Falls remain one of the most reportable, serious and costly type of adverse events costing an estimated $3,500 to $27,000 depending on the injury. The research often focuses on the elderly and their risk for falls and injury. Increasingly higher rates of falls are being reported in the middle-age inpatient 45 to 64 years of age. While predictors of falls and injuries have been studied across all adult inpatients, research has not specifically addressed fall risk characteristics in the middle-age. The World Health Organization’s (WHO), “Risk factor model for fall in older age”, framework was adapted for the middle-age inpatient. This framework identifies extrinsic and intrinsic variables from four risk factor groupings of biological, socioeconomic, behavioral, environmental and related outcomes to describe characteristics of the middle-age inpatient’s fall injury risk. Hitcho et al. (2004) seminal article was also used to identify pertinent inpatient characteristics. The purpose of this exploratory retrospective quantitative study described fall risk factors specific to the middle-age inpatient. The aims: (1) described risk factors of falls and fall injury; (2) described unit specific data, fall numbers with type of falls, injuries from falls, and prevention strategies (3) compare the incidence of fall and injury rates in the middle-age (45- 64) patients to the other hospital adult age-groups (ages 21-44 and 65-90). This study used retrospective hospital occurrence data to identify middle-age inpatient falls and related characteristics reported by staff. Chart review of inpatient falls identified 439 individual falls occurring from January 2012 through July 2014. The study sample included inpatients that fell either one-time or had a repeat fall during the study period. Analysis for data included use of descriptive statistics, crosstabs, and Poisson regression. Outcomes collected included demographics, admitting diagnosis, chief complaints, cormorbities, and discharge status, type of falls and areas of falls. There was no significant difference in rates of falls between units or in staffing ratios that had a bearing on the middle-age inpatient. Fall prevention interventions were found to be universally applied, not specific to the individual, nor based on outcomes of risk screening of anticipated physiological risk factors. In comparison of the middle-age inpatient population with those age 65 -90 years of age the rates per 1000 patient days for both falls (p=.637) and injuries (p=.626) had no significant difference. Males fell at a significantly higher rate (p=.000) than females in the middle-age inpatient and those aged 64-90 years. The middle-age inpatient fell at an alarming rate of 42% of all falls. This research provided insight into a population with acute and multiple chronic disease conditions and comorbidities that contribute to altered mental status, abnormal gait and frequently awaking at night to void. This population often overestimates their limitations and strives to maintain their autonomy. The age of the patient should not influence staff assessment of alertness and orientation. The findings of the characteristics in this research provide rich information for further research in how to include the middle-age patient in clinical decision making and education of this age group.

No description available.

The exotic plant Lantana camara L. has invaded the riparian areas of the Victoria Falls World Heritage Site in Livingstone, southern Zambia, threatening native plant communities which support populations of species of special concern. I trialled the mechanical control method of manual uprooting and 3 different herbicides applied through paint brushing of an imazapyr concentrate at 250g. l¯¹, spraying on cut stumps with metsulfron methyl at 600g.l¯¹, and foliar spraying on re-emergent lantana foliage with glyphosate at a dosage of 166g. l¯¹ in July 2008 in 20 100m2 treatment plots, 5 invaded control plots and 5 uninvaded controls. Follow-up treatments for re-sprouting lantana stumps and emerging seedlings were undertaken in June 2009. I measured effectiveness of the methods using adult lantana mortality in June 2009 and lantana seedling density in the different treatment plots during the follow-up exercise. The cost of the various methods and human labour applied were compared across the four treatments at initial clear and at follow-up. All treatments recorded a high adult lantana mortality rate, though there were no significant differences in lantana adult mortality amongst the treatments. Overall, uprooting had the highest adult mortality, followed by imazapyr, metsulfron and lastly glyphosate. Germination of lantana seedlings after clearing was high for all treatments but with no significant differences occurring between the treatments. Both adult lantana mortality and seedling density were however significantly different from the control. With labour included, chemical costs were far higher relative to uprooting, though uprooting costs were the highest when it came to the follow-up because of the emerging seedlings and some resprouting stumps. The effects of mechanical and chemical treatments on vegetation composition in the cleared areas were also assessed in order to detect any non-target and medium term effects of treatments. Contrary to expectation, none of the chemicals showed any significant effects on vegetation composition in the short and medium-term and no significant differences were found in plant species richness, diversity and seedling density between invaded and uninvaded plots at baseline, in October 2008 and in September 2009. In order to determine potential for unaided vegetation recovery in the riparian areas of the study site after lantana clearing, I conducted an investigation of soil seed banks and seed rain using 60 seed bank samples measuring 1800m³ collected from 30 invaded and uninvaded plots. Using the seedling emergence method, 1, 991 seedlings belonging to 66 species representing 27 families germinated from the seed bank. Sedges (Cyperaceae family) were the most abundant taxa in the seed banks from invaded areas, followed by Ageratum conyzoides, lantana, Triumfetta annua and Achyranthes aspera which also occurred in the uninvaded soil seed banks. The seed banks from uninvaded plots were dominated by the grass Oplismenus hirtellus. Overall, species richness, diversity and seedling density from seed banks in invaded areas did not differ significantly from seed bank in uninvaded areas and there was a low similarity in species composition when above ground vegetation was compared to seed banks from invaded and uninvaded areas. It would appear if natural regeneration occured from the current seed bank in disturbed areas, future vegetation would largely comprise of short lived, early successional species in the short term as the seed bank is dominated by non-native herbaceous weedy species. From the seed traps investigating seed rain, a total of 27 species numbering 623 individual seeds were found in the thirty 1m² seedtraps distributed in invaded and uninvaded areas at the five sites, over an intermittent period of three months. Lantana had the highest monthly arrival rate in the seed traps followed by Phoenix reclinata and Ricinus communis. The number of species with invasive potential found in the seed traps located in invaded areas was more than that found in seed traps under native vegetation cover by far. Considerable forest remnants still occur around the invaded sites, and these could serve as an important source for long-term natural re-establishment of native vegetation if seed availability by animals and wind dispersal continues, while the re-invasion of lantana is prevented by ongoing follow-ups and futher clearing of lantana invaded areas. It is concluded that while uprooting and other treatments are effective in the control of lantana, its successful control in the Victoria Falls World Heritage Site will require extensive clearing to keep it from reinvading infested areas after clearing as shown by the seed rain data. The high seedling density of lantana in the seed banks and in the cleared areas shows the need for ongoing follow-up in order to deplete soil stored seed banks. There is need for longer term research to establish what the exact follow-up requirements are in order to contain lantana re-infestation and create favourable micro-sites for native species to establish. It is predicted that ongoing lantana control in the cleared plots will most likely initiate long-term community recovery.

This study investigated the role of selected variables on organizational commitment in selected organizations in a North Texas metropolitan area. The selected (independent) variables were orientation attendance, unit size, educational level, gender, age, and length of service. Organizational commitment score was the dependent variable. The Organizational Commitment Questionnaire and a demographic questionnaire were administered to 1,055 employees. The Organizational Commitment Questionnaire contained fifteen statements which measured employees' feelings about their organization. Multiple regression was used to determine the relationship between organizational commitment and the selected variables at the .001 level of significance. It was determined that gender and length of service showed the strongest significant relationship on organizational commitment. This model shows that the six independent variables account for only 3 percent of the variance in the relationship between organizational commitment and the selected variables. Therefore, approximately 97 percent of the unexplained variance is accountable for the organizational commitment of the employees at the selected organizations used in this study. Studies using the Organizational Commitment Questionnaire to show the relationship between organizational commitment and other antecedents of organizational commitment are recommended. A follow-up study should also be conducted using the Organizational Commitment Questionnaire to show the relationship between organizational commitment and race. A follow-up study should be conducted using this questionnaire and a work ethic questionnaire to determine the relationship between organizational commitment and work ethics. An orientation attendance questionnaire should be developed and used with the Organizational Commitment Questionnaire to show the relationship between organizational commitment and orientation attendance. Additional research is necessary in other organizations and cultural settings before this study can be generalized to a greater number of employees. Recommendation is made that future researchers administer questionnaires to subjects due to the low reading and comprehension skills of many respondents.

Although most research has focused on adults, studies indicate that children also experience detrimental psychological effects as the result of natural disasters. The purpose of the present study was to determine if the tornado which struck Wichita Falls,, Texas, on April 10, 1979, had any negative effects on the academic performance or social behavior of school children. Three groups of students were studied: (a) victims of the tornado who suffered a significant loss, (b) observers of the disaster who did not suffer a significant loss, and (c) newcomers who arrived after the disaster. Achievement test scores, grades, and attendance over a 4-year period were studied. The overall results do not indicate significant differences among the three groups.

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program with multifactorial and interdisciplinary components, and an evaluation plan to help decrease falls in acute care settings. The Safe Five falls prevention program was implemented on the acute care nursing unit in an effort to decrease the inpatient falls rate on the unit. The inpatient falls data were collected retrospectively, 2 years pre implementation of the Safe Five program, and 8 to 10 months post implementation. Data were collected from the Safe Five checklists, recorded inpatient fall rates, and high fall risk chart audits provided by staff and nurse manager; they were then analyzed using the RE-AIM evaluation tool. The long-term effects of the Safe Five program include an 18% increase in patients' awareness of the importance of preventing falls, an 18% increase in staff compliance with the program, and a 14% decrease in inpatient fall rate on the unit. It is projected that the decrease in inpatient falls will result in decreased healthcare costs and improved patient satisfaction with the healthcare system, communication among the interdisciplinary team, and health outcomes for the patients.

Falls can lead to unintentional injuries and possibly death, making falls an important public health problem in terms of related health care cost, incurred disabilities, and years of life lost. Approximately 1 in every 3 Americans ages 65 years and older is at risk of falling at least once every year. Children, young adults, and middle-aged adults are also vulnerable to falls. The purpose of this study was to examine the epidemiology of falls and fall-related injuries using surveillance data from nationally representative samples of hospital emergency departments in United States. The study was guided by a social-ecological model on the premise that multiple levels of risk factors affect health. Using a cross-sectional study and archival data from NEISS-AIP between 2009 and 2011, the result of multiple logistic regression indicated that age, gender, race and body part affected were significantly associated with hospitalization due to falls (p < .001) and incident locale independently predicted hospitalization due to falls in which hospitalization due to falls was considered a proxy measure of fall severity. The odds in each of the groups for fall injuries were (a) older adults versus children, 1.07 (95% CI: 1.05-1.08); (b) males versus females, 1.23 (95% CI: 1.21-1.26); (c) Blacks versus Whites, 2.12 (95% CI: 2.11-2.13); (d) body part extremities versus head area, 0.98 (95% CI: 0.97-0.99); and (e) outside home versus inside home, 1.14 (95% CI: 1.13-1.15). The results of this study may be important in forming and implementing age-specific prevention strategies and specialized safety training programs for all age groups, thereby reducing deaths, disabilities, and considerable health care cost associated with hospitalization due to fall-related injuries.

This thesis is a report on the study of the educational opportunities, problems, and handicaps which are peculiar to the environment of the Mexican child in Wichita Falls, Texas. The purpose of this study: It is a known a fact that the educational opportunities afforded the Mexican children in Wichita Falls, Texas are inferior to those afforded the white children or Negro children. The reason for this is the unsuccessful attempt to intersperse the Mexican child with the white children after they have completed the third grade. Naturally, because of racial, differences, aptitudes, and inherent characteristics, the Mexican children are at a distinct disadvantage in attempting to compete in an educational manner with their white brother. Much has been done toward curriculum revision and in the study of needed changes in the public school program for the white children, but very little has been done to find the needs or to meet the needs of the Mexican children, although he, too, is an American citizen in most cases and is subject to the same rights, privileges, and educational advantages as the white children.

Thesis (MSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Rock falls are the cause of the majority of mining-related injuries and fatalities in deep tabular South African mines. The standard process of entry examination is performed before working shifts and after blasting to detect structurally loose rocks. This process is performed by a miner using a pinch bar to ‘sound’ a rock by striking it and making a judgement based on the frequency response of the resultant sound. The Electronic Sounding Device (ESD) developed by the CSIR aims to assist in this process by performing a concurrent prediction of the structural state of the rock based on the acoustic waveform generated in the sounding process. This project aimed to identify, develop and deploy an effective classification model to be used on the ESD to perform this assessment. The project was undertaken in three main stages: the collection of labelled acoustic samples from working areas; the extraction of descriptive features from the waveforms; and the competitive evaluation of suitable classification models. Acoustic samples of the sounding process were recorded at the Driefontein mine operation by teams of Gold Fields employees. The samples were recorded in working areas on each of the four reefs that were covered by the shafts of the mine complex. Samples were labelled as ‘safe’ or ‘unsafe’ to indicate an expert’s judgement of the rock’s structural state. A laboratory-controlled environment was also created to provide a platform from which to collect acoustic samples with objective labelling. Three sets of features were extracted from the acoustic waveforms to form a descriptive feature dataset: four statistical moments of the frequency distribution of the waveform formed; the average energy contained in 16 discrete frequency bands in the data; and 12 Mel Frequency Cepstral Coefficients (MFCCs). Classification models from four model families were competitively evaluated for best accuracy in predicting structural states. The models evaluated were k-nearest neighbours, self-organising maps, decision trees, random forests, logistic regression, neural networks, and support vector machines with radial basis function and polynomial kernels. The sensitivity of the models, i.e. their ability to avoid predicting a ‘safe’ status when the rock mass was actually loose, was used as the critical performance measure. A single-hidden-layer feed-forward neural network with 15 nodes in the hidden layer and a sigmoid activation function was found to best suited for acoustic classification on the ESD. Additional feature selection was performed to identify the optimised form of the model. The final model was successfully implemented on the ESD platform. / AFRIKAANSE OPSOMMING: Rotsstortings is die oorsaak van die meerderheid van mynbouverwante ongelukke en ongevalle in diep tabulêre Suid-Afrikaanse myne. Die standaard proses van pretoegang ondersoeke om strukturele los rotse te erken, word uitgevoer voor enige werkskof en na skietwerk. Dit word gedoen deur ‘n myner wat ‘n breekyster teen die rots kap en ‘n oordeel vel op die frekwensie weergawe van die gevolglike klank. Die ‘Elektroniese Klinking Toestel’ (Electronic Sounding Device, ESD) is ontwikkel deur die WNNR met die doel om die proses te ondersteun. Dit word gedoen deur ‘n gelyktydige voorspelling van die strukturele toestand gebaseer op die akoestiese golfvorm gegenereer in die proses van klinking. Die projek stel ten doel om ’n effektiewe klassifikasie-model te identifiseer, te ontwikkel en toe te pas in die ESD om hierdie assessering uit te voer. Die projek vind in drie stadiums plaas: die insameling van geëtiketteerde akoestiese monsters van die werkareas; die ekstraksie van beskrywende kenmerke van die golfvorms en die mededingende evaluering van geskikte klassifiseringsmodelle. Klinking akoestiese monsters is opgeneem by Driefontein mynbouoperasie deur spanne van Gold Fields se werknemers. Die akoestiese monsters is opgeneem in werkareas van elk van die vier goudriwwe wat deur die skagte van die mynkompleks gedek word. Monsters is as ‘veilig’ of ‘onveilig’ geëtiketteer as aanduiding van die ekspert se oordeel van die rots se strukturele toestand. ‘n Laboratorium gekontroleerde omgewing is ook geskep om ’n platform te skep vanwaar akoestiese monsters met objektiewe etikettering waargeneem word. Drie stelle van kenmerke is onttrek van die akoestiese golfvorms om ‘n beskrywende datastel van kenmerke te vorm: vier statistiese momente van die frekwensie verspreiding van die gevormde golfvorm; gemiddelde energie ingesluit in sestien diskrete frekwensiebande in die data; en twaalf ‘Mel Frequency Cepstrum Coefficients’ (MFCCs). Klassifikasie modelle van die vier modelsamestellings was kompeterend geëvalueer vir die beste akkuraatheid in voorspellings van strukturele toestande. Klassifikasie modelle het k-naaste bure, selforganiserende kaarte, besluitnemingsbome, lukrake woude, logistieke regressie, neurale netwerke en steun-vektor masjiene met radiale basisfunksie en polinominale kerne. Die meting van die sensitiwiteit van die modelle, met betrekking tot die vermoë van die modelle om veilige voorspellings te beperk wanneer die rotsmassa los is, was gebruik as ’n kritiese werksverrigtingsmeting. ‘n Enkel-verskuilde-laag neurale netwerk met 15 nodes in die verskuilde laag en ’n sigmoïde aktiveringsfunksie is gevind as die mees geskikte vir die ESD. Addisionele keuse van kenmerke is uitgevoer deur die geoptimiseerde vorm van die model te identifiseer. Die model was suksesvol geïmplementeer op die ESD platform.

BACKGROUND:Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density BMD] have not previously been investigated.METHODS:This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (greater than or equal to]2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI.RESULTS:Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake.CONCLUSION:These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.