Home fall of elderly people: implications of stressors and representations in the COVID-19 context.

OBJECTIVES: To describe personal conditions and home structure that predisposes the elderly to the risk of falling, in the perspective of Neuman's stressors; to describe the content, structure and origin of social representations about falling at home by elderly people; and conjecture the implications of this empirical evidence on the daily lives of the elderly in the context of the pandemic caused by COVID-19. METHOD: Mixed method with concomitant triangulation (January-July/2017), qualitative design (structural and procedural approaches to the Social Representations Theory) and quantitative (sectional) approaching elderly people ≥65 years. RESULTS: Environmental factors were identified for falling at home, fear of activities of daily living and loss of visual acuity. Feelings and behaviors mentioned in the possible central nucleus justified the modulation of behaviors. Analysis categories: 1) Representation of the (in)adaptability of the home environment; 2) Representation and overcoming limitations arising from weaknesses. CONCLUSION: It was possible to produce conjectures based on empirical evidence in the current situation in the pandemic's dynamics.

Tailored Exercise and Home Hazard Reduction Program for Fall Prevention in Older People With Cognitive Impairment: The i-FOCIS Randomized Controlled Trial.

BACKGROUND: The evidence to support effective fall prevention strategies in older people with cognitive impairment (CI) is limited. The aim of this randomized controlled trial (RCT) was to determine the efficacy of a fall prevention intervention in older people with CI. METHOD: RCT involving 309 community-dwelling older people with CI. The intervention group (n = 153) received an individually prescribed home hazard reduction and home-based exercise program during the 12-month study period. The control group (n = 156) received usual care. The primary outcome was rate of falls. Secondary outcomes included faller/multiple faller status, physical function, and quality of life. RESULTS: Participants' average age was 82 years (95% CI 82-83) and 49% were female. There was no significant difference in the rate of falls (incidence rate ratio [IRR] 1.05; 95% confidence interval [95% CI] 0.73-1.51). A sensitivity analysis, controlling for baseline differences and capping the number of falls at 12 (4 participants), revealed a nonsignificant reduction in fall rate in the intervention group (IRR 0.78; 95% CI 0.57-1.07). Analyses of secondary outcomes indicated the intervention significantly reduced the number of multiple fallers by 26% (RR 0.74; 95% CI 0.54-0.99) when adjusting for baseline differences. There was a differential impact on falls in relation to physical function (interaction term p-value = .023) with a significant reduction in fall rate in intervention group participants with better baseline physical function (IRR 0.60; 95% CI 0.37-0.98). There were no significant between-group differences for other secondary outcomes. CONCLUSIONS: This intervention did not significantly reduce the fall rate in community-dwelling older people with CI. The intervention did reduce the fall rate in participants with better baseline physical function. CLINICAL TRIALS REGISTRATION NUMBER: Australian and New Zealand Trials Registry ACTRN12614000603617.

Child understandings of the causation of childhood burn injuries: Child activity, parental domestic demands, and impoverished settings.

BACKGROUND: Burns are a global public health problem. In South Africa, the rate of paediatric burn deaths is 5 times higher than other upper middle-income countries, with concentrations in impoverished settings. Globally, the majority of research focuses on expert and caregiver descriptions of burn occurrence, causation, and prevention, with limited consideration of children's perspectives. This study investigated children's understanding of the causation and prevention of childhood burns. METHODS: Data were collected from eighteen 10- to 11-year-old children living in selected impoverished, fire-affected neighbourhoods in Cape Town, through 3 isiXhosa focus groups. All focus groups were transcribed, coded, and analysed for emerging themes through thematic analysis. RESULTS: Themes regarding burn causation and risks centred around 4 themes: (a) developmental limits in context; (b) domestic chores, child capacity, and inability to say "no"; (c) inadequate supervision and compromised caregiving; and (d) unsafe structures. Child accounts of prevention pertained to (e) burn injury prevention activities in comprised environments and emphasized child agency, and upgrading the physical environment. CONCLUSION: The children in this study ascribed burn injuries as the consequence of their developmental limits in the context of poverty, constraints on parental supervision, and unsafe environments. The children recommended safety education and upgrading their physical environments as part of burns injury prevention. The child accounts offer useful insights to inform safety interventions in impoverished settings.

"Caiu, tchau e bença": os sentimentos, comportamentos e soluções de idosos após a queda em residências unipessoais / "If you fell, bye and God bless": elderly' feelings, behaviour and the found solutions after a fall at home where they live alone / "Ha caído, adiós y bendecir": los sentimientos, comportamientos y soluciones de ancianos después de caer en viviendas

Este artigo objetiva apresentar uma análise dos sentimentos e comportamentos de idosos que residem sozinhos pós-queda em casa e as soluções dadas por eles para evitar novos acidentes. Realizou-se uma pesquisa qualitativa com técnicas de observação participante, entrevistas e documentação em caderno de anotações, fotos, áudio e vídeos. A amostra é composta por dez idosos (quatro homens e seis mulheres)com idade entre 65 e 85 anos, residentes em domicílios unipessoais, que sofreram queda na residência nosúltimos cinco anos. Cinco dos dez indivíduos entrevistados alteraram a configuração espacial da residência(adaptações e pequenas reformas) e os outros cinco declararam ter deixado de realizar a atividade que oslevaram à queda. Todos destacaram um bom grau de autonomia na realização das atividades da vida diária(AVD), mas consideram a queda como um fenômeno inevitável e possuem conhecimentos sobre os riscos, aperda da autonomia e a possibilidade de não residir mais sozinhos foram citados como elementos de medo.(AU

This paper presents an analysis of the feelings and behaviors of elderly who live alone in a post-fall eventand their solutions to prevent further accidents. A qualitative research was carried out using techniquesof participant observation, interviews and documentation in notebook, photos, audio and videos. Thesample is comprised of ten individuals (four men and six women) aged between 65 and 85 years residingin single-person households, who suffered a fall inside their home in the last five years. Five of the 10individuals interviewed changed the spatial configuration of the residence (adaptations and minor reforms)and the other five declared that they are avoiding to carry out the activity that led them to fall. All stresseda good degree of autonomy in the activities of daily living (ADL), but considered the fall as an inevitablephenomenon and, they know about risks. The loss of autonomy and the possibility of not residing aloneanymore were cited as elements of fear.

Este artículo tiene como objetivo presentar un análisis de los sentimientos y comportamientos de ancianosque residen solos post-caída en casa y las soluciones dadas por ellos para evitar nuevos accidentes. Serealizó una investigación cualitativa con técnicas de observación participante, entrevistas y documentaciónen cuaderno de notas, fotos, audio y vídeos. La muestra está compuesta por diez ancianos (cuatro hombresy seis mujeres) con edad entre 65 y 85 años, residentes en domicilios unipersonales, que sufrieron caída enla residencia en los últimos cinco años. Cinco de los diez individuos entrevistados alteraron la configuraciónespacial de la residencia (adaptaciones y pequeñas reformas) y los otros cinco declararon haber dejadode realizar la actividad que los llevaron a la caída. Todos destacaron un buen grado de autonomía en larealización de las actividades de la vida diaria (AVD), pero consideran la caída como un fenómeno inevitabley tienen conocimientos sobre los riesgos, la pérdida de la autonomía y la posibilidad de no residir más solos fueron citados como elementos de miedo.

Parents' Attitudes and Adherence to Unintentional Injury Prevention Measures in Ankara, Turkey.

BACKGROUND: Childhood unintentional injuries are perceived as a leading public health issue since they are one of the preventable causes of paediatric mortality and morbidity. Whether and how parental factors are related to childhood injury has been researched insufficiently. AIMS: To investigate parents' attitudes to preventive measures of unintentional childhood injury, and the parental adherence to these measures. STUDY DESIGN: Cross-sectional, descriptive study. METHODS: The data were collected from the parents of children younger than ten years of age admitted to university hospital outpatient clinics for any reason and who agreed to be involved in the study. The first part of the questionnaire included sociodemographic profiles of participating children. Serious injuries were considered to be any injury that requires hospital admission. The second part of the questionnaire was prepared to evaluate parents' adherence to injury prevention rules. A total score calculation about the adherence of the parents to the injury prevention rules was worked out the addition of the scores of each answer given in each age group. Answers for each item given by the parents were scored as wrong (0), sometimes (1) or correct (2). The score for each item was added and the result normalized to 100 points. Only complete questionnaires were used for analysis. RESULTS: A total of 1126 children and parent pairs agreed to participate in the survey. It was found that 13.8% of the participating children had experienced at least one serious injury. Although three-quarters of the parents had received information about injury prevention, the overall injury prevention scores were found to be low. As children's age increased, the total injury prevention scores of parents decreased significantly. Injury prevention scores were shown to increase significantly with high education and maternal occupation. However, scores were shown to decrease significantly with increased child age and family size. CONCLUSION: Our study shows that parental adherence to the child safety measures aimed at decreasing the unintentional injury risk of children is not satisfactory in Turkey. In particular, parents of 5-9-year-old children, big families (more than five people), parents with less than 8 years of education and non-working mothers should be the main target groups for intervention strategies according to our study results.

[The childhood home accidents: risk perception and behavior].

OBJECTIVE: The aim of the study was to assess the frequency and the kind of home injuries among the children and to have information on the sources of risk and hazardous behaviors in the home setting. METHODS: An anonymous questionnaire was administered to parents. In order to evaluate the risk perception in relation to the home environment, drawings to color were administered to children in kindergarten and to those of the first cycle of elementary school. A questionnaire was administered to older pupils. Statistical analyses were performed using the statistical program EPIINFO. RESULTS: The most risky behaviors showed by about half of parents were to cook lunch and doing other works in the house, cook with children in the kitchen. 28.0% said that sometimes left unattended appliances. Discordant opinions were found on the possibility of having injuries at home, in fact, 39.7% of parents affirmed that their son was victim of a home injury, compared with 64.0% of children. The number of children victims of home injuries was significantly higher among those aged between 6 and 10 years. DISCUSSION: Our search was in according with the national trend of the types and outcomes of home injuries, and confirms the existence of relationship between low educational level and higher frequency of injuries in childhood. Although prevention was considered an invaluable tool by parents to ensure the child's safety from the earliest years of life in this way, this study highlights the urgent need to take preventive action to develop an adequate safety culture.

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

OBJECTIVES: To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. DESIGN: Cross-sectional. SETTING: Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. PARTICIPANTS: A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. MEASUREMENTS: Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. RESULTS: In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. CONCLUSION: Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low.

"Oh the weather outside is frightful": Severe injury secondary to falls while installing residential Christmas lights.

INTRODUCTION: Falls are an increasingly common source of severe traumatic injury. They now account for approximately 40% of both overall trauma volumes and injury-related deaths within Canada. In northern climates, the risk of all types of falls may increase during the fall/winter months when conditions become increasingly dangerous. The purpose of this study was to define the injury and patient demographics of severe trauma that occurs during falls associated with the installation of Christmas lights. PATIENTS AND METHODS: All patients who were admitted to a referral level 1 trauma center (2002-2012) with severe injuries (ISS≥12) caused during Christmas light installation were retrospectively reviewed. Standard statistical methodology was utilised (p<0.05=significant). RESULTS: A total of 40 patients were severely injured (95% male; mean age=55 years; mean ISS=25.7 (range: 12-75)) while installing Christmas lights. Injuries included: neurologic (68%), thoracic (68%), spinal (43%), extremity (40%), and multiple other sites. Fall mechanisms were: ladder (65%), roof (30%), ground (3%) and railing (3%). Interventions included intubation and critical care (20%), as well as orthopaedic and neurosurgical operative repairs (30%). The median length of hospital stay was 15.6 days (range: 2-165). The fall-related morbidity (28%) and mortality (5%) were significant with a total of 12.5% patients requiring transfer to a long-term care or rehabilitation facility. CONCLUSIONS: Falls while installing Christmas lights during the fall/winter seasons can result in severe life-altering injuries with considerable morbidity and mortality. Caution should be employed when installing lights at any height.

Burden on family carers and care-related financial strain at the end of life: a cross-national population-based study.

BACKGROUND: The rising number of deaths from cancer and other life-limiting illnesses is accompanied by a growing number of family carers who provide long-lasting care, including end-of-life care. This population-based epidemiological study aimed to describe and compare in four European countries the prevalence of and factors associated with physical or emotional overburden and difficulties in covering care-related costs among family carers of people at the end of life. METHODS: A cross-national retrospective study was conducted via nationwide representative sentinel networks of general practitioners (GPs). Using a standardized form, GPs in Belgium, The Netherlands, Italy and Spain recorded information on the last 3 months of life of every deceased adult practice patient (1 January 2009-31 December 2010). Sudden deaths were excluded. RESULTS: We studied 4466 deaths. GPs judged family carers of 28% (Belgium), 30% (The Netherlands), 35% (Spain) and 71% (Italy) of patients as physically/emotionally overburdened (P < 0.001). For 8% (Spain), 14% (Belgium), 36% (The Netherlands) and 43% (Italy) patients, GPs reported difficulties in covering care-related costs (P < 0.001). Patients <85 years of age (Belgium, Italy) had higher odds of having physically/emotionally overburdened family carers and financial burden. Death from non-malignant illness (vs. cancer) (Belgium and Italy) and dying at home compared with other locations (The Netherlands and Italy) were associated with higher odds of difficulties in covering care-related costs. CONCLUSION: In all countries studied, and particularly in Italy, GPs observed a considerable extent of physical/emotional overburden as well as difficulties in covering care-related costs among family carers of people at the end of life. Implications for health- and social care policies are discussed.

Risk factors for unintentional poisoning in children aged 1-3 years in NSW Australia: a case-control study.

BACKGROUND: Unintentional poisoning in young children is an important public health issue. Age pattern studies have demonstrated that children aged 1-3 years have the highest levels of poisoning risk among children aged 0-4 years, yet little research has been conducted regarding risk factors specific to this three-year age group and the methodologies employed varied greatly. The purpose of the current study is to investigate a broad range of potential risk factors for unintentional poisoning in children aged 1-3 years using appropriate methodologies. METHODS: Four groups of children, one case group (children who had experienced a poisoning event) and three control groups (children who had been 'injured', 'sick' or who were 'healthy'), and their mothers (mother-child dyads) were enrolled into a case-control study. All mother-child dyads participated in a 1.5-hour child developmental screening and observation, with mothers responding to a series of questionnaires at home. Data were analysed as three case-control pairs with multivariate analyses used to control for age and sex differences between child cases and controls. RESULTS: Five risk factors were included in the final multivariate models for one or more case-control pairs. All three models found that children whose mothers used more positive control in their interactions during a structured task had higher odds of poisoning. Two models showed that maternal psychiatric distress increased poisoning risk (poisoning-injury and poisoning-healthy). Individual models identified the following variables as risk factors: less proximal maternal supervision during risk taking activities (poisoning-injury), medicinal substances stored in more accessible locations in bathrooms (poisoning-sick) and lower total parenting stress (poisoning-healthy). CONCLUSIONS: The findings of this study indicate that the nature of the caregiver-child relationship and caregiver attributes play an important role in influencing poisoning risk. Further research is warranted to explore the link between caregiver-child relationships and unintentional poisoning risk. Caregiver education should focus on the benefits of close interaction with their child as a prevention measure.

The impact of care recipient falls on caregivers.

OBJECTIVE: This study sought to explore the impact of care recipient falls on caregivers. METHODS: Ninety-six community-dwelling caregiver-care recipient dyads participated in a 12-month prospective study. Falls and other accidents and service use were recorded. Dyads were assessed at baseline and after each fall. Assessment included the Zarit Burden Interview and a post-accident survey developed for the present study. Focus groups were then conducted to further explore the impact of falls on caregivers. RESULTS: Fifty-four care recipients (56%) experienced falls within the 12 months of the study. There was a significant increase in caregiver burden after the first fall (Zarit Burden Interview score increased from 24.2±14.2 to 27.6±14.5, P<0.01). Twenty-four percent of caregivers reported that they had altered their usual routine after the fall, mainly not wanting to leave the care recipient alone. However, there was no increase in the number of services used. Focus group discussions highlighted the need for constant vigilance of the care recipient, a lack of knowledge about support services and concerns related to utilising respite care. CONCLUSION: Falls among care recipients have a significant impact on carers, including an increased fear of falling, prompting the need for even closer vigilance. WHAT IS KNOWN ABOUT THE TOPIC? Falls are a significant problem for older people as one in three older people fall each year and injurious falls are the leading cause of injury-related hospitalisation in older people. In Australia falls cost the economy over $500 million per year. WHAT DOES THIS PAPER ADD? This paper adds a unique perspective to the falls literature, that of the older person's carer. Falls are a significant problem for community-dwelling carers of older people, contributing to carer burden and impeding the carer's ability to undertake activities of daily living because of the perceived need for constant vigilance to prevent the person they care for from falling. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners should ensure that carers are aware of evidence-based falls-prevention practices and services, such as group and individual exercise programs, home modifications and podiatry, that might assist to prevent falls in the person they care for and therefore reduce the burden of care.

Prevalencia de acontecimientos potencialmente traumáticos en universitarios españoles / Prevalence of potentially traumatic events in Spanish university stu-dents

Objetivos: La prevalencia de acontecimientos potencialmente traumáticos en todas las sociedades y contextos es más alta de lo que podría suponerse. El objetivo de este trabajo es describir aquellos acontecimientos potencialmente traumáticos experimentados por una muestra de jóvenes universitarios españoles. Métodos: Se aplicó el Traumatic Life Events Questionnaire a 1033 estudiantes universitarios (M = 21.71 años; DT = 2.63) de la Universidad de Barcelona. Resultados: Un 92.3% de los estudiantes (93.4% de los varones y 91.8% de las mujeres) manifestaron haber experimentado al menos un acontecimiento potencialmente traumático a lo largo de su vida. La media de acontecimientos distintos vivenciados fue de 3.58 (DT = 2.47). Se observaron diferencias significativas en el número de acontecimientos experimentados por varones (M = 3.86; DT = 2.60) y mujeres (M = 3.45; DT = 2.40). Conclusiones: La prevalencia de acontecimientos potencialmente traumáticos en población universitaria española es más elevada que la encontrada en estudios publicados previamente. Las diferencias en los acontecimientos que experimentan ambos sexos deberían tenerse en cuenta al evaluar e intervenir en este tipo de situaciones. La importancia de la valoración personal del encuestado respecto a la vivencia de acontecimientos potencialmente traumáticos debe considerarse (AU)

Aims: The high prevalence of traumatic events among different populations has been shown in several studies. The aim of the present study is to establish the prevalence of potentially traumatic events among Spanish university students. Methods: The sample comprised 1033 under-graduates (M = 21.71 years; SD = 2.63). Data were obtained using the Traumatic Life Events Questionnaire (TLEQ) (Kubany y Haynes, 2001). Results: Ninety-two per cent of subjects (93.4% males and 91.8% females) had been exposed to at least one potentially traumatic event. Males experienced a greater mean number of events than females (males = 3.86, SD = 2.60; females = 3.45, SD = 2.40). Sex differences were also found in the appraisal of events as being traumatic and causing major distress. Conclusions: Frequency of exposure to potentially traumatic events was higher in this sample of university students than in previous studies with similar samples. The results suggest the need for trauma screening and intervention, taking into consideration the substantial gender variation. Also the individual’s appraisal for considering an event traumatic underlines the importance of taking the individual’s perception into account (AU)

[Isolated congenital anosmia--clinical and daily life aspects of a life without a sense of smell]. / Isolierte congenitale Anosmie - Klinische und alltägliche Aspekte eines Lebens ohne Geruchssinn.

BACKGROUND: Isolated congenital anosmia is a disorder (ICA) characterized by not or only rudimentary developed central olfactory structures. This results in the lack of the sense of smell since birth. Although this phenomenon is known among clinicians almost no knowledge exists on how those people cope with the disorder. MATERIAL AND METHODS: 43 people with ICA were asked with a standardised questionnaire about when they fi rst noticed their disorder, how they experience the lack of smelling ability and about different aspects of daily life. RESULTS: ICA is detected by the patients self or by their parents at the age of 10 in average. However about 13 years pass, until the right diagnosis is confirmed. In contrast to people with acquired olfactory loos ICA patients have developed strategies to adapt to the deficit in daily life. Nevertheless they report increased social insecurity and more hazardous events. CONCLUSION: The results can be of advantage for clinicians and patients to get a better understanding of the disorder.

Non fatal injuries among infants: a pilot study.

OBJECTIVE: To determine the incidence, nature and the extent of infant injuries in two suburban and rural communities of Pakistan. METHODS: The cross-sectional study was conducted on a cohort of 310 infants in suburban and rural communities of Pakistan in September 2007. The information was collected from primary care-givers based on any injury that had occurred to their infants during the preceding 3 months that required treatment at home or in a hospital. RESULT: The incidence of non-fatal injury for infants up to 1-year-old was found to be 19 injuries per 100 person (child) years of exposure (95% CI 9.90 - 27.21). In suburban area, the rate was 26 injuries/100 person (child) years (95 % CI 15.37 - 35.71), while in rural area, it was 13 injuries/100 person (child) years of exposure (95 % CI 4.79-18.39). Altogether, 13 episodes of injury were reported among infants in both the communities. The male to female infant ratio for injury was 1:2.2. Suburban area had more than double injuries compared to the rural area. CONCLUSION: The magnitude of infant injuries was quite significant, especially among suburban and female children. There is a dire need to develop community-based interventions creating awareness on the matter.

Older people's views in relation to risk of falling and need for intervention: a meta-ethnography.

AIM: This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. BACKGROUND: Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. DATA SOURCES: Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. REVIEW METHODS: Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. RESULTS: Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. CONCLUSION: In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person.

A case-control study on risk factors of domestic accidents in an elderly population.

The aim of this study was to evaluate the combined influence of several lifestyle, health and housing factors in the occurrence of home injuries (HIs) among the elderly. The subjects were recruited from 10 hospitals in Rome, Italy. This study is a paired case-control study. Cases included subjects, aged 65-85 years, who visited the Emergency Department for an HI and were subsequently hospitalised (15 September 2004-30 June 2005). Controls were the subjects of the same gender, age (±3 years) and area of residence of cases. A conditional logistic regression model was used for analysing the variables obtained. In this study, we enrolled 107 hospitalised cases. It was found that the living room was the place where 33% of the accidents occurred. Eighty-seven per cent of the accidents were falls, and 33% of the accidents were the immediate consequence of sudden malaise. One-half of the cases reported one or more leg fractures. The variables that were independently associated with HI were poor household illumination, poor emotional status, regular physical activities and housekeeping activities. We conclude that this study shows the areas of intervention to target HI prevention activities.

Falls after discharge from hospital: is there a gap between older peoples' knowledge about falls prevention strategies and the research evidence?

PURPOSE: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital. DESIGN AND METHODS: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial. Participants (n = 333) were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with current reported research evidence for falls prevention interventions. RESULTS: Participants' strategies (n = 629) were classified into 7 categories: behavioral, support while mobilizing, approach to movement, physical environment, visual, medical, and activities or exercise. Although exercise has been identified as an effective falls risk reduction strategy, only 2.9% of participants suggested engaging in exercises. Falls prevention was most often conceptualized by participants as requiring 1 (35.4%) or 2 (40.8%) strategies for avoiding an accidental event, rather than engaging in sustained multiple risk reduction behaviors. IMPLICATIONS: Results demonstrate that older patients have low levels of knowledge about appropriate falls prevention strategies that could be used after discharge in spite of their increased falls risk during this period. Findings suggest that health care workers should design and deliver falls prevention education programs specifically targeted to older people who are to be discharged from hospital.

Knowledge, attitudes and beliefs towards injury prevention: a population-based telephone survey.

Public knowledge and beliefs about injury prevention are currently poorly understood. A total of 1030 residents in the State of Queensland, Australia, responded to questions about injury prevention in or around the home, on the roads, in or on the water, at work, deliberate injury and responsibility for preventing deliberate injury allowing for comparison with reported injury prevalence data. Overall, the youngest members of society were identified as being the most vulnerable to deliberate injury with young adults accounting for 59% of responses aligning with reported data. However, younger adults failed to indicate an awareness of their own vulnerability to deliberate injury in alcohol environments even though 61% of older respondents were aware of this trend. Older respondents were the least inclined to agree that they could make a difference to their own safety in or around the home but were more inclined to agree that they could make a difference to their own safety at work. The results are discussed with a view to using improved awareness of public beliefs about injury to identify barriers to the uptake of injury prevention strategies (e.g. low perceived injury risk) as well as areas where injury prevention strategies may receive public support.

A systematic review of accidental injury from fire, wandering and medication self-administration errors for older adults with and without dementia.

The assessment of risk of injury in the home is important for older adults when considering whether they are able to live independently. The purpose of this systematic review is to determine the frequency of injury for persons with dementia and the general older adult population, from three sources: fires/burns, medication self-administration errors and wandering. Relevant articles (n=74) were screened and 16 studies were retained for independent review. The studies, although subject to selection and information bias, showed low proportions of morbidity and mortality from the three sources of injury. Data did not allow direct comparison of morbidity and mortality for persons with dementia and the general older adult population; however, data trends suggested greater event frequencies with medication self-administration and wandering for persons with dementia. Assessment targeting these sources of injury should have less emphasis in the general older adult population compared to persons with dementia.