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Fall reduction

Diane K Brown, Sue Fosnight, Maureen Whitford, Susan Hazelett, Colleen Mcquown, Jenifer C Drost, Denise J Kropp, Cynthia A Hovland, Joan E Niederriter, Rikki Patton, Abigail Morgan, Eileen Fleming, Richard P Steiner, Edward Demond Scott, Fabiana Ortiz-Figueroa
Background: One in three people over the age of 65 fall every year, with 1/3 sustaining at least moderate injury. Falls risk reduction requires an interprofessional health team approach. The literature is lacking in effective models to teach students how to work collaboratively in interprofessional teams for geriatric falls prevention. The purpose of this paper is to describe the development, administration and outcome measures of an education programme to teach principles of interprofessional care for older adults in the context of falls prevention...
2018: BMJ Open Quality
Tasha Q Thompson, M Renee Bellinger, Sean M O'Rourke, Daniel J Prince, Alexander E Stevenson, Antonia T Rodrigues, Matthew R Sloat, Camilla F Speller, Dongya Y Yang, Virginia L Butler, Michael A Banks, Michael R Miller
Phenotypic variation is critical for the long-term persistence of species and populations. Anthropogenic activities have caused substantial shifts and reductions in phenotypic variation across diverse taxa, but the underlying mechanism(s) (i.e., phenotypic plasticity and/or genetic evolution) and long-term consequences (e.g., ability to recover phenotypic variation) are unclear. Here we investigate the widespread and dramatic changes in adult migration characteristics of wild Chinook salmon caused by dam construction and other anthropogenic activities...
December 4, 2018: Proceedings of the National Academy of Sciences of the United States of America
Danielle Munford, Hilary Gunn
PURPOSE: To explore the perceptions and experiences of people with stroke living in the community with regard to the perceived causes, impact and solutions to minimise falls. METHODS: A qualitative research approach underpinned by a constructivist paradigm utilising a phenomenological methodology. Twelve people with stroke participated in focus groups; the data were analysed using thematic analysis. RESULTS: Three themes and one foundation theme were identified...
December 4, 2018: Disability and Rehabilitation
Elissa Burton, Kaela Farrier, Gill Lewin, Mark Petrich, Eileen Boyle, Keith D Hill
PURPOSE: To review available evidence on older people's ability to get up off the floor independently and determine the effectiveness of interventions to improve older adults' ability to rise from the floor. MATERIALS AND METHODS: Seven databases were searched between January 1975 and June 2018. Eligibility criteria included: people aged ≥60; interventions to improve strength/function including ability to get up off the floor (for intervention studies); comparison groups (for randomized and nonrandomized controlled trials); outcome: quantitative or qualitative evaluation of ability to get up off the floor...
December 4, 2018: Disability and Rehabilitation
Resham Thapa, Steven B Mirsky, Katherine L Tully
Cover crops are well recognized as a tool to reduce NO leaching from agroecosystems. However, their effectiveness varies from site to site and year to year depending on soil, cash and cover crop management, and climate. We conducted a meta-analysis using 238 observations from 28 studies (i) to assess the overall effect of cover crops on NO leaching and subsequent crop yields, and (ii) to examine how soil, cash and cover crop management, and climate impact the effect of non-leguminous cover crops on NO leaching...
November 2018: Journal of Environmental Quality
Elizabeth A Phelan, Katherine Ritchey
Falls are common among older adults. One in 3 adults aged 65 years or older and 1 in 2 adults aged 80 years or older fall each year. Interventions for prevention have been identified; however, they are often not addressed in primary care practice. Screening all older adults annually for falls can identify who will benefit from further clinical evaluation and management. Falls and the need for care from subsequent injury increase with age. They adversely affect quality of life and are a financial burden on the health care industry...
December 4, 2018: Annals of Internal Medicine
Robert Howard, Elizabeth Cort, Rosie Bradley, Emma Harper, Linda Kelly, Peter Bentham, Craig Ritchie, Suzanne Reeves, Waleed Fawzi, Gill Livingston, Andrew Sommerlad, Sabu Oomman, Ejaz Nazir, Ramin Nilforooshan, Robert Barber, Chris Fox, Ajay Macharouthu, Pranathi Ramachandra, Vivek Pattan, John Sykes, Valerie Curran, Cornelius Katona, Tom Dening, Martin Knapp, Renee Romeo, Richard Gray
BACKGROUND: Very late-onset (aged ≥ 60 years) schizophrenia-like psychosis (VLOSLP) occurs frequently but no placebo-controlled, randomised trials have assessed the efficacy or risks of antipsychotic treatment. Most patients are not prescribed treatment. OBJECTIVES: The study investigated whether or not low-dose amisulpride is superior to placebo in reducing psychosis symptoms over 12 weeks and if any benefit is maintained by continuing treatment thereafter...
November 2018: Health Technology Assessment: HTA
Carlos J Padilla Colón, Irma L Molina-Vicenty, María Frontera-Rodríguez, Alejandra García-Ferré, Bernabejoel Ponce Rivera, Gerardo Cintrón-Vélez, Sebastián Frontera-Rodríguez
Aging is the result of different functional changes leading to a substantial reduction of all human capabilities. A variety of anatomical and physiological changes occur with advancing age. These changes are more evident in the elderly population. There are various methods to measure muscle and bone mass loss, but the dual X-ray absorptiometry (DXA) is considered one of the most efficient. The elderly population (65 years and older) has been increasing throughout the years. Loss of muscle mass (sarcopenia) and loss bone mass (osteopenia or osteoporosis) with advancing age, when untreated, represent a major public health problem for the elderly population and may result in loss of independence in later life...
2018: Journal of Biomedicine
P S Srilatha, Meenakshi Wadhwani, Rajpal Vohra, Varun Gogia, Satpal Garg, Veena Pandey
AIM: The aim of this study is to compare the efficacy of intravitreal bevacizumab and posterior subtenons triamcinolone acetate in the management of diffuse diabetic macular edema (DME) and to evaluate their efficacy as an adjunct to modified grid laser in management of DME. DESIGN: This was a prospective, randomized clinical trial of 30 patients. MATERIALS AND METHODS: A total of 30 patients attending the medical ophthalmology clinic at a tertiary care hospital were included in the study...
September 2018: Oman Journal of Ophthalmology
Changhong Wang, Rahul Goel, Hadi Rahemi, Qianzi Zhang, Brian Lepow, Bijan Najafi
BACKGROUND: Foot problems are prevalent in older adults, which may increase the risk and concern for falls. Ankle-foot orthoses (AFO) have been shown to be effective in the stabilization of lower extremities, but their long-term effectiveness in improving balance and their potential to encourage older adults to become more physically active are still debated. OBJECTIVE: This randomized controlled trial investigated the effectiveness of daily use of a custom-made AFO on balance, fear of falling, and physical activity in older adults...
November 30, 2018: Gerontology
M O Kinney, M O McCarron, J J Craig
PURPOSE: Epilepsy mortality is of considerable public health concern, as a leading cause of premature neurological death. Recent English and Welsh mortality data suggests a falling mortality rate where epilepsy was the underlying cause of death, predominantly due to a reduction in status epilepticus (SE) mortality. We sought to validate this finding in Northern Ireland. METHODS: Officially recorded death certificate data related to epilepsy and SE were obtained from the Northern Ireland statistics and research agency...
November 26, 2018: Seizure: the Journal of the British Epilepsy Association
Abdul Salam, Emily Atkins, Johan Sundström, Yoichiro Hirakawa, Dena Ettehad, Connor Emdin, Bruce Neal, Mark Woodward, John Chalmers, Eivind Berge, Salim Yusuf, Kazem Rahimi, Anthony Rodgers
OBJECTIVE: To assess the clinical relevance of regression to the mean for clinical trials and clinical practice. METHODS: MEDLINE was searched until February 2018 for randomized trials of BP lowering with over 1000 patient-years follow-up per group. We estimated baseline mean BP, follow-up mean (usual) BP amongst patients grouped by 10 mmHg strata of baseline BP, and assessed effects of BP lowering on coronary heart disease (CHD) and stroke according to these BP levels...
January 2019: Journal of Hypertension
Francesco Costa, Marco Valgimigli
Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is key for secondary prevention of recurrent coronary ischemic events and stent thrombosis. For this purpose, DAPT showed superior efficacy compared to aspirin alone, but it is also associated with an increased risk of major, and potentially fatal, bleeding. Hence, while secondary prevention with aspirin monotherapy is generally maintained for an indefinite period, the duration of DAPT after the index event is still debated. Multiple trials have challenged the guideline recommended standard of care of 12 months of DAPT duration...
October 2018: Cardiovascular Diagnosis and Therapy
Katherine Hyland, Kathryn Garber, Shoumita Dasgupta
Rapid advances in genomic technologies combined with drastic reductions in cost and a growing number of clinical genomic tests are transforming medical practice. While enthusiasm about applications of precision medicine is high, the existing clinical genetics workforce is insufficient to meet present demands and will fall increasingly short as the use of genetic and genomic testing becomes more routine. To address this shortage, physicians in all areas of medicine will require genomic literacy. Undergraduate medical students, therefore, need a solid foundation in genetics and genomics so they can apply genomic medicine across a range of specialties...
November 29, 2018: Personalized Medicine
Jasmine C Menant, Simon C Gandevia
Poliomyelitis, often termed "polio," is an acute infectious disease caused by an enterovirus which damages the anterior horn cells of the spinal cord and brainstem. Progress to lower motor neurone cell death leads to disruption of motor units and subsequent muscle weakness or complete paralysis. Although the virus is mostly eradicated from the Western world, postpolio decline is prevalent among people aged 60 years and over. It is characterized primarily by fatigability and muscle weakness, but pain is also common...
2018: Handbook of Clinical Neurology
Prue Morgan, Jennifer L McGinley
Cerebral palsy (CP) is a lifespan motor disorder arising from damage to the developing brain before or shortly after birth. People with CP may experience problems with muscle coordination and difficulties with the organization and processing of sensory information. Functional mobility is impaired and commonly influenced by spasticity and musculoskeletal system problems such as contractures or bony torsion. Around 60% of individuals with CP are able to walk independently or with aids when entering adulthood...
2018: Handbook of Clinical Neurology
Siva Srivastava Garika, Anshul Sharma, Abdul Razik, Akshima Sharma, Ravindra Mohan Pandey, Shivanand Gamanagatti, Rakesh Kumar, Ravi Mittal
BACKGROUND: F18-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) can be used to assess changes in the metabolism of an anterior cruciate ligament (ACL) graft as it is undergoing "ligamentization." Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the preferred modality for noninvasive assessment of graft structure and graft vascularity. PURPOSE: To compare the use of F18-FDG PET/CT and DCE-MRI to assess ligamentization within the ACL graft and correlate the results with clinical tests...
November 27, 2018: American Journal of Sports Medicine
Lauren Sall, R David Hayward, Mary M Fessler, Elango Edhayan
OBJECTIVE: Disparities in treatment outcomes for traumatic injury are an important concern for care providers and policy makers. Factors that may influence these disparities include differences in risk exposure based on neighbourhood of residence and differences in quality of care between hospitals in different areas. This study examines geographical disparities within a single region: the Detroit metropolitan area. DESIGN: Data on all trauma admissions between 2006 and 2014 were obtained from the Michigan State Inpatient Database...
November 25, 2018: BMJ Open
Giacomo Koch, Sonia Bonnì, Elias Paolo Casula, Marco Iosa, Stefano Paolucci, Maria Concetta Pellicciari, Alex Martino Cinnera, Viviana Ponzo, Michele Maiella, Silvia Picazio, Fabrizio Sallustio, Carlo Caltagirone
Importance: Gait and balance impairment is associated with poorer functional recovery after stroke. The cerebellum is known to be strongly implicated in the functional reorganization of motor networks in patients with stroke, especially for gait and balance functions. Objective: To determine whether cerebellar intermittent θ-burst stimulation (CRB-iTBS) can improve balance and gait functions in patients with hemiparesis due to stroke. Design, Setting, Participants: This randomized, double-blind, sham-controlled phase IIa trial investigated efficacy and safety of a 3-week treatment of CRB-iTBS coupled with physiotherapy in promoting gait and balance recovery in patients with stroke...
November 26, 2018: JAMA Neurology
Katelyn E Senkus, Libo Tan, Kristi M Crowe-White
Cardiometabolic risk factors increase the likelihood of cardiovascular disease development by 2-fold. Lycopene, a potent lipophilic antioxidant, may be able to mediate oxidative stress, a mechanism underpinning metabolic syndrome (MetS) and its risk factors. This is, to our knowledge, the first systematic review of the literature with the purpose of investigating the relation between circulating lycopene or dietary intake of lycopene and MetS as well as its risk factors. The review was conducted using PubMed and EBSCOhost databases with the search terms "lycopene" and "metabolic syndrome...
November 24, 2018: Advances in Nutrition
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