Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

BACKGROUND: Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. OBJECTIVES: The purpose of this study was to translate research findings into a real world setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a proof of concept model for future programing. METHODS: Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. RESULTS: Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s (p = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 (p = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s (p \u3c 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care. CONCLUSION: Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention

International Factors Impacting Corporate Social Responsibility at STEM Organizations

poster abstractCorporate Social Responsibility (CSR) has gained significant attention over the past decade and continues to grow as a rising global effort in STEM organizations across multiple industries. Many countries have a longstanding history of practicing CSR and have adopted or adapted the Western model of corporate volunteerism. However, little research has been conducted to determine cultural factors that impact this practice such as volunteer motivation, satisfaction, and project types. This study explores the CSR efforts of, Eli Lilly and Company (Lilly), whose annual day of service provides employees across the globe the opportunity to serve various organizations and their communities through diverse projects. This research aims to determine the influence of culture dimensions and societal norms on multiple aspects of Lilly’s volunteer efforts such as the acceptance of the practice and perspectives of volunteers

A solute gradient in the tear meniscus I. A hypothesis to explain Marx's line

Marx's line is a line of mucosal staining behind the mucocutaneous junction. It can be demonstrated throughout life in all normal lids by staining with lissamine green and related dyes. Of all the body orifices, only the mucosae of the eye and mouth are directly exposed to the atmosphere. In this paper, we suggest that for the eye, this exposure leads to the formation of Marx's line. The tear meniscus thins progressively toward its apex, where it is pinned at the mucocutaneous junction of the lid. It also thins toward the black line, which segregates the meniscus from the tear film after the blink. We predict that, because of the geometry of the tear meniscus, evaporation generates a solute gradient across the meniscus profile in the anteroposterior plane, which peaks at the meniscus apices at the end of the interblink. One outcome would be to amplify the level of tear molarity at these sites so that they reach hyperosmolar proportions. Preliminary mathematical modeling suggests that dilution of this effect by advection and diffusion of solute away from the meniscus apex at the mucocutaneous junction will be restricted by spatial constraints, the presence of tear and surface mucins at this site, and limited fluid flow. We conclude that evaporative water loss from the tear meniscus may result in a physiological zone of hyperosmolar and related stresses to the occlusal conjunctiva, directly behind the mucocutaneous junction. We hypothesize that this stimulates a high epithelial cell turnover at this site, incomplete epithelial maturation, and a failure to express key molecules such as MUC 16 and galectin-3, which, with the tight junctions between surface epithelial cells, are necessary to seal the ocular surface and prevent penetration of dyes and other molecules into the epithelium. This is proposed as the basis for Marx's line. In Part II of this paper (also published in this issue of The Ocular Surface), we address additional pathophysiological consequences of this mechanism, affecting lid margins

A Research Study on the Reasons for High Employee Turnover Rates in a Manufacturing Facility

This research study was designed to determine the causes and possible solutions to the problem of high employee turnover rates within a particular manufacturing organization located in central Georgia. The in-depth research was completed in an ongoing effort to retain valuable employees in manufacturing organizations before these employees have reached the decision to depart the organization. The research outcome or the turnover analysis process may be useful to other companies and may add to the present academic research addressing employee turnover. The researcher incorporated qualitative research methods for cause determination. The objectives of the research were to identify work-related and external economic opportunity factors that caused turnover within the company, identify possible employee turnover solutions derived from analyzed data, and recommend solutions for the reduction in turnover rates. This turnover evaluation process provided an instrument for management to use in analyzing the turnover phenomenological approach in the organization. Data-collection methods included a combination of observations, open-ended interviews, surveys, and documents that provided preliminary background information

The Influence and Legacy of Deism in Eighteenth Century America

This thesis project, The Influence and Legacy of Deism in Eighteenth Century America, examines deism’s impact as a theological system on American life and culture in the eighteenth century. Beginning with a basic definition of the term deism, a historical background is included. Next, the work of Galileo, Bacon, Newton, and Locke is examined for its impact on eighteenth century thought as well as early deist writers such as John Toland, Matthew Tindal, and Lord Herbert of Cherbury. Moving onto America in the eighteenth century, colonial newspaper articles, letters, and other documents are examined that contain references to deism. Colleges such as Yale and Harvard are also discussed in reference to curriculum. The reaction of American churches and specifically, theological leaders such as Ezra Stiles and Timothy Dwight are explored with mention of speeches and printed documents that address deism during the period. The last section of the paper addresses the works of American deist writers such as Ethan Allen, Elihu Palmer and Thomas Paine. Their ideas are examined and how they influenced the deist movement. Lastly, Thomas Jefferson and Benjamin Franklin are discussed in regards to their private faith and the potential influence of deism on their public policies. Wrapping up the paper, deism’s disappearance at the end of the eighteenth century is explained and the entire movement summarized. Overall, the thesis focuses strictly on deism in eighteenth century American and its influence and lasting impact on American culture and life

A solute gradient in the tear meniscus II. implications for lid margin disease, including meibomian gland dysfunction

We have hypothesized previously that evaporation from the tears generates a solute gradient across the tear meniscus, which delivers hyperosmolar stress to the mucocutaneous junction (MCJ) of the lid margin. This is proposed as the basis for Marx's line, a line of staining with topically applied dyes that lies directly behind the MCJ. In this article, we consider the implications of this hypothesis for progressive damage to the lid margin as an age-related phenomenon, its amplification in dry eye states, and its possible role in the etiology of meibomian gland dysfunction (MGD). It is suggested that a hyperosmolar or related stimulus, acting behind the MCJ over a lifetime, promotes the anterior migration of the MCJ, which is a feature of the aging lid margin. This mechanism would be amplified in dry eye states, not only by reason of increased tear molarity at the meniscus apex but also by raising the concentration of inflammatory peptides at this site. This could explain the increased width and irregularity of Marx's line in dry eye. While the presence of stem cells at the lid margin may equip this region to respond to such stress, their depletion could be the basis of irreversible lid margin damage. It is further proposed, given the proximity of the MCJ to the meibomian gland orifices, that the solute gradient mechanism could play a role in the initiation of MGD by delivering hyperosmolar and inflammatory stresses to the terminal ducts and orifices of the glands. By the same token, the presence of a zone of increased epithelial permeability in this region may provide a back door route for the delivery of drugs in the treatment of MGD

Analyzing the validity of self-reports of emotional responding using an electronic device

The assessment of internal behaviors such as thoughts, feelings, or physiological symptoms not seen by the naked eye are often assessed with indirect measures such as self-reports and questionnaires given the lack of accessibility and observations by outside observers. The self-management of human behaviors, including internal events, carries socially valid implications for an individual’s quality of life, including children and individuals with neurological, developmental, and intellectual disabilities. This study aimed to address the following question: are there valid measurement procedures (e.g., collecting data on physiological responses) to analyze the correspondence between self-reports of emotional states and observable and measurable overt behaviors? To address the limitations in measurement validity of private, covert behaviors, the primary researcher of this study conducted a correspondence check of these three measurements with two participants with autism spectrum disorder in the following manner: collected heart rate data of the participants via a wearable device (Fitbit® Charge 5), conducted direct observation and data recording of overt behaviors, and collected data on the participants’ self-report of their emotional or physiological state via a 5-point rating scale across several time periods per session. Results of the study showed a strong positive correlation between observer and participant ratings from the 5-point rating scales; however, physical activity of the participants seemed to consistently mask true heart rate readings of the emotional responses. More research can be done on the correspondence of these three variables and their implications for guiding self-management programs of private events