Prevalence and predictors of falls and dizziness in people younger and older than 80 years of age-A longitudinal cohort study.

The objectives were to investigate the prevalence and predictors for falls and dizziness among people younger and older than 80 years of age. The sample was drawn from the Swedish National study on Aging and Care (SNAC) and comprised 973 and 1273 subjects with data on the occurrence of falls and dizziness respectively at baseline. Follow-ups were made after 3- and 6-years. Data included socio-demographics, physical function, health complaints, cognition, quality of life and medications. The prevalence of falls was 16.5% in those under aged 80 and 31.7% in those 80+ years while dizziness was reported by 17.8% and 31.0% respectively. Predictors for falls in those under aged 80 were neuroleptics, dependency in personal activities of daily living (PADL), a history of falling, vision impairment and higher age, and in those 80+ years a history of falling, dependency in instrumental activities of daily living (IADL), fatigue and higher age. Factors predicting dizziness in those under aged 80 were a history of dizziness, feeling nervous and reduced grip strength and in those 80+ years a history of dizziness and of falling. Predictors for falls and dizziness differed according to age. Specific factors were identified in those under aged 80. In those 80+ years more general factors were identified implying the need for a comprehensive investigation to prevent falls. This longitudinal study also showed that falling and dizziness in many older people are persistent and therefore should be treated as chronic conditions

Predictors of dizziness in older persons: a 10-year prospective cohort study in the community

BACKGROUND: The current diagnosis-oriented approach of dizziness does not suit older patients. Often, it is difficult to identify a single underlying cause, and when a diagnosis is made, therapeutic options may be limited. Identification of predictors of dizziness may provide new leads for the management of dizziness in older patients. The aim of the present study was to investigate long-term predictors of regular dizziness in older persons. METHODS: Population-based cohort study of 1,379 community-dwelling participants, aged ≥60 years, from the Longitudinal Aging Study Amsterdam (LASA). Regular dizziness was ascertained during face-to-face medical interviews during 7- and 10-year follow-up. We investigated 26 predictors at baseline from six domains: socio-demographic, medical history, medication, psychological, sensory, and balance/gait. We performed multivariate logistic regression analyses with presence of regular dizziness at 7- and 10-year follow-up as dependent variables. We assessed the performance of the models by calculating calibration and discrimination. RESULTS: Predictors of regular dizziness at 7-year follow-up were living alone, history of dizziness, history of osteo/rheumatoid arthritis, use of nitrates, presence of anxiety or depression, impaired vision, and impaired function of lower extremities. Predictors of regular dizziness at 10-year follow-up were history of dizziness and impaired function of lower extremities. Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71). CONCLUSIONS: Dizziness in older age was predicted by multiple factors. A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2318-14-133) contains supplementary material, which is available to authorized users

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Modern technology against falls – A description of the MoTFall project

To meet future challenges from an older and physically less active population innovative solutions are needed. Modern Technology against Falls (MoTFall) aims to prevent falls, increase physical activity and improve self-rated health among older people by means of an information and communication technology based system. The project has developed technology-based solutions, focusing on person-centred care. A participatory research design was applied in the development of a mobile application, a wearable inertial movement measurement unit (IMMU), called the Snubblometer (‘snubbla’ is ‘stumble’ in Swedish) and a web-based education programme for health care professionals. The mobile application includes a fall risk index, exercises and information related to falls prevention. By linking the app to the IMMU, person-centred interventions can be developed and implemented in various health care settings and with different target populations. The IMMU has shown good validity and reliability for measuring postural sway and high sensitivity and specificity for measuring a near fall. The education programme is directed at non-graduate health care professionals in nursing homes and home care. The technical solutions have potential for use in research and in clinical practice

Predictive validity and cut-off scores in four diagnostic tests for falls – a study in frail older people at home

Artikkelen rapporterer en studie hvor hensikten var å undersøke validiteten og treffsikkerheten for instrumentene Downton Fall Risk Index, Timed Up and Go og Romberg test, når det gjelder prediksjon av fall hos hjemmeboende eldre.No study has investigated the predictive validity and cut-off scores in diagnostic tests for falls used in in-home assessment in frail older people. The objective was to investigate the predictive validity for falls in the Downton Fall Risk Index (DFRI), Timed Up and Go (TUG) and Romberg test (RT) used in in-home assessment of frail older people (65+ years). Data on the diagnostic tests were collected at baseline (N = 153) and fall frequency were collected at six- and twelve-month follow-ups. The optimal cut-offs were 3 p in DFRI and 12 s in TUG. However, the validity indexes were generally low and only 40–50% were correctly classified. The RT showed low sensitivity. To increase the predictive validity for falls in this context, the use of DFRI and/or TUG as a part of a comprehensive fall-risk assessment tool, should be investigated in future studies

Elites and the expansion of education in nineteenth-century Sweden

A large literature emphasizes that elite capture of political institutions hampered the spread of mass schooling in the nineteenth and twentieth century. We collect new data on investments in elementary education and the distribution of voting rights for more than 2,000 local governments in nineteenth‐century Sweden and document that educational expenditure was higher where the distribution of political power was more unequal. In particular, areas governed by local landed elites—even those where a single landowner had de jure dictatorial powers—invested substantially more in mass schooling relative to areas where political power was more widely shared, or where it lay in the hands of capitalist elites. Our findings lend quantitative support to an earlier literature produced by economic and social historians which argues that landed elites advanced mass schooling as part of their historical role as patrons of the local community and as a response to the increasing proletarianization of the rural population, while also furthering our understanding of how Sweden maintained a high level of human capital despite its low level of economic development and restricted franchise in the nineteenth century

BIOMEX: Three different steps to approach a systematic determination of habitats and stable biosignatures in space- and Mars-like environments

BIOMEX (Biology and Mars Experiment) is a space experiment on the exposure platform EXPOSER2 launched by the Progress 56 mission on 24 July and placed on the outer side of the Russian Zvezda Module of the International Space Station (ISS). Twenty-five international institutes are working together and sharing different methods, planetary simulation facilities, and logistics to obtain information about the vitality of the tested microorganisms and the stability of biomolecules as possible biosignatures. This experiment comprises three investigational steps from the field to space: (i) field work with sample collection and habitat characterization at field sites with or without Mars analogy, (ii) Mars simulation experiments in the lab and (iii) exposure to real space conditions. For the second and third steps some of the microorganisms and bio-molecules are embedded in Marsanalog regolith mixtures, placed in compartments enriched with Mars-like CO 2 -atmosphere and exposed to solar irradiation levels approaching those affecting the surface of Mars to test habitability on Mars, as well as the ability to detect the selected, Mars-exposed bio-molecules. One of the aims of this experiment is to investigate the specific bio-related spectra of resistant molecules obtained by fluorescence analysis, Raman-spectroscopy, IR- and UV/VIS spectrometry before and after simulated and real space exposure. The obtained database of stable bio-molecules will support future exploration missions to Mars whose main goal is the search for life