The Impact of Education on Fear of Falling in Elderly Women

Context: More than one third of individuals 65 and older fall each year. Approximately 85% of these falls occur in the homes of independent older adults. Falls can lead to an increased fear of falling, defined as a pervasive concern that a fall may occur. Fear of falling can decrease quality of life due to a lower sense of well-being, limiting mobility, and reduction of social interaction. Reduction in activity can result in a sedentary lifestyle and poor balance which increases the risk of falling. Fifty percent of women 75 years and older participate in no physical activity beyond activities of daily living. Older women, on average, participate in half the amount of moderate and vigorous activity as young women. Activity and education based programs have been shown to increase balance confidence in all participants independent of the program they participated in.The aim of the intervention utilized in this study was to decrease fear of falling in elderly women and improve their overall quality of life. Objective: The purpose of the study was to determine how an educational intervention that utilized balance training and home safety assessment would impact fear of falling in elderly women at different activity levels based on the results from activPAL technology. Setting: All subject were tested at Butterfield Trail Village in Fayetteville, AR for all assessments. Participants: Eight older women; 3 in the high activity group, 2 in the moderate activity group, and 3 in the low activity group. The mean age was 79.1 years, the mean height was 161.7 cm, and the mean weight was 61.1 kg. Methods: The participants were recruited from Butterfield Trail senior living community. The participants were given a health history questionnaire and informed consent. The pre-assessment given was the Falls Efficacy Scale- International (FES-I) to determine the participants’ fear of falling. activPAL monitors were given to each participant to wear for 7 days to determine activity level. A one-on-one education session was conducted with each participant after activity assessment. A post FES-I assessment was given after completion of the education session. Main Outcome Measures: A dependent t-test was conducted to compare pre and post FES-I scores. Differences between groups (group x time) were assessed using a repeated measures ANOVA. Statistical significance was set at α = .05. Correlational analysis was conducted to examine the relationship between fear of falling and activity level Results: Statistical significance was not found in any of the outcome measures. Mean FES-I scores dependent t-test: pre 25.5 + 5.9, post 30.5 + 7.2, mean difference -1.9, p-value .58. Repeated measures ANOVA: low activity pre 27.7 + 3.5 post 32.3 + 8.1, moderate activity pre 31.0 + 1.4 post 33.5 + 6.4, high activity pre 19.0 + 3.0 post 26.7 + 7.6. Correlational analysis: a moderate correlation (-.63) was found between activity level and fear of falling. Conclusion: The education intervention utilized in this study that used a variety of materials and techniques was not effective in reducing fear of falling in elderly women across all activity levels

Concept for automatic Doppler compensation in two-way communication systems

Automatic Frequency Control system compensates for Doppler shift in two-way communication systems where one or both stations are moving. This automatic correction can be applied to the reply link to elimate frequency search for the reply or an excessive bandwidth to accommodate the Doppler

Position sensing materials wound on a reel

Electro-optical counter measures number of layers of web wound on reel and indicates layer number and web position digitally, without physically contacting reel or requiring numerical interpolation from mechanical readout device

Method and apparatus for measuring web material wound on a reel

The method and apparatus for measuring the number of layers of a web material of known thickness wound on a storage or take-up reel is presented. The method and apparatus are based on the principle that, at a relatively large radius, the loci of layers of a thin web wound on the reel approximate a family of concentric circles having radii respectively successively increasing by a length equal to the web thickness. Tachometer pulses are generated in response to linear movement of the web and reset pulses are generated in response to rotation of the reel. A digital circuit, responsive to the tachometer and reset pulses, generates data indicative of the layer number of any layer of the web and of position of the web within the layer without requiring numerical interpolation

Design Optimization for an Electro-Thermally Actuated Polymeric Microgripper

Thermal micro-actuators are a promising solution to the need for large-displacement, gentle handling force, low-power MEMS actuators. Potential applications of these devices are micro-relays, assembling and miniature medical instrumentation. In this paper the development of thermal microactuators based on SU-8 polymer is described. The paper presents the development of a new microgripper which can realize a movement of the gripping arms with possibility for positioning and manipulating of the gripped object. Two models of polymeric microgripper electrothermo- mechanical actuated, using low actuation voltages, designed for SU-8 polymer fabrication were presented. The electro-thermal microgrippers were designed and optimized using finite element simulations. Electro-thermo-mechanical simulations based on finite element method were performed for each of the model in order to compare the results. Preliminary experimental tests were carried out.Comment: Submitted on behalf of EDA Publishing Association (http://irevues.inist.fr/handle/2042/16838

Evaluating Medicaid Managed Care through a Public-Private Partnership

This paper describes how a public-private partnership paved the way for an evaluation of Medicaid managed care with previously inaccessible data. Also included are (1) a brief description of Wisconsin’s Medicaid expansion program, (2) research questions and reflections on implications generated by key informant interviews, (3) some answers to these questions and their policy implications gleaned from a Medicaid enrollee survey, and (4) an assessment of the benefits and policy implications of this partnership. The partnership developed in Wisconsin is relevant for other states with large rural populations who will be facing both welfare reform and managed care.

Emissions trading without a quantity constraint.

This paper examines the differences between standard “cap-and-trade” emissions trading plans and “credit” plans in which individual agents create credits by reducing emissions below a firmspecific baseline. The two are equivalent if the baseline is a fixed quantity, but not if the baseline is specified as a baseline emissions ratio times current output. In the latter case there is no exogenous constraint on aggregate emissions. It may be called the case of “(ratio-based) credit trading”. Examples include the Clean Development Mechanism (CDM) of the Kyoto Protocol and the Canadian Pilot Emissions Reduction Trading plan (PERT). Unlike the case of cap-and-trade, the theoretical properties of ratio-based credit trading plans are not well known. In the absence of a binding quantity constraint, it is even difficult to understand how an ERC plan can generate a positive price. This paper studies the difference between ratiobased credit trading and conventional “cap-and-trade” plans in the context of a very simple model. It also considers how the two plans might interact if, for example, credits from a credit plan could be applied to commitments under a quantity-based cap-and-trade plan, and applies its findings to current plans for credit trading, including PERT and the clean development mechanism. The paper demonstrates that ratio-based credit trading is more like a tax instrument than a quantity instrument. It shows that there is no incentive to trade in a ratio-based market in which all firms receive baselines computed using their “business as ususal” emission ratios. Combining ratio-based credit trading with “cap-and-trade” allowance markets effectively relaxes the quantity constraint in the cap-and-trade plan and reduces the price of traded allowances. In the long run, there will be no effective constraint on emissions. The results have strong implications for current policy. In particular, they suggest that mixing quantity-based and ratio-based emission trading plans is inappropriate.

Aether drift and the isotropy of the universe: a measurement of anisotropies in the primordial black-body radiation

This experiment detected and mapped large-angular-scale anisotropies in the 3 K primordial black-body radiation with a sensitivity of 2x.0001k and an angular resolution of about 10 degs. It measured the motion of the Earth with respect to the distant matter of the Universe (Aether Drift), and probed the homogeneity and isotropy of the Universe (the Cosmological Principle). The experiment used two Dicke radiometers, one at 33 GHz to detect the cosmic anisotropy, and one at 54 GHz to detect anisotropies in the residual oxygen above the detectors. The system was installed in the NASA-Ames Earth Survey Aircraft (U-2), and operated successfully in a series of flights

Using a Model to Evaluate the Impact of Managed Care on Medicaid-Eligible Moms and Their Children in a Rural Population

This paper lays out the advantages of using a model for developing research questions and methodologies aimed at evaluating how managed care arrangements for rural Medicaid moms and their children might affect their access to health care and their related health status. The PRECEDE (predisposing, reinforcing, and enabling causes in educational diagnosis and evaluation) health-education program planning model is refined and applied to a population of Medicaid-eligible moms and their children to help organize and clarify the research questions and to identify the types of variables we need to consider for this exercise. An explanation of those variables, why they are important, and how they can be obtained is presented.