Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

Background The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated.
Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined.
Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD.

Households' perceptions on sustainable home behaviour and improvements in Australia

The consumption of energy in the residential building is a major contributor to Australia's stationary energy greenhouse gas emissions. With the aim of investigating the householders' motivations and perspectives on sustainable home improvements, this study, by using an online survey instrument, collected more than 500 sets of questionnaire data from households in the state of New South Wales, Australia. Through statistical analysis of the data collected, this research has found that construction cost and government incentive were considered as major influence factors on achieving energy efficient residential building development, and the lower bills from reduced energy and water consumption were considered as the most important benefits from the households' perspectives. The research also found that although many households exhibited a high level of awareness or had implemented some sustainability improvements, the total number of potential improvements scored poorly. A suggestion, based on these research findings, is that the government should promote the reasons and benefits for sustainability home improvements that are identified in this research paper, and try to reduce material costs and improve government incentives.

How many seabirds do we need to track to define home-range area?

In recent years, marine predator and seabird tracking studies have become ever more popular. However, they are often conducted without first considering how many individuals should be tracked and for how long they should be tracked in order to make reliable predictions of a population's home-range area. Home-range area analysis of two seabird-tracking data sets was used to define the area of active use (where birds spent 100% of their time) and the core foraging area (where birds spent 50% of their time). Analysis was conducted on the first foraging trip undertaken by the birds and then the first two, three and four foraging trips combined. Appropriate asymptotic models were applied to the data, and the calculated home-range areas were plotted as a function of an increasing number of individuals and trips included in the sample. Data were extrapolated from these models to predict the area of active use and the core foraging area of the colonies sampled. Significant variability was found in the home-range area predictions made by analysis of the first foraging trip and the first four foraging trips combined. For shags, the first foraging trip predicted a 56% smaller area of active use when compared to the predictions made by combining the first four foraging trips. For kittiwakes, a 43% smaller area was predicted when comparing the first foraging trip with the four combined trips. The number of individuals that would be required to predict the home range area of the colony depends greatly on the number of trips included in the analysis. This analysis predicted that 39 (confidence interval 29-73) shags and 83 (CI: 109-161) kittiwakes would be required to predict 95% of the area of active use when the first four foraging trips are included in the sample compared with 135 (CI 96-156) shags and 248 (164-484) kittiwakes when only the first trip is included in the analysis. Synthesis and applications. Seabird and marine mammal tracking studies are increasingly being used to aid the designation of marine conservation zones and to predict important foraging areas. We suggest that many studies may be underestimating the size of these foraging areas and that better estimates could be made by considering both the duration and number of data logger deployments. Researchers intending to draw conclusions from tracking data should conduct a similar analysis of their data as used in this study to determine the reliability of their home-range area predictions.

Home-range, diet and breeding of a Powerful Owl Ninox strenua in East Gippsland, Victoria

Between 2004 and 2008 the diet and breeding success of a pair of Powerful Owls Ninox strenua were studied near Lakes Entrance, Victoria. In early November 2006 the adult female Powerful Owl was captured and radio-tracked for a period of 7.5 months. During this time the Owl's location was recorded on 111 occasions, including 65 nocturnal locations over 29 nights. Her home-range was calculated as 1589 ha using the Minimum Convex Polygon (MCP) method, or 871 ha based on the 95% Adaptive Kernel method. The area of forested habitat within the MCP home-range was 896 ha (the remainder representing cleared land). Her activity was centred primarily on the nesting gully where two dependent juveniles roosted, but several long-distance foraging expeditions (including roosting) that occurred more than 2.5 km from the juveniles were recorded. Arboreal mammals and birds dominated the Owls' diet. Low prey availability is suggested as being responsible for the single successful breeding event recorded in four nesting seasons.

Adolescents’ physical activity : competition between perceived neighborhood sport facilities and home media resources

Objective. To examine the independent, competing, and interactive effects of perceived availability of specific types of media in the home and neighborhood sport facilities on adolescents’ leisure-time physical activity (PA).

Methods. Survey data from 34 369 students in 42 Hong Kong secondary schools were collected (2006–07). Respondents reported moderate-to-vigorous leisure-time PA, presence of sport facilities in the neighborhood and of media equipment in the home. Being sufficiently physically active was defined as engaging in at least 30 minutes of non-school leisure-time PA on a daily basis. Logistic regression and post-estimation linear combinations of regression coefficients were used to examine the independent and competing effects of sport facilities and media equipment on leisure-time PA.

Results. Perceived availability of sport facilities was positively (ORboys = 1.17; ORgirls = 1.26), and that of computer/Internet negatively (ORboys = 0.48; ORgirls = 0.41), associated with being sufficiently active. A significant positive association between video game console and being sufficiently active was found in girls (ORgirls = 1.19) but not in boys. Compared with adolescents without sport facilities and media equipment, those who reported sport facilities only were more likely to be physically active (ORboys = 1.26; ORgirls = 1.34), while those who additionally reported computer/Internet were less likely to be physically active (ORboys = 0.60; ORgirls = 0.54).

Conclusions. Perceived availability of sport facilities in the neighborhood may positively impact on adolescents’ level of physical activity. However, having computer/Internet may cancel out the effects of active opportunities in the neighborhood. This suggests that physical activity programs for adolescents need to consider limiting the access to computer-mediated communication as an important intervention component.

Managing post-discharge care at home: an analysis of patients' and their carers' perceptions of information received during their stay in hospital

This small-scale study carried out in a Melbourne metropolitan hospital explored patients’ and their carers’ perceptions of information, adequacy of information, and their utilization of information concerning post-discharge care received from health professionals during their stay in hospital. The research design consisted of two stages. Stage one involved a qualitative approach using focused interviews of five pairs of patients and their carers, 2 weeks after discharge from hospital. Five main themes emerged from the content analysis of the interview transcripts: information given by health professionals to patients and carers, patients’ and carers’ psychological well-being, activities of daily living, caring tasks of the patients, and community linkages. A quantitative approach was used for stage two involving two sets of questionnaires, one for the patient and one for the carer, developed from the themes identified in stage one. A pilot study was conducted on three pairs of patients and their carers, 2 weeks after discharge from hospital. The main study consisted of a convenience sample of 40 pairs of patients and their carers who completed the questionnaires 2 weeks post-discharge. Data analysis of stage two of the study consisted of descriptive statistics and cross-tabulations. The main findings suggested that carers received very little information from health professionals concerning their patients’ health problems and care at home. The carers’ health and employment states were often not considered in their patients’ discharge plan. Carers who were present with their patients when they received information concerning post-discharge care experienced a decrease in anxiety during their patients’ convalescence at home, greater satisfaction with the information they received, and their patients experienced fewer medical problems post-discharge. The implications for nursing practice and research include recommendations for a more effective system of discharge planning, and further research to include a larger population with a more varied group of participants.

Home based business in suburban peripheral regions and government policy: a case study of Casey, Melbourne, Australia

Home based businesses (HBB) are increasingly becoming an alternative to salaried employment. This research explores the potential for HBB to contribute significantly to the economic development of peripheral metropolitan centres. Without economic development, these centres remain dormitory suburbs with unresolved associated social and ecological issues. By mapping the diversity and limitations of HBB in the City of Casey, an outer suburban peripheral area of Melbourne, Australia, this study aims to evaluate what exists and the response by governments at all levels to further business development. This study finds that the role of government is restricted to broad initial start-ups, with no programs or support for the type of innovative HBB that need to be husbanded and encouraged to grow outside of the narrow confines of their home base.

The home-market effect and bilateral trade patterns: a reexamination of the evidence

This paper finds that the evidence for the home market effect (HME) found by Hanson and Xiang (AER, 2004) is sensitive to the way the dependent and the independent variables are constructed. Second, we also find that the HME evidence goes away when we estimate their difference-in-difference gravity model on a truncated sample of positive trade flows. With Eaton–Tamura–Tobit, Heckman, and Helpman–Melitz–Rubinstein estimation of the gravity equation using Hanson and Xiang's data, we are unable to find any evidence for the HME. Finally, the HME evidence is also absent for a sample of Canadian provinces' exports to U.S. states. All of our results, taken together, do not reject the existence of the HME in general but rather suggest that the HME results found by Hanson and Xiang may not be robust.

Fidelity to foraging sites, consistency of migration routes and habitat modulation of home range by sea turtles

Aim  Resources can shape patterns of habitat utilization. Recently a broad foraging dichotomy between oceanic and coastal sites has been revealed for loggerhead sea turtles (Caretta caretta). Since oceanic and coastal foraging sites differ in prey availability, we might expect a gross difference in home-range size across these habitats. We tested this hypothesis by equipping nine adult male loggerhead sea turtles with GPS tracking devices. Location  National Marine Park of Zakynthos (NMPZ) Greece, central and eastern Mediterranean (Adriatic, Ionian and Aegean seas). Methods  In 2007, 2008 and 2009, Fastloc GPS-Argos transmitters were attached to nine male loggerheads. In addition, a Sirtrack PTT unit was attached to one male in 2007. Four of the turtles were tracked on successive years. We filtered the GPS data to ensure comparable data volumes. Route consistency between breeding and foraging sites of the four re-tracked turtles was conducted. Foraging site home range areas and within site movement patterns were investigated by the fixed kernel density method. Results  Foraging home range size ranged between circa 10 km2 at neritic habitats (coastal and open-sea on the continental shelf) to circa 1000 km2 at oceanic sites (using 90% kernel estimates), the latter most probably reflecting sparsely distributed oceanic prey. Across different years individuals did not follow exactly the same migration routes, but did show fidelity to their previous foraging sites, whether oceanic or neritic, with accurate homing in the final stages of migration. Main conclusions  The broad distribution and diverse life-history strategies of this population could complicate the identification of priority marine protected areas beyond the core breeding site.