RESPOND – A patient-centred program to prevent secondary falls in older people presenting to the emergency department with a fall: Protocol for a multi-centre randomised controlled trial

Introduction: Participation in falls prevention activities by older people following presentation to the Emergency Department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND program which is designed to improve older persons’ participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. Design and setting: An RCT at two tertiary referral EDs in Melbourne and Perth, Australia. Participants: Five-hundred and twenty eight community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who: require an interpreter or hands-on assistance to walk; live in residential aged care or >50 kilometres from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or history of psychosis; are receiving palliative care; or are unable to use a telephone will be excluded. Methods: Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates: (1) home-based risk factor assessment; (2) education, coaching, goal setting, and follow-up telephone support for management of one or more of four risk factors with evidence of effective intervention; and (3) healthcare provider communication and community linkage delivered over six months. Primary outcomes are falls and fall injuries per-person-year. Discussion: RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease however evidence to support this approach in falls prevention is limited. Trial registration. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684)

Photocatalytic activity of nitrogen-doped TiO2-based nanowires: a photo-assisted Kelvin probe force microscopy study

The emerging industrial business partnerships, which feature cross-functional and cross-company development efforts, raise the barrier for the establishment of effective knowledge sharing practices in the larger organization. This chapter aims to highlight the role of knowledge as a key enabler for effective engineering activities in the light of such emerging enterprise collaboration models. Knowledge Enabled Engineering (KEE) is presented as an approach to enhance the extended organization’s capability to establish effective collaboration among its parts, in spite of different organizational structures, technologies or processes. KEE is analysed in its constituent parts, highlighting areas, methods and tools that are particularly interesting for leveraging companies’ knowledge sharing capabilities

Feasibility and results of a randomised pilot-study of pre-discharge occupational therapy home visits

BACKGROUND: Pre-discharge home visits aim to maximise independence in the community. These visits involve assessment of a person in their own home prior to discharge from hospital, typically by an occupational therapist. The therapist may provide equipment, adapt the home environment and/or provide education. The aims of this study were to investigate the feasibility of a randomised controlled trial in a clinical setting and the effect of pre-discharge home visits on functional performance in older people undergoing rehabilitation. METHODS: Ten patients participating in an inpatient rehabilitation program were randomly assigned to receive either a pre-discharge home visit (intervention), or standard practice in-hospital assessment and education (control), both conducted by an occupational therapist. The pre-discharge home visit involved assessment of the older person's function and environment, and education, and took an average of 1.5 hours. The hospital-based interview took an average of 40 minutes. Outcome data were collected by a blinded assessor at 0, 2, 4, 8 and 12 weeks. Outcomes included performance of activities of daily living, reintegration to community living, quality of life, readmission and fall rates. RESULTS: Recruitment of 10 participants was slow and took three months. Observed performance of functional abilities did not differ between groups due to the small sample size. Difference in activities of daily living participation, as recorded by the Nottingham Extended Activities of Daily Living scale, was statistically significant but wide confidence intervals and low statistical power limit interpretation of results. CONCLUSION: Evaluation of pre-discharge home visits by occupational therapists in a rehabilitation setting is feasible, but a more effective recruitment strategy for a main study is favored by application of a multi-centre setting

Effects of Enriched Physical Activity Environments on Balance and Fall Prevention in Older Adults: A Scoping Review

The incidence of falling, due to ageing, is related to both personal and environmental factors. There is a clear need to understand the nature of the major risk factors and design features of a safe and navigable living environment for potential fallers. The aim of this scoping review was to identify studies that have examined the effectiveness of environments which promote physical activity and have an impact on falls prevention. Selected studies were identified and categorised into four main topics: built environment; environment modifications; enriched environments, and task constraints. The results of this analysis showed that there are a limited number of studies aiming to enhance dynamic postural stability and fall prevention through designing more functional environments. This scoping review study suggests that the design of interventions and the evaluation of an environment to support fall prevention is a topic for future research

Mémoire sur les différents rapports sous lesquels l'âge était considéré dans la législation romaine

Pardessus Jean-Marie. Mémoire sur les différents rapports sous lesquels l'âge était considéré dans la législation romaine. In: Mémoires de l'Institut national de France, tome 13, 1ᵉ partie, 1837. pp. 266-344

Rapport sur une nouvelle publication des Assises de Jérusalem

Pardessus Jean-Marie. Rapport sur une nouvelle publication des Assises de Jérusalem. In: Mémoires de l'Institut national de France, tome 12, 1839. pp. 86-97

De la juridiction exercée par la cour féodale du roi sur les grands vassaux de la Couronne, pendant les onzième, douzième et treizième siècles.

Pardessus Jean-Marie. De la juridiction exercée par la cour féodale du roi sur les grands vassaux de la Couronne, pendant les onzième, douzième et treizième siècles.. In: Bibliothèque de l'école des chartes. 1848, tome 9. pp. 281-304

Mémoire sur la distinction qu'on peut faire dans les textes de la loi salique entre les titres principaux et les additions qu'elle a reçues dans la suite

Pardessus Jean-Marie. Mémoire sur la distinction qu'on peut faire dans les textes de la loi salique entre les titres principaux et les additions qu'elle a reçues dans la suite. In: Mémoires de l'Institut national de France, tome 15, 2ᵉ partie, 1845. pp. 1-45