A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial

BACKGROUND: Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. METHODS: The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. DISCUSSION: This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service and for policy makers

Great Expectations: The Determinants of Female University Enrolment in Europe

We empirically investigate the determinants of the female decision of investing in post-secondary education, focusing on the role played by the context where young women take their education decision. We first develop a stylized two-period model to analyze the female decision of investing in education and highlight two main determinants: the time to be devoted to child care and the probability of working in a skilled job. We then use data on educational decisions of women in the 17-21 age group drawn from EU-Silc, available for the years 2004-2008. From the same survey we construct context indicators at the regional level, and exploit regional variability to identify how women's educational investment reacts to changes in the surrounding context. We find that the share of working women with children below 5 and the share of women with managerial positions or self-employed positively affect the probability that women enrol in post-secondary education. The same does not hold for men

Punishment should fit the crime: an assessment of the French reform of minimum mandatory penalties

Law-and-economics, Crime, Punishment, Judge behavior, K42,