Search results for: fall

Authors: Sheldon McCall, Miao Yu, Liyun Gong, Shigang Yue, Stefanos Kollias

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Falls are a significant health concern for older adults globally, and prompt identification is critical to providing necessary healthcare support. Our study proposes a new fall detection method using computer vision based on modern deep learning techniques. Our approach involves training a trans- former model on a large 2D pose dataset for general action recognition, followed by transfer learning. Specifically, we freeze the first few layers of the trained transformer model and train only the last two layers for fall detection. Our experimental results demonstrate that our proposed method outperforms both classical machine learning and deep learning approaches in fall/non-fall classification. Overall, our study suggests that our proposed methodology could be a valuable tool for identifying falls.

Keywords: healthcare, fall detection, transformer, transfer learning

Procedia PDF Downloads 141

Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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Authors: Gökhan Altay, Cafer Kayadelen

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Rock fall is a movement of huge rock blocks from dip slopes due to physical effects. It generally occurs where loose tuffs lying under basalt flow or stringcourse is being constituted by limestone layers which stand on clay. By corrosion of some parts, big cracks occur on layers and these cracks continue to grow with the effect of freezing-thawing. In this way, the breaking rocks fall down from these dip slopes. Earthquakes which can induce lots of rock movements is another reason for rock fall events. In Turkey, we have a large number of regions prone to the earthquake as in the World so this increases the possibility of rock fall events. A great number of rock fall events take place in Turkey as in the World every year. The rock fall events occurring in urban areas cause serious damages in houses, roads and workplaces. Sometimes it also hinders transportation and furthermore it maybe kills people. In Turkey, rock fall events happen mostly in Spring and Winter because of freezing- thawing of water in rock cracks frequently. In mountain and inclined areas, rock fall is risky for engineering construction and environment. Some countries can invest significant money for these risky areas. For instance, in Switzerland, approximately 6.7 million dollars is spent annually for a distance of 4 km, to the systems to prevent rock fall events. In Turkey, we have lots of urban areas and engineering structure that have the rock fall risk. The embankments are preferable for rock fall events because of its low maintenance and repair costs. Also, embankments are able to absorb much more energy according to other protection systems. The current design method of embankments is only depended on field tests results so there are inadequate studies about this design method. In this paper, the field test modeled in three dimensions and analysis are carried out with the help of ANSYS programme. By the help of field test from literature the numerical model validated. After the validity of numerical models additional parametric studies performed. Changes in deformation of embankments are investigated by the changes in, geometry, velocity and impact height of falling rocks.

Keywords: ANSYS, embankment, impact height, numerical analysis, rock fall

Procedia PDF Downloads 509

Authors: A. Metioui

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Research related to the student’s conceptual difficulties in sciences, particularly in the field of physics, are relatively numerous. In this work, we will analyze the results of qualitative research conducted with 80 elementary preservice teachers from Quebec in Canada on their understandings after studying the free fall bodies. First, we will illustrate the paper-pencil questionnaire built for this purpose. Then we will give the analysis of the experimental data. The results show that, even though there is a continuing physics education, many misconceptions persist despite the teaching provided.

Keywords: pre-service teachers, elementary school, conceptual difficulties, free fall bodies

Procedia PDF Downloads 126

Authors: Nantakrit Yodpijit, Teppakorn Sittiwanchai

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The number of older adults is rising rapidly. The world’s population becomes aging. Falls is one of common and major health problems in the elderly. Falls may lead to acute and chronic injuries and deaths. The fall-prone individuals are at greater risk for decreased quality of life, lowered productivity and poverty, social problems, and additional health problems. A number of studies on falls prevention using fall detection system have been conducted. Many available technologies for fall detection system are laboratory-based and can incur substantial costs for falls prevention. The utilization of alternative technologies can potentially reduce costs. This paper presents the new design and development of a wearable-based fall detection system using an Accelerometer and Gyroscope as motion sensors for the detection of body orientation and movement. Algorithms are developed to differentiate between Activities of Daily Living (ADL) and falls by comparing Threshold-based values with Artificial Neural Networks (ANN). Results indicate the possibility of using the new threshold-based method with neural network algorithm to reduce the number of false positive (false alarm) and improve the accuracy of fall detection system.

Keywords: aging, algorithm, artificial neural networks (ANN), fall detection system, motion sensorsthreshold

Procedia PDF Downloads 496

Authors: Rami S. Alasmari, Abdullah Al Zahrani, Hattan A. Hassani, Hattan A. Hassani, Nawwaf A. Almalky, Abdullah F. Bokhari, Alwalied A. Hafez

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Diabetes mellitus type 2 (DMT2) is a major chronic condition that is considered common among elderly people, with multiple potential complications that could contribute to falls. However, this concept is not well understood, thus, the aim of this study is to determine whether diabetes is an independent risk factor for falls in elderly. In this observational cross-sectional study, 309 diabetic patients aged 60 or more who visited the primary healthcare centers of the Ministry of National Guard Health Affairs in Jeddah were chosen via convenience sampling method. To collect the data, Semi-structured Fall Risk Assessment questionnaire and Fall Efficacy Score scale were used. The mean age of the participants was estimated to be 68.5 (SD:7.4) years. Among the participants, 48.2% experienced falling before, and 63.1% of them suffered falls in the past 12-months. The results showed that gait problems were independently associated with a higher likelihood of fall among the elderly patients (OR = 1.98, 95%CI, 1.08 to 3.62, p = 0.026. This paper suggests that diabetes mellitus is an independent fall risk factor among elderly. Therefore, identifying such patients as being at higher risk and prompt referral to a specialist falls clinic is recommended.

Keywords: diabetes, fall, elderly, risk factors

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Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Saeed Seyed Agha Banihashemi

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The history of mathematics as one of the trends in the field of mathematics has special importance and in most of the important universities of the world, this trend in the field of mathematics is taught and researched. In teaching the history of mathematics and mathematics books, special attention is paid to the scientific works of the four Greek-Indian-Islamic and European civilizations, although the history of mathematics in China and East Asia is a special category due to its ancient civilization. In this article, while examining mathematics in the Islamic empire, the factors of the scientific rise and fall of the Islamic empire, which can include mathematics, have been studied. In this article, according to my own research and other sources mentioned s, It is believed the factors of scientific rise and fall in the Islamic Empire.

Keywords: history of mathematics, alkandi, cryptology, manuscripts

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Authors: Ibrahim Sani, Suleiman Mohammed., Salisu Sulaiman, Aminu Musa

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The fall army worm (FAW), Spodoptera frugiperda (J. E. Smith) (Lepidoptera, Noctuidae) has recently become one of the major threats to maize production in the world. It is native to tropical and subtropical America and began to spread to many African and a few Asian Countries. A survey for the observation of infestation and collection of fall armyworm was conducted in field planted with maize in the northern part of Katsina state. Eggs and immature stages were collected, place in a plastic container and brought to the laboratory for observation and study of developmental stages. FAW was identified based on the morphological characteristics, i.e. the “Y” inverted shape on the head capsule and the patterns of black spots on the abdominal segments (square and trapezoidal forms). Different growing stage of maize are affected by fall armyworm, but the damage is greatest during the early growing phase of corn. Heavy infestation on the leaves also cause defoliation. Four developmental stages (eggs larvae, pupae and adults) of the FAW were studied when fed with young corn under laboratory conditions. Furthermore, effective scouting or monitoring of FAW could be practice at early stage of growth of maize.

Keywords: infestation, katsina, maize, fall armyworm

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Authors: Ayuko Itsuki, Sachiyo Aburatani

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The seasonal (January, April, July and October) and monthly soil respiration rate and the monthly litter fall amounts were examined in the laurel-leaved (B_B-1) and Cryptomeria japonica (B_B-2 and PW) forests in the Kasugayama Hill Primeval Forest (Nara, Japan). The change of the seasonal soil respiration rate corresponded to that of the soil temperature. The soil respiration rate was higher in October when fresh organic matter was supplied in the forest floor than in April in spite of the same temperature. The seasonal soil respiration rate of B_B-1 was higher than that of B_B-2, which corresponded to more numbers of bacteria and fungi counted by the dilution plate method and by the direct count method by microscopy in B_B-1 than that of B_B-2. The seasonal soil respiration rate of B_B-2 was higher than that of PW, which corresponded to more microbial biomass by the direct count method by microscopy in B_B-2 than that of PW. The correlation coefficient with the seasonal soil respiration and the soil temperature was higher than that of the monthly soil respiration. The soil respiration carbon was more than the litter fall carbon. It was suggested that the soil respiration included in the carbon dioxide which was emitted by the plant root and soil animal, or that the litter fall supplied to the forest floor included in animal and plant litter.

Keywords: field soil respiration rate, forest soil, litter fall, mineralization rate

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Authors: Ayman M. A. Rashwan, Mohamed F. Mohamed, Mohamed M. A. Abdalla

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A field experiment was conducted in the Agricultural Research Station, at El-Ghoraieb, Assiut to study dry seed yield performance of two locally adapted cultivars (‘Azmerly’ and ‘Cream 7’) and two line introductions (IT81D-1032 and IT82D-812) of common cowpea (Vigna unguiculata (L.) Walp) grown at three different within-row spaces (20, 30 and 40 cm) and two planting dates in the summer (April 15th and 30th) and in the fall season (Aug. 12th and 27th) of two successive seasons. The data showed that total dry-seed yield produced by plants grown at 20 cm was greater than at 30 cm in all cvs/lines in both years. Increases in 1000-seed weight were detected in cv ‘Azmerly’ and line IT82D-812 when they were grown at 30 cm as compared with 20 cm in the summer season. However, in the fall season such increases were found in all cvs/lines. Planting at 40 cm produced seeds of greater weight than planting at 30 cm for all cvs/lines in the fall season and also in cv. Cream 7 and line IT82D-812 in the summer season. Planting on April 15th in the summer and also planting on Aug. 12th in the fall had plants which showed increases in 1000-seed weight and total dry-seed yield. The greatest 1000-seed weight was found in the line IT81D-1032 in the summer season and in the line IT82D-812 in the fall season. The sum up results revealed that ‘Azmerly’ produced greater dry-seed yield than ‘Cream 7’ and both of them were superior to the line IT82D-812 and IT81D-1032 in the summer season. In the fall, however, the line IT82D-812 produced greater dry-seed yield than the other cultivars/lines.

Keywords: Cowpea, Assiut, fall, planting dates, El-Ghoraieb, dry-seed yield

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Authors: Kripesh Adhikari, Hamid Bouchachia, Hammadi Nait-Charif

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Falls are one of the major causes of injury and death among elderly people aged 65 and above. A support system to identify such kind of abnormal activities have become extremely important with the increase in ageing population. Pose estimation is a challenging task and to add more to this, it is even more challenging when pose estimations are performed on challenging poses that may occur during fall. Location of the body provides a clue where the person is at the time of fall. This paper presents a vision-based tracking strategy where available joints are grouped into three different feature points depending upon the section they are located in the body. The three feature points derived from different joints combinations represents the upper region or head region, mid-region or torso and lower region or leg region. Tracking is always challenging when a motion is involved. Hence the idea is to locate the regions in the body in every frame and consider it as the tracking strategy. Grouping these joints can be beneficial to achieve a stable region for tracking. The location of the body parts provides a crucial information to distinguish normal activities from falls.

Keywords: fall detection, machine learning, deep learning, pose estimation, tracking

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Authors: Ricardo Merlo

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In this paper, we analyzed the different didactic proposals for teaching about the free fall motion of bodies available online. An important aspect was the interpretation of the direction and sense of the acceleration of gravity and of the falling velocity of a body, which is why we found different applications of the Cartesian reference system used and also different graphical presentations of the velocity as a function of time and of the distance traveled vertically by the body in the period of time that it was dropped from a height h0. In this framework, a survey of previous concepts was applied to a voluntary group of first-year university students of an Engineering degree before and after the development of the class of the subject in question. Then, Hake's index (0.52) was determined, which resulted in an average learning gain from the meaningful use of the reference system and the respective graphs of v=ƒ (t) and h=ƒ (t).

Keywords: didactic gain, free–fall, physics teaching, previous knowledge

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Authors: Ahmed Ali Hassan

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The fall armyworm (FAW) was first identified in 2016 in Africa. FAW is widely distributed in Somalia and severely damages the maize crop. The effect of three different pesticides used to control the autumn armyworm, Spodoptera frugiperda (Noctuidae: Lepidoptera), on maize productivity was investigated in this study. During the 2020–2021 growing season, three insecticides (Malathion 57 EC, Ampligo150 ZC, and Carbryle 85 WP) were evaluated at field demonstration plots. Our result showed that significant mortality of S. frugiperda was observed on the treatment plot treated with Amplico. After spraying, Ampligo resulted in (92.200%) larval death. Compared to Carbaryl, which was less active and only caused 36.367% mortality after application, Malathion had a moderate mortality rate of 53.733%. Consequently, our current finding shows that the three selected insecticides reduced the damage and infestation level of S. frugiperda in the maize field conditions, and the most effective treatment was Amplico.

Keywords: maize, fall armyworm, insecticides, mortality

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Authors: T. Kobayashi, K. Shiba, T. Kaburagi, Y. Kurihara

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For the elderly living alone, falls can be a serious problem encountered in daily life. Some elderly people are unable to stand up without the assistance of a caregiver. They may become unconscious after a fall, which can lead to serious aftereffects such as hypothermia, dehydration, and sometimes even death. We treat the subject as an inverted pendulum and model its angle from the equilibrium position and its angular velocity. As the model is non-linear, we implement the filtering method with a particle filter which can estimate true states of the non-linear model. In order to evaluate the accuracy of the particle filter estimation results, we calculate the root mean square error (RMSE) between the estimated angle/angular velocity and the true values generated by the simulation. The experimental results give the highest accuracy RMSE of 0.0141 rad and 0.1311 rad/s for the angle and angular velocity, respectively.

Keywords: fall, microwave Doppler sensor, non-linear dynamics model, particle filter

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Authors: Manutchanok Jongprasithporn, Rawiphorn Srivilai, Paweena Pongsopha

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Fall is the most serious accident leading to increased unintentional injuries and mortality. Falls are not only the cause of suffering and functional impairments to the individuals, but also the cause of increasing medical cost and days away from work. The early detection of falls could be an advantage to reduce fall-related injuries and consequences of falls. Smartphones, embedded accelerometer, have become a common device in everyday life due to decreasing technology cost. This paper explores a physical activity monitoring and fall detection application in smartphones which is a non-invasive biomedical device to determine physical activities and fall event. The combination of application and sensors could perform as a biomedical sensor to monitor physical activities and recognize a fall. We have chosen Android-based smartphone in this study since android operating system is an open-source and no cost. Moreover, android phone users become a majority of Thai’s smartphone users. We developed Thai 3 Axis (TH3AX) as a physical activities and fall detection application which included command, manual, results in Thai language. The smartphone was attached to right hip of 10 young, healthy adult subjects (5 males, 5 females; aged< 35y) to collect accelerometer and gyroscope data during performing physical activities (e.g., walking, running, sitting, and lying down) and falling to determine threshold for each activity. Dependent variables are including accelerometer data (acceleration, peak acceleration, average resultant acceleration, and time between peak acceleration). A repeated measures ANOVA was performed to test whether there are any differences between DVs’ means. Statistical analyses were considered significant at p<0.05. After finding threshold, the results were used as training data for a predictive model of activity recognition. In the future, accuracies of activity recognition will be performed to assess the overall performance of the classifier. Moreover, to help improve the quality of life, our system will be implemented with patients and elderly people who need intensive care in hospitals and nursing homes in Thailand.

Keywords: activity recognition, accelerometer, fall, gyroscope, smartphone

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Authors: Ladda Thiamwong, Renata Komalasari

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Falls are the leading cause of disability and hospitalization in low-income older adults. Fear of falling is present in 20% to 85 % of older adults and has been identified as an independent risk factor of fall risk, activity restriction, and loss of independence. About 12% of American older adults have subjective cognitive decline. Cognitive impairment is also an established factor of fall risk. However, it is unclear whether measures of fear of falling and subjective cognitive decline have the greatest association with fall risk in low-income older adults. The aim of this study was to evaluate the association between fear of falling, subjective cognitive decline-functional performance (SCD-FP), and fall risk using simple screening tools. In this cross-section study, we collected data from community-dwelling older adults 60 years or older in low-income settings in Central Florida, and 86 participants were included in the data analysis. Fear of falling was assessed by the Short Fall Efficacy Scale- International (Short FES-I) with seven items. Subjective cognitive decline-functional performance (SCD-FP) was assessed by a self-reported experience of worsening or more frequent confusion or memory loss in the past 12 months and its functional implications. Fall risk was evaluated by the Centers for Disease Control and Prevention (CDC)'s Stay Independent checklist with 12 items. The majority of participants were female, and more than half of the participants were African American. More than half of the participants had a higher school degree or higher, and less than 20% had no financial problems. Less than 30% of the participants perceived their general health as very good- excellent. More than half of the participants lived alone, and less than 15% lived with a partner or spouse. About 60% of the participants had hypertension, 40% had diabetes, 16% had cancer, and 50% had arthritis. About 30% of the participants had difficulty walking up ten steps without resting, more than 40% felt unsteady when walking, and 30% had been advised to use a cane or walker to get around safely. Regression analysis showed that fall risk was associated with fear of falling ( = .524, p <.001) and subjective cognitive decline-functional performance ( = .465, p =.027). The structure coefficient showed that fear of falling (rs2 = .922) was a stronger predictor of fall risk than subjective cognitive decline-functional performance (rs2= .200). Fear of falling and subjective cognitive decline-functional performance are growing public health issues, and addressing those issues is a public priority. Proactive screening for fear of falling and subjective cognitive decline-functional performance is critical in fall prevention. A combination of all three self-reported tools (Short FES-I, SCD-FP, and CDC's Stay Independent checklist) takes less than 5 minutes to complete. Primary care providers or public health professionals should consider including these tools to screen fear of falling and subjective cognitive decline-functional performance as part of fall risk assessment, especially in low-income settings. Thus, encouraging older adults and healthcare professionals to discuss fear of falling, subjective cognitive decline, and fall risk during routine medical office visits.

Keywords: falls, fall risk, fear of falling, cognition, subjective cognitive decline, low-income, older adults, community, screening, nursing, primary care

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Authors: Bo-Jian Wu, Si-Heng Wu

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Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

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Authors: Xiang Yu, Chuntao Feng, Lu Yang, Meiyang Song, Wenhao Zhou

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The existing two-dimensional micro-Doppler features extraction ignores the correlation information between the spatial and temporal dimension features. For the range-Doppler map, the time dimension is introduced, and a frequency modulation continuous wave (FMCW) radar human fall detection algorithm based on time-varying range-Doppler features is proposed. Firstly, the range-Doppler sequence maps are generated from the echo signals of the continuous motion of the human body collected by the radar. Then the three-dimensional data cube composed of multiple frames of range-Doppler maps is input into the three-dimensional Convolutional Neural Network (3D CNN). The spatial and temporal features of time-varying range-Doppler are extracted by the convolution layer and pool layer at the same time. Finally, the extracted spatial and temporal features are input into the fully connected layer for classification. The experimental results show that the proposed fall detection algorithm has a detection accuracy of 95.66%.

Keywords: FMCW radar, fall detection, 3D CNN, time-varying range-doppler features

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Authors: Hossein Kheirollahi, Yunhua Luo

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Studying stress and strain trends in the femur and recognizing femur failure mechanism is very important for preventing hip fracture in the elderly. The aim of this study was to identify high stress and strain regions in the femur during normal walking and falling to find the mechanical behavior and failure mechanism of the femur. We developed a finite element model of the femur from the subject’s quantitative computed tomography (QCT) image and used it to identify potentially high stress and strain regions during the single-leg stance and the sideways fall. It was found that fracture may initiate from the superior region of femoral neck and propagate to the inferior region during a high impact force such as sideways fall. The results of this study showed that the femur bone is more sensitive to strain than stress which indicates the effect of strain, in addition to effect of stress, should be considered for failure analysis.

Keywords: finite element analysis, hip fracture, strain, stress

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Authors: Kai Way Li, Lang Gan

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Slip &Fall are common in Taiwan. They could result in injuries and even fatalities. Official statistics indicate that more than 15% of all occupational incidences were slip/fall related. All the workers in Taiwan are required by the law to join the worker’s insurance program administered by the Bureau of Labor Insurance (BLI). The BLI is a government agency under the supervision of the Ministry of Labor. Workers claim with the BLI for insurance compensations when they suffer fatalities or injuries at work. Injuries statistics based on worker’s compensation claims were rarely studied. The objective of this study was to quantify the injury statistics and financial cost due to slip-fall incidences based on the BLI compensation records. Compensation records in the BLI during 2007 to 2013 were retrieved. All the original application forms, approval opinions, results for worker’s compensations were in hardcopy and were stored in the BLI warehouses. Xerox copies of the claims, excluding the personal information of the applicants (or the victim if passed away), were obtained. The content in the filing forms were coded in an Excel worksheet for further analyses. Descriptive statistics were performed to analyze the data. There were a total of 35,024 claims including 82 deaths, 878 disabilities, and 34,064 injuries/illnesses which were slip/fall related. It was found that the average losses for the death cases were 40 months. The total dollar amount for these cases paid was 86,913,195 NTD. For the disability cases, the average losses were 367.36 days. The total dollar amount for these cases paid was almost 2.6 times of those for the death cases (233,324,004 NTD). For the injury/illness cases, the average losses for the illness cases were 58.78 days. The total dollar amount for these cases paid was approximately 13 times of those of the death cases (1134,850,821 NTD). For the applicants/victims, 52.3% were males. There were more males than females for the deaths, disability, and injury/illness cases. Most (57.8%) of the female victims were between 45 to 59 years old. Most of the male victims (62.6%) were, on the other hand, between 25 to 39 years old. Most of the victims were in manufacturing industry (26.41%), next the construction industry (22.20%), and next the retail industry (13.69%). For the fatality cases, head injury was the main problem for immediate or eventual death (74.4%). For the disability case, foot (17.46%) and knee (9.05%) injuries were the leading problems. The compensation claims other than fatality and disability were mainly associated with injuries of the foot (18%), hand (12.87%), knee (10.42%), back (8.83%), and shoulder (6.77%). The slip/fall cases studied indicate that the ratios among the death, disability, and injury/illness counts were 1:10:415. The ratios of dollar amount paid by the BLI for the three categories were 1:2.6:13. Such results indicate the significance of slip-fall incidences resulting in different severity. Such information should be incorporated in to slip-fall prevention program in industry.

Keywords: epidemiology, slip and fall, social burden, workers’ compensation

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Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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Authors: Nan Ding, Motoki Shino, Nobuyasu Tomokuni, Genki Murata

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The wheelchair is the major means of transport for physically disabled people. However, it cannot overcome architectural barriers such as curbs and stairs. In this paper, the authors proposed a method to avoid falling down of a wheeled inverted pendulum type robotic wheelchair for climbing stairs. The problem of this system is that the feedback gain of the wheels cannot be set high due to modeling errors and gear backlash, which results in the movement of wheels. Therefore, the wheels slide down the stairs or collide with the side of the stairs, and finally the wheelchair falls down. To avoid falling down, the authors proposed a slider control strategy based on skyhook model in order to decrease the movement of wheels, and a rotary link control strategy based on the staircase dimensions in order to avoid collision or slide down. The effectiveness of the proposed fall avoidance control strategy was validated by ODE simulations and the prototype wheelchair.

Keywords: EPW, fall avoidance control, skyhook, wheeled inverted pendulum

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Authors: Yu-Shi Ye, Jia-Min Wu, Jhih-Ci Li

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Background: Most orthopedic inpatients and primary caregivers are elderly, and patients are at high risk of falls. We set up a quality control team to analyze the root cause and found the following issues: 1. The nursing staff did not conduct cognitive assessments of patients and their primary caregivers to ensure that health education content was understood. 2. Nurses prefer to use spoken language in health education but lack the skills to use diverse teaching materials. 3. Newly recruited nurses have insufficient awareness of fall prevention. Methods: The study subjects were 16 nurses in the orthopedic ward of a teaching hospital in central Taiwan. We implemented the following strategies: 1. Developed a fall simulation teaching plan and conducted teaching courses and assessments in the morning meeting; 2. Designed and used a "fall prevention awareness card" to improve the prevention awareness of elderly patients; 3. All staff (including new staff) received experiential education training. Results: In 2021, 40% of patients in the orthopedic wards were aged 60-79 years (792/1979) with a high risk of falls. According to data collection, the incidence of falls in hospitalized patients was 0.04% (5/12651), which exceeded the threshold of 0.02% in our ward. After completing the on-the-job education training in October, the nursing staff expressed that they were more aware of the special situation of fall prevention. Through practical sharing and drills, combined with experiential teaching strategies, nurses can reconstruct the safety awareness of fall prevention and deepen their cognitive memory. Participants scored between 30 and 80 on the pretest (16 students, mean: 72.6) and between 90 and 100 on the post-test (16 students, mean: 92.6), resulting in a 73.8% improvement in overall scores. We have a total of 4 new employees who have all completed the first 3 months of compulsory PGY courses. From January to April 2022, the incidence of falls in hospitalized patients was 0.025% (1/3969). We have made good improvements and will continue to track the outcome. Discussion: In addition to enhancing the awareness of falls among nursing staff, how-to guide patients and primary caregivers to prevent falls is also the focus of improvement. The proper way of health education can be better understood through practical exercises and case sharing.

Keywords: experiential teaching strategies, fall prevention, cognitive card, elderly patients, orthopedic wards

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Authors: Jennifer Holbein, Maritza Wiedel

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Background: Aging is associated with an increased risk of falls in older adults, and as a result, falls have become public health crises. However, the incidence of falls can be reduced through healthy aging and the implementation of a regular exercise and strengthening program. Public health and healthcare professionals authorize the use of evidence‐based, exercise‐focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practices. The purpose of this study was to assess the feasibility of an intervention, A Matter of Balance, in terms of demand, acceptability, and implementation into current exercise programs. Subjects: Seventy-five participants from rural communities, above the age of sixty, were randomized to an intervention or attention-control of the standardized senior fitness test. Methods: Subject completes the intervention, which combines two components: (1) motivation and (2) fall-reducing physical activities with protocols derived from baseline strength and balanced assessments. Participants (n=75) took part in the program after completing baseline functional assessments as well as evaluations of their personal knowledge, health outcomes, demand, and implementation interventions. After 8-weeks of the program, participants were invited to complete follow-up assessments with results that were compared to their baseline functional analyses. Out of all the participants in the study who complete the initial assessment, approximately 80% are expected to maintain enrollment in the implemented prescription. Furthermore, those who commit to the program should show mitigation of fall risk upon completion of their final assessment.

Keywords: aging population, exercise, falls, functional assessment, healthy aging

Procedia PDF Downloads 100

Authors: Amy L. Smith

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This study investigates the impact of student authenticity while engaging in academic exploration of students' sense of belonging, autonomy, and persistence. Research questions include: How does incorporating authenticity in first-year academic exploration courses impact; 1) first-year students’ sense of belonging, autonomy, and persistence? 2) first-year students’ sense of belonging, autonomy, and persistence during the first and last halves of the fall semester? 3) first-year students’ sense of belonging, autonomy, and persistence among various student demographics? First-year students completed a Likert-like survey at the conclusion of eight weeks (first and last eight weeks/fall semester) academic exploration courses. Course redesign included grounding the curriculum and instruction with student authenticity and creating opportunities for students to explore, define, and reflect upon their authenticity during academic exploration. Surveys were administered at the conclusion of these eight week courses (first and last eight weeks/fall semester). Data analysis included an entropy balancing matching method and t-tests. Research findings indicate integrating authenticity into academic exploration courses for first-year students has a positive impact on students' autonomy and persistence. There is a significant difference between authenticity and first-year students' autonomy (p = 0.00) and persistence (p = 0.01). Academic exploration courses with the underpinnings of authenticity are more effective in the second half of the fall semester. There is a significant difference between an academic exploration course grounding the curriculum and instruction in authenticity offered M8A (first half, fall semester) and M8B (second half, fall semester) (p = 0); M8B courses illustrate an increase of students' sense of belonging, autonomy, and persistence. Integrating authenticity into academic exploration courses for first-year students has a positive impact on varying student demographics (p = 0.00). There is a significant difference between authenticity and low-income (p = 0.04), first-generation (p = 0.00), Caucasian (p = 0.02), and American Indian/Alaskan Native (p = 0.05) first-year students' sense of belonging, autonomy, and persistence. Academic exploration courses embedded in authenticity helps develop first-year students’ sense of belonging, autonomy, and persistence, which are effective traits of college students. As first-year students engage in content courses, professors can empower students to have greater engagement in their learning process by relating content to students' authenticity and helping students think critically about how content is authentic to them — how students' authenticity relates to the content, how students can take their content expertise into the future in ways that, to the student, authentically contribute to the greater good. A broader conversation within higher education needs to include 1) designing courses that allow students to develop and reflect upon their authenticity/to formulate answers to the questions: who am I, who am I becoming, and how will I move my authentic self forward; and 2) a discussion of how to shift from the university shaping students to the university facilitating the process of students shaping themselves.

Keywords: authenticity, first-year experience, sense of belonging, autonomy, persistence

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Authors: Innocent Pangapanga, Eric Mungatana

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Fall armyworm (FAW) (Spodoptera frugiperda), an invasive lepidopteran pest, has caused substantial yield loss since its first detection in September 2016, thereby threatening the farm productivity food security and poverty reduction initiatives in Malawi. Several stakeholders, including households, have adopted chemical pesticides to control FAW without accounting for its costs on welfare, health and the environment. Thus, this study has used panel data endogenous switching regression model to investigate the impact of FAW and the integrated pest management (IPM) –related practices on-farm productivity and food security. The study finds that FAW substantively reduces farm productivity by seven (7) percent and influences the adoption of IPM –related practices, namely, intercropping, mulching, and agroforestry, by 6 percent, ceteris paribus. Interestingly, multiple adoptions of the IPM -related practices noticeably increase farm productivity by 21 percent. After accounting for potential endogeneity through the endogenous switching regression model, the IPM practices further demonstrate tenfold more improvement on food security, implying the role of the IPM –related practices in containing the effect of FAW at the household level.

Keywords: hunger, invasive fall army worms, integrated pest management practices, farm productivity, endogenous switching regression

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Authors: Pallavi Kishore, Mariam Aslam

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The sharp decline in oil prices that started in 2014 affected most economies in the world either positively or negatively. In some economies, particularly the oil exporting countries, the effects were felt immediately. The Gulf Cooperation Council’s (GCC henceforth) countries are oil and gas-dependent with the largest oil reserves in the world. UAE (United Arab Emirates) has been striving to diversify away from oil and expects higher non-oil growth in 2018. These two factors, falling oil prices and the economy strategizing away from oil dependence, make a compelling case to study the financial performance of various sectors in the economy. Among other sectors, the insurance sector is widely recognized as an important indicator of the health of the economy. An expanding population, surge in construction and infrastructure, increased life expectancy, greater expenditure on automobiles and other luxury goods translate to a booming insurance sector. A slow-down of the insurance sector, on the other hand, may indicate a general slow-down in the economy. Therefore, a study on the insurance sector will help understand the general nature of the current economy. This study involves calculations and comparisons of ratios pre and post the fall in oil prices in the insurance sector in the UAE. A sample of 33 companies listed on the official stock exchanges of UAE-Dubai Financial Market and Abu Dhabi Stock Exchange were collected and empirical analysis employed to study the financial performance pre and post fall in oil prices. Ratios were calculated in 5 categories: Profitability, Liquidity, Leverage, Efficiency, and Investment. The means pre- and post-fall are compared to conclude that the profitability ratios including ROSF (Return on Shareholder Funds), ROCE (Return on Capital Employed) and NPM (Net Profit Margin) have all taken a hit. Parametric tests, including paired t-test, concludes that while the fall in profitability ratios is statistically significant, the other ratios have been quite stable in the period. The efficiency, liquidity, gearing and investment ratios have not been severely affected by the fall in oil prices. This may be due to the implementation of stronger regulatory policies and is a testimony to the diversification into the non-oil economy. The regulatory authorities can use the findings of this study to ensure transparency in revealing financial information to the public and employ policies that will help further the health of the economy. The study will also help understand which areas within the sector could benefit from more regulations.

Keywords: UAE, insurance sector, ratio analysis, oil price, profitability, liquidity, gearing, investment, efficiency

Procedia PDF Downloads 244

Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

Procedia PDF Downloads 96