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.

Experimental evaluation of MCDTK, the Monte Carlo DICOM Tool-Kit

The Monte Carlo DICOM Tool-Kit (MCDTK) is a software suite designed for treatment plan dose verification, using the BEAMnrc and DOSXYZnrc Monte Carlo codes. MCDTK converts DICOM-format treatment plan information into Monte Carlo input files and compares the results of Monte Carlo treatment simulations with conventional treatment planning dose calculations. In this study, a treatment is planned using a commercial treatment planning system, delivered to a pelvis phantom containing ten thermoluminescent dosimeters and simulated using BEAMnrc and DOSXYZnrc using inputs derived from MCDTK. The dosimetric accuracy of the Monte Carlo data is then evaluated via comparisons with the dose distribution obtained from the treatment planning system as well as the in-phantom point dose measurements. The simulated beam arrangement produced by MCDTK is found to be in geometric agreement with the planned treatment. An isodose display generated from the Monte Carlo data by MCDTK shows general agreement with the isodose display obtained from the treatment planning system, except for small regions around density heterogeneities in the phantom, where the pencil-beam dose calculation performed by the treatment planning systemis likely to be less accurate. All point dose measurements agree with the Monte Carlo data obtained using MCDTK, within confidence limits, and all except one of these point dose measurements show closer agreement with theMonte Carlo data than with the doses calculated by the treatment planning system. This study provides a simple demonstration of the geometric and dosimetric accuracy ofMonte Carlo simulations based on information from MCDTK.

Negligible heat strain in armored vehicle officers wearing personal body armor

Objectives This study evaluated the heat strain experienced by armored vehicle officers (AVOs) wearing personal body armor (PBA) in a sub-tropical climate. Methods Twelve male AVOs, aged 35-58 years, undertook an eight hour shift while wearing PBA. Heart rate and core temperature were monitored continuously. Urine specific gravity (USG) was measured before and after, and with any urination during the shift. Results Heart rate indicated an intermittent and low-intensity nature of the work. USG revealed six AVOs were dehydrated from pre through post shift, and two others became dehydrated. Core temperature averaged 37.4 ± 0.3°C, with maximum's of 37.7 ± 0.2°C. Conclusions Despite increased age, body mass, and poor hydration practices, and Wet-Bulb Globe Temperatures in excess of 30°C; the intermittent nature and low intensity of the work prevented excessive heat strain from developing.

Sublime acts : desire in the studio

Acknowledging the recent call to review design creativity and consideration of the body's affective states in education, this paper explores how desire, conceptualized as an immanent force (Deleuze & Guattari, 1987) and an irresistible force (Burke, 1753) can be a means of deeper engagement within the design studio. Positing 'disruption or blockage' as a key agent which propels subjects from fields of normalcy to fields of otherness, and subsequently mobilises distinct modes of desire, this paper takes Edmund Burke's Romantic sublime and Patricia Yaeger's feminine sublime as critical lenses through which to review a first year interior program posited around the body. The paper highlights how the embodiment of 'desirous processes' within the design program and relational encounters within the studio represent an overarching pedagogical 'hinge' (Ellsworth, 2005). Rather than being a point of beginning, the start of first year is seen and experienced as a threshold opening to a new rhythm in a proces of becoming that is already underway.

The naming of waterfalls

As features of the landscape, waterfalls have been studied extensively by geographers, but the names given to these landforms have received relatively little scholarly attention. This paper examines the naming of waterfalls and addresses the question of classifying these hydronyms. The subject is considered in a global historical context, focusing on place names in the anglophone world. Until the 18th and 19th centuries, relatively few waterfalls were named.With the beginning of the Industrial Revolution, water power rose in economic importance, and at the same time, there was a growing scientific and aesthetic engagement with the landscape. These developments are suggested as reasons for the increased interest in waterfalls which were then being recorded in topographical literature and on maps, individual names being given to increasing numbers of falls. European exploration added to the knowledge of the world’s waterfalls, many of which were given names by their ‘discoverers’. This naming process accelerated with the growth of domestic and overseas tourism which exploited scenic resources such as waterfalls. Until now, research on the names of waterfalls has been fragmentary, and the classification of these hydronyms has been neglected. This paper demonstrates that waterfall names can be classified in accordance with a recognised toponymic typology. Using examples drawn from waterfall guidebooks, databases, maps, and other sources, the following discussion supports George Stewart’s claim that his toponymic classification is valid for place names of all kinds.

Slow horizon

“Slow Horizon” is comprised of six lenticular panels hung in an even, horizontal sequence. As the viewer moves in front of the work, each panel alternates subtly between two vertical colour gradients. From left to right, the panels move through yellow, orange, magenta and violet to ‘midnight blue’. Together, the coloured panels comprise an abstract horizon line that references the changing nature of light at sunset. The scale, movement and chromatic qualities of the panels also allude to the formal characteristics of the screen technologies that pervade contemporary visual culture. “Slow Horizon” contributes to studies in the field of contemporary art. It is particularly concerned with the relationships between abstraction, colour, signification and perception. Since early Modernity, debates concerning representation and the formal qualities of the picture plane have been fundamental to art practice and theory. These debates have often dovetailed with questions of art’s capacity to generate shifts in thought and perception. Practitioners such as Ellsworth Kelly, James Turrell and Ed Ruscha have variously used block and blended colour to engage in these formal, symbolic and perceptual potentials of colour. Using a practice-led research methodology, “Slow Horizon” furthers this creative inquiry. By conflating the reductive visual logics of abstraction and minimalism with the iconic, romantic evocations of sunset imagery, it questions not only the contemporary relationship between abstraction and image-making, but also art’s ability to create moments of stillness and contemplation in a context significantly shaped by screen technologies. “Slow Horizon” has been exhibited internationally as part of “Supermassive” at LA Louver Gallery, Venice, California in 2013. The exhibition was reviewed in The Los Angeles Times.

Interval training program optimization in highly trained endurance cyclists

PURPOSE: The purpose of this study was to examine the influence of three different high-intensity interval training (HIT) regimens on endurance performance in highly trained endurance athletes. METHODS: Before, and after 2 and 4 wk of training, 38 cyclists and triathletes (mean +/- SD; age = 25 +/- 6 yr; mass = 75 +/- 7 kg; VO(2peak) = 64.5 +/- 5.2 mL x kg(-1) min(-1)) performed: 1) a progressive cycle test to measure peak oxygen consumption (VO(2peak)) and peak aerobic power output (PPO), 2) a time to exhaustion test (T(max)) at their VO(2peak) power output (P(max)), as well as 3) a 40-km time-trial (TT(40)). Subjects were matched and assigned to one of four training groups (G(2), N = 8, 8 x 60% T(max) at P(max), 1:2 work:recovery ratio; G(2), N = 9, 8 x 60% T(max) at P(max), recovery at 65% HR(max); G(3), N = 10, 12 x 30 s at 175% PPO, 4.5-min recovery; G(CON), N = 11). In addition to G(1), G(2), and G(3) performing HIT twice per week, all athletes maintained their regular low-intensity training throughout the experimental period. RESULTS: All HIT groups improved TT(40) performance (+4.4 to +5.8%) and PPO (+3.0 to +6.2%) significantly more than G(CON) (-0.9 to +1.1%; P < 0.05). Furthermore, G(1) (+5.4%) and G(2) (+8.1%) improved their VO(2peak) significantly more than G(CON) (+1.0%; P < 0.05). CONCLUSION: The present study has shown that when HIT incorporates P(max) as the interval intensity and 60% of T(max) as the interval duration, already highly trained cyclists can significantly improve their 40-km time trial performance. Moreover, the present data confirm prior research, in that repeated supramaximal HIT can significantly improve 40-km time trial performance.