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Sample records for susceptibility reduction fall

  1. Aircraft Survivability. Susceptibility Reduction. Fall 2010

    Science.gov (United States)

    2010-01-01

    importance of what we do, and showcased the joint nature of our organization. CDR Fehrle and LT John responded to the scene immediately to begin the...Eye-One Photo SG” spectro-photometer (Gretag Macbeth GRET-0366), which provides 10nm resolution across the 380-730nm spectral range. The paints...Approach The short timelines, prevalence, and portable nature of the aircraft threats described lead us to a change in the paradigm of aircraft

  2. Improving the Method of Roof Fall Susceptibility Assessment based on Fuzzy Approach

    Science.gov (United States)

    Ghasemi, Ebrahim; Ataei, Mohammad; Shahriar, Kourosh

    2017-03-01

    Retreat mining is always accompanied by a great amount of accidents and most of them are due to roof fall. Therefore, development of methodologies to evaluate the roof fall susceptibility (RFS) seems essential. Ghasemi et al. (2012) proposed a systematic methodology to assess the roof fall risk during retreat mining based on risk assessment classic approach. The main defect of this method is ignorance of subjective uncertainties due to linguistic input value of some factors, low resolution, fixed weighting, sharp class boundaries, etc. To remove this defection and improve the mentioned method, in this paper, a novel methodology is presented to assess the RFS using fuzzy approach. The application of fuzzy approach provides an effective tool to handle the subjective uncertainties. Furthermore, fuzzy analytical hierarchy process (AHP) is used to structure and prioritize various risk factors and sub-factors during development of this method. This methodology is applied to identify the susceptibility of roof fall occurrence in main panel of Tabas Central Mine (TCM), Iran. The results indicate that this methodology is effective and efficient in assessing RFS.

  3. Rock fall susceptibility assessment using structural geological indicators for detaching processes such as sliding or toppling

    Science.gov (United States)

    Melzner, Sandra; Tilch, Nils; Lotter, Michael; Kociu, Arben

    2010-05-01

    A structural geological assessment of cliffs in terms of rock fall susceptibility is expensive and time-consuming particularly in remote areas (exposed cliffs) where it may even be impossible. Hence it is important to develop methods and strategies that can be used to extrapolate the acquired knowledge from representative sub-regions to the whole study area. Using a case study in Carinthia (Austria), a GIS method was developed which can be used for regional, qualitative determination of the susceptibility of cliffs in carbonatic sedimentary rock, regarding two potential initial detachment processes of rock fall: sliding and/or toppling. During the development of this GIS method, it was found that not all of the mapped structural geologic parameters are equally suitable for a comprehensive regionalisation. Subsequently, only those parameters were included in the assessment which experts deemed to be representative in terms of parameter homogeneity/heterogeneity and thus applicable to the entire survey region: bedding thickness, tectonic lineaments, orientation of discontinuities and type of rock mass structure. Regions of homogeneity/heterogeneity differ with regard to parameter values, as well as parameter uncertainties and scattering. At first, the cliffs were categorised in terms of potential form and size of rock blocks by overlaying various parameter maps. In the next step, the relative orientation of the rock mass structures and their variations towards slope aspect and slope inclination were considered within a region of homogeneity. This allowed an accurate estimate of the possible maximum dip angle (or apparent dip angle) of a joint set over a wide area. It also permitted those areas to be pointed out in which process-initialising sliding and/or toppling might be possible along one or several joint sets. Comparing this method to the acquired field data has proven the approach to be successful when it comes to assessing cliffs in carbonate rocks in terms of

  4. A 10-year journey in sustaining fall reduction in an academic medical center in Singapore.

    Science.gov (United States)

    Mordiffi, Siti Zubaidah; Ng, Sow Chun; Ang, N K Emily; Lee, Siu Yin; Lee, Margaret; Teng, Siew Tin; Yip, Wai Kin; Quek, Swee Chye; Santos, Diana R

    2016-03-01

    The incidence rate of falls at 1.3 falls/1000 patient-days at a tertiary hospital in 2004 was found to be high when benchmarked against other hospitals' fall rates in Singapore. This marked the starting point of a journey of reducing fall incidence by successfully combining evidence-based healthcare measures with quality-improvement strategies. The aim of this project was to implement fall-reduction strategies in the inpatient care areas in an acute care tertiary hospital. Two action research studies commissioned for ascertaining an appropriate fall-risk assessment and effectiveness of targeted individualized interventions formed the foundation of fall-reduction strategies. Evidence-based healthcare measures were combined with quality-improvement strategies that addressed fall risks to prevent falls and mitigate injuries. The process of managing fall-related incidents was standardized as the fall rate continues to be a key nursing performance indicator. The overall fall trend decreased from 1.09/1000 patient-days in 2008 to 0.82/1000 patient-days in 2012. The decreasing trends were sustained in 2013 and 2014 at 0.91/100 and 0.85/1000, respectively. The fall injury rate reduced from 0.31/1000 patient-days in 2008 and was maintained at a rate of 0.20-0.24 during 2009-2012. The implementation of fall-reduction strategies reduced the fall incidence rate in this acute care setting. However, more work is required to ensure the changes made to the fall assessment, interventions, and processes are sustained and incorporated in patient care.

  5. Landslide hazard zonation of slopes susceptible to rock falls and topples

    Directory of Open Access Journals (Sweden)

    M. Parise

    2002-01-01

    Full Text Available A landslide hazard zonation is a division of the land surface into areas, and the relative ranking of these areas according to degrees of actual or potential hazard from landslides on slopes. Zonation from scientific research does not generally imply legal restrictions, but can be useful to those people who are charged with the land management, by providing them with information that is indispensable for planning and regulation purposes. This paper presents a zonation of rock slopes in carbonate mountains on the boundary to the east of the valley of the Sele River (Campania, southern Apennines of Italy. The mountains are severely affected by rock falls and topples, and the related hazard is, therefore, very high; the presence of inhabited areas (the towns of Valva, Colliano and Collianello and other human infrastructures at the slope foothills make these phenomena extremely dangerous to the anthropogenic environment. The area is highly seismic, as experienced on the occasion of several moderate to strong earthquakes that have hit this sector of the Apennines. According to the zonation proposed here, the ridge of Mount Valva and Mount Marzano is subdivided into four main areas on the basis of the processes which take place in the different sectors of the mountains: the source area, the talus slope, the rockfall shadow (where scattered outlying boulders are present, and the safe area (outside of the reach of fallen blocks. The four sectors were identified through air-photo interpretation and detailed field surveys, aimed in particular at characterizing and interpreting the main rock mass joint patterns, and their relative orientation with respect to the local slope direction. Geological, morphological and structural analyses permitted one to evaluate and classify those parts of the slope that are more susceptible to detachment of rocks, and to identify the more diffuse types of failure. Due to high seismicity of the study area, particular

  6. An engineering rock classification to evaluate seismic rock-fall susceptibility and its application to the Wasatch Front

    Science.gov (United States)

    Harp, E.L.; Noble, M.A.

    1993-01-01

    Investigations of earthquakes world wide show that rock falls are the most abundant type of landslide that is triggered by earthquakes. An engineering classification originally used in tunnel design, known as the rock mass quality designation (Q), was modified for use in rating the susceptibility of rock slopes to seismically-induced failure. Analysis of rock-fall concentrations and Q-values for the 1980 earthquake sequence near Mammoth Lakes, California, defines a well-constrained upper bound that shows the number of rock falls per site decreases rapidly with increasing Q. Because of the similarities of lithology and slope between the Eastern Sierra Nevada Range near Mammoth Lakes and the Wasatch Front near Salt Lake City, Utah, the probabilities derived from analysis of the Mammoth Lakes region were used to predict rock-fall probabilities for rock slopes near Salt Lake City in response to a magnitude 6.0 earthquake. These predicted probabilities were then used to generalize zones of rock-fall susceptibility. -from Authors

  7. Establishment and Characterization of GSA-1, a Human Cell Line Highly Susceptible to Apoptosis after Free-fall

    OpenAIRE

    JUN, NOMURA; JYUNI, HIMEDA; Zheng, Chen; Shigeru, SUGAYA; Shunji, TAKAHASHI; Kazuko, KITA; Masaharu, ICHINOSE; Nobuo, Suzuki; Department of Environmental Medicine, Faculty of Education, Chiba University; Plastic and Reconstructive Surgery, Chiba University; Department of Environmental Biochemistry, Graduate School of Medicine, Chiba University

    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 ...

  8. 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

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

    Science.gov (United States)

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

    2002-12-01

    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 1-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.

  10. Predation Susceptibility of Juvenile Fall Chinook Salmon Exposed to Sudden Temperature Changes and Slightly Supersaturated Dissolved Gas

    Energy Technology Data Exchange (ETDEWEB)

    Bellgraph, Brian J.; Carter, Kathleen M.; Chamness, Michele A.; Abel, Tylor K.; Linley, Timothy J.; Cullinan, Valerie I.

    2014-08-01

    High mortality of hatchery-reared juvenile fall Chinook salmon emigrating from the Clearwater River was previously measured at the confluence of the Snake and Clearwater rivers; however, the causative mechanism of mortality is unknown. To elucidate potential mechanisms, the predation susceptibility of juvenile fall Chinook salmon was assessed during simulated passage from the Clearwater River and through the confluence of the Clearwater and Snake rivers, with and without cool water flow augmentation. Emigrant-sized juvenile salmon were acclimated to temperatures typical of the Clearwater River when cool water augmentation is discharged from Dworshak Dam (10°C to 17°C) and during temperatures that would be present without augmentation (17°C to 24°C), and were then exposed to smallmouth bass within temperatures typical of the Snake River in summer (17°C to 24°C). Slightly supersaturated total dissolved gas concentrations of 105% were also simulated to more closely approximate gas conditions of both rivers in summer. Predation susceptibility of juvenile salmon acclimated at 10°C or 17°C and exposed to predators at 17°C did not differ. However, for salmon exposed to predators at 24°C, predation susceptibility was arguably higher for juvenile salmon acclimated at 10°C (a 14°C increase) than for salmon acclimated at 17°C or 24°C (7°C and 0°C increases, respectively). These results indicate that predation susceptibility may be higher when a relatively large temperature difference exists between the Clearwater and Snake rivers; that is, when cool water flow augmentation is occurs in summer. However, further research is needed to determine if high confluence mortality measured in previous studies is related to cool water augmentation and, ultimately, whether or not this mortality has a population-level effect on the dynamics of wild Snake River fall Chinook salmon.

  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. Predictors of and health- and fall-related program outcomes resulting from complete and adequate doses of a fall risk reduction program.

    Science.gov (United States)

    Mielenz, Thelma J; Durbin, Laura L; Hertzberg, Fern; Nobile-Hernandez, Diana; Jia, Haomiao

    2017-06-01

    Falls are dangerous and costly for older adults. The A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) program is an evidence-based fall risk reduction program that could help reduce this burden. This study introduced a door-through-door transportation program to improve program delivery (N = 126). Characteristics predicting completion of all eight AMOB/VLL sessions were identified using logistic regression. Individual growth models were employed to determine the immediate, intermediate, and long-term goal outcomes resulting from receiving an adequate dose of the program (five to eight sessions). Self-restriction of activities due to fear of falling (OR 5.04, 95 % CI 1.86-13.69) and a lower frequency of moderate and vigorous physical activity (OR 1.14, 95 % CI 1.04-1.27) were significantly predictive of receiving a complete dose. Three outcome goals were significant, including (1) immediate-improved self-efficacy of managing medications and treatments, (2) intermediate-reduced activity limitations, and (3) intermediate-reduced physical disability. Self-restriction of activities due to a fear of falling and physical activity levels may be simple and effective screening questions to prevent AMOB/VLL attrition. In our study, those who did receive the program improved on a specific type of self-efficacy and on self-reported physical functioning.

  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.

  14. Reduction of falls in older people by improving balance with vestibular rehabilitation (ReFOVeRe study): design and methods.

    Science.gov (United States)

    Soto-Varela, Andrés; Gayoso-Diz, Pilar; Rossi-Izquierdo, Marcos; Faraldo-García, Ana; Vaamonde-Sánchez-Andrade, Isabel; del-Río-Valeiras, María; Lirola-Delgado, Antonio; Santos-Pérez, Sofía

    2015-12-01

    Evaluate the effectiveness of vestibular rehabilitation (VR) to improve the balance in older people, assessed immediately afterwards. (a) To verify the maintenance of improvement of the balance achieved in the medium term (6-12 months). (b) To consider whether this improvement results in a reduction in the number of falls. (c) To compare among themselves the effectiveness of three different methods of VR in improving balance and to explore whether there are differences to achieve a reduction in the number of falls. Experimental study, single-centre, open, randomised (balanced blocks of patients) in four branches in parallel, in 220 elderly patients (over 64 years) with high risk of falls and a follow-up period of 12 months. Department of Otolaryngology of the University Hospital of Santiago. People over 64 years, fulfilling one of the following requirements: (a) At least one fall in the last year. (b) Take at least 16 s or require some support in perform the test "timed up and go". (c) A percentage of average balance in the sensory organisation test (SOT) in the dynamic posturography (CDP) VR. The percentage of average balance in the SOT in CDP. Secondary measures: time and supports in the test of "timed up and go", scores of the dynamic posturography and SwayStar system, and rate of falls.

  15. 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.

  16. 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 (pCawthorne and Cooksey exercises were able to promote significant improvement in the balance of this sample and they can be applied as prevention and treatment in balance disturbances in elderly people.

  17. 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

    the susceptibility towards antibiotics. The aim of this study was to identify genetic determinants that upon inactivation reduce aminoglycoside susceptibility in Staphylococcus aureus. We screened the Nebraska Transposon Mutant Library of 1920 single-gene inactivations in S. aureus strain JE2, for reduced...... 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...... the largest increase in gentamicin susceptibility and exhibited a small colony variant phenotype, whereas the remaining mutants (qoxA, qoxB, qoxC, ndh and hemX) displayed colony morphology similar to the wild type. All of the mutants, except hemX, displayed reduced membrane potential suggesting that reduced...

  18. 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 Fall.

    Science.gov (United States)

    Stivala, Adam; Hartley, Greg

    2013-11-25

    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.

  19. 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.

  20. 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).

  1. 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 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.

  2. [Options for the reduction of magnetic susceptibility artifacts caused by implanted microchips in 0.5 Tesla magnetic resonance imaging].

    Science.gov (United States)

    Piesnack, S; Oechtering, G; Ludewig, E

    2015-01-01

    Microchips contain ferromagnetic materials, which lead to severe focal image interferences when performing magnetic resonance imaging (MRI). Very small animals are particularly prone to these susceptibility artifacts, which may hinder analysis of the neck-region MRI image. We investigated the impact of sequence type on the artifact's size and determined the optimal imaging parameters to minimize these artifacts. Furthermore, the minimum distance between the microchip and the spinal canal required to assess the spinal structures should be determined. Investigations were performed on the cadavers of 26 cats and two dogs using a low-field MRI System (field strength 0.5 Tesla). To quantify susceptibility artifacts, several sequence types (spin echo, turbo-spin echo (TSE), gradient echo) and imaging parameters (echo time (TE), voxel volume, frequency direction) were systematically varied. Additionally, computed tomography imaging was performed to determine the distance between the microchip and the spinal canal. The size of the artifact was smallest with T1-weighted TSE sequences. A short TE (10 ms) and a small voxel size (acquisition matrix 256 x 256 pixels, field of view 160 mm, slice thickness 2 mm) significantly reduced artifact size. Furthermore, it could be shown that by changing the frequency- and phase-encoding direction, the shape and orientation of the maximum dimension of the artifact could be influenced. Even when using an optimized T1-weighted TSE sequence, it was impossible to evaluate the spinal cord when the distance between the microchip and the center of the spinal canal was dogs and cats, microchips can cause severe susceptibility artifacts. Because of the small distance between the microchip and the spinal structures, spinal evaluation may be limited or impossible. The investigations demonstrated that the adjustment of sequence parameters helps to significantly minimize artifact size and shape. The greatest reduction in artifact size was achieved by

  3. The Rise and Fall of Unstressed Vowel Reduction in the Spanish of Cusco, Peru: A Sociophonetic Study

    Science.gov (United States)

    Delforge, Ann Marie

    2009-01-01

    This dissertation describes the phonetic characteristics of a phenomenon that has previously been denominated "unstressed vowel reduction" in Andean Spanish based on the spectrographic analysis of 40,556 unstressed vowels extracted from the conversational speech of 150 residents of the city of Cusco, Peru. Results demonstrate that this…

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

    Energy Technology Data Exchange (ETDEWEB)

    Mavroidis, P [University of North Carolina, Chapel Hill, NC (United States); Boci, N; Kostopoulos, S; Ninos, C; Glotsos, D; Oikonomou, G; Bakas, A; Roka, V; Cavouras, D; Lavdas, E [Technological Education Institute of Athens, Athens, Attika (Greece); Sakkas, G; Tsagkalis, A [Animus Kyanoys Larissas Hospital, Larissa, Thessaly (Greece); Chatzivasileiou, V; Batsikas, G [IASO Thessalias Hospital, Larissa, Thessaly (Greece); Papanikolaou, N [University of Texas HSC SA, San Antonio, TX (United States); Stathakis, S [Cancer Therapy and Research Center, San Antonio, TX (United States)

    2015-06-15

    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.

  5. The effect of 15 weeks of exercise on balance, leg strength, and reduction in falls in 40 women aged 65 to 89 years.

    Science.gov (United States)

    Ballard, Joyce E; McFarland, Carol; Wallace, Lorraine Silver; Holiday, David B; Roberson, Glenda

    2004-01-01

    Risk of falling increases as people age, and decreased leg strength and poor balance have been implicated as contributors. Our aims were to:1) assess the efficacy of a fall-prevention exercise program on balance and leg strength in women aged 65 to 89 years and 2) conduct a 1-year follow-up to determine the effect of exercise on fall rates. Forty women were classified by falling history and fear of falling and assigned to exercise and control groups using stratified randomization. We used the Berg Balance Scale, Get-up and Go, Functional Reach, and Wall-Sit Tests to evaluate changes in balance and leg strength before and after a supervised 15-week exercise program (31-hr sessions/week). We conducted 1-year follow-up telephone interviews and compared the number of falls reported by exercise and control groups.The study used a 2 x 2 (exercise/control by pretest/post-test) factorial design with the testing times being a repeated factor, so we used analysis of variance (ANOVA) to evaluate differences between the 2 groups across testing times. Power analysis computed a priori with STPLAN software (Version 4.2) showed that a sample size of 40 was necessary to determine statistical differences in balance and leg strength. Exercise subjects showed significant improvement on 5 of 14 items (5.2%, p score (6.8%, p < or = .05). Leg strength increased significantly (p < or = .05) on post-test as measured by the Wall-Sit Test. Control subjects reported 6 falls and exercise subjects no falls during the follow-up year, but this difference was not significant using Fischer's exact test (p=.106). The exercise program resulted in increased balance and leg strength, but did not result in a significant difference in falls during the follow-up period. Further research with a larger and possibly older sample is needed to more adequately investigate this question. Health care providers who work with older women should provide exercise programs in which balance and leg strength are

  6. Effect of whole-body vibration on reduction of bone loss and fall prevention in postmenopausal women: a meta-analysis and systematic review.

    Science.gov (United States)

    Ma, Chiyuan; Liu, An; Sun, Miao; Zhu, Hanxiao; Wu, Haobo

    2016-02-17

    To examine whole-body vibration (WBV) effect on bone mineral density (BMD) and fall prevention in postmenopausal women, we performed a meta-analysis and systematic review of prospective randomized controlled trials (RCTs) comparing change in BMD of the femoral neck and lumbar spine and related factors of falls between WBV group and control group. EMBASE, PubMed, Cochrane Central Register of Controlled Trials, ISI Web of Science, and China National Knowledge Infrastructure (CNKI) were searched up to April 2015; search strategy was used as follows: (vibration) AND (osteoporo* OR muscle* OR bone mineral density OR BMD). All prospective randomized controlled trials comparing related factors of falls and BMD change in the femoral neck and lumbar spine between WBV group and control group were retrieved. Eight of 3599 studies with 1014 patients were included, 477 in the WBV group, and 537 in the control group. We found that there was no significant difference in all magnitude groups of the femoral neck (N = 936, WMD: 0.00 (-0.00, 0.01); p = 0.18). A statistical significance showed in the all magnitude groups (N = 1014, WMD: 0.01 (0.00, 0.01); p = 0.01) and low-magnitude group (N = 838, WMD: 0.01 (0.00, 0.01); p = 0.007) of the lumbar spine. No significant difference was found in high-magnitude group of the lumbar spine (N = 176, WMD: 0.00 (-0.01, 0.02); p = 0.47), low-magnitude group (N = 838, WMD: 0.00 (-0.00, 0.00); p = 0.92) and high-magnitude group (N = 98, WMD: 0.02 (-0.00, 0.05); p = 0.06) of the femoral neck. All the studies provided data of related factors of falls such as strength of the lower limb, balance, and fall rate reported effectiveness of WBV therapy. In addition, no complication was reported. Low-magnitude whole-body vibration therapy can provide a significant improvement in reducing bone loss in the lumbar spine in postmenopausal women. Moreover, whole-body vibration can be used as an intervention for fall prevention.

  7. [Assessment of fall risk and fall prevention].

    Science.gov (United States)

    Harada, Atsushi

    2012-06-01

    Typical risk factors for falls include a history of falling, decreased walking ability, and taking certain drugs. Serum vitamin D concentration is associated with falls, and vitamin D administration decreases falls. Fall prevention methods include exercise intervention, interventions other than exercise, and multifaceted interventions. However, the scientific evidence for whether fall prevention prevents fractures is poor. Fracture prevention with the use of hip protectors is effective in nursing facility dwellers, but not in elderly people living at home.

  8. The Ruby Red Slipper Program: an interdisciplinary fall management program in a community academic medical center.

    Science.gov (United States)

    Wexler, Sharon Stahl; D'Amico, Catherine O'Neill; Foster, Norma; Cataldo, Karen A; Brody, Patricia; Huang, Zheng-Bo

    2011-01-01

    Falls are a common, yet serious complication for hospitalized patients. The Ruby Red Slipper Program is an interdisciplinary fall management program that includes development and education of unit-based fall management teams. Initial outcomes demonstrated significant reductions in falls.

  9. Falls Prevention Process in Assisted Living Communities.

    Science.gov (United States)

    Coughlin, DaRae; Nordman-Oliveira, Susan E; Schlaak, Mary; Ford, James H

    2017-12-01

    Falls are a significant issue for older adults, and many older adults who once received care in nursing homes now reside in assisted living communities (ALCs). ALC staff needs to address resident falls prevention; however, federal or state requirements or oversight are limited. This research explores falls prevention in Wisconsin ALCs in the context of the Kotter Change Model to identify strategies and inform efforts to establish a more consistent, proactive falls prevention process for ALCs. A mixed methods approach demonstrated inconsistency and variability in the use of falls risk assessments and prevention programs, which led to the development of standardized, proactive falls prevention process flowcharts. This process, as delineated, provides ALCs with an approach to organize a comprehensive falls reduction strategy. Findings highlight the importance of educating staff regarding assessments, resident motivation, falls prevention programs, and feedback, all key components of the falls prevention process.

  10. Promotion of anagen, increased hair density and reduction of hair fall in a clinical setting following identification of FGF5-inhibiting compounds via a novel 2-stage process

    Science.gov (United States)

    Burg, Dominic; Yamamoto, Masakuni; Namekata, Masato; Haklani, Joseph; Koike, Koichiro; Halasz, Maria

    2017-01-01

    Background There are very few effective, scientifically validated treatments with known mechanisms of action for treatment of hair loss in both men and women. Fibroblast growth factor 5 (FGF5) is an important factor in the irreversible transition from anagen to catagen, and inhibition of FGF5 prolongs anagen phase and reduces hair loss. Objective We aimed to screen botanically derived molecules for FGF5 inhibitory activity in vitro and assess efficacy in a clinical setting. Methods We screened for FGF5 inhibitory efficacy via a novel 2-step in vitro pipeline consisting of an engineered FGF5 responsive cell line, followed by an activated dermal papillae (DP) cell method. Efficacy in a clinical setting was assessed in a randomized, single-blind, placebo-controlled trial against early- to mid-stage pattern hair loss in men and women. Results We observed FGF5 inhibitory activity for a number of compounds from the monoterpenoid family, many showing greater inhibitory efficacy than our previously reported crude plant extracts. Evaluation of a lead candidate in a clinical study over 112 days showed a significant improvement in anagen:telogen (AT) ratio (p = 0.002), reduced hair fall (p = 0.007) and improved visual grading (p = 0.004). Scientifically matched photography on a subgroup of randomly chosen participants highlighted significant improvement in hair density, with increases evident in all tested participants compared to baseline. Conclusion Isolates from the monoterpenoid family displayed efficacy in FGF5 inhibition in vitro. A topical formulation containing a leading isolate significantly improved AT ratio, reduced hair fall and increased apparent hair density in the tested population of men and women. PMID:28280377

  11. Promotion of anagen, increased hair density and reduction of hair fall in a clinical setting following identification of FGF5-inhibiting compounds via a novel 2-stage process

    Directory of Open Access Journals (Sweden)

    Burg D

    2017-02-01

    Full Text Available Dominic Burg,1 Masakuni Yamamoto,2 Masato Namekata,2 Joseph Haklani,1 Koichiro Koike,2 Maria Halasz1 1Cellmid Limited, Sydney, NSW, Australia; 2Hair Gene Research Laboratory, Advangen Inc. Kashiwanoha, Chiba-ken, Japan Background: There are very few effective, scientifically validated treatments with known mechanisms of action for treatment of hair loss in both men and women. Fibroblast growth factor 5 (FGF5 is an important factor in the irreversible transition from anagen to catagen, and inhibition of FGF5 prolongs anagen phase and reduces hair loss. Objective: We aimed to screen botanically derived molecules for FGF5 inhibitory activity in vitro and assess efficacy in a clinical setting. Methods: We screened for FGF5 inhibitory efficacy via a novel 2-step in vitro pipeline consisting of an engineered FGF5 responsive cell line, followed by an activated dermal papillae (DP cell method. Efficacy in a clinical setting was assessed in a randomized, single-blind, placebo-controlled trial against early- to mid-stage pattern hair loss in men and women. Results: We observed FGF5 inhibitory activity for a number of compounds from the monoterpenoid family, many showing greater inhibitory efficacy than our previously reported crude plant extracts. Evaluation of a lead candidate in a clinical study over 112 days showed a significant improvement in anagen:telogen (AT ratio (p = 0.002, reduced hair fall (p = 0.007 and improved visual grading (p = 0.004. Scientifically matched photography on a subgroup of randomly chosen participants highlighted significant improvement in hair density, with increases evident in all tested participants compared to baseline. Conclusion: Isolates from the monoterpenoid family displayed efficacy in FGF5 inhibition in vitro. A topical formulation containing a leading isolate significantly improved AT ratio, reduced hair fall and increased apparent hair density in the tested population of men and women. Keywords: hair growth, hair

  12. Promotion of anagen, increased hair density and reduction of hair fall in a clinical setting following identification of FGF5-inhibiting compounds via a novel 2-stage process.

    Science.gov (United States)

    Burg, Dominic; Yamamoto, Masakuni; Namekata, Masato; Haklani, Joseph; Koike, Koichiro; Halasz, Maria

    2017-01-01

    There are very few effective, scientifically validated treatments with known mechanisms of action for treatment of hair loss in both men and women. Fibroblast growth factor 5 (FGF5) is an important factor in the irreversible transition from anagen to catagen, and inhibition of FGF5 prolongs anagen phase and reduces hair loss. We aimed to screen botanically derived molecules for FGF5 inhibitory activity in vitro and assess efficacy in a clinical setting. We screened for FGF5 inhibitory efficacy via a novel 2-step in vitro pipeline consisting of an engineered FGF5 responsive cell line, followed by an activated dermal papillae (DP) cell method. Efficacy in a clinical setting was assessed in a randomized, single-blind, placebo-controlled trial against early- to mid-stage pattern hair loss in men and women. We observed FGF5 inhibitory activity for a number of compounds from the monoterpenoid family, many showing greater inhibitory efficacy than our previously reported crude plant extracts. Evaluation of a lead candidate in a clinical study over 112 days showed a significant improvement in anagen:telogen (AT) ratio (p = 0.002), reduced hair fall (p = 0.007) and improved visual grading (p = 0.004). Scientifically matched photography on a subgroup of randomly chosen participants highlighted significant improvement in hair density, with increases evident in all tested participants compared to baseline. Isolates from the monoterpenoid family displayed efficacy in FGF5 inhibition in vitro. A topical formulation containing a leading isolate significantly improved AT ratio, reduced hair fall and increased apparent hair density in the tested population of men and women.

  13. 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.

  14. A Multicomponent Fall Prevention Strategy Reduces Falls at an Academic Medical Center.

    Science.gov (United States)

    France, Dan; Slayton, Jenny; Moore, Sonya; Domenico, Henry; Matthews, Julia; Steaban, Robin L; Choma, Neesha

    2017-09-01

    While the reduction in fall rates has not kept pace with the reduction of other hospital-acquired conditions, patient safety research and quality improvement (QI) initiatives at the system and hospital levels have achieved positive results and provide insights into potentially effective risk reduction strategies. An academic medical center developed a QI-based multicomponent strategy for fall prevention and pilot tested it for six months in three high-risk units-the Neuroscience Acute Care Unit, the Myelosuppression/Stem Cell Transplant Unit, and the Acute Care for the Elderly Unit-before implementing and evaluating the strategy hospitalwide. The multicomponent fall strategy was evaluated using a pre-post study design. The main outcome measures were falls and falls with harm measured in events per 1,000 patient-days. Fall rates were monitored and compared for three classes of falls: (1) accidental, (2) anticipated physiologic, and (3) unanticipated physiologic. Statistical process control charts showed that the pilot units had achieved significant reductions in falls with harm during the last five months of data collection. Wald test and segmented regression analyses revealed significant improvements in pooled postintervention fall rates, stratified by fall type. The hospitalwide implementation of the program resulted in a 47% overall reduction in falls in the postintervention period. A fall prevention strategy that targeted the spectrum of risk factors produced measurable improvement in fall rates and rates of patient harm. Hospitals must continue developing, rigorously testing, and sharing their results and experiences in implementing and sustaining multicomponent fall prevention strategies. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  15. Home Improvements Prevent Falls

    Science.gov (United States)

    ... Adults / How Can Older Adults Prevent Falls? / Home Improvements Prevent Falls Winter 2014 Issue: Volume 8 Number 4 Page 16-17 MedlinePlus | Subscribe | Magazine Information | Contact Us | Viewers & Players Friends of the National Library of Medicine (FNLM)

  16. FCJ-210 Falling Robots

    OpenAIRE

    Lian Loke

    2016-01-01

    Falling is not usually viewed as a desirable act for humanoid robots, as it can lead to damage and injury of people, things and the robot itself. This article explores how falling can be viewed as an aesthetic, creative act, through positioning it within dance. Strategies for falling safely in dance are compared with engineering approaches to controlling falling for bipedal robots, through the language of automatic reflex, righting reaction and equilibrium response patterns in relation to gra...

  17. Peralta Facts: Fall 1983.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    Data were collected in fall 1983 to provide a profile of the student population of the Peralta Community College District (PCCD). The data revealed: (1) total student enrollment declined by 12% from fall 1982 (N=38,976) to fall 1983 (N=34,183); (2) 57% of the students whose sex was identified were women; (3) minorities constituted 58% of the…

  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)

    ... physical therapist. The physical therapist can create a custom exercise program aimed at improving your balance, flexibility, ... healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358 . Mayo Clinic Footer Legal Conditions and Terms ...

  20. Pre-impact fall detection

    OpenAIRE

    Hu, Xinyao; Qu, Xingda

    2016-01-01

    Pre-impact fall detection has been proposed to be an effective fall prevention strategy. In particular, it can help activate on-demand fall injury prevention systems (e.g. inflatable hip protectors) prior to fall impacts, and thus directly prevent the fall-related physical injuries. This paper gave a systematical review on pre-impact fall detection, and focused on the following aspects of the existing pre-impact fall detection research: fall detection apparatus, fall detection indicators, fal...

  1. Variable slice thickness (VAST) EPI for the reduction of susceptibility artifacts in whole-brain GE-EPI at 7 Tesla.

    Science.gov (United States)

    Brunheim, Sascha; Johst, Sören; Pfaffenrot, Viktor; Maderwald, Stefan; Quick, Harald H; Poser, Benedikt A

    2017-07-10

    A new technique for 2D gradient-recalled echo echo-planar imaging (GE-EPI) termed 'variable slice thickness' (VAST) is proposed, which reduces signal losses caused by through-slice susceptibility artifacts, while keeping the volume repetition time (TR) manageable. The slice thickness is varied across the brain, with thinner slices being used in the inferior brain regions where signal voids are most severe. Various axial slice thickness schemes with identical whole-brain coverage were compared to regular EPI, which may either suffer from unfeasibly long TR if appropriately thin slices are used throughout, or signal loss if no counter-measures are taken. Evaluation is based on time-course signal-to-noise (tSNR) maps from resting state data and a statistical group-level region of interest (ROI) analysis on breath-hold fMRI measurements. The inferior brain region signal voids with static B0 inhomogeneities could be markedly reduced with VAST GE-EPI in contrast to regular GE-EPI. ROI-averaged event-related signal changes showed 48% increase in VAST compared to GE-EPI with regular "thick" slices. tSNR measurements proved the comparable signal robustness of VAST in comparison to regular GE-EPI with thin slices. A novel acquisition strategy for functional 2D GE-EPI at ultrahigh magnetic field is presented to reduce susceptibility-induced signal voids and keep TR sufficiently short for whole-brain coverage.

  2. 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.

  3. 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.

  4. The extra resource burden of in-hospital falls: a cost of falls study.

    Science.gov (United States)

    Morello, Renata T; Barker, Anna L; Watts, Jennifer J; Haines, Terry; Zavarsek, Silva S; Hill, Keith D; Brand, Caroline; Sherrington, Catherine; Wolfe, Rory; Bohensky, Megan A; Stoelwinder, Johannes U

    2015-11-02

    To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia. A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs. Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission. We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8-10.4; P costs of $6669 (95% CI, $3888-$9450; P costs (mean, $4727; 95% CI, -$568 to $10 022; P = 0.080). Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

  5. Psychotropic Drug-Related Fall Incidents in Nursing Home Residents Living in the Eastern Part of The Netherlands

    NARCIS (Netherlands)

    Janus, Sarah I.M.; Reinders, Gezinus H.; van Manen, Jeanette G.; Zuidema, Sytse U.; IJzerman, Maarten J.

    2017-01-01

    Background: Older people are more susceptible to falls than younger people. Therefore, as the Dutch population ages, the total number of falls and costs associated with them will rise. The use of psychotropic drugs is associated with an increased risk of falling. To create tailored fall-prevention

  6. Focused supervision of high-risk fall dementia patients: a simple method to reduce fall incidence and severity.

    Science.gov (United States)

    Detweiler, Mark B; Kim, Kye Y; Taylor, Brenda Y

    2005-01-01

    Dementia units in nursing homes have a disproportionately high number of demographic risk factors for falls. Many residents have a previous history of falls, the inability to call for assistance, and the inability to remember safety instructions. For interdisciplinary falls review committees, this population may be the most difficult to manage. The Virginia Veterans Care Center (VVCC) Dementia Unit Interdisciplinary Fall Team instituted a novel practice for reducing the number and severity of falls among the highest risk group of dementia patients. Certified nursing assistants (CNAs) were assigned to high-risk residents for focused supervision. The patients received consistent supervision by selected CNAs during the day and evening shifts. Eight residents identified as high risk who continued to have falls despite multiple interventions were selected for the study. A comparison of four months of intervention with the four months prior to the intervention revealed a significant (p = 0. 024) fall reduction during the intervention months. Individually, seven of the eight participants had reduced falls during the intervention period. A 5-point scale for fall severity demonstrated an overall reduction in fall severity during that period. Individually, five of the eight patients had a decreased fall severity, and one had no change. Two patients experienced an increase in fall severity due to ongoing medical problems. While the small number of patients in the study limits the power of the results, this novel intervention of using designated CNAs to supervise high-risk fall residents with dementia may prove helpful for staff in other nursing facilities.

  7. 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.

  8. Fall Leaf Portraits

    Science.gov (United States)

    O'Hara, Cristina

    2012-01-01

    In this article, the author describes how students can create a stunning as well as economical mosaic utilizing fall's brilliantly colored leaves, preserved at their peak in color. Start by choosing a beautiful fall day to take students on a nature walk to collect a variety of leaves in different shapes, sizes, and colors. Focus on collecting a…

  9. Fall prevention conceptual framework.

    Science.gov (United States)

    Abraham, Sam

    2011-01-01

    Falls can have lasting psychological and physical consequences, particularly fractures and slow-healing processes, and patients may also lose confidence in walking. Injuries from falls lead to functional decline, institutionalization, higher health care costs, and decreased quality of life. The process related to the problem of patient falls in the hospital, using the nursing model developed by the theorist, Ida Jean Orlando, is explained in this article. The useful tool that provides guidance to marketers in this endeavor is Maslow's hierarchy of needs. During acute illness, individuals are greatly in need of satisfying their physiological needs. If these needs are not met, patients leave the hospital lacking a positive experience. Initial fall risk assessment is critical to plan intervention and individualize care plan. Interventions depend on the severity of fall risk factors.

  10. Falls prevention for the elderly.

    Science.gov (United States)

    Balzer, Katrin; Bremer, Martina; Schramm, Susanne; Lühmann, Dagmar; Raspe, Heiner

    2012-01-01

    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. 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. 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. Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, to a variable degree the validity of their

  11. 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

  12. Review on prevention of falls in hospital settings

    Directory of Open Access Journals (Sweden)

    Yuan-Yuan Gu

    2016-03-01

    Full Text Available This review will first cover the root causes of falls, identify preventive measures associated with these falls, and provide an overview of best practice of fall prevention at leading institutions. There is significant benefit in instituting a comprehensive program to reduce falls. After analyzing the results from many successful programs, it is apparent that an integrative program that consists of patient evaluations, environmental modification, and staff training can lead to a significant reduction in the overall prevalence of falls. Such programs can be implemented at a low cost and therefore represent an improvement in care with a high return on investment.

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

    Science.gov (United States)

    Oliveira, Fabrício M S; Horta, Bernardo C; Prata, Luana O; Santiago, Andrezza F; Alves, Andréa C; Faria, Ana M C; Gomes, Maria A; Caliari, Marcelo V

    2012-04-27

    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, non-infected (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.

  14. 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.

  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. Implementation and evaluation of a nursing home fall management program.

    Science.gov (United States)

    Rask, Kimberly; Parmelee, Patricia A; Taylor, Jo A; Green, Diane; Brown, Holly; Hawley, Jonathan; Schild, Laura; Strothers, Harry S; Ouslander, Joseph G

    2007-03-01

    To evaluate the feasibility and effectiveness of a falls management program (FMP) for nursing homes (NHs). A quality improvement project with data collection throughout FMP implementation. NHs in Georgia owned and operated by a single nonprofit organization. All residents of participating NHs. A convenience sample of 19 NHs implemented the FMP. The FMP is a multifaceted quality improvement and culture change intervention. Key components included organizational leadership buy-in and support, a designated facility-based falls coordinator and interdisciplinary team, intensive education and training, and ongoing consultation and oversight by advanced practice nurses with expertise in falls management. Process-of-care documentation using a detailed 24-item audit tool and fall and physical restraint use rates derived from quality improvement software currently used in all Georgia NHs (MyInnerView). Care process documentation related to the assessment and management of fall risk improved significantly during implementation of the FMP. Restraint use decreased substantially during the project period, from 7.9% to 4.4% in the intervention NHs (a relative reduction of 44%), and decreased in the nonintervention NHs from 7.0% to 4.9% (a relative reduction of 30%). Fall rates remained stable in the intervention NHs (17.3 falls/100 residents per month at start and 16.4 falls/100 residents per month at end), whereas fall rates increased 26% in the NHs not implementing the FMP (from 15.0 falls/100 residents/per month to 18.9 falls/100 residents per month). Implementation was associated with significantly improved care process documentation and a stable fall rate during a period of substantial reduction in the use of physical restraints. In contrast, fall rates increased in NHs owned by the same organization that did not implement the FMP. The FMP may be a helpful tool for NHs to manage fall risk while attempting to reduce physical restraint use in response to the Centers for

  17. Exercise for falls prevention in Parkinson disease

    Science.gov (United States)

    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.

    2015-01-01

    Objective: 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. Methods: 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. Results: 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 exercise group compared with controls (IRR = 0.31, 95% CI 0.15–0.62, p exercise group (IRR = 1.61, 95% CI 0.86–3.03, p = 0.13). Postintervention, the exercise group scored significantly (p 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. Classification of evidence: 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. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12608000303347). PMID:25552576

  18. Falls in the Aging Population.

    Science.gov (United States)

    Khow, Kareeann S F; Visvanathan, Renuka

    2017-08-01

    The number of people living beyond 65 years of age is increasing rapidly, and they are at increased risk of falls. Falls-related injuries and hospitalizations are steadily increasing. Falls can lead to fear of falling, loss of independence, institutionalization, and death, inevitably posing a significant burden to the health care system. Therefore, screening of people at risk of falls and comprehensive assessment of older people at high risk of falls are critical steps toward prevention. This review evaluates the current knowledge relating to falls, with particular focus on rapid screening, assessment, and strategies to prevent falls in the community. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 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.

  20. Falls and fall prevention in community-dwelling older adults

    OpenAIRE

    Tuvemo Johnson, Susanna

    2018-01-01

    Falls are the primary cause of injuries among older adults, and accidents that result from falls can lead to personal suffering and extensive societal burdens. The overall aims of this thesis were to explore and describe falls and fall prevention strategies in community-dwelling older adults and to evaluate a fall prevention home exercise program, the Otago Exercise Program (OEP), with or without motivational interviewing (MI). Methods: Qualitative and quantitative research methods were uses....

  1. Fall 1982 Retention Study.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    In fall 1982, a study was conducted in the Peralta Community College District (PCCD) using withdrawal and grade distribution data to analyze student retention patterns. Successful retention rates were based on the percentage of students who received a passing grade, while total retention rates were based on the percentage of students who received…

  2. Fall 1984 Retention Study.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    A study was conducted of the retention patterns of students enrolled in the Peralta Community College District (PCCD) in fall 1984 using college reports on withdrawals and grade distributions. The study focused on successful retention (i.e., all students who received a passing grade) and on total retention (i.e., all students who received any…

  3. Editors' Fall Picks

    Science.gov (United States)

    Heilbrun, Margaret; McCormack, Heather; Katterjohn, Anna; Kuzyk, Raya; Roncevic, Mirela; Fox, Bette-Lee; Hoffert, Barbara

    2009-01-01

    "Library Journal's" review editors select fall titles readers won't want to miss--"Waiting on a Train: The Embattled Future of Passenger Rail Service" (James McCommons); "Happy" (Alex Lemon); "Free for All: Joe Papp, the Public, and the Greatest Theater Story Ever Told" (Kenneth Turan & Joseph Papp); "In My Father's Shadow: A Daughter Remembers…

  4. Aircraft Survivability: Susceptibility Reduction, Spring 2003

    Science.gov (United States)

    2003-01-01

    EA) is desirable, and gives an overview of some current areas of research. We begin with an often-cited definition of coherency— “Two or more...decoy was also in development at that time. In the late 1980s the Universal Radar Nulling System ( URANUS ) imaging radar jammer test bed was built and...dem- onstrated using analog delay lines. A smaller version of the URANUS , the DRFM based Mini- URANUS , was developed to demonstrate coherent

  5. Falls in the nursing home: are they preventable?

    Science.gov (United States)

    Vu, Man Quang; Weintraub, Nancy; Rubenstein, Laurence Z

    2004-01-01

    Falls are prevalent in elderly patients residing in nursing homes, with approximately 1.5 falls occurring per nursing home bed-years. Although most are benign and injury-free, 10% to 25% result in hospital admission and/or fractures. Primary care providers for nursing home residents must therefore aim to reduce both the fall rate as well as the rate of fall-related morbidity in the long-term care setting. Interventions have been demonstrated to be successful in reducing falls in community-dwelling elderly patients. However, less evidence supports the efficacy of fall prevention in nursing home residents. The authors conducted a Medline search using the key words Falls and Nursing Homes. Several studies examined the efficacy of multifaceted intervention programs on reducing falls in nursing homes with varied results. Components of these intervention programs include: environmental assessment, assistive device evaluation and modification, medication changes, gait assessment and training, staff education, exercise programs, hip protector use, and blood pressure evaluation. Current literature supports the use of environmental assessment and intervention in reducing falls in nursing homes, and demonstrates an association between certain medications and falls. However, there are no studies that examine the effect of medication adjustments on fall rates. Also, the literature does not strongly suggest that exercise programs are effective in fall reduction. Although not effective in reducing fall rates, the use of hip protectors appears to result in less fall-related morbidity. More studies must be done to clarify the effects of high-risk medication reduction, the optimal nature and intensity of exercise programs, and patient targeting criteria to maximize the effectiveness of nursing home fall prevention programs. Based on the current literature, an effective multifaceted fall prevention program for nursing home residents should include risk factor assessment and

  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. The Resource. Fall 2001

    Science.gov (United States)

    2001-01-01

    Adams, Director of Scientific Visualization, initiated a Bring Your Own Data ( BYOD ) workshop for MSRC users. The first workshop was held June 25-26 in...leverage these assets in their future work. The first BYOD workshop was definitely a benefit to the users. Chris Stone, in particular was able to...publications 28 ERDC MSRC The Resource, Fall 2001 ac ro ny m s AG Access Grid AMR Adaptive Mesh Refinement BYOD Bring Your Own Data CDC Control Data

  8. Urban fall traps

    Directory of Open Access Journals (Sweden)

    Vera Lucia de Almeida Valsecchi

    2007-06-01

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

  9. 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.

  10. 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.

  11. Fall prevention walker during rehabilitation

    Science.gov (United States)

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

    2017-09-01

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

  12. Fall prevention in older persons

    African Journals Online (AJOL)

    including stroke and Parkinson's disease, which lead to poor balance and muscle weakness are important causes of falls. Dementia and delirium are also associated with increased risk of falls.[3]. Building on the risk factor evidence base, interventions for fall prevention began to be evaluated in randomised trials in the.

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

    Directory of Open Access Journals (Sweden)

    Patrícia Almeida

    2013-06-01

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

  14. Falls and the falls efficacy scale in Parkinson's disease.

    Science.gov (United States)

    Thomas, Alissa A; Rogers, Jennifer M; Amick, Melissa M; Friedman, Joseph H

    2010-07-01

    The purpose of this study was to investigate the relationship between fear of falling and fall frequency among patients with idiopathic Parkinson's disease (PD). One hundred-two participants with idiopathic PD were interviewed and examined. Participants reported the number of falls they had experienced in the preceding 3 months. They completed a mini-mental state exam (MMSE) and the falls efficacy scale (FES) questionnaire. Disease severity was determined by clinical examination using the Hoehn-Yahr staging system. Excluding two outliers who fell more than once each day, the subjects fell an average of 1.2 times in a 3 month period. There was a positive correlation between the number of falls, freezing of gait and Hoehn-Yahr score, and a negative correlation with the MMSE. In a post-hoc analysis the participants were divided into four groups based on fall frequency. The outliers had the lowest FES scores on average, similar to the scores seen in the rare fallers group. This study suggests that many factors are associated with fear of falling, including fall frequency, disease severity, and mental status. In the present study, the patients who fell the most often did not report the most fear. The lack of fear of falling but frequent falls in this small subgroup may suggest that special techniques to instill suitable caution to prevent falls are necessary, or may make training of these patients impossible.

  15. 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

  16. Exercise, Health, and Falls Risks among Older African American Women

    Directory of Open Access Journals (Sweden)

    Maria Kosma

    2017-07-01

    Full Text Available Background of Study: Although exercise has many benefits, older African American (AA women are less active than older Caucasian women and older AA men. Balance and muscle-strengthening activities are typically recommended for decreased falls, whereas the role of aerobic training alone on falls prevention is controversial. Objective: This was a mixed methods phronetic (pragmatic study – without an intervention – including quantitative data (falls risks and qualitative data on exercise behavior and its importance to health and falls prevention; therefore, the studied phenomenon was thoroughly and pragmatically investigated. The first purpose of the study was to examine differences in falls risks based on exercise type (aerobics vs. combination of aerobics, muscle training, and balance activities and exercise level (active people vs. somewhat active people. Secondly, participants’ exercise values were examined in relation to their health, falls-risk prevention, exercise behavior, and falls risks. Method: Interviews and falls risk assessments were conducted among 12 older AA women in an inner-city community center. Results: ANCOVA and ANOVA showed that the aerobics group performed better in Dynamic Gait Index (DGI and Timed Up and Go than the combination group (d =0.85, -0.97; the latter surpassed the former in Functional Reach (d = 2.27. The active group (met the 150 minutes/week exercise recommendation performed better in DGI and Six-Minute Walk than the somewhat active group (d =0.62.,50; the latter outperformed the former in balance-eyes open (d = -0.52. Emerging themes about lifestyle values included: a reasons for health conditions and staying healthy and b falls prevention. Conclusion: Exercise programs for fall risk reduction should include not only muscle strengthening and balance activities, but also aerobic exercises. Meeting minimum exercise recommendations is key to falls risk reduction. Beyond healthy diet, the role of exercise

  17. Collective Fall Protection for Construction Workers

    OpenAIRE

    Sulowski, A. C.

    2014-01-01

    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 sy...

  18. 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.

  19. 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...... registries from 2000 through 2009. Individuals aged 65 years or older who experienced a hip or a proximal humeral fracture were included. Incidence of hip and of proximal humeral fractures, incidence of FRICs (ischemic heart disease, COPD, dementia, depression, diabetes, heart failure, osteoporosis......, Parkinson's disease and stroke) and incidence rate ratios (IRR) for fractures in patients with FRICs, and all-cause mortality up to 10 years after a hip or a proximal humeral fracture were analysed. RESULTS: A total of 89,150 patients experienced hip fractures and 48,581 proximal humeral fractures. From...

  20. Increasing fall-winter energy loss from the Arctic Ocean and its role in Arctic temperature amplification

    National Research Council Canada - National Science Library

    James A. Screen; Ian Simmonds

    2010-01-01

    .... Counter-intuitively, the Arctic warming has been strongest in late fall and early winter whilst sea ice reductions and the direct ice-albedo feedback have been greatest in summer and early fall...

  1. 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...

  2. 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

    Background: 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. Objectives: (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. Method: 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. Results: 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. Conclusion: 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. PMID:26083603

  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

    Directory of Open Access Journals (Sweden)

    Patrícia A. Garcia

    2015-06-01

    Full Text Available Background: 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. Objectives: (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. Method: 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. Results: 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. Conclusion: 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. 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.

  5. Standardizing Falls Reporting: Using Data From Adverse Event Reporting to Drive Quality Improvement.

    Science.gov (United States)

    Gardner, Lea Anne; Bray, Phyllis J; Finley, Edward; Sterner, Carly; Ignudo, Thomas L; Stauffer, Cherie L; Kincaid, Shawn A; Marella, William M

    2015-09-01

    To enhance the value of the Pennsylvania Patient Safety Reporting System (PA-PSRS) falls reports by developing a falls reporting program that standardizes falls reporting and provides timely benchmarked falls rates and process measurement reports hospitals can use to identify areas of improvement in their falls program. The new PA-PSRS falls reporting program requires adherence to standardized definitions of falls to generate standardized, customizable analytic reports. An advisory committee and statewide survey guided the development of the program, data definitions, system features and functionality, and methods for stratifying reporting criteria. Three real-time falls outcomes and 2 falls process reports with multiple configurable options were created. A falls dashboard was developed based on gaps in falls risk assessment processes identified in PA-PSRS falls event reports. Six months after launching the program, 41.3% of Pennsylvania hospitals enrolled. The Authority's annual survey indicated 82.9% of participating hospitals found that the new falls analytic reports were somewhat useful to very useful. Preliminary impact on the falls with harm rate has been limited, a less than 1% reduction, but the ability to identify specific organizational and patient risk factors in a timely manner provides hospitals with opportunities to target falls prevention resources more effectively. The PA-PSRS falls reporting program's standardized definition of falls offers new analytic reports that include falls rates with benchmarking data and a falls dashboard. The benchmarking data allow hospitals to compare themselves to peer hospitals statewide. The newly expanded PA-PSRS falls reporting program has turned an adverse event-reporting program into a quality improvement tool.

  6. A piece of paper falling faster than free fall

    Science.gov (United States)

    Vera, F.; Rivera, R.

    2011-09-01

    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.

  7. 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.

  8. Characteristics and associated factors in patient falls, and effectiveness of the lower height of beds for the prevention of bed falls in an acute geriatric hospital.

    Science.gov (United States)

    Menéndez, M D; Alonso, J; Miñana, J C; Arche, J M; Díaz, J M; Vazquez, F

    2013-01-01

    Whereas several studies about patient falls have provided data for long-term healthcare institutions, less information is available for acute care centres. The objective was to analyze the characteristics of the patient falls and associated factors, and the effectiveness of the lower beds' height to reduce the frequency and the harms of the patient falls in an acute geriatric hospital. A descriptive and retrospective study using a mandatory safety incident report, the IHI Global Trigger Tool, and the claims related to patient falls between 2007 and 2011 in a 200-bed university-associated geriatric hospital. The falls rate was 5.4 falls per 1000 patient days (1.3% of falls led to fractures) and there was exitus in 6 patients (0.6%). Nearly half of the falls ocurred during the night shift (42.4%). By wards, falls were more frequent in acute geriatric wards (42.9%). A 7.5% of patients had a fall before admission. 3 (0.2%) claims due to possible clinical negligence were found. A reduction (28.3%) of bed falls with the lower height of the bed and a 1.88 times less falls with harm (RR 0.53; CI 95% 0.83-0.34) (p=0.006) was observed. The prevention of patient falls is an important task in geriatric units with a potential reduction of harms and costs, some measures such as the lower height of the bed showed a significant reduction of the falls. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

  9. Balance impairment not predictive of falls in geriatric rehabilitation wards.

    Science.gov (United States)

    Haines, Terry; Kuys, Suzanne S; Morrison, Greg; Clarke, Jane; Bew, Paul

    2008-05-01

    Falls are common among hospital inpatients, particularly in rehabilitation wards. Standing balance impairment is widely held to be a contributing factor to falls, is a component of several falls risk screening tools, and has motivated the development of balance retraining programs for the reduction of in-hospital falls. Little rigorous investigation of the link between standing balance impairment and in-hospital falls has been undertaken. We identified optimal cut-off points of four commonly used balance measures (functional reach, Timed Up and Go, step test, and timed static stance) in a prospective multicenter cohort study. Admission data (n = 1373) were clustered and matched by center then randomly allocated to development and validation data sets. Optimal cut-off points for each test were identified from the development data set. The predictive accuracy of all four balance tests was poor when the optimal cut-off was applied to the validation data set (Youden Index scores ranged between 0.02 and 0.15). These findings do not support an association between admission standing balance and falls in a geriatric rehabilitation setting. This result has implications for content of falls risk screening tools and interventions to prevent falls in a geriatric rehabilitation population.

  10. Fall Meeting Hydrology Highlights

    Science.gov (United States)

    Bales, Roger

    The AGU 1992 Fall Meeting in San Francisco offered the full range of subjects represented by the Hydrology Section's technical committees. The total number of papers was double the number of just 4 years ago. Sessions were well attended. The following highlights were prepared from material written by session organizers.There were 3 full days of papers on snow, ice, and permafrost. One highlight was the special session on new developments in glacier mass-balance studies, which was organized to compare existing methods and examine new techniques for assessing changes in ice mass of the polar ice sheets and alpine glaciers. Current methods for assessing mass change of the ice sheets include satellite laser altimetry to detect surface-elevation changes, surface-based control volume methods to determine net ice flux in a region, and ice-shelf melting and iceberg calving to determine mass loss from the ice sheet. Using these techniques, it is difficult to tell whether the ice sheet is gaining or losing mass. Methods that use drainage basin inputs/outputs indicate a net mass increase, whereas methods that emphasize oceanographic estimates of ice-shelf melting suggest a net mass decrease and estimates based on satellite altimetry are equivocal.

  11. Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®

    DEFF Research Database (Denmark)

    Masud, Tahir; Binkley, Neil; Boonen, Steven

    2011-01-01

    Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated...... into the FRAX® model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX® in individuals with a history of frequent falls....... The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk...

  12. Automatic Fall Monitoring: A Review

    Directory of Open Access Journals (Sweden)

    Natthapon Pannurat

    2014-07-01

    Full Text Available Falls and fall-related injuries are major incidents, especially for elderly people, which often mark the onset of major deterioration of health. More than one-third of home-dwelling people aged 65 or above and two-thirds of those in residential care fall once or more each year. Reliable fall detection, as well as prevention, is an important research topic for monitoring elderly living alone in residential or hospital units. The aim of this study is to review the existing fall detection systems and some of the key research challenges faced by the research community in this field. We categorize the existing platforms into two groups: wearable and ambient devices; the classification methods are divided into rule-based and machine learning techniques. The relative merit and potential drawbacks are discussed, and we also outline some of the outstanding research challenges that emerging new platforms need to address.

  13. 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

  14. Impact of a fall prevention programme in acute hospital settings in Singapore.

    Science.gov (United States)

    Koh, S L; Hafizah, N; Lee, J Y; Loo, Y L; Muthu, R

    2009-04-01

    This study aimed to develop a multifaceted strategy using tailored interventions to implement a fall prevention programme, and to achieve a change in fall prevention practices and a reduction in fall incidence at an acute care hospital in Singapore. A comparative study was conducted at two acute care hospitals (intervention and control) in Singapore. Pre-intervention, post-intervention and six-month follow-up knowledge assessments of 641 nursing staff, and audits of fall rates and fall prevention practices were performed to determine the effectiveness of a multifaceted strategy with targeted interventions in supporting the implementation of a fall prevention programme. The mean post-knowledge test scores at six months were statistically significantly higher (t[516] is -3.3, p-value is less than 0.01) at the intervention hospital (10.3 +/- 2.3) compared to the scores at the control hospital (9.8 +/- 1.8). Increased compliance with the use of fall risk assessment tools was evident in 99.4 percent and 99.3 percent of all patient records at the control and intervention hospitals, respectively. Following the implementation strategy for a fall prevention programme, there was a non-significant reduction in fall rates from 1.44 to 1.09 per 1,000 patient days at the intervention hospital. No reduction in the fall rate was observed at the control hospital. A multifaceted strategy for the implementation of a fall prevention programme was effective in increasing nurses' knowledge and the use of the fall risk assessment, but did not have a statistically significant impact on a reduction in the fall rate. The increase in nurses' knowledge and change in nursing practice were important markers of success in terms of fall prevention at the acute hospitals.

  15. Cowlitz Falls Fish Passage.

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    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.

  16. 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.

  17. Are Interprofessional Roundtable Debriefings Useful in Decreasing ED Fall Rates? Findings From a Quality-Improvement Project.

    Science.gov (United States)

    Murphy, Lynn M; Murphy, Seamus O; Hastings, Michael A; Olberding, Adam

    2015-09-01

    There are more than 1 million patient falls each year in the United States. Falls are known to be a sign of poor health, are a marker of decline in function, and are associated with high morbidity. The objective of this study was to determine the effectiveness of a Falls Roundtable intervention for reducing the rates of patient falls in an urban academic trauma center emergency department. We implemented a Falls Roundtable performance-improvement debriefing intervention in a single urban academic emergency department. To evaluate this intervention, we conducted a retrospective analysis of patient fall events 13 months before and 14 months after implementation. We evaluated pre- and post-intervention differences in the total number of assisted falls, unassisted falls, and rate of falls. Despite a slowly improving trend in falls after the intervention, there was no statistically significant improvement in the number of assisted falls, number of unassisted falls, or rate of falls. The Falls Roundtable intervention was helpful in identifying many additional actionable improvement opportunities in the emergency department. The Falls Roundtable incident debriefing intervention alone does not appear to be an effective tool for falls prevention in the ED setting but may serve as an integral component of a multifaceted fall-reduction strategy. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  18. 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.

  19. Preventing Falls and Related Fractures

    Science.gov (United States)

    ... ages. Many of us know someone who has fallen and broken a bone. While healing, the fracture ... break after every fall, the person who has fallen and broken a bone nearly always becomes fearful ...

  20. CONNECT for better fall prevention in nursing homes: results from a pilot intervention study.

    Science.gov (United States)

    Colon-Emeric, Cathleen S; McConnell, Eleanor; Pinheiro, Sandro O; Corazzini, Kirsten; Porter, Kristie; Earp, Kelly M; Landerman, Lawrence; Beales, Julie; Lipscomb, Jeffrey; Hancock, Kathryn; Anderson, Ruth A

    2013-12-01

    To determine whether an intervention that improves nursing home (NH) staff connections, communication, and problem solving (CONNECT) would improve implementation of a falls reduction education program (FALLS). Cluster randomized trial. Community (n=4) and Veterans Affairs (VA) NHs (n=4). Staff in any role with resident contact (n=497). NHs received FALLS alone (control) or CONNECT followed by FALLS (intervention), each delivered over 3 months. CONNECT used storytelling, relationship mapping, mentoring, self-monitoring, and feedback to help staff identify communication gaps and practice interaction strategies. FALLS included group training, modules, teleconferences, academic detailing, and audit and feedback. NH staff completed surveys about interactions at baseline, 3 months (immediately after CONNECT or control period), and 6 months (immediately after FALLS). A random sample of resident charts was abstracted for fall risk reduction documentation (n=651). Change in facility fall rates was an exploratory outcome. Focus groups were conducted to explore changes in organizational learning. Significant improvements in staff perceptions of communication quality, participation in decision-making, safety climate, caregiving quality, and use of local interaction strategies were observed in intervention community NHs (treatment-by-time effect P=.01) but not in VA NHs, where a ceiling effect was observed. Fall risk reduction documentation did not change significantly, and the direction of change in individual facilities did not relate to observed direction of change in fall rates. Fall rates did not change in control facilities (falls/bed per year: baseline, 2.61; after intervention, 2.64) but decreased by 12% in intervention facilities (falls/bed per year: baseline, 2.34; after intervention, 2.06); the effect of treatment on rate of change was 0.81 (95% confidence interval=0.55-1.20). CONNECT has the potential to improve care delivery in NHs, but the trend toward improving

  1. CONNECT for Better Fall Prevention in Nursing Homes: Results from a Pilot Intervention Study

    Science.gov (United States)

    Colon-Emeric, Cathleen S.; McConnell, Eleanor; Pinheiro, Sandro O.; Corazzini, Kirsten; Porter, Kristie; Earp, Kelly M.; Landerman, Lawrence; Beales, Julie; Lipscomb, Jeffrey; Hancock, Kathryn; Anderson, Ruth A.

    2014-01-01

    Background We hypothesized that an intervention which improves nursing home (NH) staff connections, communication, and problem solving (CONNECT) would improve implementation of a falls reduction education program (FALLS). Design Cluster randomized trial. Setting Community (n=4) and VA NHs (n=4) Participants Staff in any role with resident contact (n=497). Intervention NHs received FALLS alone (control) or CONNECT followed by FALLS (intervention), each delivered over 3-months. CONNECT used story-telling, relationship mapping, mentoring, self-monitoring and feedback to help staff identify communication gaps and practice interaction strategies. FALLS included group training, modules, teleconferences, academic detailing, and audit/feedback. Measurements NH staff completed surveys about interactions at baseline, 3 months (immediately following CONNECT or control period), and 6 months (immediately following FALLS). A random sample of resident charts was abstracted for fall risk reduction documentation (n=651). Change in facility fall rates was an exploratory outcome. Focus groups were conducted to explore changes in organizational learning. Results Significant improvements in staff perceptions of communication quality, participation in decision making, safety climate, care giving quality, and use of local interaction strategies were observed in intervention community NHs (treatment by time effect p=.01), but not in VA NHs where a ceiling effect was observed. Fall risk reduction documentation did not change significantly, and the direction of change in individual facilities did not relate to observed direction of change in fall rates. Fall rates did not change in control facilities (2.61 and 2.64 falls/bed/yr), but decreased by 12% in intervention facilities (2.34 to 2.06 falls/bed/yr); the effect of treatment on rate of change was 0.81 (0.55, 1.20). Conclusion CONNECT has the potential to improve care delivery in NHs, but the trend toward improving fall rates requires

  2. 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.

  3. Factors that render the kidney susceptible to tissue hypoxia in hypoxemia.

    Science.gov (United States)

    Evans, Roger G; Goddard, Duncan; Eppel, Gabriela A; O'Connor, Paul M

    2011-04-01

    To better understand what makes the kidney susceptible to tissue hypoxia, we compared, in the rabbit kidney and hindlimb, the ability of feedback mechanisms governing oxygen consumption (Vo(2)) and oxygen delivery (Do(2)) to attenuate tissue hypoxia during hypoxemia. In the kidney (cortex and medulla) and hindlimb (biceps femoris muscle), we determined responses of whole organ blood flow and Vo(2), and local perfusion and tissue Po(2), to reductions in Do(2) mediated by graded systemic hypoxemia. Progressive hypoxemia reduced tissue Po(2) similarly in the renal cortex, renal medulla, and biceps femoris. Falls in tissue Po(2) could be detected when arterial oxygen content was reduced by as little as 4-8%. Vo(2) remained stable during progressive hypoxemia, only tending to fall once arterial oxygen content was reduced by 55% for the kidney or 42% for the hindlimb. Even then, the fall in renal Vo(2) could be accounted for by reduced oxygen demand for sodium transport rather than limited oxygen availability. Hindlimb blood flow and local biceps femoris perfusion increased progressively during graded hypoxia. In contrast, neither total renal blood flow nor cortical or medullary perfusion was altered by hypoxemia. Our data suggest that the absence in the kidney of hyperemic responses to hypoxia, and the insensitivity of renal Vo(2) to limited oxygen availability, contribute to kidney hypoxia during hypoxemia. The susceptibility of the kidney to tissue hypoxia, even in relatively mild hypoxemia, may have important implications for the progression of kidney disease, particularly in patients at high altitude or with chronic obstructive pulmonary disease.

  4. Bridging the gap between research and practice: review of a targeted hospital inpatient fall prevention programme.

    Science.gov (United States)

    Barker, A; Kamar, J; Morton, A; Berlowitz, D

    2009-12-01

    Falls among older inpatients are frequent and have negative consequences. In this study, the effectiveness of a fall prevention programme in reducing falls and fall injuries in an acute hospital was studied. Retrospective audit. The Northern Hospital, an acute, metropolitan, hospital in Australia. A multi-factorial fall prevention programme that included establishment of a multidisciplinary committee, risk assessment of all patients on "high-risk" wards and targeted interventions for patients identified as high risk. Fall and fall injury rates per 1000 occupied bed-days were analysed using generalised additive models (GAM) and, because of the presence of autocorrelation, generalised additive mixed models (GAMM), respectively. During the 9-year observation of 271 095 patients, there were 2910 falls and 843 fall injuries. The GAM predicted rate of falls was stable in the 3 years after the programme was implemented, increased in 2006, then decreased between October 2006 and December 2007 from 4.13 (95% CI 3.65 to 4.67) to 2.83 (95% CI 2.24 to 3.59; p = 0.005). The GAMM predicted rate of fall injuries reduced from 1.66 (95% CI 1.24 to 2.21) to 0.61 (95% CI 0.43 to 0.88) after programme implementation (p<0.001). The falls rate varied throughout the observation period, and no significant change in the rate from preprogramme to postprogramme implementation was observed. The finding of no reduction in falls during the observation period may be explained by improved reporting throughout the observation period. The reduction in fall injuries was substantial and sustained. Identification of a local problem, use of a fall risk assessment to guide the delivery of simple interventions, integration of processes into daily clinical practice and creating systems that demand accountability of staff are factors that appear to have contributed to the programme's success.

  5. Do hospital fall prevention programs work? A systematic review.

    Science.gov (United States)

    Oliver, D; Hopper, A; Seed, P

    2000-12-01

    To analyze published hospital fall prevention programs to determine whether there is any effect on fall rates. To review the methodological quality of those programs and the range of interventions used. To provide directions for further research. Systematic review of published hospital fall prevention programs. Meta-analysis. Keyword searches of Medline, CINAHL, monographs, and secondary references. All papers were included that described fall rates before and during intervention. Risk ratios and 95% Confidence Intervals (95% CI) were estimated and random effects meta-analysis employed. Begg's test was applied to detect possible publication bias. Separate meta-analysis regressions were performed to determine whether individual components of multifaceted interventions were effective. A total of 21 papers met the criteria (18 from North America), although only 10 contained sufficient data to allow calculation of confidence intervals. A rate ratio of fall rate, resulting from an intervention. Three were randomized controlled trials (pooled rate ratio 1.0 (CI 0.60, 1.68)), seven prospective studies with historical control (0.76 (CI 0.65, 0.88)). Pooled effect rate ratio from these 10 studies was 0.79 (CI 0.69, 0.89). The remaining 11 studies were prospective studies with historical control describing fall rates only. Individual components of interventions showed no significant benefit. The pooled effect of about 25% reduction in the fall rate may be a result of intervention but may also be biased by studies that used historical controls not allowing for historical trends in the fall rate before and during the intervention. The randomized controlled trials apparent lack of effect might be due to a change in practice when patients and controls were in the same unit at the same time during a study. Studies did not analyze compliance with the intervention or opportunity costs resulting from the intervention. Research and clinical programs in hospital fall prevention should

  6. 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.

  7. 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

  8. Detecting Falls with Wearable Sensors Using Machine Learning Techniques

    Directory of Open Access Journals (Sweden)

    Ahmet Turan Özdemir

    2014-06-01

    Full Text Available Falls are a serious public health problem and possibly life threatening for people in fall risk groups. We develop an automated fall detection system with wearable motion sensor units fitted to the subjects’ body at six different positions. Each unit comprises three tri-axial devices (accelerometer, gyroscope, and magnetometer/compass. Fourteen volunteers perform a standardized set of movements including 20 voluntary falls and 16 activities of daily living (ADLs, resulting in a large dataset with 2520 trials. To reduce the computational complexity of training and testing the classifiers, we focus on the raw data for each sensor in a 4 s time window around the point of peak total acceleration of the waist sensor, and then perform feature extraction and reduction. Most earlier studies on fall detection employ rule-based approaches that rely on simple thresholding of the sensor outputs. We successfully distinguish falls from ADLs using six machine learning techniques (classifiers: the k-nearest neighbor (k-NN classifier, least squares method (LSM, support vector machines (SVM, Bayesian decision making (BDM, dynamic time warping (DTW, and artificial neural networks (ANNs. We compare the performance and the computational complexity of the classifiers and achieve the best results with the k-NN classifier and LSM, with sensitivity, specificity, and accuracy all above 99%. These classifiers also have acceptable computational requirements for training and testing. Our approach would be applicable in real-world scenarios where data records of indeterminate length, containing multiple activities in sequence, are recorded.

  9. Do leaves have to fall in their Autumn? A falls prevention strategy in action in the south east of South Australia.

    Science.gov (United States)

    Brown, D S

    2004-01-01

    The costs of falls in terms of individual suffering and to the community are high, and these costs will increase markedly as the population ages. The aim of this study into falls prevention in persons 65 years and over in the south east of South Australia, 1 April 2000-31 March 2002, was to develop and implement a multifaceted intervention program to limit the incidence of falls and to lessen the extent of falls injury in a population of elderly people. Studies in the early to mid-1990s identified that approximately one-third of people aged 65 years and over, living in the community, report one or more falls in the previous 12 months. In residential aged care and in hospital settings, the annual falls rate in this age group can be as high as 50%. The number and severity of falls injuries also increases with advancing age and with the increased incidence of osteoporosis. A total of 2148 falls were reported over the 2 years of the study from this South Australian rural region's population of 7553 people aged 65 years and over, with marked variations in number from month to month, but with no overall trend. The rate of hospital admission after a fall decreased from 12% in the first 12 months to 7% in the second. The total fracture rate decreased from 7% in the first 12 months to 4% in the second. Both reductions are statistically significant (p falls prevention strategy was associated with a decrease in reported falls injury over 2 years although it had no overall effect on the frequency of falls. A useful way to implement such a strategy was identified, as were factors necessary to achieving a reduction in fractures. The value of hip protectors as a cheap, safe, effective and immediate protection against serious injury was confirmed.

  10. 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…

  11. Susceptibility to malignant hyperthermia

    NARCIS (Netherlands)

    Snoeck, Marcus Matheus Johannes

    2004-01-01

    In this thesis the author studied the diagnostic procedures for susceptibility to malignant hyperthermia (MH), with special emphasis upon refining the biological diagnostic test and improving protocols and guidelines for investigation of MH susceptibility. MH is a pharmacogenetic disease of skeletal

  12. Antimycotics susceptibility testing of dermatophytes

    Directory of Open Access Journals (Sweden)

    Arsić-Arsenijević Valentina

    2010-01-01

    Full Text Available Dermatophytes are moulds that produce infections of the skin, hair and nails of humans and animals. The most common forms among these infections are onychomycosis and tinea pedis affecting 20% of world population. These infections are usually chronic. The treatment of dermatophytoses tends to be prolonged partly because available treatments are not very effective. Antifungal drug consumption and public health expenditure are high worldwide, as well as in Serbia. For adequate therapy, it is necessary to prove infection by isolation of dermatophytes and to test the antifungal susceptibility of isolates. Susceptibility testing is important for the resistance monitoring, epidemiological research and to compare in vitro activities of new antifungal agents. The diffusion and dilution methods of susceptibility tests are used, and technical issues of importance for the proper performance and interpretation of test results are published in the document E.DEF 9.1 (EUCAST and M38-A2 (CLSI. The aim of our paper is to promptly inform the public about technical achievements in this area, as well as the new organization of laboratory for medical mycology in our country. The formation of laboratory networks coordinated by the National Reference Laboratory for the cause of mycosis need to enable interlaboratory studies and further standardization of methods for antifungal susceptibility testing of dermatophytes, reproducibility of tests and clinical correlation monitoring (MIK values and clinical outcome of dermatophytosis. The importance of the new organization is expected efficient improvement in the dermatophytosis therapy at home, better quality of patient's life and the reduction of the cost of treatment.

  13. Fall risk in an active elderly population

    DEFF Research Database (Denmark)

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

    2007-01-01

    BACKGROUND: Falls amongst elderly people are often associated with fractures. Training of balance and physical performance can reduce fall risk; however, it remains a challenge to identify individuals at increased risk of falling to whom this training should be offered. It is believed that fall...... 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...... of community dwelling elderly. Falling is a complex phenomenon of multifactorial origin. The crucial factor in relation to fall risk is the redundancy of balance capacity against the balance demands of the individuals levels of fall-risky lifestyle and behavior. This calls for an approach to fall risk...

  14. 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…

  15. 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

  16. [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

  17. 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

  18. Osteoarthritis and falls in the older person.

    Science.gov (United States)

    Ng, Chin Teck; Tan, Maw Pin

    2013-09-01

    Osteoarthritis and falls are common conditions affecting older individuals which are associated with disability and escalating health expenditure. It has been widely assumed that osteoarthritis is an established risk factor for falls in older people. The relationship between osteoarthritis and falls has, quite surprisingly, not been adequately elucidated, and published reports have been conflicting. Our review of the existing literature has found limited evidence supporting the current assumption that the presence of osteoarthritis is associated with increased risk of falls with suggestions that osteoarthritis may actually be protective against falls related fractures. In addition, joint arthroplasty appears to increase the risk of falls in individuals with osteoarthritis.

  19. A wearable airbag to prevent fall injuries.

    Science.gov (United States)

    Tamura, Toshiyo; Yoshimura, Takumi; Sekine, Masaki; Uchida, Mitsuo; Tanaka, Osamu

    2009-11-01

    We have developed a wearable airbag that incorporates a fall-detection system that uses both acceleration and angular velocity signals to trigger inflation of the airbag. The fall-detection algorithm was devised using a thresholding technique with an accelerometer and gyro sensor. Sixteen subjects mimicked falls, and their acceleration waveforms were monitored. Then, we developed a fall-detection algorithm that could detect signals 300 ms before the fall. This signal was used as a trigger to inflate the airbag to a capacity of 2.4 L. Although the proposed system can help to prevent fall-related injuries, further development is needed to miniaturize the inflation system.

  20. 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.

  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. 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.

  3. 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.

  4. 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.

  5. Preventing Falls: Great Help for Older Americans

    Science.gov (United States)

    ... Adults / How Can Older Adults Prevent Falls? / Home Improvements Prevent Falls Winter 2014 Issue: Volume 8 Number 4 Page 14 MedlinePlus | Subscribe | Magazine Information | Contact Us | Viewers & Players Friends of the National Library of Medicine (FNLM)

  6. How Can Older Adults Prevent Falls?

    Science.gov (United States)

    ... Adults / How Can Older Adults Prevent Falls? / Home Improvements Prevent Falls Winter 2014 Issue: Volume 8 Number 4 Page 15 MedlinePlus | Subscribe | Magazine Information | Contact Us | Viewers & Players Friends of the National Library of Medicine (FNLM)

  7. Factors inducing falling in schizophrenia patients

    Science.gov (United States)

    Tsuji, Yoko; Akezaki, Yoshiteru; Mori, Kohei; Yuri, Yoshimi; Katsumura, Hitomi; Hara, Tomihiro; Usui, Yuki; Fujino, Yoritaka; Nomura, Takuo; Hirao, Fumio

    2017-01-01

    [Purpose] The purpose of this study is to investigate the factors causing falling among patients with schizophrenia hospitalized in psychiatric hospitals. [Subjects and Methods] The study subjects were divided into either those having experienced a fall within the past one year (Fall group, 12 patients) and those not having experienced a fall (Non-fall group, 7 patients), and we examined differences between the two groups. Assessment items measured included muscle strength, balance ability, flexibility, body composition assessment, Global Assessment of Functioning scale (GAF), the antipsychotic drug intake, and Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS). [Results] As a result, significant differences were observed in regard to One leg standing time with eyes open, Time Up and Go Test (TUGT), and DIEPSS Sialorrhea between the Fall group and the Non-fall group. [Conclusion] These results suggest that a decrease in balance ability was significantly correlated with falling in schizophrenia patients. PMID:28356628

  8. 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

  9. Measuring fall risk and predicting who will fall: clinimetric properties of four fall risk assessment tools for residential aged care.

    Science.gov (United States)

    Barker, Anna L; Nitz, Jennifer C; Low Choy, Nancy L; Haines, Terry

    2009-08-01

    The purpose of this prospective cohort study was to describe the clinimetric evaluation of four fall risk assessment tools (FRATs) recommended in best practice guidelines for use in residential aged care (RAC). Eighty-seven residents, mean age 81.59 years (SD +/-10.69), participated. The Falls Assessment Risk and Management Tool (FARAM), Peninsula Health Fall Risk Assessment Tool (PHFRAT), Queensland Fall Risk Assessment Tool (QFRAT), and Melbourne Fall Risk Assessment Tool (MFRAT) were completed at baseline, and 2 and 4 months, and falls occurring in the 6 months after the baseline assessment were recorded. Interrater agreement (kappa), predictive accuracy (survival analysis and Youden Index), and fit to the Rasch model were examined. Twelve-month fall history formed the predictive accuracy reference. Interrater risk classification agreement was high for the PHFRAT (small ka, Cyrillic = .84) and FARAM (small ka, Cyrillic = .81), and low for the QFRAT (small ka, Cyrillic = .51) and MFRAT (small ka, Cyrillic = .21). Survival analysis identified that 43%-66% of risk factors on each tool had no (p > .10) association with falls. No tool had higher predictive accuracy (Youden index) than the question, "has the resident fallen in past 12 months?" (p > .05). All tools did not exhibit fit to the Rasch model, invalidating summing of risk factor scores to provide an overall risk score. The studied tools have poor clinimetric properties, casting doubt about their usefulness for identifying fall risk factors for those most at risk for falling and measuring fall risk in RAC.

  10. 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.

  11. Association Between Vitamin D Dosing Regimen and Fall Prevention in Long-term Care Seniors.

    Science.gov (United States)

    Chua, Gilbert T; Wong, Roger Y

    2011-12-01

    The effectiveness of vitamin D in reducing falls among long-term care (LTC) seniors remains nonconclusive. We reviewed how vitamin D dosing regimen could affect rate of fall and number of fallers among LTC seniors. We conducted a systematic literature review. Studies were selected by two independent reviewers based on study characteristics (age 75 or older), quality assessment (primary analysis randomized controlled trials), and outcome (rate of fall and number of fallers). Analyses of all trials following trials using daily standard dosage (800-1000 IU) only were performed to compare daily standard dosage with intermittent supratherapeutic dosage in fall prevention. Seventy-nine studies were identified, with 28 selected by reviewers (kappa 0.98), and four RCT were conducted in LTC. Daily standard dosage provides greater reduction in rate of fall by 16%, which was statistically significant. However, reduction in number of fallers remained statistically insignificant even taking dosing regimen into account. Daily standard dosage of vitamin D has greater benefits in reducing fall rate than that of intermittent supratherapeutic doses, but not in number of fallers. This could imply that vitamin D is useful in preventing fall recurrence rather than first fall. Prospective studies randomizing LTC seniors to different dosing regimens are warranted.

  12. The population approach to falls injury prevention in older people: findings of a two community trial

    Directory of Open Access Journals (Sweden)

    Dietrich Uta

    2010-02-01

    Full Text Available Abstract Background There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury. The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective, population-based, multi-factorial falls injury prevention program for people over 60 years of age. Methods Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States. Results The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest. Conclusions The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those that are intensively implemented.

  13. Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment.

    Science.gov (United States)

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Park, Hyuntae; Yoshida, Daisuke; Uemura, Kazuki; Tsutsumimoto, Kota; Liu-Ambrose, Teresa; Suzuki, Takao

    2013-08-05

    The risk of falling is associated with cognitive dysfunction. Older adults with mild cognitive impairment (MCI) exhibit an accelerated reduction of brain volume, and face an increased risk of falling. The current study examined the relationship between baseline physical performance, baseline gray matter volume and falls during a 12-month follow-up period among community-dwelling older adults with MCI. Forty-two older adults with MCI (75.6 years, 43% women) underwent structural magnetic resonance imaging and baseline physical performance assessment, including knee-extension strength, one-legged standing time, and walking speed with normal pace. 'Fallers' were defined as people who had one or more falls during the 12-month follow-up period. Of the 42 participants, 26.2% (n = 11) experienced at least one fall during the 12-month follow-up period. Fallers exhibited slower walking speed and shorter one-legged standing time compared with non-fallers (both p matter volume between fallers and non-fallers, revealing that fallers exhibited a significantly greater reduction in the bilateral middle frontal gyrus and superior frontal gyrus. Poor balance predicts falls over 12 months, and baseline lower gray matter densities in the middle frontal gyrus and superior frontal gyrus were associated with falls in older adults with MCI. Maintaining physical function, especially balance, and brain structural changes through many sorts of prevention strategies in the early stage of cognitive decline may contribute to decreasing the risk of falls in older adults with MCI.

  14. 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.

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

    Science.gov (United States)

    2011-01-01

    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 elderly, however, these preliminary results require confirmation in further prospective research. PMID:21838891

  16. 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

  17. Fourie susceptible.pmd

    African Journals Online (AJOL)

    Prof. Adipala Ekwamu

    a number of cultivars exhibited field resistance to halo blight and bacterial brown spot, all cultivars were more or less susceptible to .... Cerillos. Alubia. I. 91. 57. Kranskop. Red speckled sugar. II. 97. 63. OPS-RS1. Red speckled sugar. II. 96. 63. OPS-RS2. Red speckled sugar. I. 100. 61. OPS-RS3. Red speckled sugar. II. 97.

  18. Evolution of rock falls in the Northern part of the Peloponnese, Greece

    Science.gov (United States)

    Zygouri, V.; Koukouvelas, I. K.

    2015-09-01

    Rock falls are a common fast - moving type of slope failures. Earthquake triggered rock falls attracted widespread attention since they represent serious hazard during strong earthquakes, causing severe damages and even fatalities. Strong earthquakes and their associated rock falls give rise to a sudden change in landscape evolution in tectonically active areas. The associated risk can be high both to communities and to critical infrastructures even far away from the active source slopes. Distinguishing between climatic induced and tectonically induced rock falls triggered by past earthquakes is a challenging task based on the development and the fault related discontinuities of a rock slope. We chose two case studies located in the Northern part of the Peloponnese (in Ilia and Corinthia prefecture), the Skolis Mountain and the Acrocorinthos area, in order to establish the rock fall susceptibility for each case study through the implementation of shadow angle β. The proposed methodology is based on the integrated analysis of the recurrence of rock falls, their spatial distribution and their mapping through field survey and aerial photography. Our mapping is integrated through Geographic Information System taking into account also the catalogue of historical and recent recorded seismicity in an attempt to examine triggering mechanisms and causes including the effects of climatic conditions for each case study. After the analysis of the spatial relationships between rock falls and the distribution of seismic epicentres and active faults as seismogenic sources, we conclude that both studied areas have suffered extensive rock fall phenomena induced by shallow seismicity and that the relationship between geomorphologic parameters and rock fall occurrence is strong. The research steps are described, namely, the recognition, identification, mapping and evolution of rock fall phenomena through time. Our results propose a critical threshold value of 24° for shadow angle

  19. 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.

  20. [Fear of falling in older people].

    Science.gov (United States)

    Nkodo Mekongo, Y P; De Breucker, S; Delvaux, N; Pepersack, T

    2007-01-01

    Fear of falling and poor physical performance are prominent symptoms in many older people. The prevalence of fear of falling in community-living elderly ranges between 12 % and 65 %, and is higher in women than men. It commonly occurs after falls, but it also occurs without a previous fall history. One of the major consequences of fear of falling is the restriction and avoidance of activities. However, not all elderly with fear of falling avoid activities in daily life. Some elderly only become cautious, which may be functional in preventing falls. Only a small percentage of elderly show a pattern of excessive fear and restriction of activities. The consequences of this pattern may, however, be debilitating and devastating. Excessive fear and avoidance may compromise the quality of life, and may result in a decline of physical capabilities and, ultimately, in an increased risk of falls, which may further fuel fear and avoidance. Future research should investigate whether individualised intervention strategies are efficient in preventing falls and activity-related fear of falling within this population in order to improve her quality of life.

  1. Characteristics of Falls Among Institutionalized Elderly People

    Directory of Open Access Journals (Sweden)

    Ahmad Ali Akbari Kamrani

    2007-01-01

    Full Text Available Objectives: Falls by elderly people area frequent cause of morbidity and mortality, especially in institutionalized elders. to describe the features of falls among institutionalized elderly people. Methods & Materials: characteristics of falls in the preceding six months (March 2006 - September 2006 that occurred among elder lies (aged over 60years with normal physical function and cognitive status, who lived at Kahrizak Institute, along term nursing home in Tehran, were surveyed and analyzed. Results: The mean age of the patients with falls was 76.9 yrs. These numbers of falls had occurred among 29 elders that 48.3% were women and 51.7% were men. 57.6% off alls were simple and elders could standup immediately independently. 42.4% of falls needed to help for standup, 2 elder person (2.6% had sever consequence of fall and had fractures. (Skull fracture, head trauma & hip fracture 30.3% of falls occurred in yard, 28.9% at room, 18.4%inhallway, 14.5% at WC, .3.9%at bathroom, and 3.9% at lunch saloon. Analysis of the time of falls showed: 45.3% of falls occurred at 7bl2 am, 13.2% at the lunch time (12bI4, 17% at 14b19, 11.3%at night (19b4 am, and 13.2% at 4b7 am. Conclusion: falls among elder lies occur mainly outside of room. And occur at the time of maximum activities, for example at morning; also falls have been happened more in subjects older, and occasionally result in sever injury such as head trauma, skull fracture, femur and pelvis fracture and cause more mortality and morbidity. Control of environmental risk factors could be protective factors against falls.

  2. Dogs and cats as environmental fall hazards.

    Science.gov (United States)

    Stevens, Judy A; Teh, S L; Haileyesus, Tadesse

    2010-02-01

    Falls are the leading cause of non-fatal injuries in the United States. This study assessed the prevalence of fall injuries associated with cats and dogs in the United States and describes the types of injuries sustained, the location, activity, and circumstances under which they occurred. Data were from a nationally representative sample of emergency department visits from January 1, 2001 to December 31, 2006, available through the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP). Based on 7,456 cases, an estimated 86,629 fall injuries each year were associated with cats and dogs, for an injury rate of 29.7. There were 7.5 times as many injuries involving dogs as cats and females were 2.1 times more likely to be injured than males. Injury rates were highest among people aged >/=75, but pets were a fall hazard for all ages. Fractures and contusions or abrasions were the most common injuries; the highest rates were for injuries to the extremities. About 66.4% of falls associated with cats and 31.3 % of falls associated with dogs were caused by falling or tripping over the pet. An additional 21.2% of falls related to dogs were caused by being pushed or pulled. Although pets were associated with fall injuries, this risk can be reduced by increasing public awareness about situations that can lead to falls, such as dog-walking and chasing pets, and by calling attention to the importance of obedience training for dogs to minimize hazardous behaviors such as pulling and pushing. Fall injuries represent a burden to individuals, our society and our health care system. Increasing public awareness and implementing basic prevention strategies can help people of all ages enjoy their pets, reduce their chances of experiencing pet-related falls, and lessen the impact of fall injuries on our health care system. Published by Elsevier Ltd.

  3. 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.

  4. 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.

  5. Genetic Susceptibility to Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Sanja Kovacic

    2012-01-01

    Full Text Available Atherosclerosis is a complex multifocal arterial disease involving interactions of multiple genetic and environmental factors. Advances in techniques of molecular genetics have revealed that genetic ground significantly influences susceptibility to atherosclerotic vascular diseases. Besides further investigations of monogenetic diseases, candidate genes, genetic polymorphisms, and susceptibility loci associated with atherosclerotic diseases have been identified in recent years, and their number is rapidly increasing. This paper discusses main genetic investigations fields associated with human atherosclerotic vascular diseases. The paper concludes with a discussion of the directions and implications of future genetic research in arteriosclerosis with an emphasis on prospective prediction from an early age of individuals who are predisposed to develop premature atherosclerosis as well as to facilitate the discovery of novel drug targets.

  6. 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.

  7. Effectiveness of multifaceted fall-prevention programs for the elderly in residential care.

    Science.gov (United States)

    Cusimano, M D; Kwok, J; Spadafora, K

    2008-04-01

    Unintentional falls are particularly prevalent among older people and constitute a public health concern. Not much is known about the implications of multifaceted intervention programs implemented in residential care settings. To evaluate the effectiveness of multifaceted intervention programs in reducing the number of falls, fallers, recurrent fallers, and injurious falls among older people living in residential care facilities. Comprehensive searches of Medline, PubMed, and EMBASE up to July 2007, the cited literature lists of each included study, and the internet engines Google Scholar, Yahoo, and Dogpile were performed to identify eligible studies. Eligible studies for this review were those that had randomized, controlled trials with adequate follow-up study components in their design. Studies that included elderly people in residential care who participated in multifaceted falls-prevention programs were included. Two authors independently extracted the necessary data. Studies were assessed for quality by the criteria of Downs and Black. The results of the included studies have been reviewed narratively. From 21 articles potentially relevant to the topic, five studies met the inclusion criteria and all were reasonably well conducted. Three reported significant reductions in the number of recurrent fallers, two reported significant reductions in the number of falls, and one reported significant reductions in the number of fallers. One other reported a reduction in the number of injurious falls in those who received the multifaceted prevention program compared with the control group. However, the analyses of this specific study were not based on intent-to-treat, so the effect of intervention on the number of injurious falls remains inconclusive. No study reported on adverse events, costs, or sustainability of the interventions. Multifaceted programs that encompass a wide range of intervention strategies have shown some evidence of efficacy. However, more well

  8. Marijuana Usage and Hypnotic Susceptibility

    Science.gov (United States)

    Franzini, Louis R.; McDonald, Roy D.

    1973-01-01

    Anonymous self-reported drug usage data and hypnotic susceptibility scores were obtained from 282 college students. Frequent marijuana users (more than 10 times) showed greater susceptibility to hypnosis than nonusers. (Author)

  9. 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...

  10. [Falls and renal function: a dangerous association].

    Science.gov (United States)

    De Giorgi, Alfredo; Fabbian, Fabio; Pala, Marco; Mallozzi Menegatti, Alessandra; Misurati, Elisa; Manfredini, Roberto

    2012-01-01

    Falls are an important health problem and the risk of falling increases with age. The costs due to falls are related to the progressive decline of patients' clinical conditions, with functional inability inducing increasing social costs, morbidity and mortality. Renal dysfunction is mostly present in elderly people who often have several comorbidities. Risk factors for falls have been classified as intrinsic and extrinsic, and renal dysfunction is included among the former. Chronic kidney disease per se is an important risk factor for falls, and the risk correlates negatively with creatinine clearance. Vitamin D deficiency, dysfunction of muscles and bones, nerve degeneration, cognitive decline, electrolyte imbalance, anemia, and metabolic acidosis have been reported to be associated with falls. Falls seem to be very frequent in dialysis patients: 44% of subjects on hemodialysis fall at least once a year with a 1-year mortality due to fractures of 64%. Male sex, comorbidities, predialysis hypotension, and a history of previous falls are the main risk factors, together with events directly related to renal replacement therapy such as biocompatibility of the dialysis membrane, arrhythmias, fluid overload and length of dialysis treatment. Peripheral nerve degeneration and demyelination as well as altered nerve conduction resulting in muscular weakness and loss of peripheral sensitivity are frequent when the glomerular filtration rate is less than 12 mL/min. Moreover, depression and sleep disorders can also increase the risk of falls. Kidney function is an important parameter to consider when evaluating the risk of falls in the elderly, and the development of specific guidelines for preventing falls in the uremic population should be considered.

  11. Reducing inpatient falls in a 100% single room elderly care environment: evaluation of the impact of a systematic nurse training programme on falls risk assessment (FRA).

    Science.gov (United States)

    Singh, Inderpal; Okeke, Justin

    2016-01-01

    Inpatient falls (IF) are the most commonly reported safety incidents. The high rate of inpatient falls was reported in a newly built hospital, within Aneurin Bevan University Health Board, Wales (UK). The aim of the project is to reduce the incidence of IF and associated adverse clinical outcomes in a hospital with 100% single rooms. The key mechanism for improvement was education and training of nursing staff around falls risk factors. A Plan-Do-Study-Act methodology was used and a geriatrician-led, systematic nurse training programme on the understanding and correct use of existing multifactorial falls risk assessment (FRA) tool was implemented in April 2013. Pre-training baseline data revealed inadequate falls assessment and low completion rates of the FRA tool. Subsequent, post-training data showed improvement in compliance with all aspects of FRA. Concurrent with nurse training, the actual falls incidence/1000 patient-bed-days fell significantly from the baseline of 18.19±3.46 (Nov 2011-March 2013) to 13.36±2.89 (pMarch 2014) and remained low (mean falls 12.81±2.85) until November 2015. Improved clinical outcomes have been observed in terms of a reduction of length of stay and new care home placements, making total annualised savings of £642,055.

  12. A low-power fall detection algorithm based on triaxial acceleration and barometric pressure.

    Science.gov (United States)

    Wang, Changhong; Narayanan, Michael R; Lord, Stephen R; Redmond, Stephen J; Lovell, Nigel H

    2014-01-01

    This paper proposes a low-power fall detection algorithm based on triaxial accelerometry and barometric pressure signals. The algorithm dynamically adjusts the sampling rate of an accelerometer and manages data transmission between sensors and a controller to reduce power consumption. The results of simulation show that the sensitivity and specificity of the proposed fall detection algorithm are both above 96% when applied to a previously collected dataset comprising 20 young actors performing a combination of simulated falls and activities of daily living. This level of performance can be achieved despite a 10.9% reduction in power consumption.

  13. Cathode fall measurements in fluorescent lamps

    Energy Technology Data Exchange (ETDEWEB)

    Nachtrieb, Robert [Lutron Electronics Co Inc., 7200 Suter Rd., Coopersburg, PA 18036 (United States); Khan, Farheen [Lutron Electronics Co Inc., 7200 Suter Rd., Coopersburg, PA 18036 (United States); Waymouth, John F [Consultant, 16 Bennett Rd. Marblehead, MA 01945 (United States)

    2005-09-07

    We describe an improved method and apparatus for making capacitive measurements of the cathode fall in fluorescent lamps employing known behaviour of anode oscillations to provide a zero-of-potential reference, placing the entire cathode and anode fall waveform on an absolute rather than relative scale. The improved method is applicable to any diameter of fluorescent lamp currently manufactured. We also describe a method and apparatus for making spectroscopic measurements of the cathode fall in fluorescent lamps. This uses the abrupt onset of emission of certain selected spectral lines of the rare gas filling as a signal that the cathode fall has exceeded the excitation potentials of the spectral lines in question.

  14. Factors influencing the recession rate of Niagara Falls since the 19th century

    Science.gov (United States)

    Hayakawa, Yuichi S.; Matsukura, Yukinori

    2009-09-01

    The rate of recession of Niagara Falls (Horseshoe and American Falls) in northeastern North America has been documented since the 19th century; it shows a decreasing trend from ca. 1 m y - 1 a century ago to ca. 0.1 m y - 1 at present. Reduction of the flow volume in the Niagara River due to diversion into bypassing hydroelectric schemes has often been taken to be the factor responsible, but other factors such as changes in the waterfall shape could play a role and call for a quantitative study. Here, we examine the effect of physical factors on the historically varying recession rates of Niagara Falls, using an empirical equation which has previously been proposed based on a non-dimensional multiparametric model which incorporates flow volume, waterfall shape and bedrock strength. The changes in recession rates of Niagara Falls in the last century are successfully modeled by this empirical equation; these changes are caused by variations in flow volume and lip length. This result supports the validity of the empirical equation for waterfalls in rivers carrying little transported sediment. Our analysis also suggests that the decrease in the recession rate of Horseshoe Falls is related to both artificial reduction in river discharge and natural increase in waterfall lip length, whereas that of American Falls is solely due to the reduction in flow volume.

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

    Directory of Open Access Journals (Sweden)

    Niko M. Perttila

    2017-06-01

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

  16. Dementia as a risk factor for falls and fall injuries among nursing home residents.

    Science.gov (United States)

    van Doorn, Carol; Gruber-Baldini, Ann L; Zimmerman, Sheryl; Hebel, J Richard; Port, Cynthia L; Baumgarten, Mona; Quinn, Charlene C; Taler, George; May, Conrad; Magaziner, Jay

    2003-09-01

    To compare rates of falling between nursing home residents with and without dementia and to examine dementia as an independent risk factor for falls and fall injuries. Prospective cohort study with 2 years of follow-up. Fifty-nine randomly selected nursing homes in Maryland, stratified by geographic region and facility size. Two thousand fifteen newly admitted residents aged 65 and older. During 2 years after nursing home admission, fall data were collected from nursing home charts and hospital discharge summaries. The unadjusted fall rate for residents in the nursing home with dementia was 4.05 per year, compared with 2.33 falls per year for residents without dementia (Pinjurious falls was higher than for residents without dementia. Dementia is an independent risk factor for falling. Although most falls do not result in injury, the fact that residents with dementia fall more often than their counterparts without dementia leaves them with a higher overall risk of sustaining injurious falls over time. Nursing home residents with dementia should be considered important candidates for fall-prevention and fall-injury-prevention strategies.

  17. Relationship between home hazards and falling among community-dwelling seniors using home-care services.

    Science.gov (United States)

    Leclerc, B-S; Bégin, C; Cadieux, E; Goulet, L; Allaire, J-F; Meloche, J; Leduc, N; Kergoat, M-J

    2010-02-01

    Evidence linking home hazards to falls has not been well established. The evidence-based approach to fall-risk assessment in longitudinal studies becomes difficult because of exposures that change during follow-up. We conducted a cohort study to determine the prevalence of hazards and to resolve whether they are linked to the risk of falls among 959 seniors receiving home-care services. A home hazards assessment was completed at entry and every six months thereafter using a standardized form. The adjusted (for a number of confounding factors) relationship between home hazards and falls was estimated using a survival model taking into account updated time-varying exposures and multiple events. Falls leading to a medical consultation were examined as a secondary outcome, hypothesized as a measure of severity. Home environmental hazards were found in 91% of homes, with a mean of 3.3 risks per individual. The bathroom was the most common place for hazards. The presence of hazards was significantly associated with all falls and fall-related medical consultations, and showed relatively constant effects from one fall to another. The current study is innovative in its approach and useful in its contribution to the understanding of the interaction between home environmental hazards and falls. Our results indicate that inattention to changes in exposure masks the statistical association between home hazards and falls. Each environmental hazard identified in the home increases the risk of falling by about 19%. These findings support the positive findings of trials that demonstrate the effectiveness of this home hazard reduction program, particularly for at-risk people.

  18. Naval Survivability and Susceptibility Reduction Study-Surface Ship

    Science.gov (United States)

    2012-09-01

    Mirador Electro-Optical Multi-Sensor From [15] ......................................... 8  Figure 9.  EDO Towed Array Sonar From [16...the detonation sensor. Figure 9. EDO Towed Array Sonar From [16] 5. Magnetism The Earth’s magnetic field can be measured, as the ship cuts...Time Fuze HE-VT = High Explosive, Variable Time Fuze HE-CVT = High Explosive, Controlled Variable Time Fuze Range >100 km Launch Platform Surface

  19. The Glenn A. Fry award lecture 2013: blurred vision, spectacle correction, and falls in older adults.

    Science.gov (United States)

    Elliott, David B

    2014-06-01

    This article reviews the literature on how blurred vision contributes to falls, gait, and postural control and discusses how these are influenced by spectacle correction. Falls are common and represent a very serious health risk for older people. They are not random events as studies have shown that falls are linked to a range of intrinsic and extrinsic risk factors. Vision provides a significant input to postural control in addition to providing information about the size and position of hazards and obstacles in the travel pathway and allows us to safely negotiate steps and stairs. Many studies have shown that reduced vision is a significant risk factor for falls. However, randomized controlled trials of optometric interventions and cataract surgery have not shown the expected reduction in falls rate, which may be due to magnification changes (and thus vestibulo-ocular reflex gain) in those participants who have large changes in refractive correction. Epidemiological studies have also shown that progressive addition lens and bifocal wearers are twice as likely to fall as non-multifocal wearers, laboratory-based studies have shown safer adaptive gait with single-vision glasses than progressive addition lenses or bifocals, and a randomized controlled trial has shown that an additional pair of distance vision single-vision glasses for outdoor use can reduce falls rate. Clinical recommendations to help optometrists prevent their frail, older patients from falling are suggested.

  20. 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 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.

  1. 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.

  2. 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.

  3. 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

  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. Phase processing for quantitative susceptibility mapping of regions with large susceptibility and lack of signal.

    Science.gov (United States)

    Fortier, Véronique; Levesque, Ives R

    2017-11-11

    Phase processing impacts the accuracy of quantitative susceptibility mapping (QSM). Techniques for phase unwrapping and background removal have been proposed and demonstrated mostly in brain. In this work, phase processing was evaluated in the context of large susceptibility variations (Δχ) and negligible signal, in particular for susceptibility estimation using the iterative phase replacement (IPR) algorithm. Continuous Laplacian, region-growing, and quality-guided unwrapping were evaluated. For background removal, Laplacian boundary value (LBV), projection onto dipole fields (PDF), sophisticated harmonic artifact reduction for phase data (SHARP), variable-kernel sophisticated harmonic artifact reduction for phase data (V-SHARP), regularization enabled sophisticated harmonic artifact reduction for phase data (RESHARP), and 3D quadratic polynomial field removal were studied. Each algorithm was quantitatively evaluated in simulation and qualitatively in vivo. Additionally, IPR-QSM maps were produced to evaluate the impact of phase processing on the susceptibility in the context of large Δχ with negligible signal. Quality-guided unwrapping was the most accurate technique, whereas continuous Laplacian performed poorly in this context. All background removal algorithms tested resulted in important phase inaccuracies, suggesting that techniques used for brain do not translate well to situations where large Δχ and no or low signal are expected. LBV produced the smallest errors, followed closely by PDF. Results suggest that quality-guided unwrapping should be preferred, with PDF or LBV for background removal, for QSM in regions with large Δχ and negligible signal. This reduces the susceptibility inaccuracy introduced by phase processing. Accurate background removal remains an open question. Magn Reson Med, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  6. Cost-effectiveness analysis of screening for risk of in-hospital falls using physiotherapist clinical judgement.

    Science.gov (United States)

    Haines, Terry; Kuys, Suzanne S; Morrison, Greg; Clarke, Jane; Bew, Paul

    2009-04-01

    Screening hospital patients for falls risk is now a contentious component of geriatric care despite its widespread clinical use. The economic implications of using a falls risk screening approach to deliver an effective falls prevention intervention have not previously been examined. This was a multicenter prospective longitudinal cohort and incremental cost-effectiveness analysis. One thousand one hundred twenty-three geriatric inpatients from 17 rehabilitation units across Australia. Physiotherapist accuracy in predicting patient who will fall was captured with the question "Will this patient experience one or more falls during their rehabilitation period?" Falls were measured using hospital incident reporting systems. The multicenter longitudinal cohort was undertaken to establish the predictive accuracy of physiotherapist clinical judgement. This data was used in the incremental cost-effectiveness analysis where estimates of the cost of falls and effectiveness of an intervention program were taken from previous research. The accuracy of physiotherapist clinical judgement in predicting falls was high relative to previous research (sensitivity = 0.61, specificity = 0.82, Youden index = 0.43). Selectively providing patient falls-prevention education using physiotherapist clinical judgement would reduce falls [2.2 (SD: 0.19) fallers per 100 inpatients reduction] and reduce resources spent on trying to prevent and treat injuries from in-hospital falls [$2704 AUD (SD: $432) per 100 inpatients reduction] compared with doing nothing. However, there was greater uncertainty as to whether the patient education intervention modeled should be provided selectively or universally. Preventing in-hospital falls using a targeted falls prevention intervention approach utilizing physiotherapist clinical judgement was more cost-effective than a "no intervention" approach.

  7. 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.

  8. 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…

  9. 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.

  10. Falls and stumbles in myotonic dystrophy.

    Science.gov (United States)

    Wiles, C M; Busse, M E; Sampson, C M; Rogers, M T; Fenton-May, J; van Deursen, R

    2006-03-01

    To investigate falls and risk factors in patients with myotonic dystrophy type 1 (DM1) compared with healthy volunteers. 13 sequential patients with DM1 from different kindreds were compared with 12 healthy volunteers. All subjects were evaluated using the Rivermead Mobility Index, Performance Oriented Mobility Assessment, and modified Activities Specific Balance Confidence scale. Measures of lower limb muscle strength, gait speed, and 7-day ambulatory activity monitoring were recorded. Subjects returned a weekly card detailing stumbles and falls. 11 of 13 patients (mean age 46.5 years, seven female) had 127 stumbles and 34 falls over the 13 weeks, compared with 10 of 12 healthy subjects (34.4 years, seven female) who had 26 stumbles and three falls. Patients were less active than healthy subjects but had more falls and stumbles per 5000 right steps taken (mean (SD) events, 0.21 (0.29) v 0.02 (0.02), p = 0.007). Patients who fell (n = 6) had on average a lower Rivermead Mobility score, slower self selected gait speed, and higher depression scores than those who did not. DM1 patients stumble or fall about 10 times more often than healthy volunteers. Routine inquiry about falls and stumbles is justified. A study of multidisciplinary intervention to reduce the risk of falls seems warranted.

  11. Estimation of the Population Susceptibility Against Measles in Slovakia.

    Science.gov (United States)

    Zibolenová, Jana; Chladná, Zuzana; Švihrová, Viera; Baška, Tibor; Waczulíková, Iveta; Hudečková, Henrieta

    2017-03-01

    In Slovakia, thanks to a highly effective vaccination programme, no domestic cases of measles have been reported since 1999. However, there are several outbreaks of measles currently hitting some countries in Europe. Difficulties in reaching the goal of measles elimination make it necessary to monitor the status of the population susceptibility to prevent similar outbreaks in the future. We hypothesize that immunity wanes overtime, which can substantially impact the population susceptibility. This work introduces a model that estimates a proportion of individuals susceptible to measles in the Slovak population in 2015. Our analysis is based on an age-cohort model that incorporates waning immunity, vaccination schedule and changes in demographic structure. The inputs of the model are data on the vaccination coverage, last seroprevalence survey in 2002 and age structure of the population. In a short-term horizon, waning immunity does not affect the estimated proportion of the susceptible population. However, in a long-term horizon, the antibody titers can fall below the level of protection, which would result in a substantial transfer of initially immune individuals to the compartment of the susceptible ones. Incorporating of waning immunity in the cohort model has indicated that the most susceptible cohorts are not-vaccinated youngest children and cohorts born between 1969 and 1986. Applying the model to the current situation shows that people aged 30-45 years and unvaccinated infants represent the most susceptible groups. Model partially replaces missing seroprevalence survey, but, because the parameters of model and phenomenon of waning immunity are not exactly known, we suggest reintroducing the regular national serosurveys in order to empirically determine the level of susceptibility for measles in Slovakia.

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

    NARCIS (Netherlands)

    Dautzenberg, P.L.; 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

  13. 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 Panalysis was Pinformation, 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) (Prisk of falling.

  14. 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.

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

    Science.gov (United States)

    O'Halloran, Aisling M; Pénard, Nils; Galli, Alessandra; Fan, Chie Wei; Robertson, Ian H; Kenny, Rose Anne

    2011-12-19

    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. 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. Significant increases in the mean and variability of reaction time on the SART were significantly associated with both falls (p older adults. An increase in omission errors was also associated with falls (p attention was a retrospective predictor of falling (p 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 strategies.

  16. Risk Factors for Falls and Fall-related Fractures in the Elderly

    NARCIS (Netherlands)

    G. Ziere (Gijsbertus)

    2007-01-01

    textabstractFalls are among the most common and serious problems facing older persons and are associated with considerable morbidity and mortality. They often lead to reduced functioning and nursing home admissions. The incidence of falls as well as the severity of fall-related complications rises

  17. Effectiveness of a home hazard modification program for reducing falls in urban community-dwelling older adults: A randomized controlled trial.

    Science.gov (United States)

    Kamei, Tomoko; Kajii, Fumiko; Yamamoto, Yuko; Irie, Yukako; Kozakai, Rumi; Sugimoto, Tomoko; Chigira, Ayako; Niino, Naoakira

    2015-07-01

    To evaluate the potential improvement of fall prevention awareness and home modification behaviors and to decrease indoor falls by applying a home hazard modification program (HHMP) in community-dwelling older adults followed up to 1 year in this randomized controlled trial. The present authors randomly assigned 130 older adults living in the Tokyo metropolitan region to either the HHMP intervention group (n = 67) or the control group (n = 63). Both groups received four, 2 h fall prevention multifactorial programs including education regarding fall risk factors, food and nutrition, foot self-care, and exercise sessions. However, only the HHMP group received education and practice regarding home safety by using a model mock-up of a typical Japanese home. The mean age of the HHMP group was 75.7 years and the control group 75.8. The HHMP group showed a 10.9% reduction in overall falls, and falls indoors showed an 11.7% reduction at 52 weeks. Those aged 75 years and over showed a significant reduction in both overall falls and indoor falls at 12 weeks. Fall prevention awareness and home modifications were significantly improved in the HHMP group. HHMP has the potential to improve fall prevention awareness and home modification behaviors, and specifically decreased overall and indoor falls in 12 weeks in those aged 75 years and older in community-dwelling older adults. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

  18. Magnetic susceptibilities of minerals

    Science.gov (United States)

    Rosenblum, Sam; Brownfield, I.K.

    2000-01-01

    Magnetic separation of minerals is a topic that is seldom reported in the literature for two reasons. First, separation data generally are byproducts of other projects; and second, this study requires a large amount of patience and is unusually tedious. Indeed, we suspect that most minerals probably are never investigated for this property. These data are timesaving for mineralogists who concentrate mono-mineralic fractions for chemical analysis, age dating, and for other purposes. The data can certainly be used in the ore-beneficiation industries. In some instances, magnetic-susceptibility data may help in mineral identification, where other information is insufficient. In past studies of magnetic separation of minerals, (Gaudin and Spedden, 1943; Tille and Kirkpatrick, 1956; Rosenblum, 1958; Rubinstein and others, 1958; Flinter, 1959; Hess, 1959; Baker, 1962; Meric and Peyre, 1963; Rojas and others, 1965; and Duchesne, 1966), the emphasis has been on the ferromagnetic and paramagnetic ranges of extraction. For readers interested in the history of magnetic separation of minerals, Krumbein and Pettijohn (1938, p. 344-346) indicated nine references back to 1848. The primary purpose of this paper is to report the magnetic-susceptibility data on as many minerals as possible, similar to tables of hardness, specific gravity, refractive indices, and other basic physical properties of minerals. A secondary purpose is to demonstrate that the total and best extraction ranges are influenced by the chemistry of the minerals. The following notes are offered to help avoid problems in separating a desired mineral concentrate from mixtures of mineral grains.

  19. Alcohol increases hypnotic susceptibility.

    Science.gov (United States)

    Semmens-Wheeler, Rebecca; Dienes, Zoltán; Duka, Theodora

    2013-09-01

    One approach to hypnosis suggests that for hypnotic experience to occur frontal lobe activity must be attenuated. For example, cold control theory posits that a lack of awareness of intentions is responsible for the experience of involuntariness and/or the subjective reality of hypnotic suggestions. The mid-dorso-lateral prefrontal cortex and the ACC are candidate regions for such awareness. Alcohol impairs frontal lobe executive function. This study examined whether alcohol affects hypnotisability. We administered 0.8 mg/kg of alcohol or a placebo to 32 medium susceptible participants. They were subsequently hypnotised and given hypnotic suggestions. All participants believed they had received some alcohol. Participants in the alcohol condition were more susceptible to hypnotic suggestions than participants in the placebo condition. Impaired frontal lobe activity facilitates hypnotic responding, which supports theories postulating that attenuation of executive function facilitates hypnotic response, and contradicts theories postulating that hypnotic response involves enhanced inhibitory, attentional or other executive function. Copyright © 2013. Published by Elsevier Inc.

  20. Selective attentional processing to fall-relevant stimuli among older adults who fear falling.

    Science.gov (United States)

    Brown, Lesley A; White, Patti; Doan, Jonathan B; de Bruin, Natalie

    2011-05-01

    Fear of falling is known to affect more than half of community-dwelling older adults over 60 years of age. This fear is associated with physical and psychological effects that increase the risk of falling. The authors' theory is that attentional processing biases may exist in this population that serve to perpetuate fear of falling and subsequently increase fall risk. As a starting point in testing this proposition, the authors examined selective attentional processing bias to fall-relevant stimuli among older adults. Thirty older adult participants (M(age) = 70.8 ± 5.8), self-categorized to be Fearful of Falling (FF, n = 15) or Non-Fearful of Falling (NF, n = 15) completed a visual dot-probe paradigm to determine detection latencies to fall-threatening and general-threat stimuli. Attentional processing was defined using three index scores: attentional bias, congruency index, and incongruency index. Bias indicates capture of attention, whereas congruency and incongruency imply vigilance and disengagement difficulty, respectively. Both groups showed an attentional bias to fall-threat words but those who were fearful of falling also showed an incongruency effect for fall-threat words. These findings confirm that selective attentional processing profiles for fall-relevant stimuli differ between older adults who exhibit fear of falling and those who do not have this fear. Moreover, in accordance with current interpretations of selective attentional processing, the incongruency effect noted among fall-fearful older adults presents a possibility for a difficulty disengaging from fall-threatening stimuli.

  1. 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

  2. Benzodiazepine prescriptions and falls in older men and women.

    Science.gov (United States)

    Martinez-Cengotitabengoa, Monica; Diaz-Gutierrez, Maria Jose; Besga, Ariadna; Bermúdez-Ampudia, Cristina; López, Purificación; Rondon, Marta B; Stewart, Donna E; Perez, Patricia; Gutierrez, Miguel; Gonzalez-Pinto, Ana

    2017-03-02

    Despite cautions by professional associations, benzodiazepines (BZD) and Z hypnotics (BZD/Z) are widely prescribed to older adults who are particularly susceptible to insomnia and anxiety, but who are also more sensitive to drugs adverse events. In this study, we assessed the prescription of BZD/Z drugs in a sample of older adults (≥65) who presented for emergency care after a fall. We collected the type, number and dose of BZD/Z drugs prescribed and explored gender differences in the prescription. BZD/Z drugs were prescribed to 43.6% of the sample (n=654) and more frequently to women; 78.4% of prescriptions were for BZD/Z drugs with a short half-life. The majority of patients (83.5%) were prescribed only one type of BZD/Z, but 16.5% had been prescribed multiple BZD/Z drugs, with no gender difference. Doses higher than those recommended for older adults were prescribed to 58% of patients, being the doses significantly higher for men compared to women (70.0% vs 53.1%). Over 40% of older adults presenting for emergency care after a fall had previously been prescribed BZD/Z drugs. Some important gender differences in the prescription of BZD/Z drugs were seen, especially prescription above the recommended dose and of drugs with a long-half life. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Fall prevention in the elderly: analysis and comprehensive review of methods used in the hospital and in the home.

    Science.gov (United States)

    Clyburn, Terry A; Heydemann, John A

    2011-07-01

    Falls in the elderly are a significant problem both in and out of the hospital. The Deficit Reduction Act of 2005 and the Fiscal Year 2009 Inpatient Prospective Payment System Final Rule, as outlined by the Centers for Medicare & Medicaid Services, placed on hospitals the financial burden of fall prevention for falls (ie, hospital-acquired conditions) that could have been prevented by following evidence-based guidelines. Multifaceted and individualized programs have been created to prevent falls in the elderly. Many of these interventions are based on expert opinion and statistical trends. Our review of the literature revealed that the risk of fall is only slightly greater in the hospital environment than in the home and that there is no medical evidence that evidence-based guidelines are effective in fall prevention.

  4. Magnetic susceptibility as a biosignature in stromatolites

    Science.gov (United States)

    Petryshyn, Victoria A.; Corsetti, Frank A.; Frantz, Carie M.; Lund, Steve P.; Berelson, William M.

    2016-03-01

    Microbialites have long been a focus of study in geobiology because they are macroscopic sedimentary records of the activities of microscopic organisms. However, abiotic processes can result in microbialite-like morphologies. Developing robust tools for substantiating the biogenicity of putative microbialites remains an important challenge. Here, we report a new potential biosignature based on the detrital magnetic mineral component present in nearly all sedimentary rocks. Detrital grains falling onto a hard, abiogenic, chemically precipitated structure would be expected to roll off surfaces at high incline angles. Thus, the distribution of grains in an abiogenic microbialite should exhibit a dependence on the dip angle along laminae. In contrast, a microbialite formed by the active trapping and binding of detrital grains by microorganisms could exhibit a distribution of detrital grains significantly less dependent on the dip angle of the laminae. However, given that most ancient stromatolites are micritic (composed of carbonate mud), tracking detrital grains vs. precipitated carbonate is not straightforward. Recent advances in our ability to measure miniscule magnetic fields open up the possibility to map magnetic susceptibility as a tracer of detrital grains in stromatolites. In abiogenic carbonate precipitation experiments, magnetic susceptibility fell to zero when the growth surface was inclined above 30° (the angle at which grains rolled off). In cyanobacterial mat experiments, even vertically inclined mats held magnetic material. The results indicate that cyanobacterial mats trap and bind small grains more readily than abiogenic carbonate precipitates alone. A variety of stromatolites of known and unknown biogenicity were then analyzed. Tested stromatolites span many different ages (Eocene to Holocene) and depositional environments (hot springs, lakes), and compositional forms (micritic, sparry crusts, etc.). The results were consistent with the laboratory

  5. Interventions for preventing falls in older people living in the community.

    Science.gov (United States)

    Gillespie, Lesley D; Robertson, M Clare; Gillespie, William J; Sherrington, Catherine; Gates, Simon; Clemson, Lindy M; Lamb, Sarah E

    2012-09-12

    Approximately 30% of people over 65 years of age living in the community fall each year. This is an update of a Cochrane review first published in 2009. To assess the effects of interventions designed to reduce the incidence of falls in older people living in the community. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (February 2012), CENTRAL (The Cochrane Library 2012, Issue 3), MEDLINE (1946 to March 2012), EMBASE (1947 to March 2012), CINAHL (1982 to February 2012), and online trial registers. Randomised trials of interventions to reduce falls in community-dwelling older people. Two review authors independently assessed risk of bias and extracted data. We used a rate ratio (RaR) and 95% confidence interval (CI) to compare the rate of falls (e.g. falls per person year) between intervention and control groups. For risk of falling, we used a risk ratio (RR) and 95% CI based on the number of people falling (fallers) in each group. We pooled data where appropriate. We included 159 trials with 79,193 participants. Most trials compared a fall prevention intervention with no intervention or an intervention not expected to reduce falls. The most common interventions tested were exercise as a single intervention (59 trials) and multifactorial programmes (40 trials). Sixty-two per cent (99/159) of trials were at low risk of bias for sequence generation, 60% for attrition bias for falls (66/110), 73% for attrition bias for fallers (96/131), and only 38% (60/159) for allocation concealment.Multiple-component group exercise significantly reduced rate of falls (RaR 0.71, 95% CI 0.63 to 0.82; 16 trials; 3622 participants) and risk of falling (RR 0.85, 95% CI 0.76 to 0.96; 22 trials; 5333 participants), as did multiple-component home-based exercise (RaR 0.68, 95% CI 0.58 to 0.80; seven trials; 951 participants and RR 0.78, 95% CI 0.64 to 0.94; six trials; 714 participants). For Tai Chi, the reduction in rate of falls bordered on statistical

  6. Community-based intervention to optimise falls risk management: a randomised controlled trial.

    Science.gov (United States)

    Ciaschini, P M; Straus, S E; Dolovich, L R; Goeree, R A; Leung, K M; Woods, C R; Zimmerman, G M; Majumdar, S R; Spadafora, S; Fera, L A; Lee, H N

    2009-11-01

    falls are the leading causes of accidental death and fragility fractures in older adults. Interventions that assess and reduce falls risk are underutilised. to evaluate the impact of a multifaceted community-based programme aimed at optimising evidence-based management of patients at risk for fall-related fractures. this was a randomised trial performed from 2003 to 2006. community-based intervention in Ontario, Canada. eligible patients were community-dwelling, aged > or =55 years and identified to be at risk for fall-related fractures. A total of 201 patients were allocated to the intervention group or to usual care. components of the intervention included assessment of falls risk, functional status and home environment, and patient education. primary outcome was the implementation of appropriate falls risk assessment at 6 months. Secondary outcomes included falls and fractures at 6 and 12 months. the mean age of participants was 72 years, and 41% had fallen with injury in the previous year. Compared to usual care, the intervention increased the number of referrals made to physiotherapy [21% (21/101) vs 6.0% (6/100); relative risk (RR) 3.47, 95% confidence interval (CI) 1.46-8.22] and occupational therapy [15% (15/101) vs 0%; RR 30.7, 95% CI 1.86 to >500]. At 12 months, the number of falls in the intervention group was greater than in the usual care group [23% (23/101) vs 11% (11/100); RR 2.07, 95% CI 1.07-4.02]. compared to usual care, a multi-faceted intervention increased referrals to physiotherapy and occupational therapy but did not reduce risk of falls. Similar falls reduction interventions cannot be recommended based on the results of this study.

  7. Falls risk assessment outcomes and factors associated with falls for older Indigenous Australians.

    Science.gov (United States)

    Hill, Keith D; Flicker, Leon; LoGiudice, Dina; Smith, Kate; Atkinson, David; Hyde, Zoë; Fenner, Stephen; Skeaf, Linda; Malay, Roslyn; Boyle, Eileen

    2016-12-01

    To describe the prevalence of falls and associated risk factors in older Indigenous Australians, and compare the accuracy of validated falls risk screening and assessment tools in this population in classifying fall status. Cross-sectional study of 289 Indigenous Australians aged ≥45 years from the Kimberley region of Western Australia who had a detailed assessment including self-reported falls in the past year (n=289), the adapted Elderly Falls Screening Tool (EFST; n=255), and the Falls Risk for Older People-Community (FROP-Com) screening tool (3 items, n=74) and FROP-Com falls assessment tool (n=74). 32% of participants had ≥1 fall in the preceding year, and 37.3% were classified high falls risk using the EFST (cut-off ≥2). In contrast, for the 74 participants assessed with the FROP-Com, only 14.9% were rated high risk, 35.8% moderate risk, and 49.3% low risk. The FROP-Com screen and assessment tools had the highest classification accuracy for identifying fallers in the preceding year (area under curve >0.85), with sensitivity/specificity highest for the FROP-Com assessment (cut-off ≥12), sensitivity=0.84 and specificity=0.73. Falls are common in older Indigenous Australians. The FROP-Com falls risk assessment tool appears useful in this population, and this research suggests changes that may improve its utility further. © 2016 Public Health Association of Australia.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. Predicting habitual physical activity using coping strategies in older fallers engaged in falls-prevention exercise.

    Science.gov (United States)

    Laybourne, Anne H; Biggs, Simon; Martin, Finbarr C

    2011-07-01

    One third of adults over 65 yr old fall each year. Wide-ranging consequences include fracture, reduced activity, and death. Research synthesis suggests that falls-prevention programs can be effective in reducing falls by about 20%. Strength and balance training is the most efficacious component, and the assumed method of effect is an improvement in these performance domains. There is some evidence for this, but the authors have previously proposed an alternative method, activity restriction, leading to a reduction in subsequent falls through a reduction in exposure. The aim of this study was to examine physical activity in older fallers, applying a theory of adaptation, to ascertain predictors of habitual physical activity. Referrals to hospital- and community-based exercise programs were assessed for (a) habitual walking steps and (b) coping strategies, falls self-efficacy, social support, and balance mobility. There was no average group change in physical activity. There was high interindividual variability. Two coping strategies, loss-based selection and optimization, best explained the change in physical activity between baseline and follow-up. Notwithstanding some limitations, this work suggests further use of adaptation theory in falls research. A potential application is the creation of a profiling tool to enable clinicians to better match treatment to patient.

  13. 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.

  14. Increased concern is protective for falls in Chinese older people: the chopstix fall risk study.

    Science.gov (United States)

    Kwan, Marcella M S; Tsang, William W N; Lin, Sang-I; Greenaway, Mark; Close, Jacqueline C T; Lord, Stephen R

    2013-08-01

    Chinese older people have approximately half the risk of falling as their white counterparts, but no studies to date have explained why such a disparity exists. A total of 692 Chinese and 764 white community-dwelling older people participated in a multicohort study conducted in Taiwan, Hong Kong, and Australia. Baseline measurements included sociodemographic, psychological, and physical measures; concern about falling (Falls Efficacy Scale-International scores); and physical activity levels. Falls were monitored prospectively for 12-24 months. The standardized annual fall rates for the 3 Chinese cohorts were 0.26 ± 0.47 in Taiwan, 0.21 ± 0.57 in Hong Kong, and 0.36 ± 0.80 in Australia, which were significantly lower than that of the white cohort at 0.70 ± 1.15. The fall rates for the Taiwan and Hong Kong cohorts were also significantly lower than that of the Australian Chinese cohort. The difference in fall rates was not due to better physical ability in the Chinese cohorts. However, the Chinese cohorts did more planned activity and expressed more concern about falling. Negative binomial regression analysis revealed a significant Cohort × Falls Efficacy Scale-International score interaction. After adjusting for this interaction, Falls Efficacy Scale-International scores, other predictors, and confounders, the incidence rate ratios comparing the cohorts were no longer statistically significant. Low fall rates in Chinese cohorts appear to be due to increased concern about falling as manifest in high Falls Efficacy Scale-International scores. These findings suggest that the Chinese cohorts are more likely to adapt their behaviors to lessen fall risk and that such adaptations are partially lost in Chinese people who have migrated to a "Westernized" country.

  15. Graphene susceptibility in Holstein model

    Energy Technology Data Exchange (ETDEWEB)

    Mousavi, Hamze, E-mail: hamze.mousavi@gmail.co [Department of Physics, Razi University, Kermanshah (Iran, Islamic Republic of); Nano Science and Nano Technology Research Center, Razi University, Kermanshah (Iran, Islamic Republic of)

    2011-06-15

    We study the effects of the electron-phonon interaction on the temperature dependence of the orbital magnetic susceptibility of monolayer graphene. We use the linear response theory and Green's function formalism within the Holstein Hamiltonian model. The results show that the effects of the electron-phonon interaction on the susceptibility of graphene sheet have different behaviors in two temperature regions. In the low temperature region, susceptibility increases when the electron-phonon coupling strength increases. On the other hand, the susceptibility reduces with increasing the electron-phonon coupling strength in the high temperature region. - Highlights: Effect of electron-phonon interaction on the susceptibility of graphene is studied. Linear response theory and Green's function technique in Holstein model are used. Effect of electron-phonon on susceptibility has different behaviors in two temperature regions.

  16. 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

  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. 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.

  19. Relevance of vitamin D in fall prevention.

    Science.gov (United States)

    Bischoff-Ferrari, Heike A

    2017-03-01

    This review will summarize recent clinical studies and meta-analyses on the effect of vitamin D supplementation on fall prevention. As fall prevention is fundamental in fracture prevention at older age, we discuss if and to what extend the vitamin D effect on muscle modulates hip fracture risk. Further, to explain the effect of vitamin D on fall prevention, we will review the mechanistic evidence linking vitamin D to muscle health and the potentially selective effect of vitamin D on type II fast muscle fibers.

  20. 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.

  1. 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.

  2. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes.

    Science.gov (United States)

    Anderson, Ruth A; Corazzini, Kirsten; Porter, Kristie; Daily, Kathryn; McDaniel, Reuben R; Colón-Emeric, Cathleen

    2012-02-29

    Quality improvement (QI) programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occurs within the context of relationships and interactions among individuals. Thus, QI programs will not result in optimal changes in staff behavior unless the context for social learning is present. Accordingly, we developed CONNECT, an intervention to foster systematic use of management practices, which we propose will enhance effectiveness of a nursing home Falls QI program by strengthening the staff-to-staff interactions necessary for clinical problem-solving about complex problems such as falls. The study aims are to compare the impact of the CONNECT intervention, plus a falls reduction QI intervention (CONNECT + FALLS), to the falls reduction QI intervention alone (FALLS), on fall-related process measures, fall rates, and staff interaction measures. Sixteen nursing homes will be randomized to one of two study arms, CONNECT + FALLS or FALLS alone. Subjects (staff and residents) are clustered within nursing homes because the intervention addresses social processes and thus must be delivered within the social context, rather than to individuals. Nursing homes randomized to CONNECT + FALLS will receive three months of CONNECT first, followed by three months of FALLS. Nursing homes randomized to FALLS alone receive three months of FALLs QI and are offered CONNECT after data collection is completed. Complexity science measures, which reflect staff perceptions of communication, safety climate, and care quality, will be collected from staff at baseline, three months after, and six months after baseline to evaluate immediate and sustained impacts. FALLS measures including quality indicators (process measures) and fall rates will be collected for the six months prior to baseline and the six months after the end of the intervention

  3. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes

    Directory of Open Access Journals (Sweden)

    Anderson Ruth A

    2012-02-01

    Full Text Available Abstract Background Quality improvement (QI programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occurs within the context of relationships and interactions among individuals. Thus, QI programs will not result in optimal changes in staff behavior unless the context for social learning is present. Accordingly, we developed CONNECT, an intervention to foster systematic use of management practices, which we propose will enhance effectiveness of a nursing home Falls QI program by strengthening the staff-to-staff interactions necessary for clinical problem-solving about complex problems such as falls. The study aims are to compare the impact of the CONNECT intervention, plus a falls reduction QI intervention (CONNECT + FALLS, to the falls reduction QI intervention alone (FALLS, on fall-related process measures, fall rates, and staff interaction measures. Methods/design Sixteen nursing homes will be randomized to one of two study arms, CONNECT + FALLS or FALLS alone. Subjects (staff and residents are clustered within nursing homes because the intervention addresses social processes and thus must be delivered within the social context, rather than to individuals. Nursing homes randomized to CONNECT + FALLS will receive three months of CONNECT first, followed by three months of FALLS. Nursing homes randomized to FALLS alone receive three months of FALLs QI and are offered CONNECT after data collection is completed. Complexity science measures, which reflect staff perceptions of communication, safety climate, and care quality, will be collected from staff at baseline, three months after, and six months after baseline to evaluate immediate and sustained impacts. FALLS measures including quality indicators (process measures and fall rates will be collected for the six months prior to baseline and

  4. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes

    Science.gov (United States)

    2012-01-01

    Background Quality improvement (QI) programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occurs within the context of relationships and interactions among individuals. Thus, QI programs will not result in optimal changes in staff behavior unless the context for social learning is present. Accordingly, we developed CONNECT, an intervention to foster systematic use of management practices, which we propose will enhance effectiveness of a nursing home Falls QI program by strengthening the staff-to-staff interactions necessary for clinical problem-solving about complex problems such as falls. The study aims are to compare the impact of the CONNECT intervention, plus a falls reduction QI intervention (CONNECT + FALLS), to the falls reduction QI intervention alone (FALLS), on fall-related process measures, fall rates, and staff interaction measures. Methods/design Sixteen nursing homes will be randomized to one of two study arms, CONNECT + FALLS or FALLS alone. Subjects (staff and residents) are clustered within nursing homes because the intervention addresses social processes and thus must be delivered within the social context, rather than to individuals. Nursing homes randomized to CONNECT + FALLS will receive three months of CONNECT first, followed by three months of FALLS. Nursing homes randomized to FALLS alone receive three months of FALLs QI and are offered CONNECT after data collection is completed. Complexity science measures, which reflect staff perceptions of communication, safety climate, and care quality, will be collected from staff at baseline, three months after, and six months after baseline to evaluate immediate and sustained impacts. FALLS measures including quality indicators (process measures) and fall rates will be collected for the six months prior to baseline and the six months after the

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

    Directory of Open Access Journals (Sweden)

    Huang MH

    2015-09-01

    Full Text Available Min H Huang, Tracy Shilling, Kara A Miller, Kristin Smith, Kayle LaVictoire Physical Therapy Department, School of Health Professions and Studies, University of Michigan–Flint, Flint, MI, USA Abstract: 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 P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. 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 (P<0.05. Sensitivity and specificity for correctly

  7. Melhora do equilíbrio e redução da possibilidade de queda em idosas após os exercícios de Cawthorne e Cooksey Balance improvement and reduction of likelihood of falls in older women after Cawthorne and Cooksey exercises

    Directory of Open Access Journals (Sweden)

    Angela dos Santos Bersot Ribeiro

    2005-02-01

    Full Text Available O sistema vestibular é referencial absoluto na manutenção do equilíbrio. Seu déficit funcional pelo envelhecimento resulta em alterações no equilíbrio e aumento na possibilidade de queda. OBJETIVO: Verificar se a abordagem terapêutica específica para o sistema vestibular gera aprendizado motor e contribui para a melhora do equilíbrio e a diminuição na possibilidade de queda. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Quinze mulheres, entre 60 e 69 anos, média = 64,8 anos (±2,95, residentes no município de Barra Mansa - RJ, foram submetidas aos exercícios de Cawthorne e Cooksey, durante nove semanas, três vezes por semana, durante sessenta minutos, no período de março a junho de 2003. Avaliou-se o equilíbrio pela Escala do Equilíbrio de Berg (EEB, cujos escores determinaram a possibilidade de queda (PQ. Analisaram-se os resultados pelos testes T-Student e Wilcoxon. O nível de significância foi pVestibular 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. AIM: 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. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: 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. RESULTS: Comparing the data obtained before and after intervention, we observed significant difference (p< 0.05, showing improvement in BBS scores and decrease in PF. CONCLUSION: Cawthorne and Cooksey exercises were able to promote significant improvement in the balance of this sample and they can be

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

    Directory of Open Access Journals (Sweden)

    O'Halloran Aisling M

    2011-12-01

    Full Text Available 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 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 strategies.

  9. 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.

  10. Falls Among Older Adults: An Overview

    Science.gov (United States)

    ... of traumatic brain injuries (TBI). 9 Adjusted for inflation, the direct medical costs for fall injuries are $ ... OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO (800-232-4636) , TTY: 888- ...

  11. Performances: "Aufstieg und Fall der Stadt Mahagonny"

    National Research Council Canada - National Science Library

    Gonzales, Robert

    2008-01-01

    The January 26, 2008, performance of Kurt Weill's "Aufstieg und Fall der Stadt Mahagonny" featuring Astrid Kropp under director Barrie Kosky and conductor Stefan Soltesz at the Musiktheater in Essen...

  12. Effect of free fall on higher plants.

    Science.gov (United States)

    Gordon, S. A.

    1973-01-01

    The influence of exposure to the free-fall state on the orientation, morphogenesis, physiology, and radiation response of higher plants is briefly summarized. It is proposed that the duration of the space-flight experiments has been to brief to permit meaningful effects of free fall on general biochemistry, growth, and development to appear. However, two types of significant effect did occur. The first is on differential growth - i.e., tropism and epinasty - resulting from the absence of a normal geostimulus. For these phenomena it is suggested that ground-based experiments with the clinostat would suffice to mimic the effect of the free-fall state. The second is an apparent interaction between the radiation response and some flight condition, yielding an enhanced microspore abortion, a disturbed spindle function, and a stunting of stamen hairs. It is suggested that this apparent interaction may be derived from a shift in the rhythm of the cell cycle, induced by the free fall.

  13. 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

    2016-12-23

    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. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. 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.

  15. 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

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

    Science.gov (United States)

    Toms, A P; Smith-Bateman, C; Malcolm, P N; Cahir, J; Graves, M

    2010-06-01

    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. A phantom was created using a Charnley total hip replacement. Mid-coronal T1-weighted (echo time 12ms, repetition time 400ms) images through the prosthesis were acquired with increasing bandwidths (150, 300, 454, 592, and 781Hz/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. Over 90% of the achievable reduction in artefacts was obtained with matrixes of 256x256 or greater and a receiver bandwidth of approximately 400Hz/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. Over 90% of the achievable metal artefact reduction can be realized with mid-range matrices and receiver bandwidths on a clinical 1.5T 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. Copyright 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Evaluation of accelerometer-based fall detection algorithms on real-world falls.

    Directory of Open Access Journals (Sweden)

    Fabio Bagalà

    Full Text Available Despite extensive preventive efforts, falls continue to be a major source of morbidity and mortality among elderly. Real-time detection of falls and their urgent communication to a telecare center may enable rapid medical assistance, thus increasing the sense of security of the elderly and reducing some of the negative consequences of falls. Many different approaches have been explored to automatically detect a fall using inertial sensors. Although previously published algorithms report high sensitivity (SE and high specificity (SP, they have usually been tested on simulated falls performed by healthy volunteers. We recently collected acceleration data during a number of real-world falls among a patient population with a high-fall-risk as part of the SensAction-AAL European project. The aim of the present study is to benchmark the performance of thirteen published fall-detection algorithms when they are applied to the database of 29 real-world falls. To the best of our knowledge, this is the first systematic comparison of fall detection algorithms tested on real-world falls. We found that the SP average of the thirteen algorithms, was (mean ± std 83.0% ± 30.3% (maximum value = 98%. The SE was considerably lower (SE = 57.0% ± 27.3%, maximum value = 82.8%, much lower than the values obtained on simulated falls. The number of false alarms generated by the algorithms during 1-day monitoring of three representative fallers ranged from 3 to 85. The factors that affect the performance of the published algorithms, when they are applied to the real-world falls, are also discussed. These findings indicate the importance of testing fall-detection algorithms in real-life conditions in order to produce more effective automated alarm systems with higher acceptance. Further, the present results support the idea that a large, shared real-world fall database could, potentially, provide an enhanced understanding of the fall process and the information needed

  18. Evaluation of accelerometer-based fall detection algorithms on real-world falls.

    Science.gov (United States)

    Bagalà, Fabio; Becker, Clemens; Cappello, Angelo; Chiari, Lorenzo; Aminian, Kamiar; Hausdorff, Jeffrey M; Zijlstra, Wiebren; Klenk, Jochen

    2012-01-01

    Despite extensive preventive efforts, falls continue to be a major source of morbidity and mortality among elderly. Real-time detection of falls and their urgent communication to a telecare center may enable rapid medical assistance, thus increasing the sense of security of the elderly and reducing some of the negative consequences of falls. Many different approaches have been explored to automatically detect a fall using inertial sensors. Although previously published algorithms report high sensitivity (SE) and high specificity (SP), they have usually been tested on simulated falls performed by healthy volunteers. We recently collected acceleration data during a number of real-world falls among a patient population with a high-fall-risk as part of the SensAction-AAL European project. The aim of the present study is to benchmark the performance of thirteen published fall-detection algorithms when they are applied to the database of 29 real-world falls. To the best of our knowledge, this is the first systematic comparison of fall detection algorithms tested on real-world falls. We found that the SP average of the thirteen algorithms, was (mean ± std) 83.0% ± 30.3% (maximum value = 98%). The SE was considerably lower (SE = 57.0% ± 27.3%, maximum value = 82.8%), much lower than the values obtained on simulated falls. The number of false alarms generated by the algorithms during 1-day monitoring of three representative fallers ranged from 3 to 85. The factors that affect the performance of the published algorithms, when they are applied to the real-world falls, are also discussed. These findings indicate the importance of testing fall-detection algorithms in real-life conditions in order to produce more effective automated alarm systems with higher acceptance. Further, the present results support the idea that a large, shared real-world fall database could, potentially, provide an enhanced understanding of the fall process and the information needed to design and

  19. Preventing childhood falls within the home: overview of systematic reviews and a systematic review of primary studies.

    Science.gov (United States)

    Young, Ben; Wynn, Persephone M; He, Zhimin; Kendrick, Denise

    2013-11-01

    In most countries falls are the most common medically attended childhood injury and the majority of injuries in pre-school children occur at home. Numerous systematic reviews have reviewed evidence of the effectiveness of falls prevention interventions, but this evidence has not been synthesised into an overview, making it difficult for policy makers and practitioners to easily access the evidence. To synthesise all available evidence, we conducted an overview of reviews of home safety interventions targeting childhood falls, extracted data from primary studies included in the reviews and supplemented this with a systematic review of primary studies published subsequent to the reviews. Bibliographic databases, websites, conference proceedings, journals and bibliographies of included studies were searched for systematic reviews of studies with experimental or controlled observational designs. Thirteen reviews were identified containing 24 primary studies. Searches for additional primary studies identified five further studies not included in reviews. Evidence of the effect of interventions on falls or fall injuries was sparse, with only one of three primary studies reporting this outcome finding a reduction in falls. Interventions were effective in promoting the use of safety gates and furniture corner covers. There was some evidence of a reduction in baby walker use. The effect on the use of window safety devices, non-slip bath mats/decals and the reduction of tripping hazards was mixed. There was limited evidence that interventions were effective in improving lighting in corridors, altering furniture layout and restricting access to roofs. Most interventions to prevent childhood falls at home have not been evaluated in terms of their effect on reducing falls. Policy makers and practitioners should promote use of safety gates and furniture covers and restriction of baby walker use. Further research evaluating the effect of interventions to reduce falls and falls

  20. 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 exercise group compared with controls (IRR = 0.31, 95% CI 0.15-0.62, p exercise group (IRR = 1.61, 95% CI 0.86-3.03, p = 0.13). Postintervention, the exercise group scored significantly (p 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.

  1. Microwave susceptibility experiments

    Energy Technology Data Exchange (ETDEWEB)

    McConaghy, C.

    1984-05-29

    In certain experimental environments, systems can be affected or damaged by microwave pulses. I have conducted tests at LLNL to understand the phenomenology of microwave susceptibility of system components and subsystem components. To date, my experiments have concentrated on bipolar transistors, similar to what might be used in discrete analog circuits, and on CMOS RAM chips, which might be used in a computer memory system. I observed a decrease in failure energies for both the transistor and the integrated curcuit as I shortened the microwave pulse width. An S band (2.86 GHz) transmit/receive (T/R) tube has also been tested both at S band and at X band (8.16 GHz). The S band pulse had limitations in rise-time from zero power, which had an effect on the amount of power that could be transmitted through the T/R tube, as much as 0.7% of the incident power passed through the tube. All tests were conducted in closed-waveguide or coax test-fixtures, in contrast to the anechoic chambers utilized by other experimenters. I have used both S band and X band Klystron generators. For very high power (greater than 1 MW), I used an additional pulse-compression cavity at S band. Other subsystem components such as an X band mixer and an X band T/R tube will be tested in the future. 8 references.

  2. [Antimicrobial susceptibility cumulative reports].

    Science.gov (United States)

    Canut-Blasco, Andrés; Calvo, Jorge; Rodríguez-Díaz, Juan Carlos; Martínez-Martínez, Luis

    2016-10-01

    Cumulative reports on antimicrobial susceptibility tests data are important for selecting empirical treatments, as an educational tool in programs on antimicrobial use, and for establishing breakpoints defining clinical categories. These reports should be based on data validated by clinical microbiologists using diagnostic samples (not surveillance samples). In order to avoid a bias derived from including several isolates obtained from the same patient, it is recommended that, for a defined period, only the first isolate is counted. A minimal number of isolates per species should be presented: a figure of >=30 isolates is statistically acceptable. The report is usually presented in a table format where, for each cell, information on clinically relevant microorganisms-antimicrobial agents is presented. Depending on particular needs, multiple tables showing data related to patients, samples, services or special pathogens can be prepared. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Depression and Outcome of Fear of Falling in a Falls Prevention Program.

    Science.gov (United States)

    Iaboni, Andrea; Banez, Carol; Lam, Robert; Jones, Simon A; Maki, Brian E; Liu, Barbara A; Flint, Alastair J

    2015-10-01

    To examine whether depression predicts less improvement in fear of falling and falls efficacy in older adults attending a falls prevention program (FPP). Using a prospective observational design in an academic medical center, the authors studied 69 nondemented adults aged 55 years or older (mean age: 77.8±8.9 years) who had experienced at least one fall in the previous year and who attended the FPP. The primary outcome variable was change in severity of fear of falling during the FPP. Secondary outcome variables were change in falls efficacy and fear-related restriction of activities during the FPP. Independent variables were baseline depressive disorders and depressive symptom severity. Twenty-one of 69 study participants (30.4%) had a depressive disorder at baseline. Depressive disorder and depressive symptoms were not associated with change in severity of fear of falling or restriction of activity. On the other hand, depressive disorder was associated with improvement in falls efficacy, although this finding was not significant in multivariate analysis. Among participants with a depressive disorder, improvement in falls efficacy was significantly correlated with improvement in depressive symptoms. There was no association between baseline depression and change in fear of falling in this FPP. The correlation between improvement in depressive symptoms and improvement in falls efficacy raises the question as to whether a cognitive-behavioral intervention that simultaneously targets both depression and falls efficacy would be a useful component of a FPP. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. Central and peripheral visual impairment and the risk of falls and falls with injury.

    Science.gov (United States)

    Patino, Cecilia M; McKean-Cowdin, Roberta; Azen, Stanley P; Allison, Jessica Chung; Choudhury, Farzana; Varma, Rohit

    2010-02-01

    To evaluate whether central (CVI) and peripheral visual impairment (PVI) are independent risk factors for falls and falls with injury 4 years later. Population-based, prospective cohort study. A population-based sample of 3203 adult Latinos. Baseline presenting binocular central distance acuity was measured and impairment was classified as mild (20/40-20/63) or moderate/severe (Peripheral visual impairment was classified as mild (-6 dB injury in the past 12 months were assessed by self-report at the 4-year follow-up visit. Out of 3203 individuals, 19% reported falls and 10% falls with injury 4 years after the baseline examination; participants with falls were more likely to be >or=60 years of age, be female, report lower income, have >2 comorbidities, report alcohol use, report wearing bifocal glasses, and report obesity. Among those who reported falls, 7% had CVI (visual acuity >20/40) compared with 4% who did not report falls; and 49% had PVI (mean deviation injury (OR, 2.76; 95% CI, 1.10-7.02; P(value) = 0.03; and OR, 1.40; 95% CI, 0.94-2.05 P(trend) = 0.04, respectively). Both CVI and PVI were independently associated with increased risk for falls and falls with injury 4 years after the initial examination in a dose-response manner. Although vision-related interventions for preventing falls have mainly focused on correcting CVI, this study suggests that targeting both central and peripheral components may be necessary to effectively reduce rates of falls and falls with injury related to vision loss. Copyright (c) 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  5. Feasibility of Assessing Falls Risk and Promoting Falls Prevention in Beauty Salons.

    Science.gov (United States)

    Arandia, Gabriela; Hargrove, Jennifer L; Shubert, Tiffany E; Bangdiwala, Shrikant I; Linnan, Laura A

    2017-12-01

    Falls are a major public health risk and a leading cause of emergency room visits for people of all ages. Finding ways to increase access to information and evidence-based falls prevention strategies is critically important across the lifespan. We tested the feasibility of conducting a falls risk assessment and awareness program among customers who attend beauty salons. We enrolled 78 customers from 2 beauty salons who completed a written questionnaire as well as several biometric and functional balance tests designed to assess falls risk. On average, enrolled participants were 56 years of age (range: 19-90), female (n = 70, 91%), and Black (n = 47, 62%). Eleven percent of enrolled customers were classified as at high risk of falls because they had reported two or more falls in the last 6 months. We found that younger age, higher education, employment, moderate physical activity, and decreased frequency of salon visits were associated with fewer falls. Results demonstrated initial interest in, and the feasibility of recruiting and enrolling customers into a beauty salon-based falls risk assessment and awareness program. Beauty salons, which are in all communities, represent an innovative setting for reaching people of all ages with life-saving falls prevention information and services.

  6. Fall arrest characteristics of a scissor lift.

    Science.gov (United States)

    Harris, James R; Powers, John R; Pan, Christopher S; Boehler, Brad

    2010-06-01

    Census of Fatal Occupational Injuries (CFOI) data indicate 306 aerial lift fatalities between 1992-2003. Seventy-eight of these fatalities specifically involved scissor lifts. Members of standards committees have requested that NIOSH conduct research to determine the effects of safety-control practices related to using fall-protection systems for scissor lifts. This research examined the structural and dynamic stability of a scissor lift subjected to fall arrest forces. This was accomplished by conducting drop tests from a scissor lift. Anchorage locations evaluated included manufacturer-supplied anchorage points on the scissor lift platform as well as mid-rail and top-rail locations. Preliminary drop tests determined that a 2400 lb maximum arrest force (MAF) could be generated by dropping 169 lb through a fall height of 36" using Nystron rope as a lanyard. The scissor lift maintained structural and dynamic stability for all drop tests when fully extended and on an incline. Anchoring a fall arrest system to either the mid-rail or top-rail is not a recommended practice by the scissor lift manufacturer. Anchor points are provided on the platform floor of the scissor lift for this purpose. However, our results demonstrate that the mid-rail and top-rail absorb substantial energy from an arrested fall and may have potential as appropriate anchorage points. Employers and workers should consider implementing fall arrest systems when using scissor lifts as part of their overall risk mitigation plan for fall injury prevention. (c) 2010 National Safety Council. Published by Elsevier Ltd. All rights reserved.

  7. Conjunctivitis Caused by Neisseria gonorrhoeae Isolates with Reduced Cephalosporin Susceptibility and Multidrug Resistance

    Science.gov (United States)

    Kitagawa, Yutaka; Maruyama, Yosuke; Yamaguchi, Satoshi; Sakane, Yuri; Miyamoto, Hitoshi; Ohashi, Yuichi

    2013-01-01

    We report two cases of conjunctivitis caused by Neisseria gonorrhoeae with reduced cephalosporin susceptibility. Patients showed no response to cefmenoxime eye drops and intravenous ceftriaxone administration. The patients' condition improved after the addition of oral minocycline. The isolates contained the mosaic penA for reduction of β-lactam susceptibility. PMID:24025911

  8. 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

  9. A feasibility study and pilot randomised trial of a tailored prevention program to reduce falls in older people with mild dementia

    OpenAIRE

    Wesson, Jacqueline; Clemson, Lindy; Brodaty, Henry; Lord, Stephen; Taylor, Morag; Gitlin, Laura; Close, Jacqueline

    2013-01-01

    Background People with dementia have a disproportionately high rate of falls and fractures and poorer outcomes, yet there is currently no evidence to guide falls prevention in this population. Methods A randomised trial design was used to test feasibility of study components and acceptability of a home hazard reduction and balance and strength exercise fall prevention program. The program was tailored to participant?s individual cognitive levels and implemented as a carer-supported interventi...

  10. Predictors of falling in elderly hospital patients.

    Science.gov (United States)

    Salgado, Raja I; Lord, Stephen R; Ehrlich, Frederick; Janji, Nabil; Rahman, Abdur

    2004-01-01

    A prospective study was conducted to determine whether a brief clinical assessment conducted soon after admission can accurately identify older people who fall while staying in an acute hospital. Eighty-eight non-bedfast patients aged 80-99 years took part in the study. Within 3 days of admission, these patients were assessed for the following measures: impaired orientation on the MMSE, psychoactive medication use, evidence of stroke, and impaired ability on the Get-Up-and-Go-test. The major presenting condition for each patient was also recorded. Patients were then followed up to determine whether they fell while in hospital. Impaired orientation on the MMSE, evidence of previous cerebrovascular accident, and major presenting conditions of falls and confusion were significantly associated with falls while in hospital. There was also a trend indicating that psychoactive medication use was elevated in the fallers. In contrast, there was no difference in the proportion of fallers and non-fallers who had impaired ability in the Get-Up-and-Go-test. Of the 15 patients who fell, 13 had two or more risk factors, and after controlling for possible confounding factors of age, sex and length of stay, the presence of two-plus risk factors remained strongly and significantly associated with falls (adjusted OR = 13.43; 95% CI = 1.91 - 94.40). The findings indicate that a simple screening protocol can accurately identify patients at risk of falling while in hospital.

  11. 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.

  12. [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.

  13. 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 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.

  14. Evaluation of Accelerometer-Based Fall Detection Algorithms on Real-World Falls

    NARCIS (Netherlands)

    Bagala, Fabio; Becker, Clemens; Cappello, Angelo; Chiari, Lorenzo; Aminian, Kamiar; Hausdorff, Jeffrey M.; Zijlstra, Wiebren; Klenk, Jochen

    2012-01-01

    Despite extensive preventive efforts, falls continue to be a major source of morbidity and mortality among elders. Real-time detection of falls and their urgent communication to a telecare center may enable rapid medical assistance, thus increasing the sense of security of the elderly and reducing

  15. 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

  16. Case study on possible falling patterns of a fatal fall from stairs.

    Science.gov (United States)

    Nagata, Hisao

    2014-01-01

    Considering a fatal case of an aged individual, who died due to falling down stairs, the cause of the fatal fall was investigated through experiments. A witness, who was with the victim, when the fatal accident occurred, stated that the aged individual had miss-footed, lost balance at the top of the stairs, and fell accidently from an upper floor to a lower floor. It was very questionable whether or not this witness's statements were true. The true cause of the fatal fall was unclear, because of the witness's inconsistent statements, which showed discrepancies between the initial and later statements. The cause of a fatal fall can be presumed from external and internal damages to the body and other circumstantial evidences. But it was difficult to prove the true cause of a fatal fall only from the results of the autopsy and investigation of circumstantial evidences. The author was officially requested to conduct experiments to elucidate possible falling patterns. Judging from the experimental results, deep questions about the witness's statements arose. These experimental methods and analyses in this paper could be applied to elucidate possible falling patterns of fatal falls from stairs where the fatal causes are controversial.

  17. 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....

  18. [Functional impairment, fear of falling and body composition in institutionalized elderly].

    Science.gov (United States)

    São Romão Preto, Leonel; Nogueiro Santos, Ana Luisa; Mendes, Maria Eugénia; Pinto Novo, André; Pimentel, Maria Helena

    2015-01-01

    To analyze changes in the aging process of institutionalized elderly over a 24 months period, including physical condition, fear of falling, and body composition. A longitudinal, analytic and prospective study was implemented in 3 residential care homes for seniors. Data were collected using a socio-demographic and clinical questionnaire, the Rikli and Jones Senior Fitness Test, handgrip dynamometry and bioelectric impedance. The Portuguese version of the Falls Efficacy Scale was used for measure fear of falling. Fifty-one institutionalized elderly (82.5 ± 7.4 years) were included. In the 24 months analysis period, functional decline was observed (P<.05) in tests: sit to stand, harm curl, sit and reach and Up and Go. In average falls occurred 1.7 times. Were observed a decrease of self-efficacy to prevent falling, and falls prevalence was 42.1%. Results suggest a functional decrease, mainly in variables related with strength and muscular control of arms and legs, agility/dynamic balance and flexibility. Data don't highlight significant changes in body composition, however, tend to a muscle mass and bone mineral mass reduction. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  19. 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 < 0.01). HIT and FROP scores demonstrated similar sensitivity (80 vs 82%) and specificity (32 vs 36%) for detecting hospital 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.

  20. Falls study: Proprioception, postural stability, and slips.

    Science.gov (United States)

    Sohn, Jeehoon; Kim, Sukwon

    2015-01-01

    The present study evaluated effects of exercise training on the proprioception sensitivity, postural stability, and the likelihood of slip-induced falls. Eighteen older adults (6 in balance, 6 in weight, and 6 in control groups) participated in this study. Three groups met three times per week over the course of eight weeks. Ankle and knee proprioception sensitivities and postural stability were measured. Slip-induced events were introduced for all participants before and after training. The results indicated that, overall, strength and postural stability were improved only in the training group, although proprioception sensitivity was improved in all groups. Training for older adults resulted in decreased likelihood of slip-induced falls. The study suggested that proprioception can be improved by simply being active, however, the results suggested that training would aid older adults in reducing the likelihood of slip-induced falls.

  1. 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.

  2. Electrostatic demonstration of free-fall weightlessness

    Science.gov (United States)

    Balukovic, Jasmina; Slisko, Josip; Corona Cruz, Adrian

    2015-05-01

    The phenomena of free-fall weightlessness have been demonstrated to students for many years in a number of different ways. The essential basis of all these demonstrations is the fact that in free-falling, gravitationally accelerated systems, the weight force and weight-related forces (for example, friction and hydrostatic forces) disappear. In this article, an original electrostatic demonstration of weightlessness is presented. A charged balloon fixed at the opening of a plastic container cannot lift a light styrofoam sphere sitting on the bottom when the container is at rest. However, while the system is in free-fall, the sphere becomes weightless and the charged balloon is able to lift it electrostatically.

  3. Nocturia Is Associated with Slipping and Falling.

    Directory of Open Access Journals (Sweden)

    So Young Kim

    Full Text Available Several reports have demonstrated associations between falls and nocturia in the elderly. However, little information is available regarding other age groups. This study evaluated the relationship between the frequency of nocturia and falls in men using a large, population-based survey in Korea, and the results were adjusted for various confounding factors. Data from a 2011 Korean community health survey (KCHS were retrieved for 92,660 men aged 19 to 103 years. Information regarding the history of slips or falls in the past year was collected. The frequency of nocturia was classified as 0, 1, 2, 3, 4, and ≥ 5 instances a night. Walking during the day, education, income, body mass index (BMI, smoking, alcohol consumption, sleep time, stress level and medical histories of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, angina or myocardial infarction, arthritis, and osteoporosis were adjusted using multiple logistic regression analysis with complex sampling. A subgroup analysis was conducted for young (19-30 years, middle-aged (31-60 years, and elderly individuals (61+ years. Approximately 14.6% of the men had a history of falls. Their mean age was 42.9 years, which was significantly higher than that of the non-faller group (P < 0.001. An increased frequency of nocturia was associated with increased adjusted odds ratio (AOR for falls (AOR for 1 instance of nocturia/night = 1.41 [95% confidence interval, 1.33-1.50]; AOR for 2 instances = 1.41 [1.33-1.50]; AOR for 3 instances = 2.00 [1.75-2.28]; AOR for 4 instances = 2.12 [1.73-2.61]; AOR for ≥ 5 instances = 2.02 [1.74-2.36], P < 0.001. In the subgroup analysis, the AORs for falls significantly increased in all age groups as the frequency of nocturia increased.

  4. Maxillofacial Trauma Following Road Accidents and Falls.

    Science.gov (United States)

    Einy, Shmuel; Abdel Rahman, Nura; Siman-Tov, Maya; Aizenbud, Dror; Peleg, Kobi

    2016-06-01

    Motor vehicle accidents (MVA) and falls are major causes of maxillofacial injuries posing real challenges for the medical staff. To describe the demographic and injury characteristics, as well as the treatment procedures of casualties diagnosed with maxillofacial injuries. The investigators implemented a multicenter retrospective study composed of hospitalized maxillofacial trauma patients recorded in the Israel Trauma Registry for 2000 to 2011. The predictor variable was mechanism of injury and the outcome variable was type of injury, severity, and hospital resources utilization. Descriptive and bivariate statistics with P values was set at 0.05. The study included 11,592 reported hospitalized maxillofacial trauma patients (39.4% of them were MVA, 33.5% were falls), with a male predominance of a 3:1 ratio. The high-risk age groups were the first 3 decades of life in both etiologies, while age groups above 75 years were also frequent in falls. Severity of maxillofacial injuries, multiple injuries, admission to intensive care units, hospitalization for more than 15 days, inpatient mortality, and rehabilitation after discharge was significantly higher in MVA compared with falls. Conversely, maxillofacial surgeries were performed slightly more among patients injured in falls (34.1% and 31.1% respectively), as tongue and mouth are more prone targets in falls, compared with zygoma, maxilla, mandible, and teeth in MVA. The results of this study suggest that the etiologies present an entire separate pattern of trauma. A better understanding and proper identification of their high-risk groups should lead to appropriate prevention programs and treatment protocols.

  5. pso.ATION AND ANTIMICROBIAL SUSCEPTIBILITY

    African Journals Online (AJOL)

    isolates vere made using standard methods, Antibiotic susceptibility tests against commonly prescribed ... Acute otitis media is rapid with short .... sensitivity tests. Antimicrobial susceptibility tests: The antimicrobial susceptibility patterns of major Gram positive and negative bacterial isolates obtained from clinical specimens.

  6. A failed model-based attempt to implement an evidence-based nursing guideline for fall prevention.

    Science.gov (United States)

    Semin-Goossens, Astrid; van der Helm, Jelle M J; Bossuyt, Patrick M M

    2003-01-01

    An evidence-based nursing guideline had been locally developed in 1993 to reduce fall incidence rates, creating a 30% reduction. Implementation had failed though. Between 1999 and 2001 the guideline was updated. A multifaceted intervention was chosen based on a model for implementing change. The study was performed in 2 wards. All recommendations of Grol's 5-step implementation model were followed. The aim was a reduction of 30% in fall incidence within a year. Data on falls were extracted from nursing records and Incidence Report Forms (IRFs). In a pilot study an average of 9 falls per 1000 patients per day had been recorded in the department of internal medicine and 16 in the neurology ward. Given the desired reduction of 30%, the target averages were 6 and 11 falls respectively. During the intervention year the average incidences were 8 and 13 falls (95% CI: 6-11 and 10-15). There was a changeable pattern over time without any declining trend. The percentage filled in IRFs varied strongly, with an average of 52% in the department of internal medicine and 60% in the neurology department. There has been no durable decrease in monthly falls despite the use of a model-based procedure for implementing change. Neither did we observe any improvement in filling in IRFs. It can be questioned if the nurses themselves did experience patient falls to be troublesome enough. Investigating this is difficult though. Although the most successful strategy still appears to be changing attitudes of nurses in order to increase fall prevention, there is no clear strategy on how to create this successfully.

  7. Vitamin D supplementation and falls: a trial sequential meta-analysis.

    Science.gov (United States)

    Bolland, Mark J; Grey, Andrew; Gamble, Greg D; Reid, Ian R

    2014-07-01

    Vitamin D supplementation is often recommended to prevent falls, although vitamin D trials and meta-analyses of these trials have reported conflicting results for this outcome. We aimed to assess if there was a need for further research. We explored the value of doing further randomised controlled trials assessing the effects of vitamin D supplements on falls with trial sequential analysis with a risk reduction threshold of 15%. All analyses were done using the numbers of participants who had a fall in intention-to-treat analyses. Trial sequential analysis performs a cumulative meta-analysis, but reduces the risk of false-positive results from repetitive statistical testing by maintaining the overall risk of type 1 error at 5%. In 20 existing randomised controlled trials (n=29,535), the effect estimate for vitamin D with or without calcium on falls lay within the futility boundary, providing evidence that vitamin D supplementation does not alter the relative risk by 15% or more. In a sensitivity analysis using a risk reduction threshold of 10%, the effect estimate also lay within the futility boundary. In subgroup analyses using a risk reduction threshold of 15%, the effect estimate also lay within the futility boundary for trials of vitamin D supplementation (16 trials, n=22,291) and trials of vitamin D with calcium (six trials, n=9919). In pooled analyses, supplementation with vitamin D, with or without calcium, does not reduce falls by 15% or more. Future trials with similar designs are unlikely to alter these conclusions. At present, there is little justification for prescribing vitamin D supplements to prevent falls. Health Research Council of New Zealand. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Planet Earth week featured at Fall Meeting

    Science.gov (United States)

    The Fall Meeting has been dubbed “Planet Earth Week,” in part to salute the upcoming 7-week PBS television series and university course that will be previewed at the meeting. At least four of the seven 1-hour segments of “Planet Earth” will be shown daily at the the Fall Meeting. AGU provided some of the seed money for the new series, which will have its television premiere on Wednesday, January 22, 1986, on PBS at 9 P.M. EST.

  9. Retrospective analysis of free-fall fractures with regard to height and cause of fall.

    Science.gov (United States)

    Petaros, Anja; Slaus, Mario; Coklo, Miran; Sosa, Ivan; Cengija, Morana; Bosnar, Alan

    2013-03-10

    Free-fall fractures represent a specific form of blunt force trauma that can be hard to interpret because of the numerous factors that affect it. The aim of this study is to focus on skeletal injury patterns resulting from free-falls and to analyse the relationship between specific skeletal fractures, and the height and cause (accidental vs. suicidal) of the fall. A total of 179 autopsy reports of fatal free-falls from known heights were analysed at the Department of Forensic Medicine and Criminalistics, in Rijeka, Croatia. The location, type and frequency of fractures, as well as the number and distribution of fractured regions were analysed with regard to height and cause of fall. Height was found to be the major factor influencing fracture patterns in free-falls. In our sample, the frequencies of thoracic fractures, fractures to the extremities and those to the pelvis increased with height. Head fractures show no such relationship. However, types of fractures recorded in different anatomical regions, including the cranium, differ between height groups suggesting different injury mechanisms in each. Victims of falls generally sustained fractures in more than one body region, and the number of injured regions correlates significantly with height. Although no statistical difference was found in the number of fractured regions or frequency of fractures between accidental fallers and suicidal jumpers, jumpers showed a significantly higher number of bilateral extremity fractures when compared to victims of accidental falls. Logistic regression analyses also demonstrate a significant relationship between lower extremity fractures, and the cause of the fall. Our results highlight the need for further investigations of the influence that behaviour and height have in free-fall fractures. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Nitrate reduction

    Science.gov (United States)

    Dziewinski, Jacek J.; Marczak, Stanislaw

    2000-01-01

    Nitrates are reduced to nitrogen gas by contacting the nitrates with a metal to reduce the nitrates to nitrites which are then contacted with an amide to produce nitrogen and carbon dioxide or acid anions which can be released to the atmosphere. Minor amounts of metal catalysts can be useful in the reduction of the nitrates to nitrites. Metal salts which are formed can be treated electrochemically to recover the metals.

  11. Hypnotic susceptibility and dream characteristics.

    Science.gov (United States)

    Zamore, N; Barrett, D

    1989-11-01

    This study examined the relationship of hypnotic susceptibility to a variety of dream characteristics and types of dream content. A Dream Questionnaire was constructed synthesizing Gibson's dream inventory and Hilgard's theoretical conceptions of hypnosis. Employing the Harvard Group Scale of Hypnotic Susceptibility and the Field Inventory for evaluating hypnotic response, several dream dimensions correlated significantly with hypnotizability. For subjects as a whole, the strongest correlates were the frequency of dreams which they believed to be precognitive and out-of-body dreams. Ability to dream on a chosen topic also correlated significantly with hypnotic susceptibility for both genders. For females only, there was a negative correlation of hypnotic susceptibility to flying dreams. Absorption correlated positively with dream recall, ability to dream on a chosen topic, reports of conflict resolution in dreams, creative ideas occurring in dreams, amount of color in dreams, pleasantness of dreams, bizarreness of dreams, flying dreams and precognitive dreams.

  12. 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

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

    Science.gov (United States)

    ... and Falls Osteoporosis and Falls(繁體中文) Caídas y fracturas (Falls and Fractures) Partner Resources Falls and Fractures (NIA) Caídas y fracturas (NIA) Home Bone Basics Osteoporosis Osteogenesis Imperfecta Paget’s ...

  14. 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.

  15. The 2015 AAAI Fall Symposium Series Reports

    NARCIS (Netherlands)

    Ahmed, N.; Bello, P.; Bringsjord, S.; Clark, M.; Hayes, B.; Kolobov, A.; Miller, C.; Oliehoek, F.; Stein, F.; Spaan, M.

    2016-01-01

    The Association for the Advancement of Artificial Intelligence presented the 2015 Fall Symposium Series, on Thursday through Saturday, November 12-14, at the Westin Arlington Gateway in Arlington, Virginia. The titles of the six symposia were as follows: AI for Human-Robot Interaction, Cognitive

  16. NOVA[R] Fall 2001 Teacher's Guide.

    Science.gov (United States)

    WGBH-TV, Boston, MA.

    This teacher guide includes activity information for the program NOVA, Fall 2001. Background for each activity is provided along with its correlation to the national science standards. Activities include: (1) "Search for a Safe Cigarette"; (2) "18 Ways To Make a Baby"; (3) "Secrets of Mind"; (4) "Neanderthals on…

  17. Artists Paint ... Fall: Grades K-1

    Science.gov (United States)

    Herberholz, Barbara

    2012-01-01

    Artists often paint the different seasonal activities people engage in and the way the world looks as changes take place. The weather for each of the four seasons is different. Farmers plant crops and gardens in the spring and harvest their crops in the fall, just like "The Harvesters" by Pieter Bruegel the Elder. To begin, children will observe…

  18. 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

  19. 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

  20. 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.

  1. How to catch a falling fruit

    Science.gov (United States)

    Marantan, Andrew; Mahadevan, Lakshminarayanan

    2015-03-01

    A variety of fish engage in complex hunting behaviors involving catching airborne prey falling to the surface of the water. In principle this requires that the fish develop internal models describing both the falling prey and its own motion relative to that prey. However learning such models is complicated by the fact that the fish must also account for noise in optical measurements and the refraction occurring at the air/water interface. Inspired by experimental observations, we describe how one such species (Brycon guatemalensis) might feasibly overcome these obstacles and learn a model accurate enough to catch falling fruit. Instead of learning a model for how the fruit falls and a model for how it moves in the water and a model accounting for refraction, we argue that the fish could instead learn one approximate linear model relating a set of measured inputs to a set of measured outputs valid in a limited domain of initial conditions. The fish could then make its control decisions based on the outcome predicted by this combined linear model. We also discuss how the fish can leverage neural transformations of raw data to learn a model with a larger domain of validity and yet more sensitive to noise due to nontrivial Jacobians arising from the neural transformations.

  2. Engineering and Technician Enrollments--Fall 1969.

    Science.gov (United States)

    Engineers Joint Council, New York, NY. Engineering Manpower Commission.

    Engineering and technician enrollments for Fall 1969 are reported for associate and bachelor's degree programs in engineering technology and industrial technology, and for engineering degrees at the bachelor's, master's, and doctor's levels. Statistical tables were produced by a computer analysis of data from 269 engineering schools and 558 other…

  3. 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…

  4. 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.

  5. Bodies Falling with Air Resistance: Computer Simulation.

    Science.gov (United States)

    Vest, Floyd

    1982-01-01

    Two models are presented. The first assumes that air resistance is proportional to the velocity of the falling body. The second assumes that air resistance is proportional to the square of the velocity. A program written in BASIC that simulates the second model is presented. (MP)

  6. PREDICTIVE VALUE OF THE MORSE FALL SCALE

    Directory of Open Access Journals (Sweden)

    Ivana Bóriková

    2017-03-01

    Full Text Available Aim: The goal of this study was to analyse relevant research studies focusing on the testing of the predictive value of the Morse Fall Scale measuring device on hospitalized patients. Design: Literature review. Method: Search for full text research studies in Web of Science, Scopus, ScienceDirect, and Summon Discovery Tool (licensed electronic information databases, based on pre-established criteria, and key words, from 1989 to 2016. Results: Sensitivity values ranged from 31% to 98%, and specificity values ranged from 8% to 97% in 14 analysed studies. The predictive value of the tool in validation studies varies depending on the tested cut-off value, the type of clinical ward, the frequency of assessment, the size and age of the sample, and the length of hospitalisation; therefore, the validity of the results from one study cannot by extrapolated to the entire hospitalized population of patients. Conclusion: The predictive values of the Morse Fall Scale are not stable; they vary in clinical conditions according to various factors. When implementing a tool for a specific clinical ward, an optimum cut-off score must be established to ensure that preventative strategies do not require unnecessary effort on the part of the staff, and do not increase hospital costs. Keywords: falls, hospital, Morse Fall Scale, sensitivity, specificity, review.

  7. AAAI 1991 Fall Symposium Series Reports

    OpenAIRE

    AAAI,

    1992-01-01

    The Association for the Advancement of Artificial Intelligence held its 1991 Fall Symposium Series on November 15-17 at the Asilomar Conference Center, Pacific Grove, California. This article contains summaries of the four symposia: Discourse Structure in Natural Language Understanding and Generation, Knowledge and Action at Social and Organizational Levels, Principles of Hybrid Reasoning, Sensory Aspects of Robotic Intelligence.

  8. Falls, old age and mental illness

    Directory of Open Access Journals (Sweden)

    Gorete Reis

    2015-12-01

    Full Text Available Objective Falls in older people living in the community are an important health problem particularly when in cases of hospitalization. Having a multifactorial etiology, its severity and costs requires preventive intervention. The impact on functionality and quality of life and high socioeconomic costs, are recognized. Aims: to identify the prevalence of falls in older people and characterize clinically, functionally and socially the elderly involved in an episode of urgency in a psychiatric hospital. Methods: this was a quantitative, correlational cross-sectional study. We studied the prevalence of falls and associated factors. The sample consisted of 99 elderly people involved in an episode of urgency in the biennium 2012/2013 including a psychiatric hospital in the north of Portugal. Results: suggest a prevalence of 38% of falls in an aging population. The mental disorder and addiction factors are highlighted. Conclusions: A complex interaction between multiple personal, social and environmental factors in the etiology of decline suggests the importance of prevention and monitoring programs of the risk associated with it.

  9. Gait and cognitive impairments in multiple sclerosis: the specific contribution of falls and fear of falling.

    Science.gov (United States)

    Kalron, Alon; Allali, Gilles

    2017-11-01

    Our goal was to identify the specific contribution of fear of falling (FoF) and falls with quantitative gait impairments and cognition capabilities in multiple sclerosis (MS) patients. Patients were separated into four individual subgroups as to the presence of FoF and falls (i.e., fearless/non-fallers, fearless/fallers, FoF/non-fallers and FoF/fallers). The Falls Efficacy Scale International questionnaire was used to assess the level of concern of falling. Participants were defined as "fallers" and "non-fallers" based on their fall history. Spatio-temporal parameters of gait were analyzed using an electronic mat. Cognitive performance was assessed by a computerized cognitive battery of tests. The study included 540 MS patients, 47% were defined as fallers and 61.9% reported a FoF. Non-significant differences were found between the fearless/non-fallers and fearless/fallers in all clinical, gait and cognitive scores. FoF/non-fallers walked significantly slower compared to fearless MS individuals who had previously fallen. Furthermore, the same patient group exhibited a poorer performance in the motor skills cognitive subdomain. A significant reverse relationship was found between FoF and cognitive motor skills in the fallers and non-fallers groups. FoF characterizes a more disabling symptom than falling in the MS population.

  10. Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury?

    Directory of Open Access Journals (Sweden)

    Fabio Roccia

    2014-12-01

    Full Text Available Objectives: In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall. Material and Methods: Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF, loss of consciousness (LOCF, stairs (SAF, and height (HF. Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS, facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed. Results: This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]. In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5% followed by LOCF (157; 28.2%, HF (55; 9.9%, and SAF (30; 5.4%. The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF. Conclusions: This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.

  11. 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

  12. Clinical Outcomes and History of Fall in Patients with Atrial Fibrillation Treated with Oral Anticoagulation: Insights From the ARISTOTLE Trial.

    Science.gov (United States)

    Rao, Meena P; Vinereanu, Dragos; Wojdyla, Daniel M; Alexander, John H; Atar, Dan; Hylek, Elaine M; Hanna, Michael; Wallentin, Lars; Lopes, Renato D; Gersh, Bernard J; Granger, Christopher B

    2017-11-06

    We assessed outcomes among anticoagulated patients with atrial fibrillation and a history of falling, and whether the benefits of apixaban vs warfarin are consistent in this population. Of the 18,201 patients in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) study, 16,491 had information about history of falling-753 with history of falling and 15,738 without history of falling. The primary efficacy outcome was stroke or systemic embolism; the primary safety outcome was major bleeding. When compared with patients without a history of falling, patients with a history of falling were older, more likely to be female and to have dementia, cerebrovascular disease, depression, diabetes, heart failure, osteoporosis, fractures, and higher CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or TIA or thromboembolism, Vascular disease, Age 65-74 years, Sex category female) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile international normalized ratio, Elderly, Drugs or alcohol) scores. Patients with a history of falling had higher rates of major bleeding (adjusted hazard ratio [HR] 1.39; 95% confidence interval [CI], 1.05-1.84; P = .020), including intracranial bleeding (adjusted HR 1.87; 95% CI, 1.02-3.43; P = .044) and death (adjusted HR 1.70; 95% CI, 1.36-2.14; P history of falling. Among those with a history of falling, subdural bleeding occurred in 5 of 367 patients treated with warfarin and 0 of 386 treated with apixaban. Patients with atrial fibrillation and a history of falling receiving anticoagulation have a higher risk of major bleeding, including intracranial, and death. The efficacy and safety of apixaban compared with warfarin were consistent, irrespective of history of falling. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 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.

  14. 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

  15. Hyperglycemia Increases Susceptibility to Ischemic Necrosis

    Directory of Open Access Journals (Sweden)

    D. Lévigne

    2013-01-01

    Full Text Available Diabetic patients are at risk for spontaneous foot ulcers, chronic wounds, infections, and tissue necrosis. Current theories suggest that the development and progression of diabetic foot ulcers are mainly caused by arteriosclerosis and peripheral neuropathy. Tissue necrosis plays a primordial role in the progression of diabetic foot ulcers but the underlying mechanisms are poorly understood. The aim of the present study was to investigate the effects of hyperglycemia per se on the susceptibility of ischemic tissue to necrosis, using a critical ischemic hind limb animal model. We inflicted the same degree of ischemia in both euglycemic and streptozotocin-induced hyperglycemic rats by resecting the external iliac, the femoral, and the saphenous arteries. Postoperative laser Doppler flowmetry of the ischemic feet showed the same degree of reduction in skin perfusion in both hyperglycemic and euglycemic animals. Nevertheless, we found a significantly higher rate of limb necrosis in hyperglycemic rats compared to euglycemic rats (71% versus 29%, resp.. In this study, we revealed that hyperglycemia per se increases the susceptibility to limb necrosis in ischemic conditions. Our results may help to better understand the physiopathology of progressive diabetic wounds and underline the importance of strict glycemic control in patients with critical limb ischemia.

  16. 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.

  17. 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

    2017-12-12

    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.

  18. Monitoring Emperor Goose Populations by Aerial Counts and the Fall Age Ratio - Fall 2003

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — In 2003, we photographed flocks of emperor geese (Chen canagica) during fall migration at lagoons along the north side of the Alaska Peninsula for the 19th...

  19. 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

  20. Enhancing the safety of hospitalization by reducing patient falls.

    Science.gov (United States)

    Morse, Janice M

    2002-10-01

    The iatrogenic nature of hospitalization places patients at risk of falling, injury, and death. In this article, the major principles of providing protective and preventive interventions are outlined. The principles are the establishment of a multifaceted fall prevention program that targets fall interventions according to each etiologic factor; the recognition that fall protective and prevention interventions are distinct and serve a different function; the use of the fall monitoring system comprehensively; the creation of a clinical nurse specialist position, responsible for fall intervention; and a conscious and individualized approach to fall prevention. The process and problems of the varying nature of providing fall protection and fall prevention are discussed; for example, use of a side rail as a protective strategy may be successful with one patient but considered a hazard when used with a different patient.

  1. Rich Reduction

    DEFF Research Database (Denmark)

    Niebuhr, Oliver

    2016-01-01

    Managing and, ideally, explaining phonetic variation has ever since been a key issue in the speech sciences. In this context, the major contribution of Lindblom's H&H theory was to replace the futile search for invariance by an explainable variance based on the tug-of-war metaphor. Recent empirical...... evidence on articulatory prosodies and the involvement of reduction in conveying communication functions both suggest the next steps along the line of argument opened up by Lindblom. Specifically, we need to supplement Lindblom's explanatory framework and revise the speaker-listener conflict that lies...... at the heart of the tug-of-war metaphor. The author's suggestion would be to "offshore" the tug-of-war metaphor and replace it by the ocean metaphor of Bolinger (1964), with the ups and downs at the surface of the ocean representing the speaker's variation along the hypo-hyper scale and wavelength...

  2. An evaluation of fall speed characteristics in bin and bulk microphysical schemes and use of bin fall speeds to improve forecasts of warm-season rainfall

    Science.gov (United States)

    Aligo, Eric A.

    2011-12-01

    evaluated. First, various tests were performed with various microphysical schemes and cases in order to find the vertical grid configuration that provides the best rainfall forecast. Rainfall forecasts worsened when the number of vertical levels was doubled from a control configuration of 31 levels and an over prediction of rainfall occurred. The largest improvement in skill occurred when the levels above the melting level were doubled and this was attributed to better resolved cold-cloud microphysical processes. As such, simulations using the probability matching technique employed the vertical configuration with refined vertical grid resolution above the melting layer. The different convective morphologies responded similarly when the fall speed modifications were made with all systems simulating a narrower stratiform region, less stratiform rainfall and a larger anvil. Rainfall forecasts generally improved with the use of the probability matching technique with improvements in the lightest and heaviest rainfall. The reduced stratiform rainfall occurred as a result of slower falling snow and a reduction in downward fluxes of snow, while forecasts of convective rainfall intensity improved as a result of faster falling graupel. Sensitivity tests were performed by computing bulk-like fall speeds in the bin scheme, which resulted in a modification of the particle size distribution of snow, which led to faster falling snow, larger downward fluxes of snow and a larger stratiform rain region.

  3. Circumstances and consequences of falls in polio survivors.

    Science.gov (United States)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-11-01

    Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. A survey was conducted among 376 polio survivors. Participants completed a falls history questionnaire and additional information was obtained from their medical files. Of the 305 respondents, 74% reported at least one fall in the past year and 60% two or more. Sixteen percent of fallers described a major injury after a fall in the last year and 69% reported fear of falling. One-third of fallers had reduced the amount they walked because of their fear of falling. Most reported falls in a familiar environment (86%), during ambulation (72%) and in the afternoon (50%). Quadriceps weakness of the weakest leg (Medical Research Council (MRC) ≤ 3), fear of falling and complaints of problems maintaining balance were independently associated with both falls and recurrent falls, while increasing age and medication use were not. The high rate of falls and consequences thereof, merit the implementation of fall intervention strategies. To maximize effect, they should be tailor-made and target the fall mechanisms specific to polio survivors.

  4. A Wavelet-Based Approach to Fall Detection

    Directory of Open Access Journals (Sweden)

    Luca Palmerini

    2015-05-01

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

  5. Survey on Fall Detection and Fall Prevention Using Wearable and External Sensors

    Directory of Open Access Journals (Sweden)

    Yueng Santiago Delahoz

    2014-10-01

    Full Text Available According to nihseniorhealth.gov (a website for older adults, falling represents a great threat as people get older, and providing mechanisms to detect and prevent falls is critical to improve people’s lives. Over 1.6 million U.S. adults are treated for fall-related injuries in emergency rooms every year suffering fractures, loss of independence, and even death. It is clear then, that this problem must be addressed in a prompt manner, and the use of pervasive computing plays a key role to achieve this. Fall detection (FD and fall prevention (FP are research areas that have been active for over a decade, and they both strive for improving people’s lives through the use of pervasive computing. This paper surveys the state of the art in FD and FP systems, including qualitative comparisons among various studies. It aims to serve as a point of reference for future research on the mentioned systems. A general description of FD and FP systems is provided, including the different types of sensors used in both approaches. Challenges and current solutions are presented and described in great detail. A 3-level taxonomy associated with the risk factors of a fall is proposed. Finally, cutting edge FD and FP systems are thoroughly reviewed and qualitatively compared, in terms of design issues and other parameters.

  6. Combining ability in maize for fall armyworm and southwestern corn borer resistance based on a laboratory bioassay for larval growth.

    Science.gov (United States)

    Williams, W P; Buckley, P M; Davis, F M

    1995-02-01

    The fall armyworm, Spodoptera frugiperda (J. E. Smith), and southwestern corn borer, Diatraea grandiosella Dyar, are major insect pests of maize, Zea mays L., in the southern USA. Both insects feed extensively on leaves of plants in the whorl stage of growth. A diallel cross of seven inbred lines with different levels of susceptibility to leaf feeding damage in the field was evaluated in a laboratory bioassay for fall armyworm and southwestern corn borer larval growth. Diets were prepared from lyophilized leaf tissue of field-grown plants of the inbred lines and their 21 F1 hybrids. One inbred line, Tx601, exhibited heavy leaf damage in field tests but showed moderate resistance in the laboratory bioassay. Both general and specific combining ability were highly significant sources of variation in the inheritance of fall armyworm and south-western corn borer larval growth in the laboratory bioassay. Tx601 showed excellent general combining ability for reduced larval growth of both species.

  7. Inherited susceptibility and radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Little, J.B. [Harvard School of Public Health, Boston, MA (United States)

    1997-03-01

    There is continuing concern that some people in the general population may have genetic makeups that place them at particularly high risk for radiation-induced cancer. The existence of such a susceptible subpopulation would have obvious implications for the estimation of risks of radiation exposure. Although it has been long known that familial aggregations of cancer do sometimes occur, recent evidence suggests that a general genetic predisposition to cancer does not exist; most cancers occur sporadically. On the other hand, nearly 10% of the known Mendelian genetic disorders are associated with cancer. A number of these involve a familial predisposition to cancer, and some are characterized by an enhanced susceptibility to the induction of cancer by various physical and chemical carcinogens, including ionizing radiation. Such increased susceptibility will depend on several factors including the frequency of the susceptibility gene in the population and its penetrance, the strength of the predisposition, and the degree to which the cancer incidence in susceptible individuals may be increased by the carcinogen. It is now known that these cancer-predisposing genes may be responsible not only for rare familial cancer syndromes, but also for a proportion of the common cancers. Although the currently known disorders can account for only a small fraction of all cancers, they serve as models for genetic predisposition to carcinogen-induced cancer in the general population. In the present report, the author describes current knowledge of those specific disorders that are associated with an enhanced predisposition to radiation-induced cancer, and discusses how this knowledge may bear on the susceptibility to radiation-induced cancer in the general population and estimates of the risk of radiation exposure.

  8. Heart rate and heart rate variability assessment identifies individual differences in fear response magnitudes to earthquake, free fall, and air puff in mice.

    Directory of Open Access Journals (Sweden)

    Jun Liu

    Full Text Available Fear behaviors and fear memories in rodents have been traditionally assessed by the amount of freezing upon the presentation of conditioned cues or unconditioned stimuli. However, many experiences, such as encountering earthquakes or accidental fall from tree branches, may produce long-lasting fear memories but are behaviorally difficult to measure using freezing parameters. Here, we have examined changes in heartbeat interval dynamics as physiological readout for assessing fearful reactions as mice were subjected to sudden air puff, free-fall drop inside a small elevator, and a laboratory-version earthquake. We showed that these fearful events rapidly increased heart rate (HR with simultaneous reduction of heart rate variability (HRV. Cardiac changes can be further analyzed in details by measuring three distinct phases: namely, the rapid rising phase in HR, the maximum plateau phase during which HRV is greatly decreased, and the recovery phase during which HR gradually recovers to baseline values. We showed that durations of the maximum plateau phase and HR recovery speed were quite sensitive to habituation over repeated trials. Moreover, we have developed the fear resistance index based on specific cardiac response features. We demonstrated that the fear resistance index remained largely consistent across distinct fearful events in a given animal, thereby enabling us to compare and rank individual mouse's fear responsiveness among the group. Therefore, the fear resistance index described here can represent a useful parameter for measuring personality traits or individual differences in stress-susceptibility in both wild-type mice and post-traumatic stress disorder (PTSD models.

  9. Fall Meeting abstract submission inspires science poetry

    Science.gov (United States)

    Balcerak, Ernie

    2011-08-01

    When the 4 August deadline for submitting Fall Meeting abstracts passed, AGU had received more than 20,000 abstracts, a record-breaking number. The submission process had an unexpected by-product: It inspired some scientists to write haiku on Twitter. (Haiku is a form of Japanese poetry typically having three lines, the first with five syllables, the second with seven, and the third with five.) The following are examples of the haiku tweets, with the hashtag #AGU11AbstractHaiku. (For those who want to keep updated about the Fall Meeting on Twitter, the hashtag is #AGU11.) For more information about the meeting, including registration and housing, visit http://sites.agu.org/fallmeeting/.

  10. pitting corrosion susceptibility pitting corrosion susceptibility of aisi ...

    African Journals Online (AJOL)

    eobe

    Abstract. The susceptibility of austenitic (AISI 301) stainless steel to pitting corrosion was evaluated in sodium chloride. (NaCl) solutions ... AISI 301 steel suffers from pitting corrosion in all the investigated solutions. AISI 301 steel suffers from ..... [1] Ijeomah, M.N.C. Elements of Corrosion and Protection. Theory, Auto Century ...

  11. 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

  12. Magnetic Susceptability Measurements in Superconductors

    Science.gov (United States)

    Kim, Jason; Mallory, Kendall; Seim, Ryan

    2000-04-01

    A new undergraduate research facility in magnetic susceptability measurements on superconductors is being developed at the University of Northern Colorado. Initial data measurements of the magnetic susceptability of various superconductors will be presented. These measurements were obtained with a liquid helium/nitrogen dewar that was reassembled for use in this project. The cryostat consists of two separate dewars, the first of which contains liquid nitrogen, the second, liquid helium. The liquid nitrogen dewar is used to keep the helium bath from evaporating off too quickly. Data on the evaporation rates of the two liquids will also be presented.

  13. 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.

  14. [Severe dyspnoea in children following a fall].

    Science.gov (United States)

    Zuurmond-Tromp, Karen A; Klinkenberg, Theo J; Dikkers, Freek G; Koppelman, Gerard H; de Weerd, Willemien

    2009-01-01

    A 12-year-old boy fell off his bicycle, hitting his neck on the handle-bars. He sustained a tracheal rupture, which required surgical treatment. Two other patients, a 4-year-old and a 2-year-old boy, also suffered laryngeal injuries following a fall. Both were treated conservatively, the 2-year-old boy needed endotracheal intubation and mechanical ventilation. Blunt neck trauma can cause life-threatening complications, which are difficult to diagnose.

  15. 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.

  16. Youth Attitude Tracking Study II, Fall 1983.

    Science.gov (United States)

    1983-01-01

    considered along with civilian employment. The notion expressed in - econometric research is that when youth unemployment in the civilian sector is high...young people will find military Service relatively more attractive. Conversely, when youth unemployment is low, young people are more likely to . join...AD-Ri5@ 428 YOUTH ATTITUDE TRACKING STUDY II FALL 1983(U) RESEARCH 1/4 TRIANGLE INST RESEARCH TRIANGLE PARK NC M E MARSDEN 1983 DA98-83-C-8172

  17. Predicting channel bed topography in hydraulic falls

    Science.gov (United States)

    Tam, Alexander; Yu, Zheng; Kelso, Richard M.; Binder, Benjamin J.

    2015-11-01

    We consider inverse methods for predicting the channel bed topography in experiments of hydraulic falls. Nonlinear solutions and weakly nonlinear approximations from Euler-based models are compared to experimental observations. Accurate predictions are obtained for the maximum height of the topography and its constant horizontal level far downstream using the nonlinear method. The weakly nonlinear approximation is shown only to be a good predictor of the maximum height of the topography. The error in the inverse predictions is examined and discussed.

  18. Meteorite Falls and the Fragmentation of Meteorites

    Science.gov (United States)

    Momeni, Daniel

    2016-01-01

    In order to understand the fragmentation of objects entering the atmosphere and why some produce more fragments than others, I have searched the Meteoritical Society database for meteorites greater than 20 kilograms that fell in the USA, China, and India. I also studied the video and film records of 21 fireballs that produced meteorites. A spreadsheet was prepared that noted smell, fireball, explosion, whistling, rumbling, the number of fragments, light, and impact sounds. Falls with large numbers of fragments were examined to look for common traits. These were: the Norton County aubrite, explosion and a flare greater than 100 fragments; the Forest City H5 chondrite explosion, a flare, a dust trail, 505 specimens; the Richardton H5 chondrite explosion and light, 71 specimens; the Juancheng H5 chondrite explosion, a rumbling, a flare, a dust trail,1000 specimens; the Tagish Lake C2 chondrite explosion, flare, dust trail, 500 specimens. I conclude that fragmentation is governed by the following: (1) Bigger meteors undergo more stress which results in more specimens; (2) Harder meteorites also require more force to break them up which will cause greater fragmentation; (3) Force and pressure are directly proportional during falls. General observations made were; (1) Meteorites produce fireballs sooner due to high friction; (2) Meteors tend to explode as well because of high stress; (3) Softer meteorites tend to cause dust trails; (4) Some falls produce light as they fall at high velocity. I am grateful to NASA Ames for this opportunity and Derek Sears, Katie Bryson, and Dan Ostrowski for discussions.

  19. A dynamic evidential network for fall detection.

    Science.gov (United States)

    Aguilar, Paulo Armando Cavalcante; Boudy, Jerome; Istrate, Dan; Dorizzi, Bernadette; Mota, Joao Cesar Moura

    2014-07-01

    This study is part of the development of a remote home healthcare monitoring application designed to detect distress situations through several types of sensors. The multisensor fusion can provide more accurate and reliable information compared to information provided by each sensor separately. Furthermore, data from multiple heterogeneous sensors present in the remote home healthcare monitoring systems have different degrees of imperfection and trust. Among the multisensor fusion methods, Dempster-Shafer theory (DST) is currently considered the most appropriate for representing and processing the imperfect information. Based on a graphical representation of the DST called evidential networks, a structure of heterogeneous data fusion from multiple sensors for fall detection has been proposed. The evidential networks, implemented on our remote medical monitoring platform, are also proposed in this paper to maximize the performance of automatic fall detection and thus make the system more reliable. However, the presence of noise, the variability of recorded signals by the sensors, and the failing or unreliable sensors may thwart the evidential networks performance. In addition, the sensors signals nonstationary nature may degrade the experimental conditions. To compensate the nonstationary effect, the time evolution is considered by introducing the dynamic evidential network which was evaluated by the simulated fall scenarios corresponding to various use cases.

  20. 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.

  1. 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.

  2. 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.

  3. Free fall and the equivalence principle revisited

    Science.gov (United States)

    Pendrill, Ann-Marie

    2017-11-01

    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. In addition, Newton’s third law of action and reaction causes the Earth to accelerate towards the falling object, bringing in a mass dependence in the time required for an object to reach ground—in spite of the equivalence between inertial and gravitational mass. These aspects are rarely discussed in textbooks when the motion of everyday objects are discussed. Although these effects are extremely small, it may still be important for teachers to make assumptions and approximations explicit, to be aware of small corrections, and also to be prepared to estimate their size. Even if the corrections are not part of regular teaching, some students may reflect on them, and their questions deserve to be taken seriously.

  4. 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

    with preclinical mobility limitation had almost 4-fold (incidence rate ratios 3.77; 95% CI 1.02-13.92) and those with manifest mobility limitation almost 15-fold (14.66; 2.72-79.00) adjusted risk for future falls compared to those with no mobility limitation and no previous falls. Among women without fall history......We studied if self-reported preclinical mobility limitation, described as modification of task performance without perception of difficulty, predicts future falls in older women with and without fall history. Our results suggest that combined measure of self-reported preclinical mobility limitation...... and fall history may offer one possibility for inexpensive fall-risk evaluation in clinical practice. INTRODUCTION: We studied if self-reported preclinical mobility limitation predicts future falls in older women with and without fall history. METHODS: The study population consisted of 428 community...

  5. Prevalence of Medication-Related Risks for Falls and Osteoporosis at a Hospital Network: A Post-hoc Analysis

    Directory of Open Access Journals (Sweden)

    Iouri Banakh

    2016-04-01

    Full Text Available AIM: PRO-OSTEO Extend 1was an osteoporosis management study at a Victorian Healthcare service. This post-hoc analysis examined comorbidities and drug-related risks for falls and osteoporosis, and analysed the accuracy of the medication subcomponent of the falls risk assessment tool used at the service. The secondary aim of this analysis was to evaluate the impact of proton pump inhibitors on the success of anti-osteoporosis therapies. MATERIAL AND METHODS: This analysis was part of a two year retrospective cohort study. The falls risk assessment tool medication subsection results, completed by nursing staff, were compared to scores given by the data collection pharmacist based on medical history notes using Mann-Whitney U test. The impact of proton pump inhibitors use on active osteoporosis therapy in patients admitted after a fall was analysed using the Fisher Exact test. Prevalence of medical and medication-related risk factors for osteoporosis and falls was compared between patients with fractures without osteoporosis treatment at admission and patient who were excluded from the primary study due to active osteoporosis therapy, or admission after a fall without a fracture. RESULTS: The falls risk assessment tool completion rate was approximately 80%, with accuracy below 50% P < 0.001. Medications which increase osteoporosis and falls risk were prevalent, with high use of benzodiazepines, opioids, serotonin reuptake inhibitors antidepressants and proton pump inhibitors. The impact of proton pump inhibitors carried a 14% increased relative risk of a fracture in this cohort (P = 0.218. There was also high prevalence of pre-existing fractures, pulmonary disease, heart failure and strokes in the study population. CONCLUSION: Falls risk assessment in relation to medication use is frequently inaccurate and is not done at all for a significant proportion of patients. The use proton pump inhibitors and medication-related risks for falls and

  6. Exceptional Reductions

    CERN Document Server

    Marrani, Alessio; Riccioni, Fabio

    2011-01-01

    Starting from basic identities of the group E8, we perform progressive reductions, namely decompositions with respect to the maximal and symmetric embeddings of E7xSU(2) and then of E6xU(1). This procedure provides a systematic approach to the basic identities involving invariant primitive tensor structures of various irreprs. of finite-dimensional exceptional Lie groups. We derive novel identities for E7 and E6, highlighting the E8 origin of some well known ones. In order to elucidate the connections of this formalism to four-dimensional Maxwell-Einstein supergravity theories based on symmetric scalar manifolds (and related to irreducible Euclidean Jordan algebras, the unique exception being the triality-symmetric N = 2 stu model), we then derive a fundamental identity involving the unique rank-4 symmetric invariant tensor of the 0-brane charge symplectic irrepr. of U-duality groups, with potential applications in the quantization of the charge orbits of supergravity theories, as well as in the study of mult...

  7. 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 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 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.

  8. 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.

  9. 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. Theref...

  10. Assessing Degree of Susceptibility to Landslide Hazard

    Science.gov (United States)

    Sheridan, M. F.; Cordoba, G. A.; Delgado, H.; Stefanescu, R.

    2013-05-01

    The modeling of hazardous mass flows, both dry and water saturated, is currently an area of active research and several stable models have now emerged that have differing degrees of physical and mathematical fidelity. Models based on the early work of Savage and Hutter (1989) assume that very large dense granular flows could be modeled as incompressible continua governed by a Coulomb failure criterion. Based on this concept, Patra et al. (2005) developed a code for dry avalanches, which proposes a thin layer mathematical model similar to shallow-water equations. This concept was implemented in the widely-used TITAN2D program, which integrates the shock-capturing Godunov solution methodology for the equation system. We propose a method to assess the susceptibility of specific locations susceptible to landslides following heavy tephra fall using the TIATN2D code. Successful application requires that the range of several uncertainties must be framed in the selection of model input data: 1) initial conditions, like volume and location of origin of the landslide, 2) bed and internal friction parameters and 3) digital elevation model (DEM) uncertainties. Among the possible ways of coping with these uncertainties, we chose to use Latin Hypercube Sampling (LHS). This statistical technique reduces a computationally intractable problem to such an extent that is it possible to apply it, even with current personal computers. LHS requires that there is only one sample in each row and each column of the sampling matrix, where each row (multi-dimensional) corresponds to each uncertainty. LHS requires less than 10% of the sample runs needed by Monte Carlo approaches to achieve a stable solution. In our application LHS output provides model sampling for 4 input parameters: initial random volumes, UTM location (x and y), and bed friction. We developed a simple Octave script to link the output of LHS with TITAN2D. In this way, TITAN2D can run several times with successively different

  11. Effect of Electrode Types on the Solidification Cracking Susceptibility of Austenitic Stainless Steel Weld Metal

    OpenAIRE

    J. U. Anaele; O. O. ONYEMAOBI; C. S. Nwobodo; C. C. Ugwuegbu

    2015-01-01

    The effect of electrode types on the solidification cracking susceptibility of austenitic stainless steel weld metal was studied. Manual metal arc welding method was used to produce the joints with the tungsten inert gas welding serving as the control. Metallographic and chemical analyses of the fusion zones of the joints were conducted. Results indicate that weldments produced from E 308-16 (rutile coated), E 308-16(lime-titania coated) electrodes, and TIG welded joints fall within the range...

  12. Renal disease and accidental falls: a review of published evidence

    National Research Council Canada - National Science Library

    López-Soto, Pablo Jesús; De Giorgi, Alfredo; Senno, Elisa; Tiseo, Ruana; Ferraresi, Annamaria; Canella, Cinzia; Rodríguez-Borrego, María Aurora; Manfredini, Roberto; Fabbian, Fabio

    2015-01-01

    .... The relationship between renal disease and falls is unclear, and the goal of this study was to collect the available evidence and investigate the relationship between accidental falls and renal dysfunction...

  13. Falls and other geriatric syndromes in Blantyre, Malawi: a ...

    African Journals Online (AJOL)

    Introduction. Geriatric syndromes (falls, immobility, intellectual or memory impairment .... were asked to recall all falls using a rigorous definition.19 The number of ... data on this in our study but uncorrected visual impairment, uncorrected pain ...

  14. Depression Often a Precursor to Falls in Elderly People

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_165985.html Depression Often a Precursor to Falls in Elderly People ... 26, 2017 FRIDAY, May 26, 2017 (HealthDay News) -- Depression appears to raise the risk of falls in ...

  15. Keeping children safe at home: protocol for three matched case–control studies of modifiable risk factors for falls

    Science.gov (United States)

    Kendrick, Denise; Stewart, Jane; Clacy, Rose; Coffey, Frank; Cooper, Nicola; Coupland, Carol; Hayes, Mike; McColl, Elaine; Reading, Richard; Sutton, Alex; M L Towner, Elizabeth; Craig Watson, Michael

    2012-01-01

    Background Childhood falls result in considerable morbidity, mortality and health service use. Despite this, little evidence exists on protective factors or effective falls prevention interventions in young children. Objectives To estimate ORs for three types of medically attended fall injuries in young children in relation to safety equipment, safety behaviours and hazard reduction and explore differential effects by child and family factors and injury severity. Design Three multicentre case–control studies in UK hospitals with validation of parental reported exposures using home observations. Cases are aged 0–4 years with a medically attended fall injury occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression to adjust for potential confounding variables. Unmatched analyses will use unconditional logistic regression, adjusted for age, sex, deprivation and distance from hospital in addition to other confounders. Each study requires 496 cases and 1984 controls to detect an OR of 0.7, with 80% power, 5% significance level, a correlation between cases and controls of 0.1 and a range of exposure prevalences. Main outcome measures Falls on stairs, on one level and from furniture. Discussion As the largest in the field to date, these case control studies will adjust for potential confounders, validate measures of exposure and investigate modifiable risk factors for specific falls injury mechanisms. Findings should enhance the evidence base for falls prevention for young children. PMID:22628151

  16. Reducing hazard related falls in people 75 years and older with significant visual impairment: how did a successful program work?

    Science.gov (United States)

    La Grow, S J; Robertson, M C; Campbell, A J; Clarke, G A; Kerse, N M

    2006-10-01

    In a randomized controlled trial testing a home safety program designed to prevent falls in older people with severe visual impairment, it was shown that the program, delivered by an experienced occupational therapist, significantly reduced the numbers of falls both at home and away from home. To investigate whether the success of the home safety assessment and modification intervention in reducing falls resulted directly from modification of home hazards or from behavioral modifications, or both. Participants were 391 community living women and men aged 75 years and older with visual acuity 6/24 meters or worse; 92% (361 of 391) completed one year of follow up. Main outcome measures were type and number of hazards and risky behavior identified in the home and garden of those receiving the home safety program, compliance with home safety recommendations reported at six months, location of all falls for all study participants during the trial, and environmental hazards associated with each fall. The numbers of falls at home related to an environmental hazard and those with no hazard involved were both reduced by the home safety program (n = 100 participants) compared with the group receiving social visits (n = 96) (incidence rate ratios = 0.40 (95% confidence interval, 0.21 to 0.74) and 0.43 (0.21 to 0.90), respectively). The overall reduction in falls by the home safety program must result from some mechanism in addition to the removal or modification of hazards or provision of new equipment.

  17. 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.

  18. 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.

  19. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    Science.gov (United States)

    van der Zijden, A M; Groen, B E; Tanck, E; Nienhuis, B; Verdonschot, N; Weerdesteyn, V

    2012-06-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-09-24

    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. 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 repeated measures and logistic regressions were used to investigate the effects of this program. Participants in the MOB group were less likely to have had a fall and had significant improvements in their physical risk of falling compared with adults in the comparison group. No significant effects of the MOB program on recurrent falls or the number of falls reported were found. This study contributes to our understanding of the MOB program and its effectiveness in reducing falls and the physical risk of falling among older adults. The findings support extended use of this program to reduce falls and physical risk of falling among older adults.

  1. Falls in the community: state of the science

    Science.gov (United States)

    Hester, Amy L; Wei, Feifei

    2013-01-01

    Falls and fall-related injuries among older community-dwelling adults continue to be a major health concern in the US. Falls are the leading cause of disability and trauma-related death in persons over 65 years of age. This article discusses current approaches in community fall management and challenges with these approaches, and offers some insight for community providers regarding this issue. PMID:23776331

  2. 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.

  3. 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.

  4. INTRODUCTION A fall is a sudden, unintentional change in position ...

    African Journals Online (AJOL)

    publications. Accessed 15/06/08. 21. Hindmarsh J.J., Estes E.H. Jr. Falls in older persons. Causes and interventions. Arch Intem Med. 1989;149:2217-2222. 22. Tinetti M.E., Speechley M. Prevention of Fear of Falling falls among the elderly.

  5. Geriatric fall-related injuries | Hefny | African Health Sciences

    African Journals Online (AJOL)

    Geriatric fall-related injuries. Ashraf F. Hefny, Alaa K. Abbas, Fikri M. Abu-Zidan. Abstract. Background: Falls are the leading cause of geriatric injury. Objectives: We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention.

  6. 29 CFR 1926.759 - Falling object protection.

    Science.gov (United States)

    2010-07-01

    ... aloft, shall be secured against accidental displacement. (b) Protection from falling objects other than... 29 Labor 8 2010-07-01 2010-07-01 false Falling object protection. 1926.759 Section 1926.759 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Steel Erection § 1926.759 Falling object...

  7. 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

  8. City of Klamath Falls, Oregon Geothermal Power Plant Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Brian Brown, PE; Stephen Anderson, PE, Bety Riley

    2011-07-31

    The purpose of the Klamath Falls project is to demonstrate the effectiveness of a combined thermal distribution system and power generation facility. The city of Klamath Falls operates a geothermal district heating system which would appear to be an attractive opportunity to install a power generation system. Since the two wells have operated reliably and consistently over many years, no new sources or resource exploration would be necessary. It appears that it will cost more to construct, operate, maintain and amortize a proposed geothermal facility than the long?term value of the power it would produce. The success of a future project will be determined by whether utility power production costs will remain low and whether costs of construction, operations, or financing may be reduced. There are areas that it would be possible to reduce construction cost. More detailed design could enable the city to obtain more precise quotes for components and construction, resulting in reduction in contingency projections. The current level of the contingency for uncertainty of costs is between $200,000 and $300,000. Another key issue with this project appears to be operation cost. While it is expected that only minimal routine monitoring and operating expenses will occur, the cost of water supply and waste water disposal represents nearly one quarter of the value of the power. If the cost of water alone could be reduced, the project could become viable. In addition, the projected cost of insurance may be lower than estimated under a city?wide policy. No provisions have been made for utilization of federal tax incentives. If a transaction with a third-party owner/taxpayer were to be negotiated, perhaps the net cost of ownership could be reduced. It is recommended that these options be investigated to determine if the costs and benefits could be brought together. The project has good potential, but like many alternative energy projects today, they only work economically if the

  9. [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

  10. 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.

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

    Science.gov (United States)

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

    2012-11-01

    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 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.

  12. 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.

  13. Traumatic Lung Herniation following Skateboard Fall

    Directory of Open Access Journals (Sweden)

    Dafney L. Davare

    2016-01-01

    Full Text Available Lung herniation (LH is a rare clinical entity involving the protrusion of lung outside the thoracic cage. It has a variety of etiologies and clinical presentations, making diagnosis difficult. We present a case of a 20-year-old male who reported pleuritic pain after falling from a skateboard. Evaluation through computed tomography (CT scanning of the chest revealed an anterior lung hernia associated with rib fractures. This case emphasizes the need for clinicians to include lung herniation in the differential diagnosis of patients with trauma and inexplicable or persistent pulmonary issues.

  14. 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, I2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I2 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

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

    OpenAIRE

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

    2008-01-01

    International audience; 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 ...

  16. 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.

  17. 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, Gregory M.; Reichenbach, P.; Snyder, J.B.; Borchers, J.W.; Godt, J.W.

    2008-01-01

    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 m 3 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.

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

    Science.gov (United States)

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

    2016-12-01

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

  19. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    NARCIS (Netherlands)

    Zijden, A.M. van der; Groen, B.E.; Tanck, E.J.M.; Nienhuis, B.; Verdonschot, N.J.J.; Weerdesteijn, V.G.M.

    2012-01-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force).

  20. The effects of Tai Chi on fall prevention, fear of falling and balance in older people: a meta-analysis.

    NARCIS (Netherlands)

    Logghe, I.H.; Verhagen, A.P.; Rademaker, A.C.; Bierma-Zeinstra, S.M.; Rossum, E. van; Faber, M.J.; Koes, B.W.

    2010-01-01

    OBJECTIVE: Tai Chi (TC) is an exercise training that is becoming increasingly popular as an intervention for single fall prevention. This meta-analysis was performed to evaluate the efficacy of TC on fall rate, fear of falling and balance in older people. METHODS: Randomized controlled trials

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

    DEFF Research Database (Denmark)

    Evron, Lotte; Clausen, Nina

    Falls in old age have major consequences both for the individual and for society; therefore falls prevention is a priority on the health political agenda. Unfortunately, merely half of the targeted population accepts participating in falls prevention services. Qualitative researchers suggest that...

  2. Simulated field maps for susceptibility artefact correction in interventional MRI.

    Science.gov (United States)

    Kochan, Martin; Daga, Pankaj; Burgos, Ninon; White, Mark; Cardoso, M Jorge; Mancini, Laura; Winston, Gavin P; McEvoy, Andrew W; Thornton, John; Yousry, Tarek; Duncan, John S; Stoyanov, Danail; Ourselin, Sébastien

    2015-09-01

    Intraoperative MRI (iMRI) is a powerful modality for acquiring images of the brain to facilitate precise image-guided neurosurgery. Diffusion-weighted MRI (DW-MRI) provides critical information about location, orientation and structure of nerve fibre tracts, but suffers from the "susceptibility artefact" stemming from magnetic field perturbations due to the step change in magnetic susceptibility at air-tissue boundaries in the head. An existing approach to correcting the artefact is to acquire a field map by means of an additional MRI scan. However, to recover true field maps from the acquired field maps near air-tissue boundaries is challenging, and acquired field maps are unavailable in historical MRI data sets. This paper reports a detailed account of our method to simulate field maps from structural MRI scans that was first presented at IPCAI 2014 and provides a thorough experimental and analysis section to quantitatively validate our technique. We perform automatic air-tissue segmentation of intraoperative MRI scans, feed the segmentation into a field map simulation step and apply the acquired and the simulated field maps to correct DW-MRI data sets. We report results for 12 patient data sets acquired during anterior temporal lobe resection surgery for the surgical management of focal epilepsy. We find a close agreement between acquired and simulated field maps and observe a statistically significant reduction in the susceptibility artefact in DW-MRI data sets corrected using simulated field maps in the vicinity of the resection. The artefact reduction obtained using acquired field maps remains better than that using the simulated field maps in all evaluated regions of the brain. The proposed simulated field maps facilitate susceptibility artefact reduction near the resection. Accurate air-tissue segmentation is key to achieving accurate simulation. The proposed simulation approach is adaptable to different iMRI and neurosurgical applications.

  3. Reducing Susceptibility to Courtesy Stigma.

    Science.gov (United States)

    Bachleda, Catherine L; El Menzhi, Leila

    2017-04-19

    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.

  4. Home Camera-Based Fall Detection System for the Elderly

    Directory of Open Access Journals (Sweden)

    Koldo de Miguel

    2017-12-01

    Full Text Available Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

  5. Home Camera-Based Fall Detection System for the Elderly.

    Science.gov (United States)

    de Miguel, Koldo; Brunete, Alberto; Hernando, Miguel; Gambao, Ernesto

    2017-12-09

    Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow) as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

  6. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial.

    Science.gov (United States)

    Clemson, Lindy; Cumming, Robert G; Kendig, Hal; Swann, Megan; Heard, Robert; Taylor, Kirsty

    2004-09-01

    To test whether Stepping On, a multifaceted community-based program using a small-group learning environment, is effective in reducing falls in at-risk people living at home. A randomized trial with subjects followed for 14 months. The interventions were conducted in community venues, with a follow-up home visit. Three hundred ten community residents aged 70 and older who had had a fall in the previous 12 months or were concerned about falling. The Stepping On program aims to improve fall self-efficacy, encourage behavioral change, and reduce falls. Key aspects of the program are improving lower-limb balance and strength, improving home and community environmental and behavioral safety, encouraging regular visual screening, making adaptations to low vision, and encouraging medication review. Two-hour sessions were conducted weekly for 7 weeks, with a follow-up occupational therapy home visit. The primary outcome measure was falls, ascertained using a monthly calendar mailed by each participant. The intervention group experienced a 31% reduction in falls (relative risk (RR)=0.69, 95% confidence interval (CI)=0.50-0.96; P=.025). This was a clinically meaningful result demonstrating that the Stepping On program was effective for community-residing elderly people. Secondary analysis of subgroups showed that it was particularly effective for men (n=80; RR=0.32, 95% CI=0.17-0.59). The results of this study renew attention to the idea that cognitive-behavioral learning in a small-group environment can reduce falls. Stepping On offers a successful fall-prevention option. Copyright 2004 American Geriatrics Society

  7. Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial.

    Science.gov (United States)

    Ferrer, Assumpta; Formiga, Francesc; Sanz, Héctor; de Vries, Oscar J; Badia, Teresa; Pujol, Ramón

    2014-01-01

    The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat. Sixty-five (39.6%) subjects in the intervention group and 48 (29.3%) in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94-1.75). Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03-2.09) and that functional impairment (HR 1.42, 95% CI 0.97-2.12), previous falls (HR 1.09, 95% CI 0.74-1.60), and cognitive impairment (HR 1.08, 95% CI 0.72-1.60) had no effect on the assessment. This multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study.

  8. A retrospective benefit-cost analysis of the 1997 stair-fall requirements for baby walkers.

    Science.gov (United States)

    Rodgers, Gregory B; Leland, Elizabeth W

    2008-01-01

    Based on estimates from the U.S. Consumer Product Safety Commission (CPSC), there were about 25,000 baby walker-related injuries treated annually in U.S. hospital emergency departments during the early 1990s. This amounted to about 8 injuries for every 1000 baby walkers in use. Most injuries resulted from falls down stairs. After CPSC initiated a regulatory proceeding in 1994, the CPSC staff worked with industry to address the stair-fall hazard. This cooperative effort resulted in requirements designed to prevent stair-fall injuries that became effective in 1997 as part of a revised voluntary safety standard. This study presents a retrospective benefit-cost analysis of the 1997 stair-fall requirements. The benefits were defined as the reduction in the costs of injuries resulting from the use of the safer walkers. The costs were defined as the additional resource costs associated with making baby walkers safer. The study found that the stair-fall requirements were highly effective in reducing the risk of stair-fall injury, and that the benefits of the requirements substantially exceeded the costs. The expected net benefits (i.e., benefits minus costs) amounted to an average of about $169 per walker, over the walker's expected product life. Given current U.S. sales of about 600,000 baby walkers annually, the present value of the expected net benefits associated with 1 year's production amounts to over $100 million annually. A sensitivity analysis showed that the major findings were robust with respect to variations in underlying assumptions.

  9. Falling Liquid Films in Absorption Machines

    Science.gov (United States)

    Fujita, Toshihiko

    The absorption machines of the lithium bromide-water type have recently been established as heat source equipments for residential and industrial use, which include refrigerating machines, heat pumps, and heat transformers. Several advanced cycle machines have also been proposed and tested. All of the absorption machines consist fundamentally of four kinds of heat exchangers, i.e. evaporator, absorber, generator, and condenser. The horizontal or vertical falling film system is usually applied to these heat exchangers, since the pressure drop which causes an undesirable change in the fluid temperature is relatively small in either system. The horizontal system is popular for the present, while the vertical system is going to be developed promisingly. This may save an installation space and also fit a plan for the Lorentz cycle. The purpose of this paper is to survey the available information for increasing heat and mass transfer rates in the heat exchangers of absorption machines. Emphasis is placed on the hydrodynamic characteristics of falling liquid films in absorbers and generators. The following topics are covered in this paper: 1. Characteristics of thin liquid films over horizontal tubes 2. Characteristics of wavy thin liquid films flowing down the vertical or inclined wall surface 3. Effect of the artificial surface roughness on the heat and mass transfer rates 4. Enhancement in the heat and mass transfer rates by the Marangoni convection 5. Conditions of film breakdown and the minimum wetting rates.

  10. Vaccine effects on heterogeneity in susceptibility and implications for population health management

    Science.gov (United States)

    Langwig, Kate E.; Wargo, Andrew R.; Jones, Darbi R.; Viss, Jessie R.; Rutan, Barbara J.; Egan, Nicholas A.; Sá-Guimarães, Pedro; Min Sun Kim,; Kurath, Gael; Gomes, M. Gabriela M.; Lipsitch, Marc; Bansal, Shweta; Pettigrew, Melinda M.

    2017-01-01

    Heterogeneity in host susceptibility is a key determinant of infectious disease dynamics but is rarely accounted for in assessment of disease control measures. Understanding how susceptibility is distributed in populations, and how control measures change this distribution, is integral to predicting the course of epidemics with and without interventions. Using multiple experimental and modeling approaches, we show that rainbow trout have relatively homogeneous susceptibility to infection with infectious hematopoietic necrosis virus and that vaccination increases heterogeneity in susceptibility in a nearly all-or-nothing fashion. In a simple transmission model with an R0 of 2, the highly heterogeneous vaccine protection would cause a 35 percentage-point reduction in outbreak size over an intervention inducing homogenous protection at the same mean level. More broadly, these findings provide validation of methodology that can help to reduce biases in predictions of vaccine impact in natural settings and provide insight into how vaccination shapes population susceptibility.

  11. 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.

  12. Falls Risk and Simulated Driving Performance in Older Adults

    Directory of Open Access Journals (Sweden)

    John G. Gaspar

    2013-01-01

    Full Text Available Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds to unexpected events compared to low falls risk drivers (~1.7 seconds. Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance.

  13. Prevention of falls in the elderly: a review.

    Science.gov (United States)

    Karlsson, Magnus K; Vonschewelov, Thord; Karlsson, Caroline; Cöster, Maria; Rosengen, Björn E

    2013-07-01

    Falls often result in soft tissue injuries, dislocations, fractures, longstanding pain and reduced quality of life. Therefore, fall preventive programmes have been developed. In this review, we evaluate programmes that in randomized controlled trials (RCT) have been shown with fall reducing effect. Physical exercise that includes several training modalities, especially balance and strength training, is the only intervention programme that reduces both the number of fallers and the number of falls in community dwellers. Home hazards modification reduces the fall risk in community-living elderly but has the best effects in high risk groups when the programme is led by occupational therapists. Vitamin D supplement in those with low levels of vitamin D, adjustment of psychotropic medication and modification of multi-pharmacy are drug-related programmes that reduce the fall risk. Anti-slip shoe devices in elderly who walk outdoors during icy conditions and multifaceted podiatry to patients with specific foot disability are interventions targeted at the lower extremities with a fall-reducing effect. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical procedures with fall-reducing effect. Multifactorial standardized preventive programmes that include an exercise component and individually-designed subject-specific programmes also reduce the number of falls. Fall preventive interventions should be provided to elderly by a structured approach, especially to high risk groups, as to reduce the number of falls and fallers.

  14. Doppler radar sensor positioning in a fall detection system.

    Science.gov (United States)

    Liu, Liang; Popescu, Mihail; Ho, K C; Skubic, Marjorie; Rantz, Marilyn

    2012-01-01

    Falling is a common health problem for more than a third of the United States population over 65. We are currently developing a Doppler radar based fall detection system that already has showed promising results. In this paper, we study the sensor positioning in the environment with respect to the subject. We investigate three sensor positions, floor, wall and ceiling of the room, in two experimental configurations. Within each system configuration, subjects performed falls towards or across the radar sensors. We collected 90 falls and 341 non falls for the first configuration and 126 falls and 817 non falls for the second one. Radar signature classification was performed using a SVM classifier. Fall detection performance was evaluated using the area under the ROC curves (AUCs) for each sensor deployment. We found that a fall is more likely to be detected if the subject is falling toward or away from the sensor and a ceiling Doppler radar is more reliable for fall detection than a wall mounted one.

  15. Footwear style and risk of falls in older adults.

    Science.gov (United States)

    Koepsell, Thomas D; Wolf, Marsha E; Buchner, David M; Kukull, Walter A; LaCroix, Andrea Z; Tencer, Allan F; Frankenfeld, Cara L; Tautvydas, Milda; Larson, Eric B

    2004-09-01

    To determine how the risk of a fall in an older adult varies in relation to style of footwear worn. Nested case-control study. Group Health Cooperative, a large health maintenance organization in Washington state. A total of 1,371 adults aged 65 and older were monitored for falls over a 2-year period; 327 qualifying fall cases were compared with 327 controls matched on age and sex. Standardized in-person examinations before fall occurrence, interviews about fall risk factors after the fall occurred, and direct examination of footwear were conducted. Questions for controls referred to the last time they engaged in an activity broadly similar to what the case was doing at the time of the fall. Athletic and canvas shoes (sneakers) were the styles of footwear associated with lowest risk of a fall. Going barefoot or in stocking feet was associated with sharply increased risk, even after controlling for measures of health status (adjusted odds ratio=11.2, 95% confidence interval (CI)=2.4-51.8). Relative to athletic/canvas shoes, other footwear was associated with a 1.3-fold increase in the risk of a fall (95% CI=0.9-1.9), varying somewhat by style. Contrary to findings from gait-laboratory studies, athletic shoes were associated with relatively low risk of a fall in older adults during everyday activities. Fall risk was markedly increased when participants were not wearing shoes. Copyright 2004 American Geriatrics Society

  16. Hypocapnia and its relation to fear of falling.

    Science.gov (United States)

    Clague, J E; Petrie, P J; Horan, M A

    2000-11-01

    To determine if hypocapnia occurs in patients with fear of falling and to explore potential causes of hypocapnia. Observational study in patients who fall with and without fear of falling. Rehabilitation wards of an elderly care unit. Consecutive fallers with (n = 20) and without (n = 10) fear of falling. End-tidal CO2 (PETCO2) and respiratory rate (RR) responses were measured during sustained isometric muscle contraction (SIMC) (40% of maximum voluntary contraction of quadriceps for 2 min) and during a 5-meter walk. Falls efficacy scale (FES) and Hospital anxiety and depression scale (HAD). Patients with fear of falling had significantly higher FES and HAD scores (p fear of falling (p fear of falling group than in controls (p fear of falling group than in controls (p fear of falling during SIMC and walking. Anxiety seems to be the main cause, but muscle weakness may contribute. Breathing or relaxation techniques and reconditioning may have a role in treating fear of falling in the rehabilitation setting.

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

    Science.gov (United States)

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

    2012-07-01

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

  18. A Palliative Approach to Falls in Advanced Dementia.

    Science.gov (United States)

    Iaboni, Andrea; Van Ooteghem, Karen; Marcil, Meghan N; Cockburn, Amy; Flint, Alastair J; Grossman, Daphna; Keren, Ron

    2017-12-11

    Falls are viewed as a preventable cause of injury, functional loss, and death in older adults with dementia, and have been used as a marker of quality of care in long-term care facilities. Despite intensive intervention around fall prevention in these settings, falls and injury remain frequent, particularly among residents in the advanced stages of dementia. In this clinical review, we consider the common challenges and pitfalls in both the management of falls and the provision of palliative care in advanced dementia. We then describe a palliative approach to falls in advanced dementia that involves identifying individuals who would benefit from this care approach, framing falls and loss of mobility as a quality of life issue, and devising an individualized symptom assessment and management plan. A palliative approach can lead to recognition and acceptance that recurrent falls are often symptomatic of advanced dementia, and that not all falls are preventable. We conclude that falls in the advanced stage of dementia can be sentinel events indicating the need for a palliative approach to care. Rather than replace falls prevention activities, a palliative approach to falls prompts us to select dementia stage-appropriate interventions with a focus on symptom management, comfort, and dignity. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Reductions in real versus tariff barriers: the impact on industry concentration

    DEFF Research Database (Denmark)

    Jørgensen, Jan Guldager; Schröder, Philipp

    2003-01-01

    as a reduction of trade barriers) may exert opposing forces on industry concentration, depending on whether the barrier consists of real (frictional) or tariff costs. In particular, the Herfindahl index of industry concentration falls for a reduction in real costs, but rises for a reduction in tariff costs...

  20. Doppler radar fall activity detection using the wavelet transform.

    Science.gov (United States)

    Su, Bo Yu; Ho, K C; Rantz, Marilyn J; Skubic, Marjorie

    2015-03-01

    We propose in this paper the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. The radar senses any motions from falls as well as nonfalls due to the Doppler effect. The WT is very effective in distinguishing the falls from other activities, making it a promising technique for radar fall detection in nonobtrusive inhome elder care applications. The proposed radar fall detector consists of two stages. The prescreen stage uses the coefficients of wavelet decomposition at a given scale to identify the time locations in which fall activities may have occurred. The classification stage extracts the time-frequency content from the wavelet coefficients at many scales to form a feature vector for fall versus nonfall classification. The selection of different wavelet functions is examined to achieve better performance. Experimental results using the data from the laboratory and real inhome environments validate the promising and robust performance of the proposed detector.

  1. 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

  2. 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.

  3. Neurology Falls. Patient Falls Risk Assessment, Neurology Clinic, Johns Hopkins Hospital, Baltimore, MD

    Science.gov (United States)

    2009-07-06

    Goal. 2008. Retrieved Aug. 22, from http://www.jointcommission.org/NR/rdonlyres/9EE98FF3-0567- 444D-9C91-424282FF5FCD/0/2008_FAQs_NPSG_0 9. pdf ...Male) i r Any administered antiepileptics (anticonvulsants): 2 r Any administered benzodiazepines : r II. FALL RISK ASSESSMENT IN

  4. Going nuts: Measuring free-fall acceleration by analyzing the sound of falling metal pieces

    Science.gov (United States)

    Kuhn, Jochen; Vogt, Patrik; Theilmann, Florian

    2016-03-01

    Galilei presented the kinematics of a one-dimensional accelerated motion with ease and in terms of elegant geometry. Moreover, he believed, "Philosophy [i.e. physics] is written in this grand book—I mean the universe—which stands continually open to our gaze, but it cannot be understood unless one first learns to comprehend the language and interpret the characters in which it is written. It is written in the language of mathematics, and its characters are triangles, circles, and other geometrical figures, without which it is humanly impossible to understand a single word of it." In classroom practice, however, it can be difficult to reveal this mathematical heart of nature; free fall and other accelerated motions often get obscured by friction or other sources of errors. In this paper, we introduce a method of analyzing free-fall motion indirectly by evaluating the noise of freely falling metal pieces. The method connects a deeper understanding of the mathematical structure of accelerated motion with the possibility to derive a numerical value for the free-fall acceleration g.

  5. Falling Into the Light: About Fall Prevention and Self-development


    DEFF Research Database (Denmark)

    Evron, Lotte

    2014-01-01

    It is normal to tell a story about falls focusing on the negative side. It is not normal to talk about the decline in old age as a positive thing that opens up the possibility for a more substantial quality of life and for the courage and zest for life. Nevertheless, it is what I want to write...

  6. Fall-grown oat to extend the fall grazing season for replacement dairy heifers

    Science.gov (United States)

    Our objective was to assess the pasture productivity and forage characteristics of 2 fall-grown oat (Avena sativa L.) cultivars, specifically for extending the grazing season and reducing reliance on harvested forages by replacement dairy heifers. A total of 160 gravid Holstein heifers (80 heifers/y...

  7. Smoking tobacco in Costa Rica: susceptibility, consumption and dependence

    Directory of Open Access Journals (Sweden)

    Sandra Fonseca-Chaves

    2017-03-01

    Full Text Available Objective. To identify factors associated with susceptibility, tobacco use and addiction in young people from 13 to 15 years of age, to determine conditions of risk and identify possible correlates to the development of public policies on smoking in Costa Rica. Materials and methods. Information available from the four rounds of the Global Youth Tobacco Survey (GYTS Costa Rica was used. It was based on a sample size of 11 540 youngsters from public and private schools. Indicators of interest and logistic regression models for smoking, susceptibility and addiction were estimated. Results. The prevalence of current consumption shows a significant decrease over the 14 years of the study (17.3% in 1999 and 5.0% in 2013 and, to a lesser intensity, in the index of smoking susceptibility (19.3% in 1999 and 12.4% in 2013. The proportion of young people with addiction has shown a significant increase in the same period. Conclusions. The conditions that explained the significant reduction in smoking prevalence and less susceptibility must be maintained and deepened to achieve full compliance of the MPower measures.

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

    DEFF Research Database (Denmark)

    Evron, Lotte; Clausen, Nina

    2015-01-01

    that a broader understanding of falls in old age in the health care system might help health professionals to understand the complexity of falls and by this inspire older persons to prevent falls in different ways. Using poetry and music in our performance we seek to open up for a broader understanding of falls...... prevention. Our hope is to inspire nurses and other health professionals to work with falls prevention in new ways. The performance draw on an interview study with 25 older persons where six different understandings of falls prevention were identified (1). The understandings include falls as a result of......: irresponsible behavior, disease, destiny, desire to remain independent in old age, appearing elegant/aesthetical and being physical active. One of the interviews was selected and transformed it into a poem (2-3). The poem was then translated into music by the second author. First we present the six...

  9. An Energy-Efficient Multi-Tier Architecture for Fall Detection on Smartphones

    Science.gov (United States)

    Guvensan, M. Amac; Kansiz, A. Oguz; Camgoz, N. Cihan; Turkmen, H. Irem; Yavuz, A. Gokhan; Karsligil, M. Elif

    2017-01-01

    Automatic detection of fall events is vital to providing fast medical assistance to the causality, particularly when the injury causes loss of consciousness. Optimization of the energy consumption of mobile applications, especially those which run 24/7 in the background, is essential for longer use of smartphones. In order to improve energy-efficiency without compromising on the fall detection performance, we propose a novel 3-tier architecture that combines simple thresholding methods with machine learning algorithms. The proposed method is implemented on a mobile application, called uSurvive, for Android smartphones. It runs as a background service and monitors the activities of a person in daily life and automatically sends a notification to the appropriate authorities and/or user defined contacts when it detects a fall. The performance of the proposed method was evaluated in terms of fall detection performance and energy consumption. Real life performance tests conducted on two different models of smartphone demonstrate that our 3-tier architecture with feature reduction could save up to 62% of energy compared to machine learning only solutions. In addition to this energy saving, the hybrid method has a 93% of accuracy, which is superior to thresholding methods and better than machine learning only solutions. PMID:28644378

  10. An Energy-Efficient Multi-Tier Architecture for Fall Detection Using Smartphones.

    Science.gov (United States)

    Guvensan, M Amac; Kansiz, A Oguz; Camgoz, N Cihan; Turkmen, H Irem; Yavuz, A Gokhan; Karsligil, M Elif

    2017-06-23

    Automatic detection of fall events is vital to providing fast medical assistance to the causality, particularly when the injury causes loss of consciousness. Optimization of the energy consumption of mobile applications, especially those which run 24/7 in the background, is essential for longer use of smartphones. In order to improve energy-efficiency without compromising on the fall detection performance, we propose a novel 3-tier architecture that combines simple thresholding methods with machine learning algorithms. The proposed method is implemented on a mobile application, called uSurvive, for Android smartphones. It runs as a background service and monitors the activities of a person in daily life and automatically sends a notification to the appropriate authorities and/or user defined contacts when it detects a fall. The performance of the proposed method was evaluated in terms of fall detection performance and energy consumption. Real life performance tests conducted on two different models of smartphone demonstrate that our 3-tier architecture with feature reduction could save up to 62% of energy compared to machine learning only solutions. In addition to this energy saving, the hybrid method has a 93% of accuracy, which is superior to thresholding methods and better than machine learning only solutions.

  11. Dispersion and fall out of heavier particles

    DEFF Research Database (Denmark)

    Astrup, Poul

    2016-01-01

    they may like gasses and aerosols be transported more or less far by the wind. The present paper focuses on the growth of plumes of such particles larger and heavier than aerosols and transported by the wind. Implementation in existing decision support puff dispersion programs requires a parameterization......Nuclear accidents have so far been expected to release gasses and aerosols, but other CBRN events and also nuclear accidents with release of core particles can be expected to also release larger particles to the atmosphere. If not so large and heavy, that they fall to the ground immediately...... of this growth, and two reasonable describing parameterizations have been found, one in the literature, one proposed here, and both are compared to experimental work found in the literature. The parameterization from the literature has been implemented in the dispersion program RIMPUFF, which has subsequently...

  12. High Falls Hydroelectric Plant feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Diezemann, Gustav A.

    1979-07-01

    This study was made in order to determine if re-activating the retired High Falls Hydro Station in New York would result in a more economical generation of some of the power required in the Central Hudson System than is being obtained with the oil-burning thermal plants. The findings show that the construction of a new plant is more economical than rehabilitation of the existing station. All new construction schemes are marginally unattractive at today's costs but are found to become profitable within a short period as alternative energy sources escalate in price. A new powerhouse with an installed capacity of 2390 kW proved most economical, and its construction is recommended.

  13. Comparison and Characterization of Android-Based Fall Detection Systems

    Directory of Open Access Journals (Sweden)

    Rafael Luque

    2014-10-01

    Full Text Available Falls are a foremost source of injuries and hospitalization for seniors. The adoption of automatic fall detection mechanisms can noticeably reduce the response time of the medical staff or caregivers when a fall takes place. Smartphones are being increasingly proposed as wearable, cost-effective and not-intrusive systems for fall detection. The exploitation of smartphones’ potential (and in particular, the Android Operating System can benefit from the wide implantation, the growing computational capabilities and the diversity of communication interfaces and embedded sensors of these personal devices. After revising the state-of-the-art on this matter, this study develops an experimental testbed to assess the performance of different fall detection algorithms that ground their decisions on the analysis of the inertial data registered by the accelerometer of the smartphone. Results obtained in a real testbed with diverse individuals indicate that the accuracy of the accelerometry-based techniques to identify the falls depends strongly on the fall pattern. The performed tests also show the difficulty to set detection acceleration thresholds that allow achieving a good trade-off between false negatives (falls that remain unnoticed and false positives (conventional movements that are erroneously classified as falls. In any case, the study of the evolution of the battery drain reveals that the extra power consumption introduced by the Android monitoring applications cannot be neglected when evaluating the autonomy and even the viability of fall detection systems.

  14. Comparison and characterization of Android-based fall detection systems.

    Science.gov (United States)

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

    2014-10-08

    Falls are a foremost source of injuries and hospitalization for seniors. The adoption of automatic fall detection mechanisms can noticeably reduce the response time of the medical staff or caregivers when a fall takes place. Smartphones are being increasingly proposed as wearable, cost-effective and not-intrusive systems for fall detection. The exploitation of smartphones' potential (and in particular, the Android Operating System) can benefit from the wide implantation, the growing computational capabilities and the diversity of communication interfaces and embedded sensors of these personal devices. After revising the state-of-the-art on this matter, this study develops an experimental testbed to assess the performance of different fall detection algorithms that ground their decisions on the analysis of the inertial data registered by the accelerometer of the smartphone. Results obtained in a real testbed with diverse individuals indicate that the accuracy of the accelerometry-based techniques to identify the falls depends strongly on the fall pattern. The performed tests also show the difficulty to set detection acceleration thresholds that allow achieving a good trade-off between false negatives (falls that remain unnoticed) and false positives (conventional movements that are erroneously classified as falls). In any case, the study of the evolution of the battery drain reveals that the extra power consumption introduced by the Android monitoring applications cannot be neglected when evaluating the autonomy and even the viability of fall detection systems.

  15. [Hospital falls, improvement strategy for reducing their incidence].

    Science.gov (United States)

    García-Huete, M Eloisa; Sebastián-Viana, Tomás; Lema-Lorenzo, Isabel; Granados-Martín, Mónica; Buitrago-Lobo, Nuria; Heredia-Reina, M del Pilar; Merino-Ruiz, Margarita; Ventosa-Hernández, Esther; Gutiérrez-Fernández, Carmen; Mota-Boada, M Luisa

    2016-01-01

    To evaluate the evolution of falls with the implemented measures to improve the attention of patients at risk and to reduce the number of falls. To know the characteristics of patients who have suffered fall-related injuries. All the falls registered between 2008 and 2013 have been analyzed to determine the evolution of these and to describe the implemented measures through the electronic clinical history at University Hospital of Fuenlabrada. The incidence of falls in hospitalized patients has been estimated and the evolution with the chi square test has been studied. The frequencies of the characteristics of patients who fall has been presented: age, length of stay, performed activity, patient companion, mobility level, state of consciousness. 445 registered falls happened. 2009 is the year with the highest number of falls, 86 patients fell of a total of 15,819 discharged patients (0.55%). The statistic drops until 2013, where 55 patients fell out of 15,052 discharged patients (0.37%). This difference was not statistically significant. The deployment of an assessment about fall risk at admission has helped to identify individualized risk factors. Furthermore, the awareness and alerts to the nursing staff have helped to consider fall prevention as a rutinary procedure, hence appropriate measures can be implemented on the most vulnerable patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. Hormonal changes when falling in love.

    Science.gov (United States)

    Marazziti, Donatella; Canale, Domenico

    2004-08-01

    To fall in love is the first step in pair formation in humans and is a complex process which only recently has become the object of neuroscientific investigation. The little information available in this field prompted us to measure the levels of some pituitary, adrenal and gonadal hormones in a group of 24 subjects of both sexes who had recently (within the previous six months) fallen in love, and to compare them with those of 24 subjects who were single or were part of a long-lasting relationship. The following hormones were evaluated by means of standard techniques: FSH, LH, estradiol, progesterone, dehydroepiandrosterone sulphate (DHEAS), cortisol, testosterone and androstenedione. The results showed that estradiol, progesterone, DHEAS and androstenedione levels did not differ between the groups and were within the normal ranges. Cortisol levels were significantly higher amongst those subjects who had recently fallen in love, as compared with those who had not. FSH and testosterone levels were lower in men in love, while women of the same group presented higher testosterone levels. All hormonal differences were eliminated when the subjects were re-tested from 12 to 24 months later. The increased cortisol and low FSH levels are suggestive of the "stressful" and arousing conditions associated with the initiation of a social contact. The changes of testosterone concentrations, which varied in opposite directions in the two sexes, may reflect changes in behavioural and/or temperamental traits which have yet to be clarified. In conclusion, the findings of the present study would indicate that to fall in love provokes transient hormonal changes some of which seem to be specific to each sex.

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

    National Research Council Canada - National Science Library

    Ribeiro, Angela dos Santos Bersot; Pereira, João Santos

    2005-01-01

    .... 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...

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

    Science.gov (United States)

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

    2011-03-28

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

  19. Drag crisis moderation by thin air layers sustained on superhydrophobic spheres falling in water

    KAUST Repository

    Jetly, Aditya

    2018-01-22

    We investigate the effect of thin air layers naturally sustained on superhydrophobic surfaces on the terminal velocity and drag force of metallic spheres free falling in water. The surface of 20 mm to 60 mm steel or tungsten-carbide spheres is rendered superhydrophobic by a simple coating process that uses commercially available hydrophobic agent. By comparing the free fall of unmodified spheres and superhydrophobic spheres in a 2.5 meters tall water tank, It is demonstrated that even a very thin air layer (~ 1 – 2 μm) that covers the freshly dipped superhydrophobic sphere, can reduce the drag force on the spheres by up to 80 %, at Reynolds numbers 105 - 3×105 , owing to an early drag crisis transition. This study complements prior investigations on the drag reduction efficiency of model gas layers sustained on heated metal spheres falling in liquid by the Leidenfrost effect. The drag reduction effects are expected to have significant implication for the development of sustainable air-layer-based energy saving technologies.

  20. Inferior hip dislocation after falling from height: A case report.

    Science.gov (United States)

    Tekin, Ali Çağrı; Çabuk, Haluk; Büyükkurt, Cem Dinçay; Dedeoğlu, Süleyman Semih; İmren, Yunus; Gürbüz, Hakan

    2016-01-01

    Traumatic inferior hip dislocation is the least common of all hip dislocations. Adult inferior hip dislocations usually occur after high-energy trauma, very few cases are reported without fracture. A 26-year-old female was brought to the emergency department with severe pain in the left hip, impaired posture and restricted movement following a fall from 15m height. The hip joint was fixed in 90° flexion, 15° abduction, and 20° external rotation. No neurovascular impairment was determined. On radiologic examination, a left ischial type inferior hip dislocation was detected. Hemorrhagic shock which developed due to acute blood loss to thoracic and abdominal cavity and patient died at third hour after she was brought to the hospital. Traumatic hip dislocations have high morbidity and mortality rates due to multiple organ damage, primarily of the extremities, chest and abdomen. In the treatment of traumatic hip dislocation, closed reduction is recommended through muscle relaxation under general anesthesia or sedation. This procedure should be applied before any intervention for concomitant extremity injuries. A detailed evaluation on emergency presentation, a multi-disciplinary approach and early diagnosis with the rapid application of imaging methods could be life-saving for such patients. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. 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].

  2. Falls in nursing home residents receiving pharmacotherapy for anemia

    Directory of Open Access Journals (Sweden)

    Reardon G

    2012-10-01

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

  3. Early experience of a fall and fracture prevention clinic at Mayo General Hospital.

    LENUS (Irish Health Repository)

    Hanley, A

    2010-06-01

    Falls in the elderly are a significant public health problem. Previous studies have shown that most falls are multifactorial and an efficacious way of reducing the risk of falling is provided by a falls clinic.

  4. A Falls Wheel in a Large Academic Medical Center: An Intervention to Reduce Patient Falls With Harm.

    Science.gov (United States)

    Hefner, Jennifer L; McAlearney, Ann Scheck; Mansfield, Jerry; Knupp, Amy M; Moffatt-Bruce, Susan D

    2015-01-01

    This article presents an evaluation of a multifaceted fall prevention initiative. The main element of this initiative was the creation and implementation of a Falls Wheel--a visual communication tool of a patient's fall injury risk for all care team members placed on every patient door throughout the health system. The Falls Wheel allows for patient categorization along two dimensions simultaneously: risk of fall and risk of injury from a fall. During the yearlong implementation, the rate of falls with harm dropped by almost 50%. A process audit revealed that there was high fidelity to the intervention components, including displaying the wheel correctly 95% of the time, and the Falls Wheel was updated to match the risk level in the electronic health record 70% of the time. The goal of this article was to share the experience of one health system and encourage others to adopt and rigorously test the Falls Wheel. Replication and extension of this program at other hospitals and health systems will enable staff and empower patients to reduce falls with harm and their unintended consequences.

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

    Science.gov (United States)

    Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

    2016-01-01

    Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (Pgeriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

  6. A Growing Troubling Triad: Diabetes, Aging, and Falls

    Directory of Open Access Journals (Sweden)

    Ryan T. Crews

    2013-01-01

    Full Text Available There is a significant and troubling link between diabetes (DM and falls in the elderly. Individuals with DM are prone to fall for reasons such as decreased sensorimotor function, musculoskeletal/neuromuscular deficits, foot and body pain, pharmacological complications, and specialty (offloading footwear devices. Additionally, there is some concern that DM patients are prone to have more severe problems with falls than non-DM individuals. Fractures, poorer rehabilitation, and increased number of falls are all concerns. Fortunately, efforts to mitigate falls by DM patients show promise. A number of studies have shown that balance, strength, and gait training may be utilized to successfully reduce fall risk in this population. Furthermore, new technologies such as virtual reality proprioceptive training may be able to provide this reduced risk within a safe training environment.

  7. Emerging concept: 'central benefit model' of exercise in falls prevention.

    Science.gov (United States)

    Liu-Ambrose, Teresa; Nagamatsu, Lindsay S; Hsu, Chun Liang; Bolandzadeh, Niousha

    2013-01-01

    Falls are a common geriatric syndrome and are the third leading cause of chonic disability worldwide. Falls are not random events and occur, at least in part, due to impaired physiological function, such as impaired balance, and cognitive impairment. The clinical syndrome of falls is important for Sports and Exercise Medicine Clinicians as there is Level 1 evidence that targeted exercise prescription is an effective intervention strategy. The widely accepted dogma is that improved physical function, balance and muscle strength, underlies the effectiveness of the exercise in reducing falls. However, findings from randomised controlled trials suggest that exercise reduce falls via mechanisms other than improved physiological function. The authors propose that improved cognitive function - specifically, executive functions - and associated functional plasticity may be an important yet underappreciated mechanism by which the exercise reduces falls in older adults.

  8. A novel wearable smart button system for fall detection

    Science.gov (United States)

    Zhuang, Wei; Sun, Xiang; Zhi, Yueyan; Han, Yue; Mao, Hande

    2017-05-01

    Fall has been the second most cause of accidental injury to death in the world. It has been a serious threat to the physical and mental health of the elders. Therefore, developing wearable node system with fall detecting ability has become increasingly pressing at present. A novel smart button for long-term fall detection is proposed in this paper, which is able to accurately monitor the falling behavior, and sending warning message online as well. The smart button is based on the tri-axis acceleration sensor which is used to collect the body motion signals. By using the statistical metrics of acceleration characteristics, a new SVM classification algorithm with high positive accuracy and stability is proposed so as to classify the falls and activities of daily living, and the results can be real-time displayed on Android based mobile phone. The experiments show that our wearable node system can continuously monitor the falling behavior with positive rate 94.8%.

  9. Leidenfrost vapour layer moderation of the drag crisis and trajectories of superhydrophobic and hydrophilic spheres falling in water

    KAUST Repository

    Vakarelski, Ivan Uriev

    2014-01-01

    We investigate the dynamic effects of a Leidenfrost vapour layer sustained on the surface of heated steel spheres during free fall in water. We find that a stable vapour layer sustained on the textured superhydrophobic surface of spheres falling through 95 °C water can reduce the hydrodynamic drag by up to 75% and stabilize the sphere trajectory for the Reynolds number between 104 and 106, spanning the drag crisis in the absence of the vapour layer. For hydrophilic spheres under the same conditions, the transition to drag reduction and trajectory stability occurs abruptly at a temperature different from the static Leidenfrost point. The observed drag reduction effects are attributed to the disruption of the viscous boundary layer by the vapour layer whose thickness depends on the water temperature. Both the drag reduction and the trajectory stabilization effects are expected to have significant implications for development of sustainable vapour layer based technologies. © the Partner Organisations 2014.

  10. Leidenfrost vapour layer moderation of the drag crisis and trajectories of superhydrophobic and hydrophilic spheres falling in water.

    Science.gov (United States)

    Vakarelski, Ivan U; Chan, Derek Y C; Thoroddsen, Sigurdur T

    2014-08-21

    We investigate the dynamic effects of a Leidenfrost vapour layer sustained on the surface of heated steel spheres during free fall in water. We find that a stable vapour layer sustained on the textured superhydrophobic surface of spheres falling through 95 °C water can reduce the hydrodynamic drag by up to 75% and stabilize the sphere trajectory for the Reynolds number between 10(4) and 10(6), spanning the drag crisis in the absence of the vapour layer. For hydrophilic spheres under the same conditions, the transition to drag reduction and trajectory stability occurs abruptly at a temperature different from the static Leidenfrost point. The observed drag reduction effects are attributed to the disruption of the viscous boundary layer by the vapour layer whose thickness depends on the water temperature. Both the drag reduction and the trajectory stabilization effects are expected to have significant implications for development of sustainable vapour layer based technologies.

  11. Cost-utility of medication withdrawal in older fallers: results from the improving medication prescribing to reduce risk of FALLs (IMPROveFALL trial

    Directory of Open Access Journals (Sweden)

    Suzanne Polinder

    2016-11-01

    persons who visited an emergency department due to a fall, did not lead to reduction of total health-care costs. However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant in combination with less decline in HRQoL is an important result. Trial registration The trial is registered in the Netherlands Trial Register ( NTR1593 – October 1st 2008.

  12. Educational inequalities in falls mortality among older adults: population-based multiple cause of death data from Sweden.

    Science.gov (United States)

    Ahmad Kiadaliri, Aliasghar; Turkiewicz, Aleksandra; Englund, Martin

    2018-01-01

    Falls are the leading cause of fatal injuries among elderly adults. While socioeconomic status including education is a well-documented predictor of many individual health outcomes including mortality, little is known about socioeconomic inequalities in falls mortality among adults. This study aimed to assess educational inequalities in falls mortality among older adults in Sweden using multiple cause of death data. All residents aged 50‒75 years in the Skåne region, Sweden, during 1998‒2013 (n=566 478) were followed until death, relocation outside Skåne or end of 2014. We identified any mention of falls on death certificates (n=1047). We defined three levels of education. We used an additive hazards model and Cox regression with age as time scale adjusted for marital status and country of birth to calculate slope and relative indices of inequality (SII/RII). We also computed the population attributable fraction of lower educational attainment. Analyses were performed separately for men and women. Both SII and RII revealed statistically significant educational inequalities in falls mortality among men in favour of high educated (SII (95% CI): 15.5 (9.8 to 21.3) per 100 000 person-years; RII: 2.19 (1.60 to 3.00)) but not among women. Among men, 34% (95% CI 19 to 46) of falls deaths were attributable to lower education. There was an inverse association between education and deaths from falls among men but not women. The results suggest that individual's education should be considered in falls reduction interventions. © 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.

  13. Fall Application of Anhydrous Ammonia Emits Less Nitrous Oxide than Spring Application in the Eastern Canadian Prairies

    Science.gov (United States)

    Tenuta, M.; Hanis, K.; Gervais, M.; Amiro, B. D.

    2013-12-01

    Fall application of nitrogen fertilizer results in nitrate accumulation prior to winter freeze-up which would promote denitrification and thus nitrous oxide (N2O) emissions. Therefore spring fertilization has emerged as one strategy to reduce N2O emissions. However, the effectiveness of spring fertilization for reduction of N2O emissions is yet to be ascertained. This study compared fall and spring application of anhydrous ammonia fertilizer for N2O emissions. The study was conducted at the Trace Gas Manitoba (TGAS-MAN) Long Term Greenhouse Gas Monitoring Site on clay soil of Red River Valley, Southern Manitoba. The study included two plots each four hectares in area. Both plots were planted to spring wheat in 2011 and corn in 2012. 100 and 180 kg N ha-1 as anhydrous ammonia were applied for the wheat and corn crop years, respectively. Over the study, each plot received a late fall (mid-October to early November) and a spring (at planting) treatment of fertilizer. Emissions of N2O were measured continuously from 1 October 2010 to 30 September 2012 using the flux gradient micrometeorological technique and a tunable diode laser spectrophometer. Fall and overwinter emissions of N2O were negligible. Spring melt N2O emissions were higher with fall application however post-fertilizer emissions of N2O were much greater with spring application. Over the two year study period cumulative N2O emissions were 6 kg N ha-1 more with spring than fall application. The results call to question the belief that spring application is superior to fall application of fertilizer to reduce N2O emissions in temperate climates. For the clay soil of the northern Red River Valley of the Canadian Prairies in which surface soil freezes thoroughly each winter, late fall application seems to be a better option for reducing N2O emissions.

  14. Falls in Older Adults With Cancer: Evaluation by Oncology Providers.

    Science.gov (United States)

    Guerard, Emily J; Deal, Allison M; Williams, Grant R; Jolly, Trevor A; Nyrop, Kirsten A; Muss, Hyman B

    2015-11-01

    Falls in older adults are common. Screening for falls is quick, simple, and important because falls increase the risk of morbidity and mortality in older patients with cancer. The aim of this study was to evaluate oncology providers' recognition of and response to falls in older patients with cancer. From a sample of older patients with cancer who completed a geriatric assessment blinded to oncology providers, we identified patients who self-reported falls within the past 6 months. Their history and physical and/or clinic notes completed by an oncology provider were reviewed for the following: documentation of falls, gait assessment, referral to geriatrics or physical and/or occupational therapy, and measurement of 25-hydroxy vitamin D level. In our sample of older patients with cancer who reported at least one recent fall (N = 125), the average age was 72 years (range, 65 to 93 years), 78% were female, and 62% had a breast cancer diagnosis. Chart reviews showed that 13 (10%) had falls documented, 25 (20%) had a gait assessment, eight (6%) were referred, and 21 (17%) had vitamin D level measured. We found that only 10% of older patients with cancer who self-reported a recent fall had appropriate medical record documentation. Oncologists are often the primary care providers for older patients and are largely unfamiliar with the frequency and impact of falls in this population. There is a need to increase awareness of falls prevalence and consequences among oncology providers in order to provide timely interventions to reduce the risks associated with falls. Copyright © 2015 by American Society of Clinical Oncology.

  15. Causes of falls of roof in South African collieries

    CSIR Research Space (South Africa)

    Van der Merwe, JN

    2001-08-01

    Full Text Available length, spacing, installation quality, timing of support and A general investigation f the surrounding area, including slips and faults, dimensions, other falls. Following that, the team would reassemble and reach consensus on the cause of the roof... fall. The team would then view specific areas of interest that were found during the detailed individual inspections. Finally, the team tested their diagnosis by establishing why the roof did not fall in the adjacent areas. During the underground...

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

    Science.gov (United States)

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

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

  17. Long-term Surveillance Plan for the Falls City Disposal Site, Falls City, Texas. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  18. Long-term surveillance plan for the Falls City Disposal Site, Falls City, Texas

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. DOE will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a).

  19. Differences between Gait on Stairs and Flat Surfaces in Relation to Fall Risk and Future Falls.

    Science.gov (United States)

    Wang, Kejia; Delbaere, Kim; Brodie, Matthew; Lovell, Nigel; Kark, Lauren; Lord, Stephen; Redmond, Stephen

    2017-03-03

    We used body-worn inertial sensors to quantify differences in semi-free-living gait between stairs and on normal flat ground in older adults, and investigated the utility of assessing gait on these terrains for predicting the occurrence of multiple falls. 82 community-dwelling older adults wore two inertial sensors, on the lower back and the right ankle, during several bouts of walking on flat surfaces and up and down stairs, in between rests and activities of daily living. Derived from the vertical acceleration at the lower back, step rate was calculated from the signal's fundamental frequency. Step rate variability was the width of this fundamental frequency peak from the signal's power spectral density. Movement vigor was calculated at both body locations from the signal variance. Partial Spearman correlations between gait parameters and physiological fall risk factors (components from the Physiological Profile Assessment) were calculated while controlling for age and gender. Overall, anteroposterior vigor at the lower back in stair descent was lower in subjects with longer reaction times. Older adults walked more slowly on stairs, but they were not significantly slower on flat surfaces. Using logistic regression, faster step rate in stair descent was associated with multiple prospective falls over 12 months. No significant associations were shown from gait parameters derived during walking upstairs or on flat surfaces. These results suggest that stair descent gait may provide more insight into fall risk than regular walking and stair ascent, and that further sensor-based investigation into unsupervised gait on different terrains would be valuable.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    of retrieved publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density......OBJECTIVE: To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age. DESIGN: A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity...... (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA). RESULTS: 15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate...

  1. Development of a Wearable-Sensor-Based Fall Detection System

    Directory of Open Access Journals (Sweden)

    Falin Wu

    2015-01-01

    Full Text Available Fall detection is a major challenge in the public healthcare domain, especially for the elderly as the decline of their physical fitness, and timely and reliable surveillance is necessary to mitigate the negative effects of falls. This paper develops a novel fall detection system based on a wearable device. The system monitors the movements of human body, recognizes a fall from normal daily activities by an effective quaternion algorithm, and automatically sends request for help to the caregivers with the patient’s location.

  2. [Dementia and falls: two related syndromes in old age].

    Science.gov (United States)

    Puisieux, François; Pardessus, Vinciane; Bombois, Stéphanie

    2005-12-01

    Dementia and cognitive impairment are known as a major risk for falls and subsequent adverse events in the elderly. In addition to result in serious injury, including fractures, falls lead to functional decline due to fear of falling again and self limitation of activity in older adults. All types of dementia and all degrees of severity are involved. Rather than resulting from a single cause, falls are the result of a combination of intrinsic, situational, and environmental factors. The most common risk factors for falls in patients with cognitive impairment and dementia are gait and balance disturbances, behavioral disorders, visual problems, malnutrition, adverse effects of drugs, fear of falling, neurocardiovascular instability (particularly orthostatic hypotension), and environmental hazards. Based on data from studies in cognitively normal people who fall, a multifaceted intervention, including a physical exercise programme and modification of the risk factors may prevent falls in older people with cognitive impairment and dementia. Preliminary research suggests that physiotherapy may have a role for falls prevention in these patients. However, randomized studies need to be performed.

  3. Fall risk factors in community-dwelling elderly people

    Directory of Open Access Journals (Sweden)

    Astrid Bergland

    2012-11-01

    Full Text Available Falls are a common and serious problem for older adults. Approximately one-third of older communitydwelling people fall at least once a year. The main purpose of this paper is to present risk factors for fall in older people living at home. The databases used for identifying documentation of risk factors are Cinahl, Eric, ISI Web of Science, Cochrane Medline, Psycinfo and dissertation. Many psychosocial and medical conditions and impairment of sensorimotor function, balance and gait have been shown in large epidemiological studies to be strongly associated with falls. Several of the risk factors are interrelated. The intrinsic-extrinsic distinction seem to be an oversimplification. A better understanding of falls is usually obtained when examining the person in association with the environmental factors. Advanced age, history of falls, ADL limitations, impaired gait and mobility, visual impairment, reduced sensation, muscular weakness, poor reaction time, impaired cognition, diseases as stroke, use of psychoactive medication and use of many medications are risk factors shown to be strongly associated with falls. This means recommendation of multifactorial fall risk assessment must incorporate a range of physiological and mental tests in addition to assessing balance and gait as well as taking multiple chronic diseases and medications into account. These finding underscore the importance of multidimensional fall intervention with special focus on modifiable risk factors

  4. Primary knee osteoarthritis increases the risk of falling.

    Science.gov (United States)

    Tasci Bozbas, Gulnur; Sendur, Omer Faruk; Aydemir, Ali Hakan

    2017-01-01

    The aim of this study was to investigate the effect of primary knee osteoarthritis on the risk of falling. One hundred participants (50 with knee osteoarthritis and 50 healthy controls) were included in this study. Primary knee osteoarthritis was diagnosed according to the American College of Rheumatology (ACR) criteria. Patients who were grade 2 or 3 by Kellgren-Lawrence criteria according to weight-bearing knee radiographs were included in this study. The risk of falling was evaluated by the interactive balance and coordination device both in the osteoarthritis and control groups. The functional status and pain were evaluated with respectively Lequesne Index and Visual Analogue Scale. No statistically significant differences were found between the group of primary knee osteoarthritis and control in terms of age, BMI, and gender. The median falling index was 52 in the group with knee OA, whereas it was 31 in the control group. It was determined that primary knee osteoarthritis increased the risk of falling significantly and grade 3 primary knee osteoarthritis was statistically significantly higher than grade 2 (p 0.05). Falling is among the important causes of mortality and morbidity in advanced age. Therefore, assessment of risk factors for falling and the strategies to prevent it are important. Primary knee osteoarthritis is one of the risk factors associated with falling. Therefore, medical approaches, proprioception training, balance-gait training, muscle strengthening exercises, and arrangements to prevent domestic injurious falling should be planned to reduce the risk of falling in the presence of primary knee osteoarthritis.

  5. National Fall Prevention Workshop: stepping up pan-Canadian coordination.

    Science.gov (United States)

    2012-09-01

    About one in three Canadian seniors will experience a fall at least once each year. Such falls are the leading cause of injury-related hospitalizations among older people. Apart from causing injury, falls can result in chronic pain, reduced quality of life and, in severe cases, death. Psychological effects of a fall may cause a post-fall syndrome that includes dependence on others for daily activities, loss of autonomy, confusion, immobilization and depression. Falls and the resulting injuries often occur due to a combination of factors, including health conditions associated with aging such as vision problems, osteoporosis, dementia and symptoms of a chronic disease. They can be due to the side effects of medications, environmental hazards and risk-taking behaviours. Fall prevention initiatives and strategies are taking place in all provinces and territories and at the national level. To enhance the collaborative understanding of these initiatives, a National Fall Prevention Workshop was held at the Canadian Injury Prevention and Safety Promotion Conference in Vancouver, British Columbia, on 17 November 2011. The Workshop was co-hosted by the British Columbia Injury Research and Prevention Unit (BCIRPU) and the Public Health Agency of Canada (PHAC). Fall prevention leads from each province and territory were invited to present their most recent activities and their plans.

  6. Neighborhood Environment and Falls among Community-Dwelling Older Adults.

    Science.gov (United States)

    Nicklett, Emily Joy; Lohman, Matthew C; Smith, Matthew Lee

    2017-02-10

    Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006-2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interval (CI): 0.93-0.99) and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90-0.98). A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93-0.99) and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91-1.00) in adjusted models. Conclusions: The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings.

  7. Improved Prediction of Falls in Community-Dwelling Older Adults Through Phase-Dependent Entropy of Daily-Life Walking

    Directory of Open Access Journals (Sweden)

    Espen A. F. Ihlen

    2018-03-01

    Full Text Available Age and age-related diseases have been suggested to decrease entropy of human gait kinematics, which is thought to make older adults more susceptible to falls. In this study we introduce a new entropy measure, called phase-dependent generalized multiscale entropy (PGME, and test whether this measure improves fall-risk prediction in community-dwelling older adults. PGME can assess phase-dependent changes in the stability of gait dynamics that result from kinematic changes in events such as heel strike and toe-off. PGME was assessed for trunk acceleration of 30 s walking epochs in a re-analysis of 1 week of daily-life activity data from the FARAO study, originally described by van Schooten et al. (2016. The re-analyzed data set contained inertial sensor data from 52 single- and 46 multiple-time prospective fallers in a 6 months follow-up period, and an equal number of non-falling controls matched by age, weight, height, gender, and the use of walking aids. The predictive ability of PGME for falls was assessed using a partial least squares regression. PGME had a superior predictive ability of falls among single-time prospective fallers when compared to the other gait features. The single-time fallers had a higher PGME (p < 0.0001 of their trunk acceleration at 60% of their step cycle when compared with non-fallers. No significant differences were found between PGME of multiple-time fallers and non-fallers, but PGME was found to improve the prediction model of multiple-time fallers when combined with other gait features. These findings suggest that taking into account phase-dependent changes in the stability of the gait dynamics has additional value for predicting falls in older people, especially for single-time prospective fallers.

  8. Comparison of the validity of four fall-related psychological measures in a community-based falls risk screening.

    Science.gov (United States)

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

    2011-09-01

    We examined the measurement properties offall-related psychological instruments with a sample of 133 older adults (M age = 74.4 years, SD = 9.4). Measures included the Comprehensive Falls Risk Screening Instrument, Falls-efficacy Scale-International (FES-I), Activities-specific Balance Confidence (ABC), modified Survey ofActivities and Fear ofFalling in the Elderly (mSAFFE), Consequences of Falling (CoF), Physical Activity Scale for the Elderly (PASE), and 36-Item Short-Form Health Survey (SF-36). The FES-I, ABC, mSAFFE, and CoF were significantly correlated with each othe, with SF-36, and with mobility. The ABC and mSAFFE were significantly correlated with PASE. The ABC differentiated between fallers and nonfallers and predicted total falls risk. Findings can assist with the selection of psychological instruments in a falls risk screening context.

  9. An analysis of the relationship between bodily injury severity and fall height in victims of fatal falls from height

    Directory of Open Access Journals (Sweden)

    Grzegorz Teresiński

    2017-03-01

    Full Text Available Aim of the study : One of the basic issues discussed in forensic literature regarding falls from a height is determination of fall heights and differentiation between suicidal and accidental falls. The aim of the study was to verify the usefulness of the available methods for the purposes of forensic expertises. Material and methods : The study encompassed fatalities of falls from a height whose autopsies were performed in the Department of Forensic Medicine in Lublin. Results : Similarly to other authors, the severity of injuries was assessed using the Abbreviated Injury Scale (AIS and injury severity score (ISS. The study findings demonstrated a statistically significant correlation between the fall height and the severity of injuries according to ISS and a statistically significant difference in fall heights between the groups of accidents and suicides.

  10. Characterizing Dynamic Walking Patterns and Detecting Falls with Wearable Sensors Using Gaussian Process Methods.

    Science.gov (United States)

    Kim, Taehwan; Park, Jeongho; Heo, Seongman; Sung, Keehoon; Park, Jooyoung

    2017-05-20

    By incorporating a growing number of sensors and adopting machine learning technologies, wearable devices have recently become a prominent health care application domain. Among the related research topics in this field, one of the most important issues is detecting falls while walking. Since such falls may lead to serious injuries, automatically and promptly detecting them during daily use of smartphones and/or smart watches is a particular need. In this paper, we investigate the use of Gaussian process (GP) methods for characterizing dynamic walking patterns and detecting falls while walking with built-in wearable sensors in smartphones and/or smartwatches. For the task of characterizing dynamic walking patterns in a low-dimensional latent feature space, we propose a novel approach called auto-encoded Gaussian process dynamical model, in which we combine a GP-based state space modeling method with a nonlinear dimensionality reduction method in a unique manner. The Gaussian process methods are fit for this task because one of the most import strengths of the Gaussian process methods is its capability of handling uncertainty in the model parameters. Also for detecting falls while walking, we propose to recycle the latent samples generated in training the auto-encoded Gaussian process dynamical model for GP-based novelty detection, which can lead to an efficient and seamless solution to the detection task. Experimental results show that the combined use of these GP-based methods can yield promising results for characterizing dynamic walking patterns and detecting falls while walking with the wearable sensors.

  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. A sustainable programme to prevent falls and near falls in community dwelling older people: results of a randomised trial

    OpenAIRE

    Steinberg, M; Cartwright, C; Peel, N.; Williams, G

    2000-01-01

    STUDY OBJECTIVE—In the causative mechanism of falls among older community dwellers, slips and trips have been found to be significant precursors. The purpose of the two year trial was to assess the effectiveness of multi-component interventions targeting major risk factors for falls in reducing the incidence of slips, trips and falls among the well, older community.
DESIGN—Four groups with approximately equal numbers of participants were randomly allocated to interventions. The prevention str...

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

    OpenAIRE

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

    2016-01-01

    A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall...

  14. 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".

  15. Susceptibility to shallow landslides of soil in the municipality of Temoaya, Mexico: multicriteria analysis

    Directory of Open Access Journals (Sweden)

    Patricia Flores

    2012-04-01

    Full Text Available Owing to the mountainous character of the Mexican terrain, as well as the ecological effects of changes in land use, particularly in recent decades, and the occurrence of severe and frequent hydro-meteorological phenomena, the instability of slopes dislodged by precipitation constitutes a major hazard in various regions of the country, among them the municipality of Temoaya in the State of Mexico. In this municipality, where the mountainous relief formed by poorly consolidated and faulting volcaniclastic deposits favours instability, there are 33 active processes of mass movement, of which thirty –the most important– are shallow soil translational landslides (SSTL, one is a debris slide and two are rock falls. The occurrence of SSTLs is controlled by the character of the volcaniclastic deposits, specifically pyroclastic flows of blocks, ash and pumice; because these are permeable materials they favour infiltration; if the subjacent material is impermeable or of low permeability, water accumulates on the sub-horizontal lithological contact and transforms into a flow that leads to the instability of the overlying material. A map of susceptibility to SSTLs was generated by means of a multicriteria analysis. According to the map produced, 15% of the municipality is very highly susceptible to landslides, 35% is highly susceptible, 30% shows medium susceptibility, and the remaining 20% has low or very low susceptibility.

  16. 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

  17. End effects for the falling cylinder viscometer

    Science.gov (United States)

    Wehbeh, Elias G.; Ui, T. J.; Hussey, R. G.

    1993-01-01

    Experimental results are presented for the Stokes velocity of a circular cylinder of radius a and length L moving axially through a viscous fluid contained within a coaxial closed cylindrical tube of radius b and length H. The results cover the intermediate range 0.21 ≤a/b≤0.70 and are found to be consistent with theoretical results for the narrow gap case (a≂b) and with previous experimental results for the wide gap case (a≪b). The fractional difference between the observed drag and the theoretical drag is represented well by 1.67x-0.017, where x=(b-a)(a/b)1/2/L. The negative term is interpreted as representing an effective cylinder length of 0.983L, and the 1.67x term is interpreted qualitatively as a measure of the degree to which the fluid is displaced radially by the falling cylinder. The limitations of our expression for end effects are explored experimentally. Additional experimental results are presented for two cases in which the ends of the cylindrical tube are not closed.

  18. Decadal Oscillation of Fall Temperature in Taiwan

    Directory of Open Access Journals (Sweden)

    Jau-Ming Chen

    2008-01-01

    Full Text Available This study verifies the existence of an evident decadal oscillation in fall (September - November temperature for Taiwan. It has an island-wide spatial pattern and a central frequency of 11 years. Acorresponding decadal-oscillation mode of tropical sea surface temperature (SST is found to be largely responsible for inducing the decadal temperature oscillation for Taiwan via the following regulating processes. On a decadal timescale, periods of decadal warming in Taiwan concur with major cold anomalies in tropical SST over the eastern Indian Ocean and the central Pacific. These cold SST anomalies modulate tropical Walker circulation so as to produce anomalous descending centers in their regions. Meanwhile, the complementary anomalous ascending motion and anomalous low-level convergence center occur near the Maritime continent. These anomalous ascending and descending centers act as tropical forcing sources to evoke a low-level Rossby-wave-like circulation anomaly in the Asian-Pacific regions. Taiwan is surrounded by a low-level anomalous high to its east and an anomalous low to its west. These circulations induce anomalous flows from the south to warm Taiwan via anomalous warm advection. The above regulating processes reverse in polarity during periods of decadal cooling in Taiwan.

  19. Small Sized Drone Fall Recover Mechanism Design

    Science.gov (United States)

    LIU, Tzu-Heng; CHAO, Fang-Lin; LIOU, Jhen-Yuan

    2017-12-01

    Drones uses four motors to rotate clockwise, counter-clockwise, or change in rotational speed to change its status of motion. The problem of Unmanned Aerial Vehicle turnover causes personal loses and harm local environment. Designs of devices that can let falling drones recover are discussed. The models attempt to change the orientation, so that the drone may be able to improve to the point where it can take off again. The design flow included looking for functional elements, using simplify model to estimate primary functional characteristics, and find the appropriate design parameters. For reducing the complexity, we adopted the simple rotate mechanism with rotating arms to change the fuselage angle and reduce the dependence on the extra-components. A rough model was built to verify structure, and then the concept drawing and prototype were constructed. We made the prototype through the integration of mechanical part and the electronic control circuit. The electronic control module that selected is Arduino-mini pro. Through the Bluetooth modules, user can start the rebound mechanism by the motor control signal. Protections frames are added around each propeller to improve the body rotate problem. Limited by current size of Arduino module, motor and rebound mechanism make the main chassis more massive than the commercial product. However, built-in sensor and circuit miniaturization will improve it in future.

  20. 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

  1. [Falls and osteoporotic fractures prevention units: proposed Osteoporosis, Falls and Fractures Group of the Spanish Society of Geriatrics and Gerontology].

    Science.gov (United States)

    Duaso, Enric; Casas, Alvaro; Formiga, Francesc; Lázaro Del Nogal, Montserrat; Salvà, Antoni; Marcellán, Teresa; Navarro, Carmen

    2011-01-01

    Since forming the Osteoporosis, Falls and Fractures Group of the Spanish Society (GOCF) of Geriatrics and Gerontology (SEGG) a review was performed of the epidemiology of falls, along with a description of measures that have shown a degree of effectiveness in prevention. We also present the proposal of a common basic model of action in fall prevention units, mainly addressed to the community. Finally, a consensus model falls register is presented, common to community level and institutional areas, with the objective of being useful and easy to fill in at any care level. Copyright © 2011 SEGG. Published by Elsevier Espana. All rights reserved.

  2. Predictive Factors for Inpatient Falls among Children with Cerebral Palsy.

    Science.gov (United States)

    Alemdaroğlu, Ebru; Özbudak, Sibel Demir; Mandiroğlu, Sibel; Biçer, Seda Alakoç; Özgirgin, Neşe; Uçan, Halil

    Inpatient falls are of significant concern. The aim of this prospective study was to determine the predictors of inpatient falls among children with cerebral palsy in a rehabilitation hospital. A total of 93 patients with cerebral palsy were assessed based on history, physical findings, the Selective Motor Control Test, the Gross Motor Functional Classification System, the Berg Balance Scale and the Manual Ability Classification System. Previous history of falls/frequent falls, and any falls which occurred during hospitalization, were recorded. Of all 93 patients, 25 (27%) fell and 68 (73%) did not fall. The mean age of the fallers (6.3±2.0 years) was lower than that of the non-fallers (8.1±3.9 years). Behavioral problems according to the mother's statement (OR 26.454), not being able to maintain a long sitting position (OR 10.807), ability to balance on knees without support (OR 9.810), a history of frequent falls (OR 4.893) and a negative Thomas test (OR 4.192 fold) were found to increase the risk of inpatient falls. In these children with cerebral palsy, behavioral problems according to the mother's statement, a history of frequent falls, not being able to maintain a long sitting position, a negative Thomas test, and able to balance on knees without support were associated with the risk of inpatient falls. Children with cerebral palsy may experience inpatient falls. Further studies are required in order to develop prevention programs. For patients diagnosed with cerebral palsy, these results may help identify possible inpatient fallers on hospital admission. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The characteristics and factors of emergency service visits for falls.

    Science.gov (United States)

    Malta, Deborah Carvalho; Silva, Marta Maria Alves da; Mascarenhas, Márcio Dênis Medeiros; Sá, Naíza Nayla Bandeira de; Morais Neto, Otaliba Libânio de; Bernal, Regina Tomie Ivata; Monteiro, Rosane Aparecida; Andrade, Silvânia Suely Caribé de Araújo; Gawryszewski, Vilma Pinheiro

    2012-02-01

    To analyze the characteristics of visits to the emergency services that result from falls and to identify the factors associated with these visits. A cross-sectional study of 12,617 visits that resulted from falls, recorded in the National Injury Surveillance System, was carried out. The data were collected in 23 Brazilian capitals and the Federal District between September and November 2009 using cluster sampling. Correspondence analysis was used, which allowed for the joint observation of a large number of qualitative variables. Most of the victims were male (56.5%), aged 0 to 19 years (45.7%), and identified as non-white skin color (62.2%). The majority of the falls occurred at home (54.6%) and in the street (17.4%); 14.3% were work-related. The predominant types were "falls on the same level" (57.0%) and "falls from a ladder/step" (15.6%). Most of the injuries were classified as sprains, dislocations, bruises, cuts, or lacerations (68.3%). Falls among children occurred mostly at home; among adolescents at school; and among young people at sports facilities. Falls among adults were associated with the work place, including falls from scaffolding, roofs, stairs/steps, and holes and were linked to alcohol use. Falls on the same level resulted in less serious injuries, mostly on the upper and lower limbs, and falls from scaffolding and roofs were associated with more severe injuries and hospitalization. The results show that strategies to prevent falls should target residences, schools, and work environments.

  4. 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...... of their meaning. A potential for inadvertently raising concerns over the effect of chemicals in experimental animals or man, or even the intentional misrepresentation of results to suggest chemicals are “playing” with our genes is enormous. History has shown that some individuals and groups in society are willing...

  5. Validity and sensitivity to change of the falls efficacy scales international to assess fear of falling in older adults with and without cognitive impairment

    DEFF Research Database (Denmark)

    Hauer, Klaus A; Kempen, Gertrudis I J M; Schwenk, Michael

    2011-01-01

    Measures of fear of falling have not yet been validated in patients with dementia, leaving a methodological gap that limits research in a population at high risk of falling and fall-related consequences....

  6. 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.

  7. Proteochemometric modeling of HIV protease susceptibility

    National Research Council Canada - National Science Library

    Lapins, Maris; Eklund, Martin; Spjuth, Ola; Prusis, Peteris; Wikberg, Jarl E S

    2008-01-01

    .... Therefore, we used proteochemometrics to model the susceptibility of HIV to protease inhibitors in current use, utilizing descriptions of the physico-chemical properties of mutated HIV proteases...

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

    Science.gov (United States)

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

    2017-04-01

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

  9. The implications of fall armyworm strains for insect resistance management

    Science.gov (United States)

    Fall armyworm is a long-time agricultural pest in the Western Hemisphere and has recently become a major problem in many areas of Africa. Adding to the concern is the development of resistance to a subset of Bt-toxins in some fall armyworm populations that could compromise one of the more effective...

  10. 29 CFR 1915.159 - Personal fall arrest systems (PFAS).

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Personal fall arrest systems (PFAS). 1915.159 Section 1915... Protective Equipment (PPE) § 1915.159 Personal fall arrest systems (PFAS). The criteria of this section apply to PFAS and their use. Effective January 1, 1998, body belts and non-locking snaphooks are not...

  11. Childhood Fall from Heights in Sokoto, Nigeria. | MUNGADI | Sahel ...

    African Journals Online (AJOL)

    ... commonest trauma was head injury seen in 36 patients (55.4%) and was responsible for the overall mortality of 6.8% (4 cases). Extremity fractures occurred in 18 patients (27.7%) and limb lost was recorded in 5 patients (8.5%). The biomechanics of fall, the peculiarities of fall from height in this environment and preventive ...

  12. Abdominal injuries after high falls: high incidence and increased mortality

    NARCIS (Netherlands)

    van Hensbroek, P. Boele; van Ooijen, M.; Lamers, A. B. G. N.; Ponsen, K.-J.; Goslings, J. C.

    2013-01-01

    Falls from height are a major cause of morbidity and mortality. Injuries to the extremities and head are common. However, little has been reported on abdominal injuries or their treatment. This study aims to assess the abdominal injuries, treatment, and mortality after falls from height. We searched

  13. Fall detection with body-worn sensors : A systematic review

    NARCIS (Netherlands)

    Schwickert, L.; Becker, C.; Lindemann, U.; Marechal, C.; Bourke, A.; Chiari, L.; Helbostad, J. L.; Zijlstra, Wiebren; Aminian, K.; Todd, C.; Bandinelli, S.; Klenk, J.

    2013-01-01

    Background and aims. Falls among older people remain a major public health challenge. Body-worn sensors are needed to improve the understanding of the underlying mechanisms and kinematics of falls. The aim of this systematic review is to assemble, extract and critically discuss the information

  14. The Tail-less Cat in Free-Fall.

    Science.gov (United States)

    Fredrickson, J. E.

    1989-01-01

    Describes four kinds of movement by a cat with or without angular momentum and tail or tail-less during free falling. Presents many pictures illustrating the movement. Supports the position that the angular momentum of the tail plays an important role in free fall. (YP)

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

    African Journals Online (AJOL)

    The aim of this study at the specific cement manufacturing plant and open cast mine was to develop a positioning guideline for monitoring equipment and to optimise the fall out dust sampling programme. A baseline study was conducted on existing practices and legal requirements relating to fall out dust monitoring.

  16. Verbal Politeness in Chinua Achebe's Things Fall Apart | Arua ...

    African Journals Online (AJOL)

    This article focuses on verbal politeness in Things Fall Apart. The paper adds to the available literature on Things Fall Apart, a pragmatic view. The study realizes that most of the utterances encode positive politeness which consolidates solidarity and communal living leading to cohesion in the society. There are instances of ...

  17. Falls among pregnant women in Enugu, Southeast Nigeria

    African Journals Online (AJOL)

    2013-10-04

    Oct 4, 2013 ... Background: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of ... to be associated with an increased risk of fractures, sprains, head injury .... reported causes of falls during pregnancy by the women are as shown in Table 4.

  18. Litter fall and decomposition of mangrove species Avicennia marina ...

    African Journals Online (AJOL)

    Abstract—Litter fall and decomposition of mangrove leaves were compared for different seasons, species (Avicennia marina and Rhizophora mucronata) and sites in southern Mozambique. Mangrove leaf litter fall and decomposition was estimated using small mesh collecting-baskets and litter bags respectively in 2006 and ...

  19. Hazardous Waste Cleanup: Olin Corporation in Niagara Falls, New York

    Science.gov (United States)

    The Olin Niagara Falls Plant (the Plant), comprised of two separate lots, is located south of Buffalo Avenue in Niagara Falls, approximately 1,000 feet north of the Upper Niagara River. Historically, Olin produced chlorine and caustic soda from rock salt

  20. The Fall of the Leaf, and Autumnal Tints

    NARCIS (Netherlands)

    MacDonald, Alasdair A.

    2013-01-01

    A well-known marker of the difference between British and American English is the choice between fall or autumn for the third season of the year. This note explores the evolution of the difference, and suggests that fall may have had an original reference to the seasonal discoloration, rather than

  1. CIRCUMSTANCES AND CONSEQUENCES OF FALLS IN POLIO SURVIVORS

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-01-01

    Objectives: Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. Methods: A survey was conducted among 376 polio

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

    Directory of Open Access Journals (Sweden)

    Shekhar K. Gadkaree BS

    2015-05-01

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

  3. Prevalence of selected fall variables and relationship among them in ...

    African Journals Online (AJOL)

    Prevalence of selected fall variables and relationship among them in a Nigerian stroke population. ... Design: Ex-post facto study with co-relational design. Methods-This correlation study involved 26 stroke ... interview were respectively used to assess fear, risk and incidence of falls of participants. Results- FOF prevalence ...

  4. Mesotherapy for local fat reduction.

    Science.gov (United States)

    Jayasinghe, S; Guillot, T; Bissoon, L; Greenway, F

    2013-10-01

    Mesotherapy, which is the injection of substances locally into mesodermally derived subcutaneous tissue, developed from empirical observations of a French physician in the 1950s. Although popular in Europe for many medical purposes, it is used for local cosmetic fat reduction in the United States. This paper reviews manuscripts indexed in PubMed/MEDLINE under 'mesotherapy', which pertains to local fat reduction. The history of lipolytic mesotherapy, the physiology of body fat distribution, the mechanism of action of different lipolytic stimulators and their increased efficacy in combination are reviewed. Mesotherapy falls into two categories. Lipolytic mesotherapy using lipolytic stimulators requires more frequent treatments as the fat cells are not destroyed and can refill over time. Ablative mesotherapy destroys fat cells with a detergent, causes inflammation and scarring from the fat necrosis, but requires fewer treatments. The historic and empiric mixing of sodium channel blocking local anaesthetics in mesotherapy solutions inhibits the intended lipolysis. Major mesotherapy safety concerns include injection site infections from poor sterile technique. Cosmetic mesotherapy directs the area from which fat is lost to improve self-image. Studies were of relatively small number, many with limited sample sizes. Future research should be directed towards achieving a Food and Drug Administration indication rather than continuing expansion of off-label use. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

  5. Factors Predicting Falls and Mobility Outcomes in Patients With Stroke Returning Home After Rehabilitation Who Are at Risk of Falling.

    Science.gov (United States)

    Ng, Mandy Man-Di; Hill, Keith D; Batchelor, Frances; Burton, Elissa

    2017-12-01

    To identify factors predicting falls and limited mobility in people with stroke at 12 months after returning home from rehabilitation. Observational cohort study with 12-month follow-up. Community. People with stroke (N=144) and increased falls risk discharged home from rehabilitation. Not applicable. Falls were measured using monthly calendars completed by participants, and mobility was assessed using gait speed over 5m (high mobility: >0.8m/s vs low mobility: ≤0.8m/s). Both measures were assessed at 12 months postdischarge. Demographics and functional measures, including balance, strength, visual or spatial deficits, disability, physical activity level, executive function, functional independence, and falls risk, were analyzed to determine factors significantly predicting falls and mobility levels after 12 months. Those assessed as being at high falls risk (Falls Risk for Older People in the Community [FROP-Com] score≥19) were 4.5 times more likely to fall by 12 months (odds ratio [OR], 4.506; 95% confidence interval [CI], 1.71-11.86; P=.002). Factors significantly associated with lower usual gait speed (≤0.8m/s) at 12 months in the multivariable analysis were age (OR, 1.07; 95% CI, 1.01-1.14; P=.033), physical activity (OR, 1.09; 95% CI, 1.03-1.17, P=.007), and functional mobility (OR, .83; 95% CI, .75-.93; P=.001). Several factors predicted falls and limited mobility for patients with stroke 12 months after rehabilitation discharge. These results suggest that clinicians should include assessment of falls risk (FROP-Com), physical activity, and dual-task Timed Up and Go test during rehabilitation to identify those most at risk of falling and experiencing limited mobility outcomes at 12 months, and target these areas during inpatient and outpatient rehabilitation to optimize long-term outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Elizabeth A Phelan

    2016-09-01

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

  7. Executive control deficits as a prodrome to falls in healthy older adults: a prospective study linking thinking, walking, and falling.

    Science.gov (United States)

    Herman, Talia; Mirelman, Anat; Giladi, Nir; Schweiger, Avraham; Hausdorff, Jeffrey M

    2010-10-01

    Executive function (EF) deficits may increase fall risk, even among older adults with no overt cognitive impairment. Indeed, the effects of dual tasking (DT) on gait, a challenge to executive control, are more exaggerated in persons with a history of falls. Prospective evidence is, however, lacking. We prospectively evaluated whether EF predicts falls over a 2-year period among 262 community-living, healthy, and well-functioning older adults, focusing on the 201 who reported no falls during the previous year. At baseline, participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains. Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions. The 262 participants (mean age: 76.3 ± 4.3 years, 60.3% women) had intact cognitive function on testing, a low comorbidity index, and good mobility. The EF index predicted future falls. Among those who reported no previous falls, participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up, and they were more likely to transition from nonfaller to faller sooner. DT gait variability also predicted future falls and multiple falls, whereas other measures of cognitive function, gait, and mobility did not. Among healthy older adults, individuals with poorer EF are more prone to falls. Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that demands multitasking. Optimal screening, early detection, and treatment of falls should, apparently, also target this cognitive domain.

  8. The REFORM study protocol: a cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people.

    Science.gov (United States)

    Cockayne, Sarah; Adamson, Joy; Corbacho Martin, Belen; Fairhurst, Caroline; Hewitt, Catherine; Hicks, Kate; Hull, Robin; Keenan, Anne Maree; Lamb, Sarah E; Loughrey, Lorraine; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony C; Rodgers, Sara; Vernon, Wesley; Watson, Judith; Torgerson, David

    2014-12-17

    Falls and fall-related injuries are a serious cause of morbidity and cost to society. Foot problems and inappropriate footwear may increase the risk of falls; therefore podiatric interventions may play a role in reducing falls. Two Cochrane systematic reviews identified only one study of a podiatry intervention aimed to reduce falls, which was undertaken in Australia. The REFORM trial aims to evaluate the clinical and cost-effectiveness of a multifaceted podiatry intervention in reducing falls in people aged 65 years and over in a UK and Irish setting. This multicentre, cohort randomised controlled trial will recruit 2600 participants from routine podiatry clinics in the UK and Ireland to the REFORM cohort. In order to detect a 10% point reduction in falls from 50% to 40%, with 80% power 890 participants will be randomised to receive routine podiatry care and a falls prevention leaflet or routine podiatry care, a falls prevention leaflet and a multifaceted podiatry intervention. The primary outcome is rate of falls (falls/person/time) over 12 months assessed by patient self-report falls diary. Secondary self-report outcome measures include: the proportion of single and multiple fallers and time to first fall over a 12-month period; Short Falls Efficacy Scale-International; fear of falling in the past 4 weeks; Frenchay Activities Index; fracture rate; Geriatric Depression Scale; EuroQoL-five dimensional scale 3-L; health service utilisation at 6 and 12 months. A qualitative study will examine the acceptability of the package of care to participants and podiatrists. The trial has received a favourable opinion from the East of England-Cambridge East Research Ethics Committee and Galway Research Ethics Committee. The trial results will be published in peer-reviewed journals and at conference presentations. Current Controlled Trials ISRCTN68240461 assigned 01/07/2011. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  9. 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.

  10. Individual income and falls among the elderly in Latin America.

    Science.gov (United States)

    Trujillo, Antonio J; Puvanachandra, Prasanthi; Hyder, Adnan A

    2011-04-01

    The burden of falls amongst the elderly raises important public health concerns. Empirical evidence suggests that macroeconomic growth may not be sufficient to reduce mortality and morbidity from injuries among the elderly. This paper consolidates macro- and microeconomic evidence of the effect of income on elderly falls in Latin America. Using household databases, we estimate an empirical model to assess the relationship between income and falls. The estimations indicate that an increase in personal income reduces the probability of falling; yet, the size of the effect is negligible. A 10% increase in income reduces the probability of falling between 0.001 and 0.002% while a 20% increase reduced the probability by up to 1%. These findings are consistent with macroeconomic data where morbidity and mortality among seniors are inelastic to economic growth. Policy implications of cash transfer programs targeting the elderly are discussed. © 2010 Japan Geriatrics Society.

  11. The role of exercise for fall prevention in older age

    Directory of Open Access Journals (Sweden)

    Anne Tiedemann

    2013-09-01

    Full Text Available Falls are a common, costly and preventable consequence of sensorimotor impairments that increase in prevalence with advancing age. A fall occurs when the physical ability of the individual is unable to match the immediate demands of the environment and/or of the activity being undertaken. Targeted exercise aimed at improving the physical ability of the individual, such as balance and strength training, is crucial for promoting functional independence and mobility and reducing the risk of falling in older age. Exercise programs that provide a high challenge to balance, have a high dose, include progression of intensity over time and are ongoing are most effective for preventing falls. This paper provides guidance to health professionals involved with the prescription of physical activity and exercise to older people regarding the safe and effective provision of programs aimed at improving strength and balance and preventing falls in older age.

  12. [Falls mortality trends in México, 1979-2010].

    Science.gov (United States)

    Celis-de la Rosa, Alfredo de Jesús; Méndez-Magaña, Ana; Orozco-Valerio, María; Baez-Baez, Guadalupe Laura; Dávalos-Guzmán, Julio César

    2013-01-01

    To analyze the mortality trend by accidental falls in Mexico, from 1979 to 2010. We used official mortality data in México. Variables included were mortality cause, place of lesion, age, sex, year of mortality registration, size of the town of occurrence, state, occupation, workplace falls. During that period, 124,509 deaths by accidental and intentional falls were registered; of these 77.03% were men. From 1989 (3.20 per 100,000) to 2010 (1.99 per 100,000), the mortality trend was falling (β = -0.053/ 100,000, p ≤ 0.001). In the majority of states, we found a decreased between 1993-1997 and 2006 to 2010, except in Aguascalientes, Puebla, Baja California Sur, Durango and Nuevo León. This is the first study in México that showed the descending trend of mortality in accidental falls in the last two decades.

  13. Urinary incontinence in the prediction of falls in hospitalized elderly

    Directory of Open Access Journals (Sweden)

    Hellen Cristina de Almeida Abreu

    2014-10-01

    Full Text Available Objective Analyzing the effect of urinary incontinence as a predictor of the incidence of falls among hospitalized elderly. Method Concurrent cohort study where 221 elderly inpatients were followed from the date of admission until discharge, death or fall. The Kaplan-Meier methods, the incidence density and the Cox regression model were used for the survival analysis and the assessment of the association between the exposure variable and the other variables. Results Urinary incontinence was a strong predictor of falls in the surveyed elderly, and was associated with shorter time until the occurrence of event. Urinary incontinence, concomitant with gait and balance dysfunction and use of antipsychotics was associated with falls. Conclusion Measures to prevent the risk of falls specific to hospitalized elderly patients who have urinary incontinence are necessary.

  14. Fall-prevention pilot: hazard survey and responses to recommendations.

    Science.gov (United States)

    Greene, David; Sample, Pat; Fruhauf, Christine

    2009-01-01

    This work reports a partial inventory of fall hazards for community-dwelling elders and characterizes older adult responses to fall prevention. Thirty-five seniors living in their homes participated in a fall-prevention initiative designed to identify hazards and make recommendations. Fifteen external hazards were identified and operationalized, and between one and four changes were reported per home in 18 of 22 homes, consistent with recommendations; however, most of the recommendations were unrelated to the cause of later participant falls. Considering the varied circumstances of falls in the community, we question the wisdom of designating specific risk posed by individual hazards and encourage future investigation on the merits of multifaceted evaluation and intervention including the consideration of combinations and interactions of hazards as well as raising caution and awareness.

  15. Reducing falls and resulting hip fractures among older women.

    Science.gov (United States)

    Stevens, J A; Olson, S

    2000-03-31

    Fall-related injuries are the leading cause of injury deaths and disabilities among older adults (i.e., persons aged > or = 65 years). The most serious fall injury is hip fracture; one half of all older adults hospitalized for hip fracture never regain their former level of function. In 1996, a total of 340,000 hospitalizations for hip fracture occurred among persons aged > or = 65 years, and 80% of these admissions occurred among women. From 1988 to 1996, hip fracture hospitalization rates for women aged > or = 65 years increased 23%. Risk factors for falls include increasing age, muscle weakness, functional limitations, environmental hazards, use of psychoactive medications, and a history of falls. Age is also a risk factor for hip fracture. Women aged > or = 85 years are nearly eight times more likely than women aged 65-74 years to be hospitalized for hip fracture. White women aged > or = 65 years are at higher risk for hip fracture than black women. Other riskfactors for hip fracture include lack of physical activity, osteoporosis, low body mass index, and a previous hip fracture. Because approximately 95% of hip fractures result from falls, minimizing fall risk is a practical approach to reducing these serious injuries. Research demonstrates that effective fall prevention strategies require a multifaceted approach with both behavioral and environmental components. Important elements include education and skill building to increase knowledge about fall risk factors, exercise to improve strength and balance, home modifications to reduce fall hazards, and medication assessment to minimize side effects (e.g., dizziness and grogginess). Coordination needs to be improved among the diverse Federal, state, and local organizations that conduct fall prevention activities. The effectiveness of existing fall prevention programs among specific groups of women (e.g., those aged > or = 85 years or living with functional limitations) needs careful evaluation. New primary fall

  16. Falls and Physical Activity in Persons with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    J. J. Sosnoff

    2012-01-01

    Full Text Available Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry in persons with multiple sclerosis. Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS score, and wore an accelerometer around the waist for 7 consecutive days to determine physical activity. Results. Overall, 37 persons (49.3% of the sample reported falling in the last year with 28 of the 37 falling more than once. Persons who fell in the last year had a significantly lower number of steps/day than nonfallers (3510 versus 4940 steps/day; P.05. Conclusions. Collectively, the findings suggest that fall history may have little impact on current physical activity levels in persons with multiple sclerosis.

  17. Dynamic Bayesian Networks for Context-Aware Fall Risk Assessment

    Directory of Open Access Journals (Sweden)

    Gregory Koshmak

    2014-05-01

    Full Text Available Fall incidents among the elderly often occur in the home and can cause serious injuries affecting their independent living. This paper presents an approach where data from wearable sensors integrated in a smart home environment is combined using a dynamic Bayesian network. The smart home environment provides contextual data, obtained from environmental sensors, and contributes to assessing a fall risk probability. The evaluation of the developed system is performed through simulation. Each time step is represented by a single user activity and interacts with a fall sensors located on a mobile device. A posterior probability is calculated for each recognized activity or contextual information. The output of the system provides a total risk assessment of falling given a response from the fall sensor.

  18. Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients.

    Science.gov (United States)

    Francis, Erin; Dyks, Derek; Kanji, Salmaan

    2014-11-01

    Each year, about one-third of individuals over the age of 65 years will experience a fall, and half of these will experience a subsequent fall in the following year. The use of potentially inappropriate medications (PIMs) is an important factor contributing to increased fall risk in geriatric patients. To determine the proportion of patients over the age of 65 admitted to orthopedics and general medicine services with diagnosis of a fall who experienced a change in the total number or dosage of PIMs, as defined by the Beers criteria, upon discharge from hospital. This retrospective observational study involved patients admitted to a tertiary care hospital with diagnosis of a fall between January 1 and December 31, 2011. Those aged 65 years or older with at least one PIM on admission were eligible for inclusion. Data analysis included χ(2) and Fisher testing, as well as multivariate analysis. A total of 148 patients were included, of whom 63 (43%) had an overall change in the dosage or number of PIMs during their hospital stay. Forty patients (27%) had an overall reduction in the dosage or number of PIMs upon discharge from hospital, whereas 23 (16%) experienced an overall increase in the dosage or total number of PIMs. The mean number (± standard deviation) of PIMs decreased during the hospital stay, from 1.6 ± 0.8 on admission to 1.4 ± 0.9 on discharge (p = 0.03). Benzodiazepines were the class of PIMs most frequently discontinued or reduced in dosage. One-quarter of patients admitted with falls had de-escalation of PIMs upon hospital discharge. Although dosage reduction or drug discontinuation may not be appropriate for all patients, a standardized approach to medication review during the hospital stay and improved prescriber education and awareness of PIM use among elderly individuals are warranted.

  19. Feasibility study for the City of Twin Falls Sewage Hydroelectric Project in Twin Falls County, Idaho

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-08-01

    The City of Twin Falls, Idaho authorized J-U-B Engineers, Inc., to assess the feasibility of installing a small hydropower plant on the discharge of the City's Grandview sewage trunk line. The concept of developing hydropower from sewage flow is novel and may have applications in other areas of the nation if its technical feasibility can be established. No conventional turbine would be suitable in this application without extensively screening the influent. Therefore, finding a turbine which would work satisfactorily, was one of the major aspects of the study. A solution to this problem was found in a staged, non-clog, hydraulic turbine manufactured by Cornell Pump Co. A preliminary design configuration is presented using these turbines. The economical feasibility of the project depends on future sewage flows from Idaho Frozen Foods Company, a large contributor to the present Twin Falls sewage flows. The yearly revenue, would decrease by about one-third, if Idaho Frozen Foods disconnects from the City's sewage system. Therefore, the project is less feasible, economically, without the flow contributed by Idaho Frozen Foods. The cost of energy production is 47 mils per kilowatt-hour (kWh) with this flow, and about 60 mils/kWh without this flow. At the higher flow rate (5 cfs) the total capital investment is estimated to be $270,200 or approximately $2250 per installed kW capacity. Estimated annual energy production at 5.0 cfs is 440,650 kWh with a subsequent first year annual revenue of $59,460. Power could be put on line within nine months of the time the Twin Falls City Council makes a decision to develop the project.

  20. 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

  1. Reduction in language testing

    DEFF Research Database (Denmark)

    Dimova, Slobodanka; Jensen, Christian

    2013-01-01

    /video recorded speech samples and written reports produced by two experienced raters after testing. Our findings suggest that reduction or reduction-like pronunciation features are found in tested L2 speech, but whenever raters identify and comment on such reductions, they tend to assess reductions negatively...

  2. Defining a Fall and Reasons for Falling: Comparisons among the Views of Seniors, Health Care Providers, and the Research Literature

    Science.gov (United States)

    Zecevic, Aleksandra A.; Salmoni, Alan W.; Speechley, Mark; Vandervoort, Anthony A.

    2006-01-01

    Purpose: The purpose of this study was (a) to obtain information about the perceptions held by seniors and health care providers concerning what constitutes a fall and potential reasons for falling, and (b) to compare these perceptions to the research literature. Design and Methods: As part of a larger telephone survey, interviewers asked 477…

  3. Fragility, fear of falling, physical activity and falls among older persons: some theoretical considerations to interpret mediation

    NARCIS (Netherlands)

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

    2008-01-01

    Background: In their letters to the editor, Lacherez et al. [Lacherez, P.F., Wood, J.M., Kerr, G.K., 2007. Does activity level mediate or suppress the association between fear of falling and falls? Prev. Med. 31; (Electronic publication ahead of print)] and Hafeman and Schwartz [Hafeman, D.,

  4. Fragility, fear of falling, physical activity and falls among older persons: Some theoretical considerations to interpret mediation

    NARCIS (Netherlands)

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

    2008-01-01

    Background: In their letters to the editor, Lacherez et al. [Lacherez, P.F., Wood, J.M., Kerr, G.K., 2007. Does activity level mediate or suppress the association between fear of falling and falls? Prev. Med. 31; (Electronic publication ahead of print)] and Hafeman and Schwartz [Hafeman, D.,

  5. Fear of falling in older adults living at home: associated factors.

    Science.gov (United States)

    Vitorino, Luciano Magalhães; Teixeira, Carla Araujo Bastos; Boas, Eliandra Laís Vilas; Pereira, Rúbia Lopes; Santos, Naiana Oliveira Dos; Rozendo, Célia Alves

    2017-04-10

    To identify the factors associated with the fear of falling in the older adultliving at home. Cross-sectional study with probabilistic sampling of older adultenrolled in two Family Health Strategies (FHS). The fear of falling was measured by the Brazilian version of the Falls Efficacy Scale-International and by a household questionnairethat contained the explanatory variables. Multiple Linear Regression using the stepwise selection technique and the Generalized Linear Models were used in the statistical analyses. A total of170 older adultsparticipated in the research, 85 from each FHS. The majority (57.1%) aged between 60 and 69; 67.6% were female; 46.1% fell once in the last year. The majority of the older adults(66.5%) had highfear of falling. In the final multiple linear regression model, it was identified that a higher number of previous falls, female gender, older age, and worse health self-assessment explained 37% of the fear of falling among the older adult. The findings reinforce the need to assess the fear of falling among the older adultliving at home, in conjunction with the development and use ofstrategies based on modifiable factors by professionalsto reduce falls and improve health status, which may contribute to the reduction of the fear of falling among the older adult. Identificar os fatores associados ao medo de cair em idosos residentes no domicílio. Estudo transversal com amostragem probabilística de idosos cadastrados em duas Estratégias Saúde da Família (ESF). O medo de cair foi avaliado pela versão brasileira da escala Falls Efficacy Scale International e por um inquérito domiciliar que continha as variáveis explicativas.A Regressão Linear Múltipla por meio da técnica stepwise selectione osModelos Lineares Generalizados foram utilizados nas análises estatísticas. Participaram da pesquisa170 idosos, 85 de cada ESF. A maioria (57,1%) tinha entre 60 e 69 anos de idade; 67,6% eram do sexo feminino; 46,1% tiveram queda no último ano

  6. Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study.

    Science.gov (United States)

    Karinkanta, Saija; Kannus, Pekka; Uusi-Rasi, Kirsti; Heinonen, Ari; Sievänen, Harri

    2015-09-01

    previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures. five-year health-care register-based follow-up study after a 1-year, four-arm RCT. community-dwelling older women in Finland. one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning. participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR). eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97). home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. The rise and fall of gluten!

    Science.gov (United States)

    Aziz, Imran; Branchi, Federica; Sanders, David S

    2015-08-01

    Mankind has existed for 2·5 million years but only in the last 10,000 years have we been exposed to wheat. Wheat was first cultivated in the Fertile Crescent (South Western Asia) with a farming expansion that lasted from about 9000BC to 4000BC. Thus it could be considered that wheat (and gluten) is a novel introduction to man's diet! Prior to 1939 the rationing system had already been devised. This led to an imperative to try to increase agricultural production. Thus it was agreed in 1941 that there was a need to establish a Nutrition Society. The very roots of the society were geared towards necessarily increasing the production of wheat. This goal was achieved and by the end of the 20th century, global wheat output had expanded 5-fold. Perhaps as a result the epidemiology of coeliac disease (CD) or gluten sensitive enteropathy has changed. CD is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals. CD now affects 1 % or more of all adults, for which the treatment is a strict lifelong gluten-free diet. However, there is a growing body of evidence to show that a far greater proportion of individuals without coeliac disease are taking a gluten-free diet of their own volition. This clinical entity has been termed non-coeliac gluten sensitivity (NCGS), although the condition is fraught with complexities due to overlap with other gluten-based constituents that can also trigger similar clinical symptoms. This review will explore the relationship between gluten, the rising prevalence of modern coeliac disease, and the new entity of NCGS along with its associated uncertainties.

  8. Kyphosis and incident falls among community-dwelling older adults.

    Science.gov (United States)

    McDaniels-Davidson, C; Davis, A; Wing, D; Macera, C; Lindsay, S P; Schousboe, J T; Nichols, J F; Kado, D M

    2017-10-10

    Hyperkyphosis commonly affects older persons and is associated with morbidity and mortality. Many have hypothesized that hyperkyphosis increases fall risk. Within this prospective study of older adults, kyphosis was significantly associated with incident falls over 1 year. Measures of hyperkyphosis could enhance falls risk assessments during primary care office visits. To determine the association between four measures of kyphosis and incident and injurious falls in older persons. Community-dwelling adults aged 65 and older (n = 72) residing in southern California were invited to participate in a prospective cohort study. Participants had kyphosis assessed four ways. Two standing measures included a flexicurve ruler placed against the back to derive a kyphotic index and the Debrunner kyphometer, a protractor used to measure the kyphotic angle in degrees. Two lying measures included the blocks method (number of 1.7 cm blocks needed to achieve a neutral head position while lying supine) and traditional Cobb angle calculation derived from DXA based lateral vertebral assessment. Baseline demographic, clinical, and other health information (including a timed up and go (TUG) test) were assessed at a clinic visit. Participants were followed monthly through email or postcard for 1 year, with falls outcomes confirmed through telephone interview. Mean age was 77.8 (± 7.1) among the 52 women and 20 men. Over 12 months, 64% of participants experienced at least one incident fall and 35% experienced an injurious fall. Each standard deviation increase in kyphosis resulted in more than doubling the adjusted odds of an incident fall, even after adjusting for TUG. Odds of injurious falls were less consistent across measures; after adjusting for TUG, only the blocks method was associated with injurious falls. Each kyphosis measure was independently associated with incident falls. Findings were inconsistent for injurious falls; the blocks measure suggested the strongest

  9. Falls risk assessment begins with hello: lessons learned from the use of one home health agency's fall risk tool.

    Science.gov (United States)

    Flemming, Patricia J; Ramsay, Katherine

    2012-10-01

    Identifying older adults at risk for falls is a challenge all home healthcare agencies (HHAs) face. The process of assessing for falls risk begins with the initial home visit. One HHA affiliated with an academic medical center describes its experience in development and use of a Falls Risk Assessment (FRA) tool over a 10-year period. The FRA tool has been modified since initial development to clarify elements of the tool based on research and to reflect changes in the Outcome and Assessment Information Set (OASIS) document. The primary purpose of this article is to share a validated falls risk assessment tool to facilitate identification of fall-related risk factors in the homebound population. A secondary purpose is to share lessons learned by the HHA during the 10 years using the FRA.

  10. Search for new breast cancer susceptibility genes

    NARCIS (Netherlands)

    Oldenburg, Rogier Abel

    2008-01-01

    This thesis describes the search for new high-risk breast cancer susceptibility genes by linkage analysis. To date 20-25% of familial breast cancer is explained by mutations in the high-risk BRCA1 and BRCA2 breast cancer susceptibility genes. For the remaining families the genetic etiology is

  11. Mapping markers linked to porcine salmonellosis susceptibility

    NARCIS (Netherlands)

    Galina-Pantoja, L.; Siggens, K.; Schriek, van M.G.M.; Heuven, H.C.M.

    2009-01-01

    The goal of this study was to identify pig chromosomal regions associated with susceptibility to salmonellosis. Genomic DNA from pig reference populations with differences in susceptibility to Salmonella enterica serovar Choleraesuis as quantified by spleen and liver bacterial colonization at day 7

  12. Crystal morphology change by magnetic susceptibility force

    OpenAIRE

    Katsuki, Aiko; Aibara, Shigeo; Tanimoto, Yoshifumi

    2006-01-01

    We found a change in morphology when lysozyme crystals were grown in a magnetic field. The phenomenon was caused by the magnetic force derived from the magnetic susceptibility gradient. We propose that this force should be called the “magnetic susceptibility force".

  13. Daily steps are low year-round and dip lower in fall/winter: findings from a longitudinal diabetes cohort

    Directory of Open Access Journals (Sweden)

    Sigal Ron J

    2010-11-01

    medication-treated cohort, A1C was stable year-round but a fall/winter systolic blood pressure increase was detected. Our findings signal a need to develop strategies to help patients increase step counts year-round and prevent both reductions in step counts and increases in blood pressure during the fall and winter.

  14. Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ferrer A

    2014-02-01

    assessment. Conclusion: This multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study. Keywords: elderly, falls, intervention

  15. Varre-Sai: The Recent Brazilian Fall

    Science.gov (United States)

    Zucolotto, M. E.; Antonello, L. L.; Varela, M. E.; Scorzelli, R. B.; Munayco, P.; dos Santos, E.; Ludka, Isabel P.

    2012-12-01

    Varre-Sai, the most recent Brazilian meteorite fall, on June 19th, 2010 at Varre-Sai, in Rio de Janeiro State, Brazil (20°51'41″S; 41°44'.80″W). At least eight masses (total ~3.5 kg) were recovered. Most are totally covered by fusion crust. The exposed interior is of light-grey colour with a few dark shock veins. Five thin polished and etched sections were prepared from a slice weighing 35 g on deposit at the National Museum/UFRJ. It consists mostly of chondrules ranging in size from 0.35 to ~2.2 mm, and chondrule fragments enclosed in a crystalline matrix. The matrix consists of tiny isolated subhedral and anhedral crystals and opaque minerals that are intergrown with broken chondrules. The chondritic texture is poorly defined with chondrule textures that vary from non-porphyritic to porphyritic ones. The essential minerals are olivine (Fa25±0.2) and low-Ca pyroxene (Fa21.66±0.2Wo1.4). Accessory minerals are plagioclase, apatite, Fe-Ni metal phases, troilite, chromite and magnetite. Mössbauer spectroscopy analysis confirms that the mineral phases are olivine, pyroxene, troilite and kamacite/taenite. Chemical data indicate that Varre-Sai is a member of the low iron L chondrite group. The observed texture and mineral phases led us to classify Varre-Sai as an equilibrated petrologic type 5. The shock features of the minerals (undulatory extinction, planar structure and numerous cracks), as well as plagioclase partial or totally transformed to maskelynite, suggest a shock stage S4. Also, some post-impact metamorphic processes could be inferred from the meta-sulfide conjoint grains that show complex mixtures of kamacite-taenite-tetrataenite and troilite. The occurrence of veins crosscutting the studied sections indicates that Varre-Sai was affected by a late fracturing event. Sealing of these fractures must have been a fast process, as shown by troilite globule textures pointing towards rapid solidification. The meteorite name was approved by the Nomenclature

  16. Awareness and Functional Outcome of Hip Fracture-Related Falls among Patients with a History of Recurrent Falling.

    Science.gov (United States)

    Aizen, Efraim; Nixon, Hila; Shugaev, Inna

    2018-01-01

    There is little evidence about awareness and functional outcome of hip fracture-related falls among patients with a history of recurrent falling. To measure the awareness of recurrent falling in patients and to compare their functional outcomes with those who suffered hip fracture after a sporadic isolated fall. A prospective comparative study of patients after a hip fracture-related fall was conducted. Awareness of falls was measured and functional outcome was assessed by total and motor Functional Independence Measure (FIM) score changes and efficiency and scores at admission and on discharge. Of 97 eligible participants, 49 (50.5%) were recurrent fallers. Of these recurrent falls, 19 (38.8%) were not reported, 16 (32.7%) were reported but no action was taken, and 7 (14.3%) were reported and a partial assessment performed. A full assessment was performed in only 7 cases (14.3%). FIM scores on admission and discharge were significantly higher in once-fallers. A multiple linear regression analysis showed that being a once-faller was independently associated with higher total FIM at admission (β coefficient = 0.290, P = 0.004), higher motor FIM at admission (β coefficient = 0.295, P = 0.003), higher total FIM at discharge (β Coefficient = 0.264, P = 0.009), and higher motor FIM at discharge (β coefficient = 0.230, P = 0.023). Awareness of the syndrome of recurrent falling is extremely low. Recurrent falls before a hip fracture-related fall is associated with substantial loss of functional independence. Being a recurrent faller adversely affects rehabilitation outcome of hip fracture patients.

  17. Genetic susceptibility to pancreatic cancer.

    Science.gov (United States)

    Klein, Alison P

    2012-01-01

    Pancreatic cancer is the fourth leading cause of cancer death in both men and women in the United States. However, it has the poorest prognosis of any major tumor type, with a 5-yr survival rate of approximately 5%. Cigarette smoking, increased body mass index, heavy alcohol consumption, and a diagnosis of diabetes mellitus have all been demonstrated to increase risk of pancreatic cancer. A family history of pancreatic cancer has also been associated with increased risk suggesting inherited genetic factors also play an important role, with approximately 5-10% of pancreatic cancer patients reporting family history of pancreatic cancer. While the genetic basis for the majority of the familial clustering of pancreatic cancer remains unclear, several important pancreatic cancer genes have been identified. These consist of high penetrance genes including BRCA2 or PALB2, to more common genetic variation associated with a modest increase risk of pancreatic cancer such as genetic variation at the ABO blood group locus. Recent advances in genotyping and genetic sequencing have accelerated the rate at which novel pancreatic cancer susceptibility genes have been identified with several genes identified within the past few years. This review addresses our current understanding of the familial aggregation of pancreatic cancer, established pancreatic cancer susceptablity genes and how this knowledge informs risk assessment and screening for high-risk families. Copyright © 2011 Wiley Periodicals, Inc.

  18. Genetic Susceptibility to Pancreatic Cancer

    Science.gov (United States)

    Klein, Alison P.

    2013-01-01

    Pancreatic cancer is the fourth leading cause of cancer death in both men and women in the United States. However, it has the poorest prognosis of any major tumor type, with a 5-yr survival rate of approximately 5%. Cigarette smoking, increased body mass index, heavy alcohol consumption, and a diagnosis of diabetes mellitus have all been demonstrated to increase risk of pancreatic cancer. A family history of pancreatic cancer has also been associated with increased risk suggesting inherited genetic factors also play an important role, with approximately 5–10% of pancreatic cancer patients reporting family history of pancreatic cancer. While the genetic basis for the majority of the familial clustering of pancreatic cancer remains unclear, several important pancreatic cancer genes have been identified. These consist of high penetrance genes including BRCA2 or PALB2, to more common genetic variation associated with a modest increase risk of pancreatic cancer such as genetic variation at the ABO blood group locus. Recent advances in genotyping and genetic sequencing have accelerated the rate at which novel pancreatic cancer susceptibility genes have been identified with several genes identified within the past few years. This review addresses our current understanding of the familial aggregation of pancreatic cancer, established pancreatic cancer susceptablity genes and how this knowledge informs risk assessment and screening for high-risk families. PMID:22162228

  19. Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE): A Cluster-Randomized Pragmatic Trial of a Multifactorial Fall Injury Prevention Strategy: Design and Methods.

    Science.gov (United States)

    Bhasin, Shalender; Gill, Thomas M; Reuben, David B; Latham, Nancy K; Gurwitz, Jerry H; Dykes, Patricia; McMahon, Siobhan; Storer, Thomas W; Duncan, Pamela W; Ganz, David A; Basaria, Shehzad; Miller, Michael E; Travison, Thomas G; Greene, Erich J; Dziura, James; Esserman, Denise; Allore, Heather; Carnie, Martha B; Fagan, Maureen; Hanson, Catherine; Baker, Dorothy; Greenspan, Susan L; Alexander, Neil; Ko, Fred; Siu, Albert L; Volpi, Elena; Wu, Albert W; Rich, Jeremy; Waring, Stephen C; Wallace, Robert; Casteel, Carri; Magaziner, Jay; Charpentier, Peter; Lu, Charles; Araujo, Katy; Rajeevan, Haseena; Margolis, Scott; Eder, Richard; McGloin, Joanne M; Skokos, Eleni; Wiggins, Jocelyn; Garber, Lawrence; Clauser, Steven B; Correa-De-Araujo, Rosaly; Peduzzi, Peter

    2017-10-14

    Fall injuries are a major cause of morbidity and mortality among older adults. We describe the design of a pragmatic trial to compare the effectiveness of an evidence-based, patient-centered multifactorial fall injury prevention strategy to an enhanced usual care. Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) is a 40-month cluster-randomized, parallel-group, superiority, pragmatic trial being conducted at 86 primary care practices in 10 healthcare systems across USA. The 86 practices were randomized to intervention or control group using covariate-based constrained randomization, stratified by healthcare system. Participants are community-living persons, ≥70 years, at increased risk for serious fall injuries. The intervention is a co-management model in which a nurse Falls Care Manager performs multifactorial risk assessments, develops individualized care plans, which include surveillance, follow-up evaluation, and intervention strategies. Control group receives enhanced usual care, with clinicians and patients receiving evidence-based information on falls prevention. Primary outcome is serious fall injuries, operationalized as those leading to medical attention (non-vertebral fractures, joint dislocation, head injury, lacerations, and other major sequelae). Secondary outcomes include all fall injuries, all falls, and well-being (concern for falling; anxiety and depressive symptoms; physical function and disability). Target sample size was 5,322 participants to provide 90% power to detect 20% reduction in primary outcome rate relative to control. Trial enrolled 5451 subjects in 20 months. Intervention and follow-up are ongoing. The findings of the STRIDE study will have important clinical and policy implications for the prevention of fall injuries in older adults.

  20. Single-step quantitative susceptibility mapping with variational penalties.

    Science.gov (United States)

    Chatnuntawech, Itthi; McDaniel, Patrick; Cauley, Stephen F; Gagoski, Borjan A; Langkammer, Christian; Martin, Adrian; Grant, P Ellen; Wald, Lawrence L; Setsompop, Kawin; Adalsteinsson, Elfar; Bilgic, Berkin

    2017-04-01

    Quantitative susceptibility mapping (QSM) estimates the underlying tissue magnetic susceptibility from the gradient echo (GRE) phase signal through background phase removal and dipole inversion steps. Each of these steps typically requires the solution of an ill-posed inverse problem and thus necessitates additional regularization. Recently developed single-step QSM algorithms directly relate the unprocessed GRE phase to the unknown susceptibility distribution, thereby requiring the solution of a single inverse problem. In this work, we show that such a holistic approach provides susceptibility estimation with artifact mitigation and develop efficient algorithms that involve simple analytical solutions for all of the optimization steps. Our methods employ total variation (TV) and total generalized variation (TGV) to jointly perform the background removal and dipole inversion in a single step. Using multiple spherical mean value (SMV) kernels of varying radii permits high-fidelity background removal whilst retaining the phase information in the cortex. Using numerical simulations, we demonstrate that the proposed single-step methods reduce the reconstruction error by up to 66% relative to the multi-step methods that involve SMV background filtering with the same number of SMV kernels, followed by TV- or TGV-regularized dipole inversion. In vivo single-step experiments demonstrate a dramatic reduction in dipole streaking artifacts and improved homogeneity of image contrast. These acquisitions employ the rapid three-dimensional echo planar imaging (3D EPI) and Wave-CAIPI (controlled aliasing in parallel imaging) trajectories for signal-to-noise ratio-efficient whole-brain imaging. Herein, we also demonstrate the multi-echo capability of the Wave-CAIPI sequence for the first time, and introduce an automated, phase-sensitive coil sensitivity estimation scheme based on a 4-s calibration acquisition. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley

  1. Evidence-based guidelines for fall prevention in Korea

    Science.gov (United States)

    Kim, Kwang-Il; Jung, Hye-Kyung; Kim, Chang Oh; Kim, Soo-Kyung; Cho, Hyun-Ho; Kim, Dae Yul; Ha, Yong-Chan; Hwang, Sung-Hee; Won, Chang Won; Lim, Jae-Young; Kim, Hyun Jung; Kim, Jae Gyu

    2017-01-01

    Falls and fall-related injuries are common in older populations and have negative effects on quality of life and independence. Falling is also associated with increased morbidity, mortality, nursing home admission, and medical costs. Korea has experienced an extreme demographic shift with its population aging at the fastest pace among developed countries, so it is important to assess fall risks and develop interventions for high-risk populations. Guidelines for the prevention of falls were first developed by the Korean Association of Internal Medicine and the Korean Geriatrics Society. These guidelines were developed through an adaptation process as an evidence-based method; four guidelines were retrieved via systematic review and the Appraisal of Guidelines for Research and Evaluation II process, and seven recommendations were developed based on the Grades of Recommendation, Assessment, Development, and Evaluation framework. Because falls are the result of various factors, the guidelines include a multidimensional assessment and multimodal strategy. The guidelines were developed for primary physicians as well as patients and the general population. They provide detailed recommendations and concrete measures to assess risk and prevent falls among older people. PMID:28049285

  2. Preliminary investigation of gait initiation and falls in multiple sclerosis.

    Science.gov (United States)

    Wajda, Douglas A; Moon, Yaejin; Motl, Robert W; Sosnoff, Jacob J

    2015-06-01

    To examine the relationship between gait initiation, fall history, and physiological fall risk in individuals with multiple sclerosis (MS) during both cognitive distracting and nondistracting conditions. Single time point cross-sectional analysis. University research laboratory. Ambulatory individuals (N=20) with MS ranging in age from 28 to 76 years. Not applicable. Gait initiation time was quantified as the time to toe-off of the first step after an auditory cue. Gait initiation was performed with and without a concurrent cognitive challenge of reciting alternating letters of the alphabet. Additionally, participants underwent a test of fall risk using the Physiological Profile Assessment (PPA) and provided a self-report of the number of falls in the previous 3 months. Gait initiation times ranged from .67 to 1.12 seconds during the single-task condition and .73 to 1.84 seconds during the cognitive challenge condition. PPA scores ranged from -.80 to 3.87. Participants reported a median of 0.0 falls (interquartile range, 0.0-2.75) in the previous 3 months. There was a significant correlation between PPA score and gait initiation times only in the cognitive distraction condition (ρ=.50). There was also a correlation between cognitive distraction gait initiation times and fall history (ρ=.60). The observations provide preliminary evidence that gait initiation during cognitive challenge may represent a target for fall prevention strategies in MS. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Risk factors for falls in the institutionalized elder population

    Directory of Open Access Journals (Sweden)

    Camilo Romero

    2004-12-01

    Full Text Available The objective is to determine the risk factorspredictors of falls in institutionalized elderlypeople. Methodology: Analysis of data from alongitudinal cohort study. Subjects: Institutionalizedelderly volunteers residents of a nursinghome in Arbelaez, Colombia enrolled andfollowed for six months (N= 116; mean age: 78years. Main outcome measures: Falls detected via nurses reports and medical records. Independentvariables: Baseline measures of demographics,medical history, drug intake, depression, mentalstate, visual acuity, orthostatic hypotension,body mass index, cardiovascular state, limbdeformities, limb strength, tone, trophism, rageof motion, Romberg, one leg balance test, GetUp and Go test and timed Get Up and Go test.Evaluation of home facilities by the TESS-NHand SCUEQS scales. Results: Over the six monthfollow-up 36% experienced a fall. All noneinjurious falls. The independent significantpredictors of all falls using logistic regression were female gender, history of dizziness and anabnormal one leg balance test. With coefficientB values of 1.029, 2.024 and 1.712, respectively.Conclusion: The female gender, the history ofdizziness and abnormal one-leg balance testappear to be the main and significant predictorsof falls in institutionalized elderly persons.However, no single factor seems to be accurateenough to be relied on as a sole predictor of fallrisk because so many diverse factors are involvedin falling

  4. Fidelity susceptibility in the quantum Rabi model

    Science.gov (United States)

    Wei, Bo-Bo; Lv, Xiao-Chen

    2018-01-01

    Quantum criticality usually occurs in many-body systems. Recently it was shown that the quantum Rabi model, which describes a two-level atom coupled to a single model cavity field, presents quantum phase transitions from a normal phase to a superradiate phase when the ratio between the frequency of the two-level atom and the frequency of the cavity field extends to infinity. In this work, we study quantum phase transitions in the quantum Rabi model from the fidelity susceptibility perspective. We found that the fidelity susceptibility and the generalized adiabatic susceptibility present universal finite-size scaling behaviors near the quantum critical point of the Rabi model if the ratio between frequency of the two-level atom and frequency of the cavity field is finite. From the finite-size scaling analysis of the fidelity susceptibility, we found that the adiabatic dimension of the fidelity susceptibility and the generalized adiabatic susceptibility of fourth order in the Rabi model are 4 /3 and 2, respectively. Meanwhile, the correlation length critical exponent and the dynamical critical exponent in the quantum critical point of the Rabi model are found to be 3 /2 and 1 /3 , respectively. Since the fidelity susceptibility and the generalized adiabatic susceptibility are the moments of the quantum noise spectrum which are directly measurable by experiments in linear response regime, the scaling behavior of the fidelity susceptibility in the Rabi model could be tested experimentally. The simple structure of the quantum Rabi model paves the way for experimentally observing the universal scaling behavior of the fidelity susceptibility at a quantum phase transition.

  5. Field-Evolved Mode 1 Resistance of the Fall Armyworm to Transgenic Cry1Fa-Expressing Corn Associated with Reduced Cry1Fa Toxin Binding and Midgut Alkaline Phosphatase Expression.

    Science.gov (United States)

    Jakka, Siva R K; Gong, Liang; Hasler, James; Banerjee, Rahul; Sheets, Joel J; Narva, Kenneth; Blanco, Carlos A; Jurat-Fuentes, Juan L

    2015-12-04

    Insecticidal protein genes from the bacterium Bacillus thuringiensis (Bt) are expressed by transgenic Bt crops (Bt crops) for effective and environmentally safe pest control. The development of resistance to these insecticidal proteins is considered the most serious threat to the sustainability of Bt crops. Resistance in fall armyworm (Spodoptera frugiperda) populations from Puerto Rico to transgenic corn producing the Cry1Fa insecticidal protein resulted, for the first time in the United States, in practical resistance, and Bt corn was withdrawn from the local market. In this study, we used a field-collected Cry1Fa corn-resistant strain (456) of S. frugiperda to identify the mechanism responsible for field-evolved resistance. Binding assays detected reduced Cry1Fa, Cry1Ab, and Cry1Ac but not Cry1Ca toxin binding to midgut brush border membrane vesicles (BBMV) from the larvae of strain 456 compared to that from the larvae of a susceptible (Ben) strain. This binding phenotype is descriptive of the mode 1 type of resistance to Bt toxins. A comparison of the transcript levels for putative Cry1 toxin receptor genes identified a significant downregulation (>90%) of a membrane-bound alkaline phosphatase (ALP), which translated to reduced ALP protein levels and a 75% reduction in ALP activity in BBMV from 456 compared to that of Ben larvae. We cloned and heterologously expressed this ALP from susceptible S. frugiperda larvae and demonstrated that it specifically binds with Cry1Fa toxin. This study provides a thorough mechanistic description of field-evolved resistance to a transgenic Bt crop and supports an association between resistance and reduced Cry1Fa toxin binding and levels of a putative Cry1Fa toxin receptor, ALP, in the midguts of S. frugiperda larvae. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  6. Injury from falls in infants under one year.

    Science.gov (United States)

    Mulligan, Christopher S; Adams, Susan; Tzioumi, Dimitra; Brown, Julie

    2017-08-01

    Falls in infants are a common cause of injury. Compared to older children, infants under age one are likely to have distinctive causation and injury patterns, as they are pre-mobile or have limited independent mobility and falls are more directly the responsibility of the care giver. There is little known about the mechanistic factors, predictors of injury and injury patterns in this age group. We conducted a retrospective review of infants under age one who presented after a fall to a paediatric trauma centre in Sydney, Australia. Circumstances and mechanisms of the fall, injury patterns, burden of investigations and outcomes were analysed. Over a 3-year period (2011-2013), 916 infants presented following a fall. One hundred and six (11.6%) were admitted and there was one death. Head injury was the most common reason for admission (85%). While there were severe and critical head injuries (Abbreviated Injury Scale 4-5) these were infrequent (2% of presentations). All admitted cases involved a short distance fall. Patients dropped by others were three times more likely to be admitted than infants presenting following other fall types (95% CI 1.9-4.8). Compared to other mechanisms, patients who fell from furniture had significantly longer hospital stays. Fall mechanisms involving infants being dropped by adults, and falls from beds or couches carry the highest clinical burden. These mechanisms should be targets for injury prevention and inform the design of safe equipment and environments for babies. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  7. Neighborhood Environment and Falls among Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Emily Joy Nicklett

    2017-02-01

    Full Text Available Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night. Methods: Data were analyzed from 9259 participants over four biennial waves (2006–2012 of the Health and Retirement Study (HRS, a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR: 0.96, 95% confidence interval (CI: 0.93–0.99 and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90–0.98. A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93–0.99 and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91–1.00 in adjusted models. Conclusions: The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings.

  8. [How frequent and why are skiers and snowboarders falling?].

    Science.gov (United States)

    Philippe, M; Ruedl, G; Feltus, G; Woldrich, T; Burtscher, M

    2014-12-01

    Injuries in alpine skiing and snowboarding are mainly caused by falls. In 2002, a study was conducted to gain insight into the risk factors for falls when skiing or snowboarding. Since then, the evolution of skiing, snowboarding and safety equipment, as well as slope preparation, may have altered the frequency of falls while skiing or snowboarding. In total, 1436 male and female skiers and snowboarders from all age groups were interviewed from February until April 2012, in 6 Tyrolean ski resorts. The questionnaire was nearly identical to that used in 2002. It contained questions concerning personal characteristics, falls, equipment and risk taking behaviour. The incidence of falls among skiers was 0.076 ± 0.21 per hour and that among snowboarders was 0.429 ± 0.70 per hour. Age (OR: 0.96; CI: 0.95 - 0.97), soft snow conditions (OR: 4.1; CI: 1.9 - 8.8) and poor skiing skills (beginners and intermediates) (OR: 2.6; CI: 1.2 - 8.1) were predictive for falls during skiing. Poor snowboarding skills (beginners and intermediates) (OR: 8.3; CI: 3.1 - 27.4), wearing a helmet (OR: 2.3; CI: 1.2 - 4.6) and alcohol consumption (OR: 2.1; CI: 1.2 - 3.9) were predictive for falls during snowboarding. The incidence of falls among skiers and snowboarders was substantially lower when compared to that in 2002. Improvements in skiing and snowboarding equipment as well as slope preparation may have contributed to this favourable development. We strongly assume that the lowering in fall incidence may positively affect the injury incidence. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Barometric pressure and triaxial accelerometry-based falls event detection.

    Science.gov (United States)

    Bianchi, Federico; Redmond, Stephen J; Narayanan, Michael R; Cerutti, Sergio; Lovell, Nigel H

    2010-12-01

    Falls and fall related injuries are a significant cause of morbidity, disability, and health care utilization, particularly among the age group of 65 years and over. The ability to detect falls events in an unsupervised manner would lead to improved prognoses for falls victims. Several wearable accelerometry and gyroscope-based falls detection devices have been described in the literature; however, they all suffer from unacceptable false positive rates. This paper investigates the augmentation of such systems with a barometric pressure sensor, as a surrogate measure of altitude, to assist in discriminating real fall events from normal activities of daily living. The acceleration and air pressure data are recorded using a wearable device attached to the subject's waist and analyzed offline. The study incorporates several protocols including simulated falls onto a mattress and simulated activities of daily living, in a cohort of 20 young healthy volunteers (12 male and 8 female; age: 23.7 ±3.0 years). A heuristically trained decision tree classifier is used to label suspected falls. The proposed system demonstrated considerable improvements in comparison to an existing accelerometry-based technique; showing an accuracy, sensitivity and specificity of 96.9%, 97.5%, and 96.5%, respectively, in the indoor environment, with no false positives generated during extended testing during activities of daily living. This is compared to 85.3%, 75%, and 91.5% for the same measures, respectively, when using accelerometry alone. The increased specificity of this system may enhance the usage of falls detectors among the elderly population.

  10. Orthostatic Hypotension in Middle-Age and Risk of Falls.

    Science.gov (United States)

    Juraschek, Stephen P; Daya, Natalie; Appel, Lawrence J; Miller, Edgar R; Windham, Beverly Gwen; Pompeii, Lisa; Griswold, Michael E; Kucharska-Newton, Anna; Selvin, Elizabeth

    2017-02-01

    One-third of older adults fall each year. Orthostatic hypotension (OH) has been hypothesized as an important risk factor for falls, but findings from prior studies have been inconsistent. We conducted a prospective study of the association between baseline OH (1987-1989) and risk of falls in the Atherosclerosis Risk in Communities (ARIC) Study. Falls were ascertained during follow-up via ICD-9 hospital discharge codes or Centers for Medicare & Medicaid Services claims data. OH was defined as a drop in systolic blood pressure (SBP) ≥20mm Hg or diastolic blood pressure (DBP) ≥10mm Hg within 2 minutes of moving from the supine to standing position. Changes in SBP or DBP during OH assessments were also examined as continuous variables. During a median follow-up of 23 years, there were 2,384 falls among 12,661 participants (mean age 54 years, 55% women, 26% black). OH was associated with risk of falls even after adjustment for demographic characteristics and other risk factors (hazard ratio (HR): 1.30; 95% confidence interval (CI): 1.10, 1.54; P = 0.002). Postural change in DBP was more significantly associated with risk of falls (HR 1.09 per -5mm Hg change in DBP; 95% CI: 1.05, 1.13; P < 0.001) than postural change in SBP (HR 1.03 per -5mm Hg change in SBP; 95% CI: 1.01, 1.05; P = 0.002). In a community-based, middle-aged population, OH, and in particular, postural change in DBP, were independent risk factors for falls over 2 decades of follow-up. Future studies are needed to examine OH thresholds associated with increased risk of falls. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Detecting falls as novelties in acceleration patterns acquired with smartphones.

    Directory of Open Access Journals (Sweden)

    Carlos Medrano

    Full Text Available Despite being a major public health problem, falls in the elderly cannot be detected efficiently yet. Many studies have used acceleration as the main input to discriminate between falls and activities of daily living (ADL. In recent years, there has been an increasing interest in using smartphones for fall detection. The most promising results have been obtained by supervised Machine Learning algorithms. However, a drawback of these approaches is that they rely on falls simulated by young or mature people, which might not represent every possible fall situation and might be different from older people's falls. Thus, we propose to tackle the problem of fall detection by applying a kind of novelty detection methods which rely only on true ADL. In this way, a fall is any abnormal movement with respect to ADL. A system based on these methods could easily adapt itself to new situations since new ADL could be recorded continuously and the system could be re-trained on the fly. The goal of this work is to explore the use of such novelty detectors by selecting one of them and by comparing it with a state-of-the-art traditional supervised method under different conditions. The data sets we have collected were recorded with smartphones. Ten volunteers simulated eight type of falls, whereas ADL were recorded while they carried the phone in their real life. Even though we have not collected data from the elderly, the data sets were suitable to check the adaptability of novelty detectors. They have been made publicly available to improve the reproducibility of our results. We have studied several novelty detection methods, selecting the nearest neighbour-based technique (NN as the most suitable. Then, we have compared NN with the Support Vector Machine (SVM. In most situations a generic SVM outperformed an adapted NN.

  12. Falls prevention revisited: a call for a new approach.

    Science.gov (United States)

    Dempsey, Jennifer

    2004-05-01

    Patient falls constitute a major threat to health services' ability to provide care. Previous studies confirm that nurses can identify patients at risk and that a preventative programme can reduce the rate of falls but few studies have been evaluated over time. A study was undertaken to test a Falls Prevention Programme in an acute medical area that was re-evaluated 5 years later to determine if the effects were sustainable. The design included two groups of patients admitted before and after the programme. Variables such as staffing, equipment, environment and routines were controlled. However, because of ethical approval constraints, some variables such as age, mental status, mobility and gender were not. The programme included a risk assessment tool, a choice of interventions, a graphic that alerted others to 'at risk patients' and simple patient and staff education. Data were collected using incident forms and a formula was used to calculate a rate of falls. A non-paired t-test compared rates and anova examined the relationship of age, gender, mobility and mental status on the incidence of falls. Control graphs determined the stability of the process. The falls rate was significantly reduced. Control graphs demonstrate that the process achieved greater control with less variation. In the next 5 years the falls rate increased to preprogramme levels and control graphs demonstrated that the process was no longer controlled. Compliance with the programme had deteriorated. The practice review considered skill mix, patient activity and acuity but provided no definitive answers to explain non-compliance. The implications to nursing are discussed. Clinicians are called to conduct more rigorous research into falls prevention but it may be more useful to direct research towards examining nursing work and increasing nurse autonomy in falls prevention.

  13. Parkinsonian signs are a risk factor for falls.

    Science.gov (United States)

    Dahodwala, Nabila; Nwadiogbu, Chinwe; Fitts, Whitney; Partridge, Helen; Karlawish, Jason

    2017-06-01

    Parkinsonian signs are common, non-specific findings in older adults and associated with increased rates of dementia and mortality. It is important to understand which motor outcomes are associated with parkinsonian signs. To determine the role of parkinsonian signs on fall rates among older adults. We conducted a longitudinal study of primary care patients from the University of Pennsylvania Health System. Adults over 55 years were assessed at baseline through surveys and a neurological examination. We recorded falls over the following 2 years. Parkinsonian signs were defined as the presence of 2 of 4 cardinal signs. Incident falls were compared between subjects with and without parkinsonian signs, and modified Poisson regression used to adjust for potential confounders in the relationship between parkinsonian signs and falls. 982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of participants fell and 12% exhibited parkinsonian signs at baseline. The unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95% CI 1.05-1.76, p=0.02). After adjusting for age, cognitive function, urinary incontinence, depression, diabetes, stroke and arthritis, individuals with parkinsonian signs were still 38% more likely to fall than those without parkinsonian signs (RR 1.38, 95% CI 1.04-1.82; p=0.03). Falls among those with parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04). Parkinsonian signs are a significant, independent risk factor for falls. Early detection of this clinical state is important in order to implement fall prevention programs among primary care patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Detecting falls as novelties in acceleration patterns acquired with smartphones.

    Science.gov (United States)

    Medrano, Carlos; Igual, Raul; Plaza, Inmaculada; Castro, Manuel

    2014-01-01

    Despite being a major public health problem, falls in the elderly cannot be detected efficiently yet. Many studies have used acceleration as the main input to discriminate between falls and activities of daily living (ADL). In recent years, there has been an increasing interest in using smartphones for fall detection. The most promising results have been obtained by supervised Machine Learning algorithms. However, a drawback of these approaches is that they rely on falls simulated by young or mature people, which might not represent every possible fall situation and might be different from older people's falls. Thus, we propose to tackle the problem of fall detection by applying a kind of novelty detection methods which rely only on true ADL. In this way, a fall is any abnormal movement with respect to ADL. A system based on these methods could easily adapt itself to new situations since new ADL could be recorded continuously and the system could be re-trained on the fly. The goal of this work is to explore the use of such novelty detectors by selecting one of them and by comparing it with a state-of-the-art traditional supervised method under different conditions. The data sets we have collected were recorded with smartphones. Ten volunteers simulated eight type of falls, whereas ADL were recorded while they carried the phone in their real life. Even though we have not collected data from the elderly, the data sets were suitable to check the adaptability of novelty detectors. They have been made publicly available to improve the reproducibility of our results. We have studied several novelty detection methods, selecting the nearest neighbour-based technique (NN) as the most suitable. Then, we have compared NN with the Support Vector Machine (SVM). In most situations a generic SVM outperformed an adapted NN.

  15. Economic modelling of a public health programme for fall prevention.