ABSTRACT
OBJECTIVE: To externally validate the Recurrent Fall Risk Scale (ReFR) in community-dwelling stroke survivors. METHODS: Cohort of stroke survivors with independent gait ability recruited from a reference outpatient stroke clinic. Besides sociodemographic and clinical data, the following scales were used: Modified Barthel Index (mBI), ReFR scale and National Institutes of Health Stroke Scale (NIHSS). Participants were followed up for 12 months to record the incidence of falls. Accuracy of the ReFR scale was measured by the area under the ROC curve. RESULTS: One hundred and thirteen individuals were recruited between April 2016 and November 2016: mean age 54 years (± 14), 55% women, median time since the last stroke 24 months (range 12 -48 months), posterior vascular territory affected in 35% of the sample. Median NIHSS was 3 (range 1 to 6), median mBI 49 (range 46-50), median ReFR 3 (range 2 to 5). During the follow-up period, 32 (33%) subjects had at least one fall and 18 (19%) were recurrent fallers (two or more falls). The accuracy of ReFR scale was 0.67 (95% CIâ¯=â¯0.54-0.79), pâ¯=â¯0.026. CONCLUSION: This study externally validated the ReFR as a tool to predict recurrent falls in individuals after stroke.
Subject(s)
Accidental Falls , Clinical Decision Rules , Independent Living , Stroke/diagnosis , Adult , Aged , Brazil/epidemiology , Female , Health Status , Humans , Incidence , Male , Middle Aged , Neuroimaging , Physical Examination , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Risk Assessment , Risk Factors , Sex Factors , Stroke/epidemiology , Stroke/physiopathology , Time FactorsABSTRACT
We performed a case study on a company focusing on the form of management and the shop floor workers, in order to identify the possible effects of participant work strategies on workers' health. Data on the company included its history, type of management, and organization of both production and the work process. Data on shop floor workers included age, schooling, perceptions of work, family life, recreation, and self-reported disease history. We concluded that the characteristics of the management model adopted by the company originated from ideas imported from Japan, including flexibilization of production, outsourcing, performance of multiple tasks, and participation in the work process. Workers referred to participation in the work process in an ambiguous tone. Some reported positive effects, like greater freedom and respect, with positive effects on life both inside and outside the workplace. For part of the group studied, the characteristics of the work organization model practiced in the company had negative effects on health, leading them to complain of insomnia, nervousness, work-related dreams, and headaches.
