WorldWideScience

Sample records for susceptibility reduction fall

  1. Aircraft Survivability. Susceptibility Reduction. Fall 2010

    Science.gov (United States)

    2010-01-01

    the angle and velocity of impact based on wind tunnel testing and ModSim. Test results will provide better insight into the consequences of a...http://www.ndia.org/meetings/1910/Pages/ default.aspx JASP Spring PMSG 29–31 March 2011 TBD

  2. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Teresa S. Radebaugh

    2011-01-01

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

  5. 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)

  6. Falls in Scottish homicide: lessons for homicide reduction in mental health patients

    Science.gov (United States)

    Crichton, John H. M.

    2017-01-01

    The sustained fall in Scottish homicide rates follows crime reduction measures informed by the epidemiology of suicide. The violence reduction unit targeted young men carrying knives in public. The restriction of weapons immediately to hand appears to have caused an absolute fall in homicide just as suicide reduction was observed following changes to domestic gas supply. Further homicide reduction may be accomplished in the domestic setting with targeted changes in kitchen knife design in home safety planning for high-risk households. Most commonly homicides involving those in recent contact with mental health services in the UK have domestic characteristics and similar safety planning may be targeted at those with mental disorder and a history of violence. PMID:28811910

  7. The rise and fall of tourism for poverty reduction within SNV Netherlands Development Organisation

    NARCIS (Netherlands)

    Hummel, J.A.

    2015-01-01

    Although development organizations have been involved in tourism for poverty reduction for more than 30 years, their role remains contested. In my study, I examined the rise and fall of tourism within SNV Netherlands Development Organisation in the period 1993–2013. Here, I show how and why

  8. Fall

    OpenAIRE

    Odundo, Magdalene

    2008-01-01

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

  9. Physical exercises and risk of fall reduction in elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Diogo Homann

    2010-09-01

    Full Text Available Falls are associated with morbidity and mortality in older adults. The aim of this systematic review was to identify, describe and analyze the effects of physical exercise programs on the reduction of the risk of falls in adults above the age of 60. For this purpose, the Medline/Pubmed, Lilacs, and SciELO databases available at the site of the Latin American Center of Information in Health Sciences (BIREME were searched for articles comprising the period between 1999 and 2009 using the following keywords: accidental falls, elderly, exercise. A total of 385 publications were identified and 10 articles that met the criteria established in this study were selected. Strength and balance activities were the most frequent components of the exercise programs, in addition to coordination, flexibility and aerobic exercise. However, there was no clear information regarding the frequency, duration and intensity of the sessions. It was concluded that programs combining strength and balance components with other interventions, performed at least twice a week, and monitoring the participants for 3 to 6 months after intervention were the most effective in reducing and preventing falls in older adults. However, a more detailed presentation of some methodological aspects is necessary to permit the reproduction of these studies and the comparison of their results.

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

    Science.gov (United States)

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

    2017-02-01

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

  11. A standing posture is associated with increased susceptibility to the sound-induced flash illusion in fall-prone older adults.

    Science.gov (United States)

    Stapleton, John; Setti, Annalisa; Doheny, Emer P; Kenny, Rose Anne; Newell, Fiona N

    2014-02-01

    Recent research has provided evidence suggesting a link between inefficient processing of multisensory information and incidence of falling in older adults. Specifically, Setti et al. (Exp Brain Res 209:375-384, 2011) reported that older adults with a history of falling were more susceptible than their healthy, age-matched counterparts to the sound-induced flash illusion. Here, we investigated whether balance control in fall-prone older adults was directly associated with multisensory integration by testing susceptibility to the illusion under two postural conditions: sitting and standing. Whilst standing, fall-prone older adults had a greater body sway than the age-matched healthy older adults and their body sway increased when presented with the audio-visual illusory but not the audio-visual congruent conditions. We also found an increase in susceptibility to the sound-induced flash illusion during standing relative to sitting for fall-prone older adults only. Importantly, no performance differences were found across groups in either the unisensory or non-illusory multisensory conditions across the two postures. These results suggest an important link between multisensory integration and balance control in older adults and have important implications for understanding why some older adults are prone to falling.

  12. The roles of exercise and fall risk reduction in the prevention of osteoporosis.

    Science.gov (United States)

    Henderson, N K; White, C P; Eisman, J A

    1998-06-01

    In summary, the optimal model for the prevention of osteoporotic fractures includes maximization and maintenance of bone strength and minimization of trauma. Numerous determinants of each have been identified, but further work to develop preventative strategies based on these determinants remains to be undertaken. Physical activity is a determinant of peak BMD. There also is evidence that activity during growth modulates the external geometry and trabecular architecture, potentially enhancing skeletal strength, while during the adult years activity may reduce age-related bone loss. The magnitude of the effect of a 7% to 8% increase in peak BMD, if maintained through the adult years, could translate to a 1.5-fold reduction in fracture risk. Moreover, in the older population, appropriate forms of exercise could reduce the risk of falling and, thus, further reduce fracture risk. These data must be considered as preliminary in view of the paucity of long-term fracture outcome data from randomized clinical trials. However, current information suggests that the optimal form of exercise to achieve these objectives may vary through life. Vigorous physical activity (including weight-bearing, resistance, and impact components) during childhood may maximize peak BMD. This type of activity seems optimal through the young adult years, but as inevitable age-related degeneration occurs, activity modification to limit the impact component of exercise may become necessary. In the elderly, progressive strength training has been demonstrated to be a safe and effective form of exercise that reduces risk factors for falling and may also enhance BMD. In the frail elderly, activity to improve balance and confidence also may be valuable. Group activities such as Tai Chi may be cost-effective. Precise prescriptions must await the outcome of well-designed, controlled longitudinal studies that include fracture as an outcome. However, increased physical activity seems to be a sensible

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

    Science.gov (United States)

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

    2017-10-17

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

  14. Deconstructing anti-harm-reduction metaphors; mortality risk from falls and other traumatic injuries compared to smokeless tobacco use

    Directory of Open Access Journals (Sweden)

    Bergen Paul

    2006-04-01

    Full Text Available Abstract Anti-harm-reduction advocates sometimes resort to pseudo-analogies to ridicule harm reduction. Those opposed to the use of smokeless tobacco as an alternative to smoking sometimes suggest that the substitution would be like jumping from a 3 story building rather than 10 story, or like shooting yourself in the foot rather than the head. These metaphors are grossly inappropriate for several reasons, notably including the fact that they are misleading about the actual risk levels. Based on the available literature on mortality from falls, we estimate that smoking presents a mortality risk similar to a fall of about 4 stories, while mortality risk from smokeless tobacco is no worse than that from an almost certainly non-fatal fall from less than 2 stories. Other metaphors are similarly misleading. These metaphors, like other false and misleading anti-harm-reduction statements are inherently unethical attempts to prevent people from learning accurate health information. Moreover, they implicitly provide bad advice about health behavior priorities and are intended to persuade people to stick with a behavior that is more dangerous than an available alternative. Finally, the metaphors exhibit a flippant tone that seems inappropriate for a serious discussion of health science.

  15. Balance improvement and reduction of likelihood of falls in older women after Cawthorne and Cooksey exercises.

    Science.gov (United States)

    Ribeiro, Angela dos Santos Bersot; Pereira, João Santos

    2005-01-01

    Vestibular system is the absolute referential for the maintenance of balance. Functional deficit with aging can result in balance disturbance and in increase of likelihood of falls. To verify whether specific therapeutic approach of the system can promote motor learning and can contribute to the improvement of balance and to decrease of likelihood of falls. Clinical prospective. Fifteen women, aged 60 to 69, mean = 64.8 years old (+/- 2.95), resident in Barra Mansa-RJ, were submitted to Cawthorne and Cooksey exercises during three months, three times a week, during sixty minutes. They were evaluated with Berg Balance Scale (BBS), whose scores determine the possibility of fall (PQ). Comparing the data obtained before and after intervention, we observed significant difference (pelderly people.

  16. Multiple paths towards reduced membrane potential and concomitant reduction in aminoglycoside susceptibility in staphylococcus aureus

    DEFF Research Database (Denmark)

    Vestergaard, Martin; Nøhr-Meldgaard, Katrine; Ingmer, Hanne

    2018-01-01

    susceptibility to gentamicin. 9 mutants were confirmed by E-test to display between 2 and 16-fold reduced susceptibility to this antibiotic. All of the identified genes were associated with the electron transport chain and energy metabolism. Four mutant strains (menD, hemB, aroC and SAUSA300_0355) conferred...

  17. Variations in Endosymbiont Infection Between Buprofezin-Resistant and Susceptible Strains of Laodelphax striatellus (Fallén).

    Science.gov (United States)

    Li, Yongteng; Liu, Xiangdong; Guo, Huifang

    2018-06-01

    The endosymbionts Wolbachia and Rickettsia have been shown to be correlated with the insecticide resistance of mosquito and whitefly. The small brown planthopper (SBPH), Laodelphax striatellus, harbours many species of endosymbionts, and has developed a high resistance to buprofezin in China. In this study, we examined the species and the infection incidences of endosymbionts in a buprofezin-resistant (BR) strain, a buprofezin-susceptible (BS) strain, and the BR strain after exposure to buprofezin, and we also investigated the change in buprofezin susceptibility after removal of Wolbachia from the BR strain. The results showed that Wolbachia infection incidences were 100% in both the BR and BS strains, but the Wolbachia density in the BR strain was significantly higher than that in the BS strain. There were no significant differences in Arsenophonus infection incidence between the two strains. However, the infection incidence of Serratia and double infection incidence of Serratia + Wolbachia in the BR strain were significantly higher than that in the BS strain. After the BR strain was exposed to 1200 mg/L buprofezin, the infection incidence of Arsenophonus in the surviving individuals increased, and the infection rate of Serratia did not differ, but the double infection incidence of Serratia + Wolbachia decreased. And when a Wolbachia-infected line originating from the BR strain was cleared of Wolbachia, its susceptibility to buprofezin increased. The results suggest that Serratia and Wolbachia infection might improve the buprofezin resistance of SBPH.

  18. Reduction of diuretics and analysis of water and muscle volumes to prevent falls and fall-related fractures in older adults.

    Science.gov (United States)

    Okada, Kosuke; Okada, Masahiro; Kamada, Nanao; Yamaguchi, Yumiko; Kakehashi, Masayuki; Sasaki, Hidemi; Katoh, Shigeko; Morita, Katsuya

    2017-02-01

    In an attempt to decrease the incidence of falls and fall-related fractures at a special geriatric nursing home, we endeavored to reduce diuretic doses, and examined the relationship between the effectiveness of this approach with the body compositions and activities of daily living of the study cohort. We enrolled 93 participants living in the community, 60 residents of an intermediate geriatric nursing home and 50 residents of the 100-bed Kandayama Yasuragien special geriatric nursing home. We recorded body composition using a multifrequency bioelectrical impedance analyzer. Daily loop diuretic and other diuretic regimens of those in the special geriatric nursing home were reduced or replaced with "NY-mode" diuretic therapy, namely, spironolactone 12.5 mg orally once on alternate days. The incidence of falls fell from 53 in 2011 to 29 in 2012, and there were no fall-related proximal femoral fractures for 3 years after the introduction of NY-mode diuretic therapy. We also found statistically significant differences in muscle and intracellular water volumes in our elderly participants: those with higher care requirements or lower levels of independence had lower muscle or water volumes. We found that reducing or replacing daily diuretics with NY-mode therapy appeared to reduce the incidence of falls and fall-related proximal femoral fracture, likely by preserving intracellular and extracellular body water volumes. Low-dose spironolactone (12.5 mg on alternate days) appears to be an effective means of treating elderly individuals with chronic heart failure or other edematous states, while preventing falls and fall-related fractures. Geriatr Gerontol Int 2017; 17: 262-269. © 2016 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

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

    Science.gov (United States)

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

    2017-07-17

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

  20. Reduction in soil loss from erosion-susceptible soils amended with humic substances from oxidized coal

    International Nuclear Information System (INIS)

    Piccolo, A.; Pietramellara, G.; Mbagwu, J.S.C.

    1997-01-01

    Soils that pose high risk of erosion require amendment with either natural or synthetic soil conditioners to reduce soil loss hazards. The objective of this study was to evaluate the potential of using coal-derived humic substances (as soil conditioners) to reduce runoff erosion on erosion-susceptible soils. Surface samples of severely degraded soils from Principina in Tuscany and Bovolone in Venice in Italy were used to assess the effects of five rates (0, 0.05, 0.01, 0.50 and 1.00 g/kg) of humic acids (HA) on soil loss and other hydrological parameters. The results showed that amending erosion-susceptible soils with low rates of coal-derived humic substances is a potentially effective soil management practice for reducing erosion rates

  1. Susceptibility of field populations of the fall armyworm (Lepidoptera: Noctuidae) from Florida and Puerto Rico to purified Cry1F protein and corn leaf tissue containing single and pyramided Bt genes

    Science.gov (United States)

    Larval survival of Cry1F-susceptible (FL), -resistant (PR and Cry1F-RR), and -heterozygous (FL x PR and Cry1F-RS) populations of the fall armyworm, Spodoptera frugiperda (J.E. Smith) to purified Cry1F protein and corn leaf tissue of seven Bacillus thuringiensis (Bt) corn hybrids and five non-Bt corn...

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

    Science.gov (United States)

    Karnes, Michele J.

    2011-01-01

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

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

    Science.gov (United States)

    Stivala, Adam; Hartley, Greg

    2014-01-01

    Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.

  4. Artifact Reduction of Susceptibility-Weighted Imaging Using a Short-Echo Phase Mask

    International Nuclear Information System (INIS)

    Ishimori, Y.; Monma, M.; Kohno, Y.

    2009-01-01

    Background: Susceptibility-weighted imaging (SWI) is utilized in magnetic resonance (MR) venography and other applications, but can include artifacts caused by the phase-masking process. Purpose: To demonstrate risks of filter processes used in making phase masks for SWI, and to propose a simple method for reducing artifacts. Material and Methods: Phase linearity related to echo time (TE) was evaluated for the original phase and high-pass-filtered phase using a CuSO 4 -doped water phantom. Effect of filter size of the Hanning window and background homogeneity were also evaluated in a phantom study. Use of a phase mask generated by data with differing magnitudes of TE was attempted in a human study. Shorter TE was used for making the phase mask, and the number of multiplications was increased. As short and long TEs were necessary simultaneously for phase mask and T2* contrast, a dual-echo technique was used. Results: Linearity of TE and phase value collapsed, and an unexpected negative phase appeared in the high-pass-filtered phase. Using a short-TE phase mask, phase-aliasing artifacts were reduced and visibility of deep veins was equivalent to that under conventional methods with an increased number of multiplications. Conclusion: Use of a short-echo phase mask in SWI is useful for reducing artifacts

  5. Artifact Reduction of Susceptibility-Weighted Imaging Using a Short-Echo Phase Mask

    Energy Technology Data Exchange (ETDEWEB)

    Ishimori, Y.; Monma, M. (Dept. of Radiological Sciences, Ibaraki Prefectural Univ. of Health Sciences, Inashiki-gun, Ibaraki (Japan)); Kohno, Y. (Dept. of Neurology, Ibaraki Prefectural Univ. of Health Sciences, Inashiki-gun, Ibaraki (Japan))

    2009-11-15

    Background: Susceptibility-weighted imaging (SWI) is utilized in magnetic resonance (MR) venography and other applications, but can include artifacts caused by the phase-masking process. Purpose: To demonstrate risks of filter processes used in making phase masks for SWI, and to propose a simple method for reducing artifacts. Material and Methods: Phase linearity related to echo time (TE) was evaluated for the original phase and high-pass-filtered phase using a CuSO{sub 4}-doped water phantom. Effect of filter size of the Hanning window and background homogeneity were also evaluated in a phantom study. Use of a phase mask generated by data with differing magnitudes of TE was attempted in a human study. Shorter TE was used for making the phase mask, and the number of multiplications was increased. As short and long TEs were necessary simultaneously for phase mask and T2 contrast, a dual-echo technique was used. Results: Linearity of TE and phase value collapsed, and an unexpected negative phase appeared in the high-pass-filtered phase. Using a short-TE phase mask, phase-aliasing artifacts were reduced and visibility of deep veins was equivalent to that under conventional methods with an increased number of multiplications. Conclusion: Use of a short-echo phase mask in SWI is useful for reducing artifacts

  6. Association of the weekly practice of guided physical activity with the reduction of falls and symptoms of fibromyalgia in adult women.

    Science.gov (United States)

    Martínez-Amat, Antonio; Hita-Contreras, Fidel; Latorre-Román, Pedro A; Gutierrez-López, María de la Cabeza; García-Pinillos, Felipe; Martínez-López, Emilio J

    2014-11-01

    The purpose of this study was to evaluate the effects of weekly physical activity on the risk of falls and the impact of fibromyalgia (FM) symptoms on daily function in Spanish women. Fibromyalgia is a common widespread pain condition that has been linked to an increased risk of falling and a low amount of guided physical activity, defined as regular participation in moderate-intensity exercise. Before the development of fall-risk reduction interventions, it is essential to understand the context of falls and fall-related experiences in patients with FM. Ours was a descriptive longitudinal study, wherein 140 women participated, all aged 28-73 years and belonging to AFIXA (Asociación Provincial de Fibromialgia y Síndrome de Fatiga Crónica), the Fibromyalgia Association of Jaén (Andalusia, Spain). The study took place during 2013; data were collected through fall diaries, interviews, and questionnaires. Results showed that weekly physical activity can explain up to 12% of the variance in the fear of falling and 18% of the number of falls per year in patients with FM. However, the weekly physical activity prediction against the perceived impact of FM yielded R values below 10% in the 3 factors and in the total score of the Revised Fibromyalgia Impact Questionnaire (FIQ-R). Inactive women were proven to have a significantly higher number of falls per year than active ones (1.86 ± 1.46 vs. 0.69 ± 0.43, p 0.05). In addition, physically active women had a significantly lower intensity in the symptoms of their condition (FIQ-R symptoms: 30.87 ± 8.58 vs. 34.78 ± 7.58 arbitrary units [a.u.], p = 0.014), and lower scores in the total score of the FIQ-R (54.33 ± 21.50 vs. 65.19 ± 19.27 a.u., p = 0.004). Results show that, with at least 1 hour per session of guided physical activity, a higher weekly number of sessions reduced the fear of falling in patients with FM and the total number of falls per year, and is associated with less severe symptoms (FIQ-R3).

  7. Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial.

    Science.gov (United States)

    Sosnoff, Jacob J; Moon, Yaejin; Wajda, Douglas A; Finlayson, Marcia L; McAuley, Edward; Peterson, Elizabeth W; Morrison, Steve; Motl, Robert W

    2015-10-01

    To determine the feasibility of three fall prevention programs delivered over 12 weeks among individuals with multiple sclerosis: (A) a home-based exercise program targeting physiological risk factors; (B) an educational program targeting behavioral risk factors; and (C) a combined exercise-and-education program targeting both factors. Randomized controlled trial. Home-based training with assessments at research laboratory. A total of 103 individuals inquired about the investigation. After screening, 37 individuals with multiple sclerosis who had fallen in the last year and ranged in age from 45-75 years volunteered for the investigation. A total of 34 participants completed postassessment following the 12-week intervention. Participants were randomly assigned into one of four conditions: (1) wait-list control (n = 9); (2) home-based exercise (n = 11); (3) education (n = 9); or (4) a combined exercise and education (n = 8) group. Before and after the 12-week interventions, participants underwent a fall risk assessment as determined by the physiological profile assessment and provided information on their fall prevention behaviors as indexed by the Falls Prevention Strategy Survey. Participants completed falls diaries during the three-months postintervention. A total of 34 participants completed postintervention testing. Procedures and processes were found to be feasible. Overall, fall risk scores were lower in the exercise groups (1.15 SD 1.31) compared with the non-exercise groups (2.04 SD 1.04) following the intervention (p fall prevention behaviors (p > 0.05). Further examination of home-based exercise/education programs for reducing falls in individuals with multiple sclerosis is warranted. A total of 108 participants would be needed in a larger randomized controlled trial.ClinicalTrials.org #NCT01956227. © The Author(s) 2014.

  8. Occupational trichloroethylene exposure and renal carcinoma risk: evidence of genetic susceptibility by reductive metabolism gene variants

    Science.gov (United States)

    Moore, Lee E.; Boffetta, Paolo; Karami, Sara; Brennan, Paul; Stewart, Patricia S; Hung, Rayjean; Zaridze, David; Matveev, Vsevolod; Janout, Vladimir; Kollarova, Helena; Bencko, Vladimir; Navratilova, Marie; Szeszenia-Dabrowska, Neonila; Mates, Dana; Gromiec, Jan; Holcatova, Ivana; Merino, Maria; Chanock, Stephen; Chow, Wong-Ho; Rothman, Nathaniel

    2010-01-01

    Trichloroethylene (TCE) is a suspected renal carcinogen. TCE-associated renal genotoxicity occurs predominantly through glutathione S-transferase (GST) conjugation and bioactivation by renal cysteine beta-lyase (CCBL1). We conducted a case-control study in Central Europe (1,097 cases/1,476 controls), specifically designed to assess risk associated with occupational exposure to TCE through analysis of detailed job histories. All jobs were coded for organic/chlorinated solvent and TCE exposure (ever/never) as well as the frequency and intensity of exposure based on detailed occupational questionnaires, specialized questionnaires, and expert assessments. Increased risk was observed among subjects ever TCE-exposed (OR=1.63, 95% CI: 1.04–2.54). Exposure-response trends were observed among subjects above and below the median exposure [average intensity (OR=1.38, 95% CI:0.81–2.35; OR=2.34, 95% CI:1.05–5.21, p-trend=0.02)]. A significant association was found among TCE-exposed subjects with at least one intact GSTT1 allele (active genotype) (OR=1.88, 95% CI:1.06–3.33) but not among subjects with two deleted alleles (null genotype) (OR=0.93, 95% CI:0.35–2.44, p-interaction=0.18). Similar associations for all exposure metrics including average intensity were observed among GSTT1 active subjects (OR=1.56, 95% CI:0.79–3.10; OR=2.77, 95% CI:1.01–7.58, p-trend=0.02) but not among GSTT1 nulls (OR=0.81, 95% CI:0.24–2.72; OR=1.16, 95% CI:0.27–5.04, p-trend=1.00, p-interaction=0.34). Further evidence of heterogeneity was seen among TCE-exposed subjects with ≥1 minor allele of several CCBL1 tagging SNPs: [rs2293968, rs2280841, rs2259043, rs941960]. These findings provide the strongest evidence to date that TCE exposure is associated with increased renal cancer risk, particularly among individuals carrying polymorphisms in genes that are important in the reductive metabolism of this chemical, and provides biological plausibility of the association in humans. PMID

  9. Pulmonary Rehabilitation With Balance Training for Fall Reduction in Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    Beauchamp, Marla K; Brooks, Dina; Ellerton, Cindy; Lee, Annemarie; Alison, Jennifer; Camp, Pat G; Dechman, Gail; Haines, Kimberley; Harrison, Samantha L; Holland, Anne E; Marques, Alda; Moineddin, Rahim; Skinner, Elizabeth H; Spencer, Lissa; Stickland, Michael K; Xie, Feng; Goldstein, Roger S

    2017-11-20

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. A growing body of evidence shows that individuals with COPD have important deficits in balance control that may be associated with an increased risk of falls. Pulmonary rehabilitation (PR) is a key therapeutic intervention for individuals with COPD; however, current international guidelines do not include balance training and fall prevention strategies. The primary aim of this trial is to determine the effects of PR with balance training compared to PR with no balance training on the 12-month rate of falls in individuals with COPD. Secondary aims are to determine the effects of the intervention on balance, balance confidence, and functional lower body strength, and to estimate the cost-effectiveness of the program. A total of 400 individuals from nine PR centers across Canada, Europe, and Australia will be recruited to participate in a randomized controlled trial. Individuals with COPD who have a self-reported decline in balance, a fall in the last 2 years, or recent near fall will be randomly assigned to an intervention or control group. The intervention group will undergo tailored balance training in addition to PR and will receive a personalized home-based balance program. The control group will receive usual PR and a home program that does not include balance training. All participants will receive monthly phone calls to provide support and collect health care utilization and loss of productivity data. Both groups will receive home visits at 3, 6, and 9 months to ensure proper technique and progression of home exercise programs. The primary outcome will be incidence of falls at 12-month follow-up. Falls will be measured using a standardized definition and recorded using monthly self-report fall diary calendars. Participants will be asked to record falls and time spent performing their home exercise program on the fall diary calendars. Completed calendars will

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

    Science.gov (United States)

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

    2016-01-01

    evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention.

  11. Physical exercises and risk of fall reduction in elderly: a systematic review doi: 10.5007/1980-0037.2010v12n6p471

    Directory of Open Access Journals (Sweden)

    Paulo Cesar Barauce Bento

    2010-09-01

    Full Text Available Falls are associated with morbidity and mortality in older adults. The aim of this systematic review was to identify, describe and analyze the effects of physical exercise programs on the reduction of the risk of falls in adults above the age of 60. For this purpose, the Medline/Pubmed, Lilacs, and SciELO databases available at the site of the Latin American Center of Information in Health Sciences (BIREME were searched for articles comprising the period between 1999 and 2009 using the following keywords: accidental falls, elderly, exercise. A total of 385 publications were identified and 10 articles that met the criteria established in this study were selected. Strength and balance activities were the most frequent components of the exercise programs, in addition to coordination, flexibility and aerobic exercise. However, there was no clear information regarding the frequency, duration and intensity of the sessions. It was concluded that programs combining strength and balance components with other interventions, performed at least twice a week, and monitoring the participants for 3 to 6 months after intervention were the most effective in reducing and preventing falls in older adults. However, a more detailed presentation of some methodological aspects is necessary to permit the reproduction of these studies and the comparison of their results.

  12. 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....

  13. Susceptibility of Anthonomus grandis (cotton boll weevil) and Spodoptera frugiperda (fall armyworm) to a cry1ia-type toxin from a Brazilian Bacillus thuringiensis strain.

    Science.gov (United States)

    Grossi-de-Sa, Maria Fatima; Quezado de Magalhaes, Mariana; Silva, Marilia Santos; Silva, Shirley Margareth Buffon; Dias, Simoni Campos; Nakasu, Erich Yukio Tempel; Brunetta, Patricia Sanglard Felipe; Oliveira, Gustavo Ramos; Neto, Osmundo Brilhante de Oliveira; Sampaio de Oliveira, Raquel; Soares, Luis Henrique Barros; Ayub, Marco Antonio Zachia; Siqueira, Herbert Alvaro Abreu; Figueira, Edson L Z

    2007-09-30

    Different isolates of the soil bacterium Bacillus thuringiensis produce multiple crystal (Cry) proteins toxic to a variety of insects, nematodes and protozoans. These insecticidal Cry toxins are known to be active against specific insect orders, being harmless to mammals, birds, amphibians, and reptiles. Due to these characteristics, genes encoding several Cry toxins have been engineered in order to be expressed by a variety of crop plants to control insectpests. The cotton boll weevil, Anthonomus grandis, and the fall armyworm, Spodoptera frugiperda, are the major economically devastating pests of cotton crop in Brazil, causing severe losses, mainly due to their endophytic habit, which results in damages to the cotton boll and floral bud structures. A cry1Ia-type gene, designated cry1Ia12, was isolated and cloned from the Bt S811 strain. Nucleotide sequencing of the cry1Ia12 gene revealed an open reading frame of 2160 bp, encoding a protein of 719 amino acid residues in length, with a predicted molecular mass of 81 kDa. The amino acid sequence of Cry1Ia12 is 99% identical to the known Cry1Ia proteins and differs from them only in one or two amino acid residues positioned along the three domains involved in the insecticidal activity of the toxin. The recombinant Cry1Ia12 protein, corresponding to the cry1Ia12 gene expressed in Escherichia coli cells, showed moderate toxicity towards first instar larvae of both cotton boll weevil and fall armyworm. The highest concentration of the recombinant Cry1Ia12 tested to achieve the maximum toxicities against cotton boll weevil larvae and fall armyworm larvae were 230 microg/mL and 5 microg/mL, respectively. The herein demonstrated insecticidal activity of the recombinant Cry1Ia12 toxin against cotton boll weevil and fall armyworm larvae opens promising perspectives for the genetic engineering of cotton crop resistant to both these devastating pests in Brazil.

  14. SU-E-I-62: Reduction of Susceptibility Artifacts by Increasing the Bandwidth (BW) and Echo Train Length (ETL)

    International Nuclear Information System (INIS)

    Mavroidis, P; Boci, N; Kostopoulos, S; Ninos, C; Glotsos, D; Oikonomou, G; Bakas, A; Roka, V; Cavouras, D; Lavdas, E; Sakkas, G; Tsagkalis, A; Chatzivasileiou, V; Batsikas, G; Papanikolaou, N; Stathakis, S

    2015-01-01

    Purpose: The aim of this present study is to increase bandwidth (BW) and echo train length (ETL) in Proton Density Turbo Spin Echo (PD TSE) sequences with and without fat saturation (FS) as well as in Turbo Inversion Recovery Magnitude sequences (TIRM) in order to assess whether these sequences are capable of reducing susceptibility artifacts. Methods: We compared 1) TIRM coronal (COR) with the same sequence with increased both BW and ETL 2) Conventional PD TSE sagittal (SAG) with FS with an increased BW 3) Conventional PD TSE SAG without FS with an increased BW 4) Conventional PD TSE SAG without FS with increased both BW and ETL. A quantitative analysis was performed to measure the extent of the susceptibility artifacts. Furthermore, a qualitative analysis was performed by two radiologists in order to evaluate the susceptibility artifacts, image distortion and fat suppression. The depiction of cartilage, menisci, muscles, tendons and bone marrow were also qualitatively analyzed. Results: The quantitative analysis found that the modified TIRM sequence is significantly superior to the conventional one regarding the extent of the susceptibility artifacts. In the qualitative analysis, the modified TIRM sequence was superior to the corresponding conventional one in eight characteristics out of ten that were analyzed. The modified PD TSE with FS was superior to the corresponding conventional one regarding the susceptibility artifacts, image distortion and depiction of bone marrow and cartilage while achieving effective fat saturation. The modified PD TSE sequence without FS with a high (H) BW was found to be superior corresponding to the conventional one in the case of cartilage. Conclusion: Consequently, TIRM sequence with an increased BW and ETL is proposed for producing images of high quality and modified PD TSE with H BW for smaller metals, especially when FS is used

  15. Falling chains

    OpenAIRE

    Wong, Chun Wa; Yasui, Kosuke

    2005-01-01

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

  16. Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women

    Science.gov (United States)

    Both testosterone and vitamin D levels affect muscle and thus may also affect risk of falling. The aim of this study was to investigate the association between sex hormone levels and the risk of falling in older men and women. 199 men and 246 women age 65 or older living at home followed for 3 years...

  17. Home-based exercise program and fall-risk reduction in older adults with multiple sclerosis: phase 1 randomized controlled trial.

    Science.gov (United States)

    Sosnoff, Jacob J; Finlayson, Marcia; McAuley, Edward; Morrison, Steve; Motl, Robert W

    2014-03-01

    To determine the feasibility, safety, and efficacy of a home-based exercise intervention targeting fall risk in older adults with multiple sclerosis. A randomized controlled pilot trial. A home-based exercise program. Participants were randomly allocated to either a home-based exercise intervention group (n = 13) or a waiting list control group (n = 14). The exercise group completed exercises targeting lower muscle strength and balance three times a week for 12 weeks. The control group continued normal activity. Fall risk (Physiological Profile Assessment scores), balance (Berg Balance Scale), and walking testing prior to and immediately following the 12-week intervention. Each outcome measure was placed in an analysis of covariance with group as the between-subject factor and baseline values as the covariate. Effect sizes were calculated. Twelve participants from the control group and ten from the exercise group completed the study. There were no related adverse events. Fall risk was found to decrease in the exercise group following the intervention (1.1 SD 1.0 vs. 0.6 SD 0.6) while there was an increase in fall risk in the control group (1.9 SD 1.5 vs. 2.2 SD 1.9). Effect sizes for most outcomes were large (η(2) > 0.15). Home-based exercise was found to be feasible, safe, and effective for reducing physiological fall risk in older adults with multiple sclerosis. Our findings support the implementation of a larger trial to reduce fall risk in persons with multiple sclerosis.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Fall 1993

    OpenAIRE

    Lave, Charles; Scott, Allen J.; Deluchi, Mark; Swan, David; Jacobs, Allan B.; Taylor, Brian D.

    1993-01-01

    Despite huge reductions of noxious emissions from factories and cars, Southern California's air is still terrible. It's so bad that the state is requiring that two percent of new cars sold in 1998 be zero polluters and ten percent by 2003. Many researchers here have become preoccupied with teh foul air, and so are searching for ways of making cars less obnoxious and hence better servants. 

  4. Susceptibility Testing

    Science.gov (United States)

    ... Marker Bicarbonate (Total CO2) Bilirubin Blood Culture Blood Gases Blood Ketones Blood Smear Blood Typing Blood Urea ... hours depending on the method used. There are commercial tests available that offer rapid susceptibility testing and ...

  5. Towards better fall prevention : Examining the interplay between factors that influence gait in older patients

    NARCIS (Netherlands)

    De Groot, Maartje H.

    2017-01-01

    Falling is a serious problem among older patients: it is the combination of a high fall incidence together with a high susceptibility to injuries that makes a relatively mild fall potentially dangerous to these old persons. Falling is a multifactorial problem, but postural instability during daily

  6. 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.

  7. Susceptibility of murine norovirus and hepatitis A virus to electron beam irradiation in oysters and quantifying the reduction in potential infection risks.

    Science.gov (United States)

    Praveen, Chandni; Dancho, Brooke A; Kingsley, David H; Calci, Kevin R; Meade, Gloria K; Mena, Kristina D; Pillai, Suresh D

    2013-06-01

    Consumption of raw oysters is an exposure route for human norovirus (NoV) and hepatitis A virus (HAV). Therefore, efficient postharvest oyster treatment technology is needed to reduce public health risks. This study evaluated the inactivation of HAV and the NoV research surrogate, murine norovirus-1 (MNV-1), in oysters (Crassostrea virginica) by electron beam (E-beam) irradiation. The reduction of potential infection risks was quantified for E-beam irradiation technology employed on raw oysters at various virus contamination levels. The E-beam dose required to reduce the MNV and HAV titer by 90% (D(10) value) in whole oysters was 4.05 (standard deviations [SD], ±0.63) and 4.83 (SD, ±0.08) kGy, respectively. Microbial risk assessment suggests that if a typical serving of 12 raw oysters was contaminated with 10(5) PFU, a 5-kGy treatment would achieve a 12% reduction (from 4.49 out of 10 persons to 3.95 out of 10 persons) in NoV infection and a 16% reduction (from 9.21 out of 10 persons to 7.76 out of 10 persons) in HAV infections. If the serving size contained only 10(2) PFU of viruses, a 5-kGy treatment would achieve a 26% reduction (2.74 out of 10 persons to 2.03 out of 10 persons) of NoV and 91% reduction (2.1 out of 10 persons to 1.93 out of 100 persons) of HAV infection risks. This study shows that although E-beam processing cannot completely eliminate the risk of viral illness, infection risks can be reduced.

  8. 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…

  9. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Primary Care Fall Risk Assessment for Elderly West Virginians.

    Science.gov (United States)

    Minkemeyer, Vivian M; Meriweather, Matt; Shuler, Franklin D; Mehta, Saurabh P; Qazi, Zain N

    2015-01-01

    West Virginia is ranked second nationally for the percent of its population 65 years of age. The elderly are especially susceptible to falls with fall risk increasing as age increases. Because falls are the number one cause of injury-related morbidity and mortality in the West Virginia elderly, evaluation of fall risk is a critical component of the patient evaluation in the primary care setting. We therefore highlight fall risk assessments that require no specialized equipment or training and can easily be completed at an established office visit. High quality clinical practice guidelines supported by the American Geriatric Society recommend yearly fall risk evaluation in the elderly. Those seniors at greatest risk of falls will benefit from the standardized therapy protocols outlined and referral to a balance treatment center. Patients with low-to-moderate fall risk attributed to muscle weakness or fatigue should be prescribed lower extremity strengthening exercises, such as kitchen counter exercises, to improve strength and balance.

  12. 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.

  13. Towards better fall prevention : Examining the interplay between factors that influence gait in older patients

    OpenAIRE

    De Groot, Maartje H.

    2017-01-01

    Falling is a serious problem among older patients: it is the combination of a high fall incidence together with a high susceptibility to injuries that makes a relatively mild fall potentially dangerous to these old persons. Falling is a multifactorial problem, but postural instability during daily activities, such as walking, is suggested to be the most consistent predictor of falls. Age-related neurophysiological changes and a high prevalence of clinical diseases result in a slower and less ...

  14. 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.

  15. Susceptibility to Entamoeba histolytica intestinal infection is related to reduction in natural killer T-lymphocytes in C57BL/6 mice

    Directory of Open Access Journals (Sweden)

    Fabrício M.S. Oliveira

    2012-04-01

    Full Text Available Entamoeba histolytica is a protozoan that causes amoebiasis. Recent studies demonstrated that natural killer T lymphocytes (NKT are critical for preventing the development of amoebic liver abscess. In spite of that, there are only a handful of studies in the area. Herein, we explored the role of NKT cells in E. histolytica infection using C57BL/6 wild-type and CD1-/- mice. Animals were inoculated with E. histolytica and sacrificed 48 hours later to collect caecum samples that were used for quantitative analyses of lesions, trophozoites, NK1.1+ T lymphocytes and expression of the mucus protein MUC-2 by immunohistochemistry technique. Quantitative analyses confirmed that the frequency of NK1.1+ T cells was significantly lower in samples from C57BL/6 CD1-/- mice as compared to their wild type (WT counterparts. The extension of necrotic mucosa was larger and the number of trophozoites higher in Entamoeba (Eh-infected CD1-/- mice when compared with Eh-infected WT mice. In mice from both groups, noninfected (CTRL and Eh-infected CD1-/-, there was a reduction in the thickness of the caecal mucosa and in the MUC-2-stained area in comparison with CTRL- and Eh-WT mice. Our results showed that NKT lymphocytes contribute to resistance against Entamoeba histolytica infection and to the control of inflammation in the colitis induced by infection. The presence of a normal epithelial layer containing appropriate levels of mucus had also a protective role against infection.

  16. Home Improvements Prevent Falls

    Science.gov (United States)

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

  17. 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

  18. 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

  19. 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 ...

  20. 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

  1. Risk of falls in the rheumatic patient at geriatric age

    OpenAIRE

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Sadura-Sieklucka, Teresa; Ksi??opolska-Or?owska, Krystyna

    2017-01-01

    Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in th...

  2. Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence.

    Science.gov (United States)

    McManus, Brenda A; McGovern, Eleanor; Moran, Gary P; Healy, Claire M; Nunn, June; Fleming, Pádraig; Costigan, Colm; Sullivan, Derek J; Coleman, David C

    2011-05-01

    Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and/or oral swab samples each time. Candida was recovered from 14/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and/or fluconazole susceptibility were identified in a further 3/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.

  3. Microbiological Screening of Irish Patients with Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy Reveals Persistence of Candida albicans Strains, Gradual Reduction in Susceptibility to Azoles, and Incidences of Clinical Signs of Oral Candidiasis without Culture Evidence▿†

    Science.gov (United States)

    McManus, Brenda A.; McGovern, Eleanor; Moran, Gary P.; Healy, Claire M.; Nunn, June; Fleming, Pádraig; Costigan, Colm; Sullivan, Derek J.; Coleman, David C.

    2011-01-01

    Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and/or oral swab samples each time. Candida was recovered from 14/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and/or fluconazole susceptibility were identified in a further 3/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy. PMID:21367996

  4. Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence.

    LENUS (Irish Health Repository)

    McManus, Brenda A

    2011-05-01

    Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and\\/or oral swab samples each time. Candida was recovered from 14\\/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7\\/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and\\/or fluconazole susceptibility were identified in a further 3\\/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.

  5. How to identify patients with cancer at risk of falling: a review of the evidence.

    LENUS (Irish Health Repository)

    Stone, Carol A

    2011-02-01

    Clinical experience and a limited number of studies suggest that a cancer diagnosis confers a high risk of accidental falls. The negative sequelae of falls in older persons are well documented; risk factors for falls in this population have been extensively investigated and evidence for the efficacy of interventions to reduce falls is steadily emerging. It is not known whether the risk factors for falls and effective interventions for falls risk reduction in patients with cancer are different from those in older persons.

  6. 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.

  7. 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%.

  8. 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.

  9. An update on falls

    NARCIS (Netherlands)

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

    2003-01-01

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

  10. 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.

  11. First Aid: Falls

    Science.gov (United States)

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

  12. 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

  13. Reducing the risk of baby falls in maternity units.

    Science.gov (United States)

    Janiszewski, Helen

    During a 12-month period there were 17 baby falls on the maternity wards at Nottingham University Hospitals Trust; two of the babies who fell were injured. By collecting information about the baby falls and how they happened, we were able to compile a guideline for both preventing and managing baby falls. This formed part of the trust's patient safety programme. We then piloted and implemented risk-prevention strategies for baby falls. These involved a risk assessment to identify women needing closer observation and the installation of bedside cots. These strategies brought about a marked reduction of baby falls and are now being established across all the maternity units across the trust.

  14. 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.

  15. Fall Bottom Trawl Survey

    Data.gov (United States)

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

  16. Catapults fall short

    Science.gov (United States)

    Gibson, Marcus

    2018-01-01

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

  17. 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.

  18. 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.

  19. Fall Prevention Hits Stumbling Blocks.

    Science.gov (United States)

    Huff, Charlotte

    2018-03-01

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

  20. Nutritional strategies to reduce falls risk in older people.

    Science.gov (United States)

    Nash, Louise; Bergin, Nick

    2018-03-23

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

  1. 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.

  2. 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.

  3. Fall Back Equilibrium

    NARCIS (Netherlands)

    Kleppe, J.; Borm, P.E.M.; Hendrickx, R.L.P.

    2008-01-01

    Fall back equilibrium is a refinement of the Nash equilibrium concept. In the underly- ing thought experiment each player faces the possibility that, after all players decided on their action, his chosen action turns out to be blocked. Therefore, each player has to decide beforehand on a back-up

  4. Risk of falls in the rheumatic patient at geriatric age.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Sadura-Sieklucka, Teresa; Księżopolska-Orłowska, Krystyna

    2017-01-01

    Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries. The specificity of rheumatic patient's falls is determined by numerous factors. It is not always possible to avoid them. However, it becomes vital to include fall prevention in the rehabilitation process as well as to prepare the house for the needs of an elderly person so that they are safe and as self-dependent as possible.

  5. Risk of falls in the rheumatic patient at geriatric age

    Directory of Open Access Journals (Sweden)

    Agnieszka Prusinowska

    2017-04-01

    Full Text Available Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries. The specificity of rheumatic patient’s falls is determined by numerous factors. It is not always possible to avoid them. However, it becomes vital to include fall prevention in the rehabilitation process as well as to prepare the house for the needs of an elderly person so that they are safe and as self-dependent as possible.

  6. 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.

  7. 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 ...

  8. 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.

  9. 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...

  10. Urban fall traps

    Directory of Open Access Journals (Sweden)

    Vera Lucia de Almeida Valsecchi

    2007-06-01

    Full Text Available Objectives: To evaluate the repercussion of falls in the elderly peoplewho live in the city of São Paulo and address - though synthetically- some questions regarding the city and its relation to aging and thequality of life of the elderly. Methods: This is a qualitative study. As fordata collection, “in-depth individual interviews” were applied. Selectionof subjects was guided by a procedure named as “network”. Results:Ten interviews were performed, nine with elderly individuals who werevictims of falls and one with a public authority representative. Dataresulting from interviews confirmed that significant changes occurin live of the elderly, who are victims of what has been called “urbantraps”, and that, by extrapolating mobility and dependence contexts,invade feelings, emotions and desires. The inappropriate environmentprovided by the city of São Paulo is confirmed by absence of adequateurban planning and lack of commitment of public authorities. It alsorevealed that the particular way of being old and living an elderlylife, in addition to right to citizenship, is reflected by major or lesserdifficulties imposed to the elderly to fight for their rights and have theirpublic space respected. Conclusion: The city of São Paulo is not anideal locus for an older person to live in. To the traps that are found inpublic places one can add those that are found in private places andthat contribute to the hard experience of falls among the elderly, anexperience that is sometimes fatal. In Brazil, the attention is basicallyfocused on the consequences of falls and not on prevention, by meansof urban planning that should meet the needs of the most vulnerablegroups - the physically disabled and the elderly.

  11. 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.

  12. 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.

  13. 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 ...

  14. 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

  15. 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.

  16. 1990 Fall Meeting Report

    Science.gov (United States)

    Chapman, David S.

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

  17. Falls and cerebellar ataxia

    Directory of Open Access Journals (Sweden)

    I. V. Damulin

    2015-01-01

    Full Text Available The paper considers the main causes of falls. Whatever their cause is, falls may lead to severe maladjustment in everyday life. In nearly 1 out of 10 cases, they are accompanied by severe injuries, including fractures (most commonly those of the proximal femur and humerus, hands, pelvic bones, and vertebrae, subdural hematoma, and severe soft tissue and head injuries. This process is emphasized to be multifactorial. Particular emphasis is laid on the involvement of the cerebellum and its associations, which may be accompanied by falls. This is clinically manifested mainly by gait disorders. Walking is a result of an interaction of three related functions (locomotion, maintenance of balance and adaptive reactions. In addition to synergies related to locomotion and balance maintenance, standing at rest and walking are influenced bythe following factors: postural and environmental information (proprioceptive, vestibular, and visual, the capacity to interpret and integrate this information, the ability of the musculoskeletal system to make movements, and the capability to optimally modulate these movements in view of the specific situation and the ability to choose and adapt synergy in terms of external factors and the capacities and purposes of an individual. The clinical signs of damage to the cerebellum and its associations are considered in detail. These structures are emphasized to be involved not only in movements, but also in cognitive functions. The major symptoms that permit cerebellar dysfunction to be diagnosed are given. Symptoms in cerebellar injuries are generally most pronounced when suddenly changing the direction of movements or attempting to start walking immediately after a dramatic rise. The magnitude of ataxia also increases in a patient who tries to decrease the step size. Falling tendencies or bending to one side (in other symptoms characteristic of cerebellar diseases suggest injury of the corresponding

  18. Falling Liquid Films

    CERN Document Server

    Kalliadasis, S; Scheid, B

    2012-01-01

    This research monograph gives a detailed review of the state-of-the-art theoretical methodologies for the analysis of dissipative wave dynamics and pattern formation on the surface of a film falling down a planar, inclined substrate. This prototype is an open-flow hydrodynamic instability representing an excellent paradigm for the study of complexity in active nonlinear media with energy supply, dissipation and dispersion. Whenever possible, the link between theory and experiments is illustrated and the development of order-of-magnitude estimates and scaling arguments is used to facilitate the

  19. New horizons in fall prevention.

    Science.gov (United States)

    Lord, Stephen R; Close, Jacqueline C T

    2018-04-25

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

  20. High fall incidence and fracture rate in elderly dialysis patients.

    Science.gov (United States)

    Polinder-Bos, H A; Emmelot-Vonk, M H; Gansevoort, R T; Diepenbroek, A; Gaillard, C A J M

    2014-12-01

    Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.

  1. Preventing falls in assisted living: Results of a quality improvement pilot study.

    Science.gov (United States)

    Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

    Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. [Does the care for the fear of falling bring a profit to community living elderly people who had experienced falls?].

    Science.gov (United States)

    Landrot, Marion De Rogalski; Perrot, Catherine; Blanc, Patricia; Beauchet, Olivier; Blanchon, Marie Ange; Gonthier, Régis

    2007-09-01

    fall is common in old people and has multiple consequences, physical but also psychological, with a fear of falling which results in reduction in the activities of everyday life, loss of autonomy and entry in dependence. The aim of the study was to evluate the benefit of taking into account the fear of falling in the care of old people who had experienced falls. old people who experienced falls and with a good cognitive status were followed in a day hospital during one year. Evaluation including a specific assessment of the responsibility of the psychological factor, the photolangage, was performed before and after multi-field rehabilitation. We used the rating scales ADL, IADL, SF-36, SAFE, and verbal and analogical scales of the fear of falling. fifteen patients were included (mean age 85 years +/- 5,7). The majority were women living alone, with a good nutritional status, a moderated renal insufficiency, and a comorbidity involving polymedication. Scores on the ADL and IADL scales showed a consolidation of the patients' autonomy, with a slight but significant improvement of the IADL scores (p fear of falling (visual analogical, verbal scales, SAFE) showed a statistically significant improvement (pfear of falling brings a benefit in term of quality of life and preservation of autonomy in old people living in the community who had experienced falls.

  3. Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement.

    Science.gov (United States)

    Garcia, Patrícia A; Dias, João M D; Silva, Silvia L A; Dias, Rosângela C

    2015-01-01

    The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. (i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa = 0.595) and recurrent fallers (Kappa = 0.589). The limits of agreement were 0.35 ± 1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning.

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

    Science.gov (United States)

    Martorello, Laura; Swanson, Edward

    2006-01-01

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

  5. [Can falls be prevented?].

    Science.gov (United States)

    Dubousset, Jean

    2014-06-01

    Most recommendations and measures intended to prevent falls focus on the elderly (see HAS guideline of April 2009) but, in our opinion, this isfar too late: prevention must begin much earlier, not only by identifying persons at risk, but also by providing personalized lifestyle advice adapted to each individual's biomechanical, somatic, neurological and biological characteristics. The first preventive measure is to identify a possible deterioration of balance, starting with a physical examination at the age of 45 and repeated regularly throughout life. Extrinsic preventive measures focusing on the domestic and external environments are clearly necessary. But what is most important is to detect and, if necessary, correct any degradation of intrinsic (intracorporeal or somatic) factors starting at the age of 45 years; these include vision, vestibular function and balance, proprioception, and psychological and neurological status. Chronic illnesses and their treatments must also be taken into account: treatment must be limited to indispensable drugs; sedative psychotropics must be avoided if possible; and polymedication must be tightly controlled, as it is a major risk factor for falls. Prevention also requires a diet sufficiently rich in protein, calcium and vitamin D3 (to prevent osteoporosis), and regular daily exercise adapted to the individual, if possible associated with a simultaneous cognitive task. The last key point is the absolute need for thorough functional rehabilitation after any accidental or medical trauma, regardless of age, with the aim of restoring functional status to that existing prior to the accident.

  6. FEMP Focus - Fall 2004

    Energy Technology Data Exchange (ETDEWEB)

    None

    2004-12-07

    Features information about Energy Savings Performance Contracts (ESPC), new lighting solutions for high-bay spaces, renewable energy certificates, electricity reduction measures at Federal Facilities, and more for federal agencies.

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

    Science.gov (United States)

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

    2009-08-01

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

  8. 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.

  9. 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.

  10. Reduction in Fluoroquinolone Use following Introduction of Ertapenem into a Hospital Formulary Is Associated with Improvement in Susceptibility of Pseudomonas aeruginosa to Group 2 Carbapenems: a 10-Year Study▿

    Science.gov (United States)

    Cook, Paul P.; Gooch, Michael; Rizzo, Shemra

    2011-01-01

    We examined the effect of the addition of ertapenem to our hospital formulary on the resistance of nosocomial Pseudomonas aeruginosa to group 2 carbapenems (imipenem, meropenem, and doripenem). This was a retrospective, observational study conducted between 1 January 2000 and 31 January 2009 at a large, tertiary-care hospital. Autoregressive integrated moving average (ARIMA) regression models were used to evaluate the effect of ertapenem use on the susceptibility of Pseudomonas aeruginosa to group 2 carbapenems as well as on the use of the group 2 carbapenems, ciprofloxacin, and other antipseudomonal drugs (i.e., tobramycin, cefepime, and piperacillin-tazobactam). Resistance was expressed as a percentage of total isolates as well as the number of carbapenem-resistant bacterial isolates per 10,000 patient days. Pearson correlation was used to assess the relationship between antibiotic use and carbapenem resistance. Following the addition of ertapenem to the formulary, there was a statistically significant decrease in the percentage of Pseudomonas aeruginosa isolates resistant to the group 2 carbapenems (P = 0.003). Group 2 carbapenem use and the number of carbapenem-resistant Pseudomonas aeruginosa isolates per 10,000 patient days did not change significantly over the time period. There was a large decrease in the use of ciprofloxacin (P = 0.0033), and there was a correlation of ciprofloxacin use with the percentage of isolates resistant to the group 2 carbapenems (ρ = 0.47, P = 0.002). We suspect that the improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems was related to a decrease in ciprofloxacin use. PMID:21968357

  11. Reduction in fluoroquinolone use following introduction of ertapenem into a hospital formulary is associated with improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems: a 10-year study.

    Science.gov (United States)

    Cook, Paul P; Gooch, Michael; Rizzo, Shemra

    2011-12-01

    We examined the effect of the addition of ertapenem to our hospital formulary on the resistance of nosocomial Pseudomonas aeruginosa to group 2 carbapenems (imipenem, meropenem, and doripenem). This was a retrospective, observational study conducted between 1 January 2000 and 31 January 2009 at a large, tertiary-care hospital. Autoregressive integrated moving average (ARIMA) regression models were used to evaluate the effect of ertapenem use on the susceptibility of Pseudomonas aeruginosa to group 2 carbapenems as well as on the use of the group 2 carbapenems, ciprofloxacin, and other antipseudomonal drugs (i.e., tobramycin, cefepime, and piperacillin-tazobactam). Resistance was expressed as a percentage of total isolates as well as the number of carbapenem-resistant bacterial isolates per 10,000 patient days. Pearson correlation was used to assess the relationship between antibiotic use and carbapenem resistance. Following the addition of ertapenem to the formulary, there was a statistically significant decrease in the percentage of Pseudomonas aeruginosa isolates resistant to the group 2 carbapenems (P = 0.003). Group 2 carbapenem use and the number of carbapenem-resistant Pseudomonas aeruginosa isolates per 10,000 patient days did not change significantly over the time period. There was a large decrease in the use of ciprofloxacin (P = 0.0033), and there was a correlation of ciprofloxacin use with the percentage of isolates resistant to the group 2 carbapenems (ρ = 0.47, P = 0.002). We suspect that the improvement in susceptibility of Pseudomonas aeruginosa to group 2 carbapenems was related to a decrease in ciprofloxacin use.

  12. Fall prevention in nursing homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Hauge, Johnny

    2014-01-01

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

  13. 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.

  14. 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.

  15. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home.

    Science.gov (United States)

    Russell, Katherine; Taing, Darcie; Roy, Jacqueline

    2017-12-01

    This study surveyed awareness of, and adherence to, six national fall prevention recommendations among community-dwelling older adults (n = 1050) in Ottawa. Although 76 per cent of respondents agreed falling is a concern and preventable, fewer perceived susceptibility to falling (63%). Respondents had high awareness that home modifications and physical activity can prevent falls. Reported modifications included grab bars (50%), night lights (44%), and raised toilet seats (19%). Half met aerobic activity recommendations; 38 per cent met strength recommendations. Respondents had lower awareness that an annual medication review, annual eye and physical examination, and daily vitamin D supplementation could reduce fall risk. However, reported annual medication review (79%) and eye examination (75%) was high. Nearly half met recommendations for vitamin D intake. These findings suggest a gap in knowledge of awareness and adherence to national recommendations, highlighting the ones that may require attention from those who work to prevent falls.

  16. 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.

  17. Interdisciplinary Approach to Fall Prevention in a High-Risk Inpatient Pediatric Population: Quality Improvement Project.

    Science.gov (United States)

    Stubbs, Kendra E; Sikes, Lindsay

    2017-01-01

    Within a tertiary care pediatric medical center, the largest number of inpatient falls (8.84 falls per 1,000 patient days) occurred within a 14-bed rehabilitation/transitional care unit between February and September 2009. An interdisciplinary fall prevention program, called "Red Light, Green Light," was developed to better educate all staff and family members to ensure safety of transfers and ambulation of children with neurological impairments. The purpose of this study was to develop and implement an interdisciplinary pediatric fall prevention program to reduce total falls and falls with family members present in this population. Preintervention 2009 data and longitudinal data from 2010-2014 were obtained from retrospective review of event/incident reports. This quality improvement project was based on inpatient pediatric admissions to a rehabilitation care unit accommodating children with neurological impairments. Data extraction included: total falls, falls with caregiver (alone versus staff versus family), type of falls, and falls by diagnosis. Descriptive statistics were obtained on outcome measures; chi-square statistics were calculated on preintervention and postintervention comparisons. Total falls decreased steadily from 8.84 falls per 1,000 patient days in 2009 to 1.79 falls per 1,000 patient days in 2014 (χ12=3.901, P=.048). Falls with family members present decreased 50% postintervention. (χ12=6.26, P=.012). Limitations included unit size nearly doubled postintervention, event reporting changed to both uncontrolled and controlled therapy falls (safely lowering patient to bed, chair, or floor), and enhanced reporting increased numbers of postintervention falls. The Red Light, Green Light program has resulted in reductions in overall fall rates, falls with family members present, increased staff collaboration, heightened staff and family safety awareness, and a safer environment for patients at high risk for neurological or musculoskeletal impairments

  18. 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

  19. 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

  20. Relativistic theory of the falling retroreflector gravimeter

    Science.gov (United States)

    Ashby, Neil

    2018-02-01

    We develop a relativistic treatment of interference between light reflected from a falling cube retroreflector in the vertical arm of an interferometer, and light in a reference beam in the horizontal arm. Coordinates that are nearly Minkowskian, attached to the falling cube, are used to describe the propagation of light within the cube. Relativistic effects such as the dependence of the coordinate speed of light on gravitational potential, propagation of light along null geodesics, relativity of simultaneity, and Lorentz contraction of the moving cube, are accounted for. The calculation is carried to first order in the gradient of the acceleration of gravity. Analysis of data from a falling cube gravimeter shows that the propagation time of light within the cube itself causes a significant reduction in the value of the acceleration of gravity obtained from measurements, compared to assuming reflection occurs at the face. An expression for the correction to g is derived and found to agree with experiment. Depending on the instrument, the correction can be several microgals, comparable to commonly applied corrections such as those due to polar motion and earth tides. The controversial ‘speed of light’ correction is discussed. Work of the US government, not subject to copyright.

  1. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Falls in patients with chronic obstructive pulmonary disease: a call for further research

    Science.gov (United States)

    Roig, M; Eng, JJ; MacIntyre, DL; Road, JD; Reid, WD.

    2012-01-01

    Summary Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in airflow limitation and respiratory distress. The effects of COPD, however, are not exclusively limited to respiratory function and people with COPD face many non-respiratory manifestations that affect both function and mobility. Deficits in function and mobility have been associated with an increased risk for falling in older adults. The purpose of this study was to provide a theoretical framework to identify risks factors for falls in people with COPD. We have analyzed the literature to identify possible relationships between pathophysiological changes observed in COPD and common risk factors for falls. Well-established fall risk factors in people with COPD include lower limb muscle weakness and impaired activities of daily living. Other intrinsic risk factors such as gait and balance deficits, nutritional depletion, malnutrition, depression, cognitive impairments and medications are possible risk factors that need to be confirmed with more studies. There is no evidence that visual deficits are common in COPD. The role that precipitating factors such as syncope and postural hypotension may have on fall risk is unclear. Exacerbations and dyspnea do not have a precipitating effect on fall risk but they contribute to the progressive physical deterioration that may theoretically increase the risk for falls. While these results suggest that people with COPD might have an increased susceptibility to fall compared to their healthy peers, further research is needed to determine the prevalence of falls and specific risk factors for falls in people living with COPD. PMID:19419852

  4. Cowlitz Falls fish passage

    International Nuclear Information System (INIS)

    1995-09-01

    The upper Cowlitz was once home to native salmon and steelhead. But the combined impacts of overharvest, farming, logging and road building hammered fish runs. And in the 1960s, a pair of hydroelectric dams blocked the migration path of ocean-returning and ocean-going fish. The lower Cowlitz still supports hatchery runs of chinook, coho and steelhead. But some 200 river miles in the upper river basin--much of it prime spawning and rearing habitat--have been virtually cut off from the ocean for over 26 years. Now the idea is to trap-and-haul salmon and steelhead both ways and bypass previously impassable obstacles in the path of anadromous fish. The plan can be summarized, for the sake of explanation, in three steps: (1) trap and haul adult fish--collect ocean-returning adult fish at the lowermost Cowlitz dam, and truck them upstream; (2) reseed--release the ripe adults above the uppermost dam, and let them spawn naturally, at the same time, supplement these runs with hatchery born fry that are reared and imprinted in ponds and net pens in the watershed; (3) trap and haul smolts--collection the new generation of young fish as they arrive at the uppermost Cowlitz dam, truck them past the three dams, and release them to continue their downstream migration to the sea. The critical part of any fish-collection system is the method of fish attraction. Scientists have to find the best combination of attraction system and screens that will guide young fish to the right spot, away from the turbine intakes. In the spring of 1994 a test was made of a prototype system of baffles and slots on the upriver face of the Cowlitz Falls Dam. The prototype worked at 90% efficiency in early tests, and it worked without the kind of expensive screening devices that have been installed on other dams. Now that the success of the attraction system has been verified, Harza engineers and consultants will design and build the appropriate collection part of the system

  5. Community College Estimated Growth: Fall 2010

    Science.gov (United States)

    Phillippe, Kent; Mullin, Christopher M.

    2011-01-01

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

  6. Multifactorial assessment of the risk of falls in low bone density older women

    Directory of Open Access Journals (Sweden)

    Patrícia Azevedo Garcia

    Full Text Available Abstract Introduction: Identifying effective assessment instruments for predicting falls, specifically in older women with low bone mineral density (BMD that are more susceptible to fractures remains a challenge. Objective: To evaluate risk factors for falls at baseline, to identify the falls occurrence over six months of follow-up and to investigate the predictive validity of the Quickscreen Clinical Falls Risk Assessment for predicting multiple falls among low BMD older women. Methods: A methodological study with 110 older women with diagnosis of osteoporosis or osteopenia (70.26 ± 6.24 years. The presence of two or more of the eight risk factors assessed by the QuickScreen characterized the risk of falling (baseline and monthly phone calls identified the occurrence of falls during the six months of follow-up. Results: The most prevalent falls risk factors were self-reported previous falls, polypharmacy and impairment in shifting weight and lateral instability. Most of the older women (67.3% had two or more risk factors, 24.5% reported a single fall and 13.6% reported multiple falls over the six months. The QuickScreen (cutoff ≥ 2 risk factors showed good sensitivity (73.3% and high negative predictive value (88.89% for predicting multiple falls among low BMD older women. Conclusions: The results indicated a high frequency of falls among low BMD older women. Additionally, the results highlighted that the QuickScreen instrument was able to predict multiple falls in the six months of follow-up among these older women.

  7. Martial arts fall training to prevent hip fractures in the elderly.

    Science.gov (United States)

    Groen, B E; Smulders, E; de Kam, D; Duysens, J; Weerdesteyn, V

    2010-02-01

    Hip fractures are a common and serious consequence of falls. Training of proper fall techniques may be useful to prevent hip fractures in the elderly. The results suggested that martial arts fall techniques may be trainable in older individuals. Better performance resulted in a reduced impact force. Hip fractures are a common and serious consequence of falls. Fall training may be useful to prevent hip fractures in the elderly. This pilot study determined whether older individuals could learn martial arts (MA) fall techniques and whether this resulted in a reduced hip impact force during a sideways fall. Six male and nineteen female healthy older individuals completed a five-session MA fall training. Before and after training, force and kinematic data were collected during volitional sideways falls from kneeling position. Two MA experts evaluated the fall performance. Fear of falling was measured with a visual analog scale (VAS). After fall training, fall performance from a kneeling position was improved by a mean increase of 1.6 on a ten-point scale (P < 0.001). Hip impact force was reduced by a mean of 8% (0.20 N/N, P = 0.016). Fear of falling was reduced by 0.88 on a VAS scale (P = 0.005). MA techniques may be trainable in older individuals, and a better performance may reduce the hip impact force in a volitional sideways fall from a kneeling position. The additional reduction of fear of falling might result in the prevention of falls and related injuries.

  8. Optimization of metal artefact reduction (MAR) sequences for MRI of total hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Toms, A.P., E-mail: andoni.toms@nnuh.nhs.u [Department of Radiology, Norfolk and Norwich University Hospital Trust, Norwich, Norfolk NR4 7UY (United Kingdom); Smith-Bateman, C.; Malcolm, P.N.; Cahir, J. [Department of Radiology, Norfolk and Norwich University Hospital Trust, Norwich, Norfolk NR4 7UY (United Kingdom); Graves, M. [University Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom)

    2010-06-15

    Aim: To describe the relative contribution of matrix size and bandwidth to artefact reduction in order to define optimal sequence parameters for metal artefact reduction (MAR) sequences for MRI of total hip prostheses. Methods and materials: A phantom was created using a Charnley total hip replacement. Mid-coronal T1-weighted (echo time 12 ms, repetition time 400 ms) images through the prosthesis were acquired with increasing bandwidths (150, 300, 454, 592, and 781 Hz/pixel) and increasing matrixes of 128, 256, 384, 512, 640, and 768 pixels square. Signal loss from the prosthesis and susceptibility artefact was segmented using an automated tool. Results: Over 90% of the achievable reduction in artefacts was obtained with matrixes of 256 x 256 or greater and a receiver bandwidth of approximately 400 Hz/pixel or greater. Thereafter increasing the receiver bandwidth or matrix had little impact on reducing susceptibility artefacts. Increasing the bandwidth produced a relative fall in the signal-to-noise ratio (SNR) of between 49 and 56% for a given matrix, but, in practice, the image quality was still satisfactory even with the highest bandwidth and largest matrix sizes. The acquisition time increased linearly with increasing matrix parameters. Conclusion: Over 90% of the achievable metal artefact reduction can be realized with mid-range matrices and receiver bandwidths on a clinical 1.5 T system. The loss of SNR from increasing receiver bandwidth, is preferable to long acquisition times, and therefore, should be the main tool for reducing metal artefact.

  9. 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.

  10. Genetic susceptibility of periodontitis

    NARCIS (Netherlands)

    Laine, M.L.; Crielaard, W.; Loos, B.G.

    2012-01-01

    In this systematic review, we explore and summarize the peer-reviewed literature on putative genetic risk factors for susceptibility to aggressive and chronic periodontitis. A comprehensive literature search on the PubMed database was performed using the keywords ‘periodontitis’ or ‘periodontal

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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

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

    Science.gov (United States)

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

    2008-01-01

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

  17. Head over Heels: Impact of a Health Promotion Program to Reduce Falls in the Elderly.

    Science.gov (United States)

    Gallagher, Elaine M.; Brunt, Howard

    1996-01-01

    The Falls Intervention Trials included 50 older adults as controls and 50 who were given risk assessment, individualized feedback, and a motivational video and booklet. The treatment group acted on only 50% of recommendations for risk reduction. The intervention may not have addressed many of the specific causes of falling. (SK)

  18. “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

    , and take actions to prevent falls. The climate and the structure of the ward are essential if licensed practical nurses are to be encouraged to routinely consider risk of falling and implement risk reduction strategies.

  19. Catching a Falling Star

    Science.gov (United States)

    2004-07-01

    . Comets are another important source of meteoroids and perhaps the most spectacular. After many visits near the Sun, a comet "dirty-snowball" nucleus of ice and dust decays and fragments, leaving a trail of meteoroids along its orbit. Some "meteoroid streams" cross the earth's orbit and when our planet passes through them, some of these particles will enter the atmosphere. The outcome is a meteor shower - the most famous being the "Perseids" in the month of August [2] and the "Leonids" in November. Thus, although meteors are referred to as "shooting" or "falling stars" in many languages, they are of a very different nature. More information The research presented in this paper is published in the journal Meteoritics and Planetary Science, Vol. 39, Nr. 4, p. 1, 2004 ("Spectroscopic anatomy of a meteor trail cross section with the ESO Very Large Telescope", by P. Jenniskens et al.). Notes [1] The team is composed of Peter Jenniskens (SETI Institute, USA), Emmanuël Jehin (ESO), Remi Cabanac (Pontificia Universidad Catolica de Chile), Christophe Laux (Ecole Centrale de Paris, France), and Iain Boyd (University of Michigan, USA). [2] The maximum of the Perseids is expected on August 12 after sunset and should be easily seen.

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

    Science.gov (United States)

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

    2011-08-21

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

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

    Directory of Open Access Journals (Sweden)

    Mattace-Raso Francesco US

    2011-08-01

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

  2. Relationships among cane fitting, function, and falls.

    Science.gov (United States)

    Dean, E; Ross, J

    1993-08-01

    Although canes are among the most commonly used mobility aids, little is known about the relationship between cane prescription and effectiveness. The purpose of this study was to examine the relationships among cane fitting (ie, cane fitter, cane band, and cane length), reported improvements in function, and reduction in falls. Cane users living in the community (86 women and 58 men with a median age distribution of 61 to 80 years) and sampled from seven urban shopping centers in British Columbia, Canada, participated in the study. The primary reasons cited for using a cane were joint problems (39%), general balance difficulties (30%), and a combination of joint and balance problems (15%). Measures included appropriateness of cane length and responses to closed-ended questions related to qualifications of the cane fitter, cane band, functional ability with a cane, and falling frequency. Overall, cane use was associated with improved confidence and functional ability. Canes fitted by health care workers approximated the clinically recommended length compared with canes fitted by non-health care workers, which tended to be greater than this length. There was no relationship, however, between cane fitting (cane fitter, cane hand, and appropriateness of cane length) and functional ability with a cane and falling frequency [corrected]. We concluded that health care workers may need to reconsider the variables for optimal cane prescription and their specifications for a given individual. The notion of a correct length and cane hand, for example, may be less important than factors such as the indications for cane use, comfort, and enhanced confidence.

  3. 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

  4. A Piece of Paper Falling Faster than Free Fall

    Science.gov (United States)

    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…

  5. Reversal of diabetic peripheral neuropathy with phototherapy (MIRE) decreases falls and the fear of falling and improves activities of daily living in seniors.

    Science.gov (United States)

    Powell, Mark W; Carnegie, Dale H; Burke, Thomas J

    2006-01-01

    to determine whether restoration of sensation, impaired due to diabetic peripheral neuropathy (DPN), would reduce the number of falls and the fear of falling and improve activities of daily living (ADL) in a Medicare-aged population. retrospective cohort study of patients with documented, monochromatic near-infrared phototherapy (MIRE)-mediated, symptomatic reversal of DPN. responses to a health status questionnaire following symptomatic reversal of DPN. 252 patients (mean age 76 years) provided health information following symptomatic reversal of diabetic neuropathy (mean duration 8.6 months). incidence of falls and fear of falling decreased within 1 month after reversal of peripheral neuropathy and remained low after 1 year. Likewise, improved ADL were evident soon after reversal of peripheral neuropathy and showed further improvement after 1 year. Overall, reversal of peripheral neuropathy in a clinician's office and subsequent use of MIRE at home was associated with a 78% reduction in falls, a 79% decrease in balance-related fear of falling and a 72% increase in ADL (P < 0.0002 for all results). reversal of peripheral neuropathy is associated with an immediate reduction in the absolute number of falls, a reduced fear of falling and improved ADL. These results suggest that symptomatic reversal of diabetic neuropathy will have a substantial favourable, long-term socioeconomic impact on patients with DPN and the Medicare system, and improve the quality of life for elderly patients with diabetes and peripheral neuropathy.

  6. 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

  7. Species and cultivar influences on survival and parasitism of fall armyworm.

    Science.gov (United States)

    Braman, S K; Duncan, R R; Hanna, W W; Engelke, M C

    2004-12-01

    Interactions between host plant resistance and biological control may benefit or hinder pest management efforts. Turfgrass cultivars have rarely been tested for extrinsic resistance characteristics such as occurrence and performance of beneficial arthropods on plant genotypes with resistance to known turf pests. Parasitism of fall armyworm, Spodoptera frugiperda (J.E. Smith), among six turfgrass genotypes was evaluated. The six grasses tested [Sea Isle-1 and 561-79 seashore paspalum, Paspalum vaginatum Swartz; TifSport and TifEagle hybrid Bermuda grass, Cynodon dactylon (L.) x C. transvaalensis (Burtt-Davy); and Cavalier and Palisades zoysiagrass, Zoysia japonica von Steudel and Z. matrella (L.) Merrill, respectively] represented a range in resistance to S. frugiperda. Differential recovery of larvae released as first instars reflected this gradient in resistance of Cavalier > or = Palisades > or = TifSport = TifEagle > or = 561- = Sea Isle-1 Larval recovery (percentage of initial number released) was greatest in May, less in July and August, and least in October, probably reflecting the increase in activity of on-site predators and disease pressure. Parasitism of the fall armyworm by the braconid Aleiodes laphygmae Viereck varied among turfgrass genotypes. Parasitism was greatest during July. In total, 20,400 first instars were placed in the field; 2,368 were recovered; 468 parasitoids were subsequently reared; 92.2% were A. laphygmae. In the field, the greatest percentage of reduction in S. frugiperda larvae by A. laphygmae occurred on the armyworm-susceptible seashore paspalums (51.9% on Sea Isle-1 in July). Cotesia marginiventris Cresson and Meteorus sp. also were reared from collected larvae. No parasitoids were reared from larvae collected from resistant Cavalier zoysiagrass. A. laphygmae and C. marginiventris were reared from larvae collected from the other five grass cultivars. No parasitoids of older larvae or pupae were observed.

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

    Science.gov (United States)

    Lee, Justin Yusen; Holbrook, Anne

    2017-02-20

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

  9. 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

  10. 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...

  11. 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.

  12. Inspection of four-sensor falls detector

    Directory of Open Access Journals (Sweden)

    Bartłomiej Wójtowicz

    2015-06-01

    Full Text Available The studies presented in this article are the continuation of previous work to develop a mobile fall detector. The algorithm is based on a discrete wavelet transform of the signals from the sensors available at the detector and a linear support vector machine as a classifier. Fisher score method is used for feature selection in the proposed algorithm. As a result of reducing the number of features, the number of support vectors has been also reduced — it has a direct impact on the upper estimate of the classification error. On the basis of the obtained results, the classifier parameters have been calculated. This allows presenting the developed concept in the field of ROCROCROC curves (Receiver Operating Characteristics and their comparison with the results obtained for individual sensors. The developed concept gives much better results than each of the sensors acting independently. The findings of this study have given very good results in comparison with the previous findings, with a significant reduction in the number of required features. Due to the close relationship between the number of training data and the number of support vectors which directly affect the upper estimate of the classification error, the number of features has been reduced. Finally, satisfactory results have been obtained with the reduction of the number of features from 38 to just six, ensuring that the upper estimation of the classification error in the set of the new test data does not exceed 5.3%.[b]Keywords[/b]: falls detection, data fusion, discrete wavelet transform, support vector machine

  13. NOVA Fall 2000 Teacher's Guide.

    Science.gov (United States)

    Ransick, Kristina; Rosene, Dale; Sammons, Fran Lyons; Sammons, James

    This teacher's guide complements six programs that aired on the Public Broadcasting System (PBS) in the fall of 2000. Programs include: (1) "Lincoln's Secret Weapon"; (2) "Hitler's Lost Sub"; (3) "Runaway Universe"; (4) "Garden of Eden"; (5) "Dying to Be Thin"; and (6) "Japan's Secret…

  14. Trapping fall armyworm in Africa

    Science.gov (United States)

    Fall armyworm, Spodoptera frugiperda, is a noctuid pest of row and vegetable crops throughout the Americas. It has recently invaded Africa and has been identified from almost all sub-Saharan countries. There is a strong expectation of significant damage to African maize crop yield and a high likel...

  15. Nuclear fall-out shelter

    International Nuclear Information System (INIS)

    Lowery, R.J.

    1981-01-01

    An underground nuclear fall-out shelter has a plastics shell which, apart from service and access openings, is waterproof and provided, if desired, with a concrete roof. The shelter has an access opening, an air system, lighting, water storage, sanitation and sewage facilities. (author)

  16. 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

  17. Exercises to help prevent falls

    Science.gov (United States)

    ... help prevent falls because it can: Make your muscles stronger and more flexible Improve your balance Increase how ... To make your calves and ankle muscles stronger: Hold on to a solid ... of a chair. Stand with your back straight and slightly bend ...

  18. Finding Rising and Falling Words

    NARCIS (Netherlands)

    Tjong Kim Sang, E.

    2016-01-01

    We examine two different methods for finding rising words (among which neologisms) and falling words (among which archaisms) in decades of magazine texts (millions of words) and in years of tweets (billions of words): one based on correlation coefficients of relative frequencies and time, and one

  19. AAAI 1993 Fall Symposium Reports

    OpenAIRE

    Levinson, Robert; Epstein, Susan; Terveen, Loren; Bonasso, R. Peter; Miller, David P.; Bowyer, Kevin; Hall, Lawrence

    1994-01-01

    The Association for the Advancement of Artificial Intelligence held its 1993 Fall Symposium Series on October 22-24 in Raleigh, North Carolina. This article contains summaries of the six symposia that were conducted: Automated Deduction in Nonstandard Logics; Games: Planning and Learning; Human-Computer Collaboration: Reconciling Theory, Synthesizing Practice; Instantiating Intelligent Agents; and Machine Learning and Computer Vision: What, Why, and How?

  20. Geohazard reconnaissance mapping for potential rock boulder fall using low altitude UAV photogrammetry

    Science.gov (United States)

    Sharan Kumar, N.; Ashraf Mohamad Ismail, Mohd; Sukor, Nur Sabahiah Abdul; Cheang, William

    2018-05-01

    This paper discusses potential applications of unmanned aerial vehicles (UAVs) for evaluation of risk immediately with photos and 3-dimensional digital element. Aerial photography using UAV ready to give a powerful technique for potential rock boulder fall recognition. High-resolution outputs from this method give the chance to evaluate the site for potential rock boulder falls spatially. The utilization of UAV to capture the aerial photos is a quick, reliable, and cost-effective technique contrasted with terrestrial laser scanning method. Reconnaissance of potential rock boulder susceptible to fall is very crucial during the geotechnical investigation. This process is essential in the view of the rock fall hazards nearby site before the beginning of any preliminary work. Photogrammetric applications have empowered the automated way to deal with identification of rock boulder susceptible to fall by recognizing the location, size, and position. A developing examination of the utilization of digital photogrammetry gives numerous many benefits for civil engineering application. These advancements have made important contributions to our capabilities to create the geohazard map on potential rock boulder fall.

  1. 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.

  2. SCC susceptibility evaluation of plastic deformed austenitic stainless steels

    Energy Technology Data Exchange (ETDEWEB)

    Kaneshima, Yoshiari; Totsuka, Nobuo; Arioka, Koji [Inst. of Nuclear Safety System Inc., Mihama, Fukui (Japan)

    2002-09-01

    Slow strain rate temperature (SSRT) tests were carried out to evaluate the SCC susceptibility of deformed SUS316 stainless steel in simulated primary water of pressurized water reactor (PWR). The influence of material hardness and temperature on SCC susceptibility was studied. From these tests following results were obtained. (1) Both of the total SCC and IGSCC susceptibilities increased as the hardness of deformed specimens increased. Especially over 250{approx}300HV area, this tendency remarkably increased. (2) The reduction ratio showed a plateau under 300HV area. However, over 300HV area, it decreased remarkably as the hardness increased, that is, the SCC susceptibility remarkably increased. (3) Based on the SSRT test results conducted at 320, 340 and 360degC, the total SCC susceptibility dependence on temperature was small and the IGSCC susceptibility was dependent on the temperature. From these results, the TGSCC susceptibility dependence on temperature was also small. The activation energy of total SCC and IGSCC susceptibility were calculated. (author)

  3. Naval Survivability and Susceptibility Reduction Study-Surface Ship

    Science.gov (United States)

    2012-09-01

    the load usage. Similarly, redundancy must be catered for the signal and communication lines, and the firefighting system. Having equipment...Target RCS (m2) RCS (dBsm) Relative range Aircraft carrier 100,000 50 1778 Cruiser 10,000 40 1000 Large airliner or automobile 100 20 316 Medium... airliner or bomber 40 16.0 251 Large fighter 6 7.8 157 Small fighter 2 3.0 119 Man 1 0 100 Conventional cruise missile 0.5 -3.0 84 Large bird 0.05

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

    Science.gov (United States)

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

    2018-01-01

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

  5. Intrinsic factors associated with pregnancy falls.

    Science.gov (United States)

    Wu, Xuefang; Yeoh, Han T

    2014-10-01

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

  6. Seasonal fluctuation in susceptibility to insecticides within natural populations of Drosophila melanogaster. II. Features of genetic variation in susceptibility to organophosphate insecticides within natural populations of D. melanogaster.

    Science.gov (United States)

    Miyo, Takahiro; Oguma, Yuzuru; Charlesworth, Brian

    2006-08-01

    To elucidate genetic variation in susceptibility to organophosphate insecticides within natural populations of Drosophila melanogaster, we conducted an analysis of variance for mortality data sets of isofemale lines (10-286 lines) used in the previous studies. Susceptibility of isofemale lines to the three organophosphate insecticides was continuously distributed within each natural population, ranging from susceptible to resistant. Analysis of variance showed highly significant variation among isofemale lines in susceptibility to each insecticide for each natural population. Significant genetic variances in susceptibility to the three chemicals were estimated for the Katsunuma population; 0.0529-0.2722 for malathion, 0.0492-0.1603 for prothiophos, and 0.0469-0.1696 for fenitrothion. Contrary to the consistent seasonal tendency towards an increase in mean susceptibility in the fall, reported in the previous study, genetic variances in susceptibility to the three organophosphates did not change significantly in 1997 but tended to increase by 2- to 5-times in 1998. We tested whether both the observed situations, maintenance and increase in genetic variance in organophosphate resistance, can be generated under circumstances in which the levels of resistance to the three organophosphates tended to decrease, by conducting a simulation analysis, based on the hypothesis that resistant genotypes have lower fitnesses than susceptible ones under the density-independent condition. The simulation analysis generally explained the pattern in the mean susceptibility and genetic variances in susceptibility to the three organophosphates, observed in the Katsunuma population of D. melanogaster. It was suggested that the differences in the frequencies of resistance genes in the summer population could affect the patterns in genetic variance in organophosphate resistance in the fall population.

  7. Falls-risk in senior women after radical treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Małgorzata Biskup

    2017-06-01

    Full Text Available Introduction : It is estimated that 35–40% people over the age of 65 experience at least one fall per year; for those over the age of 80 this increases to 50%, and for residents of institutional care facilities, to 60%. Aim of the research : To evaluate the functional capacity and susceptibility to falling among women over 60 years of age, who had been treated for breast cancer. Material and methods : The study group comprised 173 women aged 61–85 years (mean: 68.75 years, all breast cancer survivors treated at the Holy Cross Cancer Centre in Kielce. Functional efficiency was measured using the Senior Fitness Test (SFT, and the falls-risk assessment was carried out using the POMA Tinetti test. An additional questionnaire was used to assess the anxiety associated with falls. The relationship between functional capacity and the falls-risk, and between the amount of medication used and the falls-risk, were also assessed. Results : In all SFT tests, the women had lower scores compared to the recommended standards. Medium and high falls-risk were reported in 27% of patients. Apart from an increase in falls-risk, the women reported poorer results in all physical fitness tests. An increase in the number of medications taken was associated with lower Tinetti test results. Conclusions: Women treated for breast cancer were exposed to a high falls-risk. The treatment management applied to women with breast cancer adversely affected their functional capacities. Furthermore, an increase in the amount of medication taken by post-mastectomy women resulted in a still higher exposure to falls-risk. Task-oriented, physical rehabilitation programmes should therefore promptly be introduced to address the problem of falls and resultant fractures among senior post-mastectomy women.

  8. Historical rock falls in Yosemite National Park, California (1857-2011)

    Science.gov (United States)

    Stock, Greg M.; Collins, Brian D.; Santaniello, David J.; Zimmer, Valerie L.; Wieczorek, Gerald F.; Snyder, James B.

    2013-01-01

    Inventories of rock falls and other types of landslides are valuable tools for improving understanding of these events. For example, detailed information on rock falls is critical for identifying mechanisms that trigger rock falls, for quantifying the susceptibility of different cliffs to rock falls, and for developing magnitude-frequency relations. Further, inventories can assist in quantifying the relative hazard and risk posed by these events over both short and long time scales. This report describes and presents the accompanying rock fall inventory database for Yosemite National Park, California. The inventory database documents 925 events spanning the period 1857–2011. Rock falls, rock slides, and other forms of slope movement represent a serious natural hazard in Yosemite National Park. Rock-fall hazard and risk are particularly relevant in Yosemite Valley, where glacially steepened granitic cliffs approach 1 km in height and where the majority of the approximately 4 million yearly visitors to the park congregate. In addition to damaging roads, trails, and other facilities, rock falls and other slope movement events have killed 15 people and injured at least 85 people in the park since the first documented rock fall in 1857. The accompanying report describes each of the organizational categories in the database, including event location, type of slope movement, date, volume, relative size, probable trigger, impact to humans, narrative description, references, and environmental conditions. The inventory database itself is contained in a Microsoft Excel spreadsheet (Yosemite_rock_fall_database_1857-2011.xlsx). Narrative descriptions of events are contained in the database, but are also provided in a more readable Adobe portable document format (pdf) file (Yosemite_rock_fall_database_narratives_1857-2011.pdf) available for download separate from the database.

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

    Science.gov (United States)

    Bentley, T A; Haslam, R A

    1998-12-01

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

  10. 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

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

    Science.gov (United States)

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

    2017-11-01

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

  12. Reduction redux.

    Science.gov (United States)

    Shapiro, Lawrence

    2018-04-01

    Putnam's criticisms of the identity theory attack a straw man. Fodor's criticisms of reduction attack a straw man. Properly interpreted, Nagel offered a conception of reduction that captures everything a physicalist could want. I update Nagel, introducing the idea of overlap, and show why multiple realization poses no challenge to reduction so construed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The elderly recognizing themselves as vulnerable to falls in the concreteness of the femoral fracture.

    Science.gov (United States)

    Carvalho, César Junior Aparecido de; Bocchi, Silvia Cristina Mangini

    2017-04-01

    understand the experience of the elderly with falls followed by femoral fracture and elaborate theoretical model of this process of lived experience. qualitative research with theoretical saturation through analysis of the ninth nondirected interview of elderly who underwent such experience. Interviews were recorded, transcribed, and analyzed according to Grounded Theory. three categories emerged (sub-processes): evaluating signs and symptoms of fracture after the fall; feeling sad and insecure with the new condition; and finding oneself susceptible to fractures. From realignment of these categories (sub-processes) we could abstract the central category (process), recognizing oneself as vulnerable to falls in the concreteness of the fracture. the theoretical model considering the Symbolic Interactionism signals the implementation of continued program for fall prevention, with teaching strategies that encourage the elderly to reflect on the concreteness of contexts in which there is risk of occurring injury to their health.

  14. 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...

  15. Local quantum thermal susceptibility

    Science.gov (United States)

    de Pasquale, Antonella; Rossini, Davide; Fazio, Rosario; Giovannetti, Vittorio

    2016-09-01

    Thermodynamics relies on the possibility to describe systems composed of a large number of constituents in terms of few macroscopic variables. Its foundations are rooted into the paradigm of statistical mechanics, where thermal properties originate from averaging procedures which smoothen out local details. While undoubtedly successful, elegant and formally correct, this approach carries over an operational problem, namely determining the precision at which such variables are inferred, when technical/practical limitations restrict our capabilities to local probing. Here we introduce the local quantum thermal susceptibility, a quantifier for the best achievable accuracy for temperature estimation via local measurements. Our method relies on basic concepts of quantum estimation theory, providing an operative strategy to address the local thermal response of arbitrary quantum systems at equilibrium. At low temperatures, it highlights the local distinguishability of the ground state from the excited sub-manifolds, thus providing a method to locate quantum phase transitions.

  16. Topological Susceptibility from Slabs

    CERN Document Server

    Bietenholz, Wolfgang; Gerber, Urs

    2015-01-01

    In quantum field theories with topological sectors, a non-perturbative quantity of interest is the topological susceptibility chi_t. In principle it seems straightforward to measure chi_t by means of Monte Carlo simulations. However, for local update algorithms and fine lattice spacings, this tends to be difficult, since the Monte Carlo history rarely changes the topological sector. Here we test a method to measure chi_t even if data from only one sector are available. It is based on the topological charges in sub-volumes, which we denote as slabs. Assuming a Gaussian distribution of these charges, this method enables the evaluation of chi_t, as we demonstrate with numerical results for non-linear sigma-models.

  17. Topological susceptibility from slabs

    Energy Technology Data Exchange (ETDEWEB)

    Bietenholz, Wolfgang [Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, A.P. 70-543, Distrito Federal, C.P. 04510 (Mexico); Forcrand, Philippe de [Institute for Theoretical Physics, ETH Zürich,CH-8093 Zürich (Switzerland); CERN, Physics Department, TH Unit, CH-1211 Geneva 23 (Switzerland); Gerber, Urs [Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, A.P. 70-543, Distrito Federal, C.P. 04510 (Mexico); Instituto de Física y Matemáticas, Universidad Michoacana de San Nicolás de Hidalgo,Edificio C-3, Apdo. Postal 2-82, Morelia, Michoacán, C.P. 58040 (Mexico)

    2015-12-14

    In quantum field theories with topological sectors, a non-perturbative quantity of interest is the topological susceptibility χ{sub t}. In principle it seems straightforward to measure χ{sub t} by means of Monte Carlo simulations. However, for local update algorithms and fine lattice spacings, this tends to be difficult, since the Monte Carlo history rarely changes the topological sector. Here we test a method to measure χ{sub t} even if data from only one sector are available. It is based on the topological charges in sub-volumes, which we denote as slabs. Assuming a Gaussian distribution of these charges, this method enables the evaluation of χ{sub t}, as we demonstrate with numerical results for non-linear σ-models.

  18. Local quantum thermal susceptibility

    Science.gov (United States)

    De Pasquale, Antonella; Rossini, Davide; Fazio, Rosario; Giovannetti, Vittorio

    2016-01-01

    Thermodynamics relies on the possibility to describe systems composed of a large number of constituents in terms of few macroscopic variables. Its foundations are rooted into the paradigm of statistical mechanics, where thermal properties originate from averaging procedures which smoothen out local details. While undoubtedly successful, elegant and formally correct, this approach carries over an operational problem, namely determining the precision at which such variables are inferred, when technical/practical limitations restrict our capabilities to local probing. Here we introduce the local quantum thermal susceptibility, a quantifier for the best achievable accuracy for temperature estimation via local measurements. Our method relies on basic concepts of quantum estimation theory, providing an operative strategy to address the local thermal response of arbitrary quantum systems at equilibrium. At low temperatures, it highlights the local distinguishability of the ground state from the excited sub-manifolds, thus providing a method to locate quantum phase transitions. PMID:27681458

  19. Susceptibility to anchoring effects

    Directory of Open Access Journals (Sweden)

    Todd McElroy

    2007-02-01

    Full Text Available Previous research on anchoring has shown this heuristic to be a very robust psychological phenomenon ubiquitous across many domains of human judgment and decision-making. Despite the prevalence of anchoring effects, researchers have only recently begun to investigate the underlying factors responsible for how and in what ways a person is susceptible to them. This paper examines how one such factor, the Big-Five personality trait of openness-to-experience, influences the effect of previously presented anchors on participants' judgments. Our findings indicate that participants high in openness-to-experience were significantly more influenced by anchoring cues relative to participants low in this trait. These findings were consistent across two different types of anchoring tasks providing convergent evidence for our hypothesis.

  20. Fall Prevention in a Primary Care Setting.

    Science.gov (United States)

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

    2016-05-27

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

  1. 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.

  2. 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.

  3. 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.

  4. Falls and Fractures in the Elderly with Sinus Node Disease: The Impact of Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    Nazmi Krasniqi

    2012-01-01

    Full Text Available Background. Falls and fractures in the elderly are among the leading causes of disability. We investigated whether pacemaker implantation prevents falls in patients with SND in a large cohort of patients. Methods. Patient demographics and medical history were collected prospectively. Fall history was retrospectively reconstituted from available medical records. The 10-year probability for major osteoporotic fractures was calculated retrospectively from available medical records using the Swiss fracture risk assessment tool FRAX-Switzerland. Results. During a mean observation period of 2.3 years after implantation, the rates of fallers and injured fallers with fracture were reduced to 15% and 6%, respectively. This corresponds to a relative reduction in the number of fallers of 75% (P<0.001 and of injured fallers of 63% (P=0.014 after pacemaker implantation. Similarly, the number of falls was reduced from 60 (48% before pacemaker implantation to 22 (18% thereafter (relative reduction 63%, P=0.035 and the number of falls with injury from 22 (18% to 7 (6%, which corresponds to a relative reduction of 67%, P=0.013. Conclusion. In patients with SND, pacemaker implantation significantly reduces the number of patients experiencing falls, the total number of falls, and the risk for osteoporotic fractures.

  5. 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.

  6. Fall prevention in central coast community pharmacies.

    Science.gov (United States)

    Stuart, Gina M; Kale, Helen L

    2018-04-19

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

  7. 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.

  8. 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.

  9. 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...

  10. 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...

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

    Science.gov (United States)

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

    2017-04-01

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

  12. Older Adult Knowledge and Behavior Change in the Stepping On Fall Prevention Program in a Community Setting

    Directory of Open Access Journals (Sweden)

    Jane Strommen

    2017-10-01

    Full Text Available One out of every three Americans age 65 and over falls at least once annually. Fall-related injuries among older adults are a major public health concern, and prevention of falls has emerged as a key issue in avoiding the risks to mobility and health that exist due to falls. Stepping On is an evidence-based fall prevention program designed to help older adults take control of their fall risk factors, explore different behavioral steps, and reduce their fall risk. This study shares findings from evaluation efforts conducted with 182 older adult participants in Stepping On from 2013 to 2015. Older adults in the program demonstrated (1 high satisfaction with program quality; (2 positive impacts on knowledge related to fall risk factors and prevention; and (3 substantial followthrough on behavioral steps designed to minimize fall risk. Program participants also shared positive feedback on the program in response to open-ended questions. Implications of the findings for fall risk reduction and programs to enhance fall prevention among older adults are discussed. Programs designed to reduce fall risk factors and enhance quality of life can be a critical tool to assist older adults, educators, and community leaders in addressing this public health issue.

  13. Falling into a black hole

    OpenAIRE

    Mathur, Samir D.

    2007-01-01

    String theory tells us that quantum gravity has a dual description as a field theory (without gravity). We use the field theory dual to ask what happens to an object as it falls into the simplest black hole: the 2-charge extremal hole. In the field theory description the wavefunction of a particle is spread over a large number of `loops', and the particle has a well-defined position in space only if it has the same `position' on each loop. For the infalling particle we find one definition of ...

  14. The variability of meteoroid falling

    Science.gov (United States)

    Velasco Herrera, V. M.; Cordero, G.

    2016-10-01

    We analysed a historical catalogue of meteoroid falling during the last 400 years. We report here for the first time the synchronization between observed meteors and solar barycentric parameters in 19.6 and 13.2 years periodicities using a new multiple cross wavelet. The group of moderated number of meteors is distributed around the positive phase of the solar barycentric periodicity of 13.2 years. While the group of severe number of meteors are distributed on the positive phase of the solar barycentric periodicity of 19.6 years. These periodicities could be associated with Jupiter periodicities. So understanding the modulation of meteoroid falling is important for determining the falling patterns of these objects and for knowing when it is more likely to expect the entry of one of these objects into the Earth's atmosphere, because bodies falling onto the Earth can cause damage from minor impacts to mass-extinctions events. One of the most extreme events was the formation of the Chicxulub impact crater 65,000,000 years ago that caused one of the five major mass extinctions in the last 500,000,000 years. During the 20th and 21st centuries, a series of events demonstrated the importance of collisions between planets and small bodies (comets and asteroids), which included our own planet. In the case of the Earth, we can cite three examples: Tunguska, Curuça and Chelyabinsk. These events invite us to think that perhaps the occurrence of this phenomenon might be more common than we realize, but the lack of communication or people in the area where they happened prevents us from having a complete record. Modern man has not witnessed the impact of large asteroids or comets on our planet, but it has been observed on other planetary bodies. The most spectacular of these events was the collision of fragments of the comet Shoemaker-Levy 9 with Jupiter in 1994. The total energy of the 21 impacts on Jupiter's atmosphere was estimated as the equivalent of tens of millions of

  15. 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.

  16. Journey to a safe environment: fall prevention in an emergency department at a level I trauma center.

    Science.gov (United States)

    Alexander, Danette; Kinsley, Terry L; Waszinski, Christine

    2013-07-01

    Predicting which patients will fall is a challenging task, especially in the often unpredictable setting of an emergency department of a Level I Trauma Center. Unfortunately, there is a great potential for falls to occur in this environment. Fall risk assessment tools used in inpatient settings do not adequately capture the risk factors of patients presenting to the emergency department. The ability to accurately identify patients at risk for falling at the point of entry is the first step toward preventing patient harm. Once patients are identified as at risk for a fall, the next challenge is to be sure that they do not fall. We created the KINDER1 Fall Risk Assessment Tool for use in the emergency department. This instrument was specifically designed for the rapid identification of patients at risk for a fall as well as the re-evaluation of patients for fall risk throughout their stay in the emergency department. Once we had an appropriate assessment tool, our next challenge was for staff to consistently apply fall prevention interventions. Performing a mini-root cause analysis on each fall showed trends and in turn led to the design and implementation of specific fall prevention interventions to motivate the nursing staff to focus on fall prevention that the ED nursing leadership used to select change strategies. With improved identification of fall risk patients and consistent application of innovative prevention strategies, we were able to show a trend toward reduction of falls and fall-related injuries in our emergency department. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  17. Fall risk factors in Parkinson's disease.

    Science.gov (United States)

    Gray, P; Hildebrand, K

    2000-08-01

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

  18. Intrinsic Risk Factors of Falls in Elderly

    Directory of Open Access Journals (Sweden)

    Yasmin Amatullah

    2016-09-01

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

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

    Science.gov (United States)

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

    2015-01-20

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

  20. 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.

  1. 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.

  2. Prevalence of falls in elderly women.

    Science.gov (United States)

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

    2015-01-01

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

  3. Reducing patients' falls rate in an Academic Medical Center (AMC) using Six Sigma "DMAIC" approach.

    Science.gov (United States)

    Kuwaiti, Ahmed Al; Subbarayalu, Arun Vijay

    2017-05-08

    Purpose The purpose of this paper is to evaluate the impact of adopting the Six Sigma define, measure, analyze, improve and control (DMAIC) approach in reducing patients fall rate in an Academic Medical Center, Saudi Arabia. Design/methodology/approach A prospective study design was adopted and this study was conducted at King Fahd Hospital of the University (KFHU) during the year 2014. Based on the historical data of the patients' falls reported at KFHU during the year 2013, the goal was fixed to reduce the falls rate from 7.18 toSix Sigma "DMAIC" approach improves the processes related to the prevention of falls. A greater reduction in patients falls rate (over 70 percent) was observed after the implementation of the improvement strategy.

  4. [Vertigo and falls in the elderly. Part 1: epidemiology, pathophysiology, vestibular diagnostics and risk of falling].

    Science.gov (United States)

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

    2008-08-01

    Disorders of the equilibrium function in the elderly will increase in the coming years due to demographic changes in Germany. In addition to a reduction in the quality of life of affected patients, the risk of suffering from a fall increases with age. At the morphological level age-specific changes of the peripheral vestibular structures, somatosensory pathways and vision can be found, such as degenerative alterations, reduced number of cells and receptors and an accumulation of lipofuscin. Disorders of the equilibrium function in old age are individual-specific, complex procedures which develop from age-related physiological, degenerative alterations in the components of the sensomotor system which maintain equilibrium and can come into being together with vestibular and non-vestibular accompanying diseases as well as psychological factors.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-07-01

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

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

    International Nuclear Information System (INIS)

    Skjerve, Eystein

    1986-01-01

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

  7. 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

  8. [Antimicrobial susceptibility in Chile 2012].

    Science.gov (United States)

    Cifuentes-D, Marcela; Silva, Francisco; García, Patricia; Bello, Helia; Briceño, Isabel; Calvo-A, Mario; Labarca, Jaime

    2014-04-01

    Bacteria antimicrobial resistance is an uncontrolled public health problem that progressively increases its magnitude and complexity. The Grupo Colaborativo de Resistencia, formed by a join of experts that represent 39 Chilean health institutions has been concerned with bacteria antimicrobial susceptibility in our country since 2008. In this document we present in vitro bacterial susceptibility accumulated during year 2012 belonging to 28 national health institutions that represent about 36% of hospital discharges in Chile. We consider of major importance to report periodically bacteria susceptibility so to keep the medical community updated to achieve target the empirical antimicrobial therapies and the control measures and prevention of the dissemination of multiresistant strains.

  9. 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.

  10. 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.

  11. New methods for fall risk prediction.

    Science.gov (United States)

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

    2014-09-01

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

  12. [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.

  13. Fall determinants and home modifications by occupational therapists to prevent falls: Facteurs déterminants des chutes et modifications du domicile effectuées par les ergothérapeutes pour prévenir les chutes.

    Science.gov (United States)

    Maggi, Patrick; de Almeida Mello, Johanna; Delye, Sam; Cès, Sophie; Macq, Jean; Gosset, Christiane; Declercq, Anja

    2018-02-01

    Approximately one third of older people over 65 years fall each year. Home modifications may decrease occurrence of falls. This study aims to determine the risk factors of falls for frail older persons and to evaluate the impact of home modifications by an occupational therapist on the occurrence of falls. We conducted a longitudinal study using a quasiexperimental design to examine occurrence of falls. All participants 65 years of age and older and were assessed at baseline and 6 months after the intervention. Bivariate analysis and logistic regression models were used to study the risk factors of falls and the effect of home modifications on the incidence of falls. The main predictors of falls were vision problems, distress of informal caregiver, and insufficient informal support. Home modifications provided by an occupational therapist showed a significant reduction of falls. Informal caregivers and their health status had an impact on the fall risk of frail older persons. Home modifications by an occupational therapist reduced the fall risk of frail older persons at 6-months follow-up.

  14. Internship Progress Summary: Fall 2016

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ralph S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Valencia, Matthew John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-13

    This fall I had the opportunity to work at Los Alamos National Laboratory for the Technology Applications engineering group. I assisted two main projects during my appointment, both related to the Lab’s mission statement: “To solve national security challenges through scientific excellence.” My first project, a thermal source transfer unit, involved skills such as mechanical design, heat transfer simulation, and design analysis. The goal was to create a container that could protect a heat source and regulate its temperature during transit. I generated several designs, performed heat transfer simulations, and chose a design for prototyping. The second project was a soil drying unit for use in post blast sample analysis. To ensure fast and accurate sample processing, agents in the field wanted a system that could process wet dirt and turn it into dry powder. We designed a system of commercially available parts, and we tested the systems to determine the best methods and processes.

  15. Voices Falling Through the Air

    Directory of Open Access Journals (Sweden)

    Paul Elliman

    2012-11-01

    Full Text Available Where am I? Or as the young boy in Jules Verne’s Journey to the Centre of the Earth calls back to his distant-voiced companions: ‘Lost… in the most intense darkness.’ ‘Then I understood it,’ says the boy, Axel, ‘To make them hear me, all I had to do was to speak with my mouth close to the wall, which would serve to conduct my voice, as the wire conducts the electric fluid’ (Verne 1864. By timing their calls, the group of explorers work out that Axel is separated from them by a distance of four miles, held in a cavernous vertical gallery of smooth rock. Feeling his way down towards the others, the boy ends up falling, along with his voice, through the space. Losing consciousness he seems to give himself up to the space...

  16. 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...

  17. 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.

  18. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Michelle H. Cameron

    2013-01-01

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

  1. 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.

  2. 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.

  3. Ancestral susceptibility to colorectal cancer

    Czech Academy of Sciences Publication Activity Database

    Huhn, S.; Pardini, Barbara; Naccarati, Alessio; Vodička, Pavel (ed.); Hemminki, K.; Försti, A.

    2012-01-01

    Roč. 27, č. 2 (2012), s. 197-204 ISSN 0267-8357 R&D Projects: GA ČR GA310/07/1430; GA ČR GAP304/10/1286 Grant - others:EU FP7(XE) HEALTH-F4-2007-200767 Institutional research plan: CEZ:AV0Z50390512 Keywords : cancer susceptibility * molecular epidemiology * genetic susceptibility Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.500, year: 2012

  4. Geriatric falls: prevention strategies for the staff.

    Science.gov (United States)

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

    1993-09-01

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

  5. IDENTIFYING ROOF FALL PREDICTORS USING FUZZY CLASSIFICATION

    International Nuclear Information System (INIS)

    Bertoncini, C. A.; Hinders, M. K.

    2010-01-01

    Microseismic monitoring involves placing geophones on the rock surfaces of a mine to record seismic activity. Classification of microseismic mine data can be used to predict seismic events in a mine to mitigate mining hazards, such as roof falls, where properly bolting and bracing the roof is often an insufficient method of preventing weak roofs from destabilizing. In this study, six months of recorded acoustic waveforms from microseismic monitoring in a Pennsylvania limestone mine were analyzed using classification techniques to predict roof falls. Fuzzy classification using features selected for computational ease was applied on the mine data. Both large roof fall events could be predicted using a Roof Fall Index (RFI) metric calculated from the results of the fuzzy classification. RFI was successfully used to resolve the two significant roof fall events and predicted both events by at least 15 hours before visual signs of the roof falls were evident.

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

    Science.gov (United States)

    Bhatt, Tanvi; Yang, Feng; Wang, Edward

    2014-01-01

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

  7. Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial.

    Science.gov (United States)

    Pai, Yi-Chung; Bhatt, Tanvi; Yang, Feng; Wang, Edward

    2014-12-01

    Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults' annual falls risk in their everyday living. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). With this single session of repeated-slip exposure, training cut older adults' annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. A single session of repeated-slip exposure could improve community-dwelling older adults' resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Gait, mobility, and falls in older people

    OpenAIRE

    Gschwind, Yves Josef

    2012-01-01

    My doctoral thesis contributes to the understanding of gait, mobility, and falls in older people. All presented projects investigated the most prominent and sensitive markers for fall-related gait changes, that is gait velocity and gait variability. Based on the measurement of these spatio-temporal gait parameters, particularly when using a change-sensitive dual task paradigm, it is possible to make conclusions regarding walking, balance, activities of daily living, and falls in o...

  9. 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

  10. 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...

  11. Radar fall detection using principal component analysis

    Science.gov (United States)

    Jokanovic, Branka; Amin, Moeness; Ahmad, Fauzia; Boashash, Boualem

    2016-05-01

    Falls are a major cause of fatal and nonfatal injuries in people aged 65 years and older. Radar has the potential to become one of the leading technologies for fall detection, thereby enabling the elderly to live independently. Existing techniques for fall detection using radar are based on manual feature extraction and require significant parameter tuning in order to provide successful detections. In this paper, we employ principal component analysis for fall detection, wherein eigen images of observed motions are employed for classification. Using real data, we demonstrate that the PCA based technique provides performance improvement over the conventional feature extraction methods.

  12. Ageing vision and falls: a review.

    Science.gov (United States)

    Saftari, Liana Nafisa; Kwon, Oh-Sang

    2018-04-23

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

  13. The Fall 2000 and Fall 2001 SOHO-Ulysses Quadratures

    Science.gov (United States)

    Suess, S. T.; Poletto, G.; Rose, M. Franklin (Technical Monitor)

    2001-01-01

    SOHO-Ulysses quadrature occurs when the SOHO-Sun-Ulysses included angle is 90 degrees. It is only at such times that the same plasma leaving the Sun in the direction of Ulysses can first be remotely analyzed with SOHO instruments and then later be sampled in situ by Ulysses instruments. The quadratures in December 2000 and 2001 are of special significance because Ulysses will be near the south and north heliographic poles, respectively, and the solar cycle will be near sunspot maximum. Quadrature geometry is sometimes confusing and observations are influenced by solar rotation. The Fall 2000 and 2001 quadratures are more complex than usual because Ulysses is not in a true polar orbit and the orbital speed of Ulysses about the Sun is becoming comparable to the speed of SOHO about the Sun. In 2000 Ulysses will always be slightly behind the pole but will appear to hang over the pole for over two months because it is moving around the Sun in the same direction as SOHO. In 2001 Ulysses will be slightly in front of the pole so that its footpoint will be directly observable. Detailed plots will be shown of the relative positions of SOHO and Ulysses will their relative positions. In neither case is true quadrature actually achieved, but this works to the observers advantage in 2001.

  14. 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.

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Niko M. Perttila

    2017-06-01

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

  18. 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

  19. 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...

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

    Science.gov (United States)

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

    2012-05-01

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

  1. Reduction corporoplasty.

    Science.gov (United States)

    Hakky, Tariq S; Martinez, Daniel; Yang, Christopher; Carrion, Rafael E

    2015-01-01

    Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. The patient tolerated the procedure well and has resolution of his corporal disfigurement. Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement.

  2. 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

  3. 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.

  4. 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.

  5. Falling films on flexible inclines

    Science.gov (United States)

    Matar, O. K.; Craster, R. V.; Kumar, S.

    2007-11-01

    The nonlinear stability and dynamic behavior of falling fluid films is studied for flow over a flexible substrate. We use asymptotic methods to deduce governing equations valid in various limits. Long-wave theory is used to derive Benney-like coupled equations for the film thickness and substrate deflection. Weakly nonlinear equations are then derived from these equations that, in the limit of large wall damping and/or large wall tension, reduce to the Kuramoto-Sivashinsky equation. These models break down when inertia becomes more significant, so we also use a long-wave approximation in conjunction with integral theory to derive three strongly coupled nonlinear evolution equations for the film thickness, substrate deflection, and film volumetric flow rate valid at higher Reynolds numbers. These equations, accounting for inertia, capillary, viscous, wall tension, and damping effects, are solved over a wide range of parameters. Our results suggest that decreasing wall damping and/or wall tension can promote the development of chaos in the weakly nonlinear regime and lead to severe substrate deformations in the strongly nonlinear regime; these can give rise to situations in which the free surface and underlying substrate come into contact in finite time.

  6. Falling into Salvation in Cioran

    Directory of Open Access Journals (Sweden)

    Joseph Acquisto

    2014-01-01

    Full Text Available While, at first glance, there seems to be very little room in the thought of E.M. Cioran for the notion of salvation, a closer look reveals that Cioran returns constantly to the vocabulary and the concept of redemption. This article teases out Cioran’s complex use of the topos of salvation throughout his works, with special emphasis on his middle period. I begin by tracing Cioran’s notion of humanity’s fall into time and language, from which he claims there can be no salvation in the traditional Christian sense. Nonetheless, he retains the concept, claiming at various points that there is a kind of salvation to be found in suicide, music, silence, and skepticism. Ultimately, however, each of these provides only false salvation, since the only permanent solution to the problem of existence for Cioran would be either to cease to exist or to lose our human nature in exchange for a plant-like life. Since this is impossible, we are left with our human means of seeking deliverance. While Cioran generally condemns human attempts at creation or procreation, he takes a different approach to the act of writing. In his reflections on writing we see that salvation for Cioran is always temporary, provisional, and threatened by our next bout of lucidity, but at the same time, eternally renewable with each new act of writing.

  7. Klamath Falls geothermal field, Oregon

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.J.; Culver, G.; Lund, J.W.

    1989-09-01

    Klamath Falls, Oregon, is located in a Known Geothermal Resource Area which has been used by residents, principally to obtain geothermal fluids for space heating, at least since the turn of the century. Over 500 shallow-depth wells ranging from 90 to 2,000 ft (27 to 610 m) in depth are used to heat (35 MWt) over 600 structures. This utilization includes the heating of homes, apartments, schools, commercial buildings, hospital, county jail, YMCA, and swimming pools by individual wells and three district heating systems. Geothermal well temperatures range from 100 to 230{degree}F (38 to 110{degree}C) and the most common practice is to use downhole heat exchangers with city water as the circulating fluid. Larger facilities and district heating systems use lineshaft vertical turbine pumps and plate heat exchangers. Well water chemistry indicates approximately 800 ppM dissolved solids, with sodium sulfate having the highest concentration. Some scaling and corrosion does occur on the downhole heat exchangers (black iron pipe) and on heating systems where the geo-fluid is used directly. 73 refs., 49 figs., 6 tabs.

  8. Nuclear winter or nuclear fall?

    Science.gov (United States)

    Berger, André

    Climate is universal. If a major modern nuclear war (i.e., with a large number of small-yield weapons) were to happen, it is not even necessary to have a specific part of the world directly involved for there to be cause to worry about the consequences for its inhabitants and their future. Indeed, smoke from fires ignited by the nuclear explosions would be transported by winds all over the world, causing dark and cold. According to the first study, by Turco et al. [1983], air surface temperature over continental areas of the northern mid-latitudes (assumed to be the nuclear war theatre) would fall to winter levels even in summer (hence the term “nuclear winter”) and induce drastic climatic conditions for several months at least. The devastating effects of a nuclear war would thus last much longer than was assumed initially. Discussing to what extent these estimations of long-term impacts on climate are reliable is the purpose of this article.

  9. 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.

  10. Susceptibility Genes in Thyroid Autoimmunity

    Directory of Open Access Journals (Sweden)

    Yoshiyuki Ban

    2005-01-01

    Full Text Available The autoimmune thyroid diseases (AITD are complex diseases which are caused by an interaction between susceptibility genes and environmental triggers. Genetic susceptibility in combination with external factors (e.g. dietary iodine is believed to initiate the autoimmune response to thyroid antigens. Abundant epidemiological data, including family and twin studies, point to a strong genetic influence on the development of AITD. Various techniques have been employed to identify the genes contributing to the etiology of AITD, including candidate gene analysis and whole genome screening. These studies have enabled the identification of several loci (genetic regions that are linked with AITD, and in some of these loci, putative AITD susceptibility genes have been identified. Some of these genes/loci are unique to Graves' disease (GD and Hashimoto's thyroiditis (HT and some are common to both the diseases, indicating that there is a shared genetic susceptibility to GD and HT. The putative GD and HT susceptibility genes include both immune modifying genes (e.g. HLA, CTLA-4 and thyroid specific genes (e.g. TSHR, Tg. Most likely, these loci interact and their interactions may influence disease phenotype and severity.

  11. How Fast Does a Building Fall?

    Science.gov (United States)

    Denny, Mark

    2010-01-01

    In this paper, the time required for a tower block to collapse is calculated. The tower collapses progressively, with one floor falling onto the floor below, causing it to fall. The rate of collapse is found to be not much slower than freefall. The calculation is an engaging and relevant application of Newton's laws, suitable for undergraduate…

  12. Free Fall and the Equivalence Principle Revisited

    Science.gov (United States)

    Pendrill, Ann-Marie

    2017-01-01

    Free fall is commonly discussed as an example of the equivalence principle, in the context of a homogeneous gravitational field, which is a reasonable approximation for small test masses falling moderate distances. Newton's law of gravity provides a generalisation to larger distances, and also brings in an inhomogeneity in the gravitational field.…

  13. 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.

  14. Fall prevention strategy in an emergency department.

    Science.gov (United States)

    Muray, Mwali; Bélanger, Charles H; Razmak, Jamil

    2018-02-12

    Purpose The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services. Design/methodology/approach The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ 2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables. Findings In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool. Originality/value Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

  15. Disproportion in the falling birth rate.

    Science.gov (United States)

    Gordon, R R

    1977-10-08

    Since 1962 there has been a disproportionately greater fall in the number of small (less than 1000 g) live births than total live births: this has applied to Sheffield and to England and Wales but more to the former. This may have affected falling neonatal mortality rates.

  16. 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.

  17. Nurses' Job Satisfaction and Patient Falls

    Directory of Open Access Journals (Sweden)

    Cecilia D. Alvarez, DNP, RN

    2007-09-01

    Results and Conclusion: No significant relationship was found between overall nurses' job satisfaction and patient fall rate. MD–RN interactions (r = .65 and decision-making (r = .57 were the job satisfaction subscales that showed a significant positive correlation with patient fall rate (p < .05. Recommendations for future research are provided.

  18. Risk factors for falls of older citizens

    NARCIS (Netherlands)

    Boelens, C.; Hekman, E. E. G.; Verkerke, G. J.

    2013-01-01

    OBJECTIVE: Fall prevention is a major issue in the ageing society. This study provides an overview of all risk factors for falls of older citizens. METHOD: A literature search was conducted to retrieve studies of the past 25 years. All participants from the studies lived in the community or

  19. 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

  20. 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.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  2. [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

  3. 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.

  4. Hydrogen embrittlement susceptibility of laser-hardened 4140 steel

    Energy Technology Data Exchange (ETDEWEB)

    Tsay, L.W.; Lin, Z.W. [Nat. Taiwan Ocean Univ., Keelung (Taiwan). Inst. of Mater. Eng.; Shiue, R.K. [Institute of Materials Sciences and Engineering, National Dong Hwa University, Hualien, Taiwan (Taiwan); Chen, C. [Institute of Materials Sciences and Engineering, National Taiwan University, Taipei, Taiwan (Taiwan)

    2000-10-15

    Slow strain rate tensile (SSRT) tests were performed to investigate the susceptibility to hydrogen embrittlement of laser-hardened AISI 4140 specimens in air, gaseous hydrogen and saturated H{sub 2}S solution. Experimental results indicated that round bar specimens with two parallel hardened bands on opposite sides along the loading axis (i.e. the PH specimens), exhibited a huge reduction in tensile ductility for all test environments. While circular-hardened (CH) specimens with 1 mm hardened depth and 6 mm wide within the gauge length were resistant to gaseous hydrogen embrittlement. However, fully hardened CH specimens became susceptible to hydrogen embrittlement for testing in air at a lower strain rate. The strength of CH specimens increased with decreasing the depth of hardened zones in a saturated H{sub 2}S solution. The premature failure of hardened zones in a susceptible environment caused the formation of brittle intergranular fracture and the decrease in tensile ductility. (orig.)

  5. Influence of deformation on SCC susceptibility of austenitic stainless steel in PWR primary water

    Energy Technology Data Exchange (ETDEWEB)

    Kaneshima, Yoshiari; Totsuka, Nobuo; Nakajima, Nobuo [Institute of Nuclear Safety System Inc., Mihama, Fukui (Japan)

    2001-09-01

    Slow strain rate tests (SSRT) were carried out to evaluate the SCC susceptibility of four types of austenitic stainless steels (SUS304, SUS316, SUS304L and SUS316L) in PWR primary water. The influence of deformation on SCC susceptibility of SUS316 was studied. All types of stainless steel were susceptible to SCC, and the SCC susceptibility varied depending on the steel type. The comparison of the SSRT results and tensile test in air based on the reduction of area measurement showed that the SCC susceptibility increased with increasing the degree of deformation. For explaining the influence of deformation on SCC susceptibility, it is necessary to evaluate both intergranular and transgranular fractures. (author)

  6. Fall Detection Using Smartphone Audio Features.

    Science.gov (United States)

    Cheffena, Michael

    2016-07-01

    An automated fall detection system based on smartphone audio features is developed. The spectrogram, mel frequency cepstral coefficents (MFCCs), linear predictive coding (LPC), and matching pursuit (MP) features of different fall and no-fall sound events are extracted from experimental data. Based on the extracted audio features, four different machine learning classifiers: k-nearest neighbor classifier (k-NN), support vector machine (SVM), least squares method (LSM), and artificial neural network (ANN) are investigated for distinguishing between fall and no-fall events. For each audio feature, the performance of each classifier in terms of sensitivity, specificity, accuracy, and computational complexity is evaluated. The best performance is achieved using spectrogram features with ANN classifier with sensitivity, specificity, and accuracy all above 98%. The classifier also has acceptable computational requirement for training and testing. The system is applicable in home environments where the phone is placed in the vicinity of the user.

  7. The influence of socio-demographic and environmental factors on the fall rate in geriatric patients in primary health care

    Directory of Open Access Journals (Sweden)

    Magdalena Sylwia Kamińska

    2017-06-01

    Full Text Available Background . A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Falls are the leading cause of injuries among geriatrics and a factor which significantly lowers their quality of life. Objectives. The aim of this study was to identify fall risk factors in the elderly with regard to their environmental situation and sociodemographic data. Material and methods. This epidemiological population-based study involved 304 patients from selected outpatient clinics. The median age was 79 years. Our study employed a diagnostic survey-based method using an environmental inquiry of our devising, as well as the Tinetti Test (TT. Results . A statistically significant correlation was found between the number of falls and such variables as age, the family structure and family care efficiency (p 0.05. Regardless of whether the respondents experienced falls or not, a vast majority of them showed a need for information support concerning the reduction of fall risk in the future. Conclusions . 1. Risk factors for falls among geriatric patients include age, falls in the medical history, solitude as an adverse social situation and the unpreparedness of the family for taking non-professional care of their elderly relatives. 2. According to the respondents, information support may improve their knowledge of fall prevention and ways of handling the situation with increasingly limited self- -reliance, and the preparation of their families for taking care of them may reduce the risk of falls.

  8. 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

  9. 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 .

  10. Cerebral malaria: susceptibility weighted MRI

    Directory of Open Access Journals (Sweden)

    Vinit Baliyan

    2015-03-01

    Full Text Available Cerebral malaria is one of the fatal complications of Plasmodium falciparum infection. Pathogenesis involves cerebral microangiopathy related to microvascular plugging by infected red blood cells. Conventional imaging with MRI and CT do not reveal anything specific in case of cerebral malaria. Susceptibility weighted imaging, a recent advance in the MRI, is very sensitive to microbleeds related to microangiopathy. Histopathological studies in cerebral malaria have revealed microbleeds in brain parenchyma secondary to microangiopathy. Susceptibility weighted imaging, being exquisitely sensitive to microbleeds may provide additional information and improve the diagnostic accuracy of MRI in cerebral malaria.

  11. Topological susceptibility from the overlap

    DEFF Research Database (Denmark)

    Del Debbio, Luigi; Pica, Claudio

    2003-01-01

    The chiral symmetry at finite lattice spacing of Ginsparg-Wilson fermionic actions constrains the renormalization of the lattice operators; in particular, the topological susceptibility does not require any renormalization, when using a fermionic estimator to define the topological charge....... Therefore, the overlap formalism appears as an appealing candidate to study the continuum limit of the topological susceptibility while keeping the systematic errors under theoretical control. We present results for the SU(3) pure gauge theory using the index of the overlap Dirac operator to study...

  12. How deep-sea wood falls sustain chemosynthetic life.

    Directory of Open Access Journals (Sweden)

    Christina Bienhold

    Full Text Available Large organic food falls to the deep sea--such as whale carcasses and wood logs--are known to serve as stepping stones for the dispersal of highly adapted chemosynthetic organisms inhabiting hot vents and cold seeps. Here we investigated the biogeochemical and microbiological processes leading to the development of sulfidic niches by deploying wood colonization experiments at a depth of 1690 m in the Eastern Mediterranean for one year. Wood-boring bivalves of the genus Xylophaga played a key role in the degradation of the wood logs, facilitating the development of anoxic zones and anaerobic microbial processes such as sulfate reduction. Fauna and bacteria associated with the wood included types reported from other deep-sea habitats including chemosynthetic ecosystems, confirming the potential role of large organic food falls as biodiversity hot spots and stepping stones for vent and seep communities. Specific bacterial communities developed on and around the wood falls within one year and were distinct from freshly submerged wood and background sediments. These included sulfate-reducing and cellulolytic bacterial taxa, which are likely to play an important role in the utilization of wood by chemosynthetic life and other deep-sea animals.

  13. How Deep-Sea Wood Falls Sustain Chemosynthetic Life

    Science.gov (United States)

    Bienhold, Christina; Pop Ristova, Petra; Wenzhöfer, Frank; Dittmar, Thorsten; Boetius, Antje

    2013-01-01

    Large organic food falls to the deep sea – such as whale carcasses and wood logs – are known to serve as stepping stones for the dispersal of highly adapted chemosynthetic organisms inhabiting hot vents and cold seeps. Here we investigated the biogeochemical and microbiological processes leading to the development of sulfidic niches by deploying wood colonization experiments at a depth of 1690 m in the Eastern Mediterranean for one year. Wood-boring bivalves of the genus Xylophaga played a key role in the degradation of the wood logs, facilitating the development of anoxic zones and anaerobic microbial processes such as sulfate reduction. Fauna and bacteria associated with the wood included types reported from other deep-sea habitats including chemosynthetic ecosystems, confirming the potential role of large organic food falls as biodiversity hot spots and stepping stones for vent and seep communities. Specific bacterial communities developed on and around the wood falls within one year and were distinct from freshly submerged wood and background sediments. These included sulfate-reducing and cellulolytic bacterial taxa, which are likely to play an important role in the utilization of wood by chemosynthetic life and other deep-sea animals. PMID:23301092

  14. Using dynamic walking models to identify factors that contribute to increased risk of falling in older adults.

    Science.gov (United States)

    Roos, Paulien E; Dingwell, Jonathan B

    2013-10-01

    Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of

  15. Using Dynamic Walking Models to Identify Factors that Contribute to Increased Risk of Falling in Older Adults

    Science.gov (United States)

    Roos, Paulien E.; Dingwell, Jonathan B.

    2013-01-01

    Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of

  16. Evaluation of Local Wheat Cultivars Susceptibility to infection with Black Stem Rust

    International Nuclear Information System (INIS)

    Batta, Y.A.

    2007-01-01

    The present study was conducted to assess the susceptibility of seven local wheat cultivars from Palestine to infection with black stem rust caused by Puccinia graminis f. sp. tritici. Two techniques of disease inoculation were applied during bioassays: global inoculation of entire wheat plants with urediospores and localized inoculation with urediospores and localized inoculation with urediospores on wheat leaf-pieces incubated under humid conditions. Susceptibility of tested cultivars was evaluated according to disease scale based on number and size of typical unredial pustules that appeared after inoculation on entire plants or leaf pieces. Results obtained on bioassay of susceptibility and disease rating on entire plants indicated that Anbar, Kamata and Hetiya safra cultivars were the least susceptible to P. g. tritici infection, whereas Debiya beda cultivar was the most susceptible. The other tested cultivars such as Nab-El-Jama, sawda and Senf 870 were moderately susceptible. On leaf-pieces, Anbar and Kamatat were the least susceptible cultivars, whereas Debiya beda and Nab-El-Jamal were the most susceptible cultivars. The other tested cultivars such as Debiya swada, Senf 870 and Hetiya safra were moderately susceptible. Significant reductions were obtained for the size of unredial postules formed on leaf-pieces when inoculated in an unwounded state compared to the wounded indicating the importance of wounds during inoculation. The global results indicated the possibility of using above method of disease inoculating, scaling and rating for evaluation of wheat cultivars susceptibility for the eventual use in breeding program for resistant varieties in Palestine. (author)

  17. Reduction Corporoplasty

    Directory of Open Access Journals (Sweden)

    Tariq S. Hakky

    2015-04-01

    Full Text Available Objective Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Introduction Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. Results The patient tolerated the procedure well and has resolution of his corporal disfigurement. Conclusions Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement.

  18. A landslide susceptibility map of Africa

    Science.gov (United States)

    Broeckx, Jente; Vanmaercke, Matthias; Duchateau, Rica; Poesen, Jean

    2017-04-01

    Studies on landslide risks and fatalities indicate that landslides are a global threat to humans, infrastructure and the environment, certainly in Africa. Nonetheless our understanding of the spatial patterns of landslides and rockfalls on this continent is very limited. Also in global landslide susceptibility maps, Africa is mostly underrepresented in the inventories used to construct these maps. As a result, predicted landslide susceptibilities remain subject to very large uncertainties. This research aims to produce a first continent-wide landslide susceptibility map for Africa, calibrated with a well-distributed landslide dataset. As a first step, we compiled all available landslide inventories for Africa. This data was supplemented by additional landslide mapping with Google Earth in underrepresented regions. This way, we compiled 60 landslide inventories from the literature (ca. 11000 landslides) and an additional 6500 landslides through mapping in Google Earth (including 1500 rockfalls). Various environmental variables such as slope, lithology, soil characteristics, land use, precipitation and seismic activity, were investigated for their significance in explaining the observed spatial patterns of landslides. To account for potential mapping biases in our dataset, we used Monte Carlo simulations that selected different subsets of mapped landslides, tested the significance of the considered environmental variables and evaluated the performance of the fitted multiple logistic regression model against another subset of mapped landslides. Based on these analyses, we constructed two landslide susceptibility maps for Africa: one for all landslide types and one excluding rockfalls. In both maps, topography, lithology and seismic activity were the most significant variables. The latter factor may be surprising, given the overall limited degree of seismicity in Africa. However, its significance indicates that frequent seismic events may serve as in important

  19. The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender.

    Science.gov (United States)

    Herman, Talia; Inbar-Borovsky, Noit; Brozgol, Marina; Giladi, Nir; Hausdorff, Jeffrey M

    2009-02-01

    The Dynamic Gait Index (DGI) was developed as a clinical tool to assess gait, balance and fall risk. Because the DGI evaluates not only usual steady-state walking, but also walking during more challenging tasks, it may be an especially sensitive test. The present investigation evaluated the DGI and its association with falls, fear of falling, depression, anxiety and other measures of balance and mobility in 278 healthy elderly individuals. Measures included the DGI, the Berg Balance Test (BBT), the Timed Up and Go (TUAG), the Mini-Mental State Exam (MMSE), the Unified Parkinson's Disease Rating Scale (UPDRS) motor part, the Activities-specific Balance Confidence (ABC) scale and the number of annual falls. The DGI was moderately correlated with the BBT (r=0.53; pfall history were different. These findings suggest that the DGI, although susceptible to ceiling effects, appears to be an appropriate tool for assessing function in healthy older adults.

  20. An Event-Triggered Machine Learning Approach for Accelerometer-Based Fall Detection.

    Science.gov (United States)

    Putra, I Putu Edy Suardiyana; Brusey, James; Gaura, Elena; Vesilo, Rein

    2017-12-22

    The fixed-size non-overlapping sliding window (FNSW) and fixed-size overlapping sliding window (FOSW) approaches are the most commonly used data-segmentation techniques in machine learning-based fall detection using accelerometer sensors. However, these techniques do not segment by fall stages (pre-impact, impact, and post-impact) and thus useful information is lost, which may reduce the detection rate of the classifier. Aligning the segment with the fall stage is difficult, as the segment size varies. We propose an event-triggered machine learning (EvenT-ML) approach that aligns each fall stage so that the characteristic features of the fall stages are more easily recognized. To evaluate our approach, two publicly accessible datasets were used. Classification and regression tree (CART), k -nearest neighbor ( k -NN), logistic regression (LR), and the support vector machine (SVM) were used to train the classifiers. EvenT-ML gives classifier F-scores of 98% for a chest-worn sensor and 92% for a waist-worn sensor, and significantly reduces the computational cost compared with the FNSW- and FOSW-based approaches, with reductions of up to 8-fold and 78-fold, respectively. EvenT-ML achieves a significantly better F-score than existing fall detection approaches. These results indicate that aligning feature segments with fall stages significantly increases the detection rate and reduces the computational cost.

  1. Benzodiazepines Withdrawal: Initial Outcomes and Long-Term Impact on Falls in a French Nursing Home

    Directory of Open Access Journals (Sweden)

    Hervé Javelot

    2018-04-01

    Full Text Available Long-term use of benzodiazepines (BZDs is known to induce tolerance and dependence, and increase the risk of falls-related injuries in older adults. We present a study carried out in a French nursing home that concerns the implementation of a BZD withdrawal program reassessed at one year. BZD deprescription was achieved by gradual cessation of doses. A secondary benefit of this program was assessed by comparing the number of falls among residents before and after withdrawal. The number of falls was recorded over a six-month period prior to the onset of withdrawal (T1 and then over a six-month period after reassessment at one year (T2. At the beginning, 31 (28.7% of the patients were under BZD. Total deprescription was obtained for 11 patients. The number of falls per patient over the T1 period was not different between the two groups (future non-withdrawn and withdrawn patients in BZD: 2.1 ± 1.3 and 2.3 ± 0.6 falls per resident, respectively. Conversely, the number of falls per patient was significantly decreased in the population completely withdrawn in BZD between the T1 and T2 periods (2.3 ± 0.6 vs. 0.5 ± 0.2 falls, p = 0.01. The results show that BZD deprescription, through a gradual reduction of doses, is possible to achieve.

  2. 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.

  3. 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.

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

  6. Preclinical Alzheimer disease and risk of falls.

    Science.gov (United States)

    Stark, Susan L; Roe, Catherine M; Grant, Elizabeth A; Hollingsworth, Holly; Benzinger, Tammie L; Fagan, Anne M; Buckles, Virginia D; Morris, John C

    2013-07-30

    We determined the rate of falls among cognitively normal, community-dwelling older adults, some of whom had presumptive preclinical Alzheimer disease (AD) as detected by in vivo imaging of fibrillar amyloid plaques using Pittsburgh compound B (PiB) and PET and/or by assays of CSF to identify Aβ₄₂, tau, and phosphorylated tau. We conducted a 12-month prospective cohort study to examine the cumulative incidence of falls. Participants were evaluated clinically and underwent PiB PET imaging and lumbar puncture. Falls were reported monthly using an individualized calendar journal returned by mail. A Cox proportional hazards model was used to test whether time to first fall was associated with each biomarker and the ratio of CSF tau/Aβ₄₂ and CSF phosphorylated tau/Aβ₄₂, after adjustment for common fall risk factors. The sample (n = 125) was predominately female (62.4%) and white (96%) with a mean age of 74.4 years. When controlled for ability to perform activities of daily living, higher levels of PiB retention (hazard ratio = 2.95 [95% confidence interval 1.01-6.45], p = 0.05) and of CSF biomarker ratios (p risk factor for falls in older adults. This study suggests that subtle noncognitive changes that predispose older adults to falls are associated with AD and may precede detectable cognitive changes.

  7. Pathogenesis and treatment of falls in elderly

    Science.gov (United States)

    Pasquetti, Pietro; Apicella, Lorenzo; Mangone, Giuseppe

    2014-01-01

    Summary Falls in the elderly are a public health problem. Consequences of falls are increased risk of hospitalization, which results in an increase in health care costs. It is estimated that 33% of individuals older than 65 years undergoes falls. Causes of falls can be distinguished in intrinsic and extrinsic predisposing conditions. The intrinsic causes can be divided into age-related physiological changes and pathological predisposing conditions. The age-related physiological changes are sight disorders, hearing disorders, alterations in the Central Nervous System, balance deficits, musculoskeletal alterations. The pathological conditions can be Neurological, Cardiovascular, Endocrine, Psychiatric, Iatrogenic. Extrinsic causes of falling are environmental factors such as obstacles, inadequate footwear. The treatment of falls must be multidimensional and multidisciplinary. The best instrument in evaluating elderly at risk is Comprehensive Geriatric Assessment (CGA). CGA allows better management resulting in reduced costs. The treatment should be primarily preventive acting on extrinsic causes; then treatment of chronic and acute diseases. Rehabilitation is fundamental, in order to improve residual capacity, motor skills, postural control, recovery of strength. There are two main types of exercises: aerobic and muscular strength training. Education of patient is a key-point, in particular through the Back School. In conclusion falls in the elderly are presented as a “geriatric syndrome”; through a multidimensional assessment, an integrated treatment and a rehabilitation program is possible to improve quality of life in elderly. PMID:25568657

  8. Neuropsychological Mechanisms for Falls in Older Adults

    Directory of Open Access Journals (Sweden)

    Yu eLiu

    2014-04-01

    Full Text Available Falls, a common cause of injury among older adults, have become increasingly prevalent. As the world’s population ages, the increase in – and the prevalence of – falls among older people makes this a serious and compelling societal and healthcare issue. Physical weakness is a critical predictor in falling. While considerable research has examined this relationship, comprehensive reviews of neuropsychological predictors of falls have been lacking. In this paper, we examine and discuss current studies of the neuropsychological predictors of falls in older adults, as related to sporting and non-sporting contexts. By integrating the existing evidence, we propose that brain aging is an important precursor of the increased risk of falls in older adults. Brain aging disrupts the neural integrity of motor outputs and reduces neuropsychological abilities. Older adults may shift from unconscious movement control to more conscious or attentive motor control. Increased understanding of the causes of falls will afford opportunities to reduce their incidence, reduce consequent injuries, improve overall well-being and quality of life, and possibly to prolong life.

  9. 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.

  10. One-Year Mortality Rates Before and After Implementing Quality-Improvement Initiatives to Prevent Inpatient Falls (2012–2016

    Directory of Open Access Journals (Sweden)

    Inderpal Singh

    2018-03-01

    Full Text Available Single-room ward design has previously been associated with increased risk of inpatient falls and adverse outcomes. However, following quality initiatives, the incidence of inpatient falls has shown a sustained reduction. Benefits have also been observed in the reduction of hip fractures. However, one-year mortality trends have not been reported. The aim of this observational study is to report the trends in one-year mortality rates before and after implementing quality-improvement initiatives to prevent inpatient falls over the last 5 years (2012–2016. This retrospective observational study was conducted for all patients who had sustained an inpatient fall between January 2012 and December 2016. All the incident reports in DATIX patient-safety software which were completed for each inpatient fall were studied, and the clinical information was extracted from Clinical Work Station software. Mortality data were collected on all patients for a minimum of one year following the discharge from the hospital. The results show that 95% patients were admitted from their own homes; 1704 patients had experienced 3408 incidents of an inpatient fall over 5 years. The mean age of females (82.61 ± 10.34 years was significantly higher than males (79.36 ± 10.14 years. Mean falls/patient = 2.0 ± 2.16, range 1–33. Mean hospital stay was 45.43 ± 41.42 days. Mean hospital stay to the first fall was 14.5 ± 20.79 days, and mean days to first fall prior to discharge was 30.8 ± 34.33 days. The results showed a significant and sustained reduction in the incidence of inpatient falls. There was a downward trend in the incidence of hip fractures over the last two years. There was no significant difference in the inpatient and 30-day mortality rate over the last five years. However, mortality trends appear to show a significant downward trend in both six-month and one-year mortality rates over the last two years following the implementation of quality initiatives

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

    Directory of Open Access Journals (Sweden)

    Santosh K Verma

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

  12. 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

  13. Fall from heights: does height really matter?

    Science.gov (United States)

    Alizo, G; Sciarretta, J D; Gibson, S; Muertos, K; Romano, A; Davis, J; Pepe, A

    2018-06-01

    Fall from heights is high energy injuries and constitutes a fraction of all fall-related trauma evaluations while bearing an increase in morbidity and mortality. We hypothesize that despite advancements in trauma care, the overall survivability has not improved in this subset of trauma patients. All adult trauma patients treated after sustaining a fall from heights during a 40-month period were retrospectively reviewed. Admission demographics, clinical data, fall height (ft), injury patterns, ISS, GCS, length of stay, and mortality were reviewed. 116 patients sustained a fall from heights, 90.4% accidental. A mean age of 37± 14.7 years, 86% male, and a fall height of 19 ± 10 ft were encountered. Admission GCS was 13 ± 2 with ISS 10 ± 11. Overall LOS was 6.6 ± 14.9 days and an ICU LOS of 2.8 ± 8.9 days. Falls ≥ 25 ft.(16%) had lower GCS 10.4 ± 5.8, increased ISS 22.6 ± 13.8, a fall height 37.9 ± 13.1 ft and associated increased mortality (p < 0.001). Mortality was 5.2%, a mean distance fallen of 39 ± 22 ft. and an ISS of 31.5 ±16.5. Brain injury was the leading cause of death, 50% with open skull fractures. Level of height fallen is a good predictor of overall outcome and survival. Despite advances in trauma care, death rates remain unchanged. Safety awareness and injury prevention programs are needed to reduce the risk of high-level falls.

  14. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

  16. 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.

  17. Prion protein and scrapie susceptibility

    NARCIS (Netherlands)

    Smits, M.A.; Bossers, A.; Schreuder, B.E.C.

    1997-01-01

    This article presents briefly current views on the role of prion protein (PrP) in Transmissible Spongiform Encephalopathies or prion diseases and the effect of PrP polymoryhisms on the susceptibility to these diseases, with special emphasis on sheep scrapie. The PrP genotype of sheep apears to be a

  18. Antifungal susceptibilities of Cryptococcus neoformans.

    Science.gov (United States)

    Archibald, Lennox K; Tuohy, Marion J; Wilson, Deborah A; Nwanyanwu, Okey; Kazembe, Peter N; Tansuphasawadikul, Somsit; Eampokalap, Boonchuay; Chaovavanich, Achara; Reller, L Barth; Jarvis, William R; Hall, Gerri S; Procop, Gary W

    2004-01-01

    Susceptibility profiles of medically important fungi in less-developed countries remain uncharacterized. We measured the MICs of amphotericin B, 5-flucytosine, fluconazole, itraconazole, and ketoconazole for Cryptococcus neoformans clinical isolates from Thailand, Malawi, and the United States and found no evidence of resistance or MIC profile differences among the countries.

  19. India, Genomic diversity & Disease susceptibility

    Indian Academy of Sciences (India)

    Table of contents. India, Genomic diversity & Disease susceptibility · India, a paradise for Genetic Studies · Involved in earlier stages of Immune response protecting us from Diseases, Responsible for kidney and other transplant rejections Inherited from our parents · PowerPoint Presentation · Slide 5 · Slide 6 · Slide 7.

  20. Understanding Design Vulnerabilities in the Physical Environment Relating to Patient Fall Patterns in a Psychiatric Hospital: Seven Years of Sentinel Events.

    Science.gov (United States)

    Bayramzadeh, Sara; Portillo, Margaret; Carmel-Gilfilen, Candy

    2018-05-01

    The influence of the physical environment on patient falls has not been fully explored in psychiatric units, despite this patient population's vulnerability and the critical role of the physical environment in patient safety. The research objective is to describe the spatial and temporal pattern of falls occurrences and their location in relation to the levels of safety continuum model. This article presents an exploratory case study design. Seven years of retrospective data on patient falls, yielding 818 sentinel events, in an 81-bed psychiatric hospital in the United States were collected and analyzed. Data focused on extrinsic factors for falls, emphasizing the physical environment. Through a content analysis of the sentinel event narratives, recorded by the hospital staff, this study explored patient falls related to location and elements of the physical environment. The analysis revealed that 15% of recorded falls were attributed to some aspect of or element within the physical environment. The most typical locations of falls were patient rooms (39%), patient bathrooms (22%), and dayrooms (20%). Also, the results identified patterns of environmental factors that appeared linked to increasing patients' susceptibility to falls. Risk factors included poor nighttime lighting, flooring surfaces that were uneven, and spaces that inadvertently limited visual access and supervision. The physical environment plays an often-unexamined role in fall events and specific locations. These results are deserving of further research on design strategies and applications to reduce patient falls in psychiatric hospital settings.

  1. Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

    Science.gov (United States)

    Hoffman, Geoffrey J; Hays, Ron D; Wallace, Steven P; Shapiro, Martin F; Yakusheva, Olga; Ettner, Susan L

    2017-04-01

    Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk. Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship. Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (Pfall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired. Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

  2. 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.

  3. Precisely locating the Klamath Falls, Oregon, earthquakes

    Science.gov (United States)

    Qamar, A.; Meagher, K.L.

    1993-01-01

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

  4. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review.

    Science.gov (United States)

    Mat, Sumaiyah; Tan, Maw Pin; Kamaruzzaman, Shahrul Bahyah; Ng, Chin Teck

    2015-01-01

    osteoarthritis (OA) of knee has been reported as a risk factor for falls and reduced balance in the elderly. This systematic review evaluated the effectiveness of physical therapies in improving balance and reducing falls risk among patients with knee OA. a computerised search was performed to identify relevant studies up to November 2013. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the PeDro score. a total of 15 randomised controlled trials involving 1482 patients were identified. The mean PeDro score was 7. The pooled standardised mean difference in balance outcome for strength training = 0.3346 (95% CI: 0.3207-0.60, P = 0.01 falls risk outcomes in, strength training, Tai chi and aerobics also showed a significant reduction in reduced risk of falls significantly with pooled result 0.55 (95% CI: 0.41-0.68, P balance and falls risk in older individuals with knee OA, while water-based exercises and light treatment did not significantly improve balance outcomes. Strength training, Tai Chi and aerobics exercises can therefore be recommended as falls prevention strategies for individuals with OA. However, a large randomised controlled study using actual falls outcomes is recommended to determine the appropriate dosage and to measure the potential benefits in falls reduction. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Snubber reduction

    International Nuclear Information System (INIS)

    Olson, D.E.; Singh, A.K.

    1986-01-01

    Many safety-related piping systems in nuclear power plants have been oversupported. Since snubbers make up a large percentage of the pipe supports or restraints used in a plant, a plant's snubber population is much larger than required to adequately restrain the piping. This has resulted in operating problems and unnecessary expenses for maintenance and inservice inspections (ISIs) of snubbers. This paper presents an overview of snubber reduction, including: the incentives for removing snubbers, a historical perspective on how piping became oversupported, why it is possible to remove snubbers, and the costs and benefits of doing so

  6. 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

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

    Science.gov (United States)

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

    2017-02-02

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

  8. Reducing serious fall-related injuries in acute hospitals: are low-low beds a critical success factor?

    Science.gov (United States)

    Barker, Anna; Kamar, Jeannette; Tyndall, Tamara; Hill, Keith

    2013-01-01

    This article is a report of a study of associations between occurrence of serious fall-related injuries and implementation of low-low beds at The Northern Hospital, Victoria, Australia. A 9-year evaluation at The Northern Hospital found an important reduction in fall-related injuries after the 6-PACK falls prevention program was implemented. Low-low beds are a key component of the 6-PACK that aims to decrease fall-related injuries. A retrospective cohort study. Retrospective audit of The Northern Hospital inpatients admitted between 1999-2009. Changes in serious fall-related injuries throughout the period and associations with available low-low beds were analysed using Poisson regression. During the observation of 356,158 inpatients, there were 3946 falls and 1005 fall-related injuries of which 60 (5·9%) were serious (55 fractures and five subdural haematomas). Serious fall-related injuries declined significantly throughout the period. When there was one low-low bed to nine or more standard beds there was no statistically significant decrease in serious fall-related injuries. An important reduction only occurred when there was one low-low bed to three standard beds. The 6-PACK program has been in place since 2002 at The Northern Hospital. Throughout this time serious fall-related injuries have decreased. There appears to be an association between serious fall-related injuries and the number of available low-low beds. Threshold numbers of these beds may be required to achieve optimal usability and effectiveness. A randomized controlled trial is required to give additional evidence for use of low-low beds for injury prevention in hospitals. © 2012 Blackwell Publishing Ltd.

  9. Reducing falls among older people in general practice: The ProAct65+ exercise intervention trial.

    Science.gov (United States)

    Gawler, S; Skelton, D A; Dinan-Young, S; Masud, T; Morris, R W; Griffin, M; Kendrick, D; Iliffe, S

    2016-01-01

    participants (24%) reported one or two falls in the previous year. There was no increase in falls in either exercise group compared to UC during the intervention period (resulting from increased exposure to risk). The FaME arm experienced a significant reduction in injurious falls compared to UC (incidence rate ratio (IRR) 0.55, 95% CI 0.31, 0.96; p=0.04) and this continued during the 12 months after the end of the intervention (IRR 0.73, 95% CI 0.54, 0.99; p=0.05). There was also a significant reduction in the incidence of all falls (injurious and non-injurious) in the FaME arm compared with UC (IRR 0.74, 95% CI 0.55, 0.99; p=0.04) in the 12 month period following the cessation of the intervention. There was a non-significant reduction in the incidence of all falls in the OEP arm compared with UC (IRR 0.76, 95% CI 0.53, 1.09; p=0.14) in the 12 months following the cessation of the intervention. The effects on falls did not persist at the 24 months assessment in either exercise arm. However, when those in the FaME group who continued to achieve 150min of MVPA per week into the second post-intervention year were compared to those in the FaME group who did not maintain their physical activity, there was a significant reduction in falls incidence (IRR=0.49, 95% CI 0.30, 0.79; p=0.004). CONFbal was significantly improved at 12 months post intervention in both intervention arms compared with UC. There were no significant changes in any of the functional balance measures, FES-I or FRAT, between baseline and the end of the intervention period. Community-dwelling older adults who joined an exercise intervention (FaME) aimed at increasing MVPA did not fall more during the intervention period, fell less and had fewer injurious falls in the 12 months after cessation of the intervention. However, 24 months after cessation of exercise, the beneficial effects of FaME on falls reduction ceased, except in those who maintained higher levels of MVPA. OEP exercise appears less effective at

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

    Directory of Open Access Journals (Sweden)

    Cristina Rosa Soares Lavareda Baixinho

    2015-12-01

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

  11. 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.

  12. 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

  13. Susceptible-infected-recovered and susceptible-exposed-infected models

    International Nuclear Information System (INIS)

    Tome, Tania; De Oliveira, Mario J

    2011-01-01

    Two stochastic epidemic lattice models, the susceptible-infected-recovered and the susceptible-exposed-infected models, are studied on a Cayley tree of coordination number k. The spreading of the disease in the former is found to occur when the infection probability b is larger than b c = k/2(k - 1). In the latter, which is equivalent to a dynamic site percolation model, the spreading occurs when the infection probability p is greater than p c = 1/(k - 1). We set up and solve the time evolution equations for both models and determine the final and time-dependent properties, including the epidemic curve. We show that the two models are closely related by revealing that their relevant properties are exactly mapped into each other when p = b/[k - (k - 1)b]. These include the cluster size distribution and the density of individuals of each type, quantities that have been determined in closed forms.

  14. 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.

  15. A break-even analysis of a community rehabilitation falls prevention service.

    Science.gov (United States)

    Comans, Tracy; Brauer, Sandy; Haines, Terry

    2009-06-01

    To identify and compare the minimum number of clients that a multidisciplinary falls prevention service delivered through domiciliary or centre-based care needs to treat to allow the service to reach a 'break-even' point. A break-even analysis was undertaken for each of two models of care for a multidisciplinary community rehabilitation falls prevention service. The two models comprised either a centre-based group exercise and education program or a similar program delivered individually in the client's home. The service consisted of a physiotherapist, occupational therapist and therapy assistant. The participants were adults aged over 65 years who had experienced previous falls. Costs were based on the actual cost of running a community rehabilitation team located in Brisbane. Benefits were obtained by estimating the savings gained to society from the number of falls prevented by the program on the basis of the falls reduction rates obtained in similar multidisciplinary programs. It is estimated that a multi-disciplinary community falls prevention team would need to see 57 clients per year to make the service break-even using a centre-based model of care and 78 clients for a domiciliary-based model. The service this study was based on has the capability to see around 300 clients per year in a centre-based service or 200-250 clients per year in a home-based service. Based on the best available estimates of costs of falls, multidisciplinary falls prevention teams in the community targeting people at high risk of falls are worthwhile funding from a societal viewpoint.

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

    Directory of Open Access Journals (Sweden)

    Ta-Sen Wei

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

  17. 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

  18. 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

  19. 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

  20. Forensic Physics 101: Falls from a height

    Science.gov (United States)

    Cross, Rod

    2008-09-01

    The physics of falling from a height, a topic that could be included in a course on forensic physics or in an undergraduate class as an example of Newton's laws, is applied to a common forensic problem.

  1. Falls Among Older Adults: An Overview

    Science.gov (United States)

    ... out some of our online STEADI resources for older adults. These resources include: Stay Independent brochure What You Can Do to Prevent Falls brochure Check for Safety brochure Postural Hypotension brochure Chair Rise Exercise Related Pages Costs ...

  2. Nonlinear electromagnetic susceptibilities of unmagnetized plasmas

    International Nuclear Information System (INIS)

    Yoon, Peter H.

    2005-01-01

    Fully electromagnetic nonlinear susceptibilities of unmagnetized plasmas are analyzed in detail. Concrete expressions of the second-order nonlinear susceptibility are found in various forms in the literature, usually in connection with the discussions of various three-wave decay processes, but the third-order susceptibilities are rarely discussed. The second-order susceptibility is pertinent to nonlinear wave-wave interactions (i.e., the decay/coalescence), whereas the third-order susceptibilities affect nonlinear wave-particle interactions (i.e., the induced scattering). In the present article useful approximate analytical expressions of these nonlinear susceptibilities that can be readily utilized in various situations are derived

  3. 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.

  4. Fall risk in an active elderly population

    DEFF Research Database (Denmark)

    Læssøe, Uffe; Hoeck, Hans C.; Simonsen, Ole

    2007-01-01

    risk can be assessed by testing balance performance. In this study a test battery of physiological parameters related to balance and falls was designed to address fall risk in a community dwelling elderly population. RESULTS: Ninety-four elderly males and females between 70 and 80 years of age were...... assessment in which the physiological performance is evaluated in relation to the activity profile of the individual. Udgivelsesdato: 2007-null...

  5. On the Motion of Falling Leaves

    OpenAIRE

    Razavi, Pedram

    2010-01-01

    This paper investigates the motion of falling leaves through modeling using papers and the corresponding data collected from more than four thousands experiments. Two series of experiments were designed in order to study the relationship between different parameters which can affect different paths of motion in leaves. In the first series of experiments, the shapes of the potential paths that falling papers can take were investigated as a whole. A new classification scheme was derived from th...

  6. Quantifying Temperature Effects on Fall Chinook Salmon

    Energy Technology Data Exchange (ETDEWEB)

    Jager, Yetta [ORNL

    2011-11-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Elderly outpatient profile and predictors of falls.

    Science.gov (United States)

    Gomes, Grace Angélica de Oliveira; Cintra, Fernanda Aparecida; Batista, Fernanda Sotelo; Neri, Anita Liberalesso; Guariento, Maria Elena; Sousa, Maria da Luz Rosario de; D'Elboux, Maria José

    2013-01-01

    CONTEXT AND OBJECTIVES Falls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects. DESIGN AND SETTING Cross-sectional descriptive study forming part of the project "Quality of Life of Frail Elderly People", carried out in Campinas, Brazil. METHODS The subjects were 145 elderly individuals (76.3 ± 7.8 years old), of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out. RESULTS Cluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found. CONCLUSIONS The results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  9. Falls and depression in older people.

    Science.gov (United States)

    Turcu, Alin; Toubin, Sandrine; Mourey, France; D'Athis, Philippe; Manckoundia, Patrick; Pfitzenmeyer, Pierre

    2004-01-01

    Depression is one of the most common risk factors for falls, but links between falls and depression are still unclear. Few studies have examined the relationship between depression and gait alteration, which may increase the risk of fall. This study aims to assess a possible relationship between depression, postural and gait abnormalities, and falls. We conducted a 1-year prospective study on patients >/=70 years who were admitted to a geriatric unit for 'spontaneous' unexplained falls. Patients were tested for depression using the 30-item Geriatric Depression Scale (GDS). Their motor performances were assessed using the Mini Motor Test (MMT), which is an easy direct-observation test, validated in France, for assessment of frail old people who present with severe postural and gait impairment. This scale is composed of 4 categories of items: (1) abilities in bed; (2) quality of the sitting position; (3) abilities in the standing position, and (4) quality of gait. Sixty-nine patients were included. Depression was found in 46 patients (66.7%). The MMT score was higher in the non-depressed fallers (NDF) group (GDS 10; p predispose to falls. In clinical practice, more attention should be given to old fallers concerning diagnosis and treatment of associated depression. Copyright 2004 S. Karger AG, Basel

  10. Exercise for reducing fear of falling in older people living in the community.

    Science.gov (United States)

    Kendrick, Denise; Kumar, Arun; Carpenter, Hannah; Zijlstra, G A Rixt; Skelton, Dawn A; Cook, Juliette R; Stevens, Zoe; Belcher, Carolyn M; Haworth, Deborah; Gawler, Sheena J; Gage, Heather; Masud, Tahir; Bowling, Ann; Pearl, Mirilee; Morris, Richard W; Iliffe, Steve; Delbaere, Kim

    2014-11-28

    estimated mean differences (MD) where studies used the same continuous measures and standardised mean differences (SMD) where different measures or different formats of the same measure were used. Where possible, we performed various, usually prespecified, sensitivity and subgroup analyses. We included 30 studies, which evaluated 3D exercise (Tai Chi and yoga), balance training or strength and resistance training. Two of these were cluster-randomised trials, two were cross-over trials and one was quasi-randomised. The studies included a total of 2878 participants with a mean age ranging from 68 to 85 years. Most studies included more women than men, with four studies recruiting women only. Twelve studies recruited participants at increased risk of falls; three of these recruited participants who also had fear of falling.Poor reporting of the allocation methods in the trials made it difficult to assess the risk of selection bias in most studies. All of the studies were at high risk of performance and detection biases as there was no blinding of participants and outcome assessors and the outcomes were self reported. Twelve studies were at high risk of attrition bias. Using GRADE criteria, we judged the quality of evidence to be 'low' for fear of falling immediately post intervention and 'very low' for fear of falling at short or long-term follow-up and all other outcomes.Exercise interventions were associated with a small to moderate reduction in fear of falling immediately post intervention (SMD 0.37 favouring exercise, 95% confidence interval (CI) 0.18 to 0.56; 24 studies; 1692 participants, low quality evidence). Pooled effect sizes did not differ significantly between the different scales used to measure fear of falling. Although none of the sensitivity analyses changed the direction of effect, the greatest reduction in the size of the effect was on removal of an extreme outlier study with 73 participants (SMD 0.24 favouring exercise, 95% CI 0.12 to 0.36). None of our

  11. 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

  12. 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...

  13. Fall predictors in older cancer patients: a multicenter prospective study

    OpenAIRE

    Vande Walle, Nathalie; Kenis, Cindy; Heeren, Pieter; Van Puyvelde, Katrien; Decoster, Lore; Beyer, Ingo; Conings, Godelieve; Flamaing, Johan; Lobelle, Jean-Pierre; Wildiers, Hans; Milisen, Koen

    2014-01-01

    Background In the older population falls are a common problem and a major cause of morbidity, mortality and functional decline. The etiology is often multifactorial making the identification of fall predictors essential for preventive measures. Despite this knowledge, data on falls within the older cancer population are limited. The objective of this study was to evaluate the occurrence of falls within 2 to 3?months after cancer treatment decision and to identify predictors of falls (?1 fall)...

  14. 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...

  15. Radon reduction

    International Nuclear Information System (INIS)

    Hamilton, M.A.

    1990-01-01

    During a radon gas screening program, elevated levels of radon gas were detected in homes on Mackinac Island, Mich. Six homes on foundations with crawl spaces were selected for a research project aimed at reducing radon gas concentrations, which ranged from 12.9 to 82.3 pCi/l. Using isolation and ventilation techniques, and variations thereof, radon concentrations were reduced to less than 1 pCi/l. This paper reports that these reductions were achieved using 3.5 mil cross laminated or 10 mil high density polyethylene plastic as a barrier without sealing to the foundation or support piers, solid and/or perforated plastic pipe and mechanical fans. Wind turbines were found to be ineffective at reducing concentrations to acceptable levels. Homeowners themselves installed all materials

  16. Landslide Susceptibility Assessment Using Spatial Multi-Criteria Evaluation Model in Rwanda

    Directory of Open Access Journals (Sweden)

    Jean Baptiste Nsengiyumva

    2018-01-01

    Full Text Available Landslides susceptibility assessment has to be conducted to identify prone areas and guide risk management. Landslides in Rwanda are very deadly disasters. The current research aimed to conduct landslide susceptibility assessment by applying Spatial Multi-Criteria Evaluation Model with eight layers of causal factors including: slope, distance to roads, lithology, precipitation, soil texture, soil depth, altitude and land cover. In total, 980 past landslide locations were mapped. The relationship between landslide factors and inventory map was calculated using the Spatial Multi-Criteria Evaluation. The results revealed that susceptibility is spatially distributed countrywide with 42.3% of the region classified from moderate to very high susceptibility, and this is inhabited by 49.3% of the total population. In addition, Provinces with high to very high susceptibility are West, North and South (40.4%, 22.8% and 21.5%, respectively. Subsequently, the Eastern Province becomes the peak under low susceptibility category (87.8% with no very high susceptibility (0%. Based on these findings, the employed model produced accurate and reliable outcome in terms of susceptibility, since 49.5% of past landslides fell within the very high susceptibility category, which confirms the model’s performance. The outcomes of this study will be useful for future initiatives related to landslide risk reduction and management.

  17. Landslide Susceptibility Assessment Using Spatial Multi-Criteria Evaluation Model in Rwanda

    Science.gov (United States)

    Nsengiyumva, Jean Baptiste; Luo, Geping; Nahayo, Lamek; Huang, Xiaotao; Cai, Peng

    2018-01-01

    Landslides susceptibility assessment has to be conducted to identify prone areas and guide risk management. Landslides in Rwanda are very deadly disasters. The current research aimed to conduct landslide susceptibility assessment by applying Spatial Multi-Criteria Evaluation Model with eight layers of causal factors including: slope, distance to roads, lithology, precipitation, soil texture, soil depth, altitude and land cover. In total, 980 past landslide locations were mapped. The relationship between landslide factors and inventory map was calculated using the Spatial Multi-Criteria Evaluation. The results revealed that susceptibility is spatially distributed countrywide with 42.3% of the region classified from moderate to very high susceptibility, and this is inhabited by 49.3% of the total population. In addition, Provinces with high to very high susceptibility are West, North and South (40.4%, 22.8% and 21.5%, respectively). Subsequently, the Eastern Province becomes the peak under low susceptibility category (87.8%) with no very high susceptibility (0%). Based on these findings, the employed model produced accurate and reliable outcome in terms of susceptibility, since 49.5% of past landslides fell within the very high susceptibility category, which confirms the model’s performance. The outcomes of this study will be useful for future initiatives related to landslide risk reduction and management. PMID:29385096

  18. Reducing Susceptibility to Courtesy Stigma.

    Science.gov (United States)

    Bachleda, Catherine L; El Menzhi, Leila

    2018-06-01

    In light of the chronic shortage of health professionals willing to care for HIV/AIDS patients, and rising epidemics in many Muslim countries, this qualitative study examined susceptibility and resistance to courtesy stigma as experienced by nurses, doctors, and social workers in Morocco. Forty-nine in-depth interviews provided rich insights into the process of courtesy stigma and how it is managed, within the context of interactions with Islam, interactions within the workplace (patients, other health professionals), and interactions outside the workplace (the general public, friends, and family). Theoretically, the findings extend understanding of courtesy stigma and the dirty work literature. The findings also offer practical suggestions for the development of culturally appropriate strategies to reduce susceptibility to courtesy stigmatization. This study represents the first to explore courtesy stigma as a process experienced by health professionals providing HIV/AIDS care in an Islamic country.

  19. Genetic susceptibility to Grave's disease.

    Science.gov (United States)

    Li, Hong; Chen, Qiuying

    2013-06-01

    The variety of clinical presentations of eye changes in patients with Graves' disease (GD) suggests that complex interactions between genetic, environmental, endogenous and local factors influence the severity of Graves' ophthalmopathy (GO). It is thought that the development of GO might be influenced by genetic factors and environmental factors, such as cigarette smoking. At present, however, the role of genetic factors in the development of GO is not known. On the basis of studies with candidate genes and other genetic approaches, several susceptibility loci in GO have been proposed, including immunological genes, human leukocyte antigen (HLA), cytotoxic T-lymphocyte antigen-4 (CTLA-4), regulatory T-cell genes and thyroid-specific genes. This review gives a brief overview of the current range of major susceptibility genes found for GD.

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

    OpenAIRE

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

    2012-01-01

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

  1. 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.

  2. 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.

  3. The Correlation Between Rates of Falling, Balance, Quality of Life and Fear of Falling in Patients With Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Hamid Azadeh

    2018-04-01

    Conclusion The findings of the present study demonstrated the correlation between balance, physical dimensions of quality of life and fear of falling in patients with stroke; however, the rate of falling has no association with fear of falling.

  4. Antibiotic susceptibility of Atopobium vaginae

    Directory of Open Access Journals (Sweden)

    Verschraegen Gerda

    2006-03-01

    Full Text Available Abstract Background Previous studies have indicated that a recently described anaerobic bacterium, Atopobium vaginae is associated with bacterial vaginosis (BV. Thus far the four isolates of this fastidious micro-organism were found to be highly resistant to metronidazole and susceptible for clindamycin, two antibiotics preferred for the treatment of BV. Methods Nine strains of Atopobium vaginae, four strains of Gardnerella vaginalis, two strains of Lactobacillus iners and one strain each of Bifidobacterium breve, B. longum, L. crispatus, L. gasseri and L. jensenii were tested against 15 antimicrobial agents using the Etest. Results All nine strains of A. vaginae were highly resistant to nalidixic acid and colistin while being inhibited by low concentrations of clindamycin (range: G. vaginalis strains were also susceptible for clindamycin ( 256 μg/ml but susceptible to clindamycin (0.023 – 0.125 μg/ml. Conclusion Clindamycin has higher activity against G. vaginalis and A. vaginae than metronidazole, but not all A. vaginae isolates are metronidazole resistant, as seemed to be a straightforward conclusion from previous studies on a more limited number of strains.

  5. Antimicrobial Susceptibility Patterns Of Salmonella Species In ...

    African Journals Online (AJOL)

    % susceptible to cefepime and carbapenem, 91% to azithromycin, 82.1% to cefixime and 73% to quinolones. Also susceptibility to chloramphenicol, erythromycin, streptomycin, ampicillin, gentamicin, co-trimoxazole, augmentin and amikacin ...

  6. Antibiotic susceptibility profiles for mastitis treatment.

    Science.gov (United States)

    Hinckley, L S; Benson, R H; Post, J E; DeCloux, J C

    1985-10-01

    Susceptibility tests were performed on milk samples representing prevalent mastitis infections in certain herds. Susceptibility patterns of the same bacterial species from several mastitis infections in the same herd were consistent. The herd antibiotic susceptibility profiles were used as a basis for selecting antibiotics for treatment of all such mastitis cases in that herd. A high degree of correlation was seen between the susceptibility test results and treatment results. Susceptibility patterns of the same bacterial species from mastitis infections in different herds varied greatly, which indicated that any one antibiotic would not work equally well against the same bacterial infection in every herd. Therefore, treatment should be selected on the basis of susceptibility test results. When both Streptococcus and Staphylococcus mastitis occurred in the same herd, the susceptibility patterns for the 2 bacterial species varied widely. Therefore, for herds that experienced both streptococcal and staphylococcal mastitis, antibiotics to which both bacterial species were susceptible were used for treatment.

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

    Science.gov (United States)

    Chippendale, Tracy; Boltz, Marie

    2015-08-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  9. Assessment of risk for falls in elderly

    Directory of Open Access Journals (Sweden)

    Stanetić Kosana

    2014-01-01

    Full Text Available Introduction: Elderly persons have higher risk for falls, compared to younger population. Although no single risk factor causes all falls, a great deal of risk factors to which an individual is exposed, i.e. osteoporosis, lack of physical activity, impaired vision, usage of drugs, living settings etc, can be treated. Objective: To investigate the risk for falls in elderly patients treated in Family medicine teaching center (ECPM, Primary Health Care Center Banja Luka. Method: This prospective study was conducted in June 2012. The study included 150 patients aged 65 years and older. Patients were chosen randomly. In study were included patients who have visited their family doctors on every of Mondays in June 2012. The Tinetti Gait and Balance Instrument was used to asses the risk for falls. Patients were examined to asses gait and balance according to Tinetti questionnaire, and supplementary questionnaire was created to record data about age, sex, chronic diseases and drugs that patients take. Results: The study included 91 (60.7% female and 59 (39.3% male patients. The average age of patients was 74.71 years. 77 (51.3% were aged 65 to 75 years and 73 (48.7% were more than 75 years old. Results of Tinetti Gait and Balance Instrument showed that the risk for falls was high in 55 (36.7%, moderate in 31 (20.7% and low in 64 (42.7% patients. Conclusion: Approximately, one third of investigated patients had high risk for falls, what indicates that family doctors should be more involved in fall prevention in elderly and in constant educating of older adults and their families.

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2018-03-01

    -I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found. Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  12. Variation in susceptibility and tolerance within and between populations of Tussilago farfara L. infected by Coleosporium tussilaginis (Pers.) Berk

    NARCIS (Netherlands)

    De Nooij, M.P.; Paul, N.D.; Ayres, P.G.

    1995-01-01

    Quantitative variation in susceptibility to infection by the rust Coleosporium tussilaginis, and in reduction in growth owing to the infection, were determined in 30 clonally propagated genotypes of Tussilago farfara sampled from three geographically isolated sites, Arnhem (The Netherlands),

  13. Susceptibility tensor imaging (STI) of the brain.

    Science.gov (United States)

    Li, Wei; Liu, Chunlei; Duong, Timothy Q; van Zijl, Peter C M; Li, Xu

    2017-04-01

    Susceptibility tensor imaging (STI) is a recently developed MRI technique that allows quantitative determination of orientation-independent magnetic susceptibility parameters from the dependence of gradient echo signal phase on the orientation of biological tissues with respect to the main magnetic field. By modeling the magnetic susceptibility of each voxel as a symmetric rank-2 tensor, individual magnetic susceptibility tensor elements as well as the mean magnetic susceptibility and magnetic susceptibility anisotropy can be determined for brain tissues that would still show orientation dependence after conventional scalar-based quantitative susceptibility mapping to remove such dependence. Similar to diffusion tensor imaging, STI allows mapping of brain white matter fiber orientations and reconstruction of 3D white matter pathways using the principal eigenvectors of the susceptibility tensor. In contrast to diffusion anisotropy, the main determinant factor of the susceptibility anisotropy in brain white matter is myelin. Another unique feature of the susceptibility anisotropy of white matter is its sensitivity to gadolinium-based contrast agents. Mechanistically, MRI-observed susceptibility anisotropy is mainly attributed to the highly ordered lipid molecules in the myelin sheath. STI provides a consistent interpretation of the dependence of phase and susceptibility on orientation at multiple scales. This article reviews the key experimental findings and physical theories that led to the development of STI, its practical implementations, and its applications for brain research. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Susceptibility Tensor Imaging (STI) of the Brain

    Science.gov (United States)

    Li, Wei; Liu, Chunlei; Duong, Timothy Q.; van Zijl, Peter C.M.; Li, Xu

    2016-01-01

    Susceptibility tensor imaging (STI) is a recently developed MRI technique that allows quantitative determination of orientation-independent magnetic susceptibility parameters from the dependence of gradient echo signal phase on the orientation of biological tissues with respect to the main magnetic field. By modeling the magnetic susceptibility of each voxel as a symmetric rank-2 tensor, individual magnetic susceptibility tensor elements as well as the mean magnetic susceptibility (MMS) and magnetic susceptibility anisotropy (MSA) can be determined for brain tissues that would still show orientation dependence after conventional scalar-based quantitative susceptibility mapping (QSM) to remove such dependence. Similar to diffusion tensor imaging (DTI), STI allows mapping of brain white matter fiber orientations and reconstruction of 3D white matter pathways using the principal eigenvectors of the susceptibility tensor. In contrast to diffusion anisotropy, the main determinant factor of susceptibility anisotropy in brain white matter is myelin. Another unique feature of susceptibility anisotropy of white matter is its sensitivity to gadolinium-based contrast agents. Mechanistically, MRI-observed susceptibility anisotropy is mainly attributed to the highly ordered lipid molecules in myelin sheath. STI provides a consistent interpretation of the dependence of phase and susceptibility on orientation at multiple scales. This article reviews the key experimental findings and physical theories that led to the development of STI, its practical implementations, and its applications for brain research. PMID:27120169

  15. Measurements of temperature dependence of 'localized susceptibility'

    CERN Document Server

    Shiozawa, H; Ishii, H; Takayama, Y; Obu, K; Muro, T; Saitoh, Y; Matsuda, T D; Sugawara, H; Sato, H

    2003-01-01

    The magnetic susceptibility of some rare-earth compounds is estimated by measuring magnetic circular dichroism (MCD) of rare-earth 3d-4f absorption spectra. The temperature dependence of the magnetic susceptibility obtained by the MCD measurement is remarkably different from the bulk susceptibility in most samples, which is attributed to the strong site selectivity of the core MCD measurement.

  16. Use and clinical efficacy of standard and health information technology fall risk assessment tools.

    Science.gov (United States)

    Teh, Ruth C; Wilson, Anne; Ranasinghe, Damith; Visvanathan, Renuka

    2017-12-01

    To evaluate the health information technology (HIT) compared to Fall Risk for Older Persons (FROP) tool in fall risk screening. A HIT tool trial was conducted on the geriatric evaluation and management (GEM, n = 111) and acute medical units (AMU, n = 424). Health information technology and FROP scores were higher on GEM versus AMU, with no differences between people who fell and people who did not fall. Both score completion rates were similar, and their values correlated marginally (Spearman's correlation coefficient 0.33, P falls. Hospital fall rates trended towards reduction on AMU (4.20 vs 6.96, P = 0.15) and increase on GEM (10.98 vs 6.52, P = 0.54) with HIT tool implementation. Health information technology tool acceptability and scoring were comparable to FROP screening, with mixed effects on fall rate with HIT tool implementation. Clinician partnership remains key to effective tool development. © 2017 AJA Inc.

  17. 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.

  18. Electronic Out-fall Inspection Application - 12007

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

  19. Stick balancing, falls and Dragon-Kings

    Science.gov (United States)

    Cabrera, J. L.; Milton, J. G.

    2012-05-01

    The extent to which the occurrence of falls, the dominant feature of human attempts to balance a stick at their fingertip, can be predicted is examined in the context of the "Dragon-King" hypothesis. For skilled stick balancers, fluctuations in the controlled variable, namely the vertical displacement angle θ, exhibit power law behaviors. When stick balancing is made less stable by either decreasing the length of the stick or by requiring the subject to balance the stick on the surface of a table tennis racket, systematic departures from the power law behaviors are observed in the range of large θ. This observation raises the possibility that the presence of departures from the power law in the large length scale region, possibly Dragon-Kings, may identify situations in which the occurrence of a fall is more imminent. However, whether or not Dragon-Kings are observed, there is a Weibull-type survival function for stick falling. The possibility that increased risk of falling can, at least to some extent, be predicted from fluctuations in the controlled variable before the event occurs has important implications for the development of preventative strategies for the management of phenomena ranging from earthquakes to epileptic seizures to falls in the elderly.

  20. Detection and Prevention of Seniors Falls

    Directory of Open Access Journals (Sweden)

    Lubomír MACKŮ

    2016-11-01

    Full Text Available The paper deals with the issue of seniors’ security and safety, namely the security problems related to falls of independently living elderly citizens. The number of elderly people is growing very fast worldwide and very often they live unattended in their house or flat. In case of accidently falling down, they are often unable help themselves and stay on the floor for hours or even longer. This may lead even to the death if no help comes. Various possibilities of their fall detection are studied. We analyze the historical development, current capabilities and efficiency of different approaches and methods. We address the willingness and ability of seniors to actively use technology, detection limits, privacy, personal data security and other important factors. In addition, we discuss the challenges, current shortcomings, issues and trends in fall detection or operation reliability in real-life conditions. The main future goal would be to maintain the personal privacy and security of irrelevant information in modern fall detection systems.

  1. Elderly outpatient profile and predictors of falls

    Directory of Open Access Journals (Sweden)

    Grace Angélica de Oliveira Gomes

    Full Text Available CONTEXT AND OBJECTIVESFalls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects.DESIGN AND SETTINGCross-sectional descriptive study forming part of the project “Quality of Life of Frail Elderly People”, carried out in Campinas, Brazil.METHODSThe subjects were 145 elderly individuals (76.3 ± 7.8 years old, of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out.RESULTSCluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found.CONCLUSIONSThe results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  2. Accidents due to falls from roof slabs.

    Science.gov (United States)

    Rudelli, Bruno Alves; Silva, Marcelo Valerio Alabarce da; Akkari, Miguel; Santili, Claudio

    2013-01-01

    CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. METHODS Data were collected from 29 cases of falls from roof slabs involving children and adolescents between October 2008 and October 2009. RESULTS Cases involving males were more prevalent, accounting for 84%. The predominant age group was schoolchildren (7 to 12 years old; 44%). Leisure activities were most frequently being practiced on the roof slab at the time of the fall (86%), and flying a kite was the most prevalent game (37.9%). In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places.

  3. Accidents due to falls from roof slabs

    Directory of Open Access Journals (Sweden)

    Bruno Alves Rudelli

    Full Text Available CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. METHODS Data were collected from 29 cases of falls from roof slabs involving children and adolescents between October 2008 and October 2009. RESULTS Cases involving males were more prevalent, accounting for 84%. The predominant age group was schoolchildren (7 to 12 years old; 44%. Leisure activities were most frequently being practiced on the roof slab at the time of the fall (86%, and flying a kite was the most prevalent game (37.9%. In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places.

  4. Older people's perception of and coping with falling, and their motivation for fall-prevention programmes

    DEFF Research Database (Denmark)

    Høst, Dorte; Hendriksen, Carsten; Borup, Ina

    2011-01-01

    This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes.......This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes....

  5. Martial arts fall techniques decrease the impact forces at the hip during sideways falling.

    NARCIS (Netherlands)

    Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.E.J.

    2007-01-01

    Falls to the side and those with impact on the hip are risky for hip fractures in the elderly. A previous study has indicated that martial arts (MA) fall techniques can reduce hip impact force, but the underlying mechanism is unknown. Furthermore, the high impact forces at the hand used to break the

  6. 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.

  7. 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

  8. Seniors Falls Investigative Methodology (SFIM): A Systems Approach to the Study of Falls in Seniors

    Science.gov (United States)

    Zecevic, Aleksandra A.; Salmoni, Alan W.; Lewko, John H.; Vandervoort, Anthony A.

    2007-01-01

    An in-depth understanding of human factors and human error is lacking in current research on seniors' falls. Additional knowledge is needed to understand why seniors are falling. The purpose of this article is to describe the adapting of the Integrated Safety Investigation Methodology (ISIM) (used for investigating transportation and industrial…

  9. Responsiveness of cold tolerant chickpea characteristics in fall and spring planting: II. yield and yield components

    Directory of Open Access Journals (Sweden)

    ahmad nezami

    2009-06-01

    Full Text Available Previous research in Mashhad collection chickpeas (MCC has shown that there are some cold tolerant genotypes for fall planting in the highlands. To obtain more detailed information about the reaction of these genotypes to fall and spring planting, the yield and yield component responses of 33 chickpea genotypes (32 cold tolerant genotypes and one susceptible genotypes to four planting dates (28 Sep., 16 Oct., 2 Nov., and 7 Mar. were evaluated in 2000-2001 growing season. The experiment was conducted at the experimental field of college of agriculture, Ferdowsi University of Mashhad as a split plot design with two replications. The planting dates were imposed as main plot and chickpea genotypes as subplot. Effects of planting date and genotype on percent of plant survival (PPS after winter, number. of pod per plant, 100 seed weight, yield and Harvest Index (HI were significant (p

  10. Research on patient safety: falls and medications.

    Science.gov (United States)

    Boddice, Sandra Dawn; Kogan, Polina

    2009-10-01

    Below you will find summaries of published research describing investigations into patient safety issues related to falls and medications. The first summary provides details on the incidence of falls associated with the use of walkers and canes. This is followed by a summary of a fall-prevention intervention study that evaluated the effectiveness of widespread dissemination of evidence-based strategies in a community in Connecticut. The third write up provides information on three classes of medications that are associated with a significant number of emergency room visits. The last summary describes a pharmacist-managed medication reconciliation intervention pilot program. For additional details about the study findings and interventions, we encourage readers to review the original articles.

  11. Magnetic susceptibility of functional groups

    International Nuclear Information System (INIS)

    Herr, T.; Ferraro, M.B.; Contreras, R.H.

    1990-01-01

    Proceeding with a series of works where new criteria are applied to the the calculation of the contribution of molecular fragments to certain properties, results are presented for a group of 1-X-benzenes and 1-X-naphtalenes for the magnetic susceptibility constant. Both the diamagnetic and paramagnetic parts are taken into account. To reduce the problems associated with the Gauge dependence originated in the approximations made, Gauge independent atomic orbitals (GIAO) orbitals are used in the atomic orbital basis. Results are discussed in terms of functional groups. (Author). 17 refs., 1 fig., 3 tabs

  12. Magnetic susceptibility of curium pnictides

    International Nuclear Information System (INIS)

    Nave, S.E.; Huray, P.G.; Peterson, J.R.; Damien, D.A.; Haire, R.G.

    1981-09-01

    The magnetic susceptibility of microgram quantities of 248 CmP and 248 CmSb has been determined with the use of a SQUID micromagnetic susceptometer over the temperature range 4.2 to 340 K and in the applied magnetic field range of 0.45 to 1600 G. The fcc (NaCl-type) samples yield magnetic transitions at 73K and 162 K for the phosphide and antimonide, respectively. Together with published magnetic data for CmN and CmAs, these results indicate spatially extended exchange interactions between the relatively localized 5f electrons of the metallic actinide atoms

  13. Polygenic susceptibility to testicular cancer

    DEFF Research Database (Denmark)

    Litchfield, Kevin; Mitchell, Jonathan S; Shipley, Janet

    2015-01-01

    BACKGROUND: The increasing incidence of testicular germ cell tumour (TGCT) combined with its strong heritable basis suggests that stratified screening for the early detection of TGCT may be clinically useful. We modelled the efficiency of such a personalised screening approach, based on genetic...... known TGCT susceptibility variants. The diagnostic performance of testicular biopsy and non-invasive semen analysis was also assessed, within a simulated combined screening programme. RESULTS: The area under the curve for the TGCT PRS model was 0.72 with individuals in the top 1% of the PRS having...

  14. Falls in the elderly. I. Identification of risk factors.

    NARCIS (Netherlands)

    Bloem, B.R.; Boers, I.M.; Cramer, M.; Westendorp, R.G.J.; Gerschlager, W.

    2001-01-01

    Falls severely threaten the health of elderly persons and pose high costs to the public health service. Unfortunately, falls are often regarded as unavoidable and untreatable features of aging. Therefore, many clinicians merely treat the physical injuries of a fall. However, falls and gait

  15. 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.

  16. Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.

    Science.gov (United States)

    Honaker, Julie A; Shepard, Neil T

    2011-01-01

    Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.

  17. 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.

  18. Dynamic insecticide susceptibility changes in Florida populations of Diaphorina citri (Hemiptera: Psyllidae).

    Science.gov (United States)

    Tiwari, Siddharth; Killiny, Nabil; Stelinski, Lukasz L

    2013-02-01

    Five field populations of Diaphorina citri Kuwayama from various regions of Florida were evaluated in 2011 for resistance to commonly used insecticides. Three diagnostic doses (LD50, LD75, and LD95), developed in 2009 using a laboratory susceptible population, were used to measure changes in susceptibility levels of field-collected populations as compared with a susceptible laboratory population. Further reductions in the susceptibility levels of D. citri to chlorpyriphos and fenpropathrin were determined, compared with results obtained in 2010. Mean percent mortality obtained from all five locations was significantly lower than observed with the laboratory susceptible population for all insecticides tested. Previously, expression of five CYP4 genes was implicated in contributing to insecticide metabolism in D. citri. In the current study, we compared the relative expression of these five CYP4 genes and their associated levels of protein expression among field-collected and laboratory susceptible populations. Expression of all CYP4 genes investigated was higher in field-collected populations when normalized against the laboratory susceptible population. There was an increased signal of a band corresponding to a 45 kDa protein in four of the five field populations as measured by the Western blot assay, which suggests increased production of cytochrome P450 enzymes. The current results indicate that insecticide resistance continues to increase in Florida populations ofD. citri, particularly to chlorpyriphos and fenpropathrin. However, there was no further decrease in susceptibility of Florida populations of D. citri to neonicotinoid insecticides in 2011 as compared with previous years.

  19. Dielectric and diamagnetic susceptibilities near percolative superconductor-insulator transitions.

    Science.gov (United States)

    Loh, Yen Lee; Karki, Pragalv

    2017-10-25

    Coarse-grained superconductor-insulator composites exhibit a superconductor-insulator transition governed by classical percolation, which should be describable by networks of inductors and capacitors. We study several classes of random inductor-capacitor networks on square lattices. We present a unifying framework for defining electric and magnetic response functions, and we extend the Frank-Lobb bond-propagation algorithm to compute these quantities by network reduction. We confirm that the superfluid stiffness scales approximately as [Formula: see text] as the superconducting bond fraction p approaches the percolation threshold p c . We find that the diamagnetic susceptibility scales as [Formula: see text] below percolation, and as [Formula: see text] above percolation. For models lacking self-capacitances, the electric susceptibility scales as [Formula: see text]. Including a self-capacitance on each node changes the critical behavior to approximately [Formula: see text].

  20. Topological susceptibility from the overlap

    International Nuclear Information System (INIS)

    Del Debbio, Luigi; Pica, Claudio

    2004-01-01

    The chiral symmetry at finite lattice spacing of Ginsparg-Wilson fermionic actions constrains the renormalization of the lattice operators; in particular, the topological susceptibility does not require any renormalization, when using a fermionic estimator to define the topological charge. Therefore, the overlap formalism appears as an appealing candidate to study the continuum limit of the topological susceptibility while keeping the systematic errors under theoretical control. We present results for the SU(3) pure gauge theory using the index of the overlap Dirac operator to study the topology of the gauge configurations. The topological charge is obtained from the zero modes of the overlap and using a new algorithm for the spectral flow analysis. A detailed comparison with cooling techniques is presented. Particular care is taken in assessing the systematic errors. Relatively high statistics (500 to 1000 independent configurations) yield an extrapolated continuum limit with errors that are comparable with other methods. Our current value from the overlap is χ 1/4 = 188±12±5MeV (author)

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

    Science.gov (United States)

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

    2016-11-01

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

  2. [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.

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

    Science.gov (United States)

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

    2017-07-01

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

  4. 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

  5. Implementation of landslide susceptibility maps in Lower Austria as part of risk governance

    Science.gov (United States)

    Bell, Rainer; Petschko, Helene; Bauer, Christian; Glade, Thomas; Granica, Klaus; Heiss, Gerhard; Leopold, Philip; Pomaroli, Gilbert; Proske, Herwig; Schweigl, Joachim

    2013-04-01

    Landslides frequently cause damage to agricultural land and infrastructure in Lower Austria - a province of Austria. Also settlements and people are threatened by landslides. To reduce landslide risks and to prevent the establishment of new settlements in highly landslide prone areas, the project "MoNOE" (Method development for landslide susceptibility modeling in Lower Austria) was set up by the provincial government. The main aim of the project is the development of methods to model rock fall and slide susceptibility for an area of approx. 15,900 km2 and to implement the resulting susceptibility maps into the spatial planning strategies of the state. Right from the beginning of the project a close cooperation between the involved scientists and the stakeholders from the Geological Survey of Lower Austria and the Department of Spatial Planning and Regional Policy of Lower Austria was established to ensure that method development and final susceptibility maps meet exactly the needs and demands of the stakeholders. This posed huge challenges, together with its realization in the large study area and a (heterogeneous) complex geological situation,. Limitations were given by restricted data availability (e.g. for geology or landslide inventories) in such a large study area. Rock fall susceptibility was modeled by a combined approach of determining rock fall release areas by empirical slope thresholds (dependent on geology) followed by empirical run-out modeling. Slide susceptibility was modeled based on the statistical approaches of weights of evidence (WofE) and generalized additive models (GAM) by two different research groups. Huge efforts were spent on the validation of all susceptibility models. In a later stage of the project we found that the best scientific maps are not necessarily the best maps to be implemented in spatial planning strategies. Thus, in close cooperation with the stakeholders, decisions had to be taken to find the best resolution of the maps

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

    Science.gov (United States)

    Obuchi, Shuichi

    2008-06-01

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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Faulkner Robert A

    2007-07-01

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

  9. Montana Advanced Biofuels Great Falls Approval

    Science.gov (United States)

    This November 20, 2015 letter from EPA approves the petition from Montana Advanced Biofuels, LLC, Great Falls facility, regarding ethanol produced through a dry mill process, qualifying under the Clean Air Act for advanced biofuel (D-code 5) and renewable

  10. Student Time Usage during Fall Reading Week

    Science.gov (United States)

    Cramer, Ken; Pschibul, Rebecca

    2017-01-01

    The present study investigated the time usage and levels of perceived stress, academic workload, and recreation time for 177 students at the University of Windsor before, during, and after Fall Reading Week (FRW). Over a three-week span (at various times of the day), students received a message to their smartphone to complete a 20-second survey…

  11. Falls Prevention: Unique to Older Adults

    Science.gov (United States)

    ... may lead to malnutrition, which is a risk factor for increased risk of falling. For example, as you age, you may: have illnesses that make it hard to shop for and prepare food (such as arthritis or Alzheimer’s disease ) be housebound have difficulty chewing because of ...

  12. Wireless Falling Detection System Based on Community.

    Science.gov (United States)

    Xia, Yun; Wu, Yanqi; Zhang, Bobo; Li, Zhiyang; He, Nongyue; Li, Song

    2015-06-01

    The elderly are more likely to suffer the aches or pains from the accidental falls, and both the physiology and psychology of patients would subject to a long-term disturbance, especially when the emergency treatment was not given timely and properly. Although many methods and devices have been developed creatively and shown their efficiency in experiments, few of them are suitable for commercial applications routinely. Here, we design a wearable falling detector as a mobile terminal, and utilize the wireless technology to transfer and monitor the activity data of the host in a relatively small community. With the help of the accelerometer sensor and the Google Mapping service, information of the location and the activity data will be send to the remote server for the downstream processing. The experimental result has shown that SA (Sum-vector of all axes) value of 2.5 g is the threshold value to distinguish the falling from other activities. A three-stage detection algorithm was adopted to increase the accuracy of the real alarm, and the accuracy rate of our system was more than 95%. With the further improvement, the falling detecting device which is low-cost, accurate and user-friendly would become more and more common in everyday life.

  13. A new view on falling aprons

    NARCIS (Netherlands)

    Verhagen, H.J.; Van der Hoeven, M.; Thiel, B.

    2003-01-01

    In a flume of BallastHam Dredging a falling apron model has been constructed and loaded by current. The tests have been done with different rock sizes, different layer thickness of the top storage of the apron and two different gradings. In summary it was found that for both the narrow graded rock

  14. Early Childhood: Fall Harvest and Science.

    Science.gov (United States)

    Science and Children, 1982

    1982-01-01

    Provides instructional strategies for using fall fruits/vegetables in science lessons, including activities related to melons, pumpkins, grapes, pears, squash, and yams. Suggests extending the activities over a month or more to allow children time to explore and investigate. (JN)

  15. Delayed Capillary Breakup of Falling Viscous Jets

    NARCIS (Netherlands)

    Javadi, A.; Eggers, J.; Bonn, D.; Habibi, M.; Ribe, N.M.

    2013-01-01

    Thin jets of viscous fluid like honey falling from capillary nozzles can attain lengths exceeding 10 m before breaking up into droplets via the Rayleigh-Plateau (surface tension) instability. Using a combination of laboratory experiments and WKB analysis of the growth of shape perturbations on a jet

  16. Risk of fall in patients with COPD.

    Science.gov (United States)

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

    2018-03-21

    A matched cohort study was conducted to determine the incidence of falls in patients following a diagnosis of COPD using a UK primary care database. 44 400 patients with COPD and 175 545 non-COPD subjects were identified. The incidence rate of fall per 1000 person-years in patients with COPD was higher (44.9; 95% CI 44.1 to 45.8) compared with non-COPD subjects (24.1; 95% CI 23.8 to 24.5) (P<0.0001). Patients with COPD were 55% more likely to have an incident record of fall than non-COPD subjects (adjusted HR, 1.55; 95% CI 1.50 to 1.59). The greater falls risk in patients with COPD needs consideration and modifiable factors addressed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. AEGIS at CERN: Measuring Antihydrogen Fall

    CERN Document Server

    Giammarchi, Marco G.

    2011-01-01

    The main goal of the AEGIS experiment at the CERN Antiproton Decelerator is the test of fundamental laws such as the Weak Equivalence Principle (WEP) and CPT symmetry. In the first phase of AEGIS, a beam of antihydrogen will be formed whose fall in the gravitational field is measured in a Moire' deflectometer; this will constitute the first test of the WEP with antimatter.

  18. Does Fall History Influence Residential Adjustments?

    Science.gov (United States)

    Leland, Natalie; Porell, Frank; Murphy, Susan L.

    2011-01-01

    Purpose of the study: To determine whether reported falls at baseline are associated with an older adult's decision to make a residential adjustment (RA) and the type of adjustment made in the subsequent 2 years. Design and Methods: Observations (n = 25,036) were from the Health and Retirement Study, a nationally representative sample of…

  19. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  20. Falling balls and simple shearing strain

    International Nuclear Information System (INIS)

    Brun, J L; Pacheco, A F

    2006-01-01

    The problem of particles falling under gravity allows us to relate Hamiltonian mechanics to such different subjects as elasticity and fluid mechanics. It is with this in mind that mechanics gives us the opportunity of introducing, in a rather simple and unusual form, some concepts such as vorticity, the incompressibility condition or simple shear strain to physics students at the undergraduate level

  1. Water supply impacts of nuclear fall

    International Nuclear Information System (INIS)

    Hobbs, B.F.; Luo, Y.; Maciejowski, M.E.; Chester, C.V.

    1989-01-01

    “Nuclear winter,” more properly called “nuclear fall,” could be caused by injection of large amounts of dust into the atmosphere. Besides causing a decrease in temperature, it could be accompanied by “nuclear drought,” a catastrophic decrease in precipitation. Dry land agriculture would then be impossible, and municipal, industrial, and irrigation water supplies would be diminished. It has been argued that nuclear winter/fall poses a much greater threat to human survival than do fall out or the direct impacts of a conflict. However, this does not appear to be true, at least for the U.S. Even under the unprecedented drought that could result from nuclear fall, water supplies would be available for many essential activities. For the most part, ground water supplies would be relatively invulnerable to nuclear drought, and adequate surface supplies would be available for potable uses. This assumes that conveyance facilities and power supplies survive a conflict largely intact or can be repaired

  2. A simple strategy for fall events detection

    KAUST Repository

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

    2017-01-01

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

  3. Anode Fall Formation in a Hall Thruster

    International Nuclear Information System (INIS)

    Dorf, Leonid A.; Raitses, Yevgeny F.; Smirnov, Artem N.; Fisch, Nathaniel J.

    2004-01-01

    As was reported in our previous work, accurate, nondisturbing near-anode measurements of the plasma density, electron temperature, and plasma potential performed with biased and emissive probes allowed the first experimental identification of both electron-repelling (negative anode fall) and electron-attracting (positive anode fall) anode sheaths in Hall thrusters. An interesting new phenomenon revealed by the probe measurements is that the anode fall changes from positive to negative upon removal of the dielectric coating, which appears on the anode surface during the course of Hall thruster operation. As reported in the present work, energy dispersion spectroscopy analysis of the chemical composition of the anode dielectric coating indicates that the coating layer consists essentially of an oxide of the anode material (stainless steel). However, it is still unclear how oxygen gets into the thruster channel. Most importantly, possible mechanisms of anode fall formation in a Hall thruster with a clean and a coated anodes are analyzed in this work; practical implication of understanding the general structure of the electron-attracting anode sheath in the case of a coated anode is also discussed

  4. Protect the Ones You Love From Falls

    Centers for Disease Control (CDC) Podcasts

    2008-12-10

    This podcast, developed as part of the Protect the Ones You Love initiative, discusses steps parents can take to help protect their children from falls, one of the leading causes of child injury.  Created: 12/10/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 12/10/2008.

  5. Things Come Together with "Things Fall Apart."

    Science.gov (United States)

    Puhr, Kathleen M.

    1987-01-01

    Recommends using C. Achebe's English language novel, "Things Fall Apart," in a unit on tragedy. Provides plot summary and topics for discussion of cultural values and socialization. Notes that besides illustrating character traits, themes and plot structure of the tragic genre, the novel provides an opportunity for learning Nigerian…

  6. Have a Safe and Healthy Fall

    Centers for Disease Control (CDC) Podcasts

    2010-10-14

    Fall is a great time to try new and healthy activities with your parents! Have a food tasting or a leaf raking contest! Whatever your plans, make sure to have fun and be safe!  Created: 10/14/2010 by CDC Office of Women’s Health.   Date Released: 10/14/2010.

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

    Science.gov (United States)

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

    2008-06-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  9. 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.

  10. 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

  11. 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...

  12. 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.

  13. Magnetic susceptibility of semiconductor melts

    International Nuclear Information System (INIS)

    Kutvitskij, V.A.; Shurygin, P.M.

    1975-01-01

    The temperature dependences chi of various alloys confirm the existence of cluster formations in molten semiconductors, the stability of these formations in melts being considerably affected by the anion nature. The concentrational dependences of the magnetic susceptibility for all the investigated systems exhibit the diamagnetism maxima corresponding to the compound compositions. Heating the melt causes ''smearing'' the maxima, which is related with the cluster structure dissociation. The existence of the maxima concentrational dependence chi corresponding to BiTe and BiSe is found in the isotherms. The non-linear dependence of chi on the composition shows the absence of a single-valued relation between the phase diagram and the chi-diagram for melts

  14. Genetic susceptibility to environmental toxicants

    DEFF Research Database (Denmark)

    2001-01-01

    The toxicological challenges to the chemical industry have in recent years been greatly affected by the rapid innovation and development of analytical, molecular and genetic technologies. ECETOC recognises the importance of developing the technical and intellectual skill bases in academia...... and industrial based laboratories to meet the rapid development of the science base of toxicology. As the technology to determine genetic susceptibility develops, so scientist will be able to describe altered gene expression provoked by chemicals long before they are able to offer valid interpretations...... to take toxicological data and both interpret and extrapolate it in a manner as to cause exaggerated concern. The challenge to the toxicologist is to explain what data means and in a way that inspires the confidence in those who have to apply data to the assessment of hazard and risk management. It seems...

  15. Scalar and pseudoscalar susceptibilities in nuclei

    International Nuclear Information System (INIS)

    Ericson, Magda; Chanfray, Guy; Chanfray, Guy

    2003-01-01

    We study the two QCD susceptibilities of the nuclear medium in the linear σ model. The magnitude of the scalar one increases due to the mixing with the softer modes of the nucleon-hole excitations. The pseudoscalar susceptibility, follows the density evolution of the quark condensate and thus decreases in magnitude. At normal nuclear matter density the two susceptibilities become much close than in the vacuum, a consequence of the partial chiral symmetry restoration. (author)

  16. Unsupervised machine-learning method for improving the performance of ambulatory fall-detection systems

    Directory of Open Access Journals (Sweden)

    Yuwono Mitchell

    2012-02-01

    Full Text Available Abstract Background Falls can cause trauma, disability and death among older people. Ambulatory accelerometer devices are currently capable of detecting falls in a controlled environment. However, research suggests that most current approaches can tend to have insufficient sensitivity and specificity in non-laboratory environments, in part because impacts can be experienced as part of ordinary daily living activities. Method We used a waist-worn wireless tri-axial accelerometer combined with digital signal processing, clustering and neural network classifiers. The method includes the application of Discrete Wavelet Transform, Regrouping Particle Swarm Optimization, Gaussian Distribution of Clustered Knowledge and an ensemble of classifiers including a multilayer perceptron and Augmented Radial Basis Function (ARBF neural networks. Results Preliminary testing with 8 healthy individuals in a home environment yields 98.6% sensitivity to falls and 99.6% specificity for routine Activities of Daily Living (ADL data. Single ARB and MLP classifiers were compared with a combined classifier. The combined classifier offers the greatest sensitivity, with a slight reduction in specificity for routine ADL and an increased specificity for exercise activities. In preliminary tests, the approach achieves 100% sensitivity on in-group falls, 97.65% on out-group falls, 99.33% specificity on routine ADL, and 96.59% specificity on exercise ADL. Conclusion The pre-processing and feature-extraction steps appear to simplify the signal while successfully extracting the essential features that are required to characterize a fall. The results suggest this combination of classifiers can perform better than MLP alone. Preliminary testing suggests these methods may be useful for researchers who are attempting to improve the performance of ambulatory fall-detection systems.

  17. 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.

  18. Assessment of risk of falls in elderly living at home

    Directory of Open Access Journals (Sweden)

    Adriana de Azevedo Smith

    Full Text Available ABSTRACT Objective: to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. Method: cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS version 19 was used for statistical analysis. Results: there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001, age (0.054, cognitive status (<0.001 and history of falls (<0.001. All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment. Conclusion: female gender, older elderly (over 80 years old, with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases.

  19. Therapeutic platelet reduction: Use in postsplenectomy thrombocytosis

    Directory of Open Access Journals (Sweden)

    Gita Negi

    2015-01-01

    Full Text Available Therapeutic platelet reduction is an effective modality for the reduction of platelet count in patients with treatment of extreme thrombocytosis resulting from a variety of primary and secondary causes of thrombocytosis, which may be associated with thrombotic or hemorrhagic complications of varying degrees. These cases when symptomatic fall into the ASFA Category II indication for therapeutic platelet apheresis procedure. Here, we report a case of postsplenectomy secondary thrombocytosis presenting with extremely high platelet counts and subsequent thrombosis in the shunt and successful treatment after therapeutic platelet reduction. The case is being presented to bring forth the fact that therapeutic platelet reduction is an easy procedure that gives quick and good results and also to bring to the attention of transfusion specialists an associated but as yet unreported procedural finding.

  20. Accuracy of magnetic resonance based susceptibility measurements

    Science.gov (United States)

    Erdevig, Hannah E.; Russek, Stephen E.; Carnicka, Slavka; Stupic, Karl F.; Keenan, Kathryn E.

    2017-05-01

    Magnetic Resonance Imaging (MRI) is increasingly used to map the magnetic susceptibility of tissue to identify cerebral microbleeds associated with traumatic brain injury and pathological iron deposits associated with neurodegenerative diseases such as Parkinson's and Alzheimer's disease. Accurate measurements of susceptibility are important for determining oxygen and iron content in blood vessels and brain tissue for use in noninvasive clinical diagnosis and treatment assessments. Induced magnetic fields with amplitude on the order of 100 nT, can be detected using MRI phase images. The induced field distributions can then be inverted to obtain quantitative susceptibility maps. The focus of this research was to determine the accuracy of MRI-based susceptibility measurements using simple phantom geometries and to compare the susceptibility measurements with magnetometry measurements where SI-traceable standards are available. The susceptibilities of paramagnetic salt solutions in cylindrical containers were measured as a function of orientation relative to the static MRI field. The observed induced fields as a function of orientation of the cylinder were in good agreement with simple models. The MRI susceptibility measurements were compared with SQUID magnetometry using NIST-traceable standards. MRI can accurately measure relative magnetic susceptibilities while SQUID magnetometry measures absolute magnetic susceptibility. Given the accuracy of moment measurements of tissue mimicking samples, and the need to look at small differences in tissue properties, the use of existing NIST standard reference materials to calibrate MRI reference structures is problematic and better reference materials are required.

  1. A decreasing trend in fall-related hip fracture incidence in Victoria, Australia.

    Science.gov (United States)

    Cassell, E; Clapperton, A

    2013-01-01

    In Victoria, Australia, the age-standardised incidence of fall-related hip fracture hospitalisations decreased significantly by 25% over the period 1998/1999-2008/2009. Significant decreases in fall-related hip fractures were observed in males and females, across all 5-year age groups, in Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people. The study aim was to investigate trends in the incidence of fall-related and hip fracture hospitalisations among Victorians aged 65 years and older overall and by age, gender, country of birth, socio-economic status (SES) and location of the event (home, residential care institution, etc.) over the 11-year period 1998/1999 to 2008/2009. Annual counts and age-standardised rates for fall-related hospitalisations among people aged 65 years and older were estimated using Victorian hospital admissions data. The statistical significance of changes in trends over time were analysed using a log-linear regression model of the rate data assuming a Poisson distribution of cases. Although the age-standardised incidence of fall-related hospitalisations increased significantly by 13% (95% confidence interval [CI], 9% to 18%) in Victoria, the age-standardised incidence of fall-related hip fracture hospitalisations decreased from 600/100,000 in 1998/1999 to 467/100,000 in 2008/2009 - an estimated overall reduction of 25% (95% CI, -29% to -22%). By contrast, the age-standardised incidence of fall-related hospitalisations for fractures at other body sites either increased significantly or showed no significant change. Significant decreases in fall-related hip fractures were observed in both males and females, across all 5-year age groups, in both Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people but not in people living in residential care facilities. Despite the downward trend in the age-standardised incidence of

  2. Reduced Slc6a15 in Nucleus Accumbens D2-Neurons Underlies Stress Susceptibility.

    Science.gov (United States)

    Chandra, Ramesh; Francis, T Chase; Nam, Hyungwoo; Riggs, Lace M; Engeln, Michel; Rudzinskas, Sarah; Konkalmatt, Prasad; Russo, Scott J; Turecki, Gustavo; Iniguez, Sergio D; Lobo, Mary Kay

    2017-07-05

    Previous research demonstrates that Slc6a15, a neutral amino acid transporter, is associated with depression susceptibility. However, no study examined Slc6a15 in the ventral striatum [nucleus accumbens (NAc)] in depression. Given our previous characterization of Slc6a15 as a striatal dopamine receptor 2 (D2)-neuron-enriched gene, we examined the role of Slc6a15 in NAc D2-neurons in mediating susceptibility to stress in male mice. First, we showed that Slc6a15 mRNA was reduced in NAc of mice susceptible to chronic social defeat stress (CSDS), a paradigm that produces behavioral and molecular adaptations that resemble clinical depression. Consistent with our preclinical data, we observed Slc6a15 mRNA reduction in NAc of individuals with major depressive disorder (MDD). The Slc6a15 reduction in NAc occurred selectively in D2-neurons. Next, we used Cre-inducible viruses combined with D2-Cre mice to reduce or overexpress Slc6a15 in NAc D2-neurons. Slc6a15 reduction in D2-neurons caused enhanced susceptibility to a subthreshold social defeat stress (SSDS) as observed by reduced social interaction, while a reduction in social interaction following CSDS was not observed when Slc6a15 expression in D2-neurons was restored. Finally, since both D2-medium spiny neurons (MSNs) and D2-expressing choline acetyltransferase (ChAT) interneurons express Slc6a15, we examined Slc6a15 protein in these interneurons after CSDS. Slc6a15 protein was unaltered in ChAT interneurons. Consistent with this, reducing Slc5a15 selectively in NAc D2-MSNs, using A2A-Cre mice that express Cre selectively in D2-MSNs, caused enhanced susceptibility to SSDS. Collectively, our data demonstrate that reduced Slc6a15 in NAc occurs in MDD individuals and that Slc6a15 reduction in NAc D2-neurons underlies stress susceptibility. SIGNIFICANCE STATEMENT Our study demonstrates a role for reduced Slc6a15, a neutral amino acid transporter, in nucleus accumbens (NAc) in depression and stress susceptibility. The

  3. 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.

  4. A GIS-based extended fuzzy multi-criteria evaluation for landslide susceptibility mapping.

    Science.gov (United States)

    Feizizadeh, Bakhtiar; Shadman Roodposhti, Majid; Jankowski, Piotr; Blaschke, Thomas

    2014-12-01

    Landslide susceptibility mapping (LSM) is making increasing use of GIS-based spatial analysis in combination with multi-criteria evaluation (MCE) methods. We have developed a new multi-criteria decision analysis (MCDA) method for LSM and applied it to the Izeh River basin in south-western Iran. Our method is based on fuzzy membership functions (FMFs) derived from GIS analysis. It makes use of nine causal landslide factors identified by local landslide experts. Fuzzy set theory was first integrated with an analytical hierarchy process (AHP) in order to use pairwise comparisons to compare LSM criteria for ranking purposes. FMFs were then applied in order to determine the criteria weights to be used in the development of a landslide susceptibility map. Finally, a landslide inventory database was used to validate the LSM map by comparing it with known landslides within the study area. Results indicated that the integration of fuzzy set theory with AHP produced significantly improved accuracies and a high level of reliability in the resulting landslide susceptibility map. Approximately 53% of known landslides within our study area fell within zones classified as having "very high susceptibility", with the further 31% falling into zones classified as having "high susceptibility".

  5. Elderly fall risk prediction using static posturography

    Science.gov (United States)

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity—0.114 x Eyes Closed Vector Sum Magnitude Velocity—2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older

  6. Elderly fall risk prediction using static posturography.

    Science.gov (United States)

    Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan; McIlroy, William E

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older

  7. Elderly fall risk prediction using static posturography.

    Directory of Open Access Journals (Sweden)

    Jennifer Howcroft

    Full Text Available Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP and medial-lateral (ML center of pressure (CoP motion; AP and ML CoP root mean square distance from mean (RMS; and AP, ML, and vector sum magnitude (VSM CoP velocity were calculated. Romberg Quotients (RQ were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24, prospective all fallers (42, prospective fallers (22 single, 6 multiple, and prospective non-fallers (47. Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for

  8. Rise and fall of the German nuclear industry; Aufstieg und Fall der deutschen Atomwirtschaft

    Energy Technology Data Exchange (ETDEWEB)

    Radkau, Joachim [Bielefeld Univ. (Germany). Neuere Geschichte; Hahn, Lothar

    2013-02-01

    The book on the rise and fall of the German nuclear industry includes five chapters: (1) From the atomic project of the second world war to the ''peaceful atom''. (2) The ''peaceful atom'' as vision: the phase of speculations. (3) Achieved facts: the unplanned triumph of the light water reactor. (4) The internally suppressed risk excites the public. (5) From the creeping to the open fall.

  9. Falls in ambulatory individuals with spinal cord injury : incidence, risk factors and perceptions of falls

    OpenAIRE

    Jørgensen, Vivien

    2016-01-01

    Background: Falls in ambulatory individuals with chronic spinal cord injury (SCI) are common and may have adverse consequences. Little and inconclusive research has been done in this population, and there is a need for more knowledge in order to develop prevention strategies appropriate for this population. Aim: The overall aim of this thesis was to study the incidence of and identify the risk factors for recurrent (>2) and injurious falls in ambulatory individuals with SCI...

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

    Science.gov (United States)

    Kim, Oksoo; Kim, Jung-Hee

    2015-01-01

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

  11. Redução das internações por condições sensíveis à atenção primária no Brasil entre 1998-2009 Reducción de las internaciones por condiciones susceptibles a atención primaria en Brasil entre 1998-2009 Reduction of ambulatory care sensitive conditions in Brazil between 1998 and 2009

    Directory of Open Access Journals (Sweden)

    Antonio Fernando Boing

    2012-04-01

    Full Text Available OBJETIVO: Descrever a tendência de hospitalizações por condições sensíveis à atenção primária entre 1998 e 2009 no Brasil. MÉTODOS: Estudo ecológico de séries temporais com dados secundários referentes às internações hospitalares por condições sensíveis à atenção primária no Sistema Único de Saúde. Os dados foram obtidos do Sistema de Informações Hospitalares. As taxas de internações por 10.000 habitantes foram padronizadas por faixa etária e sexo, considerando a população brasileira masculina recenseada em 2000 como padrão. A análise de tendência da série histórica foi realizada por regressão linear generalizada pelo método de Prais-Winsten. RESULTADOS: Houve redução média anual de internações por condições sensíveis à atenção primária de 3,7% entre homens (IC95% -2,3;-5,1 e mulheres (IC95% -2,5;-5,6 entre 1998 e 2009. A tendência variou em cada unidade federativa, porém em nenhuma houve aumento das internações. No sexo masculino e feminino as maiores reduções foram observadas nas internações por úlceras gastrintestinais (-11,7% ao ano e -12,1%, respectivamente, condições evitáveis (-8,8% e -8,9% e doenças das vias aéreas inferiores (-8,0% e -8,1%. Angina (homens, infecção no rim e trato urinário (homens e mulheres e condições relacionadas ao pré-natal e parto (mulheres apresentaram aumento nas internações. Os três grupos de doenças que mais ocasionaram internações foram gastrenterites infecciosas e complicações, internações por insuficiência cardíaca e asma. CONCLUSÕES: Houve redução substancial nas internações por condições sensíveis à atenção primária no Brasil entre 1998 e 2009, porém algumas doenças apresentaram estabilidade ou acréscimo, exigindo atenção do setor saúde.OBJETIVO: Describir la tendencia de hospitalizaciones por condiciones susceptibles a atención primaria entre 1998 y 2009 en Brasil. MÉTODOS: Estudio ecológico de series

  12. 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.

  13. Cesium levels in foodstuffs fall slowly

    International Nuclear Information System (INIS)

    Rantavaara, A.

    1994-01-01

    Since spring 1986, radioactive decay has reduced the total amount of radioactive cesium 137 in the Finnish environment, originating in Chernobyl, by 17 per cent. The cesium content in fish keeps falling at a diminishing rate, depending on the species of fish and environmental factors. The use of fish from lakes need not be restricted anymore. The cesium contents of game, mushrooms and wild berries have remained steady for some years now. The same is true for agricultural produce. The contents in milk and meat still keep falling slowly. Most of the cesium ingested by finns comes from fish, then from game, reindeer and gathered foods; the lowest amounts are received from agricultural products. (orig.)

  14. FirstMile US Fall 2005 Conference

    Science.gov (United States)

    2005-12-01

    Moore, Virginia Tech 5. Broadband Delivery means Living Longer and Living Better a. The First Mile in Healthcare, Michael Ackerman, National Library of...deal with it and interact with it." The Internet will be delivered by a wide variety of means and go to places where people may not have access to...Fall 2005 Conference Proceedings First Regional Commnunity Network - OneCleveland Steven Brand, OneCleveland 4U -ýýeý L ECommunity Computing -Thin

  15. Geothermal Injection Monitoring in Klamath Falls, OR

    Energy Technology Data Exchange (ETDEWEB)

    Culver, G

    1990-01-01

    Klamath Falls has nearly a 150-year history of geothermal utilization. The geothermal aquifer has been the subject of many studies and is probably the most tested direct use reservoir in the world. This provides good background data for increased monitoring needed as new injection wells are drilled. Prior to July 1990, few injection wells existed. A city ordinance requires injection after July 1990. The city and major injectors have initiated a monitoring system.

  16. The 'Falling Box' method in general relativity

    International Nuclear Information System (INIS)

    Gladush, V.D.

    1998-01-01

    The problems of justification, generalization, and applicability of the 'falling box' method to obtained some exact solutions of the vacuum Einstein equations are investigated. The 'physical' inference of the Reissner-Nordstrom-de Sitter and Kerr metrics is shown. Explanation is given for the well-known relativistic phenomenon which consists in that gravity is created by the double density of the electrical field energy

  17. Effect of impact surface in equestrian falls

    OpenAIRE

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

    2016-01-01

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

  18. An alternative model of free fall

    Science.gov (United States)

    Lattery, Mark

    2018-03-01

    In Two World Systems (Galileo 1632/1661 Dialogues Concerning Two New Sciences (New York: Prometheus)), Galileo attempted to unify terrestrial and celestial motions using the Aristotelian principle of circularity. The result was a model of free fall that correctly predicts the linear increase of the velocity of an object released from rest near the surface of the Earth. This historical episode provides an opportunity to communicate the nature of science to students.

  19. Airman Scholar Journal. Volume 17, Fall 2011

    Science.gov (United States)

    2011-01-01

    contends there must be a balance of the formal rea- soning of the social sciences and the informal reasoning of the humanities, which is one reason...USAFA’s founding, the “American Clausewitz,” Bernard Brodie ruminated : Economists …have a theoretical train- ing that in its fundamentals bears...kindled. - Plutarch 6 Airman Scholar • Fall 2011 16 Ibid., 5-1. Admiral Larson contended that concentrating like functions within

  20. Elderly fall risk prediction using static posturography

    OpenAIRE

    Howcroft, Jennifer; Lemaire, Edward D.; Kofman, Jonathan; McIlroy, William E.

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed w...

  1. Modeling seasonal migration of fall armyworm moths

    Science.gov (United States)

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

    2016-02-01

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

  2. Beliefs about the causes of success in sports and susceptibility for doping use in adolescent athletes.

    Science.gov (United States)

    Barkoukis, Vassilis; Lazuras, Lambros; Tsorbatzoudis, Haralambos

    2014-01-01

    The present study set out to assess the impact of attributional beliefs about success on the susceptibility for doping use in adolescent athletes. The sample consisted of 309 adolescent athletes participating in both team and individual sports. Participants completed a battery of questionnaires including Beliefs about the Causes of Success in Sport Questionnaire (BACSSQ), current and past doping use, and measures of attitudes, norms, situational temptation and social desirability. Variance reduction rate analysis revealed that social desirability did not act as a confounder in the relationship between doping susceptibility and its predictors. With regard to beliefs about the causes of success dimensions, only deception emerged as a significant predictor of doping use susceptibility over and above the effects of well-established social-cognitive predictors of doping intentions and use. These findings imply that beliefs about the causes of success in youth sports may comprise another dimension of risk factors for doping susceptibility and use.

  3. 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.

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

    Science.gov (United States)

    Guo, Kexuan; Chen, Hongkai; Chen, Tao

    2017-12-01

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

  5. Task oriented training improves the balance outcome & reducing fall risk in diabetic population

    OpenAIRE

    Ghazal, Javeria; Malik, Arshad Nawaz; Amjad, Imran

    2016-01-01

    Objectives: The objective was to determine the balance impairments and to compare task oriented versus traditional balance training in fall reduction among diabetic patients. Methods: The randomized control trial with descriptive survey and 196 diabetic patients were recruited to assess balance impairments through purposive sampling technique. Eighteen patients were randomly allocated into two groups; task oriented balance training group TOB (n=8) and traditional balance training group TBT (n...

  6. Falling through the black hole horizon

    International Nuclear Information System (INIS)

    Brustein, Ram; Medved, A.J.M.

    2015-01-01

    We consider the fate of a small classical object, a “stick”, as it falls through the horizon of a large black hole (BH). Classically, the equivalence principle dictates that the stick is affected by small tidal forces, and Hawking’s quantum-mechanical model of BH evaporation makes essentially the same prediction. If, on the other hand, the BH horizon is surrounded by a “firewall”, the stick will be consumed as it falls through. We have recently extended Hawking’s model by taking into account the quantum fluctuations of the geometry and the classical back-reaction of the emitted particles. Here, we calculate the strain exerted on the falling stick for our model. The strain depends on the near-horizon state of the Hawking pairs. We find that, after the Page time when the state of the pairs deviates significantly from maximal entanglement (as required by unitarity), the induced strain in our semiclassical model is still parametrically small. This is because the number of the disentangled pairs is parametrically smaller than the BH entropy. A firewall does, however, appear if the number of disentangled pairs near the horizon is of order of the BH entropy, as implicitly assumed in previous discussions in the literature.

  7. Fall Down Detection Under Smart Home System.

    Science.gov (United States)

    Juang, Li-Hong; Wu, Ming-Ni

    2015-10-01

    Medical technology makes an inevitable trend for the elderly population, therefore the intelligent home care is an important direction for science and technology development, in particular, elderly in-home safety management issues become more and more important. In this research, a low of operation algorithm and using the triangular pattern rule are proposed, then can quickly detect fall-down movements of humanoid by the installation of a robot with camera vision at home that will be able to judge the fall-down movements of in-home elderly people in real time. In this paper, it will present a preliminary design and experimental results of fall-down movements from body posture that utilizes image pre-processing and three triangular-mass-central points to extract the characteristics. The result shows that the proposed method would adopt some characteristic value and the accuracy can reach up to 90 % for a single character posture. Furthermore the accuracy can be up to 100 % when a continuous-time sampling criterion and support vector machine (SVM) classifier are used.

  8. Hospitalisations due to falls in older persons.

    LENUS (Irish Health Repository)

    Carey, D

    2005-06-01

    This paper describes hospitalisations due to falls among people aged 65 years and over resident in the Eastern Region of Ireland. Of the 2,029 hospitalisations recorded for 2002, 78% were female and 68% were aged 75 years and over. Fractures accounted for 1,697 or 84% of cases with nearly half of them (841) sustained to the hip. Females were more likely to have a limb fracture whereas males were more likely to have a head injury. The total inpatient costs of the 2,029 hospitalisations were estimated at 10.6 million euros. Hip fractures were the costliest injuries as they accounted for 7.4 million euros (70%) of inpatient costs. There are also substantial additional costs implications for hip fractures as they constituted the majority (56%) of cases transferred to nursing\\/convalescent homes or long-stay health facilities. In keeping with an ageing population, the problem of injuries in older people is likely to increase over time and as falls are the dominant cause of those injuries, all acute and long-stay health facilities need to develop and implement fall prevention strategies for older people.

  9. Albeni Falls Wildlife Mitigation : Annual Report 2002.

    Energy Technology Data Exchange (ETDEWEB)

    Terra-Berns, Mary

    2003-01-01

    The Albeni Falls Interagency Work Group continued to actively engage in implementing wildlife mitigation actions in 2002. Regular Work Group meetings were held to discuss budget concerns affecting the Albeni Falls Wildlife Mitigation Program, to present potential acquisition projects, and to discuss and evaluate other issues affecting the Work Group and Project. Work Group members protected 1,386.29 acres of wildlife habitat in 2002. To date, the Albeni Falls project has protected approximately 5,914.31 acres of wildlife habitat. About 21% of the total wildlife habitat lost has been mitigated. Administrative activities have increased as more properties are purchased and continue to center on restoration, operation and maintenance, and monitoring. In 2001, Work Group members focused on development of a monitoring and evaluation program as well as completion of site-specific management plans. This year the Work Group began implementation of the monitoring and evaluation program performing population and plant surveys, data evaluation and storage, and map development as well as developing management plans. Assuming that the current BPA budget restrictions will be lifted in the near future, the Work Group expects to increase mitigation properties this coming year with several potential projects.

  10. Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial).

    Science.gov (United States)

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

    2017-01-01

    Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention. Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness. In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained. There was a small reduction in falls. The intervention may be cost-effective. ISRCTN ISRCTN68240461.

  11. Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial.

    Directory of Open Access Journals (Sweden)

    Sarah Cockayne

    Full Text Available Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.In the primary analysis were 484 (98.2% intervention and 507 (98.1% control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16. The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05 as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01. There was an increase (p = 0.02 in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY difference 0.0129, 95% CI -0.0050 to 0.0314 and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.There was a small reduction in falls. The intervention may be cost-effective.ISRCTN ISRCTN68240461.

  12. 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.

  13. Multifractal magnetic susceptibility distribution models of hydrothermally altered rocks in the Needle Creek Igneous Center of the Absaroka Mountains, Wyoming

    Directory of Open Access Journals (Sweden)

    M. E. Gettings

    2005-01-01

    Full Text Available Magnetic susceptibility was measured for 700 samples of drill core from thirteen drill holes in the porphyry copper-molybdenum deposit of the Stinkingwater mining district in the Absaroka Mountains, Wyoming. The magnetic susceptibility measurements, chemical analyses, and alteration class provided a database for study of magnetic susceptibility in these altered rocks. The distribution of the magnetic susceptibilities for all samples is multi-modal, with overlapping peaked distributions for samples in the propylitic and phyllic alteration class, a tail of higher susceptibilities for potassic alteration, and an approximately uniform distribution over a narrow range at the highest susceptibilities for unaltered rocks. Samples from all alteration and mineralization classes show susceptibilities across a wide range of values. Samples with secondary (supergene alteration due to oxidation or enrichment show lower susceptibilities than primary (hypogene alteration rock. Observed magnetic susceptibility variations and the monolithological character of the host rock suggest that the variations are due to varying degrees of alteration of blocks of rock between fractures that conducted hydrothermal fluids. Alteration of rock from the fractures inward progressively reduces the bulk magnetic susceptibility of the rock. The model introduced in this paper consists of a simulation of the fracture pattern and a simulation of the alteration of the rock between fractures. A multifractal model generated from multiplicative cascades with unequal ratios produces distributions statistically similar to the observed distributions. The reduction in susceptibility in the altered rocks was modelled as a diffusion process operating on the fracture distribution support. The average magnetic susceptibility was then computed for each block. For the purpose of comparing the model results with observation, the simulated magnetic susceptibilities were then averaged over the same

  14. Multifractal magnetic susceptibility distribution models of hydrothermally altered rocks in the Needle Creek Igneous Center of the Absaroka Mountains, Wyoming

    Science.gov (United States)

    Gettings, M.E.

    2005-01-01

    Magnetic susceptibility was measured for 700 samples of drill core from thirteen drill holes in the porphyry copper-molybdenum deposit of the Stinkingwater mining district in the Absaroka Mountains, Wyoming. The magnetic susceptibility measurements, chemical analyses, and alteration class provided a database for study of magnetic susceptibility in these altered rocks. The distribution of the magnetic susceptibilities for all samples is multi-modal, with overlapping peaked distributions for samples in the propylitic and phyllic alteration class, a tail of higher susceptibilities for potassic alteration, and an approximately uniform distribution over a narrow range at the highest susceptibilities for unaltered rocks. Samples from all alteration and mineralization classes show susceptibilities across a wide range of values. Samples with secondary (supergene) alteration due to oxidation or enrichment show lower susceptibilities than primary (hypogene) alteration rock. Observed magnetic susceptibility variations and the monolithological character of the host rock suggest that the variations are due to varying degrees of alteration of blocks of rock between fractures that conducted hydrothermal fluids. Alteration of rock from the fractures inward progressively reduces the bulk magnetic susceptibility of the rock. The model introduced in this paper consists of a simulation of the fracture pattern and a simulation of the alteration of the rock between fractures. A multifractal model generated from multiplicative cascades with unequal ratios produces distributions statistically similar to the observed distributions. The reduction in susceptibility in the altered rocks was modelled as a diffusion process operating on the fracture distribution support. The average magnetic susceptibility was then computed for each block. For the purpose of comparing the model results with observation, the simulated magnetic susceptibilities were then averaged over the same interval as the

  15. Hypnotic susceptibility in patients with conversion disorder

    NARCIS (Netherlands)

    Roelofs, K.; Hoogduin, C.A.L.; Keijsers, G.P.J.; Näring, G.W.B.; Moene, F.C.; Sandijck, P.

    2002-01-01

    Conversion disorder has been associated with hypnotic susceptibility for over a century and is currently still believed to be a form of autohypnosis. There is, however. little empirical evidence for the relation between hypnotic susceptibility and conversion symptoms. The authors compared 50

  16. Magnetic susceptibility measurements on Bi - Sn alloys

    International Nuclear Information System (INIS)

    Mustaffa bin Haji Abdullah

    1985-01-01

    Magnetic susceptibility measurements on eight samples of tin-rich and three samples of bismuth-rich Bi-Sn alloys were made from 85K to 300K by Faraday's method. The susceptibilities of the eight tin-rich samples are positive and greater than the susceptibility of pure tin. The values are approximately constant at low temperatures but decreasing a little bit with increasing temperature. This result is interpreted as due to the predominant contribution of the Pauli spin paramagnetic susceptibility. A small decrease in susceptibility with temperature is interpreted as due to the effect of the second order term in the expression for spin paramagnetic susceptibility. The fluctuation of the susceptibility for alloys of different composition is interpreted as due to the effect of the density of states at the Fermi levels. The three samples of bismuth-rich alloys show a transition to diamagnetic property, where the diamagnetism is increased with temperature. This result is predominant and due to the diamagnetic contribution from the ions. The increase in susceptibility with temperature is interpreted as due to an increase in the effective radii of the ions due to thermal expansion. (author)

  17. antimicrobial susceptibility pattern of Salmonella species

    African Journals Online (AJOL)

    user

    ABSTRACT. Treatment of enteric fever is increasingly becoming very challenging due to the increasing wave of antibiotic resistance. This study is a review of the contemporary antimicrobial susceptibility pattern of. Salmonella species. The antimicrobial susceptibility pattern of Salmonella species to a wide range of.

  18. Storm-Induced Slope Failure Susceptibility Mapping

    Science.gov (United States)

    2018-01-01

    A pilot study was conducted to characterize and map the areas susceptible to slope failure using state-wide available data. The objective was to determine whether it would be possible to provide slope-failure susceptibility mapping that could be used...

  19. Distribution and antibiotic susceptibility pattern of methicillin ...

    African Journals Online (AJOL)

    Distribution and antibiotic susceptibility pattern of methicillin-resistant Staphylococcus aureus isolates in a university Teaching hospital in Nigeria. ... Amoxycillin clavunanic acid and ciprofloxacin were most active with MRSA isolates showing 97% and 93.9% susceptibility to the two drugs respectively. Eighteen (54.5%) ...

  20. 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.

  1. 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.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  3. Falls among pregnant women in Enugu, Southeast Nigeria

    African Journals Online (AJOL)

    2013-10-04

    Oct 4, 2013 ... Key words: Enugu, falls, Nigeria, pregnant women, prevalence, risk factors .... in which someone is paid some wages (salary) at specific intervals, for example .... initiated the process of filling the existing gap on falls during.

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

    African Journals Online (AJOL)

    GREG

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

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

    Science.gov (United States)

    Kantayaporn, Choochat

    2012-10-01

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

  6. Directions of the US Geological Survey Landslide Hazards Reduction Program

    Science.gov (United States)

    Wieczorek, G.F.

    1993-01-01

    The US Geological Survey (USGS) Landslide Hazards Reduction Program includes studies of landslide process and prediction, landslide susceptibility and risk mapping, landslide recurrence and slope evolution, and research application and technology transfer. Studies of landslide processes have been recently conducted in Virginia, Utah, California, Alaska, and Hawaii, Landslide susceptibility maps provide a very important tool for landslide hazard reduction. The effects of engineering-geologic characteristics of rocks, seismic activity, short and long-term climatic change on landslide recurrence are under study. Detailed measurement of movement and deformation has begun on some active landslides. -from Author

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

    Science.gov (United States)

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

    2005-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Hudson Azevedo Pinheiro

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

  9. 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.

  10. 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.

  11. An approach to balance problems and falls in elderly persons

    OpenAIRE

    de Villiers, L; Kalula, S Z

    2015-01-01

    Gait instability and falls are common in elderly persons and have devastating consequences, with substantial morbidity and mortality. Furthermore, they are a precipitant for functional decline, increasing frailty and institutionalisation. The rate of falls and severity of complications increase with age and frailty. A consequence of falls with or without injury is that at least a third of persons develop a fear of falling, which leads to functional decline and a progressive decline in gait. T...

  12. [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.

  13. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.

    Science.gov (United States)

    Sherrington, Catherine; Michaleff, Zoe A; Fairhall, Nicola; Paul, Serene S; Tiedemann, Anne; Whitney, Julie; Cumming, Robert G; Herbert, Robert D; Close, Jacqueline C T; Lord, Stephen R

    2017-12-01

    Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects. Update of a systematic review with random effects meta-analysis and meta-regression. Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched from January 2010 to January 2016. We included randomised controlled trials that compared fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group. 99 comparisons from 88 trials with 19 478 participants were available for meta-analysis. Overall, exercise reduced the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, pexercise programmes that challenged balance and involved more than 3 hours/week of exercise. These variables explained 76% of the between-trial heterogeneity and in combination led to a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, pExercise also had a fall prevention effect in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I 2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I 2 21%, 3 comparisons). There was no evidence of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital. Exercise as a single intervention can prevent falls in community-dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger effects. The impact of exercise as a single intervention in clinical groups and aged care facility residents requires further investigation, but promising results are evident for people with Parkinson

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

    Science.gov (United States)

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

    2016-08-01

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

  15. The Association of Cardiovascular Disorders and Falls : A Systematic Review

    NARCIS (Netherlands)

    Jansen, Sofie; Bhangu, Jaspreet; de Rooij, Sophia; Daams, Joost; Kenny, Rose Anne; van der Velde, Nathalie

    2016-01-01

    Objective: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. Design: Systematic review. Data

  16. What Are Ways to Prevent Falls and Related Fractures?

    Science.gov (United States)

    ... risk of falling. Some tips to help prevent falls outdoors are: Use a cane or walker Wear rubber-soled shoes so you don’t slip Walk on grass when sidewalks are slick Put salt or kitty litter on icy sidewalks. Some ways to help prevent falls indoors are: Keep rooms free of clutter, especially ...

  17. Falls among pregnant women in Enugu, Southeast Nigeria | Okeke ...

    African Journals Online (AJOL)

    Background: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria. Objective: To determine the prevalence and risk factors associated with falls ...

  18. First Results of Evaluation of a Falls Clinic

    Directory of Open Access Journals (Sweden)

    Christoph Bauer

    2010-09-01

    Conclusion: The results showed that a high-risk population attended our falls clinic. We presume that the falls clinic will have a beneficial effect in reducing the prevalence of falls in a high-risk population. Further studies are necessary to test this hypothesis.

  19. Epidemiology and pathophysiology of falls in facioscapulohumeral disease

    NARCIS (Netherlands)

    Horlings, C. G. C.; Munneke, M.; Bickerstaffe, A.; Laverman, L.; Allum, J. H. J.; Padberg, G. W. A. M.; Bloem, B. R.; van Engelen, B. G. M.

    2009-01-01

    Muscle weakness is a potentially important, yet poorly studied, risk factor for falls. Detailed studies of patients with specific myopathies may shed new light on the relation between muscle weakness and falls. Here falls in patients with facioscapulohumeral disease (FSHD) who suffered from lower

  20. Epidemiology and pathophysiology of falls in facioscapulohumeral disease.

    NARCIS (Netherlands)

    Horlings, G.C.; Munneke, M.; Bickerstaffe, A.; Laverman, L.; Allum, J.H.J.; Padberg, G.W.A.M.; Bloem, B.R.; Engelen, B.G.M. van

    2009-01-01

    BACKGROUND AND AIMS: Muscle weakness is a potentially important, yet poorly studied, risk factor for falls. Detailed studies of patients with specific myopathies may shed new light on the relation between muscle weakness and falls. Here falls in patients with facioscapulohumeral disease (FSHD) who

  1. Factors associated with falls in older patients with diffuse polyneuropathy.

    Science.gov (United States)

    Richardson, James K

    2002-11-01

    To identify clinical factors associated with falls by older persons with polyneuropathy (PN). A cross-sectional study of 82 subjects aged 50 to 85 with clinical and electrodiagnostic evidence of PN. Electrodiagnostic and biomechanical research laboratories. Patients referred to the electrodiagnostic laboratory. History and physical examination, including semiquantitative methods of peripheral nerve function, and clinical balance testing. Falls were defined by retrospective self-report over a 2-year period. Forty (48.8%), 28 (34.1%), and 18 (22.0%) subjects reported a history of at least one fall, multiple falls, and injurious falls, respectively. Factors associated with single and multiple falls were similar, so only results for multiple and injurious falls are reported. Bivariate analysis showed that an increased body mass index (BMI) and more severe PN (as determined by the Michigan Diabetes Neuropathy Score) were associated with both fall categories. Men reporting falls also demonstrated a decreased unipedal stance time. Age, sex, nerve conduction study parameters, Romberg testing, medications, and comorbidities were not consistently associated with either fall category. Logistic regression demonstrated that multiple and injurious falls were associated with an increased BMI and more severe PN, controlling for age, sex, medications, and comorbidities (pseudo R2 = 0.458 and 0.484, respectively). Although previous work has demonstrated that all older persons with PN are at increased risk for falls, patients with increased BMI and more severe PN are at particularly high risk and should be targeted for intervention.

  2. Underreporting of Fall Injuries of Older Adults: Implications for Wellness Visit Fall Risk Screening.

    Science.gov (United States)

    Hoffman, Geoffrey J; Ha, Jinkyung; Alexander, Neil B; Langa, Kenneth M; Tinetti, Mary; Min, Lillian C

    2018-04-17

    To compare the accuracy of and factors affecting the accuracy of self-reported fall-related injuries (SFRIs) with those of administratively obtained FRIs (AFRIs). Retrospective observational study SETTING: United States PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 65 and older (N=47,215). We used 24-month self-report recall data from 2000-2012 Health and Retirement Study data to identify SFRIs and linked inpatient, outpatient, and ambulatory Medicare data to identify AFRIs. Sensitivity and specificity were assessed, with AFRIs defined using the University of California at Los Angeles/RAND algorithm as the criterion standard. Logistic regression models were used to identify sociodemographic and health predictors of sensitivity. Overall sensitivity and specificity were 28% and 92%. Sensitivity was greater for the oldest adults (38%), women (34%), those with more functional limitations (47%), and those with a prior fall (38%). In adjusted results, several participant factors (being female, being white, poor functional status, depression, prior falls) were modestly associated with better sensitivity and specificity. Injury severity (requiring hospital care) most substantively improved SFRI sensitivity (73%). An overwhelming 72% of individuals who received Medicare-reimbursed health care for FRIs failed to report a fall injury when asked. Future efforts to address underreporting in primary care of nonwhite and healthier older adults are critical to improve preventive efforts. Redesigned questions-for example, that address stigma of attributing injury to falling-may improve sensitivity. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

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

    Science.gov (United States)

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

    2011-03-28

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

  4. Finding optimal exact reducts

    KAUST Repository

    AbouEisha, Hassan M.

    2014-01-01

    The problem of attribute reduction is an important problem related to feature selection and knowledge discovery. The problem of finding reducts with minimum cardinality is NP-hard. This paper suggests a new algorithm for finding exact reducts

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

    Science.gov (United States)

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

    2007-08-01

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

  6. Susceptibility to hypoxia and breathing control changes after short-term cold exposures

    Directory of Open Access Journals (Sweden)

    Lyudmila T. Kovtun

    2013-08-01

    Full Text Available Background . Hypoxia is the reduction of oxygen availability due to external or internal causes. There is large individual variability of response to hypoxia. Objective . The aim of this study was to define individual and typological features in susceptibility to hypoxia, its interrelation with hypoxic and hypercapnic ventilatory responses (HVR and HCVR, respectively and their changes after cold acclimation. Design . Twenty-four healthy men were tested. HVR and HCVR were measured by the rebreathing method during hypoxic and hypercapnic tests, respectively. These tests were carried out in thermoneutral conditions before and after cold exposures (nude, at 13°C, 2 h daily, for 10 days. Susceptibility to hypoxia (sSaO2 was determined as haemoglobin saturation slope during hypoxic test. Results . It was found that HVR and HCVR significantly increased and susceptibility to hypoxia (sSaO2 tended to decrease after cold acclimation. According to sSaO2 results before cold exposures, the group was divided into 3: Group 1 – with high susceptibility to hypoxia, Group 2 – medium and Group 3 – low susceptibility. Analysis of variances (MANOVA shows the key role of susceptibility to hypoxia and cold exposures and their interrelation. Posterior analysis (Fisher LSD showed significant difference in susceptibility to hypoxia between the groups prior to cold acclimation, while HVR and HCVR did not differ between the groups. After cold acclimation, susceptibility to hypoxia was not significantly different between the groups, while HCVR significantly increased in Groups 1 and 3, HVR significantly increased in Group 3 and HCVR, HVR did not change in Group 2. Conclusions . Short-term cold exposures caused an increase in functional reserves and improved oxygen supply of tissues in Group 1. Cold exposure hypoxia has caused energy loss in Group 3. Group 2 showed the most appropriate energy conservation reaction mode to cold exposures. No relation was found between

  7. 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...

  8. 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.

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

    Science.gov (United States)

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

    2017-10-01

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

  10. 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.

  11. 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.

  12. Quedas em idosos com Vertigem Posicional Paroxística Benigna Elderly falls associated with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Fernando Freitas Ganança

    2010-02-01

    Full Text Available Vertigem Posicional Paroxística Benigna (VPPB pode causar quedas, principalmente em pacientes idosos. OBJETIVO: Verificar se o número de quedas em idosos com VPPB diminui após a realização de manobras de reposicionamento de partículas (MRP. MATERIAL E MÉTODO: Estudo retrospectivo em que foram incluídos idosos com VPPB que tenham apresentado queda no último ano. Todos os pacientes submeteram-se à MRP de acordo com o canal semicircular (CSC acometido. Após a abolição da vertigem e do nistagmo de posicionamento, os pacientes foram acompanhados ao longo de 12 meses e investigados em relação ao número de quedas neste período. Para comparar o número de quedas antes e após as MRP utilizou-se avaliação estatística por meio do teste de Wilcoxon. RESULTADOS: Foram incluídos 121 pacientes. Cento e um pacientes apresentaram acometimento do CSC posterior, 16 do lateral e quatro do anterior. Verificou-se redução do número de quedas após as MRP, com diferença estatisticamente significante na amostra geral (pBenign Paroxysmal Positional Vertigo (BPPV can cause falls, especially in the elderly. AIM: to study whether or not elderly patients with BPPV have a reduction on their falls after the particle repositioning maneuver (PRM. MATERIALS AND METHODS: retrospective study including elderly with BPPV who had fall(s during the last year. All patients were submitted to the PRM according to the affected semicircular canal (SCC. After the abolition of positioning vertigo and nystagmus, the patients were submitted to a 12 month follow-up and were investigated about the number of fall(s. Wilcoxon's test was performed to compare the number of fall(s before and after 12 months of the PRM. RESULTS: One hundred and twenty one patients were included in the study. One hundred and one patients presented involvement of the posterior SCC, 16 of the lateral and four of the anterior. We noticed a reduction on the number of falls, with statistically

  13. Risk of falls in older people during fast-walking--the TASCOG study.

    Science.gov (United States)

    Callisaya, M L; Blizzard, L; McGinley, J L; Srikanth, V K

    2012-07-01

    To investigate the relationship between fast-walking and falls in older people. Individuals aged 60-86 years were randomly selected from the electoral roll (n=176). Gait speed, step length, cadence and a walk ratio were recorded during preferred- and fast-walking using an instrumented walkway. Falls were recorded prospectively over 12 months. Log multinomial regression was used to estimate the relative risk of single and multiple falls associated with gait variables during fast-walking and change between preferred- and fast-walking. Covariates included age, sex, mood, physical activity, sensorimotor and cognitive measures. The risk of multiple falls was increased for those with a smaller walk ratio (shorter steps, faster cadence) during fast-walking (RR 0.92, CI 0.87, 0.97) and greater reduction in the walk ratio (smaller increase in step length, larger increase in cadence) when changing to fast-walking (RR 0.73, CI 0.63, 0.85). These gait patterns were associated with poorer physiological and cognitive function (prisk of multiple falls was also seen for those in the fastest quarter of gait speed (p=0.01) at fast-walking. A trend for better reaction time, balance, memory and physical activity for higher categories of gait speed was stronger for fallers than non-fallers (prisk of multiple falls. There may be two distinct groups at risk--the frail person with short shuffling steps, and the healthy person exposed to greater risk. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Sensory-Challenge Balance Exercises Improve Multisensory Reweighting in Fall-Prone Older Adults.

    Science.gov (United States)

    Allison, Leslie K; Kiemel, Tim; Jeka, John J

    2018-04-01

    Multisensory reweighting (MSR) deficits in older adults contribute to fall risk. Sensory-challenge balance exercises may have value for addressing the MSR deficits in fall-prone older adults. The purpose of this study was to examine the effect of sensory-challenge balance exercises on MSR and clinical balance measures in fall-prone older adults. We used a quasi-experimental, repeated-measures, within-subjects design. Older adults with a history of falls underwent an 8-week baseline (control) period. This was followed by an 8-week intervention period that included 16 sensory-challenge balance exercise sessions performed with computerized balance training equipment. Measurements, taken twice before and once after intervention, included laboratory measures of MSR (center of mass gain and phase, position, and velocity variability) and clinical tests (Activities-specific Balance Confidence Scale, Berg Balance Scale, Sensory Organization Test, Limits of Stability test, and lower extremity strength and range of motion). Twenty adults 70 years of age and older with a history of falls completed all 16 sessions. Significant improvements were observed in laboratory-based MSR measures of touch gain (P = 0.006) and phase (P = 0.05), Berg Balance Scale (P = 0.002), Sensory Organization Test (P = 0.002), Limits of Stability Test (P = 0.001), and lower extremity strength scores (P = 0.005). Mean values of vision gain increased more than those for touch gain, but did not reach significance. A balance exercise program specifically targeting multisensory integration mechanisms improved MSR, balance, and lower extremity strength in this mechanistic study. These valuable findings provide the scientific rationale for sensory-challenge balance exercise to improve perception of body position and motion in space and potential reduction in fall risk.

  15. 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.

  16. [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.

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

    Directory of Open Access Journals (Sweden)

    T. J. Garrett

    2012-11-01

    Full Text Available 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 aspect ratio. From a selection of the photographed hydrometeors, an illustration is provided for how the instrument might be used for making improved microwave scattering calculations. Complex, aggregated snowflake shapes appear to be more strongly forward scattering, at the expense of reduced back-scatter, than heavily rimed graupel particles of similar size.

  18. Cost of falls in old age: a systematic review.

    Science.gov (United States)

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

    2010-06-01

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

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

    Science.gov (United States)

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

    2013-11-18

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

  20. 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.