Diurnal variation of precipitation over the Carolina Sandhills region

Indian Academy of Sciences (India)

State Climate Office of North Carolina, Raleigh, NC 27695-8208, USA. ∗ e-mail: ... of the weather forecast models experience problems in accounting for the ... effect of vegetation and soil contrasts on thermally induced flow is ... Sandhills; diurnal convection; heat flux gradients; cloud–radiation interaction. J. Earth Syst. Sci.

SURVEY OF GROSS AND HISTOPATHOLOGIC FINDINGS IN TWO WINTERING SUBPOPULATIONS OF SANDHILL CRANES ( ANTIGONE CANADENSIS).

Science.gov (United States)

Hensel, Martha; Bertram, Miranda; Rech, Raquel; Hamer, Gabriel L; Hamer, Sarah A

2018-01-01

:  Sandhill Cranes ( Antigone canadensis) of the midcontinent population (MCP) and Rocky Mountain population (RMP) are migratory game birds with stable populations that travel between Canada and the southern US and Mexico. In the winters of 2012-14, we performed gross and histologic examinations of 43 hunter-harvested Sandhill Cranes in Texas (MCP) and New Mexico (RMP) to assess the impact of disease on populations. Lesions were significantly more common in the MCP relative to the RMP, likely reflecting differential environmental exposure to pathogens and parasites. Grossly, liver nodules and esophageal granulomas were present in 8-39% of birds. In feces from over half of birds, we found coccidian oocysts with mitochondrial gene sequences identical to those of Eimeria gruis and Eimeria reichenowi previously obtained from sympatric Whooping Cranes ( Grus americana). Over one-quarter of birds had liver and cardiac lesions suggestive of disseminated visceral coccidiosis. We documented proliferative colitis due to Cryptosporidium in a wild Sandhill Crane. Additionally, several endoparasites were found in histologic sections from several cranes, including a bird with respiratory trematodiasis and two birds with Tetrameres sp. in the proventriculus associated with ductal ectasia. In addition to describing lesions and parasites that impact Sandhill Crane health, these pathology data may also be relevant for the conservation of endangered Whooping Cranes using a surrogate species approach.

Impacts of Military Training and Land Management on Threatened and Endangered Species in the Southeastern Fall Line Sandhills Communities

Science.gov (United States)

2009-05-01

0.01 a 0 0.16 a 0.03 a 0.11 a Diospyros virginiana (persimmon) * 0 0 0.01 a 0 * 0 0 Nyssa sylvatica (black gum) 0 * 0 0.05 a 0 0.05 a 0 0...0 0 0.02 b 0 0.01 b 0.16 a 0 Prunus spp. (cherry) 0 0.42 a 0 * 0.02 b 0.01 b 0 0.02 b Sassafras albidum (sassafras) 0 * 0 * * 0 0 0...disturbance treatments were composed primarily of longleaf pine, turkey oak, sand post oak, bluejack oak, persimmon (Diospyros virginiana ), black gum (Nyssa

Observation of sandhill cranes' (Grus canadensis) flight behavior in heavy fog

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Kirsch, Eileen M.; Wellik, Mike J.; Suarez, Manuel J.; Diehl, Robert H.; Lutes, Jim; Woyczik, Wendy; Krapfl, Jon; Sojda, Richard S.

2015-01-01

The behaviors of birds flying in low visibility conditions remain poorly understood. We had the opportunity to monitor Sandhill Cranes (Grus canadensis) flying in heavy fog with very low visibility during a comprehensive landscape use study of refuging cranes in the Horicon Marsh in southeastern Wisconsin. As part of the study, we recorded flight patterns of cranes with a portable marine radar at various locations and times of day, and visually counted cranes as they departed the roost in the morning. We compared flight patterns during a fog event with those recorded during clear conditions. In good visibility, cranes usually departed the night roost shortly after sunrise and flew in relatively straight paths toward foraging areas. In fog, cranes departed the roost later in the day, did not venture far from the roost, engaged in significantly more circling flight, and returned to the roost site rather than proceeding to foraging areas. We also noted that compared to mornings with good visibility, cranes flying in fog called more frequently than usual. The only time in this 2-year study that observers heard young of the year calling was during the fog event. The observed behavior of cranes circling and lingering in an area while flying in poor visibility conditions suggests that such situations may increase chances of colliding with natural or anthropogenic obstacles in the vicinity.

Timing of spring surveys for midcontinent sandhill cranes

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Pearse, Aaron T.; Krapu, Gary L.; Brandt, David A.; Sargeant, Glen A.

2015-01-01

The U.S. Fish and Wildlife Service has used spring aerial surveys to estimate numbers of migrating sandhill cranes (Grus canadensis) staging in the Platte River Valley of Nebraska, USA. Resulting estimates index the abundance of the midcontinent sandhill crane population and inform harvest management decisions. However, annual changes in the index have exceeded biologically plausible changes in population size (>50% of surveys between 1982 and 2013 indicate >±20% change), raising questions about nuisance variation due to factors such as migration chronology. We used locations of cranes marked with very-high-frequency transmitters to estimate migration chronology (i.e., proportions of cranes present within the Platte River Valley). We also used roadside surveys to determine the percentage of cranes staging at the Platte River Valley but outside of the survey area when surveys occur. During March 2001–2007, an average of 86% (71–94%; SD = 7%) of marked cranes were present along the Platte River during scheduled survey dates, and 0–11% of cranes that were present along the Platte River were not within the survey boundaries. Timing of the annual survey generally corresponded with presence of the greatest proportion of marked cranes and with least inter-annual variation; consequently, accuracy of estimates could not have been improved by surveying on different dates. Conducting the survey earlier would miss birds not yet arriving at the staging site; whereas, a later date would occur at a time when a larger portion of birds may have already departed the staging site and when a greater proportion of birds occurred outside of the surveyed area. Index values used to monitor midcontinent sandhill crane abundance vary annually, in part, due to annual variation in migration chronology and to spatial distribution of cranes in the Platte River Valley; therefore, managers should interpret survey results cautiously, with awareness of a continuing need to identify and

Biodiversity in a Florida Sandhill Ecosystem

Directory of Open Access Journals (Sweden)

Samantha Robertson

2009-01-01

Full Text Available This project compares two transects of land in the University of South Florida's Botanical Gardens for their biodiversity. The transects were chosen to represent a Florida sandhill ecosystem and the individual Longleaf Pine, Saw Palmetto, Turkey Oak, Laurel Oak and Live Oak specimens were counted. All other species above waist height were counted as "other"?. Once the individuals were counted, the Simpson's and Shannon-Wiener indices were calculated. Since the Shannon-Wiener index incorporates several diversity characteristics, it is typically more reliable than Simpson's. However, both biodiversity indices agreed that transect B was more diverse than transect A.

Conflicts between sandhill cranes and farmers in the western United States: evolving issues and solutions

Science.gov (United States)

Austin, Jane E.

2012-01-01

The main conflicts between Sandhill Cranes (Grus canadensis) and farmers in western United States occur in the Rocky Mountain region during migration and wintering periods. Most crop damage by cranes occurs in mature wheat (Triticum aestivum) and barley (Hordeum vulgare), young shoots of alfalfa (Medicago sativa) and cereal grains, chilies (Capsicum annuum), and silage corn (Zea mays). Damage is related to proximity of crop fields to roost sites and timing of crane concentrations relative to crop maturity or vulnerability. The evolution of conflicts between farmers and cranes and current solutions are described for two areas of the Rocky Mountains used by staging, migrating, or wintering cranes: Grays Lake, Idaho, and the Middle Rio Grande Valley, New Mexico. In both areas, conflicts with growing crane populations were aggravated by losses of wetlands and cropland, proximity of crops to roosts and other wetland areas, changing crop types and practices, and increasing urbanization. At Grays Lake, fall-staging cranes damaged barley fields near an important breeding refuge as well as fields 15-50 km away. In the Middle Rio Grande Valley, migrating and wintering cranes damaged young alfalfa fields, chilies, and silage corn. Solutions in both areas have been addressed through cooperative efforts among federal and state agencies, that manage wetlands and croplands to increase food availability and carrying capacity on public lands, provide hazing programs for private landowners, and strategically target crane hunting to problem areas. Sustaining the success of these programs will be challenging. Areas important to Sandhill Cranes in the western United Sates experience continued loss of habitat and food resources due to urbanization, changes in agricultural crops and practices, and water-use conflicts, which threaten the abilities of both public and private landowners to manage wetlands and croplands for cranes. Conservation of habitats and water resources are important

Size and mass of grit in gizzards of sandhill cranes, tundra swans, and mute swans

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Franson, J. Christian; Hansen, Scott P.; Duerr, Adam E.; DeStefano, Stephen

2001-01-01

Because it has been suggested that waterbirds may ingest lost or discarded lead fishing weights as grit, we examined grit in the gizzards of Sandhill Cranes (Grus canadensis), Tundra Swans (Cygnus columbianus), and Mute Swans (Cygnus olor), three species where individuals have been poisoned by the ingestion of lead fishing weights. The greatest proportion (by mass) of grit in gizzards of Sandhill Cranes consisted of particles with a minimum dimension of 2.36-4.75 mm. Grit particles in swans were much smaller, with the most prevalent (by mass) being 0.6-1.18 mm. The greatest dimension of the largest grit particle found in cranes and swans was 17.4 mm and 14.0 mm, respectively. The U.S. Environmental Protection Agency has proposed a ban on lead fishing weights of ≤25.4 mm in any dimension. Based on the size of grit particles that we found in gizzards of Sandhill Cranes, Mute Swans, and Tundra Swans, we believe it is unlikely that individuals of those species would ingest, as grit, lead fishing weights larger than 25.4 mm in any dimension.

Capture of sandhill cranes using alpha-chloralose: a 10-year follow-up.

Science.gov (United States)

Hartup, Barry K; Schneider, Lauren; Engels, J Michael; Hayes, Matthew A; Barzen, Jeb A

2014-01-01

Seasonal adjustment of alpha-chloralose captures of sandhill cranes was associated with a modest increase in capture efficacy (+13%), decreased morbidity from exertional myopathy (-1.4%), and overall mortality (-1.7%) rates despite little change in sedation scores. Postcapture fluid administration also decreased confinement times by several hours over most sedation scores.

Serum corticosterone response to adrenocorticotropic hormone stimulation in Florida sandhill cranes.

Science.gov (United States)

Ludders, J W; Langenberg, J A; Czekala, N M; Erb, H N; McCormick, H

1998-10-01

Florida sandhill cranes (Grus canadensis pratensis) were conditioned to confinement in an enclosure for 7 days, 6 hr a day. On day 8, cranes were catheterized and then confined in an enclosure. Venous blood (2 ml) was collected through the catheter and an attached IV line immediately before (-60 min) and 60 min after (0 min) confinement. Using a randomization table and a restricted cross-over experimental design, cranes were injected intravenously with either saline (control) or adrenocorticotropic hormone (ACTH; cosyntropin, Cortrosyn; 0.25 mg). At 30, 60, 120, 180, 240 and 300 min after injection, blood samples were collected and assayed for corticosterone. The cranes receiving ACTH increased their serum corticosterone concentrations as much as fivefold above baseline concentrations. Serum corticosterone concentrations remained significantly elevated for approximately 60 min after ACTH stimulation. Physical restraint and catheterization caused an increase in serum corticosterone almost comparable to that induced by ACTH stimulation. In cranes injected with saline, serum corticosterone decreased within 1 hr after physical restraint and catheterization, and remained at lower levels throughout the remaining 5 hr of confinement.

Book review: Sandhill and whooping cranes: Ancient voices over America's wetlands

Science.gov (United States)

Austin, Jane E.

2011-01-01

Paul Johnsgard has long been captivated by wild cranes and their unique vocalizations, courtship dances, and wide-ranging migrations. As a scientist and an admirer, Johnsgard has watched their migrations and behaviors for decades as hundreds of thousands of cranes staged each spring by the central Platte River, not far from his home in Lincoln, Nebraska. As an artist, he has skilfully captured their courtship dances and other behaviours in his exceptional line drawings. And, as an author, he has written extensively on their ecology in three earlier books: Cranes of the World (1983), Those of the Gray Wind: the Sandhill Crane (1986), and Crane Music: a Natural History of Cranes (1991). Much has happened relative to North American cranes in the 20 years since Johnsgard published Crane Music, including increased crane abundance in many areas and the completion of multiple studies on crane ecology and conservation. This new crane book serves as an update to Crane Music and provides the reader with many useful resources for observing and learning about cranes.

Microbial water quality during the northern migration of Sandhill Cranes (Grus canadensis) at the central Platte River, Nebraska

Science.gov (United States)

Moser, Matthew T.

2014-01-01

The central Platte River is an important resource in Nebraska. Its water flows among multiple channels and supports numerous beneficial uses such as drinking water, irrigation for agriculture, groundwater recharge, and recreational activities. The central Platte River valley is an important stopover for migratory waterfowl and cranes, such as the Whooping (Grus americana) and Sandhill Cranes (Grus canadensis), in their annual northward traversal of the Central Flyway. Waterfowl, cranes, and other migratory birds moving across international and intercontinental borders may provide long-range transportation for any microbial pathogen they harbor, particularly through the spread of feces. Samples were collected weekly in the study reach from three sites (upstream, middle, and downstream from the roosting locations) during the spring of 2009 and 2010. The samples were analyzed for avian influenza, Escherichia coli, Cryptosporidium, Giardia, Campylobacter, and Legionella. Analysis indicates that several types of fecal indicator bacteria and a range of viral, protozoan, and bacterial pathogens were present in Sandhill Crane excreta. These bacteria and pathogens were present at a significantly higher frequency and densities in water and sediments when the Sandhill Cranes were present, particularly during evening roosts within the Platte River environment.

Evaluating and improving count-based population inference: A case study from 31 years of monitoring Sandhill Cranes

Science.gov (United States)

Gerber, Brian D.; Kendall, William L.

2017-01-01

Monitoring animal populations can be difficult. Limited resources often force monitoring programs to rely on unadjusted or smoothed counts as an index of abundance. Smoothing counts is commonly done using a moving-average estimator to dampen sampling variation. These indices are commonly used to inform management decisions, although their reliability is often unknown. We outline a process to evaluate the biological plausibility of annual changes in population counts and indices from a typical monitoring scenario and compare results with a hierarchical Bayesian time series (HBTS) model. We evaluated spring and fall counts, fall indices, and model-based predictions for the Rocky Mountain population (RMP) of Sandhill Cranes (Antigone canadensis) by integrating juvenile recruitment, harvest, and survival into a stochastic stage-based population model. We used simulation to evaluate population indices from the HBTS model and the commonly used 3-yr moving average estimator. We found counts of the RMP to exhibit biologically unrealistic annual change, while the fall population index was largely biologically realistic. HBTS model predictions suggested that the RMP changed little over 31 yr of monitoring, but the pattern depended on assumptions about the observational process. The HBTS model fall population predictions were biologically plausible if observed crane harvest mortality was compensatory up to natural mortality, as empirical evidence suggests. Simulations indicated that the predicted mean of the HBTS model was generally a more reliable estimate of the true population than population indices derived using a moving 3-yr average estimator. Practitioners could gain considerable advantages from modeling population counts using a hierarchical Bayesian autoregressive approach. Advantages would include: (1) obtaining measures of uncertainty; (2) incorporating direct knowledge of the observational and population processes; (3) accommodating missing years of data; and (4

Environmental assessment and finding of no significant impact: Hungry Horse--Columbia Falls line rebuild and relocation project

International Nuclear Information System (INIS)

1993-09-01

Bonneville Power Administration (BPA) has identified a need to rebuild the Hungry Horse-Columbia Falls 115,000-volt (115-kV) transmission line to 230-kV. This line supplies power to customers in the area of Columbia Falls, Montana, and integrates generation at the US Bureau of Reclamation's (USBR) Hungry Horse Dam into BPA's transmission grid. There are several problems with the existing system. The Hungry Horse-Columbia Falls 1 15-kV line is 45 years old and requires excessive maintenance. The USBR has decided to replace their aging 115-kV transformers at the dam with 230-kV transformers, which also would increase their operational flexibility. With the small conductor size and voltage of the line presently being used, significant amounts of energy are lost as the power moves across the line. Transformer failure at Hungry Horse Dam has led to joint planning between BPA and the USBR. (USBR and the US Forest Service are cooperating agencies on the proposed project.) The proposal to eliminate the 115-kV equipment and convert to 230-kV operation was the least costly of the options studied. By rebuilding the line, maintenance costs (and time required for outages) would be reduced. The increased generation at the USBR dam would be safely and consistently transmitted over the improved system, and less energy would be lost from the line, a cost and energy savings

Suspected fusariomycotoxicosis in sandhill cranes (Grus canadensis): clinical and pathological findings.

Science.gov (United States)

Roffe, Thomas J.; Stroud, Richard K.; Windingstad, Ronald M.

1989-01-01

In 1985 and 1986, large-scale natural die-offs of sandhill cranes in Texas were attributed to fusariomycotoxicosis. These birds demonstrated a progressive loss of motor control to the neck, wings, and legs. Based on necropsy and/or histopathology of 31 cranes, the most common lesions involved skeletal muscle and included hemorrhages, granulomatous myositis, thrombosis, and vascular degeneration. Serum chemistry results revealed that levels of creatinine kinase, aspartate aminotransferase, and alanine aminotransferase were above published normals. However, only alanine aminotransferase was higher in clinically affected cranes than in normal cranes collected from the same area.

Wintering ecology of sympatric subspecies of Sandhill Crane: Correlations between body size, site fidelity, and movement patterns

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Ivey, Gary L.; Dugger, Bruce D.; Herziger, Caroline P.; Casazza, Michael L.; Fleskes, Joseph P.

2015-01-01

Body size is known to correlate with many aspects of life history in birds, and this knowledge can be used to manage and conserve bird species. However, few studies have compared the wintering ecology of sympatric subspecies that vary significantly in body size. We used radiotelemetry to examine the relationship between body size and site fidelity, movements, and home range in 2 subspecies of Sandhill Crane (Grus canadensis) wintering in the Sacramento–San Joaquin Delta of California, USA. Both subspecies showed high interannual return rates to the Delta study area, but Greater Sandhill Cranes (G. c. tabida) showed stronger within-winter fidelity to landscapes in our study region and to roost complexes within landscapes than did Lesser Sandhill Cranes (G. c. canadensis). Foraging flights from roost sites were shorter for G. c. tabida than for G. c. canadensis (1.9 ± 0.01 km vs. 4.5 ± 0.01 km, respectively) and, consequently, the mean size of 95% fixed-kernel winter home ranges was an order of magnitude smaller for G. c. tabida than for G. c. canadensis (1.9 ± 0.4 km2 vs. 21.9 ± 1.9 km2, respectively). Strong site fidelity indicates that conservation planning to manage for adequate food resources around traditional roost sites can be effective for meeting the habitat needs of these cranes, but the scale of conservation efforts should differ by subspecies. Analysis of movement patterns suggests that conservation planners and managers should consider all habitats within 5 km of a known G. c. tabida roost and within 10 km of a G. c. canadensis roost when planning for habitat management, mitigation, acquisition, and easements.

Evaluation of fall armyworm resistance in maize germplasm lines using visual leaf injury rating and predator survey

Science.gov (United States)

After examining ear-colonizing pest resistance, 20 maize lines from the USDA-ARS germplasm enhancement of Maize (GEM) Program were evaluated for whorl-feeding fall armyworm (FAW) (Spodoptera frugiperda) resistance using four maize inbred lines as the resistant and susceptible controls. Both FAW inju...

Understory fuel variation at the Carolina Sandhills National Wildlife Refuge: a description of chemical and physical properties

Science.gov (United States)

Evelyn S. Wenk; G. Geoff Wang; Joan L. Walker

2013-01-01

Upland forest in the Carolina Sandhills National Wildlife Refuge is characterized by a longleaf pine (Pinus palustris) canopy with a variable understory and ground-layer species composition. The system was historically maintained by fire and has been managed with prescribed fire in recent decades. A management goal is to reduce turkey oak (...

Fire, herbicide, and chainsaw felling effects on arthropods in fire-suppressed longleaf pine sandhills at Eglin Air Force Base, Florida

Science.gov (United States)

Louis Provencher; Krista E. M. Galley; Andrea R. Litt; Doria R. Gordon; Leonard A. Brennan; George W. Tanner; Jeffrey L. Hardesty

2002-01-01

Experimentally evaluating the success of hardwood reduction techniques against a "model" reference condition of longleaf pine sandhill communities is not directly possible because reference sites are not randomized or replicated. We addressed this issue by measuring the similarity of arthropods in treatment (fire, herbicide, felling/girdling, and control) and...

Population size of Cuban Parrots Amazona leucocephala and Sandhill Cranes Grus canadensis and community involvement in their conservation in northern Isla de la Juventud, Cuba

Science.gov (United States)

Aguilera, X.G.; Alvarez, V.B.; Wiley, J.W.; Rosales, J.R.

1999-01-01

The Cuban Sandhill Crane Grus canadensis nesiotes and Cuban Parrot Amazona leucocephala palmarum are considered endangered species in Cuba and the Isla de la Juventud (formerly Isla de Pinos). Coincident with a public education campaign, a population survey for these species was conducted in the northern part of the Isla de la Juventud on 17 December 1995, from 06hoo to 10hoo. Residents from throughout the island participated, manning 98 stations, with 1-4 observers per station. Parrots were observed at 60 (61.2%) of the stations with a total of 1320, maximum (without correction for duplicate observations), and 1100, minimum (corrected), individuals counted. Sandhill cranes were sighted at 38 (38.8%) of the stations, with a total of 115 individuals. Cranes and parrots co-occurred at 20 (20.4%) of the stations.

Hydrologic and nutrient response of groundwater to flooding of cranberry farms in southeastern Massachusetts, USA

Science.gov (United States)

Seasonal flooding of cranberry farms is essential for long-term sustainability of cranberry production in southeastern Massachusetts, with roughly 90% of growers flooding for fall harvesting and winter protection. Although considered a significant source of recharge to the regional unconfined aquif...

Molecular detection of Campylobacter spp. and fecal indicator bacteria during the northern migration of Sandhill Cranes (Grus canadensis) at the Central Platte River

Science.gov (United States)

The annual Sandhill crane (Grus canadensis) migration through Nebraska is thought to be a major source of fecal pollution to the Platte River, but of unknown human health risk. To better understand potential risks, the presence of Campylobacter species and fecal bacteria were exa...

Establishment and characterization of GSA-1, a human cell line highly susceptible to apoptosis after free-fall

International Nuclear Information System (INIS)

Nomura, Jun; Himeda, Jyuni; Chen, Zheng; Sugaya, Shigeru; Takahashi, Shunji; Kita, Kazuko; Ichinose, Masaharu; Suzuki, Nobuo

2002-01-01

The induction of apoptosis by microgravity and/or gravity-changing stress is considered to be one of the important causes of cell death, although the molecular mechanisms of the apoptotic event remain unclarified. In this study, we established a cell line,GSA-1, from ethyl methanesulfonate-treated human RSa cells. GSA-1 cells were highly susceptible to apoptosis after a free-fall; 24.4% of these cells underwent apoptosis after free-fall, compared with only 6% of the RSa cells. The apoptosis of GSA-1 cells was augmented by ultraviolet (UV, principally 254-nm wavelength) irradiation before free-fall to a greater extents than those in RSa cells. The molecular mechanisms of apoptosis included p53 and Bax proteins; the expression of nuclear p53 and cytoplasmic Bax in GSA-1 cells increased at 4 h after free-fall irrespective of irradiation. In addition, the rate of removal of cyclobutane pyrimidine dimer (CPD) in UV-irradiated GSA-1 cells was higher in cells exposed to free-fall than in those under the l-G condition. Our results suggested that in GSA-1 cells, free-fall accelerates apoptosis, and that this process is associated with the accumulation of p53 and Bax, as well as CPD removal. Thus, GSA-1 cells should be useful for investigating the mechanism of cellular response, including the induction of apoptosis under gravity-changing stress. (author)

Sunn hemp as a ground cover to manage fall armyworm populations

Science.gov (United States)

Fall armyworm (FAW), Spodoptera frugiperda, is a serious pest of sweet corn in south Florida and a pest of other vegetable, row, and forage crops in the southeastern, mid-Atlantic, and central U.S. It is a migratory pest, moving north each season from overwintering areas in southern Texas and south...

Detection of Rickettsia in Rhipicephalus sanguineus Ticks and Ctenocephalides felis Fleas from Southeastern Tunisia by Reverse Line Blot Assay

Science.gov (United States)

Khrouf, Fatma; M'Ghirbi, Youmna; Znazen, Abir; Ben Jemaa, Mounir; Hammami, Adnene

2014-01-01

Ticks (n = 663) and fleas (n = 470) collected from domestic animals from southeastern Tunisia were screened for Rickettsia infection using reverse line blot assay. Evidence of spotted fever group Rickettsia was obtained. We detected Rickettsia felis in fleas, Rickettsia massiliae Bar 29 and the Rickettsia conorii Israeli spotted fever strain in ticks, and Rickettsia conorii subsp. conorii and Rickettsia spp. in both arthropods. The sensitivity of the adopted technique allowed the identification of a new association between fleas and R. conorii subsp. conorii species. The presence of these vector-borne Rickettsia infections should be considered when diagnosing this disease in humans in Tunisia. PMID:24226919

Nesting ecology of Greater Sandhill Cranes (Grus canadensis tabida) in riparian and palustrine wetlands of eastern Idaho

Science.gov (United States)

McWethy, D.B.; Austin, J.E.

2009-01-01

Little information exists on breeding Greater Sandhill Cranes (Grus canadensis tabida) in riparian wetlands of the Intermountain West. We examined the nesting ecology of Sandhill Cranes associated with riparian and palustrine wetlands in the Henry's Fork Watershed in eastern Idaho in 2003. We located 36 active crane nests, 19 in riparian wetlands and 17 in palustrine wetlands. Nesting sites were dominated by rushes (Juncus spp.), sedges (Carex spp.), Broad-leaved Cattail (Typha latifolia) and willow (Salix spp.), and adjacent foraging areas were primarily composed of sagebrush (Artemisia spp.), cinquefoil (Potentilla spp.),Rabbitbrush (Ericameria bloomeri) bunch grasses, upland forbs, Quaking Aspen (Populus tremuloides) and cottonwood (Populus spp.). Mean water depth surrounding nests was 23 cm (SD = 22). A majority of nests (61%) were surrounded by vegetation between 3060 cm, 23% by vegetation 60 cm in height. We were able to determine the fate of 29 nests, of which 20 were successful (69%). Daily nest survival was 0.986 (95% LCI 0.963, UCI 0.995), equivalent to a Mayfield nest success of 0.654 (95% LCI 0.324, UCI 0.853). Model selection favored models with the covariates vegetation type, vegetation height, and water depth. Nest survival increased with increasing water depth surrounding nest sites. Mean water depth was higher around successful nests (30 cm, SD = 21) than unsuccessful nests (15 cm, SD 22). Further research is needed to evaluate the relative contribution of cranes nesting in palustrine and riparian wetlands distributed widely across the Intermountain West.

Wintering Sandhill Crane exposure to wind energy development in the central and southern Great Plains, USA

Science.gov (United States)

Pearse, Aaron T.; Brandt, David; Krapu, Gary

2016-01-01

Numerous wind energy projects have been constructed in the central and southern Great Plains, USA, the main wintering area for midcontinental Sandhill Cranes (Grus canadensis). In an initial assessment of the potential risks of wind towers to cranes, we estimated spatial overlap, investigated potential avoidance behavior, and determined the habitat associations of cranes. We used data from cranes marked with platform transmitting terminals (PTTs) with and without global positioning system (GPS) capabilities. We estimated the wintering distributions of PTT-marked cranes prior to the construction of wind towers, which we compared with current tower locations. Based on this analysis, we found 7% spatial overlap between the distributions of cranes and towers. When we looked at individually marked cranes, we found that 52% would have occurred within 10 km of a tower at some point during winter. Using data from cranes marked after tower construction, we found a potential indication of avoidance behavior, whereby GPS-marked cranes generally used areas slightly more distant from existing wind towers than would be expected by chance. Results from a habitat selection model suggested that distances between crane locations and towers may have been driven more by habitat selection than by avoidance, as most wind towers were constructed in locations not often selected by wintering cranes. Our findings of modest regional overlap and that few towers have been placed in preferred crane habitat suggest that the current distribution of wind towers may be of low risk to the continued persistence of wintering midcontinental Sandhill Cranes in the central and southern Great Plains.

Migratory patterns of the fall armyworm (Spodoptera frugiperda) in the western hemisphere

Science.gov (United States)

Fall armyworm (FAW) is a serious pest of sweet corn in south Florida and a pest of other vegetable, row, and forage crops in the southeastern, mid-Atlantic, and central U.S. It is a migratory pest, moving north each season from overwintering areas in southern Texas and southern Florida. For the la...

Understanding toxicity at the watershed scale : design of the Syncrude Sandhill Fen watershed research project

International Nuclear Information System (INIS)

Wytrykush, C.

2010-01-01

Fens are peat-accumulating wetlands with a water table consisting of mineral-rich ground or surface water. This study discussed the construction of a fen-type reclaimed wetland constructed in a post-mining oil sands landscape. Syncrude Canada's Sandhill fen watershed project represents the first attempt at constructing a fen wetland in the oil sands region. The wetland and its watershed will be constructed on a soft tailings deposit. The design basis for the fen and watershed was developed by a team of researchers and scientists. The aim of the fen design was to control the salinity caused by tailings consolidation and seepage over time. Methods of mitigating potentially toxic effects from salinity were discussed.

Semen collection and fertility in naturally fertile sandhill cranes

Science.gov (United States)

Chen, G.; Gee, G.F.; Nicolich, Jane M.; Taylor, J.A.; Urbanek, R.P.; Stahlecker, D.W.

1997-01-01

Aviculturists often ask if semen collection will interfere with fertility in naturally fertile pairs of cranes. We used 12 naturally fertile Florida sandhill crane (Grus canadensis pratensis) pairs for this study, 6 control and 6 experimental. All pairs had produced fertile eggs in previous years and were in out-of-doors pens scattered throughout different pen complexes, within auditory range but physically isolated. Semen was collected on Tuesday mornings and Friday afternoons from 26 February 1993 to 4 June 1993. We used standard artificial insemination methods to collect and to evaluate the semen and spermatozoa. Semen collection did not affect semen quality or quantity. Semen volume, sperm density, sperm motility, sperm morphology, sperm live, sperm number per collection, and male response to semen collection exhibited significant daily variation (P semen collection began 13 days before the first egg in the experimental group, we observed no differences in the date of first egg laid or in fertility between experimental and control groups. Also, we observed no differences in the interval between clutches or in the percentage of broken eggs between experimental and control groups. Sires consistently producing better semen samples produced fewer fertile eggs than sires producing poorer semen samples (r = 0.60).

Considering transient population dynamics in the conservation of slow life-history species: An application to the sandhill crane

Science.gov (United States)

Gerber, Brian D.; Kendall, William L.

2016-01-01

The importance of transient dynamics of structured populations is increasingly recognized in ecology, yet these implications are not largely considered in conservation practices. We investigate transient and long-term population dynamics to demonstrate the process and utility of incorporating transient dynamics into conservation research and to better understand the population management of slow life-history species; these species can be theoretically highly sensitive to short- and long-term transient effects. We are specifically interested in the effects of anthropogenic removal of individuals from populations, such as caused by harvest, poaching, translocation, or incidental take. We use the sandhill crane (Grus canadensis) as an exemplar species; it is long-lived, has low reproduction, late maturity, and multiple populations are subject to sport harvest. We found sandhill cranes to have extremely high potential, but low likelihood for transient dynamics, even when the population is being harvested. The typically low population growth rate of slow life-history species appears to buffer against many perturbations causing large transient effects. Transient dynamics will dominate population trajectories of these species when stage structures are highly biased towards the younger and non-reproducing individuals, a situation that may be rare in established populations of long-lived animals. However, short-term transient population growth can be highly sensitive to vital rates that are relatively insensitive under equilibrium, suggesting that stage structure should be known if perturbation analysis is used to identify effective conservation strategies. For populations of slow life-history species that are not prone to large perturbations to their most productive individuals, population growth may be approximated by equilibrium dynamics.

The RHYTMME system: an operational real-time warning and mapping system for flash floods, debris flows, landslide and rock falls in Southeastern France.

Science.gov (United States)

Fouchier, Catherine; Mériaux, Patrice; Atger, Frédéric; Ecrepont, Stéphane; Liébault, Frédéric; Bertrand, Mélanie; Bel, Coraline; Batista, Dominique; Azemard, Pierre; Saint-Martin, Clotilde; Javelle, Pierre

2016-04-01

Almost all municipalities of Southeastern France are concerned by natural hazards triggered by heavy rainfalls such as floods, debris flows, landslides and rock falls. Although some tools exist to forecast and monitor heavy rains and floods in France, their spatial resolution sometimes does not meet the needs of local risk managers who have to monitor events at a small spatial scale. In order to improve the risk management in the mountainous and Mediterranean areas of Southeastern France, Irstea and Météo-France have led the RHYTMME project. The goal of this project is to improve the ability to forecast and localize high-risk rainfall-induced hazards in the Provence-Alpes-Côte d'Azur administrative area. This goal is currently under achievement thanks to the implementation of a real-time warning and mapping system for rainfall induced natural hazards, fed by radar data and whose outputs are made available via the Internet to operators in charge of risk management (local and regional authorities, emergency and rescue services, road and rail networks managers, ...). This system provides maps which display in real-time: - the radar estimations of rainfall for different rain durations and at the spatial resolution of 1 km² (Westrelin et al., 2013), - the estimation of the scarcity of these rainfall estimations, also at the spatial resolution of 1 km², thanks to a comparison with threshold values provided by a regionalized stochastic hourly point rainfall generator (Arnaud et al., 2007), - an anticipation of the rivers discharges, computed at the outlet of 1700 watersheds of Southeastern France thanks to the AIGA warning system which combines a rainfall runoff model and an estimation of the scarcity of the discharges thanks to a comparison with threshold values (Javelle et al., 2014). Maps of susceptibility to debris flow, landslide and rock falls can also be displayed in the RHYTMME warning system along with the real time maps of rainfall hazard (Batista, 2013a

Investigating Hydrogeologic Controls on Sandhill Wetlands in Covered Karst with 2D Resistivity and Ground Penetrating Radar

Science.gov (United States)

Downs, C. M.; Nowicki, R. S.; Rains, M. C.; Kruse, S.

2015-12-01

In west-central Florida, wetland and lake distribution is strongly controlled by karst landforms. Sandhill wetlands and lakes are sand-filled upland basins whose water levels are groundwater driven. Lake dimensions only reach wetland edges during extreme precipitation events. Current wetland classification schemes are inappropriate for identifying sandhill wetlands due to their unique hydrologic regime and ecologic expression. As a result, it is difficult to determine whether or not a wetland is impacted by groundwater pumping, development, and climate change. A better understanding of subsurface structures and how they control the hydrologic regime is necessary for development of an identification and monitoring protocol. Long-term studies record vegetation diversity and distribution, shallow ground water levels and surface water levels. The overall goals are to determine the hydrologic controls (groundwater, seepage, surface water inputs). Most recently a series of geophysical surveys was conducted at select sites in Hernando and Pasco County, Florida. Electrical resistivity and ground penetrating radar were employed to image sand-filled basins and the top of the limestone bedrock and stratigraphy of wetland slopes, respectively. The deepest extent of these sand-filled basins is generally reflected in topography as shallow depressions. Resistivity along inundated wetlands suggests the pools are surface expressions of the surficial aquifer. However, possible breaches in confining clay layers beneath topographic highs between depressions are seen in resistivity profiles as conductive anomalies and in GPR as interruptions in otherwise continuous horizons. These data occur at sites where unconfined and confined water levels are in agreement, suggesting communication between shallow and deep groundwater. Wetland plants are observed outside the historic wetland boundary at many sites, GPR profiles show near-surface layers dipping towards the wetlands at a shallower

Regional annual water yield from forest lands and its response to potential deforestation across the southeastern United States

Science.gov (United States)

Ge Sun; Steve G. McNulty; J. Lu; Devendra M. Amatya; Y. Liang; R.K. Kolka

2005-01-01

Regional water yield at a meso-scale can be estimated as the difference between precipitation input and evapotranspiration output. Forest water yield from the southeastern US varies greatly both in space and time. Because of the hot climate and high evapotranspiration, less than half of the annual precipitation that falls on forest lands is available for stream flow...

Fall risk and prevention agreement: engaging patients and families with a partnership for patient safety.

Science.gov (United States)

Vonnes, Cassandra; Wolf, Darcy

2017-01-01

Falls are multifactorial in medical oncology units and are potentiated by an older adult's response to anxiolytics, opiates and chemotherapy protocols. In addition, the oncology patient is at an increased risk for injury from a fall due to coagulopathy, thrombocytopenia and advanced age. At our National Cancer Institute-designated inpatient cancer treatment centre located in the southeastern USA, 40% of the total discharges are over the age of 65. As part of a comprehensive fall prevention programme, bimonthly individual fall reports have been presented with the Chief Nursing Officer (CNO), nursing directors, nurse managers, physical therapists and front-line providers in attendance. As a result of these case discussions, in some cases, safety recommendations have not been followed by patients and families and identified as an implication in individual falls. Impulsive behaviour was acknowledged only after a fall occurred. A medical oncology unit was targeted for this initiative due to a prolonged length of stay. This patient population receives chemotherapeutic interventions, management of oncological treatment consequences and cancer progression care. The aim of this project was to explore if initiation of a Fall Prevention Agreement between the nursing team and older adults being admitted to medical oncology units would reduce the incidence of falls and the incidence of falls with injury. In order to promote patient and family participation in the fall reduction and safety plan, the Fall Risk and Prevention Agreement was introduced upon admission. Using the Morse Fall Scoring system, patient's risk for fall was communicated on the Fall Risk and Prevention Agreement. Besides admission, patients were reassessed based on change of status, transfer or after a fall occurs. Fall and fall injuries rates were compared two-quarters prior to implementation of the fall agreement and eight-quarters post implementation. Falls and fall injuries on the medical oncology unit

On free fall of a relativistic particle

International Nuclear Information System (INIS)

Chernikov, N.A.; Paramonova, N.N.; Shavokhina, N.S.

2005-01-01

The free fall of a relativistic particle is considered: the well-known fact of the light velocity constancy is taken into account in the Galilean problem about the movement of a particle from nongravitational forces and its fall onto the ground. The velocity hodograph and the world line of the particle are found

Falls in nursing home residents receiving pharmacotherapy for anemia

Directory of Open Access Journals (Sweden)

Reardon G

2012-10-01

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

Geology and geomorphology of the Carolina Sandhills, Chesterfield County, South Carolina

Science.gov (United States)

Swezey, Christopher; Fitzwater, Bradley A.; Whittecar, G. Richard

2016-01-01

This two-day field trip focuses on the geology and geomorphology of the Carolina Sandhills in Chesterfield County, South Carolina. This area is located in the updip portion of the U.S. Atlantic Coastal Plain province, supports an ecosystem of longleaf pine (Pinus palustris) and wiregrass (Aristida stricta), and contains three major geologic map units: (1) An ~60–120-m-thick unit of weakly consolidated sand, sandstone, mud, and gravel is mapped as the Upper Cretaceous Middendorf Formation and is interpreted as a fluvial deposit. This unit is capped by an unconformity, and displays reticulate mottling, plinthite, and other paleosol features at the unconformity. The Middendorf Formation is the largest aquifer in South Carolina. (2) A 0.3–10-m-thick unit of unconsolidated sand is mapped as the Quaternary Pinehurst Formation and is interpreted as deposits of eolian sand sheets and dunes derived via remobilization of sand from the underlying Cretaceous strata. This unit displays argillic horizons and abundant evidence of bioturbation by vegetation. (3) A geomorphologic feature in the study area is a north-trending escarpment (incised by headwater streams) that forms a markedly asymmetric drainage divide. This drainage divide, as well as the Quaternary terraces deposits, are interpreted as evidence of landscape disequilibrium (possibly geomorphic responses to Quaternary climate changes).

THE STRATEGIC IMPORTANCE AND THE ACTORS OF SOUTH-EASTERN EUROPE

Directory of Open Access Journals (Sweden)

Florin Eduard GROSARU

2012-01-01

Full Text Available There is no doubt regarding the importance that south-eastern Europe has gained over the past years in geopolitical and geostrategic terms. Due to its history and considering the changes that have taken place here after the fall of the Iron Curtain, and also as a consequence of the “hot spots” emerged here on ideological, political, economic and terrorist grounds, this part of the continent still is an area of control and interests confrontations orchestrated by the actors that provide the international affairs with a multipolar dimension. All the aforementioned factors lead to various phenomena in which individual or group interests result in regional as well as global consequences.

Formative evaluation of the telecare fall prevention project for older veterans

OpenAIRE

Miake-Lye, Isomi M; Amulis, Angel; Saliba, Debra; Shekelle, Paul G; Volkman, Linda K; Ganz, David A

2011-01-01

Abstract Background Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage pa...

Developing Dynamic Reference Models and a Decision Support Framework for Southeastern Ecosystems: An Integrated Approach

Science.gov (United States)

2015-06-01

and 2010 reference conditions (Figure 23). Based on the PerMANOVA analysis of the ground cover vegetation matrix, dispersion of sample units in...Keeney, editors. Methods of soil analysis Part 2 – Chemical and microbiological properties. CRC Press, Madison, Wisconsin, USA. Kennedy, C. M., P...CRAN.R-project.org/package=labdsv. Rodgers, H. L. and L. Provencher. 1999. Analysis of longleaf pine sandhill vegetation in northwest Florida

Organic carbon input in shallow groundwater at Aspo, southeastern Sweden

International Nuclear Information System (INIS)

Wallin, B.

1993-01-01

The variation in carbon and oxygen isotopes in calcite fissure fillings and dissolved carbonate from shallow groundwaters has been examined at Aspo, southeastern Sweden. The shallow water lens is refilled by meteoric water and is considered as an open system. The σ 13 C-signatures of the dissolved carbonate fall within a narrow range of -15.8 to -17.4 per-thousand, indicative of organic an organic carbon source. The low σ 13 C-values suggest that input of soil-CO 2 is the dominating carbon source for the system. σ 13 C and σ 18 O-values in the calcite fissure fillings show a wide range in values with a possible two end-member mixing of early post glacial atmospheric CO 2 dominated system to a present day soil-CO 2 dominating carbon source

Late Pleistocene paleohydrology near the boundary of the Sonoran and Chihuahuan Deserts, southeastern Arizona, USA

Science.gov (United States)

Pigati, Jeffery S.; Bright, Jordon E.; Shanahan, Timothy M.; Mahan, Shannon

2009-01-01

Ground-water discharge (GWD) deposits form in arid environments as water tables rise and approach or breach the ground surface during periods of enhanced effective precipitation. Where preserved, these deposits contain information on the timing and elevation of past ground-water fluctuations. Here we report on the investigation of a series of GWD deposits that are exposed in discontinuous outcrops along a ???150-km stretch of the San Pedro Valley in southeastern Arizona, near the boundary of the Sonoran and Chihuahuan Deserts. Chronologic, isotopic, geochemical, faunal assemblage (ostracodes and gastropods), and sedimentological evidence collectively suggest that the elevation of the regional water table in the valley rose in response to a change in climate ???50 ka ago and remained relatively high for the next ???35 ka before falling during the B??lling-Aller??d warm period, rebounding briefly during the Younger Dryas cold event, and falling again at the onset of the Holocene. The timing of these hydrologic changes coincides closely with variations in ??18O values of calcite from a nearby speleothem to the west and changes in lake levels at pluvial Lake Cochise to the east. Thus, in southeastern Arizona, the assumption that changes in climate are reflected in all aspects of the hydrologic cycle of a region simultaneously is validated. The timing of these changes also broadly coincides with variations in the GISP2 ??18O record, which supports the hypothesis that atmospheric teleconnections existed between the North Atlantic and the deserts of the American Southwest during the late Pleistocene.

Spring migration ecology of the mid-continent sandhill crane population with an emphasis on use of the Central Platte River Valley, Nebraska

Science.gov (United States)

Krapu, Gary L.; Brandt, David A.; Kinzel, Paul J.; Pearse, Aaron T.

2014-01-01

We conducted a 10-year study (1998–2007) of the Mid-Continent Population (MCP) of sandhill cranes (Grus canadensis) to identify spring-migration corridors, locations of major stopovers, and migration chronology by crane breeding affiliation (western Alaska–Siberia [WA–S], northern Canada–Nunavut [NC–N], west-central Canada–Alaska [WC–A], and east-central Canada–Minnesota [EC–M]). In the Central Platte River Valley (CPRV) of Nebraska, we evaluated factors influencing staging chronology, food habits, fat storage, and habitat use of sandhill cranes. We compared our findings to results from the Platte River Ecology Study conducted during 1978–1980. We determined spring migration corridors used by the breeding affiliations (designated subpopulations for management purposes) by monitoring 169 cranes marked with platform transmitter terminals (PTTs). We also marked and monitored 456 cranes in the CPRV with very high frequency (VHF) transmitters to evaluate length and pattern of stay, habitat use, and movements. An estimated 42% and 58% of cranes staging in the CPRV were greater sandhill cranes (G. c. tabida) and lesser sandhill cranes (G. c. canadensis), and they stayed for an average of 20 and 25 days (2000–2007), respectively. Cranes from the WA–S, NC–N, WC–A, and EC–M affiliations spent an average of 72, 77, 52, and 53 days, respectively, in spring migration of which 28, 23, 24, and 18 days occurred in the CPRV. The majority of the WA–S subpopulation settled in the CPRV apparently because of inadequate habitat to support more birds upstream, although WA–S cranes accounted for >90% of birds staging in the North Platte River Valley. Crane staging duration in the CPRV was negatively correlated with arrival dates; 92% of cranes stayed >7 days. A program of annual mechanical removal of mature stands of woody growth and seedlings that began in the early 1980s primarily in the main channel of the Platte River has allowed distribution of crane

Modelling the limits on the response of net carbon exchange to fertilization in a south-eastern pine forest

Science.gov (United States)

Chun-Tai. Lai; G. Katul; J. Butnor; M. Siqueira; D. Ellsworth; C. Maier; Kurt Johnsen; S. Mickeand; R. Oren

2002-01-01

Using a combination of model simulations and detailed measurements at a hierarchy of scales conducted at a sandhills forest site, the effect of fertilization on net ecosystem exchange (NEE) and its components in 6-year-old Pinus taeda stands was quantified. The detailed measurements, collected over a 20-d period in September and October, included gas...

Zirconium and hafnium in the southeastern Atlantic States

Science.gov (United States)

Mertie, J.B.

1958-01-01

The principal source of zirconium and hafnium is zircon, though a minor source is baddeleyite, mined only in Brazil. Zircon is an accessory mineral in igneous, metamorphic, and sedimentary rocks, but rarely occurs in hardrock in minable quantities. The principal sources of zircon are therefore alluvial deposits, which are mined in many countries of five continents. The principal commercial deposits in the United States are in Florida, though others exist elsewhere in the southeastern Coastal Plain. The evidence indicates that conditions for the accumulation of workable deposits of heavy minerals were more favorable during the interglacial stages of the Pleistocene epoch than during Recent time. Therefore detrital ores of large volume and high tenor are more likely to be found in the terrace deposits than along the present beaches. Other concentrations of heavy minerals, however, are possible at favored sites close to the Fall Line where the Tuscaloosa formation rests upon the crystalline rocks of the Piedmont province. A score of heavy and semiheavy minerals occur in the detrital deposits of Florida, but the principal salable minerals are ilmenite, leucoxene, rutile, and zircon, though monazite and staurolite are saved at some mining plants. Commercial deposits of heavy minerals are generally required to have a tenor of 4 percent, though ores with a lower tenor can be mined at a profit if the content of monazite is notably high. The percentages of zircon in the concentrates ranges from 10 to 16 percent, and in eastern Florida from 13 to 15 percent. Thus the tenor in zircon of the ore-bearing sands ranges from 0.4 to 0.6 percent. The content of hafnium in zircon is immaterial for many uses, but for some purposes very high or very low tenors in hafnium are required. Alluvial zircon cannot be separated into such varieties, which, if needed, must be obtained from sources in bedrock. It thus becomes necessary to determine the Hf : Zr ratios in zircon from many kinds of

Measurement of functional independence level and falls-risk in individuals with undiagnosed phenylketonuria.

LENUS (Irish Health Repository)

Mazur, Artur

2009-01-01

The aim of the study was to determine the level of functional independence in adult patients with previously undiagnosed or untreated phenylketonuria (PKU). The study was conducted among 400 intellectually impaired adult residents of Social Welfare Homes in South-Eastern Poland born prior to the introduction of neonatal PKU screening programs. PKU was screened by filter paper test using tandem mass spectrometry methods, and confirmed by gas chromatography-mass spectrometric analysis of PKU organic acids in urine. Degree of functional independence included the assessment of activities of daily living (Barthel Index) and measures of balance and gait (Tinetti scale). Eleven individuals with previously untreated PKU were identified whereby eight presented with moderate disability and three with mild disability. Six had a high risk of falls and five had a moderate risk of falls. This study indicates that there is considerable number of undiagnosed PKU patients within the Polish population who require assessment and management in order to reduce the impact of the neurological and neuropsychiatric problems associated with the condition. Appropriate therapy for those with undiagnosed PKU should, in particular, address the risk of falls.

Granitic rocks from the southern Gyeongsang basin, southeastern Korea, (1)

International Nuclear Information System (INIS)

Lee, Yoon-Jong

1980-01-01

In southern Gyeongsang basin, southeastern Korea, there are many granitic rock masses. They were divided into 7 groups according to their geological evidences. K-Ar age was determined on 36 samples obtained from the respective groups. Group A: pre-Gyeongsang granitic rock (Pre-Cretaceous), A 1 220 m.y., A 2 166 m.y.; group B: outer zone granitic rock (Cretaceous), 115-72 m.y.; group C: ditto (ditto), 97-70 m.y.; group D: ditto (ditto), 89-68 m.y.; group E: ditto (ditto), 82-68 m.y.; group F: inner zone granitic rock (Cretaceous), 75-74 m.y.; group G: Tertiary granitic rock, 63-41 m.y. The large part of the Cretaceous granitic masses show the double elongated ring form. Most of the Tertiary granitic rocks were probably emplaced in close relation with the Eonyang fault line and Ulsan fault line/or their extension line of the area. (J.P.N.)

High-voltage short-fall pulse generator

International Nuclear Information System (INIS)

Dolbilov, G.V.; Fateev, A.A.; Petrov, V.A.

1986-01-01

Powerful high-voltage pulses with short fall times and relatively low afterpulse amplitude are required for the deflection systems of accelerators. A generator is described that provides, into a 75-ohm load, a voltage pulse of up to 100 kV with a fall time of less than 1 nsec and a relative afterpulse amplitude of less than or equal to 15%. The generator employs a short-circuited ferrite-filled line in which shock waves are formed. A magnetic section is used to increase power. The switch is a TGI1-2500/50 thyratron. The main causes of afterpulses and methods for reducing their amplitude are examined

Southeastern Power Administration 2011 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2011-12-31

Dear Secretary Chu: I am pleased to submit Southeastern Power Administration’s (Southeastern) fiscal year (FY) 2011 Annual Report for your review. This report reflects our agency’s programs, accomplishments, operational, and financial activities for the 12-month period beginning October 1, 2010, and ending September 31, 2011. This past year, Southeastern marketed approximately 6.2 billion kilowatt-hours of energy to 489 wholesale customers in 10 southeastern states. Revenues from the sale of this power totaled more than $264 million. With the financial assistance and support of Southeastern’s customers, funding for capitalized equipment purchases and replacements at hydroelectric facilities operated by the U.S. Army Corps of Engineers (Corps) continued in FY 2011. This funding, which totaled more than $45 million, provided much needed repairs and maintenance for aging projects in Southeastern’s marketing area. Currently, there are more than 214 customers participating in the funding efforts in the Georgia-Alabama-South Carolina, Kerr-Philpott, and Cumberland Systems of projects. Drought conditions continued in the southeastern region of the United States this past year, particularly in the Savannah River Basin. Lack of rain placed strains on our natural and financial resources. Power purchases for FY 2011 totaled approximately $38 million. About $9 million of this amount was for replacement power, which is purchased only during adverse water conditions in order to meet Southeastern’s customer contract requirements. Southeastern’s goal is to maximize the benefits of our region’s water resources. Competing uses of these resources will present another challenging year for Southeastern’s employees. With the cooperation and communication among the Department of Energy (DOE), preference customers, and Corps, I am certain Southeastern is positioned to meet these challenges in the future. We are committed to providing reliable hydroelectric power to

Rock-fall Hazard In The Yosemite Valley, California

Science.gov (United States)

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

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

Fall-related experiences of stroke survivors: a meta-ethnography.

Science.gov (United States)

Walsh, Mary; Galvin, Rose; Horgan, N Frances

2017-04-01

Health professionals view falls after stroke as common adverse events with both physical and psychological consequences. Stroke survivors' experiences are less well understood. The aim of this systematic review was to explore the perception of falls-risk within the stroke recovery experience from the perspective of people with stroke. A systematic literature search was conducted. Papers that used qualitative methods to explore the experiences of individuals with stroke around falls, falls-risk and fear of falling were included. Two reviewers independently assessed the methodological quality of papers. Meta-ethnography was conducted. Concepts from each study were translated into each other to form theories that were combined through a "lines-of-argument" synthesis. Four themes emerged from the six included qualitative studies: (i) Fall circumstances, (ii) perception of fall consequences, (iii) barriers to community participation and (iv) coping strategies. The synthesis revealed that stroke survivors' perceived consequences of falls exist on a continuum. Cognitive and emotional adjustment may be required in the successful adoption of coping strategies to overcome fall-related barriers to participation. Stroke survivors' fall-related experiences appear to exist within the context of activity and community participation. Further research is warranted due to the small number of substantive studies available for synthesis. Implications for Rehabilitation Health care professionals should recognize that cognitive and emotional adjustment may berequired for stroke survivors to accept strategies for overcoming falls-risk, including dependenceon carers and assistive devices. Several factors in addition to physical interventions may be needed to minimize falls-risk whileincreasing activity participation. These factors could include increasing public awareness about the effects of stroke and falls-risk,and ensuring access to psychological services for stroke survivors

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

Science.gov (United States)

Abdallah, C.

2010-10-01

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

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.

Southeastern Power Administration 2012 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2012-01-01

Dear Secretary Moniz: I am pleased to submit Southeastern Power Administration’s (Southeastern) fiscal year (FY) 2012 Annual Report for your review. This report reflects our agency’s programs, accomplishments, operational, and financial activities for the 12-month period beginning October 1, 2011, and ending September 30, 2012. This past year, Southeastern marketed approximately 5.4 billion kilowatt-hours of energy to 487 wholesale customers in 10 southeastern states. Revenues from the sale of this power totaled about $263 million. With the financial assistance and support of Southeastern’s customers, funding for capitalized equipment purchases and replacements at hydroelectric facilities operated by the U.S. Army Corps of Engineers (Corps) continued in FY 2012. Currently, there are more than 214 customers participating in funding infrastructure renewal efforts of powerplants feeding the Georgia-Alabama-South Carolina, Kerr-Philpott, and Cumberland Systems. This funding, which totaled more than $71 million, provided much needed repairs and maintenance for aging projects in Southeastern’s marketing area. Drought conditions continued in the southeastern region of the United States this past year, particularly in the Savannah River Basin. Lack of rainfall strained our natural and financial resources. Power purchases for FY 2012 in the Georgia-Alabama-South Carolina System totaled approximately $29 million. About $8 million of this amount was for replacement power, which is purchased only during adverse water conditions in order to meet Southeastern’s customer contract requirements. Southeastern’s goal is to maximize the benefits of our region’s water resources. Competing uses of these resources will present another challenging year for Southeastern’s employees. With the cooperation and communication among the Department of Energy (DOE), preference customers, and Corps, I am certain Southeastern is positioned to meet these challenges in the future. We

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.

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

Science.gov (United States)

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

2011-08-12

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

Southeastern Power Administration 2008 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2008-12-29

Dear Secretary Chu: I am pleased to submit Southeastern Power Administration’s (Southeastern’s) fiscal year (FY) 2008 Annual Report for your review. The information included in this document reflects our agency’s programs, accomplishments, operational and financial activities for the 12-month period beginning October 1, 2007 and ending September 30, 2008. Southeastern marketed more than 4.5 billion kilowatt-hours of energy to 491 wholesale customers in ten southeastern states this past year. Revenues from the sale of this power totaled approximately $263 million. Drought conditions persisted in the southeastern region of the United States during FY 2008 placing strains on our natural and financial resources. Power purchases for FY 2008 totaled $91 million. Approximately $44 million of this amount was for replacement power which is paid only during adverse water conditions in order to meet our customers’ contract requirements. With the continued financial assistance and support of our Federal power customers, funding for capitalized equipment purchases and replacements at U.S. Army Corps of Engineers’ (Corps) hydroelectric projects provided much needed repairs and maintenance for these aging facilities. Southeastern’s cyber and physical security programs continued to be reviewed and updated to meet Department of Energy (DOE), Homeland Security, and North American Electric Reliability Corporation (NERC) standards and requirements. In the coming year, Southeastern will continue open communication and cooperation with DOE, the Federal power customers, and the Corps to maximize the benefits of our region’s water resources. Although competing uses of water and the prolonged drought conditions will present another challenging year for our agency, Southeastern’s employees will meet these challenges and continue to provide reliable hydroelectric power to the people in the southeast. Sincerely, Kenneth E.Legg Administrator

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

Directory of Open Access Journals (Sweden)

Shimada Hiroyuki

2011-08-01

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

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

Science.gov (United States)

Verghese, Joe

2016-01-01

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

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

Science.gov (United States)

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

2016-06-02

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

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.

Person-Centered Fall Risk Awareness Perspectives: Clinical Correlates and Fall Risk.

Science.gov (United States)

Verghese, Joe

2016-12-01

To identify clinical correlates of person-centered fall risk awareness and their validity for predicting falls. Prospective cohort study. Community. Ambulatory community-dwelling older adults without dementia (N = 316; mean age 78, 55% female). Fall risk awareness was assessed using a two-item questionnaire that asked participants about overall likelihood of someone in their age group having a fall and their own personal risk of falling over the next 12 months. Incident falls were recorded over study follow-up. Fifty-three participants (16.8%) responded positively to the first fall risk awareness question about being likely to have a fall in the next 12 months, and 100 (31.6%) reported being at personal risk of falling over the next 12 months. There was only fair correlation (κ = 0.370) between responses on the two questions. Prior falls and depressive symptoms were associated with positive responses on both fall risk awareness questions. Age and other established fall risk factors were not associated with responses on either fall risk awareness question. The fall risk awareness questionnaire did not predict incident falls or injurious falls. Fall risk awareness is low in older adults. Although person-centered fall risk awareness is not predictive of falls, subjective risk perceptions should be considered when designing fall preventive strategies because they may influence participation and behaviors. © 2016, Copyright the Author Journal compilation © 2016, The American Geriatrics Society.

Preliminary peak stage and streamflow data at selected U.S. Geological Survey streamgages for flooding in the central and southeastern United States during December 2015 and January 2016

Science.gov (United States)

Holmes, Robert R.; Watson, Kara M.; Harris, Thomas E.

2016-06-16

Flooding occurred in the central and southeastern United States during December 2015 and January 2016. The flooding was the result of more than 20 inches of rain falling in a 19 day period from December 12 to December 31, 2015. U.S. Geological Survey streamgages recorded 23 peaks of record during the subsequent flooding, with a total of 172 streamgages recording peaks that ranked in the top 5 all time for the period of record.

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

Science.gov (United States)

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

2016-12-01

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

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.

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.

Religions in South-Eastern Europe: The Historico-Anthropological Approach

Directory of Open Access Journals (Sweden)

Michael Mitterauer

2008-06-01

Full Text Available The article approaches religious phenomena in South-Eastern Europe in a historico-anthropological manner. With the aid of historical comparison, the author tries to throw light on the religious phenomena of South-Eastern Europe and to present them in a lucid review. A significant place in this process is given to historical sociology as a discipline which, among other, also deals with the religious conditioning of social processes. The text consists of two parts. In the first, the author deals with the question of the religious particularity of South-Eastern Europe and considers it from several viewpoints. The author regards the most important features of the religious situation in that part of Europe as being particularism, archaicism and syncretism. He analyses the historical conditioning of the viability of the three monotheistic world religions in the region, their influence on the social development of South-Eastern Europe, the stance of the authorities towards religious communities and the existence of diverse traditions within individual religious cultures. Along with analysis of the presence of ancient elements and the continuity of pre-Christian rituals and beliefs, the author also stresses the strong syncretism marking the religious traditions of South-Eastern Europe. In the second part of the text the author compares religious phenomena in South-Eastern Europe and analyses regional religious traditions. He presents from the historico-anthropological aspect the religious rituals, the bearers of rituals, the place and time of rituals and the ritual languages of each of the world religions represented in the region. Emphasising the continuity of religious life and religious traditions in South-Eastern Europe, the author ends with the period of Communist rule in the second half of the 20th century, and deliberation that Communism, too, with its atheist doctrine in the secular form of cult, in fact carried on from religious tradition.

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.

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

Science.gov (United States)

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

2017-12-21

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

A Product Line Enhanced Unified Process

DEFF Research Database (Denmark)

Zhang, Weishan; Kunz, Thomas

2006-01-01

The Unified Process facilitates reuse for a single system, but falls short handling multiple similar products. In this paper we present an enhanced Unified Process, called UPEPL, integrating the product line technology in order to alleviate this problem. In UPEPL, the product line related activit...... activities are added and could be conducted side by side with other classical UP activities. In this way both the advantages of Unified Process and software product lines could co-exist in UPEPL. We show how to use UPEPL with an industrial mobile device product line in our case study....

The genomic history of southeastern Europe.

Science.gov (United States)

Mathieson, Iain; Alpaslan-Roodenberg, Songül; Posth, Cosimo; Szécsényi-Nagy, Anna; Rohland, Nadin; Mallick, Swapan; Olalde, Iñigo; Broomandkhoshbacht, Nasreen; Candilio, Francesca; Cheronet, Olivia; Fernandes, Daniel; Ferry, Matthew; Gamarra, Beatriz; Fortes, Gloria González; Haak, Wolfgang; Harney, Eadaoin; Jones, Eppie; Keating, Denise; Krause-Kyora, Ben; Kucukkalipci, Isil; Michel, Megan; Mittnik, Alissa; Nägele, Kathrin; Novak, Mario; Oppenheimer, Jonas; Patterson, Nick; Pfrengle, Saskia; Sirak, Kendra; Stewardson, Kristin; Vai, Stefania; Alexandrov, Stefan; Alt, Kurt W; Andreescu, Radian; Antonović, Dragana; Ash, Abigail; Atanassova, Nadezhda; Bacvarov, Krum; Gusztáv, Mende Balázs; Bocherens, Hervé; Bolus, Michael; Boroneanţ, Adina; Boyadzhiev, Yavor; Budnik, Alicja; Burmaz, Josip; Chohadzhiev, Stefan; Conard, Nicholas J; Cottiaux, Richard; Čuka, Maja; Cupillard, Christophe; Drucker, Dorothée G; Elenski, Nedko; Francken, Michael; Galabova, Borislava; Ganetsovski, Georgi; Gély, Bernard; Hajdu, Tamás; Handzhyiska, Veneta; Harvati, Katerina; Higham, Thomas; Iliev, Stanislav; Janković, Ivor; Karavanić, Ivor; Kennett, Douglas J; Komšo, Darko; Kozak, Alexandra; Labuda, Damian; Lari, Martina; Lazar, Catalin; Leppek, Maleen; Leshtakov, Krassimir; Vetro, Domenico Lo; Los, Dženi; Lozanov, Ivaylo; Malina, Maria; Martini, Fabio; McSweeney, Kath; Meller, Harald; Menđušić, Marko; Mirea, Pavel; Moiseyev, Vyacheslav; Petrova, Vanya; Price, T Douglas; Simalcsik, Angela; Sineo, Luca; Šlaus, Mario; Slavchev, Vladimir; Stanev, Petar; Starović, Andrej; Szeniczey, Tamás; Talamo, Sahra; Teschler-Nicola, Maria; Thevenet, Corinne; Valchev, Ivan; Valentin, Frédérique; Vasilyev, Sergey; Veljanovska, Fanica; Venelinova, Svetlana; Veselovskaya, Elizaveta; Viola, Bence; Virag, Cristian; Zaninović, Joško; Zäuner, Steve; Stockhammer, Philipp W; Catalano, Giulio; Krauß, Raiko; Caramelli, David; Zariņa, Gunita; Gaydarska, Bisserka; Lillie, Malcolm; Nikitin, Alexey G; Potekhina, Inna; Papathanasiou, Anastasia; Borić, Dušan; Bonsall, Clive; Krause, Johannes; Pinhasi, Ron; Reich, David

2018-03-08

Farming was first introduced to Europe in the mid-seventh millennium bc, and was associated with migrants from Anatolia who settled in the southeast before spreading throughout Europe. Here, to understand the dynamics of this process, we analysed genome-wide ancient DNA data from 225 individuals who lived in southeastern Europe and surrounding regions between 12000 and 500 bc. We document a west-east cline of ancestry in indigenous hunter-gatherers and, in eastern Europe, the early stages in the formation of Bronze Age steppe ancestry. We show that the first farmers of northern and western Europe dispersed through southeastern Europe with limited hunter-gatherer admixture, but that some early groups in the southeast mixed extensively with hunter-gatherers without the sex-biased admixture that prevailed later in the north and west. We also show that southeastern Europe continued to be a nexus between east and west after the arrival of farmers, with intermittent genetic contact with steppe populations occurring up to 2,000 years earlier than the migrations from the steppe that ultimately replaced much of the population of northern Europe.

A piece of paper falling faster than free fall

International Nuclear Information System (INIS)

Vera, F; Rivera, R

2011-01-01

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

A piece of paper falling faster than free fall

Energy Technology Data Exchange (ETDEWEB)

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

2011-09-15

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

Notes on the lesser white-lined bat, Saccopteryx leptura (Schreber (Chiroptera, Emballonuridae, from southeastern Brazil

Directory of Open Access Journals (Sweden)

Marcelo R. Nogueira

2002-12-01

Full Text Available Saccopteryx leptura (Schreber, 1774 is reported from two new localities in southeastern Brazil, both in Atlantic forest remains in the state of Rio de Janeiro. Analysisof food material showed that individuals from both localities had preyedon insects in the order Hymenoptera. Cheek contents were available from one specimen, and in this case identification of the food item (flying ants achieved generic level (Pheidole Westwood, 1841. Aspects in the social behavior observed in a colony suggest that the same traits documented in Central American populations (small colonies, monogamic mating system, and retention of young for up to a year in the parental unit may also characterize this species in the southern most part of its range. In both external and craniodental selected measurements, specimens from Rio de Janeiro were close to the upper limits of the ranges known for the species.

The variable cyclotron line of GX 301-2

Energy Technology Data Exchange (ETDEWEB)

Kreykenbohm, I.; Wilms, J.; Coburn, W.; Kuster, M.; Rothschild, R.E.; Heindl, W.A.; Kretschmar, P.; Staubert, R

2004-06-01

We present a 200 ksec observation of the High Mass X-ray Binary GX 301-2 taken in 2000 November with the Rossi X-ray Timing Explorer during the pre-periastron flare and the actual periastron passage of the neutron star. To model the spectrum we use a power law with the Fermi Dirac cutoff and a cyclotron line at higher energies plus either a reflection component or a heavily absorbed partial covering component. Although completely different, both models describe the data equally well. Phase resolved spectra show that the energy and the depth of the cyclotron resonant scattering feature vary strongly with pulse phase: It is deepest in the fall of the main pulse, the rise of the secondary pulse, and the pulse minimum in-between with {tau}{sub C}{approx}0.3. In the other phase bins the line is much less deep with {tau}{sub C}{approx}0.1. The energy of the line correlates strongly with its depth and varies by 25 % from 30.1 keV in the fall of the secondary pulse to 37.9 keV in the fall of the main pulse.

Aerial gamma ray and magnetic survey: Idaho Project, Idaho Falls quadrangle, Idaho. Final report

International Nuclear Information System (INIS)

1979-10-01

The Idaho Falls quadrangle in southeastern Idaho lies at the juncture of the Snake River Plain, the Northern Rocky Mountains, and the Basin-Range Province. Quaternary basalts of the Snake River Plain occupy 70% of the quadrangle. The rest of the area is covered by uplifted Paleozoic, Mesozoic, and Cenozoic rocks of the Pre-Late Cenozoic Orogenic Complex. Magnetic data apparently show contributions from both shallow and deep sources. The apparent expression of intrusive and extrusive rocks of late Mesozoic and Cenozoic age tends to mask the underlying structural downtrap thought to exist under the Snake River Plain. The Idaho Falls quadrangle has been unproductive in terms of uranium mining. A single claim exists in the Sawtooth Mountains, but no information was found concerning its present status at the time of this study. A total of 169 anomalies are valid according to the criteria set forth in Volume I of this report. These anomalies are scattered throughout the quadrangle, though one large group appears to relate to unnatural radiation sources in the Reactor Test Site area. The most distinctive anomalies occur in the Permian Phosphoria Formation and the Starlight Volcanics in the Port Neuf Mountains

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.

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...

Lining seam elimination algorithm and surface crack detection in concrete tunnel lining

Science.gov (United States)

Qu, Zhong; Bai, Ling; An, Shi-Quan; Ju, Fang-Rong; Liu, Ling

2016-11-01

Due to the particularity of the surface of concrete tunnel lining and the diversity of detection environments such as uneven illumination, smudges, localized rock falls, water leakage, and the inherent seams of the lining structure, existing crack detection algorithms cannot detect real cracks accurately. This paper proposed an algorithm that combines lining seam elimination with the improved percolation detection algorithm based on grid cell analysis for surface crack detection in concrete tunnel lining. First, check the characteristics of pixels within the overlapping grid to remove the background noise and generate the percolation seed map (PSM). Second, cracks are detected based on the PSM by the accelerated percolation algorithm so that the fracture unit areas can be scanned and connected. Finally, the real surface cracks in concrete tunnel lining can be obtained by removing the lining seam and performing percolation denoising. Experimental results show that the proposed algorithm can accurately, quickly, and effectively detect the real surface cracks. Furthermore, it can fill the gap in the existing concrete tunnel lining surface crack detection by removing the lining seam.

Southeastern Power Administration 2007 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2007-12-28

Dear Secretary Chu: I am proud to submit Southeastern Power Administration’s (Southeastern’s) fiscal year (FY) 2007 Annual Report for your review. The information included in this report reflects Southeastern’s programs, accomplishments, and financial activities for the 12-month period beginning October 1, 2006 and ending September 30, 2007. Southeastern marketed more than 5 billion kilowatt-hours of energy to 492 wholesale Federal power customers in an 11-state marketing area in FY 2007. Revenues from the sale of this power totaled approximately $219 million. Drought conditions continued to plague the southeast region of the United States during 2007 placing strains on our natural and financial resources. Southeastern purchased more than $40 million in replacement power to meet customer contract requirements to ensure the continued reliability of our nation’s power grid. With the financial assistance and support of our Federal power customers, continued funding for capitalized equipment replacements at various Corps of Engineers’ (Corps) hydroelectric projects provided much needed repairs and maintenance for aging facilities. Southeastern’s cyber and physical security program continued to be reviewed and updated to meet Department of Energy (DOE), Homeland Security, and North American Electric Reliability Corporation standards and requirements. Plans for the upcoming year include communication and cooperation with DOE, Federal power customers, and the Corps to maximize the benefits of our nation’s water resources. Competition for the use of water and the prolonged drought conditions will present another challenging year for our agency. The employees at Southeastern will be proactive in meeting these challenges and providing reliable hydroelectric power to the people in the southeast. Sincerely, Kenneth E. Legg Administrator

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

Science.gov (United States)

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

2016-10-01

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

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

OpenAIRE

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

2011-01-01

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

Fall Protection Introduction, #33462

Energy Technology Data Exchange (ETDEWEB)

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

2016-06-23

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

The clinical practice guideline for falls and fall risk

OpenAIRE

Vance, Jacqueline

2011-01-01

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

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

Directory of Open Access Journals (Sweden)

Beata Lindholm

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

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

Science.gov (United States)

Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccolò, Marchionni; Andrea, Ungar

2013-01-01

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

Extending GIS Technology to Study Karst Features of Southeastern Minnesota

Science.gov (United States)

Gao, Y.; Tipping, R. G.; Alexander, E. C.; Alexander, S. C.

2001-12-01

This paper summarizes ongoing research on karst feature distribution of southeastern Minnesota. The main goals of this interdisciplinary research are: 1) to look for large-scale patterns in the rate and distribution of sinkhole development; 2) to conduct statistical tests of hypotheses about the formation of sinkholes; 3) to create management tools for land-use managers and planners; and 4) to deliver geomorphic and hydrogeologic criteria for making scientifically valid land-use policies and ethical decisions in karst areas of southeastern Minnesota. Existing county and sub-county karst feature datasets of southeastern Minnesota have been assembled into a large GIS-based database capable of analyzing the entire data set. The central database management system (DBMS) is a relational GIS-based system interacting with three modules: GIS, statistical and hydrogeologic modules. ArcInfo and ArcView were used to generate a series of 2D and 3D maps depicting karst feature distributions in southeastern Minnesota. IRIS ExplorerTM was used to produce satisfying 3D maps and animations using data exported from GIS-based database. Nearest-neighbor analysis has been used to test sinkhole distributions in different topographic and geologic settings. All current nearest-neighbor analyses testify that sinkholes in southeastern Minnesota are not evenly distributed in this area (i.e., they tend to be clustered). More detailed statistical methods such as cluster analysis, histograms, probability estimation, correlation and regression have been used to study the spatial distributions of some mapped karst features of southeastern Minnesota. A sinkhole probability map for Goodhue County has been constructed based on sinkhole distribution, bedrock geology, depth to bedrock, GIS buffer analysis and nearest-neighbor analysis. A series of karst features for Winona County including sinkholes, springs, seeps, stream sinks and outcrop has been mapped and entered into the Karst Feature Database

Identification and characterization of Highlands J virus from a Mississippi sandhill crane using unbiased next-generation sequencing

Science.gov (United States)

Ip, Hon S.; Wiley, Michael R.; Long, Renee; Gustavo, Palacios; Shearn-Bochsler, Valerie; Whitehouse, Chris A.

2014-01-01

Advances in massively parallel DNA sequencing platforms, commonly termed next-generation sequencing (NGS) technologies, have greatly reduced time, labor, and cost associated with DNA sequencing. Thus, NGS has become a routine tool for new viral pathogen discovery and will likely become the standard for routine laboratory diagnostics of infectious diseases in the near future. This study demonstrated the application of NGS for the rapid identification and characterization of a virus isolated from the brain of an endangered Mississippi sandhill crane. This bird was part of a population restoration effort and was found in an emaciated state several days after Hurricane Isaac passed over the refuge in Mississippi in 2012. Post-mortem examination had identified trichostrongyliasis as the possible cause of death, but because a virus with morphology consistent with a togavirus was isolated from the brain of the bird, an arboviral etiology was strongly suspected. Because individual molecular assays for several known arboviruses were negative, unbiased NGS by Illumina MiSeq was used to definitively identify and characterize the causative viral agent. Whole genome sequencing and phylogenetic analysis revealed the viral isolate to be the Highlands J virus, a known avian pathogen. This study demonstrates the use of unbiased NGS for the rapid detection and characterization of an unidentified viral pathogen and the application of this technology to wildlife disease diagnostics and conservation medicine.

Flammability of litter from southeastern trees: a preliminary assessment

Science.gov (United States)

J. Morgan Varner; Jeffrey M. Kane; Erin M. Banwell; Jesse K. Kreye

2015-01-01

The southeastern United States possesses a great diversity of woody species and an equally impressive history of wildland fires. Species are known to vary in their flammability, but little is known about southeastern species. We used published data and our own collections to perform standard litter flammability tests on a diverse suite of 25 native overstory trees from...

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

Science.gov (United States)

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

2017-04-01

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

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

Directory of Open Access Journals (Sweden)

Mussi Chiara

2013-01-01

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

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.

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

Directory of Open Access Journals (Sweden)

Vivien Jørgensen

2017-04-01

Conclusion: Ambulatory individuals have a high risk of falling and of fall-related injuries. Fall history, fear of falling and walking speed could predict recurrent falls and injurious falls. Further studies with larger samples are needed to validate these findings. [Jørgensen V, Butler Forslund E, Opheim A, Franzén E, Wahman K, Hultling C, Seiger Å, Ståhle A, Stanghelle JK, Roaldsen KS (2017 Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study. Journal of Physiotherapy 63: 108–113

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

Science.gov (United States)

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

2018-03-19

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

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

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

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

LENUS (Irish Health Repository)

O'Halloran, Aisling M

2011-12-19

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

Southeastern Federal Power Program. Combined financial statements, September 30, 1996 and 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-05-01

The Southeastern Federal Power Program (SEFPP) consists of all activities associated with the production, transmission and disposition of Federal power marketed under Section 5 of the Flood Control Act of 1944 from projects in the ten southeastern states. The ten states are: Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Alabama, Mississippi, Tennessee, and Kentucky. Power is marketed to customers in 11 states - the above ten plus Illinois. SEFPP includes the accounts of two separate Federal government agencies- the Southeastern Power Administration (Southeastern) of the Department of Energy and the U.S. Army Corps of Engineers (Corps). Southeastern purchases, transmits, and markets power within four separate power systems (each including one or more Corps generating projects for which rates are set). Specific and joint-use costs allocated to power are included in the attached statements of assets. Federal investment and liabilities under utility plant and cash. The accounts of SEFPP are maintained in conformity with generally accepted accounting principles and the Uniform System of Accounts prescribed for electric utilities by the Federal Energy Regulatory Commission (FERC). SEFPP`s accounting policies also reflect requirements of specific legislation and executive directives issued by the applicable government agencies. Southeastern and Corps properties and income are exempt from taxation. Southeastern and the Corps receive Congressional appropriations through the Department of Energy (DOE) and the Department of Defense to finance their operations. The Corps also receives Congressional appropriations to finance construction of its hydroelectric projects.

After the Fall: A Conflict Management Program to Foster Open Society

Science.gov (United States)

Shapiro, Daniel L.

2004-01-01

The fall of the Berlin Wall rocked the sociopolitical equilibrium of eastern and central Europe. Communism lost its grip over much of Europe. The USSR, Yugoslavia, and Czechoslovakia divided along ethnic, religious, and historical lines. Ethnopolitical tensions surfaced across the region, and in Yugoslavia, tensions combusted. Whereas democracy…

The elimination half-life of benzodiazepines and fall risk: two prospective observational studies.

Science.gov (United States)

de Vries, Oscar J; Peeters, Geeske; Elders, Petra; Sonnenberg, Caroline; Muller, Majon; Deeg, Dorly J H; Lips, Paul

2013-11-01

the STOPP criteria advise against the use of long-acting benzodiazepines (LBs). to study whether LBs are associated with a higher fall risk than short-acting benzodiazepines (SBs) (elimination half-life ≤ 10 h). we used base-line data and prospective fall follow-up from the Longitudinal Aging Study Amsterdam, a longitudinal cohort study including 1,509 community-dwelling older persons (Study 1) and from a separate fall prevention study with 564 older persons after a fall (Study 2). Time to the first fall after inclusion and number of falls in the first year after inclusion were the primary endpoints. both in Study 1 and Study 2 the use of SBs was associated with time to the first fall, hazard ratio (HR) 1.62 (95% CI: 1.03-2.56) and HR 1.64 (95% CI: 1.19-2.26),respectively. LBs were not significantly associated with time to first fall, HR 1.40 (0.85-2.31) and HR 1.08 (0.72-1.62). In both studies, the use of SBs was also associated with number of falls, odds ratio (OR) 1.28 (95% CI: 1.01-1.61) and OR 1.37 (95% CI: 1.10-1.70). LBs were not significantly associated with number of falls, OR 1.23 (0.96-1.57) and 1.10 (0.82-1.48). the use of SBs is not associated with a lower fall risk compared with LBs. The use of both SBs and LBs by old persons should be strongly discouraged.

Southeastern Science Policy Colloquium

Energy Technology Data Exchange (ETDEWEB)

Humphries, F.

1995-06-22

This conference covers four main topics: (1) Southeastern Labor Market and its Impact on Corporate/Industry Development; (2) New Issues for Science and Technology in the Year 2000 and Beyond; (3) The Role of Academia in Developing the Labor Force of the Southeast; and (4) K-12 Education: Challenges for the 21st Century.

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.

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

Directory of Open Access Journals (Sweden)

Santosh K Verma

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

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

Science.gov (United States)

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

2018-05-09

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

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.

Drivers of long-term precipitation and runoff variability in the southeastern USA

Science.gov (United States)

Engström, Johanna; Waylen, Peter

2018-02-01

The hydroclimatology of the southeastern USA (AL, GA, NC, SC, and TN) is analyzed from a holistic perspective, including multiple climate drivers. Monthly precipitation modeled by the PRISM group and runoff data (1952-2011) from 18 basins are analyzed using a single-field based principal component's analysis. Results indicate that the Atlantic Multidecadal Oscillation and El Niño-Southern Oscillation are the main atmospheric drivers of hydroclimate variability in the region, sometimes operating at several months' lag. Their influence is the strongest in the fall through spring, which corresponds with the dry season in the southern parts of the study area thereby increasing pressure on already limited water resources. The Arctic Oscillation, North Atlantic Oscillation, and Pacific-North American patterns vary on shorter-term bases, and also show a significant, but temporally more sporadic influence. Insight is also brought to the ongoing discussion, confirming the disassociation of the Arctic and North Atlantic Oscillation. Findings can be used in water resources forecasting, giving an indication of expected water volumes several months ahead.

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

Science.gov (United States)

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

2017-12-01

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

On the change of fall-out measured by monitoring post at the time of nuclear explosion

International Nuclear Information System (INIS)

Nagai, Tatsuo; Honda, Tadashi; Imai, Toshio

1977-01-01

The measurement of the spatial distribution of gamma-ray by monitoring posts has been continued. The measurement has been made with scintillation counters. The annual variation of gamma dose in no-rain season was recorded as background. The depth of snow showed some correlation with the level of the background gamma dose. Natural radioactivity in the air emitted from the terrestrial surface may cause the activity of the air. The relation between rain and dose rate was investigated. The higher dose rate than the background was seen during rain fall. The increase of dose rate was observed after the Chinese nuclear explosion. After the analysis of data from various monitoring posts, the trace line of fall-out activity was determined. The trace of 500 mb, which means about 10 KT of explosion, did not cross Japan, and the trace of 300 mb, meaning 100 KT of explosion, was just over Japan. The movement of the fall out along the trace line was definitely observed. (Kato, T.)

Late Tertiary and Quaternary geology of the Tecopa basin, southeastern California

Energy Technology Data Exchange (ETDEWEB)

Hillhouse, J.W.

1987-12-31

Stratigraphic units in the Tecopa basin, located in southeastern California, provide a framework for interpreting Quaternary climatic change and tectonism along the present Amargosa River. During the late Pliocene and early Pleistocene, a climate that was appreciably wetter than today`s sustained a moderately deep lake in the Tecopa basin. Deposits associated with Lake Tecopa consists of lacustrine mudstone, conglomerate, volcanic ash, and shoreline accumulations of tufa. Age control within the lake deposits is provided by air-fall tephra that are correlated with two ash falls from the Yellowstone caldera and one from the Long Valley caldera. Lake Tecopa occupied a closed basin during the latter part, if not all, of its 2.5-million-year history. Sometime after 0.5 m.y. ago, the lake developed an outlet across Tertiary fanglomerates of the China Ranch Beds leading to the development of a deep canyon at the south end of the basin and establishing a hydrologic link between the northern Amargosa basins and Death Valley. After a period of rapid erosion, the remaining lake beds were covered by alluvial fans that coalesced to form a pediment in the central part of the basin. Holocene deposits consist of unconsolidated sand and gravel in the Amargosa River bed and its deeply incised tributaries, a small playa near Tecopa, alluvial fans without pavements, and small sand dunes. The pavement-capped fan remnants and the Holocene deposits are not faulted or tilted significantly, although basins to the west, such as Death Valley, were tectonically active during the Quaternary. Subsidence of the western basins strongly influenced late Quaternary rates of deposition and erosion in the Tecopa basin.

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.

Hydrologic interpretation of geophysical data from the southeastern Hueco Bolson, El Paso, and Hudspeth Counties, Texas

Science.gov (United States)

Gates, Joseph Spencer; Stanley, W.D.

1976-01-01

Airborne-electromagnetic and earth-resistivity surveys were used to explore for fresh ground water in the Hueco Bolson southeast of El Paso, Texas. Aerial surveys were made along about 500 miles (800 km) of flight line, and 67 resistivity soundings were made along 110 miles (180 km) of profile. The surveys did not indicate the presence of any large bodies of fresh ground water, but several areas may be underlain by small to moderate amounts of fresh to slightly saline water.The material underlying the flood plain of the Rio Grande is predominantly clay or sand of low resistivity. Along a band on the mesa next to and parallel to the flood plain, more resistive material composed partly of deposits of an ancient river channel extends to depths of about 400 to 1,700 feet (120 to 520 m). Locally, the lower part of this more resistive material is saturated with fresh to slightly saline water. The largest body of fresh to slightly saline ground water detected in this study is between Fabens and Tornillo, Texas, mostly in the sandhill area between the flood plain and the mesa. Under assumed conditions, the total amount of water in storage may be as much as 400,000 to 800,000 acre-feet (500 million to 1 billion m ).The resistivity data indicate that the deep artesian zone southwest of Fabens extends from a depth of about 1,200 feet (365 m) to about 2,800 feet (855 m).

Falling and fall risk factors in adults with haemophilia: an exploratory study.

Science.gov (United States)

Sammels, M; Vandesande, J; Vlaeyen, E; Peerlinck, K; Milisen, K

2014-11-01

Falls are a particular risk in persons with haemophilia (PWH) because of damaged joints, high risk of bleeding, possible impact on the musculoskeletal system and functioning and costs associated with treatment for these fall-related injuries. In addition, fall risk increases with age and PWH are increasingly entering the over 65 age group. The aim of this study was to determine the occurrence of falls during the past year and to explore which fall risk factors are present in community-dwelling PWH. Dutch speaking community-dwelling adults were included from the age of 40 years with severe or moderate haemophilia A or B, independent in their mobility and registered at the University Hospitals Leuven. They were asked to come to the haemophilia centre; otherwise a telephone survey was conducted. Demographic and social variables, medical variables, fall evaluation and clinical variables were queried. From the 89 PWH, 74 (83.1%) participated in the study. Twenty-four (32.4%) fell in the past year, and 10 of them (41.7%) more than once with an average of four falls. Living conditions, physical activity, avoidance of winter sports due to fear of falling, orthopaedic status, urinary incontinence and mobility impairments are potential fall risk factors in adult PWH. This exploratory study indicates that PWH are attentive to falling since they are at higher risk for falls and because of the serious consequences it might have. Screening and fall prevention should be stimulated in the daily practice of haemophilia care. © 2014 John Wiley & Sons Ltd.

Sensitivity of tree ring growth to local and large-scale climate variability in a region of Southeastern Brazil

Science.gov (United States)

Venegas-González, Alejandro; Chagas, Matheus Peres; Anholetto Júnior, Claudio Roberto; Alvares, Clayton Alcarde; Roig, Fidel Alejandro; Tomazello Filho, Mario

2016-01-01

We explored the relationship between tree growth in two tropical species and local and large-scale climate variability in Southeastern Brazil. Tree ring width chronologies of Tectona grandis (teak) and Pinus caribaea (Caribbean pine) trees were compared with local (Water Requirement Satisfaction Index—WRSI, Standardized Precipitation Index—SPI, and Palmer Drought Severity Index—PDSI) and large-scale climate indices that analyze the equatorial pacific sea surface temperature (Trans-Niño Index-TNI and Niño-3.4-N3.4) and atmospheric circulation variations in the Southern Hemisphere (Antarctic Oscillation-AAO). Teak trees showed positive correlation with three indices in the current summer and fall. A significant correlation between WRSI index and Caribbean pine was observed in the dry season preceding tree ring formation. The influence of large-scale climate patterns was observed only for TNI and AAO, where there was a radial growth reduction in months preceding the growing season with positive values of the TNI in teak trees and radial growth increase (decrease) during December (March) to February (May) of the previous (current) growing season with positive phase of the AAO in teak (Caribbean pine) trees. The development of a new dendroclimatological study in Southeastern Brazil sheds light to local and large-scale climate influence on tree growth in recent decades, contributing in future climate change studies.

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

Science.gov (United States)

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

2018-06-15

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2017-10-01

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

Field screening of experimental corn hybrids and inbred lines for multiple ear-feeding insect resistance.

Science.gov (United States)

Ni, Xinzhi; Xu, Wenwei; Krakowsky, Matthew D; Buntin, G David; Brown, Steve L; Lee, R Dewey; Coy, Anton E

2007-10-01

Identifying and using native insect resistance genes is the core of integrated pest management. In this study, 10 experimental corn, Zea mays L., hybrids and 10 inbred lines were screened for resistance to major ear-feeding insects in the southeastern Coastal Plain region of the United States during 2004 and 2005. Ear-feeding insect damage was assessed at harvest by visual damage rating for the corn earworm, Helicoverpa zea (Boddie), and by the percentage of kernels damaged by the maize weevil, Sitophilus zeamais Motschulsky, and stink bugs [combination of Euschistus servus (Say) and southern green stink bug, Nezara viridula (L.)]. Among the eight inbred lines and two control populations examined, C3S1B73-5b was resistant to corn earworm, maize weevil, and stink bugs. In contrast, C3S1B73-4 was resistant to corn earworm and stink bugs, but not to maize weevil. In a similar manner, the corn hybrid S1W*CML343 was resistant to all three ear-feeding insects, whereas hybrid C3S1B73-3*Tx205 was resistant to corn earworm and maize weevil in both growing seasons, but susceptible to stink bugs in 2005. The silk-feeding bioassay showed that corn earworm developed better on corn silk than did fall armyworm. Among all phenotypic traits examined (i.e., corn ear size, husk extension, and husk tightness), only corn ear size was negatively correlated to corn earworm damage in the inbred lines examined, whereas only husk extension (i.e., coverage) was negatively correlated to both corn earworm and maize weevil damage on the experimental hybrids examined. Such information could be used to establish a baseline for developing agronomically elite corn germplasm that confers multiple ear-feeding insect resistance.

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.

Rickettsia parkeri in Gulf Coast Ticks, Southeastern Virginia, USA

Science.gov (United States)

2011-05-01

Rickettsia parkeri in Gulf Coast Ticks, Southeastern Virginia, USA Chelsea L. Wright, Robyn M. Nadolny, Ju Jiang, Allen L. Richards, Daniel E...Virginia. We found that 43.1% of the adult Gulf Coast ticks collected in the summer of 2010 carried Rickettsia parkeri, suggesting that persons living in...or visiting southeastern Virginia are at risk for infection with this pathogen. Rickettsia parkeri is an obligate intracellular bacterium belonging

Identifying drought response of semi-arid aeolian systems using near-surface luminescence profiles and changepoint analysis, Nebraska Sandhills.

Science.gov (United States)

Buckland, Catherine; Bailey, Richard; Thomas, David

2017-04-01

Two billion people living in drylands are affected by land degradation. Sediment erosion by wind and water removes fertile soil and destabilises landscapes. Vegetation disturbance is a key driver of dryland erosion caused by both natural and human forcings: drought, fire, land use, grazing pressure. A quantified understanding of vegetation cover sensitivities and resultant surface change to forcing factors is needed if the vegetation and landscape response to future climate change and human pressure are to be better predicted. Using quartz luminescence dating and statistical changepoint analysis (Killick & Eckley, 2014) this study demonstrates the ability to identify step-changes in depositional age of near-surface sediments. Lx/Tx luminescence profiles coupled with statistical analysis show the use of near-surface sediments in providing a high-resolution record of recent system response and aeolian system thresholds. This research determines how the environment has recorded and retained sedimentary evidence of drought response and land use disturbances over the last two hundred years across both individual landforms and the wider Nebraska Sandhills. Identifying surface deposition and comparing with records of climate, fire and land use changes allows us to assess the sensitivity and stability of the surface sediment to a range of forcing factors. Killick, R and Eckley, IA. (2014) "changepoint: An R Package for Changepoint Analysis." Journal of Statistical Software, (58) 1-19.

40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.30 Section 81.30 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

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

Directory of Open Access Journals (Sweden)

Fields J

2015-06-01

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

Atmospheric ammonia measurements along the coastal lines of Southeastern China: Implications for inorganic nitrogen deposition to coastal waters

Science.gov (United States)

Wu, Shui-Ping; Dai, Lu-Hong; Wei, Ya; Zhu, Heng; Zhang, Yin-Ju; Schwab, James J.; Yuan, Chung-Shin

2018-03-01

Ambient NH3 concentrations were determined using Ogawa passive samplers along the coastal lines of southeast China from June 2015 to May 2017. Additional monitoring of PM2.5 and precipitation around Xiamen Bay during the period from November 2015 to May 2017 were carried out to estimate atmospheric inorganic nitrogen (IN) deposition to the bay. Distinct seasonal variations of ambient NH3 were observed with summer averages 1.41-5.56 times higher than winter, which agreed well with the seasonal trend of air temperature. Nitrate concentrations (pNO3-) in PM2.5 were significantly higher than ammonium concentrations (pNH4+), and both species showed higher concentrations in winter and spring and lower values in summer and fall which were influenced mainly by the monsoon cycle, gas-to-particle transformation process and rain washout. Paired t-testing revealed that no significant differences of pNO3- and pNH4+ between the urban and suburban sites around the Xiamen Bay. Unlike pNO3- and pNH4+, there were no clear seasonal trends for NH4+ and NO3- concentrations in precipitation samples (wNH4+ and wNO3-). On average, the deposition of IN consisted of NH3-N (27.4-28.2%) and pNO3--N (25.9-26.8%), followed by pNH4+-N (17.0-17.7%), wNH4+-N (14.5%), wNO3--N (13.3-13.8%) and NO2-N (0.35-0.46%); and showed distinct seasonal trends with higher values in winter/spring and lower values in summer/fall. In 2016, the total IN deposition was determined to be 36.45 and 35.92 kg N ha-1 at the urban and suburban sites around the Xiamen Bay, respectively. The proportion of IN deposition to total IN loads (terrestrial + atmospheric), varied over the range of 7.1-13.3% depending on the data source of riverine influx. Our observations revealed that the total IN deposition could account for 9.6-25.1% (based on primary productivity over Taiwan Strait) and 1.7-5.3% (based on primary productivity in Guangdong coastal region) of new productivity in Xiamen Bay, respectively. As an important nutrient

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

Science.gov (United States)

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

2013-01-01

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

Prevalence of hyponatraemia in patients over the age of 65 who have an in-hospital fall.

Science.gov (United States)

Lobo-Rodríguez, Carmen; García-Pozo, Ana M; Gadea-Cedenilla, Carmen; Moro-Tejedor, M Nieves; Pedraz Marcos, Azucena; Tejedor-Jorge, Alberto

2016-01-01

Hyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. To determine if hyponatraemia is associated with falls in elderly hospitalised patients. Design observational, analytical, case-control study. Patients older than 65 years who had fallen during their hospitalisation at Gregorio Marañón Hospital (Madrid) were considered cases. Patients who did not fall were considered to be controls, paired according to the following variables: hospital ward, age, length of hospital stay, gender and Downton fall risk index. The sample size was 206 subjects. Socio-demographic factors, variables included in the falls record sheet, Downton fall risk index and sodium levels were studied (hyponatraemia was considered Na(+)falls of P: 0.002. The adjusted OR was 3.708 (1.6-8.3), 95% CI. Risk factors for falls were identified as hyponatraemia and limb sensory deficits. Given that hyponatraemia could be considered a risk factor for falls, the inclusion of the determination of sodium level would be important for fall prevention strategies in the elderly. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

40 CFR 81.123 - Southeastern Oklahoma Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Region. 81.123 Section 81.123 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.123 Southeastern Oklahoma Intrastate Air Quality Control Region. The Southeastern Oklahoma Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

Prevalence of hyponatraemia in patients over the age of 65 who have an in-hospital fall

OpenAIRE

Lobo-Rodríguez, Carmen; García-Pozo, Ana M.; Gadea-Cedenilla, Carmen; Moro-Tejedor, M. Nieves; Pedraz Marcos, Azucena; Tejedor-Jorge, Alberto

2016-01-01

Background and aim: Hyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. Aim: To determine if hyponatraemia is associated with falls in elderly hospitalised patients. Methods: Design observational, analytical, case–control study. Study population: Patients older than 65 years who had fallen during their hospitali...

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

Science.gov (United States)

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

2016-08-01

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

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.

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.

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

Science.gov (United States)

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

2016-11-01

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

Response to state comments on the revised draft Southeastern Regional Characterization Reports for the Crystalline Repository Project

International Nuclear Information System (INIS)

1985-08-01

The purpose of this document is to respond to the comments received from the states of the Southeastern Region on the revised draft Southeastern Regional Characterization Reports (RCRs). The responses in this document indicate the manner in which the suggestions or comments received have been considered in modifying the revised draft Southeastern RCRs. Both general comments related to the overall Crystalline Repository Project (CRP) and comments on specific sections of the RCRs are addressed. This document responds to Southeastern State comments on both the revised draft Southeastern Regional Geologic Characterization Report (RGCR) and the revised draft Southeastern Regional Environmental Characterization Report (RECR)

The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain.

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Kim, J; Hwang, J Y; Oh, J K; Park, M S; Kim, S W; Chang, H; Kim, T-H

2017-05-01

The objective of this study was to assess the association between whole body sagittal balance and risk of falls in elderly patients who have sought treatment for back pain. Balanced spinal sagittal alignment is known to be important for the prevention of falls. However, spinal sagittal imbalance can be markedly compensated by the lower extremities, and whole body sagittal balance including the lower extremities should be assessed to evaluate actual imbalances related to falls. Patients over 70 years old who visited an outpatient clinic for back pain treatment and underwent a standing whole-body radiograph were enrolled. Falls were prospectively assessed for 12 months using a monthly fall diary, and patients were divided into fallers and non-fallers according to the history of falls. Radiological parameters from whole-body radiographs and clinical data were compared between the two groups. A total of 144 patients (120 female patients and 24 male patients) completed a 12-month follow-up for assessing falls. A total of 31 patients (21.5%) reported at least one fall within the 12-month follow-up. In univariate logistic regression analysis, the risk of falls was significantly increased in older patients and those with more medical comorbidities, decreased lumbar lordosis, increased sagittal vertical axis, and increased horizontal distance between the C7 plumb line and the centre of the ankle (C7A). Increased C7A was significantly associated with increased risk of falls even after multivariate adjustment. Whole body sagittal balance, measured by the horizontal distance between the C7 plumb line and the centre of the ankle, was significantly associated with risk of falls among elderly patients with back pain. Cite this article : J. Kim, J. Y. Hwang, J. K. Oh, M. S. Park, S. W. Kim, H. Chang, T-H. Kim. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain. Bone Joint Res 2017;6:-344. DOI: 10

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

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

2013-10-01

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

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.

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

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Cristina Rosa Soares Lavareda Baixinho

2015-12-01

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

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

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Chippendale, Tracy; Boltz, Marie

2015-08-01

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

Self-Consistent Dynamical Model of the Broad Line Region

Energy Technology Data Exchange (ETDEWEB)

Czerny, Bozena [Center for Theoretical Physics, Polish Academy of Sciences, Warsaw (Poland); Li, Yan-Rong [Key Laboratory for Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing (China); Sredzinska, Justyna; Hryniewicz, Krzysztof [Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw (Poland); Panda, Swayam [Center for Theoretical Physics, Polish Academy of Sciences, Warsaw (Poland); Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw (Poland); Wildy, Conor [Center for Theoretical Physics, Polish Academy of Sciences, Warsaw (Poland); Karas, Vladimir, E-mail: bcz@cft.edu.pl [Astronomical Institute, Czech Academy of Sciences, Prague (Czech Republic)

2017-06-22

We develop a self-consistent description of the Broad Line Region based on the concept of a failed wind powered by radiation pressure acting on a dusty accretion disk atmosphere in Keplerian motion. The material raised high above the disk is illuminated, dust evaporates, and the matter falls back toward the disk. This material is the source of emission lines. The model predicts the inner and outer radius of the region, the cloud dynamics under the dust radiation pressure and, subsequently, the gravitational field of the central black hole, which results in asymmetry between the rise and fall. Knowledge of the dynamics allows us to predict the shapes of the emission lines as functions of the basic parameters of an active nucleus: black hole mass, accretion rate, black hole spin (or accretion efficiency) and the viewing angle with respect to the symmetry axis. Here we show preliminary results based on analytical approximations to the cloud motion.

Self-Consistent Dynamical Model of the Broad Line Region

Directory of Open Access Journals (Sweden)

Bozena Czerny

2017-06-01

Full Text Available We develop a self-consistent description of the Broad Line Region based on the concept of a failed wind powered by radiation pressure acting on a dusty accretion disk atmosphere in Keplerian motion. The material raised high above the disk is illuminated, dust evaporates, and the matter falls back toward the disk. This material is the source of emission lines. The model predicts the inner and outer radius of the region, the cloud dynamics under the dust radiation pressure and, subsequently, the gravitational field of the central black hole, which results in asymmetry between the rise and fall. Knowledge of the dynamics allows us to predict the shapes of the emission lines as functions of the basic parameters of an active nucleus: black hole mass, accretion rate, black hole spin (or accretion efficiency and the viewing angle with respect to the symmetry axis. Here we show preliminary results based on analytical approximations to the cloud motion.

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.

Density-independent population projection trajectories of chromosome-substituted lines resistant and susceptible to organophosphate insecticides in Drosophila melanogaster

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Miyo Takahiro

2004-11-01

Full Text Available Abstract Background Seasonal fluctuations in susceptibility to organophosphate insecticides were observed in the Katsunuma population of Drosophila melanogaster for two consecutive years; susceptibility to three organophosphates tended to increase in the fall. To examine the hypothesis that variation in fitness among resistant and susceptible genotypes could trigger the change of genetic constitution within the fall population, we investigated density-independent population projection trajectories starting from single adult females with characteristics of chromosome-substituted lines resistant and susceptible to the three organophosphates. Results Density-independent population projection trajectories, expressed as the ratios of the number of each chromosome-substituted line to that of line SSS, for which all chromosomes were derived from the susceptible line, showed significant declines in numbers with time for all the resistant chromosome-substituted lines. Conclusion The declining tendency in the density-independent population projection trajectories of the resistant chromosome-substituted lines could explain the simultaneous decline in the levels of resistance to the three organophosphates, observed in the Katsunuma population in the fall.

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

Science.gov (United States)

Chippendale, Tracy; Lee, Chang Dae

2018-06-01

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

Effects of 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

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

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Niko M. Perttila

2017-06-01

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

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

Science.gov (United States)

Nassar, Nada; Helou, Nancy; Madi, Chantal

2014-06-01

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

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…

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.

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

Science.gov (United States)

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

2011-12-01

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

Survey for antibodies to infectious bursal disease virus serotype 2 in wild turkeys and Sandhill Cranes of Florida, USA.

Science.gov (United States)

Candelora, Kristen L; Spalding, Marilyn G; Sellers, Holly S

2010-07-01

Captive-reared Whooping Cranes (Grus americana) released into Florida for the resident reintroduction project experienced unusually high mortality and morbidity during the 1997-98 and 2001-02 release seasons. Exposure to infectious bursal disease virus (IBDV) serotype 2 as evidenced by seroconversion was suspected to be the factor that precipitated these mortality events. Very little is known about the incidence of IBD in wild bird populations. Before this study, natural exposure had not been documented in wild birds of North America having no contact with captive-reared cranes, and the prevalence and transmission mechanisms of the virus in wild birds were unknown. Sentinel chickens (Gallus gallus) monitored on two Whooping Crane release sites in central Florida, USA, during the 2003-04 and 2004-05 release seasons seroconverted, demonstrating natural exposure to IBDV serotype 2. Blood samples collected from Wild Turkeys (Meleagris gallopavo) and Sandhill Cranes (Grus canadensis) in eight of 21 counties in Florida, USA, and one of two counties in southern Georgia, USA, were antibody-positive for IBDV serotype 2, indicating that exposure from wild birds sharing habitat with Whooping Cranes is possible. The presence of this virus in wild birds in these areas is a concern for the resident flock of Whooping Cranes because they nest and raise their chicks in Florida, USA. However, passively transferred antibodies may protect them at this otherwise vulnerable period in their lives.

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

Science.gov (United States)

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

2017-05-01

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

Suicide in Batman, Southeastern Turkey

Science.gov (United States)

Altindag, Abdurrahman; Ozkan, Mustafa; Oto, Remzi

2005-01-01

The southeastern part of Turkey has comparatively high female suicide rates. We aimed to research social, economic, cultural, and psychiatric reasons of suicides in Batman in a case-controlled psychological autopsy study comparing suicides with matched community controls. The female suicide rate was 9.3 per 100.000 and the female/male ratio was…

Exploring the relationship between fall risk-increasing drugs and fall-related fractures.

Science.gov (United States)

De Winter, Sabrina; Vanwynsberghe, Sarah; Foulon, Veerle; Dejaeger, Eddy; Flamaing, Johan; Sermon, An; Van der Linden, Lorenz; Spriet, Isabel

2016-04-01

Hospital admissions due to fall-related fractures are a major problem in the aging population. Several risk factors have been identified, including drug use. Most studies often retrieved prescription-only drugs from national databases. These are associated with some limitations as they do not always reliably reproduce the complete patient's active drug list. To evaluate the association between the number of FRIDs intake identified by a standardised medication reconciliation process and a fall-related fracture leading to a hospital admission in older adults. The first cohort has been recruited from one traumatology ward of a tertiary teaching hospital in Belgium and the second cohort has been recruited from 11 community pharmacies in Belgium. A prospective study with two individually matched cohorts was performed. Adult patients (≥75 years) admitted with an injury due to a fall were included in the first cohort (faller group). The second cohort consisted of patients who did not suffer from a fall within the last 6 months (non-faller group). Matching was performed for age, gender, place of residence and use of a walking aid. In both groups, clinical pharmacists and undergraduate pharmacy students obtained the medication history, using a standardised approach. A list of drugs considered to increase the risk of falling was created. It included cardiovascular drugs and drugs acting on the nervous system. A linear mixed model was used to compare the number of fall risk-increasing drugs between fallers and non-fallers. The number of fall risk-increasing drugs in a faller versus a non-faller group. Sixty-one patients were matched with 121 non-fallers. Patients received on average 3.1 ± 2.1 and 3.2 ± 1.8 fall risk-increasing drugs in the faller and in the non-faller group, respectively. The mean number of fall risk-increasing drugs was comparable in both groups (p = 0.844), even after adjusting for alcohol consumption, fear of falling, vision and foot problems (p = 0

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

NARCIS (Netherlands)

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

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

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

NARCIS (Netherlands)

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

2012-01-01

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

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

NARCIS (Netherlands)

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

2012-01-01

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

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

Science.gov (United States)

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

2017-12-01

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

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.

Characterizing rainfall parameters which influence erosivity in southeastern Nigeria

International Nuclear Information System (INIS)

Obi, M.E.; Salako, F.K.

1993-12-01

An investigation was carried out to characterize some selected parameters which influence rainfall erosivity in southeastern Nigeria. Rainfall amount, distribution, duration, intensity, storm types, energy loads and frequency of rain events in the region were studied using data from stations located in three major agroecological zones. Raindrop size and detaching capacity were evaluated in one of the stations for two months. The mean annual rainfall erosivity values for southeastern Nigeria point to the fact that rainfall tend to be highly erosive. 25 refs, 6 figs, 8 tabs

QSOs with narrow emission lines

International Nuclear Information System (INIS)

Baldwin, J.A.; Mcmahon, R.; Hazard, C.; Williams, R.E.

1988-01-01

Observations of two new high-redshift, narrow-lined QSOs (NLQSOs) are presented and discussed together with observations of similar objects reported in the literature. Gravitational lensing is ruled out as a possible means of amplifying the luminosity for one of these objects. It is found that the NLQSOs have broad bases on their emission lines as well as the prominent narrow cores which define this class. Thus, these are not pole-on QSOs. The FWHM of the emission lines fits onto the smoothly falling tail of the lower end of the line-width distribution for complete QSO samples. The equivalent widths of the combined broad and narrow components of the lines are normal for QSOs of the luminosity range under study. However, the NLQSOs do show ionization differences from broader-lined QSOs; most significant, the semiforbidden C III/C IV intensity ratio is unusually low. The N/C abundance ratio in these objects is found to be normal; the Al/C abundance ratio may be quite high. 38 references

New horizons in fall prevention.

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Lord, Stephen R; Close, Jacqueline C T

2018-04-25

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

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

Science.gov (United States)

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

2018-01-11

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

Perforated peptic ulcer in southeastern Taiwan.

Science.gov (United States)

Li, Chin-Hsien; Chang, Wen-Hsiung; Shih, Shou-Chuan; Lin, Shee-Chan; Bair, Ming-Jong

2010-09-01

No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan. The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay. Aborigines were significantly different from non-aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age > or = 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock. Aborigines were different from non-aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age > or = 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.

Evolutionary history of LINE-1 in the major clades of placental mammals.

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Paul D Waters

2007-01-01

Full Text Available LINE-1 constitutes an important component of mammalian genomes. It has a dynamic evolutionary history characterized by the rise, fall and replacement of subfamilies. Most data concerning LINE-1 biology and evolution are derived from the human and mouse genomes and are often assumed to hold for all placentals.To examine LINE-1 relationships, sequences from the 3' region of the reverse transcriptase from 21 species (representing 13 orders across Afrotheria, Xenarthra, Supraprimates and Laurasiatheria were obtained from whole genome sequence assemblies, or by PCR with degenerate primers. These sequences were aligned and analysed.Our analysis reflects accepted placental relationships suggesting mostly lineage-specific LINE-1 families. The data provide clear support for several clades including Glires, Supraprimates, Laurasiatheria, Boreoeutheria, Xenarthra and Afrotheria. Within the afrotherian LINE-1 (AfroLINE clade, our tree supports Paenungulata, Afroinsectivora and Afroinsectiphillia. Xenarthran LINE-1 (XenaLINE falls sister to AfroLINE, providing some support for the Atlantogenata (Xenarthra+Afrotheria hypothesis.LINEs and SINEs make up approximately half of all placental genomes, so understanding their dynamics is an essential aspect of comparative genomics. Importantly, a tree of LINE-1 offers a different view of the root, as long edges (branches such as that to marsupials are shortened and/or broken up. Additionally, a robust phylogeny of diverse LINE-1 is essential in testing that site-specific LINE-1 insertions, often regarded as homoplasy-free phylogenetic markers, are indeed unique and not convergent.

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

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

2015-01-01

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

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

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Faulkner Robert A

2007-07-01

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

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 ...

Uranium assessment for the Precambrian pebble conglomerates in southeastern Wyoming

International Nuclear Information System (INIS)

Borgman, L.E.; Sever, C.; Quimby, W.F.; Andrew, M.E.; Karlstrom, K.E.; Houston, R.S.

1981-03-01

This volume is a geostatistical resource estimate of uranium and thorium in quartz-pebble conglomerates, and is a companion to Volume 1: The Geology and Uranium Potential to Precambrian Conglomerates in the Medicine Bow Mountains and Sierra Madre of Southeastern Wyoming; and to Volume 2: Drill-Hole Data, Drill-Site Geology, and Geochemical Data from the Study of Precambrian Uraniferous Conglomerates of the Medicine Bow Mountains and the Sierra Madre of Southeastern Wyoming

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

NARCIS (Netherlands)

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

2007-01-01

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

Dual-tasking over an extended walking distance is associated with falls among community-dwelling older adults

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Hirashima K

2015-04-01

Full Text Available Kenichi Hirashima,1,2 Yumi Higuchi,1 Masakazu Imaoka,1 Emiko Todo,1 Tomomi Kitagawa,1 Tetsuya Ueda11Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan; 2Faculty of Health and Welfare, Department of Physical Therapy, Tokushima Bunri University, Nishihamaboji, Yamashiro Town, Tokushima City, Tokushima, Japan Aim: Dual-task methods, in which walking is the primary task, are not sufficient for accurately screening for the risk of falls among healthy older adults. Therefore, the goal of this research was to investigate whether using a dual-task method over an extended walking distance can predict falls among community-dwelling older adults.Methods: We enrolled independent community-dwelling adults aged ≥65 years. Physical performance, cognitive function, psychological function, and a dual-task test were assessed at baseline. Our dual-task test required the subjects to walk 60 m while stepping over lines. The intervals between the lines ranged from 50–100 cm and were unequal. Falls and fall-related injuries were measured over a 12-month follow-up period using monthly postal surveys. Results: Ninety-two of 118 subjects (mean age, 75.4±5.5 years completed the 12-month follow-up. Sixteen (17.4% of fallers had injurious falls or fell more than or equal to two times. There were no significant differences between the fallers and non-fallers, except in age and in the number of missteps during the dual-task test when walking ≥40 m. The Kaplan–Meier analysis revealed that those who had more than one misstep while walking ≥40 m had a significantly higher incidence of injurious or multiple falls than those who had no missteps.Conclusion: Our findings suggest that the dual-task method with an extended walking distance may be able to predict falls among community-dwelling older adults. Keywords: cohort study, community-dwelling older adults, dual-task, falls

Southeastern Regional Geologic Characterization Report. Executive summary. Final report

International Nuclear Information System (INIS)

1985-08-01

This Executive Summary of the final Southeastern Regional Geologic Characterization Report (RGCR) is issued primarily for public information purposes, and provides a general overview of the report. The complete RGCR presents available regional geologic information pertinent to siting a repository for high-level nuclear waste in crystalline rock in central Maryland; noncoastal Virginia, North Carolina, and South Carolina; and northern Georgia. For each of the states within the Southeastern Region, information is provided on the geologic disqualifying factor and the geologic regional screening variables to be used in region-to-area screening

Southeastern Regional Environmental Characterization Report: executive summary. Final report

International Nuclear Information System (INIS)

1985-08-01

This Executive Summary of the final ''Southeastern Regional Environmental Characterization Report'' (RECR) is issued primarily for public information purposes and provides a general overview of the report. The complete RECR presents available regional environmental information pertinent to siting a repository or high-level nuclear waste in crystalline rock in central Maryland; noncoastal Virginia, North Carolina, and South Carolina; and northern Georgia. For each of the states within the Southeastern Region, information is provided on the environmental disqualifying factors and the environmental regional screening variables to be used in region-to-area screening

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

Hydrogeologic characteristics and geospatial analysis of water-table changes in the alluvium of the lower Arkansas River Valley, southeastern Colorado, 2002, 2008, and 2015

Science.gov (United States)

Holmberg, Michael J.

2017-05-15

The U.S. Geological Survey in cooperation with the Lower Arkansas Valley Water Conservancy District measures groundwater levels periodically in about 100 wells completed in the alluvial material of the Arkansas River Valley in Pueblo, Crowley, Otero, Bent, and Prowers Counties in southeastern Colorado, of which 95 are used for the analysis in this report. The purpose of this report is to provide information to water-resource administrators, managers, planners, and users about groundwater characteristics in the alluvium of the lower Arkansas Valley extending roughly 150 miles between Pueblo Reservoir and the Colorado-Kansas State line. This report includes three map sheets showing (1) bedrock altitude at the base of the alluvium of the lower Arkansas Valley; (2) estimated spring-to-spring and fall-to-fall changes in water-table altitude between 2002, 2008, and 2015; and (3) estimated saturated thickness in the alluvium during spring and fall of 2002, 2008, and 2015, and thickness of the alluvium in the lower Arkansas Valley. Water-level changes were analyzed by geospatial interpolation methods.Available data included all water-level measurements made between January 1, 2001, and December 31, 2015; however, only data from fall and spring of 2002, 2008, and 2015 are mapped in this report. To account for the effect of John Martin Reservoir in Bent County, Colorado, lake levels at the reservoir were assigned to points along the approximate shoreline and were included in the water-level dataset. After combining the water-level measurements and lake levels, inverse distance weighting was used to interpolate between points and calculate the altitude of the water table for fall and spring of each year for comparisons. Saturated thickness was calculated by subtracting the bedrock surface from the water-table surface. Thickness of the alluvium was calculated by subtracting the bedrock surface from land surface using a digital elevation model.In order to analyze the response

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

Science.gov (United States)

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

2016-06-01

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

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

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

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Michelle H. Cameron

2013-01-01

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

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

Formative evaluation of the telecare fall prevention project for older veterans.

Science.gov (United States)

Miake-Lye, Isomi M; Amulis, Angel; Saliba, Debra; Shekelle, Paul G; Volkman, Linda K; Ganz, David A

2011-05-23

Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage patients to appropriate services. Here we report the formative evaluation of this project. To evaluate the intervention we: 1) interviewed patient and employee stakeholders, 2) reviewed participating patients' electronic health record data and 3) abstracted information from meeting minutes. We describe the implementation process, including whether the project was implemented according to plan; identify barriers and facilitators to implementation; and assess the incremental benefit to the quality of health care for fall prevention received by patients in the project. We also estimate the cost of developing the pilot project. The project underwent multiple changes over its life span, including the addition of an option to mail patients educational materials about falls. During the project's lifespan, 113 patients were considered for inclusion and 35 participated. Patient and employee interviews suggested support for the project, but revealed that transportation to medical care was a major barrier in following up on fall risks identified by nurse telephone triage. Medical record review showed that the project enhanced usual medical care with respect to home safety counseling. We discontinued the program after 18 months due to staffing limitations and competing priorities. We estimated a cost of $9194 for meeting time to develop the project. The project appeared feasible at its outset but could not be sustained past the first cycle of evaluation due to insufficient resources and a waning of local

Formative evaluation of the telecare fall prevention project for older veterans

Directory of Open Access Journals (Sweden)

Saliba Debra

2011-05-01

Full Text Available Abstract Background Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage patients to appropriate services. Here we report the formative evaluation of this project. Methods To evaluate the intervention we: 1 interviewed patient and employee stakeholders, 2 reviewed participating patients' electronic health record data and 3 abstracted information from meeting minutes. We describe the implementation process, including whether the project was implemented according to plan; identify barriers and facilitators to implementation; and assess the incremental benefit to the quality of health care for fall prevention received by patients in the project. We also estimate the cost of developing the pilot project. Results The project underwent multiple changes over its life span, including the addition of an option to mail patients educational materials about falls. During the project's lifespan, 113 patients were considered for inclusion and 35 participated. Patient and employee interviews suggested support for the project, but revealed that transportation to medical care was a major barrier in following up on fall risks identified by nurse telephone triage. Medical record review showed that the project enhanced usual medical care with respect to home safety counseling. We discontinued the program after 18 months due to staffing limitations and competing priorities. We estimated a cost of $9194 for meeting time to develop the project. Conclusions The project appeared feasible at its outset but could not be sustained past the first cycle of

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

Science.gov (United States)

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

2016-01-01

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

Differentiation of volcanic ash-fall and water-borne detrital layers in the Eocene Senakin coal bed, Tanjung Formation, Indonesia

Science.gov (United States)

Ruppert, L.F.; Moore, T.A.

1993-01-01

The Sangsang deposit of the Eocene Senakin coal bed, Tanjung Formation, southeastern Kalimantan, Indonesia, contains 11 layers, which are thin ( 70%). These layers are characterized by their pelitic macroscopic texture. Examination of eight of the layers by scanning-electron microscopy, energy-dispersive X-ray, and X-ray diffraction analyses show that they are composed primarily of fairly well-crystallized kaolinite, much of which is vermicular. Accessory minerals include abundant Ti oxide, rare-earth element-rich Ca and A1 phosphates, quartz that luminescences in the blue color range, and euhedral to subhedral pyroxene, hornblende, zircon, and sanidine. Although this mineral suite is suggestive of volcanic ash-fall material, only the four pelitic layers in the middle of the bed are thought to be solely derived from volcanic ash-falls on the basis of diagnostic minerals, replaced glass shards, and lithostratigraphic relationships observed in core and outcrop. The three uppermost pelitic layers contain octahedral chromites, some quartz grains that luminesce in teh orange color range, and some quartz grains that contain two-phase fluid inclusions. These layers are interpreted to be derived from a combination of volcanic ash-fall material and hydrologic transport of volcaniclastic sediment. In contrast, the lowermost pelitic layer, which contains large, rounded FeMg-rich chromites, is thought to have been dominantly deposited by water. The source of the volcanic ash-fall material may have been middle Tertiary volcanism related to plate tectonic activity between Kalimantan and Sulawesi. The volcanic ash was deposited in sufficient amounts to be preserved as layers within the coal only in the northern portions of the Senakin region: the southern coal beds in the region do not contain pelitic layers. ?? 1993.

[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.

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.

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.

Geothermometric evaluation of geothermal resources in southeastern Idaho

Science.gov (United States)

Neupane, G.; Mattson, E. D.; McLing, T. L.; Palmer, C. D.; Smith, R. W.; Wood, T. R.; Podgorney, R. K.

2016-01-01

Southeastern Idaho exhibits numerous warm springs, warm water from shallow wells, and hot water from oil and gas test wells that indicate a potential for geothermal development in the area. We have estimated reservoir temperatures from chemical composition of thermal waters in southeastern Idaho using an inverse geochemical modeling technique (Reservoir Temperature Estimator, RTEst) that calculates the temperature at which multiple minerals are simultaneously at equilibrium while explicitly accounting for the possible loss of volatile constituents (e.g., CO2), boiling and/or water mixing. The temperature estimates in the region varied from moderately warm (59 °C) to over 175 °C. Specifically, hot springs near Preston, Idaho, resulted in the highest reservoir temperature estimates in the region.

Agronomic performance of new open pollinated experimental lines of broccoli (Brassica oleracea L. var. italica evaluated under organic farming.

Directory of Open Access Journals (Sweden)

Samira Sahamishirazi

Full Text Available In order to develop new open pollinating cultivars of broccoli for organic farming, two experiments were conducted during fall 2015 and spring 2016. This study was aimed at comparing the agronomic performance of eleven new open pollinating breeding lines of broccoli to introduce new lines and to test their seasonal suitability for organic farming. Field experiments were carried out at the organic research station Kleinhohenheim of the University of Hohenheim (Stuttgart-Germany. Different agronomic traits total biomass fresh weight, head fresh weight, head diameter, hollow-stem, fresh weight harvest index and marketable yield were assessed together with commercial control cultivars. The data from both experiments were analyzed using a two-stage mixed model approach. In our study, genotype, growing season and their interaction had significant effects on most traits. Plants belonging to the fall growing season had bigger sizes in comparison to spring with significantly (p< 0.0001 higher biomass fresh weight. Some experimental lines had significant lower head fresh weight in spring in comparison to the fall season. The high temperature during the harvest period for the spring season affected the yield negatively through decreasing the firmness of broccoli heads. The low average minimum temperatures during the spring growing season lead to low biomass fresh weight but high fresh weight harvest index. Testing the seasonal suitability of all open pollinating lines showed that the considered fall season was better for broccoli production. However, the change in yield between the fall and the spring growing season was not significant for "Line 701" and "CHE-MIC". Considering the expression of different agronomic traits, "CHE-GRE-G", "Calinaro" and "CAN-SPB" performed the best in the fall growing season, and "CHE-GRE-G", "CHE-GRE-A", "CHE-BAL-A" and "CHE-MIC" and "Line 701" were best in the spring growing season, specifically due to the highest marketable

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.

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2018-03-01

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

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

Science.gov (United States)

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

2016-06-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Optimal population prediction of sandhill crane recruitment based on climate-mediated habitat limitations

Science.gov (United States)

Gerber, Brian D.; Kendall, William L.; Hooten, Mevin B.; Dubovsky, James A.; Drewien, Roderick C.

2015-01-01

Prediction is fundamental to scientific enquiry and application; however, ecologists tend to favour explanatory modelling. We discuss a predictive modelling framework to evaluate ecological hypotheses and to explore novel/unobserved environmental scenarios to assist conservation and management decision-makers. We apply this framework to develop an optimal predictive model for juvenile (time-scales and spring/summer weather affects recruitment.Our predictive modelling framework focuses on developing a single model that includes all relevant predictor variables, regardless of collinearity. This model is then optimized for prediction by controlling model complexity using a data-driven approach that marginalizes or removes irrelevant predictors from the model. Specifically, we highlight two approaches of statistical regularization, Bayesian least absolute shrinkage and selection operator (LASSO) and ridge regression.Our optimal predictive Bayesian LASSO and ridge regression models were similar and on average 37% superior in predictive accuracy to an explanatory modelling approach. Our predictive models confirmed a priori hypotheses that drought and cold summers negatively affect juvenile recruitment in the RMP. The effects of long-term drought can be alleviated by short-term wet spring–summer months; however, the alleviation of long-term drought has a much greater positive effect on juvenile recruitment. The number of freezing days and snowpack during the summer months can also negatively affect recruitment, while spring snowpack has a positive effect.Breeding habitat, mediated through climate, is a limiting factor on population growth of sandhill cranes in the RMP, which could become more limiting with a changing climate (i.e. increased drought). These effects are likely not unique to cranes. The alteration of hydrological patterns and water levels by drought may impact many migratory, wetland nesting birds in the Rocky Mountains and beyond

Assessment of environmental radioactivity for Sanliurfa region of southeastern Turkey

International Nuclear Information System (INIS)

Bozkurt, Ahmet; Yorulmaz, Nuri; Kam, Erol; Karahan, Gursel; Osmanlioglu, Ahmet Erdal

2007-01-01

This study assesses the level of background radiation for Sanliurfa province of southeastern Turkey. Measurements of outdoor gamma radiation (of terrestrial and cosmic origin) in air were performed at 112 locations using a plastic scintillator and the average absorbed dose was found as 60.9 nGy/h (corresponding to an effective dose of 74.7μSv/y). The radionuclide activity concentrations in 45 soil samples collected from the study area were measured through gamma-ray spectrometry and the average activities were determined as 20.8, 24.95 and 298.6 for the natural radionuclides 238 U, 232 Th and 40 K, respectively, and 9.08 Bq/kg for the fission product 137 Cs. The natural radioactivity sources resulted in an effective dose of 46.9μSv/y. The radioactivity levels of 53 drinking water samples were measured as 0.038 Bq/l for gross-alpha activity and 0.1324 Bq/l for gross-beta activity using gross-alpha and gross-beta counting methods (equivalent to an effective dose of 7.76μSv/y). When compared with the data available for other Turkish cities, the outdoor gamma doses and soil radioactivity concentrations obtained in this study indicate a background radiation level that falls within natural limits. On the other hand, the measured gross-alpha and -beta activities in drinking water are relatively higher

Summary of southeastern group breakout sessions

Science.gov (United States)

Bob Ford; Charles P. Nicholson

1993-01-01

The breakout sessions held by the southeastern representatives at the Partners In Flight meeting in Colorado were extremely well attended Most states were represented, as well as several federal agencies (including USFS, USFWS, TVA, EPA), and non-government organizations. Two sessions were held, one to discuss a strategy of management by...

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

NARCIS (Netherlands)

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

2005-01-01

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

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.

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.

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

Directory of Open Access Journals (Sweden)

D. Collado-Mateo

2015-01-01

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

Fall risk assessment: retrospective analysis of Morse Fall Scale scores in Portuguese hospitalized adult patients.

Science.gov (United States)

Sardo, Pedro Miguel Garcez; Simões, Cláudia Sofia Oliveira; Alvarelhão, José Joaquim Marques; Simões, João Filipe Fernandes Lindo; Melo, Elsa Maria de Oliveira Pinheiro de

2016-08-01

The Morse Fall Scale is used in several care settings for fall risk assessment and supports the implementation of preventive nursing interventions. Our work aims to analyze the Morse Fall Scale scores of Portuguese hospitalized adult patients in association with their characteristics, diagnoses and length of stay. Retrospective cohort analysis of Morse Fall Scale scores of 8356 patients hospitalized during 2012. Data were associated to age, gender, type of admission, specialty units, length of stay, patient discharge, and ICD-9 diagnosis. Elderly patients, female, with emergency service admission, at medical units and/or with longer length of stays were more frequently included in the risk group for falls. ICD-9 diagnosis may also be an important risk factor. More than a half of hospitalized patients had "medium" to "high" risk of falling during the length of stay, which determines the implementation and maintenance of protocoled preventive nursing interventions throughout hospitalization. There are several fall risk factors not assessed by Morse Fall Scale. There were no statistical differences in Morse Fall Scale score between the first and the last assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2015-12-01

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

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

Science.gov (United States)

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

2015-01-01

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

The vegetation of Malilangwe Wildlife Reserve, south-eastern ...

African Journals Online (AJOL)

The vegetation of Malilangwe Wildlife Reserve, south-eastern Zimbabwe. ... African Journal of Range and Forage Science ... Comparisons with other southern African savannas are made, and similarities and differences are discussed.

77 FR 26604 - Progressive Rail, Incorporated-Lease and Operation Exemption-Rail Line of Union Pacific Railroad...

Science.gov (United States)

2012-05-04

... main tracks, sidetracks, and bridges, and to construct a number of new sidings and yard tracks to... Company (CN) line at Cameron, the CN line is officially out of service and would require extensive rehabilitation to be made operable, and (2) there is a CN line at Chippewa Falls, but the Line does not extend to...

Epidemiology of falls in older age.

Science.gov (United States)

Peel, Nancye May

2011-03-01

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

Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study.

Science.gov (United States)

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

2018-04-01

Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence. Copyright © 2017 John Wiley & Sons, Ltd.

Fall Prevention Hits Stumbling Blocks.

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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.

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

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

2012-01-01

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

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

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

2007-08-01

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

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

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

2017-07-01

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

Isolation and characterization of the fall Chinook aquareovirus

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Makhsous, Negar; Jensen, Nicole L.; Haman, Katherine H.; Batts, William N.; Jerome, Keith R.; Winton, James; Greninger, Alexander L.

2017-01-01

BackgroundSalmon are paramount to the economy, ecology, and history of the Pacific Northwest. Viruses constitute one of the major threats to salmon health and well-being, with more than twenty known virus species that infect salmon. Here, we describe the isolation and characterization of the fall Chinook aquareovirus, a divergent member of the species Aquareovirus B within the family Reoviridae.MethodsThe virus was first found in 2014 as part of a routine adult broodstock screening program in which kidney and spleen tissue samples from healthy-appearing, adult fall Chinook salmon (Oncorhynchus tshawytscha) returning to a hatchery in Washington State produced cytopathic effects when inoculated onto a Chinook salmon embryo cell line (CHSE-214). The virus was not able to be confirmed by an RT-PCR assay using existing aquareovirus pan-species primers, and instead was identified by metagenomic next-generation sequencing. Metagenomic next-generation sequencing was used to recover the full genome and completed using 3′ RACE.ResultsThe genome of the fall Chinook aquareovirus contains 11 segments of double-stranded RNA totaling 23.3 kb, with each segment flanked by the canonical sequence termini found in the aquareoviruses. Sequence comparisons and a phylogenetic analysis revealed a nucleotide identity of 63.2% in the VP7 gene with the Green River Chinook virus, placing the new isolate in the species Aquareovirus B. A qRT-PCR assay was developed targeting the VP2, which showed rapid growth of the isolate during the initial 5 days in culture using CHSE-214 cells.ConclusionsThis sequence represents the first complete genome of an Aquareovirus B species. Future studies will be required to understand the potential pathogenicity and epidemiology of the fall Chinook aquareovirus.

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

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Hudson Azevedo Pinheiro

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

Agronomic performance of new open pollinated experimental lines of broccoli (Brassica oleracea L. var. italica) evaluated under organic farming.

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Sahamishirazi, Samira; Moehring, Jens; Zikeli, Sabine; Fleck, Michael; Claupein, Wilhelm; Graeff-Hoenninger, Simone

2018-01-01

In order to develop new open pollinating cultivars of broccoli for organic farming, two experiments were conducted during fall 2015 and spring 2016. This study was aimed at comparing the agronomic performance of eleven new open pollinating breeding lines of broccoli to introduce new lines and to test their seasonal suitability for organic farming. Field experiments were carried out at the organic research station Kleinhohenheim of the University of Hohenheim (Stuttgart-Germany). Different agronomic traits total biomass fresh weight, head fresh weight, head diameter, hollow-stem, fresh weight harvest index and marketable yield were assessed together with commercial control cultivars. The data from both experiments were analyzed using a two-stage mixed model approach. In our study, genotype, growing season and their interaction had significant effects on most traits. Plants belonging to the fall growing season had bigger sizes in comparison to spring with significantly (pbroccoli heads. The low average minimum temperatures during the spring growing season lead to low biomass fresh weight but high fresh weight harvest index. Testing the seasonal suitability of all open pollinating lines showed that the considered fall season was better for broccoli production. However, the change in yield between the fall and the spring growing season was not significant for "Line 701" and "CHE-MIC". Considering the expression of different agronomic traits, "CHE-GRE-G", "Calinaro" and "CAN-SPB" performed the best in the fall growing season, and "CHE-GRE-G", "CHE-GRE-A", "CHE-BAL-A" and "CHE-MIC" and "Line 701" were best in the spring growing season, specifically due to the highest marketable yield and proportion of marketable heads.

Climate-driven ground-level ozone extreme in the fall over the Southeast United States.

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Zhang, Yuzhong; Wang, Yuhang

2016-09-06

Ground-level ozone is adverse to human and vegetation health. High ground-level ozone concentrations usually occur over the United States in the summer, often referred to as the ozone season. However, observed monthly mean ozone concentrations in the southeastern United States were higher in October than July in 2010. The October ozone average in 2010 reached that of July in the past three decades (1980-2010). Our analysis shows that this extreme October ozone in 2010 over the Southeast is due in part to a dry and warm weather condition, which enhances photochemical production, air stagnation, and fire emissions. Observational evidence and modeling analysis also indicate that another significant contributor is enhanced emissions of biogenic isoprene, a major ozone precursor, from water-stressed plants under a dry and warm condition. The latter finding is corroborated by recent laboratory and field studies. This climate-induced biogenic control also explains the puzzling fact that the two extremes of high October ozone both occurred in the 2000s when anthropogenic emissions were lower than the 1980s and 1990s, in contrast to the observed decreasing trend of July ozone in the region. The occurrences of a drying and warming fall, projected by climate models, will likely lead to more active photochemistry, enhanced biogenic isoprene and fire emissions, an extension of the ozone season from summer to fall, and an increase of secondary organic aerosols in the Southeast, posing challenges to regional air quality management.

New methods for fall risk prediction.

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

2014-09-01

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

A new diminutive frog species of Adelophryne (Amphibia: Anura: Eleutherodactylidae) from the Atlantic Forest, southeastern Brazil.

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Lourenço-de-Moraes, Ricardo; Ferreira, Rodrigo Barbosa; Fouquet, Antoine; Bastos, Rogério Pereira

2014-08-04

The genus Adelophryne is composed of diminutive frogs occurring in northern Amazonia and the Atlantic Forest. Herein we describe a new species of Adelophryne found in the leaf litter of primary and secondary forests in the mountainous region of Espírito Santo state, southeastern Brazil. The new species is characterized by its small body size, two phalanges in the finger IV, and a glandular ridge line that runs from the posterior part of eye to the insertion of the forelimb. This species is sensitive to edge effect and conversion of native forest into coffee and Eucalyptus plantations and may be listed as Endangered (EN) under B1ab(iii) criteria of the IUCN Red List.

First Aid: Falls

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

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

Directory of Open Access Journals (Sweden)

Hill AM

2013-06-01

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

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

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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.

Fall risk factors in Parkinson's disease.

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Gray, P; Hildebrand, K

2000-08-01

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

Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients.

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Luzia, Melissa de Freitas; Victor, Marco Antonio de Goes; Lucena, Amália de Fátima

2014-01-01

to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. the prevalence of the ND Risk for falls was 4%. The patients' profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event.

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

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

2017-12-01

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

Differentiation of volcanic ash-fall and water-borne detrital layers in the Eocene Senakin coal bed, Tanjung Formation, Indonesia

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Ruppert, L F; Moore, T A [US Geological Survey, Reston, VA (USA). National Center

1993-02-01

The Sangsang deposit of the Eocene Senakin coal bed, Tanjung Formation, southeastern Kalimantan, Indonesia, contains 11 layers, which are thin ([lt] 5 cm) and high in ash ([gt] 70%). These layers are characterized by their pelitic macroscopic texture. Examination of eight of the layers by scanning-electron microscopy, energy-dispersive X-ray, and X-ray diffraction analyses show that they are composed primarily of fairly well-crystallized kaolinite, much of which is vermicular. Accessory minerals include abundant Ti oxide, rare-earth element-rich Ca and Al phosphates, quartz that luminesces in the blue colour range, and euhedral to subhedral pyrooxene, hornblende, zircon, and sanidine. Although this mineral suite is suggestive of volcanic ash-fall material, only the four pelitic layers in the middle of the bed are thought to be solely derived from volcanic ash-falls on the basis of diagnostic minerals, replaced glass shards, and lithostratigraphic relationships observed in core and outcrop. The three uppermost pelitic layers contain octahedral chromites, some quartz grains that luminesce in the organic colour range, and some quartz grains that contain two-phase fluid inclusions. These layers are interpreted to be derived from a combination of volcanic ash-fall material and hydrologic transport of volcaniclastic sediment. In contrast, the lowermost pelitic layer, which contains large, rounded FeMg-rich chromites, is thought to have been dominantly deposited by water. The source of the volcanic ash-fall material may have been middle Tertiary volcanism related to plate tectonic activity between Kalimantan and Sulawesi. The volcanic ash was deposited in sufficient amounts to be preserved as layers within the coal only in the northern portions of the Senakin region: the southern coal beds in the region do not contain pelitic layers. 29 refs., 8 figs., 3 tabs.

Spatial dynamics of understorey insectivorous birds and arthropods in a southeastern Brazilian Atlantic woodlot

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MA. Manhães

Full Text Available Spatial distribution and spatial relationships in capture rates of understorey insectivorous birds and density of arthropods were investigated in a patch of upper montane rain forest in Minas Gerais state, southeastern Brazil, from January to December 2004. The composition of the arthropod fauna collected was similar to that reported for other tropical forests, with predominance of Araneae, Coleoptera, Hymenoptera and Hemiptera non-Heteroptera. A total of 26 bird species were captured, among which the more common were Dysithamnus mentalis, Conopophaga lineata, Platyrinchus mystaceus, Basileuterus culicivorus and Sclerurus scansor. Variation in the bird capture rates among sampling net lines were not correlated with arthropod density. Rather, individual analyses of some bird species suggest that spatial distribution of understorey insectivorous birds is better explained by habitat type.

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

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

2005-07-01

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

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

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Lee, Justin Yusen; Holbrook, Anne

2017-02-20

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

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

LENUS (Irish Health Repository)

Stone, Carol A

2012-06-10

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

Community College Estimated Growth: Fall 2010

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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,…

Intrinsic factors associated with pregnancy falls.

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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.

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

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

2016-11-01

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

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%.

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.

76 FR 33967 - Irish Potatoes Grown in Southeastern States; Suspension of Marketing Order Provisions

Science.gov (United States)

2011-06-10

... IR] Irish Potatoes Grown in Southeastern States; Suspension of Marketing Order Provisions AGENCY... suspends the marketing order for Irish potatoes grown in Southeastern states (order), and the rules and regulations implemented thereunder, through March 1, 2014. The order regulates the handling of Irish potatoes...

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.

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

Science.gov (United States)

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

2013-06-01

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

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.

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

Directory of Open Access Journals (Sweden)

Justin Yusen Lee

2017-02-01

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

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 ...

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

Science.gov (United States)

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

2017-10-01

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

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

Development and feasibility of falls prevention advice.

Science.gov (United States)

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

2011-10-01

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

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

Science.gov (United States)

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

2014-07-01

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

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...

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

Directory of Open Access Journals (Sweden)

G. F. Wieczorek

2008-05-01

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

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

Science.gov (United States)

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

2008-05-01

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

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...

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.

Improving rapeseed production practices in the southeastern United States

Energy Technology Data Exchange (ETDEWEB)

Thomas, D.L.; Breve, M.A.; Raymer, P.L.; Minton, N.A.; Sumner, D.R. (Georgia Univ., Tifton, GA (USA). Georgia Coastal Plain Experiment Station)

1990-04-01

Oilseed rape or rapeseed is a crop which offers a potential for double-cropping in the southeastern United States. This final project report describes the results from a three year study aimed at evaluating the effect of different planting and harvesting practices on establishment and yield of three rape cultivars, and the double cropping potential of rapeseed in the southeastern United States. The project was conducted on two yield sites in Tifton, Georgia during 1986--87, 1987--88 and 1988--89. The general objective of this research is to improve the seed and biomass yield of winter rapeseed in the southeastern United States by developing appropriate agronomic practices for the region. The primary constraint is to grow rapeseed within the allowable period for double cropping with an economically desirable crop, such as peanut or soybean. Planting and harvesting are the most critical steps in this process. Therefore, the specific objectives of this research were: evaluate and improve the emergence of rapeseed by developing planting techniques that enhance the soil, water and seed regimes for winter rapeseed in the southeast, and evaluate and improve the yields of harvested rapeseed by developing techniques for determining the optimum timing of harvest and efficient methods for harvesting winter rapeseed in the southeast. 6 refs., 12 figs., 9 tabs.

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

Science.gov (United States)

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

2017-05-01

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

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

NARCIS (Netherlands)

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

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

Emerging Energy Alternatives for the Southeastern States

Science.gov (United States)

Stefanakos, E. K. (Editor)

1978-01-01

The proceedings of the first symposium on emerging energy alternatives for the Southeastern States are presented. Some topics discussed are: (1) solar energy, (2) wood energy, (3) novel energy sources, (4) agricultural and industrial process heat, (5) waste utilization, (6) energy conservation and (7) ocean thermal energy conversion.

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

Science.gov (United States)

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

2017-12-07

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

[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.

A Wavelet-Based Approach to Fall Detection

Directory of Open Access Journals (Sweden)

Luca Palmerini

2015-05-01

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

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

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

Science.gov (United States)

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

2016-12-01

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

Visceral Leishmaniasis in Southeastern Iran: A Narrative Review

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Iraj SHARIFI

2017-02-01

Full Text Available Background: Visceral leishmaniasis (VL has strong links with poverty, substantial medical and veterinary impacts. This review aimed to focus in studies published during 1994-2016 on VL in southeastern Iran.Methods: The present review is based on expert knowledge and historical studies published during the past 23 yr (1994-2016 on VL in southeastern Iran. In addition, related literature found in PubMed by using the keywords such as visceral leishmaniasis, kala-azar, and Leishmania infantum are included.Results: Overall, 118 children aged 4.2 yr were detected as infected with human VL (HVL. The majority of the cases were from Orzoieh district (37.1% in southwest of Kerman Province, followed by Sirjan (15.7%, Jiroft (14.8%, Kahnuj (9.3% and to lesser extent from other areas. The male to female ratio was 1.7. The three most frequent clinical features were represented by fever (100.0%, anemia (95.0% and splenomegaly (91.5%. Altogether, 42.0% of the VL cases developed secondary bacterial infections, the overall case-fatality rate was 3.4%, and majorities (88.0% of the VL patients were undernourished. Overall, 733 dogs and wild canines were examined by different techniques with various seroprevalence ranges.Conclusion: In southeastern Iran, VL is endemic in Orzoieh district in Kerman Province. While the dogs are implicated as the main domestic reservoir of VL, wide range of wild canines can serve as a secondary potential reservoir host.

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

DEFF Research Database (Denmark)

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

2010-01-01

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

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

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Kim, Oksoo; Kim, Jung-Hee

2015-01-01

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

Prevalence of falls in elderly women.

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Vitor, Priscila Regina Rorato; de Oliveira, Ana Carolina Kovaleski; Kohler, Renan; Winter, Gabriele Regiane; Rodacki, Cintia; Krause, Maressa Priscila

2015-01-01

To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. The prevalence of falls in this sample was 32.4%. Among women fallers, 40% self-reported a high fear of falling. It is recommended that functional and resistance exercises are included in the preventive strategies for reducing risk factors for falls and its determinants in elderly women. Level of Evidence II, Prognostic-Prospective Study.

Ageing vision and falls: a review.

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Saftari, Liana Nafisa; Kwon, Oh-Sang

2018-04-23

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

Circulation in the Southeastern Mediterranean Sea (EGITTO-NICOP)

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2007-09-30

Circulation in the Southeastern Mediterranean Sea (EGITTO-NICOP) Pierre-Marie Poulain Istituto Nazionale di Oceanografia e di Geofisica ...Nazionale di Oceanografia e di Geofisica Sperimentale,Borgo Grotta Gigante, 42/c,34010 Sgonico (Trieste), Italy, , 8. PERFORMING ORGANIZATION REPORT NUMBER

Translocation of Soil Particles during Secondary Soil Tillage along Contour Lines

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Novák Petr

2018-04-01

Full Text Available A high percentage of arable land and erosion risk on agricultural land are typical of current agriculture. While tillage erosion is a less frequently studied issue, it impacts vast areas of agricultural land. Not all relationships between cultivation equipment, the gradient of the plot and other factors have been known until now. Intensive soil tillage can be a crucial erosive factor mainly when the cultivation equipment moves in a fall line direction. Nevertheless, even when the equipment moves along contour lines, soil particles can be translocated perpendicular to the direction of the equipment movement (in a fall line direction. This phenomenon has not yet been adequately studied. For measurements, a field trial with secondary tillage of soil was laid out (a seedbed preparation implement was used. The objective of the trial was to evaluate the effect of the working tools of the cultivation equipment on the crosswise and lengthwise translocation of soil particles during soil tillage. Aluminium cubes, with a side length of 16 mm, were used as tracers. Before the operation, the tracers were inserted in a row perpendicular (at a right angle to a direction of the equipment passes. After the equipment passes, position of tracers was evaluated within a two-axis grid. The trial was performed at three gradients of the plot (2°, 6° and 11°. For each gradient, the 1-pass, 2-pass and 3-pass treatments were tested. The equipment always moved along the plot contour line. After the equipment passes in all treatments, all tracers were localized on an orthogonal grid. The results of the trial demonstrate the effect of the slope gradient on the crosswise translocation of particles during secondary tillage of soil in the slope direction. The tillage equipment translocated particles in the fall line direction even if it passed along the contour line. With the increasing intensity of passes, the effect of the equipment on crosswise translocation increases

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

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

2016-01-01

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

Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients1

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Luzia, Melissa de Freitas; Victor, Marco Antonio de Goes; Lucena, Amália de Fátima

2014-01-01

Objectives to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. Method a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. Results the prevalence of the ND Risk for falls was 4%. The patients' profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). Conclusion the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event. PMID:26107834

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

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

2016-01-01

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

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....

Home Improvements Prevent Falls

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... 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 ...

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

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

2015-05-01

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

Fall Prevention in a Primary Care Setting.

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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.

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

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

2017-10-01

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

Fall prevention in central coast community pharmacies.

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Stuart, Gina M; Kale, Helen L

2018-04-19

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

[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.

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

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

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

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

2017-01-01

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

Falls and patient safety for older adults.

Science.gov (United States)

Aronovitch, Sharon A

2006-10-01

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

The trace metals accumulation in marine organisms of the southeastern Adriatic coast, Montenegro

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Joksimovic Danijela

2012-01-01

Full Text Available The concentration and accumulation of trace metals (Co, Ni, As, Cd, Pb and Hg were measured in sea water, sediments and marine organisms in the coastline of the Montenegro. The obtained results of trace metals in seagrass and mussels were compared with those found in the water column and sediment. Sampling was performed in the fall of 2005 at five locations in the Montenegrin coastline, Sveta Stasija, Herceg Novi, Zanjice, Budva and Bar, which present different levels and sources of human impact. The heavy metals analyses in seawater, sediment, P. oceanica and M. galloprovincialis identified the harbor of Bar as the most Hg-contaminated site, Zanjice as the most As contaminated and Sveta Stasija as the most Pb-contaminated areas of the Montenegrin coastal area. This study showed that P. oceanica may have a greater bioaccumulation capacity than M. galloprovincialis for the considered metals, except for As and Hg, and both organisms may reflect contamination in the water column and in the sediment. For the first time, seagrass P. oceanica and M. galloprovincialis were employed as metal bioindicators for the southeastern Adriatic. The results of this study could serve as a baseline in the future for the assessment of anthropogenic effects in this marine ecosystem.

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

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Obuchi, Shuichi

2008-06-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

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

2015-05-01

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

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

Compliant flooring to prevent fall-related injuries: a scoping review protocol.

Science.gov (United States)

Lachance, Chantelle C; Jurkowski, Michal P; Dymarz, Ania C; Mackey, Dawn C

2016-08-16

Fall-related injuries can have serious consequences for older adults, including increased risk of dependence in daily activities and mortality. Compliant flooring is a passive intervention that may reduce the incidence and severity of fall-related injuries in healthcare settings, including acute and long-term care, but few sites have implemented compliant flooring, in part because synthesised evidence about key performance aspects has not been available. We will conduct a scoping review to address the question: 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? We will conduct a comprehensive and systematic literature search of academic databases (AgeLine, CINAHL, EBM Reviews, MEDLINE (Ovid), SportDiscus and Web of Science) and grey literature (clinical trial registries, theses/dissertations, abstracts/conference proceedings and relevant websites). 2 team members will independently screen records (first titles and abstracts, then full text) and extract data from included records. Numerical and narrative analyses will be presented by theme (biomechanical efficacy, clinical effectiveness, cost-effectiveness, workplace safety). This scoping review responds to the information needs of healthcare decision-makers tasked with preventing fall-related injuries. This review will summarise evidence about compliant flooring as a potential intervention for preventing fall-related injuries in older adults and identify gaps in evidence and new avenues for research. Results will be especially useful in long-term care, but also applicable in acute care, assisted living and home care. We will disseminate the review's findings via open-access publications, conference presentations, a webinar, a Stakeholder Symposium and a Knowledge-to-Action Report. Published by the BMJ Publishing Group Limited. For permission to use (where not

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.

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.

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 ...

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.

Drought-sensitive aquifer settings in southeastern Pennsylvania

Science.gov (United States)

Zimmerman, Tammy M.; Risser, Dennis W.

2005-01-01

This report describes the results of a study conducted by the U.S. Geological Survey, in cooperation with the Pennsylvania Department of Conservation and Natural Resources, Bureau of Topographic and Geologic Survey, to determine drought-sensitive aquifer settings in southeastern Pennsylvania. Because all or parts of southeastern Pennsylvania have been in drought-warning or drought-emergency status during 6 of the past 10 years from 1994 through 2004, this information should aid well owners, drillers, and water-resource managers in guiding appropriate well construction and sustainable use of Pennsylvania's water resources. 'Drought-sensitive' aquifer settings are defined for this study as areas unable to supply adequate quantities of water to wells during drought. Using information from previous investigations and a knowledge of the hydrogeology and topography of the study area, drought-sensitive aquifer settings in southeastern Pennsylvania were hypothesized as being associated with two factors - a water-table decline (WTD) index and topographic setting. The WTD index is an estimate of the theoretical water-table decline at the ground-water divide for a hypothetical aquifer with idealized geometry. The index shows the magnitude of ground-water decline after cessation of recharge is a function of (1) distance from stream to divide, (2) ground-water recharge rate, (3) transmissivity, (4) specific yield, and (5) duration of the drought. WTD indices were developed for 39 aquifers that were subsequently grouped into categories of high, moderate, and low WTD index. Drought-sensitive settings determined from the hypothesized factors were compared to locations of wells known to have been affected (gone dry, replaced, or deepened) during recent droughts. Information collected from well owners, drillers, and public agencies identified 2,016 wells affected by drought during 1998-2002. Most of the available data on the location of drought-affected wells in the study area were

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

OpenAIRE

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

2012-01-01

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

DOMESTIC VS INTERNATIONAL RISK DIVERSIFICATION POSSIBILITIES IN SOUTHEASTERN EUROPEAN STOCK MARKETS

Directory of Open Access Journals (Sweden)

Sinisa Bogdan

2016-12-01

Full Text Available Modern portfolio theory is one of the most important investment decision tools in finances. In 1952 Harry Markowitz set the foundations of the Modern portfolio theory, since than this theory was a backbone of many studies that dealt with investment decisions. This research applies mean-variance portfolio optimization on the international Southeastern Europe and domestic Croatian stock market exchange. Aim of this research is to compare risk diversification possibilities on the Southeastern European capital markets and on the Croatian Capital market. By analyzing nine stock market indices in the Southeastern Europe and twenty stocks from Zagreb Stock Exchange in the period of 36 months, results clearly show that internationally diversified portfolios offer better portfolio risk reduction than domestically diversified portfolios. Lowest achieved risk in international portfolio outperformed lowest achieved risk in domestic portfolio. Since risk is lower, returns are also much lower compared to domestic stock portfolios. Results of this research also report that domestic stock portfolios outperformed international portfolios at the risk level equal or higher than 0,97%, for the same risk, domestic portfolios offer greater returns.

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

Science.gov (United States)

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

2018-05-01

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

Analysis of rainfall related to landslide activity during January-February 2003, South-Eastern Sector of Italy

International Nuclear Information System (INIS)

Fiorillo, Francesco

2004-01-01

On 24-26 th January 2003 a heavy storm struck the South-Eastern sector of the Italian peninsula, causing severe damage to agriculture and roads of the Abruzzo, Molise, Campania and Puglia regions. The areas involved are characterised by hilly morphology, up to 900m a.s.l. inland, and are made up of mainly argillaceous sequences of Flysch and fore deep deposits of the Apennine chain. Thousands of landslides occurred along hilly areas, generally characterized by shallow movements which ceased after some meters; deep-seated landslides also occurred and with reactivations of previous instabilities. Flood phenomena occurred in several places, mainly along the high-order drainage lines. The area is known to fall within a Mediterranean climate, with a long, hot 'dry season' between June and September and a temperate-wet season between October and May. Thus, the 24-26 January 2003 storm occurred in the mid-wet season, during winter; moreover, neither solid precipitation nor snow melt phenomena occurred. The first available hydrological data show that the 24-26 th January 2003 storm was the maximum in the historical series of some rain gauges, considering 24-hour and 2-day cumulative rainfall; return time reaches values exceeding 70 years, with usual distribution function (Gumbel, GEV, Lognormal). The storm occurred after a wet period, characterized by previous storms, which most likely caused the reaching of field capacity of the soil. All shallow landslides occurred during or immediately after this storm and, thus, were most likely caused by positive pore pressure development. At least 10 continuous rainy days after the storm (until 6th February 2003) were recorded, though they were characterized by low rainfall; it is important to highlight that it was mainly during these rainy days that some deep seated landslides were reactivated. On the bases of historical hydrological data and landslide activity, this study analyses the possible relation between rainfall and

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.

FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

Directory of Open Access Journals (Sweden)

Michaela Dingová

2017-03-01

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

Zoonotic Leprosy in the Southeastern United States

Science.gov (United States)

Sharma, Rahul; Singh, Pushpendra; Loughry, W.J.; Lockhart, J. Mitchell; Inman, W. Barry; Duthie, Malcolm S.; Pena, Maria T.; Marcos, Luis A.; Scollard, David M.; Cole, Stewart T.

2015-01-01

Nine-banded armadillos (Dasypus novemcinctus) are naturally infected with Mycobacterium leprae and have been implicated in zoonotic transmission of leprosy. Early studies found this disease mainly in Texas and Louisiana, but armadillos in the southeastern United States appeared to be free of infection. We screened 645 armadillos from 8 locations in the southeastern United States not known to harbor enzootic leprosy for M. leprae DNA and antibodies. We found M. leprae–infected armadillos at each location, and 106 (16.4%) animals had serologic/PCR evidence of infection. Using single-nucleotide polymorphism variable number tandem repeat genotyping/genome sequencing, we detected M. leprae genotype 3I-2-v1 among 35 armadillos. Seven armadillos harbored a newly identified genotype (3I-2-v15). In comparison, 52 human patients from the same region were infected with 31 M. leprae types. However, 42.3% (22/52) of patients were infected with 1 of the 2 M. leprae genotype strains associated with armadillos. The geographic range and complexity of zoonotic leprosy is expanding. PMID:26583204

Entropy dynamics in cone production of longleaf pine forests in the southeastern United States

Science.gov (United States)

Xiongwen Chen; Dale G. Brockway; Qinfeng Guo

2016-01-01

Sporadic temporal patterns of seed production are a challenge for the regeneration and restoration of longleaf pine, which is a keystone component of an endangered ecosystem in the southeastern United States. In this study, long-term data for longleaf pine cone production, collected at six sites across the southeastern region, was examined from the perspective of...

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

Science.gov (United States)

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

2016-06-20

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

A simple strategy for fall events detection

KAUST Repository

Harrou, Fouzi

2017-01-20

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

Analysis of the seismicity of Southeastern Sicily: a proposed tectonic interpretation

Directory of Open Access Journals (Sweden)

M. S. Barbano

2000-06-01

Full Text Available Southeastern Sicily is one of the Italian regions with high seismic risk and is characterised by the occurrence in the past of large destructive events (MS = 6.4-7.3 over a territory which is densely urbanised today. The main earthquakes were analysed and some minor damaging shocks reviewed to investigate the main seismogenic features of the region. The comparison between the pattern of seismicity and evidence of Quaternary tectonics allowed us to propose a first tentative, tectonic interpretation of the earthquakes. On the whole, the seismicity of SE Sicily seems distributed along regional fault systems which have had a role in the recent geodynamic evolution of the area. The Malta escarpment, the only structure whose late Quaternary-recent activity is currently known, appears the most probable source for earthquakes with about 7 magnitude. Although no evidence of tectonics subsequent to the middle Pleistocene is available for them, the Scicli line and the NE-SW fault system delimiting the northern sector of the Hyblean plateau seem seismically active with events with maximum magnitude of 5.2 and 6.4, respectively.

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

NARCIS (Netherlands)

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

2013-01-01

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

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

Science.gov (United States)

Kato, Chikako; Ida, Kunio; Harada, Atsushi

2009-09-01

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

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

Science.gov (United States)

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

2016-12-01

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

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.

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.

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.

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.

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

Science.gov (United States)

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

2018-05-01

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

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

Science.gov (United States)

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

2017-12-01

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

Raindrop fall velocities from an optical array probe and 2-D video disdrometer

Science.gov (United States)

Bringi, Viswanathan; Thurai, Merhala; Baumgardner, Darrel

2018-03-01

We report on fall speed measurements of raindrops in light-to-heavy rain events from two climatically different regimes (Greeley, Colorado, and Huntsville, Alabama) using the high-resolution (50 µm) Meteorological Particle Spectrometer (MPS) and a third-generation (170 µm resolution) 2-D video disdrometer (2DVD). To mitigate wind effects, especially for the small drops, both instruments were installed within a 2/3-scale Double Fence Intercomparison Reference (DFIR) enclosure. Two cases involved light-to-moderate wind speeds/gusts while the third case was a tornadic supercell and several squall lines that passed over the site with high wind speeds/gusts. As a proxy for turbulent intensity, maximum wind speeds from 10 m height at the instrumented site recorded every 3 s were differenced with the 5 min average wind speeds and then squared. The fall speeds vs. size from 0.1 to 2 and > 0.7 mm were derived from the MPS and the 2DVD, respectively. Consistency of fall speeds from the two instruments in the overlap region (0.7-2 mm) gave confidence in the data quality and processing methodologies. Our results indicate that under low turbulence, the mean fall speeds agree well with fits to the terminal velocity measured in the laboratory by Gunn and Kinzer from 100 µm up to precipitation sizes. The histograms of fall speeds for 0.5, 0.7, 1 and 1.5 mm sizes were examined in detail under the same conditions. The histogram shapes for the 1 and 1.5 mm sizes were symmetric and in good agreement between the two instruments with no evidence of skewness or of sub- or super-terminal fall speeds. The histograms of the smaller 0.5 and 0.7 mm drops from MPS, while generally symmetric, showed that occasional occurrences of sub- and super-terminal fall speeds could not be ruled out. In the supercell case, the very strong gusts and inferred high turbulence intensity caused a significant broadening of the fall speed distributions with negative skewness (for drops of 1.3, 2 and 3 mm). The

preliminary investigation of pegmatites in obudu area, southeastern

African Journals Online (AJOL)

Stream sediment samples were collected from Southern Obudu. Plateau area ... The elements in Obudu stream sediments show perfect, strong, moderate and weak correlations among themselves ..... also be due to the low radioactive materials in the area. However .... geochemistry in southeastern Asia: soils, sediments ...

Delay line clipping in a scintillation camera system

International Nuclear Information System (INIS)

Hatch, K.F.

1979-01-01

The present invention provides a novel base line restoring circuit and a novel delay line clipping circuit in a scintillation camera system. Single and double delay line clipped signal waveforms are generated for increasing the operational frequency and fidelity of data detection of the camera system by base line distortion such as undershooting, overshooting, and capacitive build-up. The camera system includes a set of photomultiplier tubes and associated amplifiers which generate sequences of pulses. These pulses are pulse-height analyzed for detecting a scintillation having an energy level which falls within a predetermined energy range. Data pulses are combined to provide coordinates and energy of photopeak events. The amplifiers are biassed out of saturation over all ranges of pulse energy level and count rate. Single delay line clipping circuitry is provided for narrowing the pulse width of the decaying electrical data pulses which increase operating speed without the occurrence of data loss. (JTA)

Oak-Black Bear Relationships in Southeastern Uplands

Science.gov (United States)

Joseph D. Clark

2004-01-01

Bears (Ursus americanus) primarily occur in upland habitats in the Southeast because uplands were the last to be developed for agriculture and were more likely to become publicly owned. National parks and forests created in the early to mid-1900s served as sources to supply surrounding uplands with bears. Bears could not survive in southeastern...

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

Science.gov (United States)

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

2018-04-11

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

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

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

Science.gov (United States)

Ylitalo, Kelly R; Karvonen-Gutierrez, Carrie A

2016-10-01

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

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

Directory of Open Access Journals (Sweden)

Häggqvist Beatrice

2012-10-01

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

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...

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

Science.gov (United States)

Kim, Hunkyung; Yoshida, Hideyo; Suzuki, Takao

2014-04-01

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

Southeastern Community College Annual Progress Report, December 1995.

Science.gov (United States)

Gardner, R. Gene

Presenting information on the status of Southeastern Community College (SCC), in Iowa, this annual progress report highlights basic institutional data, financial information, and improvements and planned changes of the college as of 1995. Part 1 presents basic data on SCC, including facility locations, assessed property valuation, district…

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.

Fear of Falling in Older Adults: Comprehensive Review

Directory of Open Access Journals (Sweden)

Dukyoo Jung, PhD, RN

2008-12-01

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

Cluster analysis of Southeastern U.S. climate stations

Science.gov (United States)

Stooksbury, D. E.; Michaels, P. J.

1991-09-01

A two-step cluster analysis of 449 Southeastern climate stations is used to objectively determine general climate clusters (groups of climate stations) for eight southeastern states. The purpose is objectively to define regions of climatic homogeneity that should perform more robustly in subsequent climatic impact models. This type of analysis has been successfully used in many related climate research problems including the determination of corn/climate districts in Iowa (Ortiz-Valdez, 1985) and the classification of synoptic climate types (Davis, 1988). These general climate clusters may be more appropriate for climate research than the standard climate divisions (CD) groupings of climate stations, which are modifications of the agro-economic United States Department of Agriculture crop reporting districts. Unlike the CD's, these objectively determined climate clusters are not restricted by state borders and thus have reduced multicollinearity which makes them more appropriate for the study of the impact of climate and climatic change.

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

Science.gov (United States)

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

2018-01-01

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

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.

A seasonal-scale climatological analysis correlating spring tornadic activity with antecedent fall-winter drought in the southeastern United States

International Nuclear Information System (INIS)

Shepherd, Marshall; Mote, Thomas L; Niyogi, Dev

2009-01-01

Using rain gauge and satellite-based rainfall climatologies and the NOAA Storm Prediction Center tornado database (1952-2007), this study found a statistically significant tendency for fall-winter drought conditions to be correlated with below-normal tornado days the following spring in north Georgia (i.e. 93% of the years) and other regions of the Southeast. Non-drought years had nearly twice as many tornado days in the study area as drought years and were also five to six times more likely to have multiple tornado days. Individual tornadic events are largely a function of the convective-mesoscale thermodynamic and dynamic environments, thus the study does not attempt to overstate predictability. Yet, the results may provide seasonal guidance in an analogous manner to the well known Sahelian rainfall and Cape Verde hurricane activity relationships.

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

Directory of Open Access Journals (Sweden)

Schwenk Michael

2012-04-01

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

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

Science.gov (United States)

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

2003-08-01

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

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

Science.gov (United States)

Gustavsson, Johanna; Jernbro, Carolina; Nilson, Finn

2018-12-01

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

Falls: Epidemiology, Pathophysiology, and Relationship to Fracture

OpenAIRE

Berry, Sarah D.; Miller, Ram

2008-01-01

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

A REVERBERATION LAG FOR THE HIGH-IONIZATION COMPONENT OF THE BROAD-LINE REGION IN THE NARROW-LINE SEYFERT 1 Mrk 335

International Nuclear Information System (INIS)

Grier, C. J.; Peterson, B. M.; Pogge, R. W.; Martini, Paul; Zu, Y.; Kochanek, C. S.; Shappee, B. J.; Stanek, K. Z.; Araya Salvo, C.; Beatty, T. G.; Bird, J. C.; Denney, K. D.; Bentz, M. C.; Sergeev, S. G.; Borman, G. A.; Kaspi, S.; Bord, D. J.; Che, X.; Chen, C.; Cohen, S. A.

2012-01-01

We present the first results from a detailed analysis of photometric and spectrophotometric data on the narrow-line Seyfert 1 (NLS1) galaxy Mrk 335, collected over a 120 day span in the fall of 2010. From these data we measure the lag in the He II λ4686 broad emission line relative to the optical continuum to be 2.7 ± 0.6 days and the lag in the Hβλ4861 broad emission line to be 13.9 ± 0.9 days. Combined with the line width, the He II lag yields a black hole mass M BH = (2.6 ± 0.8) × 10 7 M ☉ . This measurement is consistent with measurements made using the Hβλ4861 line, suggesting that the He II emission originates in the same structure as Hβ, but at a much smaller radius. This constitutes the first robust lag measurement for a high-ionization line in an NLS1 galaxy and supports a scenario in which the He II emission originates from gas in virial motion rather than outflow.

A REVERBERATION LAG FOR THE HIGH-IONIZATION COMPONENT OF THE BROAD-LINE REGION IN THE NARROW-LINE SEYFERT 1 Mrk 335

Energy Technology Data Exchange (ETDEWEB)

Grier, C. J.; Peterson, B. M.; Pogge, R. W.; Martini, Paul; Zu, Y.; Kochanek, C. S.; Shappee, B. J.; Stanek, K. Z.; Araya Salvo, C.; Beatty, T. G.; Bird, J. C. [Department of Astronomy, The Ohio State University, 140 W 18th Avenue, Columbus, OH 43210 (United States); Denney, K. D. [Dark Cosmology Centre, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, DK-2100 Copenhagen (Denmark); Bentz, M. C. [Department of Physics and Astronomy, Georgia State University, Astronomy Offices, One Park Place South SE, Suite 700, Atlanta, GA 30303 (United States); Sergeev, S. G.; Borman, G. A. [Crimean Astrophysical Observatory, P/O Nauchny Crimea 98409 (Ukraine); Kaspi, S. [School of Physics and Astronomy, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978 (Israel); Bord, D. J. [Department of Natural Sciences, The University of Michigan-Dearborn, 4901 Evergreen Rd, Dearborn, MI 48128 (United States); Che, X. [Department of Astronomy, University of Michigan, 500 Church Street, Ann Arbor, MI 41809 (United States); Chen, C.; Cohen, S. A. [Department of Physics and Astronomy, Dartmouth College, 6127 Wilder Laboratory, Hanover, NH 03755 (United States); and others

2012-01-15

We present the first results from a detailed analysis of photometric and spectrophotometric data on the narrow-line Seyfert 1 (NLS1) galaxy Mrk 335, collected over a 120 day span in the fall of 2010. From these data we measure the lag in the He II {lambda}4686 broad emission line relative to the optical continuum to be 2.7 {+-} 0.6 days and the lag in the H{beta}{lambda}4861 broad emission line to be 13.9 {+-} 0.9 days. Combined with the line width, the He II lag yields a black hole mass M{sub BH} = (2.6 {+-} 0.8) Multiplication-Sign 10{sup 7} M{sub Sun }. This measurement is consistent with measurements made using the H{beta}{lambda}4861 line, suggesting that the He II emission originates in the same structure as H{beta}, but at a much smaller radius. This constitutes the first robust lag measurement for a high-ionization line in an NLS1 galaxy and supports a scenario in which the He II emission originates from gas in virial motion rather than outflow.

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

Low cloud precipitation climatology in the southeastern Pacific marine stratocumulus region using CloudSat

International Nuclear Information System (INIS)

Rapp, Anita D; Lebsock, Matthew; L’Ecuyer, Tristan

2013-01-01

A climatology of low cloud surface precipitation occurrence and intensity from the new CloudSat 2C-RAIN-PROFILE algorithm is presented from June 2006 through December 2010 for the southeastern Pacific region of marine stratocumulus. Results show that over 70% of low cloud precipitation falls as drizzle. Application of an empirical evaporation model suggests that 50–80% of the precipitation evaporates before it reaches the surface. Segregation of the CloudSat ascending and descending overpasses shows that the majority of precipitation occurs at night. Examination of the seasonal cycle shows that the precipitation is most frequent during the austral winter and spring; however there is considerable regional variability. Conditional rain rates increase from east to west with a maximum occurring in the region influenced by the South Pacific Convergence Zone. Area average rain rates are highest in the region where precipitation rates are moderate, but most frequent. The area average surface rain rate for low cloud precipitation for this region is ∼0.22 mm d −1 , in good agreement with in situ estimates, and is greatly improved over earlier CloudSat precipitation products. These results provide a much-needed quantification of surface precipitation in a region that is currently underestimated in existing satellite-based precipitation climatologies. (letter)

Identifying nursing home residents at risk for falling.

Science.gov (United States)

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

1998-05-01

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

Exploring changes in rainfall intensity and seasonal variability in the Southeastern U.S.: Stakeholder engagement, observations, and adaptation

Directory of Open Access Journals (Sweden)

Daniel R. Dourte

2015-01-01

Full Text Available The distribution of rainfall has major impacts in agriculture, affecting the soil, hydrology, and plant health in agricultural systems. The goal of this study was to test for recent changes in rainfall intensity and seasonal rainfall variability in the Southeastern U.S. by exploring the data collaboratively with agricultural stakeholders. Daily rainfall records from the Global Historical Climatology Network were used to analyze changes in rain intensity and seasonal rainfall variability. During the last 30 years (1985–2014, there has been a significant change (53% increase in the number of extreme rainfall days (>152.4 mm/day and there have been significant decreases in the number of moderate intensity (12.7–25.4 mm/day and heavy (25.4–76.2 mm/day rainfall days in the Southeastern U.S., when compared to the previous 30-year period (1955–1984. There have also been significant decreases in the return period of months in which greater than half of the monthly total rain occurred in a single day; this is an original, stakeholder-developed rainfall intensity metric. The variability in spring and summer rainfall increased during the last 30 years, but winter and fall showed less variability in seasonal totals in the last 30 years. In agricultural systems, rainfall is one of the leading factors affecting yield variability; so it can be expected that more variable rainfall and more intense rain events could bring new challenges to agricultural production. However, these changes can also present opportunities for producers who are taking measures to adjust management strategies to make their systems more resilient to increased rain intensity and variability.

INTERNET ADDICTION IN BALKAN AND SOUTH-EASTERN EUROPEAN COUNTRIES

Directory of Open Access Journals (Sweden)

Ioannis PETASAKIS

2012-12-01

Full Text Available The use of Internet has increased dramatically in recent years. Although there is no standardized definition of Internet addiction, there is acknowledgement among researchers that this phenomenon does exist. In this study, we identify various similarities and differences among people in the Balkan and South-Eastern European countries about Internet addiction. There are many factors such as cultural differences, gender differences, psychosocial variables, computer attitudes and time.We present the experience from studies concerning Internet addiction in all over the world. A specific research with the use of Young's 20-scale was also conducted in five Balkan and South-Eastern European countries (Republic of Moldova, Romania, Republic of Bulgaria, Hellenic Republic, Republic of Cyprus.The findings are interesting. Although there is a need for Interest using, there are also cases where the addiction, dependence and abuse is apparent.

Intrinsic Risk Factors of Falls in Elderly

Directory of Open Access Journals (Sweden)

Yasmin Amatullah

2016-09-01

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

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators.

Science.gov (United States)

Vlaeyen, Ellen; Stas, Joke; Leysens, Greet; Van der Elst, Elisa; Janssens, Elise; Dejaeger, Eddy; Dobbels, Fabienne; Milisen, Koen

2017-05-01

To identify the barriers and facilitators for fall prevention implementation in residential care facilities. Systematic review. Review registration number on PROSPERO: CRD42013004655. Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills

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

Science.gov (United States)

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

2015-01-01

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

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

Prevalence of falls in elderly women

OpenAIRE

Vitor,Priscila Regina Rorato; Oliveira,Ana Carolina Kovaleski de; Kohler,Renan; Winter,Gabriele Regiane; Rodacki,Cintia; Krause,Maressa Priscila

2015-01-01

OBJECTIVE: To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. METHODS: Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. RES...

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

Science.gov (United States)

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

2017-03-01

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

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

OpenAIRE

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

2015-01-01

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

Tandem Stance Avoidance Using Adaptive and Asymmetric Admittance Control for Fall Prevention.

Science.gov (United States)

Nakagawa, Shotaro; Hasegawa, Yasuhisa; Fukuda, Toshio; Kondo, Izumi; Tanimoto, Masanori; Di, Pei; Huang, Jian; Huang, Qiang

2016-05-01

Fall prevention is one of the most important functions of walking assistance devices for user's safety. It is preferable that these devices prevent the user from being in the state where the risk of falling is high rather than helping them recovering from falling motion. During turning, when the user is in the tandem stance, a state where both legs form a line along walking direction, a support base that is surrounded by two legs becomes small, and a stability margin becomes small. This paper therefore aims to prevent the tandem stance by using nonwearable robot "intelligent cane" for the elderly or physically challenged person. Generally, the behavior of the lower limb follows the upper body turning. This paper therefore introduces a cane robot control method which constrains the behavior of user's upper body. By adjusting an admittance parameter of the robot according to the positions of a support leg, the robot resists to turn while a support leg is on the same side of the turning direction. A swing leg on the turning direction side therefore freely moves to the turning direction, while a swing leg on the opposite direction side of turning hardly move to the turning direction.

Some Spatial Aspects of Southeastern United States Climatology.

Science.gov (United States)

Soule, Peter T.

1998-01-01

Focuses on the climatology of an eight-state region in the southern and southeastern United States. Discusses general controls of climate and spatial patterns of various climatic averages. Examines mapped extremes as a means of fostering increased awareness of the variability that exists for climatic conditions in the region. (CMK)

The Economics Of Goat Production In Southeastern Nigeria ...

African Journals Online (AJOL)

The West African Dwarf goat is indigenous to Southeastern Nigeria and is raised by many families under small·scale and intensive management systems. Results showed that the average households kept 6 goats, but that expansion was limited by hour and feed procurement problems. Both males and females owned goats ...

[Fall risk assessment in regular exercising elderly women].

Science.gov (United States)

Kikuchi, Reiko; Kozaki, Koichi; Kawashima, Yumiko; Iwata, Akiko; Hasegawa, Hiroshi; Igata, Akihiro; Toba, Kenji

2008-09-01

Fall prevention is important for elderly people to maintain their functional independence. We made a longitudinal fall-risk assessment using our "Fall-predicting score" of women who are 60 years or older and who exercised regularly. We sent "fall-predicting questionnaires" to 632 elderly women aged 60 years or older (mean 65.0+/-4.3), members of "Miishima gymnastics program", and asked about their fall history of falling in the past year in 2004 and 2005. We performed a logistic regression analysis to determine the future risk factor of falling in 2005. The number of people who fell was 134 (21.2%) in 2004 and 121 (19.1%) in 2005. The number of people who fell decreased in the seventh decade, but increased in the eighth decade, and members for 6-10 years showed most decreased fall rates. Logistic regression analysis revealed that age, falls in 2004, "tripping", "cannot squeeze a towel", and "walk steep slope around the house" were significant independent risk factors of "falls in 2005". Logistic regression analysis of non-fallers in 2004 showed that age and "tripping" were the significant independent risk factors of "falls in 2005", and the analysis of people who fell in 2004 showed that age, "tripping", "cannot squeeze a towel", "walk steep slope around the house", and "taking more than 5 medicines" were significant independent risk factors for falls in 2005. In regular exercising elderly women, exercise appears to prevent falls in people in the seventh decade and in the members of 6-10 years. Age, past history of falls, and fall-predicting questionnaire were important risk predictors of future falls.

The Assessment Of Small Games On Fadama Land In Southeastern ...

African Journals Online (AJOL)

The Assessment Of Small Games On Fadama Land In Southeastern Nigeria And The Potential For Development. ... country can offer feasible operational strategy for sustainable wildlife species development. ... AJOL African Journals Online.

Impaired perceived timing of falls in the elderly.

Science.gov (United States)

Lupo, Julian; Barnett-Cowan, Michael

2018-01-01

Falls are the leading cause of injury-related deaths and hospitalizations, with older adults at an increased risk. As humans age, physical changes and health conditions make falls more likely. While we know how the body reflexively responds to prevent injury during a fall, we know little about how people perceive the fall itself. We previously found that young adults required a fall to precede a comparison sound stimulus by approximately 44ms to perceive the two events as simultaneous. This may relate to common anecdotal reports suggesting that humans often describe distortions in their perception of time - time seems to slow down during a fall - with very little recollection of how and when the fall began. Here we examine whether fall perception changes with age. Young (19-25y) and older (61-72y) healthy adults made temporal order judgments identifying whether the onset of their fall or the onset of a comparison sound came first to measure the point of subjective simultaneity. Results show that fall perception is nearly twice as slow for older adults, where perturbation onset has to precede sound onset by ∼88ms to appear coincident, compared to younger adults (∼44ms). We suggest that such age-related differences in fall perception may relate to increased fall rates in older adults. We conclude that a better understanding of how younger versus older adults perceive falls may identify important factors for innovative fall prevention strategies and rehabilitative training exercises to improve fall awareness. Copyright © 2017 Elsevier B.V. All rights reserved.

Radiation equivalence of genotoxic chemicals - Validation in cultered mammalian cell lines

International Nuclear Information System (INIS)

Murthy, M.S.S.

1982-01-01

Published data on mutations induced by ionizing radiation and 6 monofunctional alkylating agents, namely EMS, MMS, ENNG, MNNG, ENU and MNU, in different cell lines (Chinese hamster ovary, Chinese hamster lung V79, mouse lymphoma L5178 and human cells) were analysed so that radiation-equivalent chemical (REC) values could be calculated. REC values thus obtained for a given alkylating agent with different cell lines fall within a narrow range suggesting its validation in cultured mammalian cell systems including human. (orig.)

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

Directory of Open Access Journals (Sweden)

Elizabeth A Phelan

2016-09-01

Full Text Available A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ with a history of repeated falls or fall-related healthcare use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79±8 years; 68% were female, and 10% were non-white. They averaged 6 primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall risk factors varied from 24% (for home safety to 78% (for vitamin D. An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21% and home safety (24%. Use of a structured visit note template independently predicted assessment of fall risk factors (P=0.003. Geriatrics specialists were more likely to use a structured note template (p=.04 and perform more fall risk factor assessments (4.6 vs. 3.6, p=.007 than general internists. These results suggest opportunities for improving multifactorial fall risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

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

Falling into the Light-using music and poetry as complementary modes of understanding falls in old age

DEFF Research Database (Denmark)

Evron, Lotte; Clausen, Nina

that a broader understanding of falls in old age in the health care system might help health professionals to understand the complexity of falls and by this inspire older persons to prevent falls in different ways. Using poetry and music in our performance we seek to open up for a broader understanding of falls......: irresponsible behavior, disease, destiny, desire to remain independent in old age, appearing elegant/aesthetical and being physical active. One of the interviews was selected and transformed it into a poem (2-3). The poem was then translated into music by the second author. First we present the six...... understandings of falls in old age then we read the poem and finally a musical interpretation of the poem is performed by song and cello. The music is written for soprano and cello and created with direct inspiration from the poem. The fall is reproduced in a series of descending tones coming back as a "chorus...

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...

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...

Aquatic macroinvertebrate diversity and composition in streams along an altitudinal gradient in Southeastern Brazil

OpenAIRE

Henriques-Oliveira, Ana Lucia; Nessimian, Jorge Luiz

2010-01-01

Aquatic macroinvertebrate diversity and composition in streams along an altitudinal gradient in Southeastern Brazil. A study concerning taxonomic richness and composition of the aquatic insect fauna in streams within the same catchment basin along an altitudinal gradient in Southeast Brazil, was conducted to test the hypothesis that there is a faunal discontinuity in the biocenotic composition, related to differences in altitude and latitude. In Southeastern Brazil, around latitude 22°, this ...

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

Falls in Parkinson's disease and Huntington's disease

NARCIS (Netherlands)

Grimbergen, Yvette Anna Maria

2012-01-01

Falls in Parkinson’s (PD) and Huntington’s disease (HD) are common. 50 % of moderately affected PD patients sustained two or more falls during a prospective follow-up of 6 months. During a 3 month period 40 % of HD patients reported one or more fall. Many falls resulted in minor injuries and 42 % of

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

Science.gov (United States)

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

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

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...

[Vertigo and falls in the elderly: Part 2: Fall diagnostics, prophylaxis and therapy].

Science.gov (United States)

Walther, L E; Nikolaus, T; Schaaf, H; Hörmann, K

2008-09-01

In many acute or chronic vestibular diseases in old age, the risk of falling is increased. A fear of falling often develops together with further limitations to physical activity and subsequent physical and psychological consequences. Falls represent a substantial health-related risk factor. A regular balance, walking and muscle training is an effective prophylaxis. Components of the treatment of vestibular diseases in old age are counselling and encouragement (psychotherapy), treatment of the specific organic disease, specific vestibular rehabilitation and a symptomatic medication therapy. Vertigo in old age is a multifactorial process. The differential diagnosis of disorders of the equilibrium function in old age represents a challenge which can only be overcome by interdisciplinary cooperation.

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

Science.gov (United States)

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

2011-01-01

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

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.

Anxiety disorders and falls among older adults.

Science.gov (United States)

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

2016-11-15

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

Frequency and circumstances of falls in people with inclusion body myositis: a questionnaire survey to explore falls management and physiotherapy provision.

Science.gov (United States)

Hiscock, A; Dewar, L; Parton, M; Machado, P; Hanna, M; Ramdharry, G

2014-03-01

To survey the incidence and circumstances of falls for people with inclusion body myositis (IBM) in the UK, and to investigate the provision of physiotherapy and falls management. Postal questionnaire survey. Participants completed questionnaires at home. Ninety-four people diagnosed with IBM were screened against the inclusion criteria. Seventy-two potential participants were sent a questionnaire, and 62 were completed and returned. Invited participants were sent an adapted Falls Event Questionnaire pertaining to falls, perceived causes of falls and the provision of physiotherapy. Questionnaires were returned anonymously. The proportions of respondents who reported a fall or a near fall, along with the frequencies of falls and near falls were calculated. Descriptive data of falls were collected pertaining to location and cause. Data analysis was performed to investigate provision of physiotherapy services. The response rate was 86% [62/72, mean (standard deviation) age 68 (8) years]. Falls were reported by 98% (61/62) of respondents, with 60% (37/62) falling frequently. In this study, age was not found to be an indicator of falls risk or frequency. Twenty-one percent (13/62) of respondents had not seen a physiotherapist in relation to their IBM symptoms, and of those that had, 31% (15/49) had not seen a physiotherapist until more than 12 months after IBM was diagnosed. Only 18% (11/61) of fallers reported that they had received falls management input. Falls are a common occurrence for people with IBM, independent of age and years since symptoms first presented, and are poorly addressed by appropriate physiotherapy management. National falls guidelines are not being followed, and referral rates to physiotherapy need to improve. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

High temperature superconducting Josephson transmission lines for pulse and step sharpening

International Nuclear Information System (INIS)

Martens, J.S.; Wendt, J.R.; Hietala, V.M.; Ginley, D.S.; Ashby, C.I.H.; Plut, T.A.; Vawter, G.A.; Tigges, C.P.; Siegal, M.P.; Hou, S.Y.; Phillips, J.M.; Hohenwarter, G.K.G.

1992-01-01

An increasing number of high speed digital and other circuit applications require very narrow impulses or rapid pulse edge transitions. Shock wave transmission lines using series or shunt Josephson junctions are one way to generate these signals. Using two different high temperature superconducting Josephson junction processes (step-edge and electron beam defined nanobridges), such transmission lines have been constructed and tested at 77 K. Shock wave lines with approximately 60 YBaCuO nanobridges, have generated steps with fall times of about 10 ps. With step-edge junctions (with higher figures of merit but lower uniformity), step transition times have been reduced to an estimated 1 ps

Role of physical activity in the occurrence of falls and fall-related injuries in community-dwelling adults over 50 years old.

Science.gov (United States)

Pereira, Catarina L N; Baptista, Fátima; Infante, Paulo

2014-01-01

This study examined the effect of the type, level and amount of physical activity in falls and fall-related injuries. Participants were 506 community-dwelling adults aged >50 years (390 women: 67.7 ± 6.8 years and 116 men: 69.6 ± 6.6 years). Falls, fall-related injuries (slight and severe), and physical activity (type, level and energy expenditure) were evaluated by questionnaires. Confounders included co-morbidities, fear of falling, environmental hazards and physical fitness. After adjustment for confounders, logistic analysis revealed that the likelihood of falling decreased by 2% for each 100 metabolic expenditure (MET-min/week) of total physical activity and increased by 5% for each 100 MET-min/week of vigorous-intensity physical activity; total physical activity >1125 MET-min/week and vigorous physical activity physical activity level, increased physical activity levels diminished the likelihood of the occurrence of severe fall-related injuries by 76% (moderate) and 58% (high; p active, especially sufficiently active, reduces fall-related injuries by decreasing falls and by safeguarding against severe injuries when falls occur. At least 1125 MET-min/week of total physical activity including >500 MET-min/week of vigorous intensity seems to prevent falls and, therefore, fall-related injuries.

FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

OpenAIRE

Michaela Dingová; Eva Králová

2017-01-01

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

Reducing falls and improving mobility in multiple sclerosis.

Science.gov (United States)

Sosnoff, Jacob J; Sung, JongHun

2015-06-01

Falls are common in persons with multiple sclerosis (MS), and are related to physical injury and reduce the quality of life. Mobility impairments are a significant risk factor for falls in persons with MS. Although there is evidence that mobility in persons with MS can be improved with rehabilitation, much less is known about fall prevention. This review focuses on fall prevention in persons with MS. Ten fall prevention interventions consisting of 524 participants with a wide range of disability were systematically identified. Nine of the 10 investigations report a reduction in falls and/or proportion of fallers following treatment. The vast majority observed an improvement in balance that co-occurred with the reduction in falls. Methodological limitations preclude any firm conclusions. Numerous gaps in the understanding of fall prevention in persons with MS are discussed. Well-designed randomized control trials targeting mobility and falls are warranted.

Fall prevention in high-risk patients.

Science.gov (United States)

Shuey, Kathleen M; Balch, Christine

2014-12-01

In the oncology population, disease process and treatment factors place patients at risk for falls. Fall bundles provide a framework for developing comprehensive fall programs in oncology. Small sample size of interventional studies and focus on ambulatory and geriatric populations limit the applicability of results. Additional research is needed. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk of Falling in Older Women

OpenAIRE

Laura Armas; Joan Lappe; Veronica J. Slavik; Kellan Slattery; Shih-Chuan Cheng; Davender S. Malik; John N. Mordeson

2015-01-01

We propose a weighted average approach to measure the risk of falling in older women. We consider four causal variables of falling, namely serum 25-OHD levels, medication use, fracture, and age. We use five methods to derive linear equations with these four factors as independent variables in the linear equations with risk of falling as the dependent variable.

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.

Disease state fingerprint for fall risk assessment.

Science.gov (United States)

Similä, Heidi; Immonen, Milla

2014-01-01

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

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.

Circuit QED with hybrid metamaterial transmission lines

Energy Technology Data Exchange (ETDEWEB)

Ruloff, Stefan; Taketani, Bruno; Wilhelm, Frank [Theoretical Physics, Universitaet des Saarlandes, Saarbruecken (Germany)

2016-07-01

We're working on the theory of metamaterials providing some interesting results. The negative refraction index causes an opposite orientation of the wave vector k and the Poynting vector S of the travelling waves. Hence the metamaterial has a falling dispersion relation ∂ω(k)/∂k < 0 implying that low frequencies correspond to short wavelengths. Metamaterials are simulated by left-handed transmission lines consisting of discrete arrays of series capacitors and parallel inductors to ground. Unusual physics arises when right-and left-handed transmission lines are coupled forming a hybrid metamaterial transmission line. E.g. if a qubit is placed in front of a hybrid metamaterial transmission line terminated in an open circuit, the spontaneous emission rate is weakened or unaffected depending on the transition frequency of the qubit. Some other research interests are the general analysis of metamaterial cavities and the mode structure of hybrid metamaterial cavities for QND readout of multi-qubit operators. Especially the precise answer to the question about the definition of the mode volume of a metamaterial cavity is one of our primary goals.

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

Science.gov (United States)

2008-01-01

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

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.

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

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

Science.gov (United States)

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

2016-01-01

A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79 ± 8 years; 68% were female, and 10% were non-white. They averaged six primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall-risk factors varied from 24% (for home safety) to 78% (for vitamin D). An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21%) and home safety (24%). Use of a structured visit note template independently predicted assessment of fall-risk factors (p = 0.003). Geriatrics specialists were more likely to use a structured note template (p = 0.04) and perform more fall-risk factor assessments (4.6 vs. 3.6, p = 0.007) than general internists. These results suggest opportunities for improving multifactorial fall-risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice. PMID:27660753

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

Science.gov (United States)

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

2016-01-01

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

Incidence of in-hospital falls in geriatric patients before and after the introduction of an interdisciplinary team-based fall-prevention intervention.

Science.gov (United States)

von Renteln-Kruse, Wolfgang; Krause, Tom

2007-12-01

Falls are among the most common unwanted events in older hospital inpatients, but evidence of effective prevention is still limited compared with that in the community and in long-term care facilities. This article describes a prevention program and its effects on the incidence of falls in geriatric hospital wards. It was a prospective cohort study with historical control including all 4,272 patients (mean age 80, 69% female) before and 2,982 (mean age 81, 69% female) after introduction of the intervention. The intervention included fall-risk assessment on admission and reassessment after a fall; risk alert; additional supervision and assistance with the patients' transfer and use of the toilet; provision of an information leaflet; individual patient and caregiver counseling; encouragement of appropriate use of eyeglasses, hearing aids, footwear, and mobility devices; and staff education. Measurements included standardized fall-incidence reporting, activity of daily living and mobility status, number of falls and injurious falls, and number of patients who fell. Before the intervention was introduced, 893 falls were recorded. After the intervention was implemented, only 468 falls were recorded (incidence rate ratio (IRR)=0.82, 95% confidence interval (CI)=0.73-0.92), 240 versus 129 total injurious falls (IRR=0.84, 95% CI=0.67-1.04), 10 versus nine falls with fracture (IRR=1.40, 95% CI=0.51-3.85) and 611 versus 330 fallers. The relative risk of falling was significantly reduced (0.77, 95% CI=0.68-0.88). A structured multifactorial intervention reduced the incidence of falls, but not injurious falls, in a hospital ward setting with existing geriatric multidisciplinary care. Improvement of functional competence and mobility may be relevant to fall prevention in older hospital inpatients.