Risks factors for significant injury after geriatric falls

Elderly falls are a healthcare epidemic. We aimed to identify risk factors of serious falls by linking data on functional status from the Global Longitudinal Study of Osteoporosis in Women (GLOW) and our institutional trauma registry. 124 of 5,091 local women enrolled in GLOW were evaluated by our trauma team for injuries related to a fall during the study period. Median injury severity score was 9. The most common injuries were intertrochanteric femur fracture (n = 25, 9.8%) and skin contusion/hematoma to face (n = 12, 4.7%). Injured women were older than the uninjured cohort (median 80 versus 68 years), more likely to have cardiovascular disease and osteoarthritis, and less likely to have high cholesterol. Prospectively collected Short Form 36 (SF-36) baseline activity status revealed greater limitation in all assessed activities in women evaluated for fall-related injuries in our trauma center. In multivariable analysis, age (per 10 year increase) and two or more self-reported falls in the baseline survey were the strongest predictors of falling (both HR 2.4, p <0.0001 and p<0.001 respectively), followed by history of osteoarthritis (HR 1.6, p= 0.01). Functional status was no longer associated with risk of fall when adjusting for these factors.Functional status appears to be a surrogate marker for frailty. With the aging of the US population and long lifespan of American women, this finding has important implications for both fall prevention strategies and research intended to better understand why aging women fall as burdensome validated metrics may not be the best indicators of fall risk. The authors have no conflict of interests to declare. Funding statement: This work was partially supported by grants from NIH (8KL2TR000160-03), AHRQ (R01HS22694), and PCORI (ME-1310-07682) to HS

The Policy and Practice of Music Education in England, 2010-2020

Since the introduction of the National Plan for Music Education there have been significant changes in music education within England. Whilst some celebrate figures that report increased access and engagement, many teachers and others continue to have legitimate concerns regarding the quality of the music education on offer in schools and Music Education Hubs. There are concerns that the provision of music education is incoherent and patchy across the country. Many would argue that the opportunity to access high‐quality music education has become a ‘postcode lottery’. There is a sense that the fragmentation of music education as a result of curriculum reforms and the diversity of approaches taken by Music Education Hubs and other bodies has significantly enhanced this incoherence. This article seeks to review the policy and practice of music education in England over the last 10 years. It draws on recent research from various sources and maintains a particular focus on government policy and the consequences of this for the field as a whole. It reflects on how things could be improved in the future. It argues for a clearer focus on a practitioner‐led approach to research and advocacy, in particular one led by the notion of ‘policy as practice’ rather than continuing with the current approach and its intrinsic failings

Geographical distribution of fractionated local fallout from the Nagasaki A-bomb

NRC publication: Ye

Effectiveness of tree rings for recording Pu history at Nagasaki, Japan

NRC publication: Ye

Plutonium mass balance released from the Nagasaki A-Bomb and the applicability for future environmental research

NRC publication: Ye