Evaluation of the effect of patient education on rates of falls in older hospital patients: Description of a randomised controlled trial

Background. Accidental falls by older patients in hospital are one of the most commonly reported adverse events. Falls after discharge are also common. These falls have enormous physical, psychological and social consequences for older patients, including serious physical injury and reduced quality of life, and are also a source of substantial cost to health systems worldwide. There have been a limited number of randomised controlled trials, mainly using multifactorial interventions, aiming to prevent older people falling whilst inpatients. Trials to date have produced conflicting results and recent meta-analyses highlight that there is still insufficient evidence to clearly identify which interventions may reduce the rate of falls, and falls related injuries, in this population. Methods and design. A prospective randomised controlled trial (n = 1206) is being conducted at two hospitals in Australia. Patients are eligible to be included in the trial if they are over 60 years of age and they, or their family or guardian, give written consent. Participants are randomised into three groups. The control group continues to receive usual care. Both intervention groups receive a specifically designed patient education intervention on minimising falls in addition to usual care. The education is delivered by Digital Video Disc (DVD) and written workbook and aims to promote falls prevention activities by participants. One of the intervention groups also receives follow up education training visits by a health professional. Blinded assessors conduct baseline and discharge assessments and follow up participants for 6 months after discharge. The primary outcome measure is falls by participants in hospital. Secondary outcome measures include falls at home after discharge, knowledge of falls prevention strategies and motivation to engage in falls prevention activities after discharge. All analyses will be based on intention to treat principle. Discussion. This trial will examine the effect of a single intervention (specifically designed patient education) on rates of falls in older patients in hospital and after discharge. The results will provide robust recommendations for clinicians and researchers about the role of patient education in this population. The study has the potential to identify a new intervention that may reduce rates of falls in older hospital patients and could be readily duplicated and applied in a wide range of clinical settings. Trial Registration. ACTRN12608000015347

Shear Stress Statistics in a Compound Channel Flow

The results of comprehensive measurements of three-dimensional turbulent velocities carried out in a laboratory compound channel are presented. Tests were performed in a two-stage channel with a smooth main channel bed consisting of concrete and rough floodplains and sloping banks. Instantaneous velocities were measured with the use of a three-component acoustic Doppler velocimeter. The main aim of the study is the recognition of structure of Reynolds stresses in turbulent open channel flows. Particular attention has been paid to bursting events such as ejections and sweeps. The bursting phenomenon occurs originally near the buffer layer and then shows a coherent or organized flow structure during its convection process. The probability density distributions of the turbulent velocities were measured at different distances from the bed in the main channel and also above the inclined walls. In the main channel, the lateral turbulent velocity is seen to follow the normal Gaussian distribution more closely than the remaining two components. Above the inclined walls, all distributions turned out to have greater skewness. The probability density distributions of correlations between velocity fluctuations were also calculated. These distributions have long tails and sharp peaks and fit the theoretical distributions very well. The structure of instantaneous Reynolds stresses was analyzed by a quadrant technique with an arbitrarily chosen threshold level. It has been shown that the largest contribution to turbulent stresses comes from the second quadrant (ejection) and the fourth quadrant (sweep). The basic temporal characteristics for quadrant events, like the average and maximum time for a zero hole size, have been determined in the study. Calculations of maximum duration times for all events reveal that times are greater for even quadrants than for odd quadrants

Measurements of 3D turbulence structure in a compound channel

The paper describes some turbulence measurements carried out in an experimental compound channel with flood plains. The surface of the main channel bed was smooth and made of concrete, whereas the floodplains and sloping banks were covered by cement mortar composed with terrazzo. Instantaneous velocities were measured be means of a three-component acoustic Doppler velocity meter (ADV) manufactured by Sontek Inc. This article presents the results of measurements of primary velocity, the distribution of turbulent intensities, Reynolds stresses, autocorrelation functions, turbulent scales, as well as the energy spectra

Properties of a streamwise turbulent flow field in an open two-stage channel

The results of the experimental studies, aimed at the recognition of the streamwise turbulent structure in a compound channel, are reported in this paper. Three sets of measurements with electromagnetic liquid velocity meter were used: one in a smooth channel, one with the rough overbank channels and the last one with the modelled high vegetation occurring on floodplains. The analyses included vertical distributions of local mean velocities, depth-averaged mean velocities, bed shear stresses, turbulent intensities, higher order velocity moments, autocorrelation and velocity spectra. Relevant turbulent temporal and spatial scales were evaluated. All the properties were investigated with special emphasis placed on the influence of roughness on them

Pervasive Web Access via Public Communication Walls

Abstract. Multi-user communication and interaction via public displays together the pervasive and seamless access to the WWW in public areas via mobile phones or handheld devices is enabled via the WebWall system. A software framework for the operation of WebWalls has been developed, strictly separating WebWall access technologies (like HTTP, email, SMS, WAP, EMS, MMS or even simple paging protocols found on mobile phones) from the physical display technologies used and the presentation logic involved. The architecture integrates ubiquitous wireless networks (GSM, IEEE802.11b), allowing a vast community of mobile users to access the WWW via public communication displays in an ad-hoc mode. A centralized backend infrastructure hosting content posted by users in a display independent format has been developed together with rendering engines exploiting the particular features of the respective physical output devices installed in public areas like airports, trainstations, public buildings, lecture halls, fun and leisure centres and even car navigation systems. A variety of different modular service classes has been developed to support the posting or pulling of WWW media elements ranging from simple sticky notes, opinion polls, auctions, image and video galleries to mobile phone controlled web browsing. 1

Comparison of user performance in mixed 2D-3D multi-display environments

Stereoscopic displays and volumetric 3D displays capable of delivering 3D views have in use for many years. These standalone displays have been investigated in detail for their impact on users’ viewing experiences. Effects like aesthenopia and nausea are well-known for flat-screen based stereoscopic displays. However, these devices have not been tested in the context of multi-display environments (MDEs). The performance cost of repetitive switching between a 3D (stereo or volumetric) display and a standard 2D display are not known. In this paper, we perform a thorough user study where we investigate the effects of using such 3D displays within the context of a MDE. We report on our findings and discuss the implications of the same on designs involving such hybrid setups. Our experiments show that in the condition involving two 2D displays which allow for motion parallax and perspective correction, the participants performed the task the fastest