 11 fall-related behaviors may be effective indicators to predict falls among the elderly patients with dementia.

  18. Need satisfaction, motivational regulations and exercise: moderation and mediation effects.

    Science.gov (United States)

    Weman-Josefsson, Karin; Lindwall, Magnus; Ivarsson, Andreas

    2015-05-20

    Based on the Self-determination theory process model, this study aimed to explore relationships between the latent constructs of psychological need satisfaction, autonomous motivation and exercise behaviour; the mediational role of autonomous motivation in the association of psychological need satisfaction with exercise behaviour; as well as gender and age differences in the aforementioned associations. Adult active members of an Internet-based exercise program (n = 1091) between 18 and 78 years of age completed a test battery on motivational aspects based on Self-determination theory. The Basic Psychological Needs in Exercise Scale and the Behavioural Regulation in Exercise Questionnaire-2 were used to measure need satisfaction and type of motivation and the Leisure Time Exercise Questionnaire to measure self-reported exercise. Need satisfaction predicted autonomous motivation, which in turn predicted exercise, especially for women. Autonomous motivation was found to mediate the association between need satisfaction and exercise. Age and gender moderated several of the paths in the model linking need satisfaction with motivation and exercise. The results demonstrated gender and age differences in the proposed sequential mechanisms between autonomous motivation and exercise in the process model. This study thus highlights a potential value in considering moderating factors and the need to further examine the underlying mechanisms between needs, autonomous motivation, and exercise behaviour.

  19. Effect of PD-WEBB training on balance impairment and falls in people with Parkinson’s disease%PD-WEBB训练对帕金森病平衡障碍和跌倒的影响

    Institute of Scientific and Technical Information of China (English)

    谷绍娟; 宋治; 范学军; 陈茹; 郑文; 严文广

    2013-01-01

    Objective:To determine the effect of Parkinson’s disease-weight bearing exercise for better balance (PD-WEBB) exercise on balance impairment and falls in people with Parkinson's disease (PD).Methods:A single-blind, randomized controlled clinical trial was conducted. The falls efficacy scale score, unified Parkinson disease rating scale (UPDRS) score and Mini-BESTest score were measured and compared between a PD-WEBB group and a control group. Results:hTe falls effcacy scale score, UPDRS-2 score, UPDRS-3 score and Mini-BESTest score were improved in the PD-WEBB group compared with the control group (P Conclusion:PD-WEBB training can significantly improve the balance impairment and quality of life to prevent falls. PD-WEBB training is suitable for PD patients in China, and is a reasonable, effective and sustainable training of family and community assessment model.%目的:评价PD-WEBB训练对帕金森病(Parkinson’s disease,PD)患者平衡障碍和跌倒的影响。方法:采用随机、单盲、对照设计分析PD-WEBB训练8周前后PD-WEBB组与对照组PD患者跌倒功效量表(falls effcacy scale,FES)评分、帕金森病综合评分量表(UPDRS)评分和Mini-Balance Evaluation Systems Test (Mini-BESTest)评分的变化。结果:8周后PD-WEBB组FES评分、UPDRS-2评分、UPDRS-3评分和Mini-BESTest评分较对照组有明显变化(P<0.05),而两组间UPDRS-1评分变化不明显。结论:PD-WEBB训练可以明显改善PD患者的平衡障碍,提高患者日常生活质量,预防跌倒。PD-WEBB训练适合中国PD患者,是一种合理有效的可持续的家庭训练模式。

  20. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of a health claim related to vitamin D and risk of falling pursuant to Article 14 of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    Following an application from DSM Nutritional Products Europe AG, submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of the United Kingdom, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver an opinion on the scientific...

  1. Effects of brood pheromone (SuperBoost) on consumption of protein supplement and growth of honey bee (Hymenoptera: Apidae) colonies during fall in a northern temperate climate.

    Science.gov (United States)

    Sagili, Ramesh R; Breece, Carolyn R

    2012-08-01

    Honey bee, Apis mellifera L. (Hymenoptera: Apidae), nutrition is vital for colony growth and maintenance of a robust immune system. Brood rearing in honey bee colonies is highly dependent on protein availability. Beekeepers in general provide protein supplement to colonies during periods of pollen dearth. Honey bee brood pheromone is a blend of methyl and ethyl fatty acid esters extractable from cuticle of honey bee larvae that communicates the presence of larvae in a colony. Honey bee brood pheromone has been shown to increase protein supplement consumption and growth of honey bee colonies in a subtropical winter climate. Here, we tested the hypothesis that synthetic brood pheromone (SuperBoost) has the potential to increase protein supplement consumption during fall in a temperate climate and thus increase colony growth. The experiments were conducted in two locations in Oregon during September and October 2009. In both the experiments, colonies receiving brood pheromone treatment consumed significantly higher protein supplement and had greater brood area and adult bees than controls. Results from this study suggest that synthetic brood pheromone may be used to stimulate honey bee colony growth by stimulating protein supplement consumption during fall in a northern temperate climate, when majority of the beekeepers feed protein supplement to their colonies.

  2. Prognostic Effect of the Nocturnal Blood Pressure Fall in Hypertensive Patients: The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) Meta-Analysis.

    Science.gov (United States)

    Salles, Gil F; Reboldi, Gianpaolo; Fagard, Robert H; Cardoso, Claudia R L; Pierdomenico, Sante D; Verdecchia, Paolo; Eguchi, Kazuo; Kario, Kazuomi; Hoshide, Satoshi; Polonia, Jorge; de la Sierra, Alejandro; Hermida, Ramon C; Dolan, Eamon; O'Brien, Eoin; Roush, George C

    2016-04-01

    The prognostic importance of the nocturnal systolic blood pressure (SBP) fall, adjusted for average 24-hour SBP levels, is unclear. The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) examined this issue in a meta-analysis of 17 312 hypertensives from 3 continents. Risks were computed for the systolic night-to-day ratio and for different dipping patterns (extreme, reduced, and reverse dippers) relative to normal dippers. ABC-H investigators provided multivariate adjusted hazard ratios (HRs), with and without adjustment for 24-hour SBP, for total cardiovascular events (CVEs), coronary events, strokes, cardiovascular mortality, and total mortality. Average 24-hour SBP varied from 131 to 140 mm Hg and systolic night-to-day ratio from 0.88 to 0.93. There were 1769 total CVEs, 916 coronary events, 698 strokes, 450 cardiovascular deaths, and 903 total deaths. After adjustment for 24-hour SBP, the systolic night-to-day ratio predicted all outcomes: from a 1-SD increase, summary HRs were 1.12 to 1.23. Reverse dipping also predicted all end points: HRs were 1.57 to 1.89. Reduced dippers, relative to normal dippers, had a significant 27% higher risk for total CVEs. Risks for extreme dippers were significantly influenced by antihypertensive treatment (Panalysis of hypertensive patients, the nocturnal BP fall provided substantial prognostic information, independent of 24-hour SBP levels. © 2016 American Heart Association, Inc.

  3. Effects of a chair-yoga exercises on stress hormone levels, daily life activities, falls and physical fitness in institutionalized older adults.

    Science.gov (United States)

    Furtado, G E; Uba-Chupel, M; Carvalho, H M; Souza, N R; Ferreira, J P; Teixeira, A M

    2016-08-01

    The aim of this study was to assess the changes mediated by exercise on activities of daily life and falls, physical fitness, salivary cortisol and alpha amylase in older adults living in social and health care givers centers. Sample consisted in 35 women (83.81 ± 6.6 years old) were divided into two groups: chair-yoga exercises group (CY, n = 20) and control group (CG, n = 15). All subjects were evaluated before and after 14-weeks. CY was involved in exercise classes two times per week, while the GC did not participate in any exercise. Fear of falling decreased in both groups, cortisol increased and alpha-amylase decreased in the CG. No significant changes occurred in physical fitness outcomes. CY practice was able to maintain the physical fitness scores and stress hormone levels, but was not able to improve the subject's perception on the ability to perform the instrumental activities of daily life. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Falling films on flexible inclines

    Science.gov (United States)

    Matar, O. K.; Craster, R. V.; Kumar, S.

    2007-11-01

    The nonlinear stability and dynamic behavior of falling fluid films is studied for flow over a flexible substrate. We use asymptotic methods to deduce governing equations valid in various limits. Long-wave theory is used to derive Benney-like coupled equations for the film thickness and substrate deflection. Weakly nonlinear equations are then derived from these equations that, in the limit of large wall damping and/or large wall tension, reduce to the Kuramoto-Sivashinsky equation. These models break down when inertia becomes more significant, so we also use a long-wave approximation in conjunction with integral theory to derive three strongly coupled nonlinear evolution equations for the film thickness, substrate deflection, and film volumetric flow rate valid at higher Reynolds numbers. These equations, accounting for inertia, capillary, viscous, wall tension, and damping effects, are solved over a wide range of parameters. Our results suggest that decreasing wall damping and/or wall tension can promote the development of chaos in the weakly nonlinear regime and lead to severe substrate deformations in the strongly nonlinear regime; these can give rise to situations in which the free surface and underlying substrate come into contact in finite time.

  5. Nuclear winter or nuclear fall?

    Science.gov (United States)

    Berger, André

    Climate is universal. If a major modern nuclear war (i.e., with a large number of small-yield weapons) were to happen, it is not even necessary to have a specific part of the world directly involved for there to be cause to worry about the consequences for its inhabitants and their future. Indeed, smoke from fires ignited by the nuclear explosions would be transported by winds all over the world, causing dark and cold. According to the first study, by Turco et al. [1983], air surface temperature over continental areas of the northern mid-latitudes (assumed to be the nuclear war theatre) would fall to winter levels even in summer (hence the term “nuclear winter”) and induce drastic climatic conditions for several months at least. The devastating effects of a nuclear war would thus last much longer than was assumed initially. Discussing to what extent these estimations of long-term impacts on climate are reliable is the purpose of this article.

  6. Regulative effects of curcumin spice administration on gut microbiota and its pharmacological implications

    OpenAIRE

    Shen, Liang; Liu, Lu; Ji, Hong-Fang

    2017-01-01

    ABSTRACT Curcumin, the major active component of turmeric (Curcuma longa), is widely used as a spice and food-coloring agent, and also exhibits multiple biological activities. However, as curcumin has poor systemic bioavailability its pharmacology remains to be elucidated. Owing to the high concentration of curcumin in the gastrointestinal tract after oral administration, we hypothesize that it may exert regulative effects on the gut microbiota. We investigated the regulative effects of oral ...

  7. Epidemiology of falls in older age.

    Science.gov (United States)

    Peel, Nancye May

    2011-03-01

    Worldwide, falls among older people are a public health concern because of their frequency and adverse consequences in terms of morbidity, mortality, and quality of life, as well as their impact on health system services and costs. This epidemiological review outlines the public health burden of falls and