ITC/USA 2015 Conference Proceedings / The Fifty-First Annual International Telemetering Conference and Technical Exhibition / October 26-29, 2015 / Bally's Hotel & Convention Center, Las Vegas, NV / Falls prevention efforts for older adults have become increasingly important and are now a significant research effort. As part of the prevention effort, analysis of gait has become increasingly important. Data is typically collected in a laboratory setting using 3-D motion capture, which can be time consuming, invasive and requires expensive and specialized equipment as well as trained operators. Inertial sensors, which are smaller and more cost effective, have been shown to be useful in falls research. Smartphones now contain Micro Electro-Mechanical (MEM) Inertial Measurement Units (IMUs), which make them a compelling platform for gait data acquisition. This paper reports the development of an iOS app for collecting accelerometer data and an offline machine learning system to classify a subject, based on this data, as faller or non-faller based on their history of falls. The system uses the accelerometer data captured on the smartphone, extracts discriminating features, and then classifies the subject based on the feature vector. Through simulation, our preliminary and limited study suggests this system has an accuracy as high as 85%. Such a system could be used to monitor an at-risk person's gait in order to predict an increased risk of falling.

published_or_final_version / Sports Science / Master / Master of Science in Sports Science

Healthy spiritual development of adolescents is lacking in our society. Research shows that the topic of spiritual development for adolescents has been neglected for some time. It is clear from Scripture that spiritual development needs to take place in the life of a believer and that it is in fact an ongoing process. Even though spirituality has not been classified as something scientific during the modern era, spirituality has made its way back in scientific circles. The scientific disciplines of sociology and psychology have indicated that adolescents have a need for spiritual development and that spiritual issues are important to them. However, adolescents of the twenty-first century also face some unique challenges that have an impact on their spiritual development. Both the quantitative and qualitative methods of research were used and it was clear from both these studies that there were certain areas with regard to spiritual development that needed attention. The results in particular showed that the majority of those adolescents who took part in the research did not spend enough time on spiritual practices and most of them have taken part in some form of risky behaviour. The overall influences from family, friends and youth leaders were positive and in general it seemed that the majority of adolescents who took part in the research had a good relationship with parents and youth leaders. Adolescents need help in their spiritual development and according to Scripture parents and youth/church leaders have the responsibility to assist them. Guidance was given to adolescents and to major role players in their lives to assist them in the process of spiritual development. / Thesis (MA (Pastoral Studies))--North-West University, Potchefstroom Campus, 2013

In this days the osteoporosis is getting to the centre of interest because of its increasing. It is the worldwide problem. Physical activity is one of the main factors affecting the course of disease. Suitable physical activity is possible to reduce a risk of falls, fractures with following, frequently fatal complications. Finding the ma in problems lowering balance ability of endangered population groups and subsequently targeted physical program it possible to include in preventive program of safety locomotion and give support to enhance quality of life for endangered persons. Powered by TCPDF (www.tcpdf.org)

Thesis advisor: Barbara E. Wolfe / Patient quality outcomes in the United States (U.S.) healthcare system are largely stagnant or making minimal improvements, resulting in unnecessary morbidity, mortality, and costs (AHRQ, 2012 National Healthcare Quality Report). As the US implements the 2010 Patient Protection and Affordability Act, there is fiscal pressure to attain and sustain significant improvements to patient quality outcomes. This necessitates an understanding of how the processes and structures of care influence patient quality outcomes (Donabedian, 1966) in a complex care environment. To begin addressing this gap, this investigation examined the influence of unit-level authentic leadership (AL) and structural empowerment (SE) on staff nurse decisional involvement (DI) and patient quality outcomes on general care units in the acute-care hospital setting. This study used a cross-sectional survey design. Participants were staff nurses working on 105 general care units across eleven US hospitals. The surveys measured staff nurse perceptions of AL, SE, and DI at the care unit level. The patient quality outcomes of interest were falls with injury, hospital acquired pressure ulcers and patient satisfaction. Care unit level AL and SE had a significant influence on actual staff nurse DI (p = .002 and < .001, respectively) and the degree of dissonance between actual and preferred DI (p < .001). AL and SE had a significant inverse relationship with patient falls with injury (p = .017 and .028, respectively), yet a positive relationship with HAPU rates (p = .051 and .026, respectively). While AL did not have a significant relationship with any of the three patient satisfaction metrics, a significant positive relationship with SE was found (p = .002, .001, and .002, respectively). There was no support for a relationship between actual staff nurse DI and any of the patient quality outcomes. This study extends previous research in this area in that it is the first to examine actual patient quality outcomes at the care unit level. These findings provide support for the unique contributions to patient quality outcomes at the care unit level, indicating the need to develop AL among front-line nurse managers and SE in nurse work environments. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

INTRODUÇÃO: Frente ao aumento gradativo de quedas da própria altura com o avançar da idade, torna-se imprescindível conhecer os fatores de risco implicados na sua ocorrência em mulheres na transição e após menopausa, com o intuito de contribuir com estratégias de prevenção e promoção da saúde no cotidiano. OBJETIVO: Estimar a prevalência de quedas referidas e caracterizar a associação entre as quedas com variáveis clínicas e epidemiológicas das mulheres da Estratégia de Saúde da Família do Município de Pindamonhangaba, SP. MÉTODOS: Em estudo com delineamento observacional do tipo transversal vinculado ao Projeto de Saúde de Pindamonhangaba (PROSAPIN), foram utilizados dados secundários randomizados de 875 mulheres com idade entre 35 a 65 anos e investigadas por meio de um inquérito domiciliar e medidas antropométricas. A variável queda foi incluída como dependente, enquanto que as independentes foram representadas pela idade, estado civil, renda, escolaridade, raça, ocupação, histórico ginecológico, doenças crônicas referidas e mensuradas, medicamentos, obesidade (índice de massa corpórea), hábito alimentar, consumo de bebidas alcoólicas, tabagismo, sono, depressão e atividade física habitual. RESULTADOS: Participaram do estudo 749 mulheres com média de 47,7 anos (com desvio padrão de 8,1); a prevalência de quedas da própria altura foi de 17,6 por cento (IC de 14,9 - 20,5), sendo a maioria (54,6 por cento) na pós menopausa. Das mulheres que caíram, a prevalência de recorrência foi de 45,2 por cento. As principais causas foram escorregões (29,4 por cento) e tropeços (19,8 por cento). Após análise multivariada constatou-se associação das quedas com a idade (p=0,018), qualidade do sono ruim (0,007) e comorbidades como a hipertensão arterial (p=0,032) e depressão (p=0,003). As comorbidades hipertensão arterial (p=0,055) e depressão (p=0,001) associaram-se também as quedas recorrentes, bem como restrições às atividades de vida diária (p=0,000). CONCLUSÃO: A maior prevalência de quedas ocorreu após a menopausa e entre os principais fatores associados à sua gênese emergiram a idade, hipertensão arterial, depressão e sono ruim / INTRODUCTION: Faced the gradual increase of falls from height with advancing age, it becomes essential to know the risk factors of the falls on women in transition and after menopause, in order to contribute with strategies for prevention and health promotion in their daily routine. OBJECTIVE: To estimate the prevalence of referred falls and characterize the association between falls and clinical and epidemiological variables of women of the Family Health Strategy of Pindamonhangaba City, SP. METHODS: In a study with observational design of the type cross-sectional linked to Health Project of Pindamonhangaba (PROSAPIN), it was used secondary randomized data from 875 women from 35 to 65 years old and they were investigated through a household survey and anthropometric measurements. The falls were included as a dependent variable and age, marital status, income, education, race, occupation, gynecologic history, chronic disease and those measured, medicines, obesity (body mass index), dietary habits, alcohol consumption, smoking, sleep, depression and physical activity. RESULTS: There were 749 women investigated with average age of 47.7 years (standard deviation 8.1); the prevalence of falls from height was 17.6 percent (95 percentCI: 14.9 - 20.5), the majority (54.2 percent) of the fallers were in the post menopausal. Of the women who fell, the prevalence of recurrence was 45.2 percent. The main causes were slipping (29.4 percent) and setbacks (19.8 percent). After multivariate analysis, it was found an association of falls with age (p=0.018), poor sleep quality (p=0.007) and comorbidities as hypertension (p=0.032) and depression (p=0.003). The comorbidities hypertension (p=0.055) and depression (p=0,001) associated too with recurrent falls, as well restricted the activities of daily living (p=0.000). CONCLUSION: The highest prevalence of falls occurred after the menopause and among the main factors associated its genesis emerged the age, hypertension, depression and bad sleep

Background: Fear of falling is now recognized as an independent fall risk factor due to its prevalence in older adults. Objectives: The purpose of this study was to gain a better understanding of fear of falling levels in community-dwelling older adults before and after attending a fall prevention clinic. Methods: An explanatory sequential mixed methods design was used. The Falls Efficacy Scale-International (FES-I) tool assessed fear of falling levels before and after attending a fall prevention clinic (n=32). Semi-structured interviews were then conducted in a sample of these participants (n=12). Results: There was no statistically significant difference in the before (M=30.44, SD=9.8) and after (M=31.72, SD=8.3) FES-I scores. Three themes emerged from the qualitative analysis: 1. Concerns about falling, 2. Decreased concerns about falling and 3. An increased self-awareness of fall risks. Conclusion: Further use of cognitive-behavioural therapy should be considered in falls risk reduction interventions for community-dwelling older adults with fear of falling.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Este estudo teve como objetivo validar o resultado de enfermagem Comportamento de prevenÃÃo de queda, apresentado pela Nursing Outcomes Classification (NOC). O processo de validaÃÃo focalizou pessoas acometidas por acidente vascular cerebral (AVC) e seus cuidadores, com foco no contexto domiciliar. Estudo do tipo metodolÃgico, realizado em duas etapas (validaÃÃo de conteÃdo e clÃnica) a partir de um instrumento proposto por Vitor (2010), o qual apresentou para o resultado 28 indicadores e definiÃÃes operacionais direcionadas inicialmente à populaÃÃo em geral. Estes foram revistos e organizados em 22 indicadores voltados ao ambiente domiciliar, local onde acontece o tipo mais comum de queda, a da prÃpria altura. A etapa de validaÃÃo de conteÃdo foi iniciada com avaliaÃÃo do instrumento por juÃzes quanto à aparÃncia. Em seguida, 22 especialistas avaliaram os tÃtulos e definiÃÃes de cada indicador, segundo os critÃrios psicomÃtricos de simplicidade, clareza, precisÃo e adequaÃÃo. ApÃs atendimento Ãs sugestÃes dos especialistas, procedeu-se à validaÃÃo clÃnica, precedida por um teste piloto para ajustes à populaÃÃo. Etapa realizada por duas duplas de profissionais treinados, no ambulatÃrio de dois hospitais de referÃncia ao atendimento a pacientes com AVC, com participaÃÃo de 106 pacientes e/ou cuidadores. Uma dupla aplicou o instrumento com as definiÃÃes operacionais e outra aplicou o instrumento contento apenas tÃtulos e escala da NOC. Os dados foram organizados em planilhas e analisados com o software SPSS 22. Para a etapa de validaÃÃo de conteÃdo foi calculado teste binomial, enquanto que, para a etapa clÃnica, utilizaram-se os testes de Friedman para verificar diferenÃa entre avaliadores, anÃlise da diferenÃa mÃnima significante (DMS), Alfa de Cronbach e Coeficiente de CorrelaÃÃo Intraclasse (CCI) para comparaÃÃo das avaliaÃÃes. O projeto foi apreciado por Comità de Ãtica em Pesquisa, aprovado sob os Pareceres n 49.912 e n 392.531; todos os participantes foram orientados quanto aos objetivos e assinatura do Termo de Consentimento. Na validaÃÃo de conteÃdo, a maioria dos especialistas foi de mulheres, mÃdia de 33,1 anos, 9,5 anos de formaÃÃo, doutores, profissionais de InstituiÃÃes de Ensino Superior. Os indicadores que se apresentaram estatisticamente significantes, pelo teste binomial, foram: Prende pequenos tapetes e Controla a inquietaÃÃo, e todos apresentaram-se apropriados ao paciente com AVC (100% e p=1,000). Na etapa clÃnica, houve discreta predominÃncia de homens participantes (51,9%), na maioria idosos, casados, aposentados, com baixa escolaridade e renda, residindo com a famÃlia e com sequelas fÃsicas do AVC, implicando a necessidade de um cuidador. O teste de Friedman indicou diferenÃas entre avaliaÃÃo das duplas em doze indicadores (p <0,05), destes, cinco demonstraram diferenÃas nas mÃdias de postos maiores que a DMS. Todos os indicadores apresentaram-se estatisticamente significantes (p<0,001) e satisfatÃrios segundo o (CCI). Esta etapa foi importante para constataÃÃo da manutenÃÃo ou nÃo de indicadores, que totalizaram 18 ao final. Assim, de forma geral, observou-se que houve maior concordÃncia entre a dupla que utilizou o instrumento com as definiÃÃes de cada indicador. Destaca-se a eficÃcia do processo de construÃÃo de referentes empÃricos e adequaÃÃo a populaÃÃes especÃficas, bem como a necessidade contÃnua de estudos nesta linha de conhecimentos. / This study aimed to validate the nursing outcome Fall prevention behavior from the Nursing Outcomes Classification (NOC). The validation process focused on people with stroke and their caregivers in the home context. This is a methodological study performed in two stages (content and clinical validation) by a tool proposed by Vitor (2010) who presented 28 indicators and operational definitions related to the general population. The tool was revised and organized in 22 indicators towards to the home environment which is the most common place where falls from height happen. The content validity stage was started with assessment by judges about the appearance. Then, 22 specialists evaluated the titles and definitions of each indicator according to psychometric criteria of simplicity, clearness, precision and suitability. After perform the changes suggested by the specialists, the clinical validation was performed at first by a pilot test in order to adjust the tool to the population. This stage was developed with 106 patients and/or caregivers interviewed by two pairs of trained professionals in the ambulatory service of two hospitals that are reference in the care of people with stroke. One pair of evaluators applied the form with the operational definitions while the other pair applied the form with only the titles and NOC scale. The data were organized in sheets and analyzed by the SPSS 22 program through the calculation of the binomial test. The clinical validation stage applied the Friedman test to verify differences among the evaluators, the calculation of the minimum significant difference (MSD), Cronbach alpha and intraclass correlation coefficient (ICC) to compare the evaluatorsâ assessment. The study was approved by an Ethical Committee by the nÂ49.912 and nÂ392.531; all the participants (specialists, patients and caregivers) were oriented about the goals and the Consent Term. At the content stage, the specialists were most female, with age average of 33.1 years old, 9.5 years of graduation, PhD, working in Post-secondary Institutions. The indicators statistically significant by the Binomial test were: Attaches small rugs and Controls restlessness and all of them were appropriated to the patient with stroke (100% and p=1.000). Most participants were male (51.9%), elderly people, married, retired, with low school grade and low income, living with family and with physical sequelae from the stroke, which requires the need of a caregiver. The Friedman test showed differences in the evaluations of the pairs of professionals for twelve indicators (p<0.05), five of them showed difference in the mean rank higher than the MSD. All the indicators showed statistical significance (p<0.001) and the ICC. This stage was important to realize the need of keeping or not the indicators, which were 18 at the end. Thus, it is noted that the tests showed more agreement between de pair that used the tool with the indicators for each definition. It is possible to highlight the efficiency of empirical references construction and its suitability to specific populations, besides the need of continuous researches in this field of study.

Falls are a cause of concern for the elderly since it can render a person immobile. A monitoring system can summon immediate aid by the automatic detection of fall events. The application of ultra-wideband (UWB) signals for a monitoring system was chosen due to its unique characteristics such as wide spectrum, immunity to interference, penetrability, and application for the detection of people. Part of this monitoring system is boundary detection with the purpose of isolating the location of fall events and to function as a mask to define an area of interest. A study of various localizing methods using measurements such as power, distance, and angle with ultra-wideband is presented. A frequency modulated continuous wave (FMCW) based system is an acceptable solution for boundary detection. A FMCW system measures distance with UWB signals. With the addition of a unique reflector, the system is able to identify the reflector via the return frequency-spectrum fingerprint. With distance and the addition angle measurements, the system can determine the boundary with a sensor located at a single location.

Thirty percent of older adults fall every year with devastating physical and economic consequences. Physical activity is the primary recommendation for fall prevention, but less than 30% of older adults meet the physical activity guidelines of the various professional organizations. Recent work demonstrated that psychological factors were more specific in identifying fall risk but work on psychological issues related to physical activity in the older adult is limited. This study explored motivation and limits to being physically active in 76 adults with a mean age of 88 living in the assisted living setting, using concurrent mixed method research. The theoretical foundation was a 3-pronged method using self-determination, self-efficacy, and resilience theories to explore such issues as autonomy, vicarious experience, and positivism. Quantitative data were used to examine the individual influences of various psychological factors on physical activity participation through multi regression analysis. No significant relationships were found, although it emerged that fear of falling was a greater influence in limiting physical activity than balance confidence or fall efficacy. Qualitative open-ended questions further explored the research question with triangulation through interviews with activity staff. Four primary themes emerged covering function, emotions, influences, and "want" demonstrating a strong desire for healthy living and independence. Results of this study can assist the development of suitable programs for this population. Implications for positive social change include the potential to increase physical activity and possibly decrease the number of devastating falls in the older adult population.