Thesis (Ph. D.)--Ohio State University, 2008. / Title from first page of PDF file. Includes bibliographical references (p. 209-216).

Background: The support of intersections in coal mines is an important safety issue in the U.S., as intersections are by far the most common area for unplanned falls of ground. A relatively comprehensive, nation-wide study of falls of ground is coupled with a national survey to mines about their support methods to determine common characteristics of failure and recommend changes to improve stability, and recommendations for future research. Methods: Over 600 fall of ground reports were collected from nine of the 11 Mine Safety and Health Administration (MSHA) District offices, and data was compiled to determine common characteristics of these unplanned falls. Statistical analysis was conducted on the data to examine which variables affected fall dimensions. To obtain data on current support usage, mail and phone surveys were collected with responses from 70 underground coal mines, representing approximately 235 million tons of annual production, or 66% of the U.S. total. These surveys provided a national snapshot of what support mines are using as well as typical extraction height, intersection width, and other details. Rocscience's Phase2 software was used to model a typical coal mine intersection and examine possible stability changes with different support options. Results: Surveys from underground mines revealed that the current industry average for intersection width is 20ft, average bolt length is 6ft, average distance from pillars to the first row of bolts is 3 to 4 ft, and a great majority of mines do not angle bolts over pillars. The fall of ground study confirmed that most falls are thicker than the average bolt length of 6 ft. and tend to be massive, extending past the intersection width of 20ft. The study also showed that falls with longer roof bolts installed typically had thicker falls which broke above the anchorage zone. Statistical analysis found a few questionably significant interactions, with the most prominent being the effect of roof type on fall height. Immediate roof geologies of dark shale and thinly laminated shale resulted in higher roof falls than other types. 2D modeling was unsuccessful at replicating the type of massive shear failures that have been commented on by MSHA personnel and that the study data suggests. It is the author's opinion that Phase2 and 2-D modeling in general may not be powerful or comprehensive enough to capture the true shear behavior of the rock strata in the roof beam because it cannot effectively model failure and dilation. Conclusions: Increasing bolt length may not be the most effective solution to reducing massive intersection failures. Rather, installing angled bolts over pillars may increase the strength of the system at the crucial roof-pillar edge. Weathering of bolts and/or rock are likely contributing to the significant number of cutter failures happening months or years after excavation. Recommendations for future action include 3D modeling of cutter failure and benefits of angled bolts over pillars. More consistent and thorough MSHA 7000 50a forms will enable more accurate statistical analysis and a better understanding of massive failure characteristics.

Falls can have severe consequences for elderly adults. In 2000, nearly 10,300 people aged 65 years or older died as a result of falls, and 2.6 million individuals were treated for non-fatal fall-related injuries. In order to reduce fall incidences, it is important to identify possible causes of falls, such as muscle weakness and imbalance. In this study, we examined balance control in the elderly during task transitions while performing the Timed Up and Go test (TUG). The TUG is a commonly used clinical balance test that includes transition phases between three daily activity tasks: sit-to-stand, walking and turning. Our findings suggested that elderly adults, especially fallers, have reduced balance control ability while making transitions during TUG. During sit-to-walk (STW), when compared to young adults, elderly adults demonstrated a smaller forward center of mass (COM) velocity, a smaller anterior-posterior (A-P) COM-Ankle angle, and a larger upward kinetic energy ratio at seat-off. Additionally, the medial-lateral COM control in elderly fallers was also perturbed due to their significant reduction in forward COM velocity. The reduced initial hip extensor moment and increased ankle plantarflexor moment in elderly fallers was associated with their reduced generation of horizontal momentum during STW. Smaller A-P COM-Ankle angles and taking more steps when making a turn demonstrated a reduction in balance control ability in elderly adults. Our analyses suggest that balance control is an important factor contributing to longer STW and turning durations of TUG. Furthermore, lower extremity muscle strength at hip and knee joints demonstrated a stronger association with STW than turning duration. To enhance the early detection of fall risk, we also assessed the ability of balance tests to predict future risk of falling in elderly adults. Our results indicated that biomechanical balance parameters measured during TUG were associated with future fall status. Among all biomechanical parameters investigated, frontal plane balance control parameters appear to be the most significant predictors for future falls. This dissertation includes unpublished co-authored material.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A ocorrÃncia de quedas constitui sÃrio problema de saÃde em idade mais avanÃada. Dessa forma, os fatores envolvidos devem ser continuamente avaliados com vistas à melhoria da qualidade de vida do idoso. Teve-se como objetivo investigar as circunstÃncias de ocorrÃncia das quedas nos Ãltimos seis meses em idosos com e sem AVE, assim como os fatores intrÃnsecos e extrÃnsecos a eles relacionados. Estudo do tipo caso-controle, realizado em trÃs AssociaÃÃes Beneficentes Cearenses de ReabilitaÃÃo e um Centro de ReferÃncia da AssistÃncia Social na cidade de Fortaleza no perÃodo de janeiro a abril de 2010. Estabeleceram-se um grupo caso e trÃs grupos controles, cada um com quinze idosos, pareados por idade e sexo, com base na ocorrÃncia ou nÃo de quedas nos Ãltimos seis meses e de acidente vascular encefÃlico. Utilizou-se um formulÃrio organizado em quatro partes para a caracterizaÃÃo do paciente, condiÃÃes intrÃnsecas e extrÃnsecas atuais, ocorrÃncia de quedas e fatores ambientais envolvidos. Com a aprovaÃÃo por Comità de Ãtica em Pesquisa, a coleta de dados ocorreu no dia em que o idoso se encontrava na unidade, apÃs esclarecimento dos objetivos e assinatura do Termo de Consentimento Livre e Esclarecido. Os dados obtidos foram analisados pelo Predictive Analysis Software 18.0. Em sua maioria, os grupos foram formados por mulheres, aposentados, com companheiro, baixa renda per capita e escolaridade. Os idosos tiveram uma mÃdia de 1,4 AVE, em um tempo mÃdio de 5,6 anos e hemiparesia como principal sequela. Quanto Ãs variÃveis com associaÃÃo estatÃstica, destacaram-se: Uso de anti-hipertensivos entre os grupos que sofreram quedas independente de ocorrÃncia de AVE; Uso de inibidores da ECA no caso de idosos com AVE com ou sem quedas; AlteraÃÃes nos pÃs entre o grupo caso e indivÃduos sem queda e sem AVE. Com relaÃÃo Ãs variÃveis ForÃa diminuÃda em membros inferiores, Excesso de mÃveis em casa, Dificuldade na marcha e Mobilidade fÃsica prejudicada, encontrou-se associaÃÃo em todos os casos entre o grupo de indivÃduos com AVE e quedas e aqueles sem AVE e sem quedas. Dificuldade na marcha e Mobilidade fÃsica prejudicada tambÃm estiveram estatisticamente associadas entre o grupo caso e indivÃduos sem AVE e com relato de quedas. As variÃveis Ãndice de Barthel, Atividades Instrumentais de Vida DiÃria, Escala GeriÃtrica e de Tinetti, alÃm de ForÃa de preensÃo palmar direita tambÃm apresentaram associaÃÃo estatÃstica entre o grupo caso de indivÃduos com AVE e quedas e aqueles sem AVE, com ou sem quedas. As quedas aconteceram predominantemente no perÃodo da manhÃ, em ambiente iluminado, sem corrimÃo ou objetos, com piso Ãspero e seco, uso de chinelo com solado de borracha. NÃo se constatou ser o AVE um evento associado Ãs quedas, fortalecendo a relaÃÃo causal multifatorial. As variÃveis envolvidas com o evento queda estiveram fortemente relacionadas aos fatores intrÃnsecos envolvidos com o equilÃbrio. Os fatores extrÃnsecos, contudo, podem ser os mais facilmente modificÃveis. Nesse Ãmbito, os profissionais de saÃde devem avaliar rotineiramente todas as variÃveis envolvidas com o evento queda, no intuito de melhorar a qualidade de vida desses indivÃduos. / The falls occurrence represents a serious health problem for aged. Therefore the factors involved must be continuous assess in order to improve the aged life quality. The aim was to investigate the falls occurrence in the last six months at elderly with and without stroke and to identify the intrinsic and extrinsic factors involved. A case-control study carried at three Beneficent Associations of Rehabilitation from Cearà and a Reference Center of Social Worker in Fortaleza city from January to April 2010. A case group and three control groups were established with 15 elderly paired off by sex, age, falls occurrence in the last six months and stroke occurrence. It was used a form organized in four parts with the objective to characterize the patient, actual intrinsic and extrinsic conditions, falls occurrence and environment factors involved. The data were gathered with the Research Ethical Committee approval and when the elderly were enlightened at the collected data unit about the aim of the research, and the patient signing of authorization term. The data obtained was analyzed by Predictive Analysis Software 18.0. The groups were mainly composed by women, retired people, persons with partners, low school grade and low financial income. The elderly with stroke presented an average of 1,4 occurrence in an average period of 5,6 years and the main consequence was hemiparesis. As far as statistical associated variables concern, the followings were here highlighted: Use of antihypertensive among the groups with falls despite the occurrence of a stroke; Use of ACE inhibitor at aged with stroke whom were fallers or not; Foot alterations between the case group and people without falls neither stroke. Besides the variables Decreased strength at lower members, excess of home furniture, Gait difficulty and Impaired physical mobility was found in all association among the fallers participants with stroke and those without stroke neither falls. Gait difficulty and Impaired physical mobility were statistically associated between the case group and people without stroke and fall occurrence. The Barthel index, daily instrumental life activities, Geriatric scale and Tinetti scale, besides right hand grip strength, also found statistical association between the case group and aged without stroke fallers or not. The falls occurred mostly in the morning, in bright environment without handrail or objects, in rough and dry floor, use of rubber slippers. It was not verified to be the stroke an event associated to falls, a fact that strengthens the multifarious cause relation. The variables involved with fall event were strongly related to intrinsic factors involved with the balance issue. The extrinsic factors, however, could be easily modified. Therefore health professionals should routinely assess all fall variables involved in order to improve the life quality of elderly people.

Orientador: Arlene Maria Valente Coimbra / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T22:44:35Z (GMT). No. of bitstreams: 1 Montedori_KedmaTeixeira_M.pdf: 1883080 bytes, checksum: 5a9d1864fd5aa1f9ce7426274dea1238 (MD5) Previous issue date: 2012 / Resumo: O medo de cair entre idosos tem recebido destaque como um potencial problema de saúde pública, de importância equivalente a uma queda. O grande interesse no entendimento desse fenômeno se dá principalmente pelas conseqüências negativas que esse pode acarretar. O medo de cair representa uma condição multifatorial, responsável pela restrição de atividades e limitação funcional. O presente estudo, na área da saúde e qualidade de vida na velhice, tem em sua composição dois artigos que investigam o medo de cair em duas populações distintas. O objetivo do artigo um foi identificar os fatores associados ao medo de cair em idosos de comunidade. Tratou-se de um estudo transversal, epidemiológico cuja amostra aleatória foi constituída por 2209 idosos, com idade igual ou superior a 60 anos. Sendo (39,67%) homens e (69,33%) mulheres. Os resultados encontrados foram: 72% dos idosos apresentaram medo de cair, 68,59% dos idosos sem histórico de quedas no último ano, apresentaram medo de cair, 85,92% dos idosos que não praticavam Atividade Física Vigorosa (AFV) apresentaram medo de cair. Os fatores de associação ao medo de cair foi composto das variáveis: sexo feminino (p <0,001; OR=2,59 95% IC 2,07-3,23), depressão Escala de Depressão Geriatrica(EDG) (p <0,001; OR=2,12 95% IC 1,56-2,88), AFV (p <0,001; OR=1,90 95% IC 1,47-2,46), necessidade de hospitalização durante o ano anterior (p=0,006; OR=1,41 95% IC 1,12-1,79), maior número de pessoas dependentes (p=0,008; OR=,905 95% IC 0,839-0,975), saúde percebida atual - ruim ou muito ruim (p=0,005; OR=2,212 95% IC 1,25-3,59), quedas no último ano (p=0,02; OR=1,34 95% IC 1,04-1,74). O objetivo do artigo dois foi identificar a influência dos parâmetros de medidas na avaliação do medo de cair e o impacto destes no equilíbrio estático, dinâmico e funcional . Esse foi um estudo transversal observacional com amostra de conveniência, composta por 147 mulheres com 60 anos e mais. A coleta de dados foi feita de maneira cega, tanto na fase de recrutamento quanto na fase da entrevista. Os resultados encontrados foram: a prevalência do medo de cair variou de 78,77 a 96,58%, a idade média foi de 74,93 ± 8,32 anos e a média de comorbidades foi de 3,50 ± 1,59 comorbidades. Houve relação de significância na comparação do medo de cair (pergunta direta) e Berg Balance Scale (BBS) (p=0,025), e medo de cair Falls Eficacy Scole -Internacional - Brasil (FES-I-Brasil) com Timed Up and Go (TUG) (p=0,012). A correlação do medo de cair (0-10) foi estatisticamente significante com TUG (p=0,0175) e BBS (p=0,042) e a correlação do medo de cair (escore total FES-I-Brasil) foi significante para TUG (p<0,001), BBS (p<0,001) e estabilometria (categoria pé direito à frente x) (p=0,045). A partir do modelo univariado, a variável escore total da FES-I-Brasil foi significativamente associada ao equilíbrio dinâmico (TUG) (p<0,001; OR1,088 95% IC 1.045-1.118) e ao equilíbrio funcional (BBS) (p<0,001; OR=1.066 95% IC 1.028-1.104) e a varível medo de cair (0-10) foi estatisticamente associada ao equilíbrio dinâmico (TUG)(p=0.014; OR=1,126 95% IC 1.024 - 1.128) . Pelos resultados da análise multivariada, o escore total da FES-I-BRASIL foi selecionado como sendo significativamente associada ao pior equilíbrio dinâmico (TUG) (p<0,001; OR=1,088) e pior equilíbrio funcional (BBS) (p<0,001; OR=1,071 95% IC 1.031 - 1.113). Conclui-se que os aspectos relacionados ao processo do envelhecimento predispõem à manifestação do medo de cair, bem como a medida escolhida para avaliar esse medo influencia nas conseqüências relativas ao equilíbrio / Abstract: The fear of falling among the elderly has received attention as a potential public health problem of comparable importance to a fall. The great interest in understanding this phenomenon is caused mainly by the negative consequences that may result. Fear of falling is a multifactorial condition responsible for the restricted activity and functional limitation. This study, in the health and quality of life in old age, has in its composition two articles that investigate the fear of falling into two distinct populations. The aim of this paper was to outline a model predictive of fear of falling through the related factors in the elderly community. It was a cross-sectional, epidemiological whose random sample consisted of 2209 individuals aged less than 60 years. As (39.67%) and men (69.33%) women. The results were: 72% of elderly people showed fear of falling, 68.59% of the elderly without a history of falls in the last year, showed fear of falling, 85.92% of the elderly who did not engage in vigorous physical activity (AFV) were afraid of falling. The predictive model of fear of falling was composed of variables: female sex (p <0.001, OR = 2.59 95% CI 2.07 to 3.23), depression (GDS) (p <0.001, OR = 2.12 95% CI 1.56 to 2.88), AFV (p <0.001, OR = 1.90 95% CI 1.47 to 2.46), need for hospitalization during the previous year (p = 0.006, OR = 1 , 41 95% CI 1.12 to 1.79), greater number of dependents (p = 0.008, OR = 905 95% CI 0.839 to 0.975), perceived health today - bad or very bad (p = 0.005, OR = 2.212 95% CI 1.25 to 3.59), falls in the past year (p = 0.02, OR = 1.34 95% CI 1.04 to 1.74). Article 2 The aim was to identify the influence of measurement parameters in the assessment of fear of falling and the impact of static balance, dynamic and functional. This was an observational cross-sectional study with a convenience sample composed of 147 women aged 60 and over. Data collection was done blindly, both at recruitment and during the interview. The results were: the prevalence of fear of falling ranged from 78.77 to 96.58%, the mean age was 74.93 ± 8.32 years and mean comorbidity was 3.50 ± 1.59 comorbidities. There was significant relationship to compare the fear of falling (direct question) and BBS (p = 0.025), and fear of falling Falls Eficacy Scale - Internacional - Brasil (FES-I-Brazil), TUG (p = 0.012). The correlation between fear of falling (0-10) was statistically significant with Timed Up Go (TUG) (p = 0.0175) and Berg Balance Scale (BBS) (p = 0.042) and the correlation of fear of falling (FES-I total score, Brazil) was significant for TUG ( p <0.001), BBS (p <0.001) and stabilometry (category right foot x) (p = 0.045). From the univariate model, the variable total score of the FES-I-Brazil was significantly associated with the dynamic balance (TUG) (p <0.001; OR1, 088 95% CI 1045-1118) and the functional balance (BBS) (p < 0.001, OR = 1,066 95% CI 1028-1104) and varível fear of falling (0-10) was statistically associated with the dynamic balance (TUG) (p = 0.014, OR = 1.126 95% CI 1024 to 1128). The results of the multivariate analysis, the total score of the FES-I-BRAZIL has been selected as being significantly associated with worse dynamic balance (TUG) (p <0.001, OR = 1.088) and worse functional balance (BBS) (p <0.001, OR 95% CI = 1.071 from 1031 to 1113). We conclude that the aspects related to the aging process predispose the manifestation of fear of falling, and the measure chosen to evaluate the consequences that fear influences on the balance / Mestrado / Gerontologia / Mestre em Gerontologia

Class of 2012 Abstract / Specific Aims: The purpose of this study was to test an interactive educational program for older adults on preventing accidental falls. Methods: This was a prospective, descriptive study evaluating the helpfulness of an interactive educational program. English speaking residents were recruited from five independent senior living communities in Arizona. The intervention consisted of a 30-minute interactive PowerPoint presentation followed by a 10-minute question and answer session. Information provided during the presentation focused on information from the CDC and the Fall Prevention Center of Excellence. Participants completed an anonymous questionnaire to rate the helpfulness of the program. The primary dependent variable was overall helpfulness of the educational session. Other variables included: intention of changing future behavior related to preventing falls, whether participants would recommend the program to others, participant perception of gained knowledge, change in fear of falling, and interest in meeting with pharmacist to discuss medications. Categorical data was analyzed by calculating frequencies and percentages and continuous data by calculating means and SDs. A t-test for independent groups was used to compare men and women. Main Results: A total of 93 individuals attended the presentations. Out of 81 completed surveys, 5 did not indicate gender, 7 additional did not indicate age, and 6 were over 89 years of age. Demographic data for the men and women was similar. 90% of participants indicated that the program was either "very helpful" or "moderately helpful". 92% of participants responded “absolutely yes” or “likely” that they would recommend the program. No participants strongly disagreed that they had a better understanding of fall risks or medications that increase fall risk. 87% of participants responded “absolutely yes” or “likely” that they plan to increase daily exercise . 42% of participants said it was “not likely” that they plan to make changes in their living environment. Conclusions: An interactive educational program on fall safety and prevention is helpful for older adults. As one of the most widely accessible health care providers, pharmacists and pharmacy students are well suited to provide patient education and improve outcomes. The results of this study provide preliminary data supporting the usefulness of a patient education program on fall safety prevention administered by pharmacy students.

No description available.

Clinical relevance: Mobility and fall risk may be important considerations in choosing between intraocular lenses. Background: Fall risk in older adults increases when wearing multifocal spectacles, but little is known about mobility among individuals with different types of intraocular lenses. This study compared visual function, fall risk and balance control following bilateral implantation of monofocal or multifocal intraocular lenses. Methods: This was a non-randomised, cross-sectional study involving adults with bilateral intraocular lenses. Participants completed questionnaires concerning physical functioning, fall history and balance-related confidence. Binocular visual acuity, contrast sensitivity (Pelli-Robson chart and computerized testing), depth perception and glare sensitivity were assessed. Physical performance measures included the Sensory Organization Test, preferred gait speed, Dynamic Gait Index and wayfinding in a virtual environment. Results: Fifteen participants (mean ± standard deviation, 67.1 ± 6.8 years) had monofocal intraocular lenses and 14 participants (68.1 ± 6.1 years) had multifocal intraocular lenses. Contrast sensitivity in the monofocal group was significantly better than that in the multifocal group (p = 0.02) at intermediate and high spatial frequencies. Contrast sensitivity of the monofocal group also was less affected by glare than the contrast sensitivity of the multifocal group, at an intermediate spatial frequency (p = 0.02). However, the multifocal group had significantly better Dynamic Gait Index scores (p = 0.04), even after controlling for perceived physical function. Conclusions: The participants with monofocal intraocular lenses generally had better contrast sensitivity than did those with multifocal intraocular lenses. However, the scores on a mobility test that is associated with fall risk were worse for those with monofocal lenses.

No description available.

The biomechanics of slips are commonly studied in laboratory settings in an effort to improve the understanding of slip mechanisms for the advancement of slip and fall prevention strategies and risk assessment methods.  Prior studies have shown changes in gait after slipping, and these changes can reduce the external validity of experimental results.  As such, most researchers only slip participants one time.  The ability to slip participants more than once, after allowing gait to return to a natural baseline, would improve the experimental efficiency of these studies.  Therefore, the goal of this study was to determine the time duration of slip-induced changes in gait. The required coefficient of friction (RCOF), a parameter highly predictive of risk of slipping, was measured on thirty-one young male adults during level gait on three separate days before slipping, immediately (<10 minutes) after slipping, and either one, two, four, or six weeks later.  On average, the RCOF decreased 12% from its baseline value (0.20) after slipping, indicating the adoption of a protective gait with a decreased risk of slipping.  The RCOF data trended toward baseline values 4-6 weeks after the slip experience, but remained statistically different from baseline.  This indicates that the slip-induced gait alterations have long-lasting effects, enduring up to six weeks after the slip experience. / Master of Science