Elderly fall risk prediction using static posturography

Science.gov (United States)

2017-01-01

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

Elderly fall risk prediction using static posturography.

Science.gov (United States)

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

2017-01-01

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

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

Feature extraction and selection for objective gait analysis and fall risk assessment by accelerometry

Directory of Open Access Journals (Sweden)

Cremer Gerald

2011-01-01

Full Text Available Abstract Background Falls in the elderly is nowadays a major concern because of their consequences on elderly general health and moral states. Moreover, the aging of the population and the increasing life expectancy make the prediction of falls more and more important. The analysis presented in this article makes a first step in this direction providing a way to analyze gait and classify hospitalized elderly fallers and non-faller. This tool, based on an accelerometer network and signal processing, gives objective informations about the gait and does not need any special gait laboratory as optical analysis do. The tool is also simple to use by a non expert and can therefore be widely used on a large set of patients. Method A population of 20 hospitalized elderlies was asked to execute several classical clinical tests evaluating their risk of falling. They were also asked if they experienced any fall in the last 12 months. The accelerations of the limbs were recorded during the clinical tests with an accelerometer network distributed on the body. A total of 67 features were extracted from the accelerometric signal recorded during a simple 25 m walking test at comfort speed. A feature selection algorithm was used to select those able to classify subjects at risk and not at risk for several classification algorithms types. Results The results showed that several classification algorithms were able to discriminate people from the two groups of interest: fallers and non-fallers hospitalized elderlies. The classification performances of the used algorithms were compared. Moreover a subset of the 67 features was considered to be significantly different between the two groups using a t-test. Conclusions This study gives a method to classify a population of hospitalized elderlies in two groups: at risk of falling or not at risk based on accelerometric data. This is a first step to design a risk of falling assessment system that could be used to provide

Space vector-based analysis of overmodulation in triangle ...

Indian Academy of Sciences (India)

methods such as vector control or field oriented control are used for fast dynamic response .... This average voltage vector falls in sector-I as shown in figure 5 for .... The dwell times T1, T2 and Tz can be derived using volt-second balance.

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.

Fall Detection Using Smartphone Audio Features.

Science.gov (United States)

Cheffena, Michael

2016-07-01

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

Multi-objective based on parallel vector evaluated particle swarm optimization for optimal steady-state performance of power systems

DEFF Research Database (Denmark)

Vlachogiannis, Ioannis (John); Lee, K Y

2009-01-01

In this paper the state-of-the-art extended particle swarm optimization (PSO) methods for solving multi-objective optimization problems are represented. We emphasize in those, the co-evolution technique of the parallel vector evaluated PSO (VEPSO), analysed and applied in a multi-objective problem...

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

NARCIS (Netherlands)

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

2007-01-01

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

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

Science.gov (United States)

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

2011-08-12

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

Falls in older people

NARCIS (Netherlands)

van Dieën, Jaap H.; Pijnappels, Mirjam

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

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

NARCIS (Netherlands)

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

2005-01-01

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

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

Directory of Open Access Journals (Sweden)

Shimada Hiroyuki

2011-08-01

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

New methods for fall risk prediction.

Science.gov (United States)

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

2014-09-01

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

Statistical motion vector analysis for object tracking in compressed video streams

Science.gov (United States)

Leny, Marc; Prêteux, Françoise; Nicholson, Didier

2008-02-01

Compressed video is the digital raw material provided by video-surveillance systems and used for archiving and indexing purposes. Multimedia standards have therefore a direct impact on such systems. If MPEG-2 used to be the coding standard, MPEG-4 (part 2) has now replaced it in most installations, and MPEG-4 AVC/H.264 solutions are now being released. Finely analysing the complex and rich MPEG-4 streams is a challenging issue addressed in that paper. The system we designed is based on five modules: low-resolution decoder, motion estimation generator, object motion filtering, low-resolution object segmentation, and cooperative decision. Our contributions refer to as the statistical analysis of the spatial distribution of the motion vectors, the computation of DCT-based confidence maps, the automatic motion activity detection in the compressed file and a rough indexation by dedicated descriptors. The robustness and accuracy of the system are evaluated on a large corpus (hundreds of hours of in-and outdoor videos with pedestrians and vehicles). The objective benchmarking of the performances is achieved with respect to five metrics allowing to estimate the error part due to each module and for different implementations. This evaluation establishes that our system analyses up to 200 frames (720x288) per second (2.66 GHz CPU).

A piece of paper falling faster than free fall

International Nuclear Information System (INIS)

Vera, F; Rivera, R

2011-01-01

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

A piece of paper falling faster than free fall

Energy Technology Data Exchange (ETDEWEB)

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

2011-09-15

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

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

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.

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...

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

NARCIS (Netherlands)

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

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

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.

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

NARCIS (Netherlands)

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

2007-01-01

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

Using Akka Platform in Unidentified Falling Object Detection on the LHC.

CERN Document Server

Motesnitsalis, Evangelos

2013-01-01

During my participation in the CERN Summer Student Program 2013, I worked under the Technology Department of CERN and, more specifically, in the Machine Protection and Electrical Integrity (MPE) Group. The MPE Group supports LHC operation and maintains state‐of‐the art technology for magnet circuit protection and interlock systems for the present and future accelerators, magnet test facilities and CERN hosted experiments. Within this context, we developed an application that parallelizes the Unidentified Falling Object Detection Algorithm on the LHC Operational Data Analysis Software. For this reason, we used a JVM-based toolkit, named Akka, which parallelizes the execution by creating a number of actors that run simultaneously. The results of the new approach are presented on the last part of this report. They tend to be quite interesting and promising as we managed to reduce the execution time of the analysis by a factor of 10 on a local machine and the first attempts to execute the program on a cluster...

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

Free Falling in Stratified Fluids

Science.gov (United States)

Lam, Try; Vincent, Lionel; Kanso, Eva

2017-11-01

Leaves falling in air and discs falling in water are examples of unsteady descents due to complex interaction between gravitational and aerodynamic forces. Understanding these descent modes is relevant to many branches of engineering and science such as estimating the behavior of re-entry space vehicles to studying biomechanics of seed dispersion. For regularly shaped objects falling in homogenous fluids, the motion is relatively well understood. However, less is known about how density stratification of the fluid medium affects the falling behavior. Here, we experimentally investigate the descent of discs in both pure water and in stable linearly stratified fluids for Froude numbers Fr 1 and Reynolds numbers Re between 1000 -2000. We found that stable stratification (1) enhances the radial dispersion of the disc at landing, (2) increases the descent time, (3) decreases the inclination (or nutation) angle, and (4) decreases the fluttering amplitude while falling. We conclude by commenting on how the corresponding information can be used as a predictive model for objects free falling in stratified fluids.

Support vector machine as a binary classifier for automated object detection in remotely sensed data

International Nuclear Information System (INIS)

Wardaya, P D

2014-01-01

In the present paper, author proposes the application of Support Vector Machine (SVM) for the analysis of satellite imagery. One of the advantages of SVM is that, with limited training data, it may generate comparable or even better results than the other methods. The SVM algorithm is used for automated object detection and characterization. Specifically, the SVM is applied in its basic nature as a binary classifier where it classifies two classes namely, object and background. The algorithm aims at effectively detecting an object from its background with the minimum training data. The synthetic image containing noises is used for algorithm testing. Furthermore, it is implemented to perform remote sensing image analysis such as identification of Island vegetation, water body, and oil spill from the satellite imagery. It is indicated that SVM provides the fast and accurate analysis with the acceptable result

Support vector machine as a binary classifier for automated object detection in remotely sensed data

Science.gov (United States)

Wardaya, P. D.

2014-02-01

In the present paper, author proposes the application of Support Vector Machine (SVM) for the analysis of satellite imagery. One of the advantages of SVM is that, with limited training data, it may generate comparable or even better results than the other methods. The SVM algorithm is used for automated object detection and characterization. Specifically, the SVM is applied in its basic nature as a binary classifier where it classifies two classes namely, object and background. The algorithm aims at effectively detecting an object from its background with the minimum training data. The synthetic image containing noises is used for algorithm testing. Furthermore, it is implemented to perform remote sensing image analysis such as identification of Island vegetation, water body, and oil spill from the satellite imagery. It is indicated that SVM provides the fast and accurate analysis with the acceptable result.

Accelerometer and Camera-Based Strategy for Improved Human Fall Detection

KAUST Repository

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

2016-01-01

In this paper, we address the problem of detecting human falls using anomaly detection. Detection and classification of falls are based on accelerometric data and variations in human silhouette shape. First, we use the exponentially weighted moving average (EWMA) monitoring scheme to detect a potential fall in the accelerometric data. We used an EWMA to identify features that correspond with a particular type of fall allowing us to classify falls. Only features corresponding with detected falls were used in the classification phase. A benefit of using a subset of the original data to design classification models minimizes training time and simplifies models. Based on features corresponding to detected falls, we used the support vector machine (SVM) algorithm to distinguish between true falls and fall-like events. We apply this strategy to the publicly available fall detection databases from the university of Rzeszow’s. Results indicated that our strategy accurately detected and classified fall events, suggesting its potential application to early alert mechanisms in the event of fall situations and its capability for classification of detected falls. Comparison of the classification results using the EWMA-based SVM classifier method with those achieved using three commonly used machine learning classifiers, neural network, K-nearest neighbor and naïve Bayes, proved our model superior.

Accelerometer and Camera-Based Strategy for Improved Human Fall Detection

KAUST Repository

Zerrouki, Nabil

2016-10-29

In this paper, we address the problem of detecting human falls using anomaly detection. Detection and classification of falls are based on accelerometric data and variations in human silhouette shape. First, we use the exponentially weighted moving average (EWMA) monitoring scheme to detect a potential fall in the accelerometric data. We used an EWMA to identify features that correspond with a particular type of fall allowing us to classify falls. Only features corresponding with detected falls were used in the classification phase. A benefit of using a subset of the original data to design classification models minimizes training time and simplifies models. Based on features corresponding to detected falls, we used the support vector machine (SVM) algorithm to distinguish between true falls and fall-like events. We apply this strategy to the publicly available fall detection databases from the university of Rzeszow’s. Results indicated that our strategy accurately detected and classified fall events, suggesting its potential application to early alert mechanisms in the event of fall situations and its capability for classification of detected falls. Comparison of the classification results using the EWMA-based SVM classifier method with those achieved using three commonly used machine learning classifiers, neural network, K-nearest neighbor and naïve Bayes, proved our model superior.

A Cognitive Skill Classification Based on Multi Objective Optimization Using Learning Vector Quantization for Serious Games

Directory of Open Access Journals (Sweden)

Moh. Aries Syufagi

2013-09-01

Full Text Available Nowadays, serious games and game technology are poised to transform the way of educating and training students at all levels. However, pedagogical value in games do not help novice students learn, too many memorizing and reduce learning process due to no information of player’s ability. To asses the cognitive level of player ability, we propose a Cognitive Skill Game (CSG. CSG improves this cognitive concept to monitor how players interact with the game. This game employs Learning Vector Quantization (LVQ for optimizing the cognitive skill input classification of the player. CSG is using teacher’s data to obtain the neuron vector of cognitive skill pattern supervise. Three clusters multi objective XE "multi objective"  target will be classified as; trial and error, carefully and, expert cognitive skill. In the game play experiments employ 33 respondent players demonstrates that 61% of players have high trial and error, 21% have high carefully, and 18% have high expert cognitive skill. CSG may provide information to game engine when a player needs help or when wanting a formidable challenge. The game engine will provide the appropriate tasks according to players’ ability. CSG will help balance the emotions of players, so players do not get bored and frustrated. 

Fall Risk Assessment and Early-Warning for Toddler Behaviors at Home

Directory of Open Access Journals (Sweden)

Mau-Tsuen Yang

2013-12-01

Full Text Available Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second.

Fall Risk Assessment and Early-Warning for Toddler Behaviors at Home

Science.gov (United States)

Yang, Mau-Tsuen; Chuang, Min-Wen

2013-01-01

Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM) classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second. PMID:24335727

Fall risk assessment and early-warning for toddler behaviors at home.

Science.gov (United States)

Yang, Mau-Tsuen; Chuang, Min-Wen

2013-12-10

Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM) classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second.

The Effect of Personalization on Smartphone-Based Fall Detectors

Directory of Open Access Journals (Sweden)

Carlos Medrano

2016-01-01

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

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

Science.gov (United States)

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

2011-01-01

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

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

OpenAIRE

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

2015-01-01

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

Prevalence of falls in elderly women

OpenAIRE

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

2015-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

Visual hull method for tomographic PIV measurement of flow around moving objects

Energy Technology Data Exchange (ETDEWEB)

Adhikari, D.; Longmire, E.K. [University of Minnesota, Department of Aerospace Engineering and Mechanics, Minneapolis, MN (United States)

2012-10-15

Tomographic particle image velocimetry (PIV) is a recently developed method to measure three components of velocity within a volumetric space. We present a visual hull technique that automates identification and masking of discrete objects within the measurement volume, and we apply existing tomographic PIV reconstruction software to measure the velocity surrounding the objects. The technique is demonstrated by considering flow around falling bodies of different shape with Reynolds number {proportional_to}1,000. Acquired image sets are processed using separate routines to reconstruct both the volumetric mask around the object and the surrounding tracer particles. After particle reconstruction, the reconstructed object mask is used to remove any ghost particles that otherwise appear within the object volume. Velocity vectors corresponding with fluid motion can then be determined up to the boundary of the visual hull without being contaminated or affected by the neighboring object velocity. Although the visual hull method is not meant for precise tracking of objects, the reconstructed object volumes nevertheless can be used to estimate the object location and orientation at each time step. (orig.)

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.

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

DEFF Research Database (Denmark)

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

2009-01-01

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

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

Directory of Open Access Journals (Sweden)

Michelle H. Cameron

2013-01-01

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

Intrinsic factors associated with pregnancy falls.

Science.gov (United States)

Wu, Xuefang; Yeoh, Han T

2014-10-01

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

Polarization observables D/sub NN/, P and A for vector pp → vector pπ+n at 800 MeV

International Nuclear Information System (INIS)

Bonner, B.E.; McNaughton, M.W.; van Dyck, O.B.

1983-01-01

In conjunction with a vector polarization transfer measurement in the vector pp → vector dπ + reaction, we also obtained data on polarization observables for vector pp → vector pπ + n at 800 MeV incident proton energy. Scattered protons were detected in a spectrometer at angles from 5 0 to 11 0 . Pions were detected in coincidence at angles 80 0 to 130 0 . The proton momentum range covered was from 800 to 1300 MeV/c. The prominent peak observed near 1150 MeV/c in the proton spectrum is a reflection of Δ ++ production at center of mass angles from 0 0 to 30 0 . Regions of the spectrum corresponding to Δ ++ production at backward THETA/sub cm/ angles and to the 1 S 0 np final state interaction fall below the momentum acceptance limit for the spectrometer setting used in the present measurements. The events were binned into five proton momentum bins for the determination of the polarization observables D/sub NN/, P, and A

Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial.

NARCIS (Netherlands)

Smulders, E.; Weerdesteijn, V.G.M.; Groen, B.E.; Duysens, J.E.J.; Eijsbouts, A.; Laan, R.F.J.M.; Lankveld, W.G.J.M. van

2010-01-01

OBJECTIVE: To evaluate the efficacy of the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis and a fall history in a randomized controlled trial. Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength. A decrease in the number of

Fall risk factors in Parkinson's disease.

Science.gov (United States)

Gray, P; Hildebrand, K

2000-08-01

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

Accurate Fall Detection in a Top View Privacy Preserving Configuration.

Science.gov (United States)

Ricciuti, Manola; Spinsante, Susanna; Gambi, Ennio

2018-05-29

Fall detection is one of the most investigated themes in the research on assistive solutions for aged people. In particular, a false-alarm-free discrimination between falls and non-falls is indispensable, especially to assist elderly people living alone. Current technological solutions designed to monitor several types of activities in indoor environments can guarantee absolute privacy to the people that decide to rely on them. Devices integrating RGB and depth cameras, such as the Microsoft Kinect, can ensure privacy and anonymity, since the depth information is considered to extract only meaningful information from video streams. In this paper, we propose an accurate fall detection method investigating the depth frames of the human body using a single device in a top-view configuration, with the subjects located under the device inside a room. Features extracted from depth frames train a classifier based on a binary support vector machine learning algorithm. The dataset includes 32 falls and 8 activities considered for comparison, for a total of 800 sequences performed by 20 adults. The system showed an accuracy of 98.6% and only one false positive.

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.

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

Directory of Open Access Journals (Sweden)

Fields J

2015-06-01

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

Fall detection using supervised machine learning algorithms: A comparative study

KAUST Repository

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

2017-01-01

Fall incidents are considered as the leading cause of disability and even mortality among older adults. To address this problem, fall detection and prevention fields receive a lot of intention over the past years and attracted many researcher efforts. We present in the current study an overall performance comparison between fall detection systems using the most popular machine learning approaches which are: Naïve Bayes, K nearest neighbor, neural network, and support vector machine. The analysis of the classification power associated to these most widely utilized algorithms is conducted on two fall detection databases namely FDD and URFD. Since the performance of the classification algorithm is inherently dependent on the features, we extracted and used the same features for all classifiers. The classification evaluation is conducted using different state of the art statistical measures such as the overall accuracy, the F-measure coefficient, and the area under ROC curve (AUC) value.

Fall detection using supervised machine learning algorithms: A comparative study

KAUST Repository

Zerrouki, Nabil

2017-01-05

Fall incidents are considered as the leading cause of disability and even mortality among older adults. To address this problem, fall detection and prevention fields receive a lot of intention over the past years and attracted many researcher efforts. We present in the current study an overall performance comparison between fall detection systems using the most popular machine learning approaches which are: Naïve Bayes, K nearest neighbor, neural network, and support vector machine. The analysis of the classification power associated to these most widely utilized algorithms is conducted on two fall detection databases namely FDD and URFD. Since the performance of the classification algorithm is inherently dependent on the features, we extracted and used the same features for all classifiers. The classification evaluation is conducted using different state of the art statistical measures such as the overall accuracy, the F-measure coefficient, and the area under ROC curve (AUC) value.

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.

Wireless Falling Detection System Based on Community.

Science.gov (United States)

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

2015-06-01

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

Classification of older adults with/without a fall history using machine learning methods.

Science.gov (United States)

Lin Zhang; Ou Ma; Fabre, Jennifer M; Wood, Robert H; Garcia, Stephanie U; Ivey, Kayla M; McCann, Evan D

2015-01-01

Falling is a serious problem in an aged society such that assessment of the risk of falls for individuals is imperative for the research and practice of falls prevention. This paper introduces an application of several machine learning methods for training a classifier which is capable of classifying individual older adults into a high risk group and a low risk group (distinguished by whether or not the members of the group have a recent history of falls). Using a 3D motion capture system, significant gait features related to falls risk are extracted. By training these features, classification hypotheses are obtained based on machine learning techniques (K Nearest-neighbour, Naive Bayes, Logistic Regression, Neural Network, and Support Vector Machine). Training and test accuracies with sensitivity and specificity of each of these techniques are assessed. The feature adjustment and tuning of the machine learning algorithms are discussed. The outcome of the study will benefit the prediction and prevention of falls.

On the Modulation of Meteoroid Falling by Solar Inertial Motion

Science.gov (United States)

Velasco Herrera, Victor Manuel; Cordero, Guadalupe; López Hernández, Juan Gabriel

2016-07-01

We present a historical report of falls of meteoroids over the last 400 years. We report here for the first time synchronization between observed meteors and solar barycentric parameters in 19.6 and 13.2 years periodicities using the multiple cross wavelet. These periodicities could be associated with Jupiter periodicities. Bodies falling on Earth can cause from minor damage to level of mass extinctions events. So understanding the modulation on meteoroid falling is important to determine patterns of falling of these objects, and to know when it is more probable to expect the entry of one of these object into the Earth's atmosphere

Objective assessment of fall risk in Parkinson's disease using a body-fixed sensor worn for 3 days.

Science.gov (United States)

Weiss, Aner; Herman, Talia; Giladi, Nir; Hausdorff, Jeffrey M

2014-01-01

Patients with Parkinson's disease (PD) suffer from a high fall risk. Previous approaches for evaluating fall risk are based on self-report or testing at a given time point and may, therefore, be insufficient to optimally capture fall risk. We tested, for the first time, whether metrics derived from 3 day continuous recordings are associated with fall risk in PD. 107 patients (Hoehn & Yahr Stage: 2.6±0.7) wore a small, body-fixed sensor (3D accelerometer) on lower back for 3 days. Walking quantity (e.g., steps per 3-days) and quality (e.g., frequency-derived measures of gait variability) were determined. Subjects were classified as fallers or non-fallers based on fall history. Subjects were also followed for one year to evaluate predictors of the transition from non-faller to faller. The 3 day acceleration derived measures were significantly different in fallers and non-fallers and were significantly correlated with previously validated measures of fall risk. Walking quantity was similar in the two groups. In contrast, the fallers walked with higher step-to-step variability, e.g., anterior-posterior width of the dominant frequency was larger (p = 0.012) in the fallers (0.78 ± 0.17 Hz) compared to the non-fallers (0.71 ± 0.07 Hz). Among subjects who reported no falls in the year prior to testing, sensor-derived measures predicted the time to first fall (p = 0.0034), whereas many traditional measures did not. Cox regression analysis showed that anterior-posterior width was significantly (p = 0.0039) associated with time to fall during the follow-up period, even after adjusting for traditional measures. These findings indicate that a body-fixed sensor worn continuously can evaluate fall risk in PD. This sensor-based approach was able to identify transition from non-faller to faller, whereas many traditional metrics were not successful. This approach may facilitate earlier detection of fall risk and may in the future, help reduce high costs associated with falls.

Objective Assessment of Fall Risk in Parkinson's Disease Using a Body-Fixed Sensor Worn for 3 Days

Science.gov (United States)

Weiss, Aner; Herman, Talia; Giladi, Nir; Hausdorff, Jeffrey M.

2014-01-01

Background Patients with Parkinson's disease (PD) suffer from a high fall risk. Previous approaches for evaluating fall risk are based on self-report or testing at a given time point and may, therefore, be insufficient to optimally capture fall risk. We tested, for the first time, whether metrics derived from 3 day continuous recordings are associated with fall risk in PD. Methods and Materials 107 patients (Hoehn & Yahr Stage: 2.6±0.7) wore a small, body-fixed sensor (3D accelerometer) on lower back for 3 days. Walking quantity (e.g., steps per 3-days) and quality (e.g., frequency-derived measures of gait variability) were determined. Subjects were classified as fallers or non-fallers based on fall history. Subjects were also followed for one year to evaluate predictors of the transition from non-faller to faller. Results The 3 day acceleration derived measures were significantly different in fallers and non-fallers and were significantly correlated with previously validated measures of fall risk. Walking quantity was similar in the two groups. In contrast, the fallers walked with higher step-to-step variability, e.g., anterior-posterior width of the dominant frequency was larger (p = 0.012) in the fallers (0.78±0.17 Hz) compared to the non-fallers (0.71±0.07 Hz). Among subjects who reported no falls in the year prior to testing, sensor-derived measures predicted the time to first fall (p = 0.0034), whereas many traditional measures did not. Cox regression analysis showed that anterior-posterior width was significantly (p = 0.0039) associated with time to fall during the follow-up period, even after adjusting for traditional measures. Conclusions/Significance These findings indicate that a body-fixed sensor worn continuously can evaluate fall risk in PD. This sensor-based approach was able to identify transition from non-faller to faller, whereas many traditional metrics were not successful. This approach may facilitate earlier detection of fall

Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

Science.gov (United States)

Mirelman, Anat; Herman, Talia; Brozgol, Marina; Dorfman, Moran; Sprecher, Elliot; Schweiger, Avraham; Giladi, Nir; Hausdorff, Jeffrey M

2012-01-01

Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021), the attention index (RR: .84; CI: .75-.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (pfalls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

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

African Journals Online (AJOL)

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

Variable ordering structures in vector optimization

CERN Document Server

Eichfelder, Gabriele

2014-01-01

This book provides an introduction to vector optimization with variable ordering structures, i.e., to optimization problems with a vector-valued objective function where the elements in the objective space are compared based on a variable ordering structure: instead of a partial ordering defined by a convex cone, we see a whole family of convex cones, one attached to each element of the objective space. The book starts by presenting several applications that have recently sparked new interest in these optimization problems, and goes on to discuss fundamentals and important results on a wide ra

Risk factors for falls of older citizens

NARCIS (Netherlands)

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

2013-01-01

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

Vector Antenna and Maximum Likelihood Imaging for Radio Astronomy

Science.gov (United States)

2016-03-05

398, 1994. [21] A. Nehorai, K. C. Ho, and B. T. G. Tan , “Minimum- 14 noise-variance beamformer with an electromagnetic vector sensor,” IEEE...G. Eslinger, A. Nicholas , and C. Pong, “The MicroMAS CubeSat Mission,” AGU Fall Meet. Abstr., vol. -1, p. 2162, Dec. 2012. [39] W. Blackwell, G

Fall predictors in older cancer patients: a multicenter prospective study

OpenAIRE

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

2014-01-01

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

Magnetic vector field tag and seal

Science.gov (United States)

Johnston, Roger G.; Garcia, Anthony R.

2004-08-31

One or more magnets are placed in a container (preferably on objects inside the container) and the magnetic field strength and vector direction are measured with a magnetometer from at least one location near the container to provide the container with a magnetic vector field tag and seal. The location(s) of the magnetometer relative to the container are also noted. If the position of any magnet inside the container changes, then the measured vector fields at the these locations also change, indicating that the tag has been removed, the seal has broken, and therefore that the container and objects inside may have been tampered with. A hollow wheel with magnets inside may also provide a similar magnetic vector field tag and seal. As the wheel turns, the magnets tumble randomly inside, removing the tag and breaking the seal.

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

Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition.

Directory of Open Access Journals (Sweden)

Anat Mirelman

Full Text Available Recent findings suggest that executive function (EF plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk.We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR. After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021, the attention index (RR: .84; CI: .75-.94, p = .002 and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027 were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p<0.02.These findings demonstrate that among community-living older adults, the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.

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

Science.gov (United States)

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

2015-12-01

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

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

NARCIS (Netherlands)

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

2017-01-01

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

Using raster and vector data to identify objects for classify in flood risk. A case study: Raciborz

Science.gov (United States)

Porczek, Mariusz; Rucińska, Dorota; Lewiński, Stanisław

2018-01-01

The severe flood of 1997, which seriously affected Polish, Czech and German territories, gave impetus to research into the management of flood-prone areas. The material losses caused by the "Flood of the Millennium" totalled billions of Polish zloty. The extent of the disaster and of infrastructure repair costs changed the attitude of many branches of the economy, and of science. This is the direct result of consideration of the introduction of changes into spatial management and crisis management. At the same time, it focused the interest of many who were trained in analysing the vulnerability of land-use features to natural disasters such as floods. Research into the spatial distribution of geographic environmental features susceptible to flood in the Odra valley was conducted at the Faculty of Geography and Regional Studies of the University of Warsaw using Geographic Information Systems (GIS). This study seeks to examine the possibility of adapting vector and raster data and using them for land-use classification in the context of risk of flood and inundation damage. The analysed area of the city and surrounding area of Raciborz, on the upper Odra River, is a case study for identifying objects and lands susceptible to natural hazards based on publicly available satellite databases of the highest resolution, which is a very important factor in the quality of further risk analyses for applied use. The objective of the research was to create a 10×10-m-pixel raster network using raster data made available by ESA (Copernicus Land Monitoring Service) and vector data from Open Street Map.

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

Science.gov (United States)

Lee, Justin Yusen; Holbrook, Anne

2017-02-20

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

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

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

Science.gov (United States)

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

2017-12-22

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

The "Aachen fall prevention App" - a Smartphone application app for the self-assessment of elderly patients at risk for ground level falls.

Science.gov (United States)

Rasche, Peter; Mertens, Alexander; Bröhl, Christina; Theis, Sabine; Seinsch, Tobias; Wille, Matthias; Pape, Hans-Christoph; Knobe, Matthias

2017-01-01

Fall incidents are a major problem for patients and healthcare. The "Aachen Fall Prevention App" (AFPA) represents the first mobile Health (mHealth) application (app) empowering older patients (persons 50+ years) to self-assess and monitor their individual fall risk. Self-assessment is based on the "Aachen Fall Prevention Scale," which consists of three steps. First, patients answer ten standardized yes-no questions (positive criterion ≥ 5 "Yes" responses). Second, a ten-second test of free standing without compensatory movement is performed (positive criterion: compensatory movement). Finally, during the third step, patients rate their subjective fall risk on a 10-point Likert scale, based on the results of steps one and two. The purpose of this app is (1) to offer a low-threshold service through which individuals can independently monitor their individual fall risk and (2) to collect data about how a patient-centered mHealth app for fall risk assessment is used in the field. The results represent the first year of an ongoing field study. From December 2015 to December 2016, 197 persons downloaded the AFPA (iOS ™ and Android ™ ; free of charge). N  = 111 of these persons voluntarily shared their data and thereby participated in the field study. Data from a final number of n  = 79 persons were analyzed due to exclusion criteria (age, missing objective fall risk, missing self-assessment). The objective fall risk and the self-assessed subjective risk measured by the AFPA showed a significant positive relationship. The "Aachen Fall Prevention App" (AFPA) is an mHealth app released for iOS and Android. This field study revealed the AFPA as a promising tool to raise older adults' awareness of their individual fall risk by means of a low-threshold patient-driven fall risk assessment tool.

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

Directory of Open Access Journals (Sweden)

Justin Yusen Lee

2017-02-01

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

Link-Based Similarity Measures Using Reachability Vectors

Directory of Open Access Journals (Sweden)

Seok-Ho Yoon

2014-01-01

Full Text Available We present a novel approach for computing link-based similarities among objects accurately by utilizing the link information pertaining to the objects involved. We discuss the problems with previous link-based similarity measures and propose a novel approach for computing link based similarities that does not suffer from these problems. In the proposed approach each target object is represented by a vector. Each element of the vector corresponds to all the objects in the given data, and the value of each element denotes the weight for the corresponding object. As for this weight value, we propose to utilize the probability of reaching from the target object to the specific object, computed using the “Random Walk with Restart” strategy. Then, we define the similarity between two objects as the cosine similarity of the two vectors. In this paper, we provide examples to show that our approach does not suffer from the aforementioned problems. We also evaluate the performance of the proposed methods in comparison with existing link-based measures, qualitatively and quantitatively, with respect to two kinds of data sets, scientific papers and Web documents. Our experimental results indicate that the proposed methods significantly outperform the existing measures.

Motoric Cognitive Risk Syndrome and Falls Risk: A Multi-Center Study

Science.gov (United States)

Callisaya, Michele L.; Ayers, Emmeline; Barzilai, Nir; Ferrucci, Luigi; Guralnik, Jack M.; Lipton, Richard B.; Otahal, Petr; Srikanth, Velandai K.; Verghese, Joe

2016-01-01

Background The Motoric Cognitive Risk Syndrome (MCR) is characterized by slow gait speed and cognitive complaints. Objectives The objective of this study was to determine if the presence of MCR increases the risk of falls in older people. Methods Individual participant data (n = 6,204) from five longitudinal studies from three countries were used for this analysis. MCR diagnosis was defined as both the presence of objectively measured slow gait speed and subjective cognitive complaints in those without dementia or mobility disability. Falls were prospectively ascertained using phone calls or questionnaires. Log binomial regression was performed to determine if MCR increased the risk of falls separately in each cohort. Random effects meta-analysis was used to pool results from all cohorts. Results The mean age of participants was 74.9 (SD 6.8) years and 44% (n = 2728) were male. Overall 33.9% (n = 2104) reported a fall over follow-up. Pooled relative risk of MCR with any falls was RR 1.44 95% CI 1.16, 1.79. The components of MCR, slow gait (RR 1.30 95% CI 1.14, 1.47) and cognitive complaint (RR 1.25, 95% CI 1.07, 1.46) were also associated with an increased risk of any falls. In sub-analyses MCR was associated with any fall independent of previous falls (RR 1.29 95% CI 1.09, 1.53) and with multiple falls (RR 1.77, 95% CI 1.25, 2.51). Conclusion MCR is associated with an increased risk of falls. The increase in risk was higher than for its individual components. The simplicity of the MCR makes it an attractive falls risk screening tool for the clinic. PMID:27340851

Interventions for preventing falls in people after stroke.

NARCIS (Netherlands)

Verheyden, G.S.; Weerdesteijn, V.G.M.; Pickering, R.M.; Kunkel, D.; Lennon, S.; Geurts, A.C.H.; Ashburn, A.

2013-01-01

BACKGROUND: Falls are one of the most common medical complications after stroke with a reported incidence of 7% in the first week after stroke onset. Studies investigating falls in the later phase after stroke report an incidence of up to 73% in the first year post-stroke. OBJECTIVES: To evaluate

An introduction to vectors, vector operators and vector analysis

CERN Document Server

Joag, Pramod S

2016-01-01

Ideal for undergraduate and graduate students of science and engineering, this book covers fundamental concepts of vectors and their applications in a single volume. The first unit deals with basic formulation, both conceptual and theoretical. It discusses applications of algebraic operations, Levi-Civita notation, and curvilinear coordinate systems like spherical polar and parabolic systems and structures, and analytical geometry of curves and surfaces. The second unit delves into the algebra of operators and their types and also explains the equivalence between the algebra of vector operators and the algebra of matrices. Formulation of eigen vectors and eigen values of a linear vector operator are elaborated using vector algebra. The third unit deals with vector analysis, discussing vector valued functions of a scalar variable and functions of vector argument (both scalar valued and vector valued), thus covering both the scalar vector fields and vector integration.

Falling-sphere radioactive viscometry

International Nuclear Information System (INIS)

Souza, R. de.

1987-01-01

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

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

Science.gov (United States)

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

2018-05-01

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

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

Science.gov (United States)

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

2017-05-01

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

The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis.

Science.gov (United States)

Arnold, C M; Faulkner, R A; Gyurcsik, N C

2011-01-01

Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. EE participants with low baseline falls efficacy demonstrated significantly (pfalls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (pfalls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes.

Fibromyalgia is Associated with Impaired Balance and Falls

Science.gov (United States)

Jones, Kim D.; Horak, Fay B.; Winters, Kerri Stone; Morea, Jessica M.; Bennett, Robert M.

2010-01-01

Background/Objective The purpose of this study was to determine whether FM patients differ from matched healthy controls in clinical tests of balance ability and fall frequency. Methods 34 FM patients and 32 age matched controls were administered the Balance Evaluation-Systems Test (BESTest), rated their balance confidence with the Activities-Specific Balance Confidence Scale (ABC) and reported the number of falls in the last 6 months. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess FM severity. Results FM patients had significantly impaired balance in all components of the BESTest compared to controls. They also scored more poorly on balance confidence. Overall fibromyalgia severity (FIQ) correlated significantly with the BESTest, and the ABC scale. The BESTest and ABC correlated significantly with 6 commonly reported FM symptoms (excluding pain). FM patients reported a total of 37 falls over the last six-months compared to 6 falls in healthy controls. Conclusion Fibromyalgia is associated with balance problems and increased fall frequency. Patients were aware of their balance problems. These results suggest that FM may affect peripheral and/or central mechanisms of postural control. Further objective study is needed to identify the relative contributions of neural and musculoskeletal impairments to postural stability in FM, thus providing clinicians with exercise prescriptions that maximize postural stability. PMID:19125137

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

Directory of Open Access Journals (Sweden)

Christina Brogårdh

2017-08-01

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

The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis

Science.gov (United States)

Faulkner, R.A.; Gyurcsik, N.C.

2011-01-01

ABSTRACT Purpose: Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Method: Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. Results: EE participants with low baseline falls efficacy demonstrated significantly (pbalance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (pbalance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Conclusions: Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes. PMID:22942514

An Object-Based Classification of Mangroves Using a Hybrid Decision Tree—Support Vector Machine Approach

Directory of Open Access Journals (Sweden)

Benjamin W. Heumann

2011-11-01

Full Text Available Mangroves provide valuable ecosystem goods and services such as carbon sequestration, habitat for terrestrial and marine fauna, and coastal hazard mitigation. The use of satellite remote sensing to map mangroves has become widespread as it can provide accurate, efficient, and repeatable assessments. Traditional remote sensing approaches have failed to accurately map fringe mangroves and true mangrove species due to relatively coarse spatial resolution and/or spectral confusion with landward vegetation. This study demonstrates the use of the new Worldview-2 sensor, Object-based image analysis (OBIA, and support vector machine (SVM classification to overcome both of these limitations. An exploratory spectral separability showed that individual mangrove species could not be spectrally separated, but a distinction between true and associate mangrove species could be made. An OBIA classification was used that combined a decision-tree classification with the machine-learning SVM classification. Results showed an overall accuracy greater than 94% (kappa = 0.863 for classifying true mangroves species and other dense coastal vegetation at the object level. There remain serious challenges to accurately mapping fringe mangroves using remote sensing data due to spectral similarity of mangrove and associate species, lack of clear zonation between species, and mixed pixel effects, especially when vegetation is sparse or degraded.

Optimization of Support Vector Machine (SVM) for Object Classification

Science.gov (United States)

Scholten, Matthew; Dhingra, Neil; Lu, Thomas T.; Chao, Tien-Hsin

2012-01-01

The Support Vector Machine (SVM) is a powerful algorithm, useful in classifying data into species. The SVMs implemented in this research were used as classifiers for the final stage in a Multistage Automatic Target Recognition (ATR) system. A single kernel SVM known as SVMlight, and a modified version known as a SVM with K-Means Clustering were used. These SVM algorithms were tested as classifiers under varying conditions. Image noise levels varied, and the orientation of the targets changed. The classifiers were then optimized to demonstrate their maximum potential as classifiers. Results demonstrate the reliability of SVM as a method for classification. From trial to trial, SVM produces consistent results.

Local Patch Vectors Encoded by Fisher Vectors for Image Classification

Directory of Open Access Journals (Sweden)

Shuangshuang Chen

2018-02-01

Full Text Available The objective of this work is image classification, whose purpose is to group images into corresponding semantic categories. Four contributions are made as follows: (i For computational simplicity and efficiency, we directly adopt raw image patch vectors as local descriptors encoded by Fisher vector (FV subsequently; (ii For obtaining representative local features within the FV encoding framework, we compare and analyze three typical sampling strategies: random sampling, saliency-based sampling and dense sampling; (iii In order to embed both global and local spatial information into local features, we construct an improved spatial geometry structure which shows good performance; (iv For reducing the storage and CPU costs of high dimensional vectors, we adopt a new feature selection method based on supervised mutual information (MI, which chooses features by an importance sorting algorithm. We report experimental results on dataset STL-10. It shows very promising performance with this simple and efficient framework compared to conventional methods.

The supersymmetric configurations of N=2, d=4 supergravity coupled to vector supermultiplets

CERN Document Server

Meessen, P

2006-01-01

We classify all the supersymmetric configurations of ungauged N=2,d=4 supergravity coupled to n vector multiplets and determine under which conditions they are also classical solutions of the equations of motion. The supersymmetric configurations fall into two classes, depending on the timelike or null nature of the Killing vector constructed from Killing spinor bilinears. The timelike class configurations are essentially the ones found by Behrndt, Luest and Sabra, which exhaust this class and are the ones that include supersymmetric black holes. The null class configurations include pp-waves and cosmic strings.

Fear of falling and associated factors in community elderly with cataracts

OpenAIRE

Cascalho, Lorena de Andrade; Paz, Leonardo Petrus da Silva; Romão, Juliana de Faria Fracon e; Menezes, Ruth Losada de

2016-01-01

ABSTRACT Objective: To investigate prevalence of the fear of falling of elderly with cataracts living in the community and the associated factors with high concern with falling occurrences. Methods: A cross-sectional, analytical and observational study. It was composed by 86 elderly diagnosed with bilateral cataracts. To quantify the fear of falling among elderly, the scale Falls Efficacy Scale-International-Brasil (FES-I-BRASIL) was used. Other variables were obtained through application o...

A Cognitive Skill Classification Based On Multi Objective Optimization Using Learning Vector Quantization for Serious Games

Directory of Open Access Journals (Sweden)

Moh. Aries Syufagi

2011-12-01

Full Text Available Nowadays, serious games and game technology are poised to transform the way of educating and training students at all levels. However, pedagogical value in games do not help novice students learn, too many memorizing and reduce learning process due to no information of player’s ability. To asses the cognitive level of player ability, we propose a Cognitive Skill Game (CSG. CSG improves this cognitive concept to monitor how players interact with the game. This game employs Learning Vector Quantization (LVQ for optimizing the cognitive skill input classification of the player. CSG is using teacher’s data to obtain the neuron vector of cognitive skill pattern supervise. Three clusters multi objective target will be classified as; trial and error, carefully and, expert cognitive skill. In the game play experiments using 33 respondent players demonstrates that 61% of players have high trial and error cognitive skill, 21% have high carefully cognitive skill, and 18% have high expert cognitive skill. CSG may provide information to game engine when a player needs help or when wanting a formidable challenge. The game engine will provide the appropriate tasks according to players’ ability. CSG will help balance the emotions of players, so players do not get bored and frustrated. Players have a high interest to finish the game if the player is emotionally stable. Interests in the players strongly support the procedural learning in a serious game.

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

Science.gov (United States)

Brewin, Dorothy; Naninni, Angela

2014-01-01

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

Identifying nursing home residents at risk for falling.

Science.gov (United States)

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

1998-05-01

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

Functional ability and health status of community-dwelling late age elderly people with and without a history of falls

OpenAIRE

Thiwabhorn Thaweewannakij, PT, PhD; Patcharawan Suwannarat, PT, PhD candidate; Lugkana Mato, PT, PhD; Sugalya Amatachaya, PT, PhD

2016-01-01

Background: Obvious functional deterioration is demonstrated in elderly people aged 75 years and older. However, there is only little objective evidence relating to falls in these individuals. Objective: This cross-sectional study compared functional abilities and health status in the elderly age at least 75 years with no fall, single fall (1 fall), and multiple falls (≥2 falls) during the past 6 months. Furthermore, the study describes fall information of the participants. Methods: Nin...

A posture recognition based fall detection system for monitoring an elderly person in a smart home environment.

Science.gov (United States)

Yu, Miao; Rhuma, Adel; Naqvi, Syed Mohsen; Wang, Liang; Chambers, Jonathon

2012-11-01

We propose a novel computer vision based fall detection system for monitoring an elderly person in a home care application. Background subtraction is applied to extract the foreground human body and the result is improved by using certain post-processing. Information from ellipse fitting and a projection histogram along the axes of the ellipse are used as the features for distinguishing different postures of the human. These features are then fed into a directed acyclic graph support vector machine (DAGSVM) for posture classification, the result of which is then combined with derived floor information to detect a fall. From a dataset of 15 people, we show that our fall detection system can achieve a high fall detection rate (97.08%) and a very low false detection rate (0.8%) in a simulated home environment.

High fall incidence and fracture rate in elderly dialysis patients

NARCIS (Netherlands)

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

2014-01-01

Background: Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors

The CAREFALL Triage instrument identifying risk factors for recurrent falls in elderly patients

NARCIS (Netherlands)

Hensbroek, van P. Boele; Dijk, van N.; Breda, van G.F.; Scheffer, A.C.; Cammen, van der T.J.; Lips, P.T.A.M.; Goslings, J.C.; Rooij, S.E.

2009-01-01

OBJECTIVE: To validate the CAREFALL Triage Instrument (CTI), a self-administered questionnaire concerning modifiable risk factors for recurrent falls in elderly patients who experienced fall. METHODS: This study in patients 65 years or older who experienced fall was performed at the accident and

The CAREFALL Triage instrument identifying risk factors for recurrent falls in elderly patients

NARCIS (Netherlands)

Boele van Hensbroek, Pieter; van Dijk, Nynke; van Breda, G. Fenna; Scheffer, Alice C.; van der Cammen, Tischa J.; Lips, Paul; Goslings, J. Carel; de Rooij, Sophia E.

2009-01-01

Objective: To validate the CAREFALL Triage Instrument (CTI), a self-administered questionnaire concerning modifiable risk factors for recurrent falls in elderly patients who experienced fall. Methods: This study in patients 65 years or older who experienced fall was performed at the accident and

Meromorphic Vector Fields and Circle Packings

DEFF Research Database (Denmark)

Dias, Kealey

The objective of the Ph.D. project is to initiate a classification of bifurcations of meromorphic vector fields and to clarify their relation to circle packings. Technological applications are to image analysis and to effective grid generation using discrete conformal mappings. The two branches...... of dynamical systems, continuous and discrete, correspond to the study of differential equations (vector fields) and iteration of mappings respectively. In holomorphic dynamics, the systems studied are restricted to those described by holomorphic (complex analytic) functions or meromorphic (allowing poles...... as singularities) functions. There already exists a well-developed theory for iterative holomorphic dynamical systems, and successful relations found between iteration theory and flows of vector fields have been one of the main motivations for the recent interest in holomorphic vector fields. Restricting...

How Fast Do Objects Fall in Visual Memory? Uncovering the Temporal and Spatial Features of Representational Gravity.

Science.gov (United States)

De Sá Teixeira, Nuno

2016-01-01

Visual memory for the spatial location where a moving target vanishes has been found to be systematically displaced downward in the direction of gravity. Moreover, it was recently reported that the magnitude of the downward error increases steadily with increasing retention intervals imposed after object's offset and before observers are allowed to perform the spatial localization task, in a pattern where the remembered vanishing location drifts downward as if following a falling trajectory. This outcome was taken to reflect the dynamics of a representational model of earth's gravity. The present study aims to establish the spatial and temporal features of this downward drift by taking into account the dynamics of the motor response. The obtained results show that the memory for the last location of the target drifts downward with time, thus replicating previous results. Moreover, the time taken for completion of the behavioural localization movements seems to add to the imposed retention intervals in determining the temporal frame during which the visual memory is updated. Overall, it is reported that the representation of spatial location drifts downward by about 3 pixels for each two-fold increase of time until response. The outcomes are discussed in relation to a predictive internal model of gravity which outputs an on-line spatial update of remembered objects' location.

Novel sensing technology in fall risk assessment in older adults: a systematic review.

Science.gov (United States)

Sun, Ruopeng; Sosnoff, Jacob J

2018-01-16

Falls are a major health problem for older adults with significant physical and psychological consequences. A first step of successful fall prevention is to identify those at risk of falling. Recent advancement in sensing technology offers the possibility of objective, low-cost and easy-to-implement fall risk assessment. The objective of this systematic review is to assess the current state of sensing technology on providing objective fall risk assessment in older adults. A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Twenty-two studies out of 855 articles were systematically identified and included in this review. Pertinent methodological features (sensing technique, assessment activities, outcome variables, and fall discrimination/prediction models) were extracted from each article. Four major sensing technologies (inertial sensors, video/depth camera, pressure sensing platform and laser sensing) were reported to provide accurate fall risk diagnostic in older adults. Steady state walking, static/dynamic balance, and functional mobility were used as the assessment activity. A diverse range of diagnostic accuracy across studies (47.9% - 100%) were reported, due to variation in measured kinematic/kinetic parameters and modelling techniques. A wide range of sensor technologies have been utilized in fall risk assessment in older adults. Overall, these devices have the potential to provide an accurate, inexpensive, and easy-to-implement fall risk assessment. However, the variation in measured parameters, assessment tools, sensor sites, movement tasks, and modelling techniques, precludes a firm conclusion on their ability to predict future falls. Future work is needed to determine a clinical meaningful and easy to interpret fall risk diagnosis utilizing sensing technology. Additionally, the gap between functional evaluation and user experience to technology should be addressed.

Assessment of risk of falls in elderly living at home

Directory of Open Access Journals (Sweden)

Adriana de Azevedo Smith

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

SUPPORT VECTOR MACHINE CLASSIFICATION OF OBJECT-BASED DATA FOR CROP MAPPING, USING MULTI-TEMPORAL LANDSAT IMAGERY

Directory of Open Access Journals (Sweden)

R. Devadas

2012-07-01

Full Text Available Crop mapping and time series analysis of agronomic cycles are critical for monitoring land use and land management practices, and analysing the issues of agro-environmental impacts and climate change. Multi-temporal Landsat data can be used to analyse decadal changes in cropping patterns at field level, owing to its medium spatial resolution and historical availability. This study attempts to develop robust remote sensing techniques, applicable across a large geographic extent, for state-wide mapping of cropping history in Queensland, Australia. In this context, traditional pixel-based classification was analysed in comparison with image object-based classification using advanced supervised machine-learning algorithms such as Support Vector Machine (SVM. For the Darling Downs region of southern Queensland we gathered a set of Landsat TM images from the 2010–2011 cropping season. Landsat data, along with the vegetation index images, were subjected to multiresolution segmentation to obtain polygon objects. Object-based methods enabled the analysis of aggregated sets of pixels, and exploited shape-related and textural variation, as well as spectral characteristics. SVM models were chosen after examining three shape-based parameters, twenty-three textural parameters and ten spectral parameters of the objects. We found that the object-based methods were superior to the pixel-based methods for classifying 4 major landuse/land cover classes, considering the complexities of within field spectral heterogeneity and spectral mixing. Comparative analysis clearly revealed that higher overall classification accuracy (95% was observed in the object-based SVM compared with that of traditional pixel-based classification (89% using maximum likelihood classifier (MLC. Object-based classification also resulted speckle-free images. Further, object-based SVM models were used to classify different broadacre crop types for summer and winter seasons. The influence of

Management of older patients presenting after a fall - an accident ...

African Journals Online (AJOL)

Background. It is common for older patients to present to accident and emergency (AE) departments after a fall. Management should include assessment and treatment of the injuries and assessment and correction of underlying risk factors in order to prevent recurrent falls. Objectives. To determine management of older ...

Staircase falls: High-risk groups and injury characteristics in 464 patients

NARCIS (Netherlands)

Boele van Hensbroek, P.; Mulder, S.; Luitse, J. S. K.; van Ooijen, M. R.; Goslings, J. C.

2009-01-01

Introduction: Few data are available about the epidemiology and injury characteristics in staircase falls. The available literature mainly concerns children and autopsy studies. Objective: To describe the epidemiology and injury characteristics of staircase falls, and to identify high-risk groups

Quantitative falls risk estimation through multi-sensor assessment of standing balance.

Science.gov (United States)

Greene, Barry R; McGrath, Denise; Walsh, Lorcan; Doheny, Emer P; McKeown, David; Garattini, Chiara; Cunningham, Clodagh; Crosby, Lisa; Caulfield, Brian; Kenny, Rose A

2012-12-01

Falls are the most common cause of injury and hospitalization and one of the principal causes of death and disability in older adults worldwide. Measures of postural stability have been associated with the incidence of falls in older adults. The aim of this study was to develop a model that accurately classifies fallers and non-fallers using novel multi-sensor quantitative balance metrics that can be easily deployed into a home or clinic setting. We compared the classification accuracy of our model with an established method for falls risk assessment, the Berg balance scale. Data were acquired using two sensor modalities--a pressure sensitive platform sensor and a body-worn inertial sensor, mounted on the lower back--from 120 community dwelling older adults (65 with a history of falls, 55 without, mean age 73.7 ± 5.8 years, 63 female) while performing a number of standing balance tasks in a geriatric research clinic. Results obtained using a support vector machine yielded a mean classification accuracy of 71.52% (95% CI: 68.82-74.28) in classifying falls history, obtained using one model classifying all data points. Considering male and female participant data separately yielded classification accuracies of 72.80% (95% CI: 68.85-77.17) and 73.33% (95% CI: 69.88-76.81) respectively, leading to a mean classification accuracy of 73.07% in identifying participants with a history of falls. Results compare favourably to those obtained using the Berg balance scale (mean classification accuracy: 59.42% (95% CI: 56.96-61.88)). Results from the present study could lead to a robust method for assessing falls risk in both supervised and unsupervised environments.

Fall scenarios In causing older women's hip fractures.

Science.gov (United States)

Hägvide, Mona-Lisa; Larsson, Tore J; Borell, Lena

2013-01-01

Falls and fall-related injuries among older women constitute a major public health problem with huge costs for the society and personal suffering. The aim of this study was to describe and illustrate how a number of circumstances, conceptualized as a scenario, that were related to the individual, the environment, and the ongoing occupation contributed to a fall that led to a hip fracture among women. The sample included 48 women over 55 years old. Interviews were conducted during home visits and the analysis provided a descriptive picture of circumstances in the shape of a scenario related to the risk of falling. A number of scenarios were developed based on the data and named to provide an understanding of the interplay between the individual, the environment, and the ongoing occupation at the time of the fall. By applying the concept of a scenario, occupational therapists can increase the awareness of fall risks among older people, and are relevant also for interior designers, architects, and town planners to consider when designing the local environment as well as furniture and other objects.

Integrating Transgenic Vector Manipulation with Clinical Interventions to Manage Vector-Borne Diseases.

Directory of Open Access Journals (Sweden)

Kenichi W Okamoto

2016-03-01

Full Text Available Many vector-borne diseases lack effective vaccines and medications, and the limitations of traditional vector control have inspired novel approaches based on using genetic engineering to manipulate vector populations and thereby reduce transmission. Yet both the short- and long-term epidemiological effects of these transgenic strategies are highly uncertain. If neither vaccines, medications, nor transgenic strategies can by themselves suffice for managing vector-borne diseases, integrating these approaches becomes key. Here we develop a framework to evaluate how clinical interventions (i.e., vaccination and medication can be integrated with transgenic vector manipulation strategies to prevent disease invasion and reduce disease incidence. We show that the ability of clinical interventions to accelerate disease suppression can depend on the nature of the transgenic manipulation deployed (e.g., whether vector population reduction or replacement is attempted. We find that making a specific, individual strategy highly effective may not be necessary for attaining public-health objectives, provided suitable combinations can be adopted. However, we show how combining only partially effective antimicrobial drugs or vaccination with transgenic vector manipulations that merely temporarily lower vector competence can amplify disease resurgence following transient suppression. Thus, transgenic vector manipulation that cannot be sustained can have adverse consequences-consequences which ineffective clinical interventions can at best only mitigate, and at worst temporarily exacerbate. This result, which arises from differences between the time scale on which the interventions affect disease dynamics and the time scale of host population dynamics, highlights the importance of accounting for the potential delay in the effects of deploying public health strategies on long-term disease incidence. We find that for systems at the disease-endemic equilibrium, even

Concern with falls in elderly people attended in an Integral Attention Center

Directory of Open Access Journals (Sweden)

Elizandro Correia de Araújo

2016-11-01

Full Text Available Falls are concerning factors in elderly people, because they cause diverse complications. The objective of this study was to identify the level of concern with falls, associating them with self-reported diseases and history of falls of elderly attended in an Integral Attention Center. This was a descriptive study with 80 elderly. The results demonstrated an extreme concern regarding the possibility of falling for most female, married, of 60-79 years and receiving low monthly income; there is also extreme concern for those with hypertension and arthrosis. Nursing should establish integral actions to map elderly with risk of falling and, that promote awareness for these elderly and their family members regarding fall prevention measures, to prevent falls and to reduce the fear of falling.

Risk of falls and associated factors in institutionalized elderly

Directory of Open Access Journals (Sweden)

Jacy Aurelia Vieira de Sousa

2016-01-01

Full Text Available Objective: to identify the factors associated with the risk of falls in institutionalized elderly. Methods: analytical study carried out in two long-stay institutions for the elderly, with 61 residents of both sexes. Data collection was performed by means of a socio-demographic and clinical form and Downton’s Fall Risk Index. Results: 31 (50.8% old people at high risk of falling were identified. There was an association of risk for falls in institutionalized elderly with gender (p=0.007, age (p=0.004, time of institutionalization (p=0.028, adverse events (p=0.000, use (p=0.035 and number of drugs (p=0.038, use of auxiliary equipment (p=0.022, type of walking (p=0.044 and history of falls in the last 12 months (p=0.000 Conclusion: it is recognized as essential to identify factors associated with the occurrence of falls for the prioritization of specific interventions aimed at institutionalized elderly.

Risk of falls and associated factors in institutionalized elderly

Directory of Open Access Journals (Sweden)

Jacy Aurelia Vieira de Sousa

2016-06-01

Full Text Available Objective: to identify the factors associated with the risk of falls in institutionalized elderly. Methods: analytical study carried out in two long-stay institutions for the elderly, with 61 residents of both sexes. Data collection was performed by means of a socio-demographic and clinical form and Downton’s Fall Risk Index. Results: 31 (50.8% old people at high risk of falling were identified. There was an association of risk for falls in institutionalized elderly with gender (p=0.007, age (p=0.004, time of institutionalization (p=0.028, adverse events (p=0.000, use (p=0.035 and number of drugs (p=0.038, use of auxiliary equipment (p=0.022, type of walking (p=0.044 and history of falls in the last 12 months (p=0.000. Conclusion: it is recognized as essential to identify factors associated with the occurrence of falls for the prioritization of specific interventions aimed at institutionalized elderly.

Susceptibility Status of The Malaria Vector Anopheles Arabiensis To ...

African Journals Online (AJOL)

Background: Increasing insecticide resistancein the major anopheline vectors remain the main obstacle for malaria control programmes in African countries including Sudan. Objectives: To assess the susceptibility status of Anopheles arabiensis the malaria vector to different classes of insecticides in Khartoum State.

JAKEF, Gradient or Jacobian Function from Objective Function or Vector Function

International Nuclear Information System (INIS)

Hillstrom, K.E.

1988-01-01

1 - Description of program or function: JAKEF is a language processor that accepts as input a single- or double-precision ANSI standard 1977 FORTRAN subroutine defining an objective function f(x), or a vector function F(x), and produces as output a single- or double- precision ANSI standard 1977 FORTRAN subroutine defining the gradient of f(x), or the Jacobian of F(x). 2 - Method of solution: JAKEF is a four-pass compiler consisting of a lexical preprocessor, a parser, a tree-building and flow analysis pass, and a differentiator and output construction pass. The lexical preprocessor reworks the input FORTRAN program to give it a recognizable lexical structure. The parser transforms the pre-processed input into a string of tokens in a post-fix representation of the program tree. The tree-building and flow analysis pass constructs a tree out of the post-fix token string. The differentiator identifies relevant assignment statements; then, if necessary, it analyzes them into component statements governed by a single differentiation rule and augments each of these statements with a call to a member of the run-time support package which implements the differentiation rule. After completing the construction of the main body of the routine, JAKEF inserts calls to support package routines that complete the differentiation. This results in a modified program tree in a form compatible with FORTRAN rules. 3 - Restrictions on the complexity of the problem: Statement functions and Equivalence's that involve the independent variables are not handled correctly. Variables, constants, or functions of type COMPLEX are not recognized. Character sub-string expressions and alternate returns are not permitted

A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls

OpenAIRE

Conroy, Simon; Kendrick, Denise; Harwood, Rowan; Gladman, John; Coupland, Carol; Sach, Tracey; Drummond, Avril; Youde, Jane; Edmans, Judi; Masud, Tahir

2010-01-01

Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process. Design: multicentre randomised controlled trial. Setting: eight general practices and three day hospitals based in the East Midlands, UK. Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at ...

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.

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

Science.gov (United States)

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

2016-06-02

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

Objective Assessment of the Severity of Patients Suffering from Fall from Height with Combined Injuries of the Abdominal Parenchymal Organs

Directory of Open Access Journals (Sweden)

Abdukhakim Khadjibaev

2015-06-01

Full Text Available In recent years, fall from a height (FFH has been a relatively frequent cause of injury and death in the urban environment. The purpose of this study was to optimize the risk stratification of FFH victims with combined injuries of the abdominal organs by using Injury Severity Score (ISS scale. The study included 111 patients (aged between 15 and 80 years injured by FFH. All the falls were accidental and occurred mainly among males (82%. The height of the fall ranged from 2 to 5 meters. Combined injuries were found in 98 patients and isolated injuries in 13 patients. The combination of the 6 injured body regions was identified in 5 patients, 5 regions in 17, 4 in 35, 3 in 23, and 2 in 18. The abdomen trauma was most commonly associated with the following injured body regions: head and neck-chest-extremities and pelvis (13.3%, head and neck-chest-extremities (12.2%, and head and neck-chest-pelvis (9.2%. Among the combined injuries of the abdomen, ruptures of parenchymal organs (liver, spleen and kidneys were predominant. To assess the severity of the injury, the ISS scale was applied. The injuries of abdominal parenchymal organs were evaluated according to the AAST (American Association for the Surgery of Trauma classification. Comparative analysis of the assessment of the severity of a patient's condition according to the traditional scale and the ISS scale showed that the ISS scale promotes the active and timely detection of the extremely severe and terminal condition in patients with injuries due to FFH with combined trauma of the abdominal organs. Objective assessment of the severity of trauma and the dominant injury region allows determining the optimal treatment algorithm and predicting the outcome of the injury.

Incidence of falls and preventive actions in a University Hospital.

Science.gov (United States)

Luzia, Melissa de Freitas; Cassola, Talita Portela; Suzuki, Lyliam Midori; Dias, Vera Lucia Mendes; Pinho, Leandro Barbosa de; Lucena, Amália de Fátima

2018-01-01

Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

Mitigating fall risk: A community fall reduction program.

Science.gov (United States)

Reinoso, Humberto; McCaffrey, Ruth G; Taylor, David W M

One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Verghese, Joe

2016-12-01

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

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

Science.gov (United States)

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

2016-12-01

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

Improving Vector Evaluated Particle Swarm Optimisation by incorporating nondominated solutions.

Science.gov (United States)

Lim, Kian Sheng; Ibrahim, Zuwairie; Buyamin, Salinda; Ahmad, Anita; Naim, Faradila; Ghazali, Kamarul Hawari; Mokhtar, Norrima

2013-01-01

The Vector Evaluated Particle Swarm Optimisation algorithm is widely used to solve multiobjective optimisation problems. This algorithm optimises one objective using a swarm of particles where their movements are guided by the best solution found by another swarm. However, the best solution of a swarm is only updated when a newly generated solution has better fitness than the best solution at the objective function optimised by that swarm, yielding poor solutions for the multiobjective optimisation problems. Thus, an improved Vector Evaluated Particle Swarm Optimisation algorithm is introduced by incorporating the nondominated solutions as the guidance for a swarm rather than using the best solution from another swarm. In this paper, the performance of improved Vector Evaluated Particle Swarm Optimisation algorithm is investigated using performance measures such as the number of nondominated solutions found, the generational distance, the spread, and the hypervolume. The results suggest that the improved Vector Evaluated Particle Swarm Optimisation algorithm has impressive performance compared with the conventional Vector Evaluated Particle Swarm Optimisation algorithm.

Slip and fall risk on ice and snow:identification, evaluation and prevention

OpenAIRE

Gao, Chuansi

2004-01-01

Slip and fall accidents and associated injuries on ice and snow are prevalent among outdoor workers and the general public in winter in many regions of the world. To understand and tackle this multi-factorial problem, a multidisciplinary approach was used to identify and evaluate slip and fall risks, and to propose recommendations for prevention of slips and falls on icy and snowy surfaces. Objectives were to present a systems perspective of slip and fall accidents and related risk factors; t...

Synthetic Aperture Vector Flow Imaging

DEFF Research Database (Denmark)

Villagómez Hoyos, Carlos Armando

The main objective of this project was to continue the development of a synthetic aperture vector flow estimator. This type of estimator is capable of overcoming two of the major limitations in conventional ultrasound systems: 1) the inability to scan large region of interest with high temporal......, this thesis showed that novel information can be obtained with vector velocity methods providing quantitative estimates of blood flow and insight into the complexity of the hemodynamics dynamics. This could give the clinician a new tool in assessment and treatment of a broad range of diseases....

Quantitative falls risk estimation through multi-sensor assessment of standing balance

International Nuclear Information System (INIS)

Greene, Barry R; McGrath, Denise; Walsh, Lorcan; Doheny, Emer P; McKeown, David; Garattini, Chiara; Cunningham, Clodagh; Crosby, Lisa; Caulfield, Brian; Kenny, Rose A

2012-01-01

Falls are the most common cause of injury and hospitalization and one of the principal causes of death and disability in older adults worldwide. Measures of postural stability have been associated with the incidence of falls in older adults. The aim of this study was to develop a model that accurately classifies fallers and non-fallers using novel multi-sensor quantitative balance metrics that can be easily deployed into a home or clinic setting. We compared the classification accuracy of our model with an established method for falls risk assessment, the Berg balance scale. Data were acquired using two sensor modalities—a pressure sensitive platform sensor and a body-worn inertial sensor, mounted on the lower back—from 120 community dwelling older adults (65 with a history of falls, 55 without, mean age 73.7 ± 5.8 years, 63 female) while performing a number of standing balance tasks in a geriatric research clinic. Results obtained using a support vector machine yielded a mean classification accuracy of 71.52% (95% CI: 68.82–74.28) in classifying falls history, obtained using one model classifying all data points. Considering male and female participant data separately yielded classification accuracies of 72.80% (95% CI: 68.85–77.17) and 73.33% (95% CI: 69.88–76.81) respectively, leading to a mean classification accuracy of 73.07% in identifying participants with a history of falls. Results compare favourably to those obtained using the Berg balance scale (mean classification accuracy: 59.42% (95% CI: 56.96–61.88)). Results from the present study could lead to a robust method for assessing falls risk in both supervised and unsupervised environments. (paper)

Correlates of falling during 24 h among elderly Danish community residents

DEFF Research Database (Denmark)

Larsen, Erik Roj; Mosekilde, Leif; Foldspang, Anders

2004-01-01

Objectives. To identify dietary, medical, and environmental correlates of falling during the last 24 h among elderly community residents. The limited accuracy of recall of falls in the elderly in previous studies was the reason for a 24-h time frame. Methods. The study composes 4281 community res...

Stealth configurations in vector-tensor theories of gravity

Science.gov (United States)

Chagoya, Javier; Tasinato, Gianmassimo

2018-01-01

Studying the physics of compact objects in modified theories of gravity is important for understanding how future observations can test alternatives to General Relativity. We consider a subset of vector-tensor Galileon theories of gravity characterized by new symmetries, which can prevent the propagation of the vector longitudinal polarization, even in absence of Abelian gauge invariance. We investigate new spherically symmetric and slowly rotating solutions for these systems, including an arbitrary matter Lagrangian. We show that, under certain conditions, there always exist stealth configurations whose geometry coincides with solutions of Einstein gravity coupled with the additional matter. Such solutions have a non-trivial profile for the vector field, characterized by independent integration constants, which extends to asymptotic infinity. We interpret our findings in terms of the symmetries and features of the original vector-tensor action, and on the number of degrees of freedom that it propagates. These results are important to eventually describe gravitationally bound configurations in modified theories of gravity, such as black holes and neutron stars, including realistic matter fields forming or surrounding the object.

Characterization of malaria vectors in Huye District, Southern Rwanda

African Journals Online (AJOL)

Background: Effective control of malaria requires knowledge of vector species, their feeding and resting behaviour as well as breeding habitats. The objective of this study was to determine malaria vector species abundance and identify their larval habitats in Huye district, southern Rwanda. Methods: Adult mosquitoes were ...

Human-Structure Dynamic Interaction during Short-Distance Free Falls

Directory of Open Access Journals (Sweden)

E. Shahabpoor

2016-01-01

Full Text Available The dynamic interactions of falling human bodies with civil structures, regardless of their potentially critical effects, have sparsely been researched in contact biomechanics. The physical contact models suggested in the existing literature, particularly for short-distant falls in home settings, assume the human body falls on a “rigid” (not vibrating ground. A similar assumption is usually made during laboratory-based fall tests, including force platforms. Based on observations from a set of pediatric head-first free fall tests, the present paper shows that the dynamics of the grounded force plate are not always negligible when doing fall test in a laboratory setting. By using a similar analogy for lightweight floor structures, it is shown that ignoring the dynamics of floors in the contact model can result in an up to 35% overestimation of the peak force experienced by a falling human. A nonlinear contact model is suggested, featuring an agent-based modelling approach, where the dynamics of the falling human and the impact object (force plate or a floor structure here are each modelled using a single-degree-of-freedom model to simulate their dynamic interactions. The findings of this research can have wide applications in areas such as impact biomechanics and sports science.

CERN vector boson hunt successful

International Nuclear Information System (INIS)

Robinson, A.L.

1983-01-01

UA-1 and UA-2 are code names for two groups of physicists at the European Laboratory for Particle Physics (CERN), together comprising almost 200 researchers. From data collected in two 3-month-long runs last fall and spring, the groups have collected 100 intermediate vector bosons (90 W's and 10 Z 0 's) whose properties so far fit the predictions of the unified quantum field theory of the electromagnetic and weak forces. Although the number of events is short of staggering, the discovery is immensely important. Physicists have been looking for the W for about 50 years. The Z 0 is crucial to the success of the method by which the two forces were melded into one - the electro-weak force

A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults.

Science.gov (United States)

Rice, Laura A; Ousley, Cherita; Sosnoff, Jacob J

2015-01-01

To systematically review peer-reviewed literature pertaining to risk factors, outcome measures and interventions managing fall risk in non-ambulatory adults. Twenty-one papers were selected for inclusion from databases including PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Consumer Health Complete and Web of Science. Selected studies involved a description of fall related risk factors, outcomes to assess fall risk and intervention studies describing protocols to manage fall risk in non-ambulatory adults. Studies were selected by two reviewers and consultation provided by a third reviewer. The most frequently cited risk factors/characteristics associated with falls included: wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. The majority of the outcomes were found to evaluate seated postural control. One intervention study was identified describing a protocol targeting specific problems of individual participants. A global fall prevention program was not identified. Several risk factors associated with falls were identified and must be understood by clinicians to better serve their clients. To improve objective assessment, a comprehensive outcome assessment specific to non-ambulatory adults is needed. Finally, additional research is needed to examine the impact of structured protocols to manage fall risk in non-ambulatory adults. Falls are a common health concern for non-ambulatory adults. Risk factors commonly associated with falls include wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. Limited outcome measures are available to assess fall risk in non-ambulatory adults. Clinicians must be aware of the known risk factors and provide comprehensive education to their clients on the potential for falls. Additional research is needed to develop and evaluate protocols to clinically manage fall

The falls and the fear of falling among elderly institutionalized

Directory of Open Access Journals (Sweden)

Patrícia Almeida

2013-06-01

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

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

Science.gov (United States)

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

2017-12-21

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

Elderly individuals with increased risk of falls show postural balance impairment

OpenAIRE

Oliveira, Márcio Rogério de; Inokuti, Thiago Tadashi; Bispo, Nuno Noronha da Costa; Oliveira, Deise Aparecida de Almeida Pires; Oliveira, Rodrigo Franco de; Silva Jr., Rubens Alexandre da

2015-01-01

Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platf...

The variability of meteoroid falling

Science.gov (United States)

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

2016-10-01

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

Improving Vector Evaluated Particle Swarm Optimisation by Incorporating Nondominated Solutions

Directory of Open Access Journals (Sweden)

Kian Sheng Lim

2013-01-01

Full Text Available The Vector Evaluated Particle Swarm Optimisation algorithm is widely used to solve multiobjective optimisation problems. This algorithm optimises one objective using a swarm of particles where their movements are guided by the best solution found by another swarm. However, the best solution of a swarm is only updated when a newly generated solution has better fitness than the best solution at the objective function optimised by that swarm, yielding poor solutions for the multiobjective optimisation problems. Thus, an improved Vector Evaluated Particle Swarm Optimisation algorithm is introduced by incorporating the nondominated solutions as the guidance for a swarm rather than using the best solution from another swarm. In this paper, the performance of improved Vector Evaluated Particle Swarm Optimisation algorithm is investigated using performance measures such as the number of nondominated solutions found, the generational distance, the spread, and the hypervolume. The results suggest that the improved Vector Evaluated Particle Swarm Optimisation algorithm has impressive performance compared with the conventional Vector Evaluated Particle Swarm Optimisation algorithm.

Older Adults' Perceptions of Clinical Fall Prevention Programs: A Qualitative Study

Directory of Open Access Journals (Sweden)

Rebecca Calhoun

2011-01-01

Full Text Available Objective. To investigate motivational factors and barriers to participating in fall risk assessment and management programs among diverse, low-income, community-dwelling older adults who had experienced a fall. Methods. Face-to-face interviews with 20 elderly who had accepted and 19 who had not accepted an invitation to an assessment by one of two fall prevention programs. Interviews covered healthy aging, core values, attributions/consequences of the fall, and barriers/benefits of fall prevention strategies and programs. Results. Joiners and nonjoiners of fall prevention programs were similar in their experience of loss associated with aging, core values they expressed, and emotional response to falling. One difference was that those who participated endorsed that they “needed” the program, while those who did not participate expressed a lack of need. Conclusions. Interventions targeted at a high-risk group need to address individual beliefs as well as structural and social factors (transportation issues, social networks to enhance participation.

Symptoms of Knee Instability are Risk Factors for Recurrent Falls

Science.gov (United States)

Nevitt, Michael C; Tolstykh, Irina; Shakoor, Najia; Nguyen, Uyen-Sa D.T.; Segal, Neil A; Lewis, Cora; Felson, David T

2016-01-01

Objectives Whether knee instability contributes to the increased risk of falls and fractures observed in persons with knee osteoarthritis (OA) has not been studied. We examined the association of knee buckling with the risk of falling and fall-related consequences in older adults with, or at high risk for, knee OA. Methods At the 60 month visit of the Multicenter Osteoarthritis Study, men and women ages 55 to 84 were asked about knee buckling in the past 3 months and whether they fell when a knee buckled. Falls and fall-related injuries in the past 12 months and balance confidence were assessed at 60 and 84 months. Multivariate logistic regression was used to assess the association of knee buckling with falls and their consequences. Results 1,842 subjects (59% women, mean [SD] age= 66.9 [7.8] and BMI= 30.3 [5.7]) were included. At 60 months 16.8% reported buckling and at 84 months 14.1% had recurrent (≥2) falls. Bucklers at 60 months had a 1.6 to 2.5-fold greater odds of recurrent falls, fear of falling and poor balance confidence at 84 months. Those who fell when a knee buckled at baseline had a 4.5-fold, 2-fold and 3-fold increased odds two years later of recurrent falls, significant fall injuries and fall injuries that limited activity, respectively, and were 4 times more likely to have poor balance confidence. Conclusion Interventions that reduce knee buckling may help prevent falls, fall-related injuries and adverse psychological consequences of falls in persons with knee OA. PMID:26853236

Fear of falling and associated factors in community elderly with cataracts

Directory of Open Access Journals (Sweden)

Lorena de Andrade Cascalho

Full Text Available ABSTRACT Objective: To investigate prevalence of the fear of falling of elderly with cataracts living in the community and the associated factors with high concern with falling occurrences. Methods: A cross-sectional, analytical and observational study. It was composed by 86 elderly diagnosed with bilateral cataracts. To quantify the fear of falling among elderly, the scale Falls Efficacy Scale-International-Brasil (FES-I-BRASIL was used. Other variables were obtained through application of a structured questionnaire. Results: Between participants, 41.9% reported low concern of falling, while 58.1% reported high concern. From those last ones, 52% fell at least once on the past 12 months and, 30% of them are recurrent fallers. The activities "to walk in slippery surfaces", "to walk in irregular surfaces" and, "to walk up and down the stairs" represented higher concern for elderly. Conclusion: Cataracts or any other visual issue predispose falls due to difficulty in overcoming obstacles present in the environment. Fear of falling is especially associated with factors acquired after the first fall episode.

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.

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

Polarized object detection in crabs: a two-channel system.

Science.gov (United States)

Basnak, Melanie Ailín; Pérez-Schuster, Verónica; Hermitte, Gabriela; Berón de Astrada, Martín

2018-05-25

Many animal species take advantage of polarization vision for vital tasks such as orientation, communication and contrast enhancement. Previous studies have suggested that decapod crustaceans use a two-channel polarization system for contrast enhancement. Here, we characterize the polarization contrast sensitivity in a grapsid crab . We estimated the polarization contrast sensitivity of the animals by quantifying both their escape response and changes in heart rate when presented with polarized motion stimuli. The motion stimulus consisted of an expanding disk with an 82 deg polarization difference between the object and the background. More than 90% of animals responded by freezing or trying to avoid the polarized stimulus. In addition, we co-rotated the electric vector (e-vector) orientation of the light from the object and background by increments of 30 deg and found that the animals' escape response varied periodically with a 90 deg period. Maximum escape responses were obtained for object and background e-vectors near the vertical and horizontal orientations. Changes in cardiac response showed parallel results but also a minimum response when e-vectors of object and background were shifted by 45 deg with respect to the maxima. These results are consistent with an orthogonal receptor arrangement for the detection of polarized light, in which two channels are aligned with the vertical and horizontal orientations. It has been hypothesized that animals with object-based polarization vision rely on a two-channel detection system analogous to that of color processing in dichromats. Our results, obtained by systematically varying the e-vectors of object and background, provide strong empirical support for this theoretical model of polarized object detection. © 2018. Published by The Company of Biologists Ltd.

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

Science.gov (United States)

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

2016-08-01

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

Falling chains

OpenAIRE

Wong, Chun Wa; Yasui, Kosuke

2005-01-01

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

Falls in institutionalized older adults: risks, consequences and antecedents

Directory of Open Access Journals (Sweden)

Antonio Herculano de Araújo Neto

Full Text Available ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey, Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0. Results: A total of 66.7% (30 falls occurred, 20% (9 of them in the external area, with 66.7% (30 of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5. The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05. Conclusion: It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls.

Falls in institutionalized older adults: risks, consequences and antecedents

OpenAIRE

Araújo Neto, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

2017-01-01

ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova ...

Risk factors associated with visiting or not visiting the accident & emergency department after a fall

NARCIS (Netherlands)

Scheffer, Alice C.; van Hensbroek, Pieter Boele; van Dijk, Nynke; Luitse, Jan S. K.; Goslings, Johannes C.; Luigies, René H.; de Rooij, Sophia E.

2013-01-01

Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a

Balance Training Reduces Falls Risk in Older Individuals With Type 2 Diabetes

OpenAIRE

Morrison, Steven; Colberg, Sheri R.; Mariano, Mira; Parson, Henri K.; Vinik, Arthur I.

2010-01-01

OBJECTIVE This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50–75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. RESULTS Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also e...

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

Science.gov (United States)

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

2016-10-01

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

Assessment of risk for falls in elderly

Directory of Open Access Journals (Sweden)

Stanetić Kosana

2014-01-01

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

Ferromagnetic Objects Magnetovision Detection System.

Science.gov (United States)

Nowicki, Michał; Szewczyk, Roman

2013-12-02

This paper presents the application of a weak magnetic fields magnetovision scanning system for detection of dangerous ferromagnetic objects. A measurement system was developed and built to study the magnetic field vector distributions. The measurements of the Earth's field distortions caused by various ferromagnetic objects were carried out. The ability for passive detection of hidden or buried dangerous objects and the determination of their location was demonstrated.

The clinical practice guideline for falls and fall risk

OpenAIRE

Vance, Jacqueline

2011-01-01

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

The development of a fear of falling interdisciplinary intervention program

Directory of Open Access Journals (Sweden)

Fernando Gomez

2008-01-01

Full Text Available Fernando Gomez, Carmen-Lucia CurcioResearch Group on Gerontology and Geriatrics, Health Sciences Faculty, University of Caldas, Manizales, ColombiaObjective: To describe the development process of a protocol for a fear of falling interdisciplinary intervention program based on the main factors associated with fear of falling.Design/methods: The process of developing a protocol consisted of defining the target population, selecting the initial assessment components, adapting the intervention program based on findings about fear of falling and restriction of activities in this population.Settings: University-affiliated outpatient vertigo, dizziness and falls clinic in coffee-growers zone of Colombian Andes Mountains.Results: An intervention program was developed based on three main falling conceptual models. A medical intervention, based on a biomedical and pathophysiological model, a physiotherapeutic intervention based on a postural control model and a psychological intervention based on a biological-behavioral model.Conclusion: This interdisciplinary fear of falling intervention program developed is based on particular characteristics of target population, with differences in the inclusion criteria and the program intervention components; with emphasis on medical (recurrent falls and dizziness evaluation and management, psychological (cognitive-behavioral therapy and physiotherapeutic (balance and transfers training components.Keywords: fear of falling, elderly programs, Colombian, intervention

Comparison of different strategies of referral to a fall clinic: how to achieve an optimal casemix?

NARCIS (Netherlands)

Schoon, Y.; Hoogsteen-Ossewaarde, M.E.; Scheffer, A.C.; Rooij, F.J.M. van; Olde Rikkert, M.G.M.; Rooij, S.E. De

2011-01-01

OBJECTIVE To study the potential differences in patient characteristics between two referral methods to a fall clinic, specifically: case-finding of patients admitted to an emergency department because of a fall, compared to direct referral to the fall clinic via the general practitioner. DESIGN:

Vitamin D status in relation to one-year risk of recurrent falling in older men and women

NARCIS (Netherlands)

M.B. Snijder (Marieke); N.M. van Schoor (Natasja); S. Pluijm (Saskia); R.M. van Dam (Rob); M. Visser (Marjolein); P. Lips (Paul)

2006-01-01

textabstractBackground: Falls frequently occur in the elderly and are a major cause of morbidity and mortality. Objective: The objective of the study was to prospectively investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and risk of recurrent falling in older men and

Edge smoothing for real-time simulation of a polygon face object system as viewed by a moving observer

Science.gov (United States)

Lotz, Robert W. (Inventor); Westerman, David J. (Inventor)

1980-01-01

The visual system within an aircraft flight simulation system receives flight data and terrain data which is formated into a buffer memory. The image data is forwarded to an image processor which translates the image data into face vertex vectors Vf, defining the position relationship between the vertices of each terrain object and the aircraft. The image processor then rotates, clips, and projects the image data into two-dimensional display vectors (Vd). A display generator receives the Vd faces, and other image data to provide analog inputs to CRT devices which provide the window displays for the simulated aircraft. The video signal to the CRT devices passes through an edge smoothing device which prolongs the rise time (and fall time) of the video data inversely as the slope of the edge being smoothed. An operational amplifier within the edge smoothing device has a plurality of independently selectable feedback capacitors each having a different value. The values of the capacitors form a series which doubles as a power of two. Each feedback capacitor has a fast switch responsive to the corresponding bit of a digital binary control word for selecting (1) or not selecting (0) that capacitor. The control word is determined by the slope of each edge. The resulting actual feedback capacitance for each edge is the sum of all the selected capacitors and is directly proportional to the value of the binary control word. The output rise time (or fall time) is a function of the feedback capacitance, and is controlled by the slope through the binary control word.

Predictors of the risk of falls among elderly with chronic atrial fibrillation

Directory of Open Access Journals (Sweden)

Angela Cristina Silva dos Santos

2012-01-01

Full Text Available OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 107 took part in this study. Their age was 77.9±6.4 years, and 62 were female. They were divided into two groups: a no history of falls in the previous year and b a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%. Among them, 27 (49.1% presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that selfreported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

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

Directory of Open Access Journals (Sweden)

Beata Lindholm

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

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

Science.gov (United States)

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

2013-01-01

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

Factors associated with the risk of falls in hospitalized adult patients

Directory of Open Access Journals (Sweden)

Vivian Lemes Lobo Bittencourt

Full Text Available Abstract OBJECTIVE Analyzing factors related to the risk of falls in hospitalized adult patients. METHOD A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis. RESULTS 612 patients participated in the study. An association (p<0.001 was found between the high risk of falls and clinical neurological hospitalization, surgical trauma (hospitalization and comorbidities such as diabetes mellitus, systemic arterial hypertension, visual impairment, vertigo and fear of falling. CONCLUSION An association between the risk of falls was found due to hospitalization, comorbidities and intrinsic factors. Regarding extrinsic factors, an association between mats/carpets and risk of falls was found. No association between the risk of falls with other extrinsic factors was found.

Perceived object stability depends on multisensory estimates of gravity.

Science.gov (United States)

Barnett-Cowan, Michael; Fleming, Roland W; Singh, Manish; Bülthoff, Heinrich H

2011-04-27

How does the brain estimate object stability? Objects fall over when the gravity-projected centre-of-mass lies outside the point or area of support. To estimate an object's stability visually, the brain must integrate information across the shape and compare its orientation to gravity. When observers lie on their sides, gravity is perceived as tilted toward body orientation, consistent with a representation of gravity derived from multisensory information. We exploited this to test whether vestibular and kinesthetic information affect this visual task or whether the brain estimates object stability solely from visual information. In three body orientations, participants viewed images of objects close to a table edge. We measured the critical angle at which each object appeared equally likely to fall over or right itself. Perceived gravity was measured using the subjective visual vertical. The results show that the perceived critical angle was significantly biased in the same direction as the subjective visual vertical (i.e., towards the multisensory estimate of gravity). Our results rule out a general explanation that the brain depends solely on visual heuristics and assumptions about object stability. Instead, they suggest that multisensory estimates of gravity govern the perceived stability of objects, resulting in objects appearing more stable than they are when the head is tilted in the same direction in which they fall.

Perceived object stability depends on multisensory estimates of gravity.

Directory of Open Access Journals (Sweden)

Michael Barnett-Cowan

Full Text Available BACKGROUND: How does the brain estimate object stability? Objects fall over when the gravity-projected centre-of-mass lies outside the point or area of support. To estimate an object's stability visually, the brain must integrate information across the shape and compare its orientation to gravity. When observers lie on their sides, gravity is perceived as tilted toward body orientation, consistent with a representation of gravity derived from multisensory information. We exploited this to test whether vestibular and kinesthetic information affect this visual task or whether the brain estimates object stability solely from visual information. METHODOLOGY/PRINCIPAL FINDINGS: In three body orientations, participants viewed images of objects close to a table edge. We measured the critical angle at which each object appeared equally likely to fall over or right itself. Perceived gravity was measured using the subjective visual vertical. The results show that the perceived critical angle was significantly biased in the same direction as the subjective visual vertical (i.e., towards the multisensory estimate of gravity. CONCLUSIONS/SIGNIFICANCE: Our results rule out a general explanation that the brain depends solely on visual heuristics and assumptions about object stability. Instead, they suggest that multisensory estimates of gravity govern the perceived stability of objects, resulting in objects appearing more stable than they are when the head is tilted in the same direction in which they fall.

Mobility, balance and falls in persons with multiple sclerosis.

Directory of Open Access Journals (Sweden)

Jacob J Sosnoff

Full Text Available BACKGROUND: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS. This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS. METHODS: 52 ambulatory persons with MS (PwMS participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS. Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. RESULTS: Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. CONCLUSIONS: The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established.

Mobility, Balance and Falls in Persons with Multiple Sclerosis

Science.gov (United States)

Sosnoff, Jacob J.; Socie, Michael J.; Boes, Morgan K.; Sandroff, Brian M.; Pula, John H.; Suh, Yoojin; Weikert, Madeline; Balantrapu, Swathi; Morrison, Steven; Motl, Robert W.

2011-01-01

Background There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). Methods 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. Results Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. Conclusions The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established. PMID:22132196

Vitamin D status in relation to one-year risk of recurrent falling in older men and woman

NARCIS (Netherlands)

Snijder, M.B.; van Schoor, N.M.; Pluijm, S.M.F.; van Dam, R.M.; Visser, M.; Lips, P.T.A.M.

2006-01-01

Background: Falls frequently occur in the elderly and are a major cause of morbidity and mortality. Objective: The objective of the study was to prospectively investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and risk of recurrent falling in older men and women. Design:

Elderly outpatient profile and predictors of falls.

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

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

2014-12-15

In the older population falls are a common problem and a major cause of morbidity, mortality and functional decline. The etiology is often multifactorial making the identification of fall predictors essential for preventive measures. Despite this knowledge, data on falls within the older cancer population are limited. The objective of this study was to evaluate the occurrence of falls within 2 to 3 months after cancer treatment decision and to identify predictors of falls (≥1 fall) during follow-up. Older patients (70 years or more) with a cancer treatment decision were included. At baseline, all patients underwent geriatric screening (G8 and Flemish Triage Risk Screening Tool), followed by a geriatric assessment including living situation, activities of daily living (ADL), instrumental activities of daily living (IADL), fall history in the past 12 months, fatigue, cognition, depression, nutrition, comorbidities and polypharmacy. Questionnaires were used to collect follow-up (2-3 months) data. Univariate and multivariate analyses were performed to identify predictors for falls (≥1 fall) during follow-up. At baseline, 295 (31.5%) of 937 included patients reported at least one fall in the past 12 months with 88 patients (29.5%) sustaining a major injury. During follow-up (2-3 months), 142 (17.6%) patients fell, of whom 51.4% fell recurrently and 17.6% reported a major injury. Baseline fall history in the past 12 months (OR = 3.926), fatigue (OR = 0.380), ADL dependency (OR = 0.492), geriatric risk profile by G8 (OR = 0.471) and living alone (OR = 1.631) were independent predictors of falls (≥1 fall) within 2-3 months after cancer treatment decision. Falls are a serious problem among older cancer patients. Geriatric screening and assessment data can identify patients at risk for a fall. A patient with risk factors associated with falls should undergo further evaluation and intervention to prevent potentially injurious fall incidents.

Garment-based detection of falls and activities of daily living using 3-axis MEMS accelerometer

International Nuclear Information System (INIS)

Nyan, M N; Tay, Francis E H; Manimaran, M; Seah, K H W

2006-01-01

This paper studied the detection of falls and activities of daily living (ADL) with two objectives: (1) minimum number of sensors for a broad range of activities and (2) maximize the comfort of the wearer for long term use. We used a garment to provide long term comfort for the wearer, with a 3-axis MEMS accelerometer on the shoulder position, as a wearable platform. ADL were detected in time-frequency domain and summation of absolute peak values of 3-D acceleration signals was used as feature in fall detection. 6 male and female subjects performed approximately five-hour long experiment. Sensitivity of 94.98% and specificity of 98.83% for altogether 1495 activities were achieved. Our garment-based detection system fulfilled the objective of providing the comfort of the wearer in long term monitoring of falls and ADL with high sensitivity. In fall detection, our device can summon medical assistances via SMS (Short Message Service). This detection system can raise fall alarm (fall SMS) automatically to individuals to get a shortened interval of the arrival of assistance

Correlation Between Pain, Fear of Falling and Disability in Low Back Pain

Science.gov (United States)

Pal, Bharat Prakash

2015-01-01

Objective To ascertain if there is a correlation between low back pain (LBP), fear of falling, and disability so that the patients with LBP are aware of the fact that other problems may occur with LBP. Hence, steps can be taken for decreasing the fear of falling and disability in order to improve the condition of patients. Methods A sample size of 100 patients with low back pain, with a range of ages from 40 to 73 years, participated in the study. The Falls Efficacy Scale was used to assess the fear of falling and the Oswestry Disability Index was used to assess the disability and pain in LBP individuals. Results The Pearson correlation analysis signifies the relationship between pain, fear of falling, and disability in LBP. Conclusion First, LBP increases the fear of falling. Second, LBP can result in a person becoming disabled. Third, the fear of falling and disability are correlated with each other. PMID:26605180

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

Science.gov (United States)

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

2017-04-01

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

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

Directory of Open Access Journals (Sweden)

Mussi Chiara

2013-01-01

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

Ferromagnetic Objects Magnetovision Detection System

Directory of Open Access Journals (Sweden)

Michał Nowicki

2013-12-01

Full Text Available This paper presents the application of a weak magnetic fields magnetovision scanning system for detection of dangerous ferromagnetic objects. A measurement system was developed and built to study the magnetic field vector distributions. The measurements of the Earth’s field distortions caused by various ferromagnetic objects were carried out. The ability for passive detection of hidden or buried dangerous objects and the determination of their location was demonstrated.

High fall incidence and fracture rate in elderly dialysis patients.

Science.gov (United States)

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

2014-12-01

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

Risk assessment of fall-related occupational accidents in the workplace

Science.gov (United States)

Tsukada, Tsukimi; Sakakibara, Hisataka

2016-01-01

Objectives: This study aimed to examine effective assessment methods of falls in the workplace. Methods: There were 436 employees (305 males and 131 females) of electrical appliance manufacturers included in this study. In 2014, a baseline survey was conducted using the fall scores questionnaire and the self-check risk assessment of falls and other accidents in the workplace (physical function measurement and questionnaire). In 2015, the occurrence of falls in the past year was investigated. Multivariate logistic regression analyses were performed to examine factors relevant to falls. Results: In total, 62 subjects (14.2%) fell during the year, including those who fell during off-hours. The occurrence of falls during that one year was only associated with having experienced falls during the past year in the baseline survey (odds ratio [OR] 5.0; 95% confidence interval [CI] 2.5-9.7). Falls during that year were also related to the inability to walk 1 km continuously (OR 0.1; 95% CI 0.1-0.6), tripping sometimes (OR 4.0; 95% CI 1.6-9.9), step height differences at home (OR 3.0; 95% CI 1.3-6.8), and working in the production section (OR 0.2; 95% CI 0.1-0.5). Measurements of physical functions, such as muscle strength, balance, and agility, were not different between subjects who fell and those who did not. Conclusions: Our results showed that the questionnaire assessing falls during the past year could be useful to assess the risk of falls in the workplace. Annual checks for falls may contribute to fall prevention programs in the workplace. PMID:27725487

Classification of subsurface objects using singular values derived from signal frames

Science.gov (United States)

Chambers, David H; Paglieroni, David W

2014-05-06

The classification system represents a detected object with a feature vector derived from the return signals acquired by an array of N transceivers operating in multistatic mode. The classification system generates the feature vector by transforming the real-valued return signals into complex-valued spectra, using, for example, a Fast Fourier Transform. The classification system then generates a feature vector of singular values for each user-designated spectral sub-band by applying a singular value decomposition (SVD) to the N.times.N square complex-valued matrix formed from sub-band samples associated with all possible transmitter-receiver pairs. The resulting feature vector of singular values may be transformed into a feature vector of singular value likelihoods and then subjected to a multi-category linear or neural network classifier for object classification.

The rise and fall of V4334 Sagittarii (Sakurai's object)

NARCIS (Netherlands)

Duerbeck, HW; Liller, W; Sterken, C; Benetti, S; van Genderen, AM; Arts, J; Kurk, JD; Janson, M; Voskes, T; Brogt, E; Arentoft, T; Dijkstra, R

CCD UBVRi photometry of the final helium flash object V4334 Sgr (Sakurai's object) carried out during 1997-1999 is presented, and the light curve from its prediscovery rise to the dust obscuration phase is constructed. The optical light curve can be divided into four sections, the rise to maximum,

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.

[Evaluation of a simple screening tool for ambulant fall prevention].

Science.gov (United States)

Knobe, M; Rasche, P; Rentemeister, L; Bliemel, C; Bücking, B; Bollheimer, L C; Pape, H-C

2018-02-02

An individual's risk of falling is generally difficult to detect and it is likely to be underestimated. Thus, preventive measures are challenging and they demand sufficient integration and implementation into aftercare and outpatient management. The Aachen Falls Prevention Scale (AFPS) is a quick and easy tool for patient-driven fall risk assessment. Older adults' risk of falling is identified in a suitable manner and they then have the opportunity to independently assess and monitor their risk of falling. The aim of the current study was to evaluate the AFPS as a simple screening tool in geriatric trauma patients via the identification of influencing factors, e.g. objective or subjective fall risk, fear of falling (FOF) and demographic data. In this context, we investigated older adults' willingness to take part in special activities concerning fall prevention. Retrospectively, all patients over 70 years of age who received in-hospital fracture treatment between July 2014 and April 2016 were analyzed at a level I trauma center. After identification of 884 patients, participants completed a short questionnaire (47 questions, yes/no, Likert scale) comprising the AFPS. A history of falls in the past year was considered an indicator of a balance disorder. In addition, ambulant patients were invited to participate between July and August 2016. In total, 201 patients (mean 80.4 years, range 63-97 years) performed a self-assessment based on the AFPS. After steps 1 and 2 of the AFPS had been completed, 95 (47%) participants rated their subjective risk of falling as high (more than 5 points). Of the participants 84 (42%) were objectively classified as "fallers" with significant effects on their AFPS evaluation and rating of their subjective risk of falling. Furthermore, 67% of the participants identified a general practitioner as their main contact person, and 43% of the respondents viewed the AFPS as a beneficial screening tool in fall risk evaluation (8

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

Directory of Open Access Journals (Sweden)

Vivien Jørgensen

2017-04-01

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

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

Science.gov (United States)

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

2018-03-19

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

2D vector-cyclic deformable templates

DEFF Research Database (Denmark)

Schultz, Nette; Conradsen, Knut

1998-01-01

In this paper the theory of deformable templates is a vector cycle in 2D is described. The deformable template model originated in (Grenander, 1983) and was further investigated in (Grenander et al., 1991). A template vector distribution is induced by parameter distribution from transformation...... matrices applied to the vector cycle. An approximation in the parameter distribution is introduced. The main advantage by using the deformable template model is the ability to simulate a wide range of objects trained by e.g. their biological variations, and thereby improve restoration, segmentation...... and probabillity measurement. The case study concerns estimation of meat percent in pork carcasses. Given two cross-sectional images - one at the front and one near the ham of the carcass - the areas of lean and fat and a muscle in the lean area are measured automatically by the deformable templates....

Local dynamic stability and variability of gait are associated with fall history in elderly subjects

OpenAIRE

Toebes, M.J.P.; Hoozemans, M.J.M.; Furrer, R.; Dekker, J.; van Dieen, J.H.

2012-01-01

Gait parameters that can be measured with simple instrumentation may hold promise for identifying individuals at risk of falling. Increased variability of gait is associated with increased risk of falling, but research on additional parameters indicates that local dynamic stability (LDS) of gait may also be a predictor of fall risk. The objective of the present study was to assess the association between gait variability, LDS of gait and fall history in a large sample of elderly subjects.Subj...

Prevalence and correlates of participation in fall prevention exercise/physical activity by older adults

NARCIS (Netherlands)

Merom, D.; Pye, V.; Macniven, R.; van der Ploeg, H.; Milat, A.; Sherrington, C.; Lord, S.; Bauman, A.

2012-01-01

Objective: To examine older people's participation in fall prevention exercise/physical activities. Methods: Participants comprised 5,681 randomly selected older people (≥ 65. years) who took part in the 2009 New South Wales (Australia) Fall Prevention telephone survey (61% response-rate). The

Prediction of Risk of Falling Among Institutionalized Elderly People in Iran

Directory of Open Access Journals (Sweden)

Ahmad Ali Akbari-Kamrani

2003-07-01

Full Text Available Objective: Aging decline abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly people. Materials & Methods: Prospective non–interventional methodological discriminative–validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/ without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using / without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use / nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases independent variable was history of falling and dependent variables were the results of the two functional assessment methods. In order to accomplish the aim of study, two functional assessment methods, Berg scale and Tinetti scale, were used and the validity indices of these methods were calculated. Results: Independent t test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (p=0.00l and Tinetti Scale (p=0.00l. Conclusion: The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

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

Science.gov (United States)

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

2017-09-04

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

The Impact of a Training Intervention Program on Fall-related Psychological Factors Among Male Older Adults in Arak

OpenAIRE

Daryoush Khajavi; Ahmad Farokhi; Ali Akbar Jaberi Moghadam; Anooshirvan Kazemnejad

2014-01-01

Objectives: Falls and fall-related physiological and psychological events are major problems for elderly people. The objective of this research was to examine the effect of an interventional training program on fall-related psychological factors among the elderly men in Arak. Methods & Materials: In this quasi experiment research on male older adults in Arak, 27 participants randomly assigned to Control group (mean age=70.21±6.65) and Experimental group (mean age=66.07±4.38)...

Investigation into slipping and falling accidents and materials handling in the South African mining industry.

CSIR Research Space (South Africa)

Schutte, PC

2003-03-01

Full Text Available The objective of this study was to analyze information on slipping and falling accidents and materials handling activities in the South African mining industry. Accident data pertaining to slipping, falling and materials handling accidents...

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

Directory of Open Access Journals (Sweden)

Santosh K Verma

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

Role of environmental hazards in fall of community dwelling elderly

International Nuclear Information System (INIS)

Shabbir, M.; Shah, S.I.H.

2013-01-01

Evidence linking home hazards to falls has not been well established. Falls and fall injury are a major public health concern for the elderly. Fall of elderly is very much affected by environmental hazards. Falls are a major cause of morbidity and mortality in persons older than 60. There is a greater-than-linear increase in the rate of falls with environmental hazards. This cross section survey will not only lay the foundation for further study on this topic but also provide the basis for the development of preventive program of falls for the elders of Pakistan. Objective: To explore the role of environmental hazards of fall in the community dwelling elders is the area which is lacking in research. Methods: This cross sectional study was conducted from October to December 2010 in Lahore and its peripheries and also the patients in hospital settings come after fractures or fall injuries. The total number of people included was 100. Community dwelling Elders above 60 years having recent history of at least one fall were included regardless of gender. The data were entered and analyzed using SPSS 11.5. Results: There were 71 people out of 100 who fell inside the home, 10 fell outside the home and 18 were not applicable to this question. There were 19% people, who fell repeatedly at one place, 31 people replied about hazard environment where fallen that contribute to fall. According to 24 people they had Safety checks of their home yard and/ or neighborhood which will assist to avoid future fall. Conclusion: Most elderly persons live in a risky home setting. It is vital that environmental hazard be recognized and removed for wellbeing of elderly. (author)

Vector field statistical analysis of kinematic and force trajectories.

Science.gov (United States)

Pataky, Todd C; Robinson, Mark A; Vanrenterghem, Jos

2013-09-27

When investigating the dynamics of three-dimensional multi-body biomechanical systems it is often difficult to derive spatiotemporally directed predictions regarding experimentally induced effects. A paradigm of 'non-directed' hypothesis testing has emerged in the literature as a result. Non-directed analyses typically consist of ad hoc scalar extraction, an approach which substantially simplifies the original, highly multivariate datasets (many time points, many vector components). This paper describes a commensurately multivariate method as an alternative to scalar extraction. The method, called 'statistical parametric mapping' (SPM), uses random field theory to objectively identify field regions which co-vary significantly with the experimental design. We compared SPM to scalar extraction by re-analyzing three publicly available datasets: 3D knee kinematics, a ten-muscle force system, and 3D ground reaction forces. Scalar extraction was found to bias the analyses of all three datasets by failing to consider sufficient portions of the dataset, and/or by failing to consider covariance amongst vector components. SPM overcame both problems by conducting hypothesis testing at the (massively multivariate) vector trajectory level, with random field corrections simultaneously accounting for temporal correlation and vector covariance. While SPM has been widely demonstrated to be effective for analyzing 3D scalar fields, the current results are the first to demonstrate its effectiveness for 1D vector field analysis. It was concluded that SPM offers a generalized, statistically comprehensive solution to scalar extraction's over-simplification of vector trajectories, thereby making it useful for objectively guiding analyses of complex biomechanical systems. © 2013 Published by Elsevier Ltd. All rights reserved.

Accidents due to falls from roof slabs.

Science.gov (United States)

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

2013-01-01

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

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.

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

Science.gov (United States)

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

2018-05-09

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

Falls in multiple sclerosis.

Science.gov (United States)

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

2011-07-01

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

Emerging Vector-Borne Diseases - Incidence through Vectors.

Science.gov (United States)

Savić, Sara; Vidić, Branka; Grgić, Zivoslav; Potkonjak, Aleksandar; Spasojevic, Ljubica

2014-01-01

Vector-borne diseases use to be a major public health concern only in tropical and subtropical areas, but today they are an emerging threat for the continental and developed countries also. Nowadays, in intercontinental countries, there is a struggle with emerging diseases, which have found their way to appear through vectors. Vector-borne zoonotic diseases occur when vectors, animal hosts, climate conditions, pathogens, and susceptible human population exist at the same time, at the same place. Global climate change is predicted to lead to an increase in vector-borne infectious diseases and disease outbreaks. It could affect the range and population of pathogens, host and vectors, transmission season, etc. Reliable surveillance for diseases that are most likely to emerge is required. Canine vector-borne diseases represent a complex group of diseases including anaplasmosis, babesiosis, bartonellosis, borreliosis, dirofilariosis, ehrlichiosis, and leishmaniosis. Some of these diseases cause serious clinical symptoms in dogs and some of them have a zoonotic potential with an effect to public health. It is expected from veterinarians in coordination with medical doctors to play a fundamental role at primarily prevention and then treatment of vector-borne diseases in dogs. The One Health concept has to be integrated into the struggle against emerging diseases. During a 4-year period, from 2009 to 2013, a total number of 551 dog samples were analyzed for vector-borne diseases (borreliosis, babesiosis, ehrlichiosis, anaplasmosis, dirofilariosis, and leishmaniasis) in routine laboratory work. The analysis was done by serological tests - ELISA for borreliosis, dirofilariosis, and leishmaniasis, modified Knott test for dirofilariosis, and blood smear for babesiosis, ehrlichiosis, and anaplasmosis. This number of samples represented 75% of total number of samples that were sent for analysis for different diseases in dogs. Annually, on average more then half of the samples

Incidence and predicting factors of falls of older inpatients

Directory of Open Access Journals (Sweden)

Hellen Cristina de Almeida Abreu

2015-01-01

Full Text Available OBJECTIVE To estimate the incidence and predicting factors associated with falls among older inpatients. METHODS Prospective cohort study conducted in clinical units of three hospitals in Cuiaba, MT, Midwestern Brazil, from March to August 2013. In this study, 221 inpatients aged 60 or over were followed until hospital discharge, death, or fall. The method of incidence density was used to calculate incidence rates. Bivariate analysis was performed by Chi-square test, and multiple analysis was performed by Cox regression. RESULTS The incidence of falls was 12.6 per 1,000 patients/day. Predicting factors for falls during hospitalization were: low educational level (RR = 2.48; 95%CI 1.17;5.25, polypharmacy (RR = 4.42; 95%CI 1.77;11.05, visual impairment (RR = 2.06; 95%CI 1.01;4.23, gait and balance impairment (RR = 2.95; 95%CI 1.22;7.14, urinary incontinence (RR = 5.67; 95%CI 2.58;12.44 and use of laxatives (RR = 4.21; 95%CI 1.15;15.39 and antipsychotics (RR = 4.10; 95%CI 1.38;12.13. CONCLUSIONS The incidence of falls of older inpatients is high. Predicting factors found for falls were low education level, polypharmacy, visual impairment, gait and balance impairment, urinary incontinence and use of laxatives and antipsychotics. Measures to prevent falls in hospitals are needed to reduce the incidence of this event.

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

Science.gov (United States)

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

2017-12-01

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

Embedded DSP-based telehealth radar system for remote in-door fall detection.

Science.gov (United States)

Garripoli, Carmine; Mercuri, Marco; Karsmakers, Peter; Jack Soh, Ping; Crupi, Giovanni; Vandenbosch, Guy A E; Pace, Calogero; Leroux, Paul; Schreurs, Dominique

2015-01-01

Telehealth systems and applications are extensively investigated nowadays to enhance the quality-of-care and, in particular, to detect emergency situations and to monitor the well-being of elderly people, allowing them to stay at home independently as long as possible. In this paper, an embedded telehealth system for continuous, automatic, and remote monitoring of real-time fall emergencies is presented and discussed. The system, consisting of a radar sensor and base station, represents a cost-effective and efficient healthcare solution. The implementation of the fall detection data processing technique, based on the least-square support vector machines, through a digital signal processor and the management of the communication between radar sensor and base station are detailed. Experimental tests, for a total of 65 mimicked fall incidents, recorded with 16 human subjects (14 men and two women) that have been monitored for 320 min, have been used to validate the proposed system under real circumstances. The subjects' weight is between 55 and 90 kg with heights between 1.65 and 1.82 m, while their age is between 25 and 39 years. The experimental results have shown a sensitivity to detect the fall events in real time of 100% without reporting false positives. The tests have been performed in an area where the radar's operation was not limited by practical situations, namely, signal power, coverage of the antennas, and presence of obstacles between the subject and the antennas.

Identification of fall risk factors in older adult emergency department patients.

Science.gov (United States)

Carpenter, Christopher R; Scheatzle, Mark D; D'Antonio, Joyce A; Ricci, Paul T; Coben, Jeffrey H

2009-03-01

Falls represent an increasingly frequent source of injury among older adults. Identification of fall risk factors in geriatric patients may permit the effective utilization of scarce preventative resources. The objective of this study was to identify independent risk factors associated with an increased 6-month fall risk in community-dwelling older adults discharged from the emergency department (ED). This was a prospective observational study with a convenience sampling of noninstitutionalized elders presenting to an urban teaching hospital ED who did not require hospital admission. Interviews were conducted to determine the presence of fall risk factors previously described in non-ED populations. Subjects were followed monthly for 6 months through postcard or telephone contact to identify subsequent falls. Univariate and Cox regression analysis were used to determine the association of risk factors with 6-month fall incidence. A total of 263 patients completed the survey, and 161 (61%) completed the entire 6 months of follow-up. Among the 263 enrolled, 39% reported a fall in the preceding year, including 15% with more than one fall and 22% with injurious falls. Among those completing the 6 months of follow-up, 14% reported at least one fall. Cox regression analysis identified four factors associated with falls during the 6-month follow-up: nonhealing foot sores (hazard ratio [HR] = 3.71, 95% confidence interval [CI] = 1.73 to 7.95), a prior fall history (HR = 2.62, 95% CI = 1.32 to 5.18), inability to cut one's own toenails (HR = 2.04, 95% CI = 1.04 to 4.01), and self-reported depression (HR = 1.72, 95% CI = 0.83 to 3.55). Falls, recurrent falls, and injurious falls in community-dwelling elder ED patients being evaluated for non-fall-related complaints occur at least as frequently as in previously described outpatient cohorts. Nonhealing foot sores, self-reported depression, not clipping one's own toenails, and previous falls are all associated with falls after

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

Science.gov (United States)

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

2015-07-01

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

Extraction and Analysis of Mega Cities’ Impervious Surface on Pixel-based and Object-oriented Support Vector Machine Classification Technology: A case of Bombay

Science.gov (United States)

Yu, S. S.; Sun, Z. C.; Sun, L.; Wu, M. F.

2017-02-01

The object of this paper is to study the impervious surface extraction method using remote sensing imagery and monitor the spatiotemporal changing patterns of mega cities. Megacity Bombay was selected as the interesting area. Firstly, the pixel-based and object-oriented support vector machine (SVM) classification methods were used to acquire the land use/land cover (LULC) products of Bombay in 2010. Consequently, the overall accuracy (OA) and overall Kappa (OK) of the pixel-based method were 94.97% and 0.96 with a running time of 78 minutes, the OA and OK of the object-oriented method were 93.72% and 0.94 with a running time of only 17s. Additionally, OA and OK of the object-oriented method after a post-classification were improved up to 95.8% and 0.94. Then, the dynamic impervious surfaces of Bombay in the period 1973-2015 were extracted and the urbanization pattern of Bombay was analysed. Results told that both the two SVM classification methods could accomplish the impervious surface extraction, but the object-oriented method should be a better choice. Urbanization of Bombay experienced a fast extending during the past 42 years, implying a dramatically urban sprawl of mega cities in the developing countries along the One Belt and One Road (OBOR).

Detection of a meteorite 'stream' - Observations of a second meteorite fall from the orbit of the Innisfree chondrite

Science.gov (United States)

Halliday, I.

1987-03-01

The first observational evidence of multiple meteorite falls from the same orbit is adduced from the February 6, 1980 fall of a meteorite precisely 3 yr after the fall of the Innisfree meteorite. Due consideration of the detection probability for two related objects with the meteorite camera network in western Canada suggests that the Innisfree brecciated LL chondrite was a near-surface fragment from a parent object whose radius was of the order of several tens of meters. A meteorite mass of 1.8 kg is predicted for the new object, whose recovery in the vicinity of Ridgedale, Saskatchewan, is now sought for the sake of comparison with the Innisfree chondrite.

Pull test performance and correlation with falls risk in Parkinson?s disease

Directory of Open Access Journals (Sweden)

Renato P. Munhoz

2014-08-01

Full Text Available Postural instability (PI and falls are major sources of disability in Parkinson’s disease (PD. Our objectives were to evaluate the correlation between the pull-test (PT scores and falls. Patients underwent a standardized data collection including demographic, clinical data, and the UPDRS scores for falls and the PT. Cases with scores >1 for falls were considered frequent fallers. 264 patients were included with mean age 67.6±10 years, mean age of onset 59.1±10.7 years. Comparison between PT scores versus the proportion of frequent fallers and the mean score of the UPDRS for falls showed that for each increase in the PT score, both parameters were significantly worse, with positive linear relationship. For any abnormal PT score, sensibility and negative predictive value were excellent; specificity and positive predictive value improved with worse PT scores. In conclusion, the PT provides important and reliable information regarding PI and the risk of falls in PD.

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

Science.gov (United States)

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

2014-11-01

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

Vector analysis

CERN Document Server

Newell, Homer E

2006-01-01

When employed with skill and understanding, vector analysis can be a practical and powerful tool. This text develops the algebra and calculus of vectors in a manner useful to physicists and engineers. Numerous exercises (with answers) not only provide practice in manipulation but also help establish students' physical and geometric intuition in regard to vectors and vector concepts.Part I, the basic portion of the text, consists of a thorough treatment of vector algebra and the vector calculus. Part II presents the illustrative matter, demonstrating applications to kinematics, mechanics, and e

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

Science.gov (United States)

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

2018-06-15

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2017-10-01

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

Equivalent Fall Risk in Elderly Patients on Hemodialysis and Peritoneal Dialysis.

Science.gov (United States)

Farragher, Janine; Rajan, Tasleem; Chiu, Ernest; Ulutas, Ozkan; Tomlinson, George; Cook, Wendy L; Jassal, Sarbjit V

2016-01-01

♦ Accidental falls are common in the hemodialysis (HD) population. The high fall rate has been attributed to a combination of aging, kidney disease-related morbidity, and HD treatment-related hazards. We hypothesized that patients maintained on peritoneal dialysis (PD) would have fewer falls than those on chronic HD. The objective of this study was to compare the falls risk between cohorts of elderly patients maintained on HD and PD, using prospective data from a large academic dialysis facility. ♦ Patients aged 65 years or over on chronic in-hospital HD and PD at the University Health Network were recruited. Patients were followed biweekly, and falls occurring within the first year recorded. Fall risk between the 2 groups was compared using both crude and adjusted Poisson lognormal random effects modeling. ♦ Out of 258 potential patients, 236 were recruited, assessed at baseline, and followed biweekly for falls. Of 74 PD patients, 40 (54%) experienced 86 falls while 76 out of 162 (47%) HD patients experienced a total of 305 falls (crude fall rate 1.25 vs 1.60 respectively, odds ratio [OR] falls in PD patients 0.78, 95% confidence interval [CI] 0.61 - 0.92, p = 0.04). After adjustment for differences in comorbidity, number of medications, and other demographic differences, PD patients were no less likely to experience accidental falls than HD patients (OR 1.63, 95% CI 0.88 - 3.04, p = 0.1). ♦ We conclude that accidental falls are equally common in the PD population and the HD population. These data argue against post-HD hypotension as the sole contributor to the high fall risk in the dialysis population. Copyright © 2016 International Society for Peritoneal Dialysis.

Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups

OpenAIRE

Marschollek, Michael; Gövercin, Mehmet; Rust, Stefan; Gietzelt, Matthias; Schulze, Mareike; Wolf, Klaus-Hendrik; Steinhagen-Thiessen, Elisabeth

2012-01-01

Abstract Background Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2). Methods A ...

Fall 2011 Small Pelagics Survey (PC1108, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Objectives of the Fall 2011 Small Pelagics Survey were to sample the waters of the northern Gulf of Mexico less than 500 meters deep with 90-ft high opening fish...

Fall 2010 Small Pelagics Survey (PC1006, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Objectives of the Fall 2010 Small Pelagics Survey were to sample the waters of the northern Gulf of Mexico less than 500 meters deep with 90-ft high opening fish...

Impact of Falls on Physical Activity in People with Parkinson's Disease.

Science.gov (United States)

Hiorth, Ylva Hivand; Larsen, Jan Petter; Lode, Kirsten; Tysnes, Ole-Bjørn; Godfrey, Alan; Lord, Sue; Rochester, Lynn; Pedersen, Kenn Freddy

2016-01-01

A complex relationship exists between motor impairment, physical activity (sedentary behavior, standing and ambulatory activity) and falls in people with Parkinson's disease (PD). To explore associations between recent fall history and the ability to retain an active lifestyle as determined by the volume, pattern and variability of physical activity in people with PD. Forty-eight participants with PD were recruited from the Norwegian ParkWest study. Body posture and ambulatory activity were monitored objectively over 7 days using the activPAL3 accelerometer. Clinical assessments included the Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale motor section and Falls Efficacy Scale-International. Structured interviews were performed to obtain information about demographics, fall history last 6 months, mobility and dementia. Participants with a fall history (n = 20) spent more time sedentary and less time standing than non-falling participants (n = 28). There were no significant differences regarding pattern or variability of sedentary behavior, standing or ambulatory activity in falling versus non-falling participants. Confidence in being able to get up from floor contributed significantly to time spent in sedentary behavior and ambulatory activity in participants with fall history, whereas motor impairment was significantly associated with time spent in all facets of physical activity for non-falling participants. Fall history in our PD cohort was associated with a more sedentary lifestyle, but not less ambulatory activity. More emphasis on improving the capacity to safely complete activities of daily living and increase confidence in getting up from floor may reduce sedentary behavior in people with PD.

Prediction of Post-stroke Falls by Quantitative Assessment of Balance

OpenAIRE

Lee, Hyun Haeng; Jung, Se Hee

2017-01-01

Objective To evaluate characteristics of the postural instability in patients with stroke and to present a prediction model of post-stroke falls. Methods Patients with a first-ever stroke who had been evaluated by the Balance Master (BM) at post-stroke 3 months (?1 month) between August 2011 and December 2015 were enrolled. Parameters for the postural instability, such as the weight bearing asymmetry (WBA) and postural sway velocity (PSV), were obtained. The fall events in daily lives were as...

Vector-Tensor and Vector-Vector Decay Amplitude Analysis of B0→φK*0

International Nuclear Information System (INIS)

Aubert, B.; Bona, M.; Boutigny, D.; Couderc, F.; Karyotakis, Y.; Lees, J. P.; Poireau, V.; Tisserand, V.; Zghiche, A.; Grauges, E.; Palano, A.; Chen, J. C.; Qi, N. D.; Rong, G.; Wang, P.; Zhu, Y. S.; Eigen, G.; Ofte, I.; Stugu, B.; Abrams, G. S.

2007-01-01

We perform an amplitude analysis of the decays B 0 →φK 2 * (1430) 0 , φK * (892) 0 , and φ(Kπ) S-wave 0 with a sample of about 384x10 6 BB pairs recorded with the BABAR detector. The fractions of longitudinal polarization f L of the vector-tensor and vector-vector decay modes are measured to be 0.853 -0.069 +0.061 ±0.036 and 0.506±0.040±0.015, respectively. Overall, twelve parameters are measured for the vector-vector decay and seven parameters for the vector-tensor decay, including the branching fractions and parameters sensitive to CP violation

Geriatric fall-related injuries.

African Journals Online (AJOL)

Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

Factors associated with occasional and recurrent falls in Mexican community-dwelling older people

Science.gov (United States)

Mino-León, Dolores; Cruz-Arenas, Esteban

2018-01-01

Falls are a frequent event among older adults that can cause wounds, disability, psychological disorders, and premature death. Although the large number of existing studies on the issue, few have been conducted in middle- and low-income countries. The objective of the present study is to identify the sociodemographic, medical, and functional performance factors associated with occasional and recurrent falls in Mexican older adults dwelling in community. Cross-sectional analysis of 9 598 adults ≥60 years old who participated in the fourth round (2015) of the Mexican Health and Aging Study. Bivariate tests were performed to evaluate the differences between covariates by distinct fall groups (no falls, occasional falls, and recurrent falls). Multiple logistic regressions with unadjusted and adjusted models were estimated. Approximately 46% of older adults had had at least one fall during the previous two years (one fall 16% and recurrent falls 30%). Occasional falls were only associated with being a woman; in addition to the sex, recurrent falls were strongly associated with advanced age, rural residence, bad and very bad self-perception of health status, activity-limiting pain, urinary incontinence, depression, arthritis, limitations in basic activities of daily living, and limitations in advanced activities of daily living. Falls, primarily recurrent falls, deserve to be addressed through multifactorial strategies that include different areas of intervention. PMID:29462159

Factors associated with occasional and recurrent falls in Mexican community-dwelling older people.

Directory of Open Access Journals (Sweden)

Marcela Agudelo-Botero

Full Text Available Falls are a frequent event among older adults that can cause wounds, disability, psychological disorders, and premature death. Although the large number of existing studies on the issue, few have been conducted in middle- and low-income countries. The objective of the present study is to identify the sociodemographic, medical, and functional performance factors associated with occasional and recurrent falls in Mexican older adults dwelling in community. Cross-sectional analysis of 9 598 adults ≥60 years old who participated in the fourth round (2015 of the Mexican Health and Aging Study. Bivariate tests were performed to evaluate the differences between covariates by distinct fall groups (no falls, occasional falls, and recurrent falls. Multiple logistic regressions with unadjusted and adjusted models were estimated. Approximately 46% of older adults had had at least one fall during the previous two years (one fall 16% and recurrent falls 30%. Occasional falls were only associated with being a woman; in addition to the sex, recurrent falls were strongly associated with advanced age, rural residence, bad and very bad self-perception of health status, activity-limiting pain, urinary incontinence, depression, arthritis, limitations in basic activities of daily living, and limitations in advanced activities of daily living. Falls, primarily recurrent falls, deserve to be addressed through multifactorial strategies that include different areas of intervention.

About vectors

CERN Document Server

Hoffmann, Banesh

1975-01-01

From his unusual beginning in ""Defining a vector"" to his final comments on ""What then is a vector?"" author Banesh Hoffmann has written a book that is provocative and unconventional. In his emphasis on the unresolved issue of defining a vector, Hoffmann mixes pure and applied mathematics without using calculus. The result is a treatment that can serve as a supplement and corrective to textbooks, as well as collateral reading in all courses that deal with vectors. Major topics include vectors and the parallelogram law; algebraic notation and basic ideas; vector algebra; scalars and scalar p

Clinical prediction of fall risk and white matter abnormalities: a diffusion tensor imaging study

Science.gov (United States)

The Tinetti scale is a simple clinical tool designed to predict risk of falling by focusing on gait and stance impairment in elderly persons. Gait impairment is also associated with white matter (WM) abnormalities. Objective: To test the hypothesis that elderly subjects at risk for falling, as deter...

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

Science.gov (United States)

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

2013-01-01

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

Vectors

DEFF Research Database (Denmark)

Boeriis, Morten; van Leeuwen, Theo

2017-01-01

should be taken into account in discussing ‘reactions’, which Kress and van Leeuwen link only to eyeline vectors. Finally, the question can be raised as to whether actions are always realized by vectors. Drawing on a re-reading of Rudolf Arnheim’s account of vectors, these issues are outlined......This article revisits the concept of vectors, which, in Kress and van Leeuwen’s Reading Images (2006), plays a crucial role in distinguishing between ‘narrative’, action-oriented processes and ‘conceptual’, state-oriented processes. The use of this concept in image analysis has usually focused...

Vector regression introduced

Directory of Open Access Journals (Sweden)

Mok Tik

2014-06-01

Full Text Available This study formulates regression of vector data that will enable statistical analysis of various geodetic phenomena such as, polar motion, ocean currents, typhoon/hurricane tracking, crustal deformations, and precursory earthquake signals. The observed vector variable of an event (dependent vector variable is expressed as a function of a number of hypothesized phenomena realized also as vector variables (independent vector variables and/or scalar variables that are likely to impact the dependent vector variable. The proposed representation has the unique property of solving the coefficients of independent vector variables (explanatory variables also as vectors, hence it supersedes multivariate multiple regression models, in which the unknown coefficients are scalar quantities. For the solution, complex numbers are used to rep- resent vector information, and the method of least squares is deployed to estimate the vector model parameters after transforming the complex vector regression model into a real vector regression model through isomorphism. Various operational statistics for testing the predictive significance of the estimated vector parameter coefficients are also derived. A simple numerical example demonstrates the use of the proposed vector regression analysis in modeling typhoon paths.

The Impact of a Training Intervention Program on Fall-related Psychological Factors Among Male Older Adults in Arak

Directory of Open Access Journals (Sweden)

Daryoush Khajavi

2014-04-01

Full Text Available Objectives: Falls and fall-related physiological and psychological events are major problems for elderly people. The objective of this research was to examine the effect of an interventional training program on fall-related psychological factors among the elderly men in Arak. Methods & Materials: In this quasi experiment research on male older adults in Arak, 27 participants randomly assigned to Control group (mean age=70.21±6.65 and Experimental group (mean age=66.07±4.38. Experimental group members participated in a 12 week interventional training program. Results: The findings showed that training intervention program improved fall-related psychological factors (Fall Self-Efficacy/Fear of Fall and Activities-specific Balance Confidence/Balance Self-Efficacy in experimental group. No significant changes appeared in fall-related psychological factors in control group members who did not perform any regular training program. Conclusion: According to the findings, regular interventional training program can decrease fear of fall and increase balance confidence in performing the activities of everyday life by improving physical and motor fitness levels. These improvements can lead to physical and psychological health, increase in quality of life among older adults, and eventually successful aging.

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

Science.gov (United States)

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

2016-08-01

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

Appetite and falls: Old age and lived experiences

Directory of Open Access Journals (Sweden)

Marianne Mahler

2012-02-01

Full Text Available Falling among older adults is a well-known public health problem but the association between falling and appetite is seldom studied although poor nutritional status is accepted as a risk factor for falls. On this background the aim of this study was to understand how older adults, who have fallen several times within a year, related their experiences of appetite as a phenomenon in everyday life. In narrative in-depth interviews, eight women and four men contributed with their stories. Using interpretative phenomenology the thematic analysis resulted in three main themes: appetite for food; appetite for social relations and appetite for influence. Eating was not trivial everyday routine and required self-regimentation. Meals were not an object of desire, but of discipline out of the wish to survive. Feelings, reflections and ambivalence were bound to the lack of appetite on food. The participants were oriented towards the forbidden, the delicious and to everyday food as a strengthener and as medicine. In their dependency on help, home was the framework for establishing social relations as means of social support. As well as family and neighbours, the significant others were persons on whom the participants were dependent. Personal relationships and mutual dependencies may ensure social security in lives characterised by contingency and maintain influence in daily life. Falling is both a dramatic and a trivial incident where life and death could be at stake. From this perspective, connectedness was prominent in all fall stories. The quest for influence and a sense of social connectedness was the incentive to re-enter local community arenas and to express solidarity. In health-care practice multi-factorial fall-prevention should be complemented with a multi-dimensional approach in order to balance the medical approach with humanistic and societal approaches towards fall-prevention.

Differing approaches to falls and fracture prevention between Australia and Colombia

Science.gov (United States)

Gomez, Fernando; Curcio, Carmen Lucia; Suriyaarachchi, Pushpa; Demontiero, Oddom; Duque, Gustavo

2013-01-01

Falls and fractures are major causes of morbidity and mortality in older people. More importantly, previous falls and/or fractures are the most important predictors of further events. Therefore, secondary prevention programs for falls and fractures are highly needed. However, the question is whether a secondary prevention model should focus on falls prevention alone or should be implemented in combination with fracture prevention. By comparing a falls prevention clinic in Manizales (Colombia) versus a falls and fracture prevention clinic in Sydney (Australia), the objective was to identify similarities and differences between these two programs and to propose an integrated model of care for secondary prevention of fall and fractures. A comparative study of services was performed using an internationally agreed taxonomy. Service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE) and previous reports in the literature. Comparison included organization, administration, client characteristics, and interventions. Several similarities and a number of differences that could be easily unified into a single model are reported here. Similarities included population, a multidisciplinary team, and a multifactorial assessment and intervention. Differences were eligibility criteria, a bone health assessment component, and the therapeutic interventions most commonly used at each site. In Australia, bone health assessment is reinforced whereas in Colombia dizziness assessment and management is pivotal. The authors propose that falls clinic services should be operationally linked to osteoporosis services such as a “falls and fracture prevention clinic,” which would facilitate a comprehensive intervention to prevent falls and fractures in older persons. PMID:23378748

A High-yield Fall Risk and Adverse Events Screening Questions From the Stopping Elderly Accidents, Death, and Injuries (STEADI) Guideline for Older Emergency Department Fall Patients.

Science.gov (United States)

Sri-On, Jiraporn; Tirrell, Gregory Philip; Kamsom, Anucha; Marill, Keith A; Shankar, Kalpana Narayan; Liu, Shan W

2018-03-25

The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall. We conducted a prospective study at two urban, teaching hospitals. We included patients aged ≥ 65 years who presented to the ED for an accidental fall. Data were gathered for fall-relevant comorbidities, high-risk medications for falls, and the responses to 12 questions from the STEADI guideline recommendation. Our outcomes were the number of 6-month adverse events that were defined as mortality, ED revisit, subsequent hospitalization, recurrent falls, and a composite outcome. There were 548 (86.3%) patients who completed follow-up and 243 (44.3%) patients experienced an adverse event after a fall within 6 months. In multivariate analysis, seven questions from the STEADI guideline predicted various outcomes. The question "Had previous fall" predicted recurrent falls (odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.52 to 3.97), the question "Feels unsteady when walking sometimes" (OR = 2.34, 95% CI = 1.44 to 3.81), and "Lost some feeling in their feet" predicted recurrent falls. In addition to recurrent falls risk, the supplemental questions "Use or have been advised to use a cane or walker," "Take medication that sometimes makes them feel light-headed or more tired than usual," "Take medication to help sleep or improve mood," and "Have to rush to a toilet" predicted other outcomes. A STEADI score of ≥4 did not predict adverse outcomes although seven individual questions from the STEADI guidelines were associated with increased adverse outcomes within 6 months. These may be organized into three categories (previous falls, physical activity, and high-risk medications) and may assist emergency physicians to evaluate and refer high-risk fall patients for a comprehensive

Fear of falling and activity restriction{ in older adults from the urban community of Londrina: a cross-sectional study

Directory of Open Access Journals (Sweden)

Fabiana Satiko Fucahori

Full Text Available Objective The objective of this study was to assess the fear of falling and restriction of activities in the elderly of the city of Londrina (PR. Materials and method A cross-sectional study was conducted with individuals over 60 years old of both sexes. They were interviewed at their home with the Falls Efficacy Scale International - Brazil the Survey of Activities and Fear of Falling in the Elderly a socio-demographic and health perception questionnaire. Results The participants were 38 elderly people (mean age 71.6 ± 6.1 years with a prevalence of women (68.4%. The occurrence of a fall in the last year was reported by 44.7% of the elderly, and the prevalence of the fear of falling again by 56.3%. In the evaluation of the Falls Efficacy Scale, 97.4% of participants reported fear of falling in at least one of the activities while 55.3% had score ≥ 23 points showing high risk for falls. Fifty two percent of the elders restricted their activity due the fear of falling. Conclusion These results show a high frequency of fear of falling associated with restriction of activities and individuals with a high risk potential for falls. The evaluation of this data contributes to establishing indicators and development of preventive strategies and specific interventions for the elderly with fear of falling.

Preventing falls and fractures.

Science.gov (United States)

Ulfarsson, J; Robinson, B E

1994-11-01

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

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

Science.gov (United States)

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

2016-11-01

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

Kochen-Specker vectors

International Nuclear Information System (INIS)

Pavicic, Mladen; Merlet, Jean-Pierre; McKay, Brendan; Megill, Norman D

2005-01-01

We give a constructive and exhaustive definition of Kochen-Specker (KS) vectors in a Hilbert space of any dimension as well as of all the remaining vectors of the space. KS vectors are elements of any set of orthonormal states, i.e., vectors in an n-dimensional Hilbert space, H n , n≥3, to which it is impossible to assign 1s and 0s in such a way that no two mutually orthogonal vectors from the set are both assigned 1 and that not all mutually orthogonal vectors are assigned 0. Our constructive definition of such KS vectors is based on algorithms that generate MMP diagrams corresponding to blocks of orthogonal vectors in R n , on algorithms that single out those diagrams on which algebraic (0)-(1) states cannot be defined, and on algorithms that solve nonlinear equations describing the orthogonalities of the vectors by means of statistically polynomially complex interval analysis and self-teaching programs. The algorithms are limited neither by the number of dimensions nor by the number of vectors. To demonstrate the power of the algorithms, all four-dimensional KS vector systems containing up to 24 vectors were generated and described, all three-dimensional vector systems containing up to 30 vectors were scanned, and several general properties of KS vectors were found

Identification of fall risk predictors in daily life measurements: gait characteristics' reliability and association with self-reported fall history.

Science.gov (United States)

Rispens, Sietse M; van Schooten, Kimberley S; Pijnappels, Mirjam; Daffertshofer, Andreas; Beek, Peter J; van Dieën, Jaap H

2015-01-01

Background. Gait characteristics extracted from trunk accelerations during daily life locomotion are complementary to questionnaire- or laboratory-based gait and balance assessments and may help to improve fall risk prediction. Objective. The aim of this study was to identify gait characteristics that are associated with self-reported fall history and that can be reliably assessed based on ambulatory data collected during a single week. Methods. We analyzed 2 weeks of trunk acceleration data (DynaPort MoveMonitor, McRoberts) collected among 113 older adults (age range, 65-97 years). During episodes of locomotion, various gait characteristics were determined, including local dynamic stability, interstride variability, and several spectral features. For each characteristic, we performed a negative binomial regression analysis with the participants' self-reported number of falls in the preceding year as outcome. Reliability of gait characteristics was assessed in terms of intraclass correlations between both measurement weeks. Results. The percentages of spectral power below 0.7 Hz along the vertical and anteroposterior axes and below 10 Hz along the mediolateral axis, as well as local dynamic stability, local dynamic stability per stride, gait smoothness, and the amplitude and slope of the dominant frequency along the vertical axis, were associated with the number of falls in the preceding year and could be reliably assessed (all P 0.75). Conclusions. Daily life gait characteristics are associated with fall history in older adults and can be reliably estimated from a week of ambulatory trunk acceleration measurements. © The Author(s) 2014.

Association between dentures and the rate of falls in dementia

Directory of Open Access Journals (Sweden)

Eshkoor SA

2014-06-01

Full Text Available Sima Ataollahi Eshkoor,1 Tengku Aizan Hamid,1 Siti Sa'adiah Hassan Nudin,2 Chan Yoke Mun11Institute of Gerontology, Universiti Putra Malaysia, Serdang, 2Institute for Behavioral Research, Kuala Lumpur, MalaysiaBackground: Poor oral health, chronic diseases, functional decline, and low cognitive ability can increase the risk of falls in the elderly.Objectives: The current study aimed to show the effects of oral health, diabetes mellitus (DM, hypertension (HT, heart disease, functional status, and sociodemographic factors on the risk of falls in elderly with dementia.Materials and methods: The sample comprised 1,210 Malaysian elderly who were demented and noninstitutionalized. This study was a national cross-sectional survey entitled “Determinants of Health Status among Older Malaysians”. The effects of age, ethnicity, sex differences, marital status, educational level, oral health, DM, HT, heart disease, and functional status on the risk of falls were evaluated. The multiple logistic regression model was used to estimate the effects of contributing variables on the risk of falls in samples.Results: The prevalence of falls was approximately 17% in subjects. It was found that age (odds ratio [OR] 1.02, non-Malay ethnicity (OR 1.66, heart disease (OR 1.92, and functional decline (OR 1.58 significantly increased the risk of falls in respondents (P<0.05. Furthermore, having teeth (OR 0.59 and dentures (OR 0.66 significantly decreased the rate of falls (P<0.05.Conclusion: It was concluded that age, non-Malay ethnicity, functional decline, heart disease, and oral health significantly affected falls in dementia.Keywords: chronic diseases, dementia, fall, functional decline, oral health

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

Science.gov (United States)

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

2013-10-01

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

Criteria, objectives and methodology for evaluating marine protected ...

African Journals Online (AJOL)

As a first step, 14 objectives are defined that may be met by MPAs. These fall into three categories: biodiversity protection, fisheries management and human utilization. A series of criteria were then proposed which can be used selectively to quantify the degree to which MPAs meet these objectives. Each of the objectives is ...

Mobility Device Use Among Older Adults and Incidence of Falls and Worry About Falling: Findings From the 2011–2012 National Health and Aging Trends Study

Science.gov (United States)

Gell, Nancy M.; Wallace, Robert B.; LaCroix, Andrea Z.; Mroz, Tracy M.; Patel, Kushang V.

2015-01-01

OBJECTIVES To examine mobility device use prevalence among community-dwelling older adults in the U.S. and to investigate the incidence of falls and worry about falling by the type and number of mobility devices used. DESIGN Analysis of cross-sectional and longitudinal data from the 2011–2012 National Health and Aging Trends Study SETTING In-person interviews in the homes of study participants PARTICIPANTS Nationally representative sample of Medicare beneficiaries(N=7609). MEASUREMENTS Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, one-year fall history and worry about falling. RESULTS Twenty-four percent of adults age ≥65 reported mobility device use in 2011 and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with non-White race/ethnicity, female sex, lower education level, greater multi-morbidity, and obesity (all P-values falls and recurrent falls were not associated with the use of multiple devices or any one particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users, compared with non-users. CONCLUSION The percentage of older adults reporting mobility device use is higher compared to results from previous national surveys and multiple device use is common among those who use any device. Mobility device use is not associated with increased incidence of falls compared to non-device users. Cane-only users may compensate for worry about falling by limiting activity. PMID:25953070

iFall: an Android application for fall monitoring and response.

Science.gov (United States)

Sposaro, Frank; Tyson, Gary

2009-01-01

Injuries due to falls are among the leading causes of hospitalization in elderly persons, often resulting in a rapid decline in quality of life or death. Rapid response can improve the patients outcome, but this is often lacking when the injured person lives alone and the nature of the injury complicates calling for help. This paper presents an alert system for fall detection using common commercially available electronic devices to both detect the fall and alert authorities. We use an Android-based smart phone with an integrated tri-axial accelerometer. Data from the accelerometer is evaluated with several threshold based algorithms and position data to determine a fall. The threshold is adaptive based on user provided parameters such as: height, weight, and level of activity. The algorithm adapts to unique movements that a phone experiences as opposed to similar systems which require users to mount accelerometers to their chest or trunk. If a fall is suspected a notification is raised requiring the user's response. If the user does not respond, the system alerts pre-specified social contacts with an informational message via SMS. If a contact responds the system commits an audible notification, automatically connects, and enables the speakerphone. If a social contact confirms a fall, an appropriate emergency service is alerted. Our system provides a realizable, cost effective solution to fall detection using a simple graphical interface while not overwhelming the user with uncomfortable sensors.

Temporal association between hospitalization and rate of falls after discharge.

Science.gov (United States)

Mahoney, J E; Palta, M; Johnson, J; Jalaluddin, M; Gray, S; Park, S; Sager, M

2000-10-09

Evidence suggests that acute illness and hospitalization may increase the risk for falls. To evaluate the rate of falls, and associated risk factors, for 90 days following hospital discharge. We consecutively enrolled 311 patients, aged 65 years and older, discharged from the hospital after an acute medical illness and receiving home-nursing services. Patients were assessed within 5 days of discharge for prehospital and current functioning by self-report, and balance, vision, cognition, and delirium by objective measures. Patients were followed up weekly for 13 weeks for falls, injuries, and health care use. The rate of falls was significantly higher in the first 2 weeks after hospitalization (8.0 per 1000 person-days) compared with 3 months later (1.7 per 1000 person-days) (P =.002). Fall-related injuries accounted for 15% of all hospitalizations in the first month after discharge. Independent prehospital risk factors significantly associated with falls included dependency in activities of daily living, use of a standard walker, 2 or more falls, and more hospitalizations in the year prior. Posthospital risk factors included use of a tertiary amine tricyclic antidepressant, probable delirium, and poorer balance, while use of a cane was protective. The rate of falls is substantially increased in the first month after medical hospitalization, and is an important cause of injury and morbidity. Posthospital risk factors may be potentially modifiable. Efforts to assess and modify risk factors should be integral to the hospital and posthospital care of older adults (those aged >/=65 years).

Elementary vectors

CERN Document Server

Wolstenholme, E Œ

1978-01-01

Elementary Vectors, Third Edition serves as an introductory course in vector analysis and is intended to present the theoretical and application aspects of vectors. The book covers topics that rigorously explain and provide definitions, principles, equations, and methods in vector analysis. Applications of vector methods to simple kinematical and dynamical problems; central forces and orbits; and solutions to geometrical problems are discussed as well. This edition of the text also provides an appendix, intended for students, which the author hopes to bridge the gap between theory and appl

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.

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

Science.gov (United States)

Chippendale, Tracy; Boltz, Marie

2015-08-01

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

Incorporating in vivo fall assessments in the simulation of femoral fractures with finite element models

NARCIS (Netherlands)

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

2015-01-01

Femoral fractures are a major health issue. Most experimental and finite element (FE) fracture studies use polymethylmethacrylate cups on the greater trochanter (GT) to simulate fall impact loads. However, in vivo fall studies showed that the femur is loaded distally from the GT. Our objective was

A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly

NARCIS (Netherlands)

Weerdesteyn, [No Value; Rijken, H; Smits-Engelsman, BCM; Mulder, T; Duysens, J

2006-01-01

Background: Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. Objective: To test

A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.

NARCIS (Netherlands)

Weerdesteijn, V.G.M.; Rijken, H.A.F.M.; Geurts, A.C.H.; Smits-Engelsman, B.C.M.; Mulder, T.; Duysens, J.E.J.

2006-01-01

BACKGROUND: Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. OBJECTIVE: To test

Vectors to success

International Nuclear Information System (INIS)

Otsason, J.

1998-01-01

The Vector Pipeline project linking the Chicago supply hub to markets in eastern Canada, the northeastern U.S. and the Mid-Atlantic states, is described. Subsidiary objectives of the promoters are to match market timing to upstream pipelines and market requirements, and to provide low cost expandability to complement upstream expandability. The presentation includes description of the project, costs, leased facilities, rates and tariffs, right of way considerations, storage facilities and a project schedule. Construction is to begin in March 1999 and the line should be in service in November 1999

An alternative model of free fall

Science.gov (United States)

Lattery, Mark

2018-03-01

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

Robust multi-objective calibration strategies – possibilities for improving flood forecasting

Directory of Open Access Journals (Sweden)

G. H. Schmitz

2012-10-01

Full Text Available Process-oriented rainfall-runoff models are designed to approximate the complex hydrologic processes within a specific catchment and in particular to simulate the discharge at the catchment outlet. Most of these models exhibit a high degree of complexity and require the determination of various parameters by calibration. Recently, automatic calibration methods became popular in order to identify parameter vectors with high corresponding model performance. The model performance is often assessed by a purpose-oriented objective function. Practical experience suggests that in many situations one single objective function cannot adequately describe the model's ability to represent any aspect of the catchment's behaviour. This is regardless of whether the objective is aggregated of several criteria that measure different (possibly opposite aspects of the system behaviour. One strategy to circumvent this problem is to define multiple objective functions and to apply a multi-objective optimisation algorithm to identify the set of Pareto optimal or non-dominated solutions. Nonetheless, there is a major disadvantage of automatic calibration procedures that understand the problem of model calibration just as the solution of an optimisation problem: due to the complex-shaped response surface, the estimated solution of the optimisation problem can result in different near-optimum parameter vectors that can lead to a very different performance on the validation data. Bárdossy and Singh (2008 studied this problem for single-objective calibration problems using the example of hydrological models and proposed a geometrical sampling approach called Robust Parameter Estimation (ROPE. This approach applies the concept of data depth in order to overcome the shortcomings of automatic calibration procedures and find a set of robust parameter vectors. Recent studies confirmed the effectivity of this method. However, all ROPE approaches published so far just identify

High Temperature Falling Particle Receiver (2012 - 2016) - Final DOE Report

Energy Technology Data Exchange (ETDEWEB)

Ho, Clifford K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-04-15

The objective of this work was to advance falling particle receiver designs for concentrating solar power applications that will enable higher temperatures (>700 °C) and greater power-cycle efficiencies (≥50% thermal-to-electric). Modeling, design, and testing of components in Phases 1 and 2 led to the successful on-sun demonstration in Phase 3 of the world’s first continuously recirculating high-temperature 1 MW_t falling particle receiver that achieved >700 °C particle outlet temperatures at mass flow rates ranging from 1 – 7 kg/s.

[EXTRINSIC AND INTRINSIC FACTORS FOR FALLS THAT CAUSED HIP FRACTURE].

Science.gov (United States)

Tsur, Atzmon; Shakeer, Nael; Segal, Zvi; Itah, Dorit; Eluz, Dana

2017-05-01

Among the reasons described as possibly causing falls in older and elderly people are extrinsic factors such as bumping into objects, slipping on a wet floor, etc., and intrinsic factors - those that occur suddenly without warning. To investigate the connection between the reasons for falls, extrinsic or intrinsic and different medical and nonmedical factors. The survey included 82 people, 53 women and 29 men, who fell and broke their hip, underwent surgery, and were treated at the Rehabilitation Department. Data showed that 39 people fell due to extrinsic factors and 43 due to intrinsic reasons. We examined the correlation with several factors, both medical and non-medical, that may have influenced the scenario of each group. Falls due to extrinsic reasons took place at all hours of the day and night, mainly in people who were alone and who wore shoes or sandals at the time of the fall and who either suffered from slight or no disturbances in attention and concentration. Falls due to intrinsic reasons occurred mainly during rest or sleep hours, in people who walked barefoot or with socks or slippers and who suffered moderate or severe disturbances in attention and concentration. Although the differences in the extrinsic vs. intrinsic reasons for falls that led to broken hips were fairly clear, it would be difficult to recommend new tools for prevention of this phenomenon. Trying to predict an infrequent future event such as a traumatic fall is inherently difficult.

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

Directory of Open Access Journals (Sweden)

Patrícia Azevedo Garcia

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

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

Science.gov (United States)

Chippendale, Tracy; Lee, Chang Dae

2018-06-01

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

Falling through the black hole horizon

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Science.gov (United States)

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

2013-04-01

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

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

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.

Insights about Fall Prevention of Older Adults in the State of Hawai'i.

Science.gov (United States)

Yamazaki, Yuka; Hayashida, Cullen T; Yontz, Valerie

2017-01-01

The senior population in Hawai'i is growing at a dramatic pace. In the older population, falls and fall-related injuries are leading causes of morbidity and mortality. Moreover, the health care costs for falls are very high. The State of Hawai'i has taken measures to prevent falls through the promotion of medication reviews, vision checks, home assessments, and exercise. However, current published examinations of fall preventive measures have been insufficient, and more research is needed to confirm risk factors, effectiveness of preventive measures, and to explore future objectives. This paper examined the validity of fall risk factors and fall preventive measures for Hawai'i's seniors by conducting mail questionnaire surveys to a sample of seniors using medical alert services from one company in Hawai'i. The results of chi-square analysis suggest that having reduced ability to perform Activities of Daily Living (ADL) and reduced Instrumental Activities of Daily Living (IADL) were associated with a greater risk of falls ( P fall preventions with their family members or friends and health providers compared with those who did not ( P = .048 and .003, respectively). Evidence-based exercise programs for strengthening muscles and controlling physical balance may be needed to improve ADL and IADL. Furthermore, the results suggest that seniors do not accept that they are at risk of falling before they actually fall. Public health providers should consider how they approach seniors, and how they inform them of the importance of fall prevention across the life span.

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

Science.gov (United States)

Nassar, Nada; Helou, Nancy; Madi, Chantal

2014-06-01

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

Estimating fall risk with inertial sensors using gait stability measures that do not require step detection

NARCIS (Netherlands)

Riva, F.; Toebes, M.J.P.; Pijnappels, M.A.G.M.; Stagni, R.; van Dieen, J.H.

2013-01-01

Falls have major consequences both at societal (health-care and economy) and individual (physical and psychological) levels. Questionnaires to assess fall risk are commonly used in the clinic, but their predictive value is limited. Objective methods, suitable for clinical application, are hence

Fall Enrollment Report. 2014

Science.gov (United States)

Iowa Department of Education, 2014

2014-01-01

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

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

OpenAIRE

Kim, Sukwon

2006-01-01

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

Influences of a Church-Based Intervention on Falls Risk Among Seniors.

Science.gov (United States)

Briggs, Morgan; Morzinski, Jeffrey A; Ellis, Julie

2017-08-01

Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency. The 100 Healthy, At-Risk Families study team implemented 8 monthly educational health sessions promoting self-care and social support. Community nurses led the 60- to 90-minute sessions at each of 10 churches. To collect study data, nurses interviewed enrolled seniors pre- and post-intervention. Descriptive and comparison statistics were analyzed in Excel and Statistical Package for Social Sciences. Senior data at baseline found high rates of polypharmacy and physical imbalance, and no significant depression or gaps in social support. There was not a statistically significant change pre- to post-program in fall frequency "in prior year." Study findings reveal insights about African American senior health and fall risks. Church settings may provide a protective, psychosocial buffer for seniors, while polypharmacy and mobility/balance concerns indicate need for continued attention to fall risks. No increase in pre- to post-program falls was encouraging.

Students fall for Fall Meeting

Science.gov (United States)

Smedley, Kara

2012-02-01

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

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

Science.gov (United States)

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

2017-05-01

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

Study of The Vector Product using Three Dimensions Vector Card of Engineering in Pathumwan Institute of Technology

Science.gov (United States)

Mueanploy, Wannapa

2015-06-01

The objective of this research was to offer the way to improve engineering students in Physics topic of vector product. The sampling of this research was the engineering students at Pathumwan Institute of Technology during the first semester of academic year 2013. 1) Select 120 students by random sampling are asked to fill in a satisfaction questionnaire scale, to select size of three dimensions vector card in order to apply in the classroom. 2) Select 60 students by random sampling to do achievement test and take the test to be used in the classroom. The methods used in analysis of achievement test by the Kuder-Richardson Method (KR- 20). The results show that 12 items of achievement test are appropriate to be applied in the classroom. The achievement test gets Difficulty (P) = 0.40-0.67, Discrimination = 0.33-0.73 and Reliability (r) = 0.70.The experimental in the classroom. 3) Select 60 students by random sampling divide into two groups; group one (the controlled group) with 30 students was chosen to study in the vector product lesson by the regular teaching method. Group two (the experimental group) with 30 students was chosen to learn the vector product lesson with three dimensions vector card. 4) Analyzed data between the controlled group and the experimental group, the result showed that experimental group got higher achievement test than the controlled group significant at .01 level.

Association between falls in elderly women and chronic diseases and drug use: cross sectional study

OpenAIRE

Lawlor, Debbie A; Patel, Rita; Ebrahim, Shah

2003-01-01

OBJECTIVE: To assess the associations between having had a fall and chronic diseases and drug use in elderly women. DESIGN: Cross sectional survey, using data from the British women's heart and health study. SETTING: General practices in 23 towns in Great Britain. PARTICIPANTS: 4050 women aged 60-79 years. MAIN OUTCOME MEASURE: Whether women had had falls in the previous 12 months. RESULTS: The prevalence of falling increased with increasing numbers of simultaneously occurring chronic disease...

SEAMAP and NRDA 2010 Fall Plankton Survey (GU1004, EK60)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Primary objectives were to assess the occurrence, abundance and geographical distribution of the early life stages of fall spawning fishes, especially red drum, red...

Elderly individuals with increased risk of falls show postural balance impairment

Directory of Open Access Journals (Sweden)

Márcio Rogério de Oliveira

Full Text Available Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platform to measure postural balance through parameters from the center of pressure (COP. Results Elderly individuals were split into two groups according to the score observed with the Downton scale: G1 — low fall risk (score ≤ 2 — and G2 — high fall risk (score > 2. No differences were observed between the groups concerning gender (P > 0.05, Chi Square test. On the other hand, individuals from G2 showed postural instability when compared to individuals from G1, and individuals from G2 showed higher values in all COP parameters analysed (Mann-Whitney test, P < 0.05. Conclusion It can be concluded that the Downton scale has sensitivity for identifying individuals with balance impairment as well as a risk of falls. Therefore, it may be suggested that this scale may be useful in primary health care for detecting falls in the elderly.

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

Science.gov (United States)

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

2016-04-01

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

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

NARCIS (Netherlands)

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

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

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

NARCIS (Netherlands)

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

2012-01-01

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

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

NARCIS (Netherlands)

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

2012-01-01

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

Type, Number or Both? A Population-Based Matched Case-Control Study on the Risk of Fall Injuries among Older People and Number of Medications beyond Fall-Inducing Drugs

OpenAIRE

Laflamme, Lucie; Mon?rrez-Espino, Joel; Johnell, Kristina; Elling, Berty; M?ller, Jette

2015-01-01

Objectives Drug use is a modifiable risk factor for fall-related injuries in older people. Whereas the injurious effect of polypharmacy is established, that of low numbers of medications has not been fully ascertained. Neither do we know whether it is the number per se or the type of medications that actually matters. We assessed this question for fall injuries leading to hospitalization. Design National register-based, population-based, matched case-control study. Setting Community dwellers ...

Falling into a black hole

OpenAIRE

Mathur, Samir D.

2007-01-01

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

Hybridization between multi-objective genetic algorithm and support vector machine for feature selection in walker-assisted gait.

Science.gov (United States)

Martins, Maria; Costa, Lino; Frizera, Anselmo; Ceres, Ramón; Santos, Cristina

2014-03-01

Walker devices are often prescribed incorrectly to patients, leading to the increase of dissatisfaction and occurrence of several problems, such as, discomfort and pain. Thus, it is necessary to objectively evaluate the effects that assisted gait can have on the gait patterns of walker users, comparatively to a non-assisted gait. A gait analysis, focusing on spatiotemporal and kinematics parameters, will be issued for this purpose. However, gait analysis yields redundant information that often is difficult to interpret. This study addresses the problem of selecting the most relevant gait features required to differentiate between assisted and non-assisted gait. For that purpose, it is presented an efficient approach that combines evolutionary techniques, based on genetic algorithms, and support vector machine algorithms, to discriminate differences between assisted and non-assisted gait with a walker with forearm supports. For comparison purposes, other classification algorithms are verified. Results with healthy subjects show that the main differences are characterized by balance and joints excursion in the sagittal plane. These results, confirmed by clinical evidence, allow concluding that this technique is an efficient feature selection approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Adaptação cultural e validação da escala “falls efficacy scale” de Tinetti

OpenAIRE

Melo, Cristina Argel de

2011-01-01

Introduction: Fear of falling is a health problem as serious as falls, a construct that needs to be assessed, understood and treated in a specific way. Objective: To culturally adapt and validate the "Falls Efficacy Scale" from Tinetti. Methods: The instrument used for the adaptation and validation was the 'Falls Efficacy Scale (FES) from Tinetti. Linguistics and Semantic Equivalence was performed using a panel of translators, Content Equivalence was achieved through ordinary p...

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

Science.gov (United States)

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

2017-12-01

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

Genetic manipulation of endosymbionts to control vector and vector borne diseases

Directory of Open Access Journals (Sweden)

Jay Prakash Gupta

Full Text Available Vector borne diseases (VBD are on the rise because of failure of the existing methods of control of vector and vector borne diseases and the climate change. A steep rise of VBDs are due to several factors like selection of insecticide resistant vector population, drug resistant parasite population and lack of effective vaccines against the VBDs. Environmental pollution, public health hazard and insecticide resistant vector population indicate that the insecticides are no longer a sustainable control method of vector and vector-borne diseases. Amongst the various alternative control strategies, symbiont based approach utilizing endosymbionts of arthropod vectors could be explored to control the vector and vector borne diseases. The endosymbiont population of arthropod vectors could be exploited in different ways viz., as a chemotherapeutic target, vaccine target for the control of vectors. Expression of molecules with antiparasitic activity by genetically transformed symbiotic bacteria of disease-transmitting arthropods may serve as a powerful approach to control certain arthropod-borne diseases. Genetic transformation of symbiotic bacteria of the arthropod vector to alter the vector’s ability to transmit pathogen is an alternative means of blocking the transmission of VBDs. In Indian scenario, where dengue, chikungunya, malaria and filariosis are prevalent, paratransgenic based approach can be used effectively. [Vet World 2012; 5(9.000: 571-576

Association between obesity, risk of falls and fear of falling in older women

Directory of Open Access Journals (Sweden)

Silvia Gonçalves Ricci Neri

2017-11-01

Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n4p450   The aim of this cross-sectional study was to investigate the association between obesity, risk of falls and fear of falling in older women. Two hundred and twenty-six volunteers (68.05 ± 6.22 years, 68.06 ± 11.79 kg, 1.56 ± 0.06 m were classified as normal weight, overweight or obese, according to the body mass index. Risk of falls and fear of falling were evaluated using QuickScreen Clinical Falls Risk Assessment and Falls Efficiency Scale – International (FES-I, respectively. Comparisons between groups were conducted using Chi-square and ANOVA One-way tests. The significance level was set at p< 0.05. Obesity was associated with greater probability of falls (p< 0.001, which may be partly explained by decreased muscle strength (p< 0.001 and reaction time (p< 0.001. In addition, significant differences between groups was observed in FES-I score (p< 0.01, with obese women showing more pronounced fear of falling (30.10 ± 8.4 than normal weigh (25. 33 ± 7.11, p< 0.01 and overweight subjects (26.97 ± 7.05, p< 0.05. These findings corroborate previous evidence pointing obesity as a major risk factor for falls. Therefore, health professionals dealing with fall prevention should consider the effects of overweight.

Emerging vector borne diseases – incidence through vectors

Directory of Open Access Journals (Sweden)

Sara eSavic

2014-12-01

Full Text Available Vector borne diseases use to be a major public health concern only in tropical and subtropical areas, but today they are an emerging threat for the continental and developed countries also. Nowdays, in intercontinetal countries, there is a struggle with emerging diseases which have found their way to appear through vectors. Vector borne zoonotic diseases occur when vectors, animal hosts, climate conditions, pathogens and susceptible human population exist at the same time, at the same place. Global climate change is predicted to lead to an increase in vector borne infectious diseases and disease outbreaks. It could affect the range and popultion of pathogens, host and vectors, transmission season, etc. Reliable surveilance for diseases that are most likely to emerge is required. Canine vector borne diseases represent a complex group of diseases including anaplasmosis, babesiosis, bartonellosis, borreliosis, dirofilariosis, erlichiosis, leishmaniosis. Some of these diseases cause serious clinical symptoms in dogs and some of them have a zoonotic potential with an effect to public health. It is expected from veterinarians in coordination with medical doctors to play a fudamental role at primeraly prevention and then treatment of vector borne diseases in dogs. The One Health concept has to be integrated into the struggle against emerging diseases.During a four year period, from 2009-2013, a total number of 551 dog samples were analysed for vector borne diseases (borreliosis, babesiosis, erlichiosis, anaplasmosis, dirofilariosis and leishmaniasis in routine laboratory work. The analysis were done by serological tests – ELISA for borreliosis, dirofilariosis and leishmaniasis, modified Knott test for dirofilariosis and blood smear for babesiosis, erlichiosis and anaplasmosis. This number of samples represented 75% of total number of samples that were sent for analysis for different diseases in dogs. Annually, on avarege more then half of the samples

Risk Profiles for Falls among Older Adults: New Directions for Prevention

Directory of Open Access Journals (Sweden)

William A. Satariano

2017-08-01

Full Text Available ObjectiveTo address whether neighborhood factors, together with older adults’ levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM analysis to conduct this descriptive analysis.MethodThis is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC. Interviews focused on neighborhood characteristics, physical and cognitive function, walking, and falls and injuries. Four risk profiles (higher order interactions of individual and neighborhood factors were derived from GoM analysis.ResultsProfiles 1 and 2 reflect previous results showing that frail older adults are likely to fall indoors (Profile 1; healthy older adults are likely to fall outdoors (Profile 2. Profile 3 identifies the falls risk for older with mild cognitive impairment living in moderately walkable neighborhoods. Profile 4 identifies the risk found for healthy older adults living in neighborhoods with low walkability.DiscussionNeighborhood walkability, in combination with levels of health and functioning, is associated with both indoor and outdoor falls. Descriptive results suggest possible research hypotheses and new directions for prevention, based on individual and neighborhood factors.

Vector-vector production in photon-photon interactions

International Nuclear Information System (INIS)

Ronan, M.T.

1988-01-01

Measurements of exclusive untagged /rho/ 0 /rho/ 0 , /rho//phi/, K/sup *//bar K//sup */, and /rho/ω production and tagged /rho/ 0 /rho/ 0 production in photon-photon interactions by the TPC/Two-Gamma experiment are reviewed. Comparisons to the results of other experiments and to models of vector-vector production are made. Fits to the data following a four quark model prescription for vector meson pair production are also presented. 10 refs., 9 figs

New horizons in fall prevention.

Science.gov (United States)

Lord, Stephen R; Close, Jacqueline C T

2018-04-25

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

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.

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

Science.gov (United States)

Hauer, Klaus A; Kempen, Gertrudis I J M; Schwenk, Michael; Yardley, Lucy; Beyer, Nina; Todd, Chris; Oster, Peter; Zijlstra, G A Rixt

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. The objectives of this study are to determine: (1) the validity of the 7-item Short Falls Efficacy Scale International (Short FES-I) in geriatric patients with and without cognitive impairment, and (2) the sensitivity to change of the 10-item Falls Efficacy Scale (FES), the 16-item FES-I and the 7-item Short FES-I in geriatric patients with dementia. Cross-sectional data of community-dwelling older adults and geriatric rehabilitation patients (n = 284) collected during face-to-face interviews were used to determine construct and discriminant validity by testing for differences within variables related to fear of falling. Sensitivity to change was studied in an intervention study including patients with mild to moderate dementia (n = 130) as determined by standard response means (SRMs). The Short FES-I showed excellent construct and discriminant validity in the total group and subsamples according to cognitive status. Sensitivity to change was adequate to good in the FES (range SRM: 0.18-0.77) and FES-I (range SRM: 0.21-0.74), with the Short FES-I showing the highest peak sensitivity to change (range SRM: 0.18-0.91). The Short FES-I is a valid measure to assess fear of falling in frail older adults with and without cognitive impairment, yet it may show floor effects in higher functioning older people. All scales, including the Short FES-I, were sensitive to detecting intervention-induced changes in concerns about falling in geriatric patients with dementia. Copyright © 2010 S. Karger AG, Basel.

Dizziness, Physical Exercise, Falls, and Depression in Adults and the Elderly

Directory of Open Access Journals (Sweden)

Teixeira, Adriane Ribeiro

2015-11-01

Full Text Available Introduction Dizziness is a symptom that can lead to falls, which, in turn, undermine onés independence and autonomy, leading to several comorbidities. The practice of physical exercise, however, can help prevent falls. Objective The objective of this study is to confirm the association between physical exercise, dizziness, probability of falling, and depressive symptoms in a group of middle-aged adults and seniors. Methods The authors evaluated subjects based on history, the Geriatric Depression Scale, and functional reach test. Results The sample consisted of 90 individuals with a mean age of 69.3 ± 6.8 years. The authors found that 37.8% had been practicing exercise, 33.7% had depressive symptoms, and their probability of falling was above average in the functional reach test. Conclusion The results of this study indicated an association between dizziness, exercise practice and depressive symptoms, indicating that physical activity is a beneficial factor for the aging population.

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

Science.gov (United States)

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

2015-01-01

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

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

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.

Diagnosis and Tests: Evaluating a Fall or Risk of Falling

Science.gov (United States)

... as a physical therapist, who can evaluate your fall risk. If your healthcare provider concludes that you are ... to check for things that can impact your fall risk, such as electrolyte balance and the possibility of ...

Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden

OpenAIRE

Vikman, Irene; Nordlund, Anders; Näslund, Annika; Nyberg, Lars

2011-01-01

Artikkelen omhandler en studie hvor hensikten var å undersøke forekomst, inkludert variasjoner ad sesonger, omstendigheter og skader relatert til fall hos eldre som bor hjemme og mottar hjemmesykepleie, samt undersøke om det er en sammenheng mellom fall og type/omfang hjelp fra hjemmesykepleien. Objectives: falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this ...

Studying a free fall experiment using short sequences of images

International Nuclear Information System (INIS)

Vera, Francisco; Romanque, Cristian

2008-01-01

We discuss a new alternative for obtaining position and time coordinates from a video of a free fall experiment. In our approach, after converting the video to a short sequence of images, the images are analyzed using a web page application developed by the author. The main advantage of the setup explained in this work, is that it is simple to use, no software license fees are necessary, and can be scaled-up to be used by a big number of students in introductory physics courses. The steps involved in the full analysis of a falling object are: we grab a short digital video of the experiment and convert it to a sequence of images, then, using a web page that includes all the necessary javascript, the student can easily click on the object of interest to obtain the (x,y,t) coordinates, finally, the student analyze motion using a spreadsheet.

The design and development of a complex multifactorial falls assessment intervention for falls prevention: The Prevention of Falls Injury Trial (PreFIT).

Science.gov (United States)

Bruce, Julie; Ralhan, Shvaita; Sheridan, Ray; Westacott, Katharine; Withers, Emma; Finnegan, Susanne; Davison, John; Martin, Finbarr C; Lamb, Sarah E

2017-06-01

This paper describes the design and development of a complex multifactorial falls prevention (MFFP) intervention for implementation and testing within the framework of a large UK-based falls prevention randomised controlled trial (RCT). A complex intervention was developed for inclusion within the Prevention of Falls Injury Trial (PreFIT), a multicentre pragmatic RCT. PreFIT aims to compare the clinical and cost-effectiveness of three alternative primary care falls prevention interventions (advice, exercise and MFFP), on outcomes of fractures and falls. Community-dwelling adults, aged 70 years and older, were recruited from primary care in the National Health Service (NHS), England. Development of the PreFIT MFFP intervention was informed by the existing evidence base and clinical guidelines for the assessment and management of falls in older adults. After piloting and modification, the final MFFP intervention includes seven falls risk factors: a detailed falls history interview with consideration of 'red flags'; assessment of balance and gait; vision; medication screen; cardiac screen; feet and footwear screen and home environment assessment. This complex intervention has been fully manualised with clear, documented assessment and treatment pathways for each risk factor. Each risk factor is assessed in every trial participant referred for MFFP. Referral for assessment is based upon a screening survey to identify those with a history of falling or balance problems. Intervention delivery can be adapted to the local setting. This complex falls prevention intervention is currently being tested within the framework of a large clinical trial. This paper adheres to TIDieR and CONSORT recommendations for the comprehensive and explicit reporting of trial interventions. Results from the PreFIT study will be published in due course. The effectiveness and cost-effectiveness of the PreFIT MFFP intervention, compared to advice and exercise, on the prevention of falls and

Rare Hadronic B Decays to Vector, Axial-Vector and Tensors

International Nuclear Information System (INIS)

Gao, Y.Y.

2011-01-01

The authors review BABAR measurements of several rare B decays, including vector-axial-vector decays B ± → φK 1 ± (1270), B ± → φ K 1 ± (1400) and B ± → b 1 # -+ρ# ± , vector-vector decays B ± → φK* ± (1410), B 0 → K* 0 (bar K)* 0 , B 0 → K*0K*0 and B 0 → K*+K*-, vector-tensor decays B ± → φK* 2 (1430) ± and φK 2 (1770)/ ± (1820), and vector-scalar decays B ± → φK* 0 (1430) ± . Understanding the observed polarization pattern requires amplitude contributions from an uncertain source.

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

Science.gov (United States)

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

2016-06-01

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

Reciprocal relationship between fear of falling and depression in elderly Chinese primary care patients.

Science.gov (United States)

Chou, Kee-Lee; Chi, Iris

2008-09-01

The objective of the current study is to investigate the link between depression and fear of falling in Hong Kong Chinese older adults in primary are settings. Using longitudinal data collected on 321 Chinese primary care patients 65 years of age and older, the authors investigated the reciprocal relationship between fear of falling and depression and examined whether functional disability and social functioning mediated the link between fear of falling and depression. Participants were recruited from three primary care units in Hong Kong. Subjects were assessed in Cantonese by two trained assessors with Minimum Data Set-Home Care twice over a period of one year. Findings revealed that fear of falling at baseline significantly predicted depression at 12 month follow-up assessment after age, gender, marital status, education and depression at baseline were adjusted, but depression at baseline did not predict fear of falling at 12 months after fear of falling at baseline was adjusted. Moreover, social functioning mediated the impact of fear of falling on depression. The findings presented here indicate that fear of falling potentially increases the risk of depression in Chinese older adults in primary care settings.

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

The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation

Science.gov (United States)

Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

2014-01-01

Objective To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Design and setting Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Participants Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Interventions Not applicable. Main outcome measure(s) Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales’ classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. Results A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. PMID:24849795

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

Science.gov (United States)

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

2011-01-01

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

Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals.

Science.gov (United States)

Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, Göran; Nordström, Peter

2017-11-01

fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls. this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015. postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination. during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22). objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

Vector analysis

CERN Document Server

Brand, Louis

2006-01-01

The use of vectors not only simplifies treatments of differential geometry, mechanics, hydrodynamics, and electrodynamics, but also makes mathematical and physical concepts more tangible and easy to grasp. This text for undergraduates was designed as a short introductory course to give students the tools of vector algebra and calculus, as well as a brief glimpse into these subjects' manifold applications. The applications are developed to the extent that the uses of the potential function, both scalar and vector, are fully illustrated. Moreover, the basic postulates of vector analysis are brou

Connection between competence, usability, environment and risk of falls in elderly adults

Directory of Open Access Journals (Sweden)

José Alex Leiva-Caro

2015-12-01

Full Text Available Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

Two-year trajectory of fall risk in people with Parkinson’s disease: a latent class analysis

Science.gov (United States)

Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

2015-01-01

Objective To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson’s disease (PD). Design Latent class analysis, specifically growth mixture modeling (GMM) of longitudinal fall risk trajectories. Setting Not applicable. Participants 230 community-dwelling PD participants of a longitudinal cohort study who attended at least two of five assessments over a two year period. Interventions Not applicable. Main Outcome Measures Fall risk trajectory (low, medium or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6-monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. Results The GMM optimally grouped participants into three fall risk trajectories that closely mirrored baseline fall risk status (p=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium risk trajectories (pfall risk (posterior probability fall risk trajectories over two years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. PMID:26606871

Impact of deforestation on known malaria vectors in Sonitpur district of Assam, India.

Science.gov (United States)

Saxena, Rekha; Nagpal, B N; Singh, V P; Srivastava, Aruna; Dev, Vas; Sharma, M C; Gupta, H P; Tomar, Arvind Singh; Sharma, Shashi; Gupta, Sanjeev Kumar

2014-09-01

An alarming rate of deforestation has been reported from Sonitpur district of Assam, India therefore, a study was initiated during 2009 using remote sensing (RS) to assess deforested areas in the district and to study the impact on malaria vectors in order to formulate appropriate control strategy. RS imageries of 2000 and 2009 were used to assess deforested areas in the selected district. Entomological data were collected in four surveys during 2009-2011. The data were analyzed statistically using test of single proportions (χ 2 ) and pair-wise comparison. Vector incrimination was done using enzyme-linked immunosorbent assay (ELISA) and entomological inoculation rate (EIR) was calculated to estimate transmission intensity. The deforested areas were identified in north-western parts of Sonitpur district falling in Dhekiajuli Primary Health Centre (PHC). The forest cover of the PHC decreased >50% during 2000-2009. Five species of anopheline vectors were collected. Anopheles minimus sensu lato (s.l.) was collected least abundantly while An. culicifacies s.l. prevailed most abundantly and significant difference was observed between proportions of the collected vector species. Pair-wise comparison between An. culicifacies s.l. and An. minimus s.l. was also found statistically significant indicating that An. culicifacies s.l. is establishing its population in deforested areas. An. culicifacies s.l. was found ELISA positive and EIR was measured as 4.8 during transmission season. An. culicifacies s.l. replaced An. minimus s.l., the vector of malaria in northeast India and was found ELISA positive, therefore could have possible role in malaria transmission in the deforested areas of the district.

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

Science.gov (United States)

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

2016-01-01

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

Relations of Preschoolers' Visual-Motor and Object Manipulation Skills With Executive Function and Social Behavior.

Science.gov (United States)

MacDonald, Megan; Lipscomb, Shannon; McClelland, Megan M; Duncan, Rob; Becker, Derek; Anderson, Kim; Kile, Molly

2016-12-01

The purpose of this article was to examine specific linkages between early visual-motor integration skills and executive function, as well as between early object manipulation skills and social behaviors in the classroom during the preschool year. Ninety-two children aged 3 to 5 years old (M age  = 4.31 years) were recruited to participate. Comprehensive measures of visual-motor integration skills, object manipulation skills, executive function, and social behaviors were administered in the fall and spring of the preschool year. Our findings indicated that children who had better visual-motor integration skills in the fall had better executive function scores (B = 0.47 [0.20], p gender, Head Start status, and site location, but not after controlling for children's baseline levels of executive function. In addition, children who demonstrated better object manipulation skills in the fall showed significantly stronger social behavior in their classrooms (as rated by teachers) in the spring, including more self-control (B - 0.03 [0.00], p social behavior in the fall and other covariates. Children's visual-motor integration and object manipulation skills in the fall have modest to moderate relations with executive function and social behaviors later in the preschool year. These findings have implications for early learning initiatives and school readiness.

A Classification Detection Algorithm Based on Joint Entropy Vector against Application-Layer DDoS Attack

Directory of Open Access Journals (Sweden)

Yuntao Zhao

2018-01-01

Full Text Available The application-layer distributed denial of service (AL-DDoS attack makes a great threat against cyberspace security. The attack detection is an important part of the security protection, which provides effective support for defense system through the rapid and accurate identification of attacks. According to the attacker’s different URL of the Web service, the AL-DDoS attack is divided into three categories, including a random URL attack and a fixed and a traverse one. In order to realize identification of attacks, a mapping matrix of the joint entropy vector is constructed. By defining and computing the value of EUPI and jEIPU, a visual coordinate discrimination diagram of entropy vector is proposed, which also realizes data dimension reduction from N to two. In terms of boundary discrimination and the region where the entropy vectors fall in, the class of AL-DDoS attack can be distinguished. Through the study of training data set and classification, the results show that the novel algorithm can effectively distinguish the web server DDoS attack from normal burst traffic.

Vectors and Rotations in 3-Dimensions: Vector Algebra for the C++ Programmer

Science.gov (United States)

2016-12-01

release; distribution is unlimited. 1. Introduction This report describes 2 C++ classes: a Vector class for performing vector algebra in 3-dimensional...ARL-TR-7894•DEC 2016 US Army Research Laboratory Vectors and Rotations in 3-Dimensions:Vector Algebra for the C++ Programmer by Richard Saucier...Army Research Laboratory Vectors and Rotations in 3-Dimensions:Vector Algebra for the C++ Programmer by Richard Saucier Survivability/Lethality

Falls in people with MS—an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States

Science.gov (United States)

Gunn, H; Freeman, J; Hoang, P; Lord, S; Mazumder, Rajarshi; Cameron, Michelle

2015-01-01

Background: Falls are common in people with multiple sclerosis (PwMS). Previous studies have generally included small samples and had varied methods. Objectives: The objectives of this paper are to compile fall rates across a broad range of ages and disease severity and to definitively assess the extent to which MS-associated and demographic factors influence fall rates. Methods: Individual data from studies in four countries that prospectively measured falls for three months were analyzed. We determined fall rates, prevalence of fallers (≥1 falls) and frequent fallers (≥2 falls), location and timing of falls, and fall-related demographic factors. Results: A total of 537 participants reported 1721 falls: 56% were fallers and 37% frequent fallers. Most falls occurred indoors (65%) between 6 a.m. and 6 p.m. (75%). Primary progressive MS was associated with significantly increased odds of being a faller (odds ratio (OR) 2.02; CI 1.08–3.78). Fall risk peaked at EDSS levels of 4.0 and 6.0 with significant ORs between 5.30 (2.23–12.64) and 5.10 (2.08–12.47). The fall rate was lower in women than men (relative risk (RR) 0.80; CI 0.67–0.94) and decreased with increasing age (RR 0.97 for each year, CI 0.95–0.98). Conclusion: PwMS are at high risk of falls and there are important associations between falls and MS-associated disability, gender and age. PMID:24948687

LAPLACE-RUNGE-LENZ VECTOR IN QUANTUM MECHANICS IN NONCOMMUTATIVE SPACE

Directory of Open Access Journals (Sweden)

Peter Prešnajder

2014-04-01

Full Text Available The object under scrutiny is the dynamical symmetry connected with conservation of the Laplace-Runge-Lenz vector (LRL in the hydrogen atom problem solved by means of noncommutative quantum mechanics (NCQM. The considered noncommutative configuration space has such a “fuzzy”structure that the rotational invariance is not spoilt. An analogy with the LRL vector in the NCQM is brought to provide our results and also a comparison with the standard QM predictions.

[Risk factors for falls and survival after falling in elderly people in a community].

Science.gov (United States)

Kato, Ryuichi; Takagi, Chika; Sakurai, Naoko; Hoshi, Tanji

2012-05-01

The purpose of this study was to assess the risk factors associated with falls and to examine the effects of falls on survival of elderly people in a community. A questionnaire survey was conducted in 16,462 urban elderly dwellers aged 65 years or more in City A in September 2001. A follow-up survey was carried out in September 2004. We analyzed the data of 8,285 subjects who answered both questionnaires and had not relocated by August 2007. Baseline assessments of health and functioning were carried out in 2001. Falls experienced during the 1-year period before September 2004 were recorded, and the deaths were recorded until August 2007. Statistical analysis was performed using a logistic regression model and Cox's proportional hazards analysis. A total of 6,420 subjects (3,127 men and 3,293 women) who had provided complete answers about their falls were included in the analyses. Of these, 27.8% of women and 16.4% of men had experienced falls, while 6.2% of women and 2.1% of men had experienced falls that caused fractures. We found that the likelihood of fall, with or without fracture development, was greater in women than in men (P falls tended to increase with age in both women and men. Risk factors associated with falls, in addition to age and gender, were pain (odds ratio [OR], 1.75), lack of instrumental activities of daily living (IADL; OR, 1.45), poor self-rated health status (OR, 1.42), and presence of disease (OR, 1.35). Risk factors associated with falls that caused fracture were pain (OR, 1.85) and lack of IADL (OR, 1.61). Cox's proportional hazards analysis showed a significant increase in mortality in both men and women who had experienced falls than in those who had not (hazard ratio [HR], 1.94, 1.43). Aging, pain and disease, lack of IADL, and poor self-rated health status were all significant risk factors for falls in elderly people, and a fall was related to subsequent mortality.

Geriatric fall-related injuries.

Science.gov (United States)

Hefny, Ashraf F; Abbas, Alaa K; Abu-Zidan, Fikri M

2016-06-01

Falls are the leading cause of geriatric injury. We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

Seasonal changes in the apparent position of the Sun as elementary applications of vector operations

International Nuclear Information System (INIS)

Levine, Jonathan

2014-01-01

Many introductory courses in physics face an unpleasant chicken-and-egg problem. One might choose to introduce students to physical quantities such as velocity, acceleration, and momentum in over-simplified one-dimensional applications before introducing vectors and their manipulation; or one might first introduce vectors as mathematical objects and defer demonstration of their physical utility. This paper offers a solution to this pedagogical problem: elementary vector operations can be used without mechanics concepts to understand variations in the solar latitude, duration of daylight, and orientation of the rising and setting Sun. I show how sunrise and sunset phenomena lend themselves to exercises with scalar products, vector products, unit vectors, and vector projections that can be useful for introducing vector analysis in the context of physics. (paper)

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.

The epidemiology of slips, trips, and falls in a helicopter manufacturing plant.

Science.gov (United States)

Amandus, Harlan; Bell, Jennifer; Tiesman, Hope; Biddle, Elyce

2012-06-01

The purpose of this evaluation was to evaluate the causes and costs of slips, trips, and falls (STFs) in a helicopter manufacturing plant. STFs are a significant portion of the total industry injury burden. For this study, 4,070 helicopter plant workers who were employed from January 1, 2004, through February 28, 2008, were enrolled. Company records on workers' compensation claims, occupational health first report of injury, and payroll records on hours worked were collected. Cause and source of all injuries, including STFs, were coded for analysis. During the 4-year study period, there were 2,378 injuries and 226 STFs (46 falls [20%] to a lower level, 117 [52%] falls on the same level, 41 [18%] from loss of balance without a fall, and 22 [10%] from other events). Of the 226 STFs, 123 falls to the same level were caused by slippery substances (52), objects on floor (43), and surface hazards (28), and they cost $1,543,946. Falls to lower levels primarily involved access to stands to and from aircraft and falling off large machines. More than half of the STF injury claims likely could have been prevented by housekeeping and maintenance, and this cost saving could reasonably offset a considerable portion of the cost of prevention. Training and stand modifications could be considered to prevent falls from elevation from stands, machines, and aircraft. Recommendations for STF prevention are discussed.

Prevalence and Determinants of Fall-Related Injuries among Older Adults in Ecuador

Directory of Open Access Journals (Sweden)

Carlos H. Orces

2014-01-01

Full Text Available Objectives. To estimate the prevalence and determinants of fall-related injuries in the previous year among adults aged 60 years or older in Ecuador. Methods. The prevalence of fall-related injuries was estimated using cross-sectional data from the first national survey of Health, Wellbeing, and Aging study. Logistic regression models were used to examine the associations between participants’ demographic characteristics and fall-related injuries. Results. Of 5,227 participants with a mean age of 72.6 years, 11.4% (95% CI, 10.3%–12.7% reported a fall-related injury in Ecuador, representing an estimated 136,000 adults aged 60 years or older. Fall-related injuries were more frequently reported among older adults residing in the most urbanized and populated provinces of the country. After controlling for potential confounders, self-reported race as Indigenous (OR 2.2; 95% CI, 2.11–2.31, drinking alcohol regularly (OR 2.54; 95% CI, 2.46–2.63, subjects with greater number of comorbid conditions (OR 2.03; 95% CI, 1.97–2.08, and urinary incontinence (OR 1.83; 95% CI, 1.79–1.87 were factors independently associated with increased odds of sustaining fall-related injuries. Conclusions. Fall-related injuries represent a considerable burden for older adults in Ecuador. The present findings may assist public health authorities to implement fall prevention programs among subjects at higher risk for this type of injury.

Mapping of courses on vector biology and vector-borne diseases systems: time for a worldwide effort

Science.gov (United States)

Casas, Jérôme; Lazzari, Claudio; Insausti, Teresita; Launois, Pascal; Fouque, Florence

2016-01-01

Major emergency efforts are being mounted for each vector-borne disease epidemiological crisis anew, while knowledge about the biology of arthropods vectors is dwindling slowly but continuously, as is the number of field entomologists. The discrepancy between the rates of production of knowledge and its use and need for solving crises is widening, in particular due to the highly differing time spans of the two concurrent processes. A worldwide web based search using multiple key words and search engines of onsite and online courses in English, Spanish, Portuguese, French, Italian and German concerned with the biology of vectors identified over 140 courses. They are geographically and thematically scattered, the vast majority of them are on-site, with very few courses using the latest massive open online course (MOOC) powerfulness. Over two third of them is given in English and Western Africa is particularity poorly represented. The taxonomic groups covered are highly unbalanced towards mosquitoes. A worldwide unique portal to guide students of all grades and levels of expertise, in particular those in remote locations, is badly needed. This is the objective a new activity supported by the Special Programme for Research and Training in Tropical Diseases (TDR). PMID:27759770

Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women.

Science.gov (United States)

Afrin, Nadia; Honkanen, Risto; Koivumaa-Honkanen, Heli; Lukkala, Pyry; Rikkonen, Toni; Sirola, Joonas; Williams, Lana J; Kröger, Heikki

2016-09-01

To ascertain whether the risk of falls of different types is related to morbidity (number of chronic medical conditions) among postmenopausal women. This cohort study uses data from a population-based prospective cohort study (OSTPRE). The study population consisted of 10,594 women aged 47-56 years living in Kuopio Province, Eastern Finland, in 1989, who responded to postal enquiries at both baseline and 5-year follow-up, in 1994. Morbidity (i.e. number of diagnosed chronic medical conditions) was reported in 1989 and falls in 1994. Falls were categorized as slip or nonslip, and 'frequent falls' was defined as two or more in a 12-month period. The risk (odds ratio (OR) with 95% CI) of a fall increased with the number of chronic medical conditions. The OR was 1.28 (1.17-1.40) for those with 1-2 conditions and 1.41 (1.24-1.60) for those with multimorbidity (≥3 conditions) compared with healthy respondents. Multimorbidity was associated with a greater risk of the woman experiencing frequent nonslip falls (OR=2.57; 2.01-3.29) than frequent slip falls (OR=1.46; 1.17-1.80). Adjusting with logistic regression for age, number of medications and smoking did not affect the risk estimates. Multimorbidity has a much smaller effect on slip than on nonslip falls in postmenopausal women. This should be taken into account when investigating the effects of multimorbidity on fall risk in varying weather conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2016-01-01

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

Measurement of Charmless B to Vector-Vector decays at BaBar

International Nuclear Information System (INIS)

Olaiya, Emmanuel

2011-01-01

The authors present results of B → vector-vector (VV) and B → vector-axial vector (VA) decays B 0 → φX(X = φ,ρ + or ρ 0 ), B + → φK (*)+ , B 0 → K*K*, B 0 → ρ + b 1 - and B + → K* 0 α 1 + . The largest dataset used for these results is based on 465 x 10 6 Υ(4S) → B(bar B) decays, collected with the BABAR detector at the PEP-II B meson factory located at the Stanford Linear Accelerator Center (SLAC). Using larger datasets, the BABAR experiment has provided more precise B → VV measurements, further supporting the smaller than expected longitudinal polarization fraction of B → φK*. Additional B meson to vector-vector and vector-axial vector decays have also been studied with a view to shedding light on the polarization anomaly. Taking into account the available errors, we find no disagreement between theory and experiment for these additional decays.

The Impact of Fear of Falling on Functional Independence Among Older Adults Receiving Home Health Services

Directory of Open Access Journals (Sweden)

Katherine A. Lawson OTR, LMSSW, PhD

2014-07-01

Full Text Available Background: Falls are the fifth leading cause of death for adults aged 65 years and older. Several intrinsic and extrinsic fall risk factors have been identified, butthere is less understanding of the impact of a fear of falling on falls. Seventy percent of recent fallers and 40% percent of non-fallers report a fear of falling. Therefore, the purpose of this study was to examine the correlation between a fear of falling and a history of falls, as well as the impact on the functional independence of community-dwelling older adults receiving home health services. Methods: The participants completed the Falls Efficacy Scale, the Modified Timed Up and Go Test, self- reported fear of falling, and the KATZ ADL-staircase. The participants were primarily Hispanic females. Results: There was not a significant correlation between a fear of falling and a history of falls. Only participants' age, gender, and the number of medical diagnoses were predictive of past falls. There was a moderate correlation between impaired functional mobility and dependence with activities of daily living (ADL. Additionally, a fear of falling was associated with dependence to perform ADLs as measured objectively. Conclusion: Future studies need to examine the effectiveness of interventions that include dual-task challenges during therapeutic interventions and ADL retraining to reduce fall risk among older adults.

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

Science.gov (United States)

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

2018-03-01

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

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

Science.gov (United States)

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

2016-06-01

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

Predicting geriatric falls following an episode of emergency department care: a systematic review.

Science.gov (United States)

Carpenter, Christopher R; Avidan, Michael S; Wildes, Tanya; Stark, Susan; Fowler, Susan A; Lo, Alexander X

2014-10-01

Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor's accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the

Longitudinal Trends in Fall Accidents in Community Dwelling Korean Adults: The 2008?2013 Korean Community Health Survey

OpenAIRE

Hong, Ickpyo; Simpson, Annie N.; Logan, Sarah; Woo, Hee-Soon

2016-01-01

Objective To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. Methods We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. Results Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 10...

Issues in Geriatric Care: Falls.

Science.gov (United States)

Patel, Dipesh; Ackermann, Richard J

2018-05-01

One in three older adults falls each year. There are approximately 2.5 million falls among older adults treated in emergency departments. Falls account for 87% of all fractures in this age group. The biggest risk factor for falling is a history of falls. Other risk factors include frailty, sedative and anticholinergic drugs, polypharmacy, and a variety of medical conditions. Current recommendations are that all patients age 65 years and older should be asked about falls each year. Patients also can be screened for fall risk with a variety of approaches including questionnaires and the Timed Up & Go test. For patients who have fallen or are at risk, care should focus on correcting reversible home environmental factors that predispose to falls, minimizing the use of drugs with sedating properties, addressing vision conditions, recommending physical exercise (including balance, strength, and gait training), and managing postural hypotension as well as foot conditions and footwear. In addition, vitamin D and calcium supplementation should be considered. For patients needing anticoagulation for medical reasons, an assessment must balance fall risk (and thus bleeding from a fall) versus the risk of discontinuing anticoagulation (eg, sustaining an embolic stroke from atrial fibrillation). Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

A Decision Support System for Preventing Falls in Elderly People

Directory of Open Access Journals (Sweden)

Estelle Courtial

2015-12-01

Full Text Available Preventing falls in older people is a real challenge for Public Health. This paper addresses this issue by designing a decision support system which provides a fall risk index. The proposed approach is based on three selected tests (the Timed up and go (TUG, the 30s sit-to-stand and the 4-stage balance tests, which are widely used in the medical sector for assessing mobility and balance of the elderly. During the tests, a video records the older person performing the test and thanks to an image processing algorithm, kinematics and biomechanics parameters are extracted. Based on fuzzy logic, a decision support system fuses all these data and estimates a fall risk index according to the senior's age and gender. It can also assist the Health Professional in making improved medical diagnosis relied on targeted measurements. Simulation results drawing on experimental data of 12 older persons performing the TUG test illustrate the feasibility and the effectiveness of the proposed approach. Objectively assessing the senior's motor functions and the fall risk is possible in less than 10 minutes, at low cost and in an easy and non invasive way.

Falls self-efficacy and falls incidence in community-dwelling older people: the mediating role of coping.

Science.gov (United States)

Loft, Christine C; Jones, Fergal W; Kneebone, Ian I

2017-11-08

A cognitive behavioral model predicts that coping responses mediate the relationship between falls related psychological concerns and falls incidence, in community-dwelling older people. If empirical support could be found for this pathway then interventions could be developed to reduce falls risk by targeting coping strategies. Therefore, this study aimed to begin the process of testing whether coping responses mediate the association between falls self-efficacy (a principal element of falls related psychological concerns) and falls incidence, in community-dwelling older people. In a cross-sectional design, 160 community-dwelling older people (31 male, 129 female; mean age 83.47 years) completed the Falls Efficacy Scale-International, the Revised-Ways of Coping Questionnaire, the Turning to Religion subscale of the COPE, and a falls questionnaire. Data were analyzed via mediation analysis using a bootstrapping approach. Lower falls self-efficacy was associated with higher falls incidence, and more self-controlling coping was found to be a partial mediator of this association, with a confidence interval for the indirect effect of (0.003, 0.021) and an effect size of κ 2 = 0.035. The association was not mediated by the other measured coping responses; namely, turning to religion, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem-solving, and positive reappraisal. Self-controlling coping may mediate the association between falls self-efficacy and falling. If longitudinal studies confirm this finding then coping could be targeted in interventions to reduce falls.

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

Directory of Open Access Journals (Sweden)

Daniel K. Y. Chan

2008-10-01

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

Vectorization of KENO IV code and an estimate of vector-parallel processing

International Nuclear Information System (INIS)

Asai, Kiyoshi; Higuchi, Kenji; Katakura, Jun-ichi; Kurita, Yutaka.

1986-10-01

The multi-group criticality safety code KENO IV has been vectorized and tested on FACOM VP-100 vector processor. At first the vectorized KENO IV on a scalar processor became slower than the original one by a factor of 1.4 because of the overhead introduced by the vectorization. Making modifications of algorithms and techniques for vectorization, the vectorized version has become faster than the original one by a factor of 1.4 and 3.0 on the vector processor for sample problems of complex and simple geometries, respectively. For further speedup of the code, some improvements on compiler and hardware, especially on addition of Monte Carlo pipelines to the vector processor, are discussed. Finally a pipelined parallel processor system is proposed and its performance is estimated. (author)

Older Adults' Perspectives on Home Exercise after Falls Rehabilitation: Understanding the Importance of Promoting Healthy, Active Ageing

Science.gov (United States)

Hawley, Helen

2009-01-01

Objective To explore what might encourage older people to exercise at home after falls rehabilitation. Design: Qualitative research methods were used based on a grounded theory approach, to provide insights into older adults' experiences following a fall, of both rehabilitation and home exercise. Setting: Community dwellings. Method: Nine…

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

Science.gov (United States)

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

2016-08-01

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

Local dynamic stability and variability of gait are associated with fall history in elderly subjects.

Science.gov (United States)

Toebes, Marcel J P; Hoozemans, Marco J M; Furrer, Regula; Dekker, Joost; van Dieën, Jaap H

2012-07-01

Gait parameters that can be measured with simple instrumentation may hold promise for identifying individuals at risk of falling. Increased variability of gait is associated with increased risk of falling, but research on additional parameters indicates that local dynamic stability (LDS) of gait may also be a predictor of fall risk. The objective of the present study was to assess the association between gait variability, LDS of gait and fall history in a large sample of elderly subjects. Subjects were recruited and tested at a large national fair. One hundred and thirty four elderly, aged 50-75, who were able to walk without aids on a treadmill, agreed to participate. After subjects walked on a treadmill, LDS (higher values indicate more instability) and variability parameters were calculated from accelerometer signals (trunk worn). Fall history was obtained by self-report of falls in the past 12 months. Gait variability and short-term LDS were, individually and combined, positively associated with fall history. In conclusion, both increased gait variability and increased short-term LDS are possible risk factors for falling in the elderly. Copyright © 2012 Elsevier B.V. All rights reserved.

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2016-09-01

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

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Epidemiology of falls in older age.

Science.gov (United States)

Peel, Nancye May

2011-03-01

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

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

Science.gov (United States)

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

2018-04-01

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

Fall Prevention Hits Stumbling Blocks.

Science.gov (United States)

Huff, Charlotte

2018-03-01

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

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

Science.gov (United States)

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

2012-01-01

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

INST7150 - Advanced Topics in Learning Object Design and Reuse, Fall 2005

OpenAIRE

Wiley, David

2005-01-01

This course is designed to help you understand and apply advanced topics in the design, creation, and reuse of learning objects. The course is structured around a practical, hands-on project using learning objects, intermingled with readings and discussion on a variety of topics.

[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

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

Science.gov (United States)

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

2017-07-01

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

Chaotic Dynamics of Falling Disks: from Maxwell to Bar Tricks.

Science.gov (United States)

Field, Stuart

1998-03-01

Understanding the motion of flat objects falling in a viscous medium dates back to at least Newton and Maxwell, and is relevant to problems in meteorology, sedimentology, aerospace and chemical engineering, and nori/disks/pub.html>bar wagering strategies. Recent theoretical studies have emphasized the role played by deterministic chaos. Here we nori/falling.html>report(S. B. Field, M. Klaus, M. G. Moore, and F. Nori, Nature 388), 252 (1997) experimental observations and theoretical analysis of the dynamics of disks falling in water/glycerol mixtures. We find four distinct types of motion, and map out a ``phase diagram'' in the appropriate variables. The apparently complex behavior of the disks can be reduced to a series of one-dimensional maps which display a discontinuity at the crossover from periodic and chaotic motion. This discontinuity leads to an unusual intermittency transition between the two behaviors, which has not previously been observed experimentally in any system.

Versatile generation of optical vector fields and vector beams using a non-interferometric approach.

Science.gov (United States)

Tripathi, Santosh; Toussaint, Kimani C

2012-05-07

We present a versatile, non-interferometric method for generating vector fields and vector beams which can produce all the states of polarization represented on a higher-order Poincaré sphere. The versatility and non-interferometric nature of this method is expected to enable exploration of various exotic properties of vector fields and vector beams. To illustrate this, we study the propagation properties of some vector fields and find that, in general, propagation alters both their intensity and polarization distribution, and more interestingly, converts some vector fields into vector beams. In the article, we also suggest a modified Jones vector formalism to represent vector fields and vector beams.

Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument

NARCIS (Netherlands)

van Nieuwenhuizen, R.C.; van Dijk, N.; van Breda, F.G.; Scheffer, A.C.; Korevaar, J.C.; van der Cammen, T.J.; Lips, P.T.A.M.; Goslings, J.C.; Rooij, S.E.

2010-01-01

Objective: Falls in older people are a common presenting complaint. Knowledge of modifiable risk factors may lead to a more tailored approach to prevent recurrent falls and/or fractures. We investigated prevalence of 8 modifiable risk factors for recurrent falling and/or a serious consequence of the

Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument.

NARCIS (Netherlands)

Nieuwenhuizen, R.C. van; Dijk, N. van; Breda, F.G. van; Scheffer, A.C.; Korevaar, J.C.; Cammen, T.J. van der; Lips, P.; Goslings, J.C.; Rooij, S.E. de

2010-01-01

OBJECTIVE: Falls in older people are a common presenting complaint. Knowledge of modifiable risk factors may lead to a more tailored approach to prevent recurrent falls and/or fractures. We investigated prevalence of 8 modifiable risk factors for recurrent falling and/or a serious consequence of the

Identification of Elderly Falling Risk by Balance Tests Under Dual Tasks Conditions

Directory of Open Access Journals (Sweden)

Mohammad Ali Aslankhani

2010-03-01

Full Text Available Objectives: This study aimed to identify elderly fallers and non-fallers by balance test under dual tasks conditions. Methods & Materials: This study was an analyze-comparative study. Subjects were from three park of Tehran. Subjects were 20 older adults with outhistory of falls (aged 75.95±6.28 years and 21 older adults with a history of 2 or more falls in the previous one year (aged 72.50±7.31 Years . All subjects performed Timed Up & Go test under 3 conditions (TimedUp & Go, Timed Up & Go with numbers counter randomly [TUG cognitive], and Timed Up & Go while carrying a full cup of water [TUG manual]. A multivariate analysis of variance and logistic regression analyses were performed. Results: The results showed significant difference between elderly fallers and non fallers in fall risk composed dependent variable (P=0.0005, as the non fallers had greater score than the elderly fallers. Also, results showed that TUG cognitive has prediction capacity of elderly fall (P=0.013. Conclusion: Consequently, balance under cognitive dual task conditions could be useful method in identification of risk of falling and planning dual task exercise program and physiotherapy to preventfalls.

First Aid: Falls

Science.gov (United States)

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

Fall related hospital admissions among seniors in Poland in 2010.

Science.gov (United States)

Buczak-Stec, Elzbieta; Goryński, Paweł

2013-01-01

Falls among elderly people causing hospitalization are considered one of the most important public health problems. Our objective was to analyse fall related hospital admissions among seniors (> or = 65 years old) in Poland in 2010. The analyses were conducted with regard to gender, place of residence and age. Additionally, the health consequences of falls among elderly people were studied. Injuries and other consequences of external causes, were expressed in the form of three-character ICD-10 codes representing the underlying disease (S00-T98). Data on hospital admissions resulting from falls among seniors were obtained from the database held at the Department - Centre for Monitoring and Analyses of Population Health Status and Health Care System by the National Institute of Public Health - National Institute of Hygiene. Analysis has shown that the hospitalization ratio due to falls is much higher for women than for men. On average, 1 024 per 100 000 women are hospitalized due to a fall, while the number for men is 649. For every analysed age group women are at a higher risk of hospitalization due to a fall than men. In 2010 nearly 70% of hospital admissions of elderly people due to a fall were caused by a fall on the same level as a result of tripping or slipping (31 712 hospitalizations). No differences in relation to gender were observed. Risk of hospitalization due to a fall increases with age. For people over 80 years of age it is 2.5 times higher than for people in the 65-69 age group (1 459 and 570 per 100 000 respectively). It was observed that the length of hospital stay increases with age. There were no significant differences between the number of hospitalizations depending on the place of residence. The analysis showed that differences in the length of stay for women and men are statistically significant. However, there was no statistically significant difference between the lengths of stay depending on a place of residence. Almost one-third of

A sight on the current nanoparticle-based gene delivery vectors

Science.gov (United States)

Dizaj, Solmaz Maleki; Jafari, Samira; Khosroushahi, Ahmad Yari

2014-05-01

Nowadays, gene delivery for therapeutic objects is considered one of the most promising strategies to cure both the genetic and acquired diseases of human. The design of efficient gene delivery vectors possessing the high transfection efficiencies and low cytotoxicity is considered the major challenge for delivering a target gene to specific tissues or cells. On this base, the investigations on non-viral gene vectors with the ability to overcome physiological barriers are increasing. Among the non-viral vectors, nanoparticles showed remarkable properties regarding gene delivery such as the ability to target the specific tissue or cells, protect target gene against nuclease degradation, improve DNA stability, and increase the transformation efficiency or safety. This review attempts to represent a current nanoparticle based on its lipid, polymer, hybrid, and inorganic properties. Among them, hybrids, as efficient vectors, are utilized in gene delivery in terms of materials (synthetic or natural), design, and in vitro/ in vivo transformation efficiency.

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

Directory of Open Access Journals (Sweden)

Hill AM

2013-06-01

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

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

Science.gov (United States)

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

2008-06-01

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

Vectorized Monte Carlo

International Nuclear Information System (INIS)

Brown, F.B.

1981-01-01

Examination of the global algorithms and local kernels of conventional general-purpose Monte Carlo codes shows that multigroup Monte Carlo methods have sufficient structure to permit efficient vectorization. A structured multigroup Monte Carlo algorithm for vector computers is developed in which many particle events are treated at once on a cell-by-cell basis. Vectorization of kernels for tracking and variance reduction is described, and a new method for discrete sampling is developed to facilitate the vectorization of collision analysis. To demonstrate the potential of the new method, a vectorized Monte Carlo code for multigroup radiation transport analysis was developed. This code incorporates many features of conventional general-purpose production codes, including general geometry, splitting and Russian roulette, survival biasing, variance estimation via batching, a number of cutoffs, and generalized tallies of collision, tracklength, and surface crossing estimators with response functions. Predictions of vectorized performance characteristics for the CYBER-205 were made using emulated coding and a dynamic model of vector instruction timing. Computation rates were examined for a variety of test problems to determine sensitivities to batch size and vector lengths. Significant speedups are predicted for even a few hundred particles per batch, and asymptotic speedups by about 40 over equivalent Amdahl 470V/8 scalar codes arepredicted for a few thousand particles per batch. The principal conclusion is that vectorization of a general-purpose multigroup Monte Carlo code is well worth the significant effort required for stylized coding and major algorithmic changes

Indicators of sarcopenia and their relation to intrinsic and extrinsic factors relating to falls among active elderly women

OpenAIRE

Rossetin, Liliana Laura; Rodrigues, Elisangela Valevein; Gallo, Luiza Herminia; Macedo, Darla Silvério; Schieferdecker, Maria Eliana Madalozzo; Pintarelli, Vitor Last; Rabito, Estela Iraci; Gomes, Anna Raquel Silveira

2016-01-01

Abstract Introduction: Musculoskeletal aging can impair functional performance increasing the risk of falls. Objective: To analyze the correlation between sarcopenia and the intrinsic and extrinsic factors involved in falls among community-dwelling elderly women. Method: A cross-sectional study evaluated the number of falls of 85 active community-dwelling elderly women in the previous year and then divided them into two groups: non-fallers (n=61) and fallers (n=24). The sarcopenia indic...

Fall risk as a function of time after admission to sub-acute geriatric hospital units.

Science.gov (United States)

Rapp, Kilian; Ravindren, Johannes; Becker, Clemens; Lindemann, Ulrich; Jaensch, Andrea; Klenk, Jochen

2016-10-07

There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014. Falls, personal characteristics and functional status at admission were extracted from the hospital information system. The rehabilitation stay was divided in 3-day time-intervals. The fall rate was calculated for each time-interval in all patients combined and in subgroups of patients. To analyse the influence of covariates on fall risk over time multivariate negative binomial regression models were applied for each of 5 time-intervals. The overall fall rate was 10.2 falls/1,000 person-days with highest fall risks during the first week and decreasing risks within the following weeks. A particularly pronounced risk pattern with high fall risks during the first days and decreasing risks thereafter was observed in men, disoriented people, and people with a low functional status or impaired cognition. In disoriented patients, for example, the fall rate decreased from 24.6 falls/1,000 person-days in day 2-4 to about 13 falls/1,000 person-days 2 weeks later. The incidence rate ratio of baseline characteristics changed also over time. Fall risk differs considerably over time during sub-acute hospitalisation. The strongest association between time and fall risk was observed in functionally limited patients with high risks during the first days after admission and declining risks thereafter. This should be considered in the planning and application of fall prevention measures.

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

2008-01-01

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

Vector Network Coding

OpenAIRE

Ebrahimi, Javad; Fragouli, Christina

2010-01-01

We develop new algebraic algorithms for scalar and vector network coding. In vector network coding, the source multicasts information by transmitting vectors of length L, while intermediate nodes process and combine their incoming packets by multiplying them with L X L coding matrices that play a similar role as coding coefficients in scalar coding. Our algorithms for scalar network jointly optimize the employed field size while selecting the coding coefficients. Similarly, for vector co...

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

Science.gov (United States)

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

2017-10-17

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

Schools as Potential Risk Sites for Vector-Borne Disease Transmission: Mosquito Vectors in Rural Schools in Two Municipalities in Colombia.

Science.gov (United States)

Olano, Víctor Alberto; Matiz, María Inés; Lenhart, Audrey; Cabezas, Laura; Vargas, Sandra Lucía; Jaramillo, Juan Felipe; Sarmiento, Diana; Alexander, Neal; Stenström, Thor Axel; Overgaard, Hans J

2015-09-01

Dengue and other vector-borne diseases are of great public health importance in Colombia. Vector surveillance and control activities are often focused at the household level. Little is known about the importance of nonhousehold sites, including schools, in maintaining vector-borne disease transmission. The objectives of this paper were to determine the mosquito species composition in rural schools in 2 municipalities in Colombia and to assess the potential risk of vector-borne disease transmission in school settings. Entomological surveys were carried out in rural schools during the dry and rainy seasons of 2011. A total of 12 mosquito species were found: Aedes aegypti, Anopheles pseudopunctipennis, Culex coronator, Cx. quinquefasciatus, and Limatus durhamii in both immature and adult forms; Ae. fluviatilis, Cx. nigripalpus, Cx. corniger, and Psorophora ferox in immature forms only; and Ae. angustivittatus, Haemagogus equinus, and Trichoprosopon lampropus in adult forms only. The most common mosquito species was Cx. quinquefasciatus. Classrooms contained the greatest abundance of adult female Ae. aegypti and Cx. quinquefasciatus. The most common Ae. aegypti breeding sites were containers classified as "others" (e.g., cans), followed by containers used for water storage. A high level of Ae. aegypti infestation was found during the wet season. Our results suggest that rural schools are potentially important foci for the transmission of dengue and other mosquito-borne diseases. We propose that public health programs should be implemented in rural schools to prevent vector-borne diseases.

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

Science.gov (United States)

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

2005-07-01

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