A pre-test, post-test, randomized control study (n=78) was conducted to test whether participation in Stay on Your Feet (SOYF), a falls prevention program for community-dwelling older adults, improved participants’ falls-related self-efficacy and balance. The Activities Balance Confidence (ABC) Scale (Powell & Myers, 1995) was used to measure falls-related self-efficacy and the Timed Up and Go (TUG) test (Podsiadlo & Richardson, 1991) was used to measure balance. Participants in both the intervention and control groups scored at the higher end of the ABC Scale (range 0-100) at baseline (mean 76.78 ± 18.91 and 82.46 ± 18.27 respectively) and at follow-up (mean 75.01 ± 19.51 and 84.10 ± 12.49 respectively), suggesting participants in this study were already fairly confident in their ability to manage daily activities without losing their balance. TUG times at baseline and follow-up testing were low suggesting participants had good balance. The SOYF program did not meet its intended objectives of improving falls-related self-efficacy and balance for participants who received the program. Recommendations for changes to future SOYF programming include targeting older adults with a history of falls or identified falls risk factors. The SOYF program was not effective for this study group; however, it may work for older adults at higher-risk for falls. / Thesis (Master, Nursing) -- Queen's University, 2007-09-27 19:47:26.195

The tittle: The falls of senior people at home surroundings and thein preventions The goal: The goal of this theses was to finf out the degrese of seniors knowing at preventative moves which can avoid falls and through question forms to analyze how the information about danger from the falls at home surroundings influenced the seniors effort to modify their homes. The mothod: At my thesis I used the mothod of quantity analyses. I obtained the data through questionn aires. The interviewed respondents are senior people at age of 65 and more. I interviewed 130 respondents in total and Theky were dividend into 2 groups according to the age or purposes of this thesis. In the first group are seniors between 65 and 74 and the other group is represented by people at age 75 and more. The questionnaire contained 23 questions and was split u pinto 6 domains. The first free questions were related to personal datas and social background of seniors. Next free questions find out the fall at anamnesis and the others are directed to home safeness, foreknowledge about preventive moves and the reslting behavior of respondents in relation to Pasove increase of home safeness. The results: The single points of the questionnaire are graphically illustrated and compared with available literature or other essays. The...

The aim of this study was to evaluate the effect of participation in the Otago Exercise Programme (OEP) on strength and balance. The change in a number of balance and strength measures were compared between a group of community dwelling women over the age of 80 years participating in the OEP and a control group matched by gender and age.Study design: A cohort study of two independent groups.Participants: Nineteen women over the age of 80 years who were community dwelling and participating in the OEP and 18 age matched community dwelling women who continued with their normal activities of daily living.Main outcome measures: Participants' strength and balance was measured using the timed up and go test, the step test, the 30 second chair stand test and gait velocity. Participants' fear of falling was measured with the Modified Falls Efficacy Scale and falls were monitored using a falls diary.Results: There were no statistically significant improvements in strength and balance in the OEP group and no statistically significant differences between the OEP and control group, after participating in the OEP for 6 months. The only statistically significant change in the OEP group was a slowing of gait velocity, all other outcome measures remained unchanged for both the OEP group and the control group.Conclusions: There were no statistically significant improvements in strength and balance after participating in the OEP. These results are consistent with those of the original Otago trial and the subsequent meta-analysis of all the Otago trials. The results from this study need to be interpreted with caution, as due to the small sample size the study was underpowered. The critical components of the OEP remain unknown.

The aim of this study was to evaluate the effect of participation in the Otago Exercise Programme (OEP) on strength and balance. The change in a number of balance and strength measures were compared between a group of community dwelling women over the age of 80 years participating in the OEP and a control group matched by gender and age.Study design: A cohort study of two independent groups.Participants: Nineteen women over the age of 80 years who were community dwelling and participating in the OEP and 18 age matched community dwelling women who continued with their normal activities of daily living.Main outcome measures: Participants' strength and balance was measured using the timed up and go test, the step test, the 30 second chair stand test and gait velocity. Participants' fear of falling was measured with the Modified Falls Efficacy Scale and falls were monitored using a falls diary.Results: There were no statistically significant improvements in strength and balance in the OEP group and no statistically significant differences between the OEP and control group, after participating in the OEP for 6 months. The only statistically significant change in the OEP group was a slowing of gait velocity, all other outcome measures remained unchanged for both the OEP group and the control group.Conclusions: There were no statistically significant improvements in strength and balance after participating in the OEP. These results are consistent with those of the original Otago trial and the subsequent meta-analysis of all the Otago trials. The results from this study need to be interpreted with caution, as due to the small sample size the study was underpowered. The critical components of the OEP remain unknown.

Yes / Falls are the most common safety incident reported by acute hospitals. In England national guidance recommends delivery of a multifactorial falls risk assessment (MFRA) and interventions tailored to address individual falls risk factors. However, there is variation in how these practices are implemented. This study aimed to explore the variation by examining what supports or constrains delivery of MFRAs and tailored interventions in acute hospitals. A realist review of literature was conducted with searches completed in three stages: (1) to construct hypotheses in the form of Context, Mechanism, Outcome configurations (CMOc) about how MFRAs and interventions are delivered, (2) to scope the breadth and depth of evidence available in Embase to test the CMOcs, and (3) following prioritisation of CMOcs, to refine search strategies for use in multiple databases. Citations were managed in EndNote; titles, s, and full texts were screened, with 10% independently screened by two reviewers. Two CMOcs were prioritised for testing labelled: Facilitation via MFRA tools, and Patient Participation in interventions. Analysis indicated that MFRA tools can prompt action, but the number and type of falls risk factors included in tools differ across organisations leading to variation in practice. Furthermore, the extent to which tools work as prompts is influenced by complex ward conditions such as changes in patient condition, bed swaps, and availability of falls prevention interventions. Patient participation in falls prevention interventions is more likely where patient directed messaging takes individual circumstances into account, e.g., not wanting to disturb nurses by using the call bell. However, interactions that elicit individual circumstances can be resource intensive and patients with cognitive impairment may not be able to participate despite appropriately directed messaging. Organisations should consider how tools can be developed in ways that better support consistent and comprehensive identification of patients' individual falls risk factors and the complex ward conditions that can disrupt how tools work as facilitators. Ward staff should be supported to deliver patient directed messaging that is informed by their individual circumstances to encourage participation in falls prevention interventions, where appropriate. PROSPERO: CRD42020184458. / This research is funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research (HSDR) Programme (project number NIHR129488).

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.

Chan Sieu Gaen. / Year shown on spine: 1997. / Questionnaries in Chinese and English. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references. / Acknowledgement / List of tables --- p.i / Abstract --- p.vi / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.0 --- Demographic changes of the population / Chapter 2.0 --- Falls / Chapter 2.1 --- Significance of the problem / Chapter 2.2 --- Physical consequences of falls / Chapter 2.3 --- Psychological consequences of falls / Chapter 2.4 --- Impact on health services / Chapter 2.5 --- Mortality / Chapter 2.6 --- Economic consequences / Chapter Chapter 2 --- Risk factors for falls --- p.12 / Chapter 2.1 --- Environmental hazards and circumstances of falls / Chapter 2.2 --- Social demographic factors / Chapter 2.3 --- Health status / Chapter 2.4 --- History of falls / Chapter 2.5 --- Mental/Depression / Chapter 2.6 --- Health behavior / Chapter 2.7 --- Bone mass and anthropometric factors / Chapter 2.8 --- Risk factors for multiple falls / Chapter 2.9 --- Fall injuries / Chapter 2.10 --- Additive effects of risk factors / Chapter Chapter 3 --- "Limitation of previous studies, objectives and study methods" --- p.31 / Chapter 3.1 --- Hospital reports and instiutional-based studies / Chapter 3.2 --- Study design / Chapter 3.3 --- Selection of subjects / Chapter 3.4 --- Classification and definition of falls / Chapter 3.5 --- Studies on falls in Hong Kong / Chapter 3.6 --- Hong Kong study / Chapter 3.7 --- Study methods / Chapter 3.8 --- Data collection / Chapter 3.9 --- Data analysis / Chapter Chapter 4 --- Characteristics of respondents and distribution of falls --- p.48 / Chapter 4.1 --- Characteristics of respondents / Chapter 4.2 --- Proportion of fallers and rate of falls / Chapter 4.3 --- Discussion / Chapter Chapter 5 --- Circumstances and consequences of falls --- p.65 / Chapter 5.1 --- Time and place of falls / Chapter 5.2 --- Activity during and reasons for falls / Chapter 5.3 --- Predisposing factors for falls / Chapter 5.4 --- Consequences of falls / Chapter 5.5 --- Discussion / Chapter Chapter 6 --- Characteristics of fallers and nonfallers --- p.85 / Chapter 6.1 --- Sociodemographic characteristics / Chapter 6.2 --- Health status / Chapter 6.3 --- Health behavior / Chapter 6.4 --- Bone mass and body measurements / Chapter Chapter 7 --- Risk factors associated with fallers --- p.99 / Chapter 7.1 --- Risk factors for fallers (including single and multiple) / Chapter 7.2 --- Multiple fallers / Chapter 7.3 --- Risk factors for single and multiple fallers (vs. non- fallers) / Chapter 7.4 --- Comparison of risk factors associated with major injurious falls vs. those with non-major injurious falls / Chapter 7.5 --- Independent predictors of fallers / Chapter 7.6 --- The additive effects of independent risk factors / Chapter Chapter 8 --- Discussion on risk factors associated with falls --- p.131 / Chapter 8.1 --- Social demographic factors and falls / Chapter 8.2 --- Acute illnesses/chronic diseases / Chapter 8.3 --- Medical consultation and hospitalization / Chapter 8.4 --- History of falls / Chapter 8.5 --- Perceived health status and ADL / Chapter 8.6 --- Mental status / Chapter 8.7 --- Health behavior / Chapter 8.8 --- Physical measurement and neuromuscular impairment / Chapter 8.9 --- Vision / Chapter 8.10 --- Medications / Chapter 8.11 --- Fallers with occasional falls/multiple falls / Chapter 8.12 --- Additive effect of risk factors / Chapter Chapter 9 --- Conclusion and recommendations --- p.147 / Chapter 9.1 --- Summary of findings / Chapter 9.2 --- Confirmation of risk factors found in baseline cross-sectional study / Chapter 9.3 --- Limitation of the present study / Chapter 9.4 --- Strength of the present study / Chapter 9.5 --- Recommendations on areas for further research / Chapter 9.6 --- Recommendations on prevention and intervention measures / References --- p.155 / Appendix / Calculation of sample size --- p.1 / Pooled logistic regression analysis on risk factors associated with falls --- p.2 / Baseline questionnaire --- p.3 / First follow-up questionnaire --- p.4 / Fall ascertainment questionnaire --- p.5

This thesis presents two studies that investigate how vision is used to control rapid, compensatory reach-to-grasp reactions. Compensatory grasping reactions were evoked in healthy young adults via unpredictable translations of large platforms on which the subjects stood or walked. The first study tracked natural gaze behaviour during responses to unexpected balance perturbations. It provided evidence that, unlike with voluntary movements, the eyes do not lead the hand during balance recovery – subjects relied on ‘stored’ information from central vision, continuously-available peripheral vision, or a combination of these sources to guide the hand. The second study investigated the efficacy of reliance on peripheral vision to guide rapid reach-to-grasp balance-recovery reactions. Peripheral vision was found to guide reach-to-grasp responses with sufficient accuracy to achieve a functional grasp of a relatively small handhold; however, peripherally-guided movements were slower when the handhold was in the extreme periphery.

This thesis presents two studies that investigate how vision is used to control rapid, compensatory reach-to-grasp reactions. Compensatory grasping reactions were evoked in healthy young adults via unpredictable translations of large platforms on which the subjects stood or walked. The first study tracked natural gaze behaviour during responses to unexpected balance perturbations. It provided evidence that, unlike with voluntary movements, the eyes do not lead the hand during balance recovery – subjects relied on ‘stored’ information from central vision, continuously-available peripheral vision, or a combination of these sources to guide the hand. The second study investigated the efficacy of reliance on peripheral vision to guide rapid reach-to-grasp balance-recovery reactions. Peripheral vision was found to guide reach-to-grasp responses with sufficient accuracy to achieve a functional grasp of a relatively small handhold; however, peripherally-guided movements were slower when the handhold was in the extreme periphery.

In Canada, falls are one of the leading causes of injury and deaths for seniors. These types of injuries can typically be avoided through falls prevention programs, and past studies suggest that these health services have significantly reduced seniors’ falls risk and rates in Canada. Despite the abundance of falls prevention research, practices and programs available in the country, Aboriginal Elders remain overrepresented in fall-related injury and fatality rates. The elevated rates of falls for Aboriginal Elders indicate that current falls prevention programs and standards may not be reaching those most vulnerable to fall hazards and injuries. My thesis is written in the publishable paper format and is comprised of two papers. Using an exploratory case study methodology in paper one, I investigated the social determinants of health that Inuvialuit Elders and LFPPs identify as factors that increase, decrease, or have no effect on the likelihood of an Inuvialuit Elder experiencing a fall. Together, we found that personal health status and conditions, personal health practices and coping skills, physical environments, social support networks, and access to health services increase Inuvialuit Elders likelihood of experiencing a fall, health practices and coping skills and access to health services decrease Inuvialuit Elders likelihood of experiencing a fall, and culture has no affect on the likelihood of Inuvialuit Elders experiencing a fall. In paper two, I used a participatory action research approach informed by postcolonial theory to examine what current falls prevention recommendations are offered by local falls prevention programmers (LFPPs) in order to reduce fall rates among Inuvialuit Elders in Inuvik, Northwest Territories, Canada; and to understand how falls prevention programs for Inuvialuit Elders can be co-created with participants to be culturally safe. In it, I provide the recommended strategies of developing and implementing a culturally safe falls prevention program for Inuvialuit Elders, as suggested by the LFPPs and Inuvialuit Elders who participated in the research. Taken together, the papers in this thesis make it apparent that research concerning falls prevention for Aboriginal Elders and falls prevention programs continues to be influenced by colonial practices. As a result, there is a demonstrated need for program development and research in this area to work towards reducing health disparities and challenging colonial practices.