“Because It Kind of Falls in Between, Doesn’t It? Like an Acute Thing and a Chronic”: the Psychological Experience of Anaphylaxis in Adulthood

Anaphylaxis is a serious, rare condition increasing in prevalence. This study explored the psychological experience of adult-onset anaphylaxis from patient, family and staff perspectives. Semi-structured interviews were conducted with twelve participants. Two global themes emerged from thematic analysis: ‘controllability’ (‘an unknown and distressing experience’, ‘the importance of control over triggers’ and ‘responsibility but no control: the impact on others’) and ‘conflict’ (‘rejecting illness identity’, ‘minimisation of risk’, ‘accessing specialist care: running in slow motion’ and ‘patient-centred versus service-centred care’). Findings highlight the importance of perceived control and emphasise the presence of conflict in the experience of this complex, episodic condition.

Report on the University of Northern Iowa, Cedar Falls, Iowa for the year ended June 30, 2015

Report on the University of Northern Iowa, Cedar Falls, Iowa for the year ended June 30, 2015

Falls and the Social Isolation of Older Adults in the National Health and Aging Trends Study

Thesis (Ph.D.)--University of Washington, 2016-08

Understanding of genetic test results for osteogenesis imperfecta by attorneys and child welfare workers in non-accidental injury cases

Thesis (Ph.D.)--University of Washington, 2016-08

The Role of Accidental and Therapeutic Hypothermia in Non-Fatal Drowning

A case of non-fatal drowning with a successful outcome despite a submersion time of 25 min is described. Our case report emphasizes the role of accidental hypothermia in the survival of drowning victims with hypoxic brain injury, and supports the use of therapeutic hypothermia in the resuscitation of these patients.

Women's Rights National Historical Park, Seneca Falls, New York /

Panel title.

Accidental SUSY: Enhanced bulk supersymmetry from brane back-reaction

We compute how bulk loops renormalize both bulk and brane effective interactions for codimension-two branes in 6D gauged chiral supergravity, as functions of the brane tension and brane-localized flux. We do so by explicitly integrating out hyper- and gauge-multiplets in 6D gauged chiral supergravity compactified to 4D on a flux-stabilized 2D rugby-ball geometry, specializing the results of a companion paper, arXiv:1210.3753 , to the supersymmetric case. While the brane back-reaction generically breaks supersymmetry, we show that the bulk supersymmetry can be preserved if the amount of brane- localized flux is related in a specific BPS-like way to the brane tension, and verify that the loop corrections to the brane curvature vanish in this special case. In these systems it is the brane-bulk couplings that fix the size of the extra dimensions, and we show that in some circumstances the bulk geometry dynamically adjusts to ensure the supersymmetric BPS-like condition is automatically satisfied. We investigate the robustness of this residual supersymmetry to loops of non-supersymmetric matter on the branes, and show that supersymmetry- breaking effects can enter only through effective brane-bulk interactions involving at least two derivatives. We comment on the relevance of this calculation to proposed applications of codimension-two 6D models to solutions of the hierarchy and cosmological constant problems. © 2013 SISSA.

Geriatric fall-related injuries.

Background: Falls are the leading cause of geriatric injury. Objectives: We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. Methods: All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. Results: We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

Falls and other geriatric syndromes in Blantyre, Malawi: a community survey of older adults

Background The prevalence of geriatric syndromes (falls, immobility, intellectual or memory impairment, and incontinence) is unknown in many resource-poor countries. With an aging population such knowledge is essential to develop national policies on the health and social needs of older people. The aim of this study was to provide a preliminary survey to explore the prevalence of falls and other geriatric syndromes and their association with known risk factors in people aged > 60 years in urban Blantyre, Malawi. Methods This was a cross-sectional, community survey of adults aged > 60 years. Subjects were recruited at home or in the waiting areas of chronic care clinics. They were interviewed to complete a questionnaire on ageassociated syndromes and comorbid problems. The Abbreviated Mental Test (AMT) and Timed Up and Go (TUG) tests were carried out. Results Ninety-eight subjects were studied; 41% reported falling in the past 12 months, 33% of whom (13% of all subjects) were recurrent fallers. Twenty-five percent reported urine incontinence, 66% self-reported memory difficulties, and 11% had an AMT score < 7. A history of falling was significantly associated with urine incontinence (p=0.01), selfreported memory problems (p=0.004) and AMT score < 7 (p=0.02). Conclusions Geriatric syndromes, including falls, appear to be prevalent in older people in Blantyre, Malawi. Falling is associated with cognitive impairment and urinary incontinence. There is an urgent need for more understanding of geriatric problems in this setting to develop national policies on health and social needs of older people. It is likely that many of the contributory factors to falls would be amenable to multifactorial interventions similar to those found to be effective in developed countries.

Why do hospitalized older adults take risks that may lead to falls?

Background: The behaviour of hospitalized older adults can contribute to falls, a common adverse event during and after hospitalization. Objective: To understand why older adults take risks that may lead to falls in the hospital setting and in the transition period following discharge home. Design: Qualitative research. Setting and participants: Hospital patients from inpatient medical and rehabilitation wards (n = 16), their informal caregivers (n = 8), and health professionals (n = 33) recruited from Southern Health hospital facilities, Victoria, Australia. Main variables studied: Perceived motivations for, and factors contributing to risk taking that may lead to falls. Main outcome measures: Semi-structured, in depth interviews and focus groups were used to generate qualitative data. Interviews were conducted both 2 weeks post-hospitalization and 3 months post-hospitalization. Results: Risk taking was classified as; (i) enforced (ii) voluntary and informed and (iii) voluntary and mal informed. Five key factors that influence risk taking behaviour were (i) risk compensation ability of the older adult, (ii) willingness to ask for help, (iii) older adult desire to test their physical boundaries, (iv) communication failure between and within older adults, informal care givers and health professionals and (v) delayed provision of help. Discussion and Conclusion: Tension exists between taking risks as a part of rehabilitation and the effect it has on likelihood of falling. Health professionals and caregivers played a central role in mitigating unnecessary risk taking, though some older adults appear more likely to take risks than others by virtue of their attitudes.

Factors associated with accidental injuries in children with ADHD-combined type: more than a motor problem?

OBJECTIVE: We explored the relationship between accidental injuries, motor impairment, and co-occurring autism spectrum disorder (ASD) symptoms in children with ADHD-combined type (ADHD-CT).

METHOD: Participants were 32 male children diagnosed with ADHD-CT and 23 typically developing male children (7-12 years, full scale IQ [FSIQ] > 80). Parents completed a customized questionnaire on the occurrence of accidental injuries (e.g., bruises, cuts) their child experienced in the past 12 months. Motor proficiency was assessed using the Movement ABC-2 (MABC-2). Parents rated motor, ADHD-CT, ASD, and anxiety symptoms.

RESULTS: Children with ADHD-CT had significantly increased parent-reported accidental injuries compared with typically developing children. Among children with ADHD-CT, Spearman's rho rank correlations revealed no association between increased accidental injuries and MABC-2 score, but significant associations with increased hyperactivity/impulsivity, ASD, and anxiety symptoms.

CONCLUSION: Although these findings require validation, they suggest a need for further research investigating the contribution of co-occurring ASD and anxiety symptoms to accidental injuries in children with ADHD-CT.

Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women

OBJECTIVE: To ascertain whether the risk of falls of different types is related to morbidity (number of chronic medical conditions) among postmenopausal women. STUDY DESIGN: This cohort study uses data from a population-based prospective cohort study (OSTPRE). The study population consisted of 10,594 women aged 47-56 years living in Kuopio Province, Eastern Finland, in 1989, who responded to postal enquiries at both baseline and 5-year follow-up, in 1994. Morbidity (i.e. number of diagnosed chronic medical conditions) was reported in 1989 and falls in 1994. Falls were categorized as slip or nonslip, and 'frequent falls' was defined as two or more in a 12-month period. RESULTS: The risk (odds ratio (OR) with 95% CI) of a fall increased with the number of chronic medical conditions. The OR was 1.28 (1.17-1.40) for those with 1-2 conditions and 1.41 (1.24-1.60) for those with multimorbidity (≥3 conditions) compared with healthy respondents. Multimorbidity was associated with a greater risk of the woman experiencing frequent nonslip falls (OR=2.57; 2.01-3.29) than frequent slip falls (OR=1.46; 1.17-1.80). Adjusting with logistic regression for age, number of medications and smoking did not affect the risk estimates. CONCLUSION: Multimorbidity has a much smaller effect on slip than on nonslip falls in postmenopausal women. This should be taken into account when investigating the effects of multimorbidity on fall risk in varying weather conditions.