scholarly journals A Survey for Ascertaining Details Related to Falls on Stairs or Escalators

2021 ◽  
Vol 9 (2) ◽  
pp. 50-57
Author(s):  
Deborah J Hilton
Keyword(s):  
High Risk ◽  
Fear Of Falling ◽  
Large Percentage ◽  
Train Station ◽  
Australian Institute ◽  
High Heels ◽  
Poor Lighting

Introduction: The Australian Institute of Health and Welfare, publication titled; ‘Injury in Australia: falls’ states that in 2017–18, 42% of hospitalized injury cases were due to falls, and 40% of injury deaths were due to falls. In Melbourne City, at various stations, there are extremely long escalators, and alarmingly, one sign previously displayed states there are approximately 2-3 falls/ week on train station escalators.Objectives: The aim of the survey was to ascertain the percentage of people who’ve fallen downstairs and escalators.Methods: Distribution of a general convenience survey [n=125] was performed to ascertain the percentage of people who’ve fallen downstairs and escalators. Additional questions related to rain, high-risk footwear, poor lighting, and how many falls they have had. Following that, regardless of whether or not they’d had a fall, questions then focused on whether they had a fear of falling and whether they felt uncomfortable around crowds on stairs or escalators.Results and Discussion: Completed survey forms were eighty-two in total. 29% of people had fallen, with 16% of those people indicating rain, 16% in either high heels or thongs, while 25% indicated poor visibility. Of those who had fallen, the estimate of the number of falls down stairs or escalators ranged from 1–20, with the average being three falls. 39% of respondents, irrespective of whether or not they had fallen, had fear, while 43% felt uncomfortable around crowds.Conclusion: Falls downstairs or escalators are relatively common, in addition to a large percentage of people having fear or feeling uncomfortable.

scholarly journals 24-Months Cluster-Randomized Intervention Trial of a Targeted Fall Prevention Program in a Primary Care Setting

2021 ◽  
Author(s):  
Christian Hentschke ◽  
Martin Halle ◽  
Barbara Geilhof ◽  
Peter Landendoerfer ◽  
Wolfgang Blank ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Fall Prevention ◽  
Care Setting ◽  
Primary Care Setting ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Risk Of Falling ◽  
Injurious Falls ◽  
Cluster Randomized

Abstract Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. Design and Setting In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Intervention and Measurements Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. Results After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). Conclusions In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.

Risky Business Revisited: White-Collar Crime and the Orange County Bankruptcy

1998 ◽  
Vol 44 (3) ◽  
pp. 367-387 ◽  
Author(s):  
Susan Will ◽  
Henry N. Pontell ◽  
Richard Cheung
Keyword(s):  
High Risk ◽  
Fear Of Falling ◽  
Orange County ◽  
White Collar Crime ◽  
White Collar ◽  
Financial Difficulties ◽  
Savings And Loan ◽  
Financial Scandals ◽  
Derivative Market ◽  
Risky Business

Orange County's bankruptcy is the largest governmental bankruptcy in U.S. history. Initial reports blamed the county's financial difficulties on the county treasurer's gambling with taxpayer dollars in the high-risk derivative market. This article forwards the argument that it was not simply “risky business” that caused the bankruptcy; rather, fraud and other forms of white-collar crime played a significant role in the $2 billion debacle. Using concepts and theories from the literature on white-collar crime and drawing comparisons with other financial scandals, most notably the savings and loan crisis, the authors argue that the financial downfall of Orange County was due to a “criminogenic environment” that allowed for concerted ignorance among officials who were motivated by a fear of falling from their positions of power.

scholarly journals Perceptions Related to Falls and Fall Prevention Among Hospitalized Adults

2015 ◽  
Vol 24 (5) ◽  
pp. e78-e85 ◽  
Author(s):  
Renee Samples Twibell ◽  
Debra Siela ◽  
Terrie Sproat ◽  
Gena Coers
Keyword(s):  
At Risk ◽  
High Risk ◽  
Risk Behaviors ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Adverse Outcomes ◽  
High Likelihood ◽  
High Risk Behaviors

Background Prevention of falls during hospitalization depends in part on the behaviors of alert patients to prevent falls. Research on acutely ill patients’ intentions to behave in ways that help prevent falls and on the patients’ perceptions related to falls is limited. Objective To explore hospitalized adults’ perceptions related to risk for falling, fear of falling, expectations of outcomes of falling, and intention to engage in behaviors to prevent falls. Methods Adult, alert, acutely ill inpatients (N = 158) at risk for falling completed a survey consisting of 4 scales and 3 single items. Nurses’ assessments and patients’ perceptions of the risk for falling were compared. Results Decreased intentions to engage in behaviors to prevent falls were correlated with patients’ increased confidence in their ability to perform high-risk behaviors without help and without falling (P < .001), decreased fear of falling (P < .001), and decreased perceived likelihood of adverse outcomes if they did fall (P < .001). Although nurses’ assessments indicated a risk for falls, 55.1% of the patients did not perceive a high likelihood of falling while hospitalized. Whereas 75% of patients intended to ask for help before getting out of bed, 48% were confident that they could get out of bed without help and without falling. Conclusions Although assessments may indicate a risk for falling, acutely ill inpatients may not perceive they are likely to fall. Patients’ intentions to engage in behaviors to prevent falls vary with the patients’ fall-related perceptions of confidence, outcomes, and fear related to falling.

scholarly journals Assessment of Risk Factors for Falls among Patients with Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jacek Wilczyński ◽  
Magdalena Ścipniak ◽  
Kacper Ścipniak ◽  
Kamil Margiel ◽  
Igor Wilczyński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
High Risk ◽  
Fear Of Falling ◽  
External Factors ◽  
Low Risk ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson’s disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson’s disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility ( χ 2 = 31.86 , p < 0.001 ), number of falls ( χ 2 = 37.92 , p < 0.001 ), independence of the subjects ( χ 2 = 19.28 , p < 0.001 ), type of injury suffered during the fall ( χ 2 = 36.93 , p < 0.001 ), external factors ( χ 2 = 33.36 , p < 0.001 ), and the level of fear of falling ( χ 2 = 8.88 , p < 0.001 ). A significant relationship also occurred between the number of falls and the fear of falling ( χ 2 = 33.49 , p < 0.001 ) and between the number of falls and disease severity ( χ 2 = 45.34 , p < 0.001 ). The applied physiotherapy did not reduce the risk of falls ( χ 2 = 3.18 , p = 0.17 ). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one’s path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.

scholarly journals THE RELATIONSHIP OF FRAILTY, FEAR OF FALLING, AND DEPRESSION WITH HRQOL IN HIGH-RISK OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S877-S877
Author(s):  
Michelle A McKay ◽  
Linda Copel ◽  
Catherine Todd-Magel
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
High Risk ◽  
Physical Functioning ◽  
Fear Of Falling ◽  
Well Being ◽  
Community Dwelling ◽  
Mental Functioning ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract One in four older adults fall every year. Falls result in negative outcomes including decreased health-related quality of life (HRQoL). Frailty, fear of falling, depression, and HRQoL are not routinely screened in high-risk community-dwelling older adults. Continued study of modifiable fall risk factors is warranted due to varied reported prevalence rates, inconsistent definitions and the persistent high rate of falls resulting in poor HRQoL. The purpose of the study was to determine the relationship between frailty, fear of falling, and depression with physical and mental functioning and well-being measures of HRQoL in community-dwelling older adults 55 years of age and older. A cross-sectional correlational design and chart review were conducted. The sample consisted of 84 primarily African American (81%) nursing home eligible members of the Program for All-Inclusive Care for the Elderly (PACE) program. Data were analyzed with correlational statistics, multiple linear, and hierarchical regression models. Physical functioning and well-being measures were significantly decreased when compared to the general population. Increased frailty, fear of falling, and depression were associated with decreased physical and mental well-being. In the regression model, frailty and fear of falling were significant predictors of decreased physical functioning and well-being, and depression was a significant predictor of decreased mental functioning and well-being. This study provides clarification of the relationship between frailty, fear of falling, and depression with HRQoL in high-risk older adults. Screening for common modifiable risk factors can assist in the development of targeted interventions and treatments to improve HRQoL in high-risk older adults.

Measuring fear of falling among high-risk, urban, community-dwelling older adults

2016 ◽  
Vol 37 (6) ◽  
pp. 489-495 ◽  
Author(s):  
Sherry A. Greenberg ◽  
Eileen Sullivan-Marx ◽  
Marilyn (Lynn) S. Sommers ◽  
Jesse Chittams ◽  
Pamela Z. Cacchione
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Fear Of Falling ◽  
Urban Community ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

Multidimensional risk score to stratify community-dwelling older adults by future fall risk using the Stopping Elderly Accidents, Deaths and Injuries (STEADI) framework

2020 ◽  
pp. injuryprev-2020-044014
Author(s):  
Brian C Helsel ◽  
Karen A Kemper ◽  
Joel E Williams ◽  
Khoa Truong ◽  
Marieke Van Puymbroeck
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Predictive Model ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Alternative Interpretation ◽  
Community Dwelling ◽  
Point Method ◽  
Risk Estimates ◽  
Stratification Method

BackgroundThe Stopping Elderly Accidents, Deaths and Injuries (STEADI) screening algorithm aligns with current fall prevention guidelines and is easy to administer within clinical practice. However, the stratification into low, moderate and high risk categories limits the meaningful interpretation of the fall-related risk factors.MethodsBaseline measures from a modified STEADI were used to predict self-reported falls over 4 years in 3170 respondents who participated in the 2011–2015 National Health and Aging Trends Study. A point method was then applied to find coefficient-based integers and 4-year fall risk estimates from the predictive model. Sensitivity and specificity estimates from the point method and the combined moderate and high fall risk STEADI categories were compared.ResultsThere were 886 (27.95%) and 387 (12.21%) respondents who were classified as moderate and high risk, respectively, when applying the stratification method. Falls in the past year (OR: 2.16; 95% CI: 1.61 to 2.89), multiple falls (OR: 2.94; 95% CI: 1.89 to 4.55) and a fear of falling (OR: 1.77; 95% CI: 1.45 to 2.16) were among the significant predictors of 4-year falls in older adults. The point method revealed integers that ranged from 0 (risk: 27.21%) to 44 (risk: 99.71%) and a score of 10 points had comparable discriminatory capacity to the combined moderate and high STEADI categories.ConclusionCoefficient-based integers and their risk estimates can provide an alternative interpretation of a predictive model that may be useful in determining fall risk within a clinical setting, tracking changes longitudinally and defining the effectiveness of an intervention.

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

2014 ◽  
Vol 27 (3) ◽  
pp. 379-387 ◽  
Author(s):  
Fabiana Satiko Fucahori ◽  
Anália Rosário Lopes ◽  
Juliana Jaqueline Aparecida Correia ◽  
Carolina Kruleske da Silva ◽  
Celita Salmaso Trelha
Keyword(s):  
High Risk ◽  
High Frequency ◽  
Fear Of Falling ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Activity Restriction ◽  
The City ◽  
Risk Potential

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.

scholarly journals Web-Based Telepresence Exercise Program for Community-Dwelling Elderly Women With a High Risk of Falling: Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Jeeyoung Hong ◽  
Hyoun-Joong Kong ◽  
Hyung-Jin Yoon
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Elderly Women ◽  
Fear Of Falling ◽  
Intervention Group ◽  
Exercise Program ◽  
The Elderly ◽  
Community Dwelling ◽  
Control Group ◽  
Risk Of Falling

BACKGROUND While physical exercise is known to help prevent falls in the elderly, bad weather and long distance between the home and place of exercise represent substantial deterrents for the elderly to join or continue attending exercise programs outside their residence. Conventional modalities for home exercise can be helpful but do not offer direct and prompt feedback to the participant, which minimizes the benefit. OBJECTIVE We aimed to develop an elderly-friendly telepresence exercise platform and to evaluate the effects of a 12-week telepresence exercise program on fall-related risk factors in community-dwelling elderly women with a high risk of falling. METHODS In total, 34 women aged 68-91 years with Fall Risk Assessment scores >14 and no medical contraindication to physical training-based therapy were recruited in person from a senior citizen center. The telepresence exercise platform included a 15-inch tablet computer, custom-made peer-to-peer video conferencing server system, and broadband Internet connectivity. The Web-based program included supervised resistance exercises performed using elastic resistance bands and balance exercise for 20-40 minutes a day, three times a week, for 12 weeks. During the telepresence exercise session, each participant in the intervention group was supervised remotely by a specialized instructor who provided feedback in real time. The women in the control group maintained their lifestyle without any intervention. Fall-related physical factors (body composition and physical function parameters) and psychological factors (Korean Falls Efficacy Scale score, Fear of Falling Questionnaire score) before and after the 12-week interventional period were examined in person by an exercise specialist blinded to the group allocation scheme. RESULTS Of the 30 women enrolled, 23 completed the study. Compared to women in the control group (n=13), those in the intervention group (n=10) showed significant improvements on the scores for the chair stand test (95% confidence interval -10.45 to -5.94, P<.001), Berg Balance Scale (95% confidence interval -2.31 to -0.28, P=.02), and Fear of Falling Questionnaire (95% confidence interval 0.69-3.5, P=.01). CONCLUSIONS The telepresence exercise program had positive effects on fall-related risk factors in community-dwelling elderly women with a high risk of falling. Elderly-friendly telepresence technology for home-based exercises can serve as an effective intervention to improve fall-related physical and psychological factors. CLINICALTRIAL Clinical Research Information Service KCT0002710; https://cris.nih.go.kr/cris/en/search/ search_result_st01.jsp?seq=11246 (Archived by WebCite at http://www.webcitation.org/6zdSUEsmb)

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