scholarly journals Falls prevention among older adults at a Nursing home in a northern suburban of Perth in Western Australia

2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Horatius Musembi Malilu ◽  
Deborah Sundin
Keyword(s):  
Older Adults ◽  
Falls Prevention ◽  
Residential Home ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Retrospective Audit ◽  
Walking Aids ◽  
Purposeful Sampling ◽  
Risk Of Falls

The objective was to identify factors leading to falls and determine the role of nurses and carers play in falls prevention. A retrospective audit of the performance of nurses and carers regarding falls prevention among older adults was used. Residents who had a fall during July 2015 (n=25) were identified using purposeful sampling. Data for this study were collected from the files of these residents. Data analysis was done by using the Fisher exact test which was appropriate for the collected data. Residents aged 85-89 years had the most falls (32%); however, one resident who fell five times in the studied month was aged 90 years. Residents aged 70-74 years had the lowest number of falls (8%). Twenty-two (88%) of the residents who fell were incontinent, 20 (80%) were confused, 19 (76%) were using walking aids and four (16%) were blind. Only five (20%) residents who reported falls in the studied month were independent. Most falls occurred among residents of advanced age, and among those who had incontinence, were confused and failed to use walking aids. Residential home staff should increase vigilance during specific times and monitors closely residents with a high risk of falls.

The Role of Podiatry in the Prevention of Falls in Older People

2013 ◽  
Vol 103 (6) ◽  
pp. 452-456 ◽  
Author(s):  
Bijan Najafi ◽  
Eling D. de Bruin ◽  
Neil D. Reeves ◽  
David G. Armstrong ◽  
Hylton B. Menz
Keyword(s):  
Older Adults ◽  
Surgical Intervention ◽  
Fear Of Falling ◽  
Falls Prevention ◽  
Foot And Ankle ◽  
Special Issue ◽  
Age Related ◽  
Risk Of Falls ◽  
Foot Problems

Given the age-related decline in foot strength and flexibility, and the emerging evidence that foot problems increase the risk of falls, established guidelines for falls prevention recommend that older adults have their feet examined by a podiatrist as a precautionary measure. However, these guidelines do not specify which intervention activities might be performed. Published in this special issue of JAPMA are nine high-quality articles, including seven original studies and two basic science reviews, focusing on the benefit and impact of footwear and foot and ankle interventions in reducing the risk of falling. The selected studies discuss various relevant questions related to podiatric intervention, including adherence to intervention; preference and perception of older adults in selecting footwear; benefit of insoles, footwear, and nonslip socks in preventing falls; fear of falling related to foot problems; benefit of podiatric surgical intervention; and benefit of foot and ankle exercise in preventing falls. (J Am Podiatr Med Assoc 103(6): 452–456, 2013)

Environmental Demands Associated With Community Mobility in Older Adults With and Without Mobility Disabilities

2002 ◽  
Vol 82 (7) ◽  
pp. 670-681 ◽  
Author(s):  
Anne Shumway-Cook ◽  
Aftab E Patla ◽  
Anita Stewart ◽  
Luigi Ferrucci ◽  
Marcia A Ciol ◽  
...  
Keyword(s):  
Older Adults ◽  
Weather Conditions ◽  
Grocery Store ◽  
Fisher Exact Test ◽  
Ambient Conditions ◽  
Mobility Disability ◽  
Exact Test ◽  
Mobility Function ◽  
Community Mobility ◽  
Trip Frequency

Abstract Background and Purpose. In this study, the influence of 8 dimensions of the physical environment on mobility in older adults with and without mobility disability was measured. This was done in order to identify environmental factors that contribute to mobility disability. Subjects. Subjects were 36 older adults (≥70 years of age) who were recruited from 2 geographic sites (Seattle, Wash, and Waterloo, Ontario, Canada) and were grouped according to level of mobility function (physically able [ability to walk ½ mile (0.8 km) or climb stairs without assistance], physically disabled). Methods. Subjects were observed and videotaped during 3 trips into the community (trip to grocery store, physician visit, recreational trip). Frequency of encounters with environmental features within each of the 8 dimensions was recorded. Differences in baseline characteristics and environmental encounters were analyzed using an analysis of variance or the Fisher exact test, as appropriate. Results. Mobility disability among older adults was not associated with a uniform decrease in encounters with environmental challenges across all dimensions. Environmental dimensions that differed between subjects who were physically able and those with physical disability included temporal factors, physical load, terrain, and postural transition. Dimensions that were not different included distance, density, ambient conditions (eg, light levels and weather conditions), and attentional demands. Discussion and Conclusion. Understanding the relationship of the environment to mobility is crucial to both prevention and rehabilitation of mobility disability in older adults. Among older adults, certain dimensions of the environment may disable community mobility more than others.

scholarly journals Manual tracking impairs postural stability in older adults

2017 ◽  
Vol 80 (9) ◽  
pp. 539-548
Author(s):  
Anna Rossiter ◽  
Matthew J Allsop ◽  
Rachael K Raw ◽  
Lindsay Howard ◽  
Raymond J Holt ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Postural Sway ◽  
Tracking Error ◽  
Task Demands ◽  
Falls Prevention ◽  
Cognitive Capacity ◽  
Risk Of Falls ◽  
The Relationship ◽  
Manual Performance

Introduction Older adults show increased postural sway and a greater risk of falls when completing activities with high cognitive demands. While dual-task approaches have clarified an association between cognitive processes and postural control, it is unclear how manual ability, which is also required for the successful completion of cognitively demanding tasks (such as putting a key into a lock), affects this relationship. Method Kinematic technology was used to explore the relationship between postural sway and manual control in healthy younger and older adults. Participants ( n = 82) remained standing to complete a visual-motor tracking task on a tablet computer. Root mean square tracking error measured manual performance, and a balance board measured deviations in centre of pressure as a marker of postural sway. Results Older adults displayed poorer manual accuracy and increased postural sway across all testing conditions. Conclusions Cognitive capacity can interact with multiple task demands, and in turn affect postural sway in older adults. Improving our understanding of factors that influence postural control will assist falls-prevention efforts and inform clinical practice.

scholarly journals Physical and Mental Health, Technology Use, and Loneliness in Older Adults During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 585-585
Author(s):  
Martha Coates ◽  
Zachary Hathaway ◽  
Katelyn Moore ◽  
Yaegin Park ◽  
Jenny Tsui ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Technology Use ◽  
Electronic Device ◽  
Community Dwelling ◽  
Retirement Community ◽  
Physical And Mental Health ◽  
Exact Test ◽  
Community Dwelling Older Adults

Abstract Social isolation is a negative outcome of COVID-19. This study examined patterns of physical and mental health and technology use in older adults, and loneliness during the COVID-19 pandemic. We recruited 115 community-dwelling older adults 65 and older (72% female) from the Pennsylvania region via Research Match (N=84) or from a retirement community (N=31). A significant association between loneliness and worsening of health during the pandemic was observed, Fisher’s Exact Test 6.90, p=.03. Those who were lonely demonstrated significantly lower Mental Component Summary Scores (M = 42.75, SD = 11.55) compared to those who were not lonely (M= 55.34, SD= 7.66), t(49) = 5.84, p <.01. Those reporting loneliness were more likely to use a new electronic device to communicate with family during COVID-19 pandemic, X2, (1, N= 107) = 6.24, p =.01. These findings suggest the important role of technology to decrease loneliness in older adults during a pandemic.

scholarly journals ´Feet are second class citizens`: exploring the perceptions of Scottish and Portuguese older adults about feet, falls and exercise- a qualitative study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Monserrat Conde ◽  
Gordon J. Hendry ◽  
Jim Woodburn ◽  
Dawn A. Skelton
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Qualitative Study ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Main Theme ◽  
Foot And Ankle ◽  
Falls Risk ◽  
Risk Factors For Falls

Abstract Introduction Foot problems are likely to contribute to falls risk in older adults. Foot and ankle exercises may be beneficial, but uptake may be influenced by cultural factors. Few studies have explored the views of older adults from different cultural backgrounds about foot-specific falls risk factors, and foot and ankle falls prevention exercises. Objectives To explore the views of Scottish and Portuguese community-dwelling older adults who have experienced a fall, about any foot risk factors for falls, and foot and ankle exercises. Methods Cross-cultural qualitative study with (n = 6) focus groups exploring the perceptions of Scottish (n = 10, mean age 76 yrs) and Portuguese older adults (n = 14, mean age 66 years) aged, applying thematic analysis. Results One main theme `evolving awareness about feet and falls prevention´ and three subthemes; (i) Feet are often forgotten, (ii) the important role of footwear, (iii) need to look at my feet and do the exercises were identified. Scottish participants had more experience of falls prevention but there was a lack of knowledge surrounding foot-specific falls risk factors, and the role of ankle and foot exercise in the prevention of falls. Portuguese participants exhibited a fatalistic approach to falls. Conclusions Older adults from both nations had little knowledge of foot-specific falls risk factors, being initially unaware of the functional status of their feet and of the role of exercise in foot care and falls management. There were differences between national groups that should be accounted for when developing culturally adequate interventions.

scholarly journals Anaplasma spp. in dairy ruminants in Jordan: high individual and herd-level seroprevalence and association with abortions

2019 ◽  
Vol 31 (3) ◽  
pp. 481-484 ◽  
Author(s):  
Mohammad M. Obaidat ◽  
Alaa E. Bani Salman
Keyword(s):  
Small Ruminants ◽  
Dairy Farms ◽  
Fisher Exact Test ◽  
High Seroprevalence ◽  
Exact Test ◽  
Sheep And Goats ◽  
Associated Risk Factors ◽  
The Individual ◽  
Apparently Healthy

We estimated the seroprevalence of, and associated risk factors for, anaplasmosis in dairy cows, sheep, and goats in all regions of Jordan. Apparently healthy animals from 135 farms (31 cow, 68 sheep, and 36 goat farms) were tested for Anaplasma spp. antibodies by a competitive ELISA. At the farm level, 36%, 94%, and 94% of cow, sheep, and goat farms, respectively, were seropositive for Anaplasma spp. At the individual animal level, 22%, 89%, and 82% of the tested cows, sheep, and goats, respectively, were seropositive, which demonstrates widespread and high seroprevalence of Anaplasma spp. in dairy farms in Jordan. Seroprevalence did not vary between regions. Using the Fisher exact test, there was a significant association between high seroprevalence and recent abortion in small ruminants. There is an urgent need for further investigation of this disease, and the potential role of Anaplasma spp. in abortions, on dairy farms in Jordan.

scholarly journals Walking Aids for Older Adults: Review of End-User Needs

2016 ◽  
Vol 12 (12) ◽  
pp. 109 ◽  
Author(s):  
Nazanin Mansouri ◽  
Khaled Goher
Keyword(s):  
Older Adults ◽  
Healthcare Services ◽  
Successful Implementation ◽  
Clear Understanding ◽  
Severe Injuries ◽  
Walking Aids ◽  
The World ◽  
Information And Communication ◽  
International Conventions

Aged population of senior citizens is growing noticeably at different regions in the world. Consequently, there are great numbers of demands for healthcare services. One of the services is assistive walking devices which have important role in mobility, stability, walking, and independency of older adults. Although various type of walking devices are available for older adults, yet fall incidents with severe injuries take place. Therefore, it is critical to analyze fall incidents, find out fall factors, and assess walking devices to minimize fall. This paper mainly focuses on risk factors of fall, considerable role of Information and Communication Technology (ICT) in walking devices, and also analyzes fall incidents with the purpose of understanding how fall incidents take place. This paper assists to have a clear understanding about fall incidents and its associated injuries.peration and its successful implementation will be the guarantor of justice and prevent impunity and escape the Probable criminals and suspects to countries far away from the crime scene. In the last two centuries globally in many countries have enacted expanded domestic law in the area of extradition to many extradition treaties and international conventions in this field has joined. Palermo Convention, including the most recent documents that contain comprehensive provisions on extradition and numerous countries has come to join in. In Iran in 1960 Legislator comprehensive and modern law in the area of extradition imposed And many international laws in this area has been invoked and respected. So, we gathered to view the article Ferraro circuit analysis on the world of law and the Palermo Convention and international law in the field of extradition elaborated on. The present article deals with these issues on two separate levels.

The Walking Ability in Healthy Older Adults: The Role of Aging and Physical Activity and Its Interface with Agility, Balance, Cognition, and Risk of Falls

2017 ◽  
pp. 73-90 ◽  
Author(s):  
Emerson Sebastião ◽  
Flávia Gomes de Melo Coelho ◽  
Carla Manuela Crispim Nascimento ◽  
Larissa Pires de Andrade ◽  
Jessica Rodrigues Pereira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Walking Ability ◽  
Healthy Older Adults ◽  
Risk Of Falls

Alterations of DNA damage response (DDR) genes correlate with favorable response and overall survival (OS) in anti-PD-1/PD-L1-treated advanced urothelial cancer (UC).

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 438-438 ◽  
Author(s):  
Monika Joshi ◽  
Petros Grivas ◽  
Amir Mortazavi ◽  
Paul Monk ◽  
Steven K. Clinton ◽  
...  
Keyword(s):  
Response Rate ◽  
Objective Response ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Cox Proportional Hazard ◽  
Platinum Based Chemotherapy ◽  
Tumor Mutational Burden ◽  
Cox Proportional Hazard Regression

438 Background: DDR gene alterations may contribute to higher tumor mutational burden (TMB) via genomic instability in addition to APOBEC mutagenesis. We previously showed that ATM mutations correlated with shorter OS in UC, while Teo et al. showed patients (pts) with DDR alterations benefited from PD-1/PD-L1 blockade in advanced UC. Here, we aimed to validate those findings and further explore the prognostic role of ATM mutations in advanced UC treated with anti-PD-1/PD-L1 agents. Methods: The study included 53 pts who had FoundationOne tumor tissue genomic sequencing and anti-PD-1/PD-L1 therapy. Fisher exact test was used to test difference in objective response rate (ORR). OS was measured from time of initial UC diagnosis and Cox proportional hazard regression analysis was performed to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: The cohort had a median age of 66 (range 21–81) with 34% females and 64.2% platinum-based chemotherapy. DDR alterations (including ATM) were present in 49.1% pts (26/53) and favored a higher ORR (37.5% vs. 23.1%, p = 0.26). Compared with those without DDR alterations, pts with DDR alterations (excluding ATM) seemed to have longer OS, although significance was not reached likely due to a short follow-up time (HR = 0.53, 95% CI 0.20–1.38, p = 0.19). ATM alterations seemed to favor higher response rate to PD-1/PD-L1 blockade (ORR, 40% vs. 28.9%, p = 0.6), but was associated with significantly shorter OS (HR = 5.7, 95% CI 1.65–19.74, p = 0.006) in overall pts and in subgroups with/without platinum-based chemotherapy (data not shown). Pts with ≥ 3 DDR alterations (including ATM) had substantial higher TMB (13.9–72.2 perMb, median 22.6) and benefited the most from PD-1/PD-L1 blockade with 80% ORR vs. 24.4% ORR in pts with < 3 DDR alterations. Conclusions: Our study supported that DDR alterations are associated with higher response rate and prolonged OS in advanced UC pts receiving anti-PD-1/PD-L1 agents, likely from impact on TMB. However, ATM alterations correlated with poor prognosis also in those pts. Further studies are needed to assess the clinical utility of DDR alterations in directing therapies in UC.

scholarly journals 12 Exploring Hospital Discharge as An Opportunity for Falls Prevention Exercise Referral

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
C Buckland ◽  
J Whitney
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Hospital Discharge ◽  
Behaviour Change ◽  
Fall Prevention ◽  
Falls Prevention ◽  
Good Opportunity ◽  
Risk Of Falls ◽  
Exercise Referral ◽  
Sustainability Model

Abstract Topic Proactive prevention is at the core of the NHS Long Term plan and falls prevention is an important public health priority. National guidance recommends that all health professionals have competence in falls assessment and prevention and advise that older adults at risk of falls are considered for strength and balance exercise. With rising numbers of older adults occupying inpatient beds, some clinicians may not have the skills to identify these opportunities to prevent falls. Previously, physiotherapy staff on a respiratory medicine ward were not delivering best practice in falls prevention. Aim Within 3 months, to achieve a 30% increase in older adults at risk of falls, being offered exercise referral at hospital discharge. Intervention Quality improvement methodology including stakeholder engagement and Plan-Do-Study-Act cycles were used to influence behaviour change amongst physiotherapy staff on a respiratory ward. Interventions included training and a documentation sticker. For evaluation, the weekly number of older adults at risk of falls with evidence of offer for falls prevention exercise was collected over 13 weeks and evaluated on a Statistical Process Control chart. Staff confidence scores and cohort data were also recorded and described using descriptive statistics. The NHS Improvement Sustainability Model was used to measure project sustainability. Improvement At baseline, 0/18 (0%) older adults had an offer for fall prevention exercise. Over the intervention period, this increased to 22/37 (59.5%) and demonstrated special cause variation that was confidently assigned to the interventions. There was a 44.5% improvement in staff confidence in offering fall prevention exercise. The project scored 53.7% using the NHS sustainability model. Discussion This project demonstrated favourable behaviour change in falls prevention practice amongst physiotherapy staff on a respiratory ward. There was variability in the improvement possibly as a result of contextual influences of staffing and seasonality. Hospital discharge is a good opportunity to assess falls risk in older adults and offer information and referral for exercise. Wider implementation may be useful to help older adults optimise health outcomes but will depend on organisational stakeholder support to improve sustainability.

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