Analysis of Multi-variate Recurrent Fall Risk Factors in Elderly People Using Residential Assessment Instrument-Home Care: Comparisons between Single and Recurrent Fallers

PURPOSE: This study was done to determine the risk factors for recurrent fallers (2+falls) compared to single fallers. METHODS: Participants were 104 community-dwelling people 65 yr of age or older. The data were collected from June 1, 2008 to June 30, 2009 using the Residential Assessment Instrument-Home Care. RESULTS: Over the past 90 days, 55.7% of the 104 participants fell once, and 44.2% experienced recurrent falls (2+falls). In comparison of recurrent fallers with single fallers, there were significant differences in scores on the following factors: gender (chi2=4.22, p=.040), age (chi2=5.74, p=.017), educational level (chi2=5.22, p=.022), living arrangements (chi2=35.02, p<.001), cardiovascular diseases (chi2=17.10, p<.001), hypertension (chi2=4.43, p=.035), diabetes mellitus (chi2=4.44, p=.035), glaucoma (chi2=13.95, p<.001), Minimal Data Set (MDS)-Pain (t=-2.56, p=.012), fear of falling (chi2=4.08, p=.034), reduced vision (t=-3.06, p=.003), MDS-activity of daily living (t=3.46, p=.001), MDS-Instrumental Activities of daily living (t=3.24, p=.002), cognition (MDS-Cognition Performance Scale) (t=3.40, p=.001), and 'difficulties entering and leaving the house' (chi2=4.53, p=.033). CONCLUSION: It is important to assess the risk factors for recurrent falls and develop differentiated strategies that will help prevent recurrent falls. Additionally, utilizing a standardized tool, such as RAI-HC, would help health professionals assess multi-variate fall risk factors to facilitate comparisons of different community care settings.

Visual impairment in the hearing impaired students.

Background: Ocular problems are more common in children with hearing problems than in normal children. Neglected visual impairment could aggravate educational and social disability. Aim: To detect and treat visual impairment, if any, in hearing-impaired children. Setting and Design: Observational, clinical case series of hearing-impaired children in schools providing special education. Materials and Methods: Hearing-impaired children in selected schools underwent detailed visual acuity testing, refraction, external ocular examination and fundoscopy. Ocular motility testing was also performed. Teachers were sensitized and trained to help in the assessment of visual acuity using Snellen's E charts. Refractive errors and squint were treated as per standard practice. Statistical Analysis: Excel software was used for data entry and SSPS for analysis. Results: The study involved 901 hearing-impaired students between four and 21 years of age, from 14 special education schools. A quarter of them (216/901, 24%) had ocular problems. Refractive errors were the most common morbidity 167(18.5%), but only 10 children were using appropriate spectacle correction at presentation. Fifty children had visual acuity less than 20/80 at presentation; after providing refractive correction, this number reduced to three children, all of whom were provided low-vision aids. Other common conditions included strabismus in 12 (1.3%) children, and retinal pigmentary dystrophy in five (0.6%) children. Conclusion: Ocular problems are common in hearing-impaired children. Screening for ocular problems should be made mandatory in hearing-impaired children, as they use their visual sense to compensate for the poor auditory sense.

Prevalencia de agudeza visual baja y trastornos oftalmológicos en niños de seis años de la ciudad de Santa Fe / Prevalence of low visual acuity and ophthalmological disorders in six year old children from Santa Fe city

Introducción. Las alteraciones de la agudeza visual no tratadas en los niños conllevan un riesgo elevado de consecuencias irreversibles. Los objetivos del presente trabajo son: determinar la prevalencia deagudeza visual baja y diagnosticar los trastornos oftalmológicos causantes en niños de seis años de la ciudad de Santa Fe, Argentina. Métodos. Diseño observacional, descriptivo y de corte transversal. Se evaluó la agudeza visual, quese define como la capacidad del ojo de discriminar puntos separados y reconocer formas, con la tablade Snellen para visión lejana, en 177 niños de seis años pertenecientes a cuatro escuelas primarias dela ciudad de Santa Fe. A aquellos que presentaron agudeza visual baja se les realizó una evaluación oftalmológica y se entrevistó a las madres paraconocer los antecedentes patológicos de los hijos.Resultados. La prevalencia de agudeza visual bajafue del 10,7 por ciento (n= 19). La prevalencia de ambliopía fue del 3,9 por ciento. Los vicios de refracción fueron la únicacausa de baja agudeza visual, y predominó el astigmatismo.Los antecedentes patológicos más frecuentes fueron: infecciones oculares, nacimiento prematuro, antecedentes de desnutrición y tabaquismo materno.Conclusiones. Se halló una prevalencia de agudeza visual baja inferior a la informada en la mayoría deotros estudios. Los datos de este estudio pueden ser la base para investigaciones adicionales tendientes a corroborar o refutar la prevalencia aquí informada.

Visual impairment and motor vehicle accidents

To examine the association between visual impairment and sustaining an injurious Motor Vehicle Accident [MVA] among drivers seen at the Accident and Emergency Department of Al-Ain Hospital, United Arab Emirates, [UAE]. A cross-sectional hospital based study. Accident Emergency Department [AED], Al-Ain Hospital, UAE. Male and females aged 18 years and above interviewed during the period January 1996 to December 1997. A total of 1542 drivers were examined and treated, but only 1428 drivers gave consent for the study. Socio-demographic data, visual acuity, level of injury, data about driving behavior and data from police reports were collected and analyzed. Study subjects were classified into two groups based on visual acuity: normal vision and visually impaired. A total of 1428 drivers were included in our study. of these, 1221 patients [85.6%] had normal vision, 207 patients [14.5%] were visually impaired at the time of sustaining MVA. The majority of victims [77%] were males. Most of the drivers [55%] were young and under the age of 40 years; 39.7% were UAE nationas; 32% had a primary school education; 37.5% had less than 2 years driving experience and 17.2% always used seat belts. Most [59%] admitted to crossing red traffic lights, 61.3% excessive speeding; 32.6% smoking while driving; 29.8% to using telephones while driving; 32.1% to putting their child in the front seat. Significantly higher risk was observed for careless driving [RR=1.29; 95% CI=1.10-1.66, p=0.049], speeding violations [RR=1.32; 95% CI=1.01-l.73, 0.041], and property damage [RR=1.80; 95% CI=l.31-2.48; p=0.05] among drivers having vision impairment. Visual impairment is considered a risk factor for MVA. Further investigation is essential and will require close inter-sectoral collaboration between traffic police, health, law, and transport authorities

Um ensaio sobre a relaçäo entre a baixa visäo em idosos e as atividades da vida diária / An essay about the relationship among the low vision in elderly and the activities of the daily life

O estudo tem como objetivo identificar as dificuldades que o idoso com baixa visäo apresenta na realizaçäo das atividades de vida diária...