The Influence of Socioeconomic Factors on Fear of Falling and Mobility Outcomes after Lower Limb Loss: a Preliminary Study

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with socioeconomic difficulty would have reduced access to PT after amputation, and [2] individuals with limb loss will have increased fear of falling and decreased mobility performance when compared to non-amputee, age-matched controls. Subjects: 23 participants (7 females,16 males) mean age 51.30 years old (+ 13.17 SD, range 22-70) with lower limb loss ambulating with a definitive prosthesis. Materials/Methods: Participants completed a survey that included the Fear of Falling Avoidance Behavior Questionnaire (FFABQ), questions to determine their socioeconomic status, and whether they received PT after amputation. Mobility outcomes were measured using the standardized Timed Up and Go test (TUG) and the Six Minute Walk Test (6MWT). Results: There was no statistically significant difference in access to PT after amputation between those with and without financial difficulty (p=.354). However, 75% of participants who had no socioeconomic difficulty reported receiving PT, in comparison to only 25% in those who had socioeconomic difficulty. Additionally, 34.8% of our participants reported socioeconomic difficulties. When comparing the participants with amputation to the non-amputee, age-matched controls, there was a significant difference in the TUG (p\u3c.001), 6MWT (p\u3c.001), and FFABQ (p=.008). On average, participants with limb loss were 4.4 seconds slower on the TUG, walked 136.4m less on the 6MWT, and had an increased FFABQ score of 6.6 points out of 56 points. Discussion: Access to physical therapy and socioeconomic status have been overlooked in current literature for individuals after amputation. While the effect of socioeconomic status on PT access did not reach statistical significance in this preliminary study, only 25% of those who reported socioeconomic difficulty received physical therapy after amputation, compared to 75% in those who reported no difficulty. Further research is needed to determine whether low socioeconomic status is predictive of receiving rehabilitation services post-amputation and long-term outcomes. Our findings also showed that when compared to age-matched non-amputees, amputees tend to have impaired mobility and higher degree of fear of falling. These findings agree with current literature. Conclusion: Although not statistically significant, our preliminary findings showed that socioeconomic difficulty may affect access to physical therapy after amputation. Furthermore, our data demonstrated that individuals with lower limb loss exhibit reduced mobility performance and increased fear of falling when compared to the age-matched controls

Estimation of inertial platform errors

Equations for inertial platform error mode

JUDGMENTS-SETTING ASIDE-FAILURE OF LOCAL AGENT TO NOTIFY CORPORATION OF SERVICE OF SUMMONS

Service of summons was made upon a ticket agent employed by a lessee of the defendant coach line in accordance with a North Carolina statute which provides that any person receiving or collecting money within the state for a corporation is a \u27\u27local agent for the purpose of service of process. This agent did not notify the defendant corporation of the summons, and a default judgment was entered. On appeal it was held that the judgment should not be set aside for want of service of summons, since the ticket agent was within the statutory definition of \u27\u27local agent. The defendant then succeeded in having the judgment set aside under a North Carolina statute allowing a default judgment to be set aside in the discretion of the trial judge where the defendant can show mistake, inadvertence, surprise or excusable neglect. On the second appeal, held, the trial judge correctly found excusable neglect where the defendant had no notice due to the neglect of the statutory agent. To hold as a matter of law that no relief could be granted under these circumstances would be a denial of due process of law. Townsend v. Carolina Coach Co., (N.C. 1949) 56 S.E. (2d) 39

TORTS-ATTRACTIVE NUISANCE-PONDS

Plaintiff\u27s four-year-old daughter drowned in a pond on defendant\u27s land. The pond was from six to ten feet deep, with extremely steep banks, and contained various forms of marine life and debris. The pond was useless and was eliminated by the defendant soon after the drowning. The defendant knew that at least twenty small children resided in the immediate area and the pond was visible and accessible to them. In a damage action for the death, held, the defendant was liable under the attractive nuisance doctrine. Saxton v. Plum Orchards, Inc., (La. 1949) 40 S. (2d) 791 (1949)

JUDGMENTS-COLLATERAL ATTACK-INSUFFICIENCY OF THE CAUSE OF ACTION AS A BASIS FOR DENYING JURISDICTION OF A COURT RENDERING A DEFAULT JUDGMENT

In a previous action, A, as assignee of a conditional sales contract, sought to recover the property when the purchase price was not paid. Defendant counterclaimed for damages because of alleged fraud of the assignor in making the sale. On appeal, the Montana Supreme Court held that defendant could not have an affirmative judgment on the counterclaim, but could use his claim as recoupment only. On remand, A\u27s attorney moved for continuance until his client could secure a new attorney. The motion was denied, and on the day set for trial A was not represented. As a consequence, a default judgment was entered for the amount of the counterclaim. Land belonging to A was levied upon and sold to defendant in satisfaction of this judgment. In the present action to quiet title, B, son of A, contended that the affirmative judgment upon the counterclaim was void and that the levy and sale did not pass title to the land. Held, since defendant did not state a cause of action in the first case sufficient for an affirmative judgment, the default judgment is void and subject to collateral attack. Apple v. Edwards, (Mont. 1949) 211 P. (2d) 138

The Chinese Housing Provident Fund

The Chinese government has embarked upon an effort to reduce the number of tenants living in publicly owned housing. This is a significant challenge for any government, but may be especially so for a country where private homeownership is a new option. Out of concern that many of its citizens could not afford to purchase their housing units, the Chinese government created the Housing Provident Fund. This program, which is similar to housing fund programs in other countries such as Thailand and Singapore, combines a 401(k)-like savings and retirement account with subsidized mortgage rates and price discounts to provide a mechanism through which an employee could save for, and eventually complete, a housing purchase.

Role Transition from Student to Occupational Therapist in an Acute Care Physical Dysfunction Setting

Purpose: There are limited tools to assist new graduates and novice occupational therapist as they navigate their job responsibilities within acute physical dysfunction settings. The purpose of this scholarly project was to create a resource to address the challenges faced when transitioning to an acute physical dysfunction setting. Methods: An extensive literature review was conducted on topics relating to: occupational therapy, role transitioning, job responsibilities in an acute setting, environment of acute setting, readiness skills of occupational therapists, challenges faced in an acute setting, and current tools utilized to assist novice therapists in their work transition. The search databases used included: Pubmed, CINAHL, and PsycINFO. Current research has identified that new graduates face many challenges as they transition from student to a qualified occupational therapist including: learning to work collaboratively with other professions, applying highly specific technical skills, and confidence in professional interaction and decision making (Cusick, McIntosh, & Santiago, 2004; Morley, 2007; Robertson & Griffiths 2009; Seah, Mackenzie, & Gamble, 2011; Tryssenaar & Perkins, 2001). Environmental aspects of practice within acute physical dysfunction setting further contribute to practice challenges including: limited space, fast pace, and exposure to extensive medical equipment (Cusick, McIntosh, & Santiago, 2004). Results: Guided by the Occupational Adaptation model, the Novice Adaptation Tool (NAT) was developed. This tool provides a structure for novice therapist to evaluate their relative mastery in areas of assessment, treatment planning, intervention, documentation, communication and professionalism, and to work collaboratively with a mentor to address areas of need. A five-stage process allows for self-evaluation, collaborate discussion, en-vivo observation, reflective processing, and goal re-evaluation. Two case studies are included to illustrate tool use. Conclusion: The NAT offers an efficient and yet thorough format to facilitate new graduate and novice occupational therapist transition to acute physical dysfunction settings

Temperature Dependency of Electrostatic Breakdown in LDPE and PEEK

Electrostatic breakdown is a leading cause of many of the anomalies and failures attributed to spacecraft interactions with the space environment. It is therefore critical to understand how the electrostatic field strength varies due to changing environmental conditions, including temperature and radiation dose. Standard step-up to electrostatic discharge (ESD) tests were performed on two polymers, low density polyethylene (LDPE) and polyetheretherketone (PEEK). Tests were done at room temperature and at other temperatures ranging from ~130 K to ~350 K. Preliminary analysis found that samples tested at a higher temperature had lower average breakdown field strength and a narrower distribution of breakdown field values. These results are considered with respect to a proposed dual-defect theory for electrostatic breakdown, which incorporates both lower energy recoverable defect modes that can be generated and annihilated through thermal annealing and higher energy irrecoverable defect modes such as those created by radiation damage. The model predicts that at lower electric field strengths, an annealing process occurs due to the higher temperature which limits the density of low energy defects in the material. This means that while the overall breakdown field strength decreases, the minimum field strength required to breakdown the material would increase, thereby narrowing the breakdown distribution. This work was supported by a NASA Space Technology Research Fellowship