Explore the vast range of titles available.

Falls are one of the common health and well-being issues among the older adults. Internet of things (IoT)-based health monitoring systems have been developed over the past two decades for improving healthcare services for older adults to support an independent lifestyle. This research systematically reviews technological applications related to falls detection and falls management. The systematic review was conducted in accordance to the preferred reporting items for systematic reviews and meta-analysis statement (PRISMA). Twenty-four studies out of 806 articles published between 2015 and 2017 were identified and included in this review. Selected studies were related to pre-fall and post-fall applications using motion sensors (10; 41.67%), environment sensors (10; 41.67%) and few studies used the combination of these types of sensors (4; 16.67%). As an outcome of this review, we postulated a falls management framework (FMF). FMF considered pre- and post-fall strategies to support older adults live independently. A part of this approach involved active analysis of sensor data with the aim of helping the older adults manage their risk of fall and stay safe in their home. FMF aimed to serve the researchers, developers, clinicians and policy makers with pre- and post-falls management strategies to enhance the older adults’ independent living and well-being.

Background Falls are a common and serious health issue facing the global population, causing an estimated 646,000 deaths per year globally. Wearable devices typically combine accelerometers, gyroscopes and even barometers; using the data collected and inputting this into an algorithm that decides whether a fall has occurred. The purpose of this umbrella review was to provide a comprehensive overview of the systematic reviews on the effectiveness of wearable electronic devices for falls detection in adults. Methods MEDLINE, Embase, Cochrane Database of Systematic Reviews (CDSR), and CINAHL, were searched from their inceptions until April 2019 for systematic reviews that assessed the accuracy of wearable technology in the detection of falls. Results Seven systematic reviews were included in this review. Due to heterogeneity between the included systematic reviews in their methods and their reporting of results, a meta-analysis could not be performed. Most devices tested used accelerometers, often in combination with gyroscopes. Three systematic reviews reported an average sensitivity of 93.1% or greater and an average specificity of 86.4% or greater for the detection of falls. Placing sensors on the trunk, foot or leg appears to provide the highest accuracy for falls detection, with multiple sensors increasing the accuracy, specificity, and sensitivity of these devices. Conclusions This review demonstrated that wearable device technology offers a low-cost and accurate way to effectively detect falls and summon for help. There are significant differences in the effectiveness of these devices depending on the type of device and its placement. Further high-quality research is needed to confirm the accuracy of these devices in frail older people in real-world settings.

A large-plot field experiment was conducted at Keiser, AR, from fall of 2010 through fall of 2013 to understand to what extent soybean in-crop herbicide programs and postharvest fall management practices impact Palmer amaranth population density and seed production over three growing seasons. The effect of POST-only (glyphosate-only) or PRE followed by (fb) POST (glyphosate or glufosinate) + residual herbicide treatments were evaluated alone and in combination with postharvest management options of soybean residue spreading or soil incorporation, use of cover crops, windrowing with/without burning, and residue removal. Significant differences were observed between fall management practices on Palmer amaranth population density each fall. The use of cover crops and residue collection and removal fb the incorporation of crop residues into soil during the formation of beds were the most effective practices in reducing Palmer amaranth population. In contrast, the effects of fall management practices on Palmer amaranth seed production were inconsistent among years. The inclusion of a PRE herbicide application into the herbicide program significantly reduced Palmer amaranth population density and subsequent seed production each year when compared to the glyphosate-only program. Additionally, the glufosinate-containing residual program was superior to the glyphosate-containing residual program in reducing Palmer amaranth seed production. PRE fb POST herbicides resulted in significant decreases in the Palmer amaranth population density and seed production compared to POST application of glyphosate alone for all fall management practices, including the no-till practice. This study demonstrated that crop residue management such as chaff removal from the field, the use of cover crops, or seed incorporation during bed formation in combination with an effective PRE plus POST residual herbicide program is important for optimizing in-season management of Palmer amaranth and subsequently reducing the population density, which has a profound impact on lessening the risk for herbicide resistance and the consistency and effectiveness of future weed management efforts. Nomenclature: Glufosinate; glyphosate; Palmer amaranth, Amaranthus palmeri S. Wats.; soybean, Glycine max (L.) Merr.

IntroductionFalls are a significant cause of injury in older adults who are disproportionately at higher risk due to multiple factors such as, mobility issues, co-morbidities and polypharmacy. There are several evidence-based interventions that can be implemented to reduce the risk of – and manage falls.ObjectivesAssess whether Woodlands Hospital has implemented the standards set by NICE guidelines on the management of Falls in Older People.MethodsRetrospective audit of patients admitted to Woodlands Hospital from 1st June to 1st December 2018. 113 patient records were analysed to determine; was an falls risk assessment completed on admission, did patients ’at risk of falls’ have individualized interventions in place, was a falls risk assessment completed weekly at MDT, following a fall, were patients checked for signs of fracture before moved, was a medical examination completed and were neurological observations completed in patients with observed head injury or where it could not be excluded?Results100% of patients had individualised interventions to reduce risk of falls and 97.3% of patients had an assessment of risks completed on admission. 60.3% of patients were checked for signs of fracture. 78.3% of patients had a physical examination within 12 hours. 75% of patients had neurological observations completed.ConclusionsRisk assessment for falls and individualized interventions for patients at risk of falls were completed at a high standard. There remains scope for improvement of review of risk of falls during weekly MDT, documentation of checking for signs of fractures and neurological examination. The outcomes were relayed to the unit and plans to re-audit in September 2021.DisclosureNo significant relationships.

Background After a fall, more than half of older people living alone are unable to get up or get help independently. Fall-related recumbency makes affected individuals aware of functional status limitations and increased vulnerability. Patient-centered therapy is needed to manage physical, psychological, and social needs. This review summarizes the current evidence on care options for the special patient population. Methods The scoping review used the six-step framework proposed by Arksey and O´Malley and was conducted in accordance with the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework for scoping reviews. The literature searches were conducted in five databases and ten online archives. Articles were screened, assessed and selected using defined inclusion and exclusion criteria. Articles were included if they were published in either German or English and related to the care of long lies. Thematic synthesis was based on the literature review. Results The search yielded 1047 hits, of which 19 research papers were included. Two themes were identified: (1) acute therapy, focused on prolonged recumbency and pronounced physical effects; and (2) preventive therapy, which examined standing up training, technical aids, and social control systems in the context of fall management. Conclusions There are a limited number of interventions that relate to the patient population. The interventions are predominantly presented independently, so there is a lack of structuring of the interventions in the form of a treatment pathway. In addition to pooling professional expertise and an interprofessional approach, it is important to continue inpatient treatment in the home setting, even though the effectiveness of interventions in a home setting has hardly been verified thus far. The solution for a missing treatment process is first of all a planned, interprofessional and intersectoral approach in therapy.

Insecticides and genetically modified Bt crops are the main tools for control of the fall armyworm, Spodoptera frugiperda (J.E. Smith). Since its invasion of Africa, the Far East, and Australia where Bt crops are largely absent, insecticide use has increased and reduced susceptibility to several insecticides used for decades in its native distribution area have been reported. Poor efficacy at field-level is sometimes incorrectly ascribed to pest resistance, while numerous other factors influence efficacy at field-level. In this paper, we review the history of insecticide resistance in S. frugiperda and discuss the influence that life history traits, migration ecology, and chemical control practices may have on control efficacy and resistance evolution. The indirect role that poor national policies have on pesticide use practices, and indirectly on control efficacy and selection pressure is discussed. Evidence shows that local selection for resistance drives resistance evolution. Integrated pest management, rather than reliance on a single tactic, is the best way to suppress S. frugiperda numbers and the over-use of insecticides which selects for resistance.

Objectives: Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. We aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Method: Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas (females = 76.1%, mean age = 76.23, SD = 6.44, with chronic condition = 79.5%). They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Results: Regression analyses indicated that fear of fall was the most predictive factor of CSMoF among older persons, accounting for about 25% of the variance. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF, but to a lesser extent than fear of falls and fall perceptions. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Conclusion: The joint effects of perception of falls and fear of falls likely explain CSMoF among older adults more than physical functional indicators. Fall prevention programs for older adults should prioritize to address modifiable subjective factors of fall perceptions, fear of falls, and CSMoF across health and functioning statuses.

Objective The aim of this study was to describe the process used to develop a theory‐based, online fall prevention self‐management programme for ambulatory and non‐ambulatory people with multiple sclerosis (pwMS). Methods The development process was guided by the Medical Research Council framework of complex interventions and began with a scoping review of the literature on self‐management of falls in pwMS. Subsequent phases of development were performed through iterative and concurrent processes and were informed by the perspectives of pwMS and healthcare professionals with MS expertise. Results Through a systematic and iterative process in close collaboration with pwMS and healthcare professionals, a theory‐based online fall prevention self‐management programme, Fewer Falls in MS, for ambulatory and non‐ambulatory pwMS was developed. The programme is grounded in theory and pedagogical models and features utilization of action plans to address diverse influences on fall risks. Conclusions A carefully operationalized definition of self‐management and an iterative co‐development process were essential to the creation of the Fewer falls in MS programme. Continuation of the co‐development process and collaboration with end users was needed to refine the programme. Patient or Public Contribution PwMS and healthcare professionals were involved throughout the development process of the programme. The patient organization Neuro Sweden was contacted in the initial phase to discuss the relevance of a self‐management programme to prevent falls in MS. They supported the research group (all authors) in identification of and contact with pwMS with interest to participate. Three members of the research group (S.T.J., M.F. and C.Y.), that is, the operative group, met neuro Sweden and one pwMS to further discuss the relevance of a self‐management programme to prevent falls. To develop the process and content of the fall prevention programme, a co‐design process was performed together with pwMS and healthcare professionals. The results of the co‐design process are presented in this manuscript. In addition to participating in the co‐design process, pwMS and healthcare professionals provided feedback to the research group on programme process and content on several occasions during the subsequent programme development process. In a pretest (Beta version) of the programme, four pwMS acted as test subjects and provided additional feedback on the programme to the research group. Trial Registration NCT04317716.

Background Half of Canadians living in long-term care (LTC) homes will fall each year resulting in consequences to independence, quality of life, and health. The objective in this study was to analyze factors that contribute to, or are protective against, falls in Canadian LTC homes. Methods We analyzed of a retrospective cohort of a stratified random sample of Canadian LTC homes in Western Canada from 2011–2017. We accessed variables from the RAI–MDS 2.0 to assess the association of the dependent variable “fall within the last 31–180 days” with multiple independent factors, using generalized estimating equation models. Results A total of 28,878 LTC residents were analyzed. Factors found to increase the odds of falling were other fractures (OR 3.64 [95% confidence interval; CI 3.27, 4.05]), hip fractures (OR 3.58 [3.27, 3.93]), moderately impaired cognitive skills (OR 2.45 [2.28, 2.64]), partial support to balance standing (OR 2.44 [2.30, 2.57]), wandering (OR 2.31 [2.18, 2.44]). Conclusion A range of factors identified were associated with falls for people living in LTC homes. Individual physical ability represented the largest group of independent factors contributing to falls. Residents who experience any fracture or an acute change in behaviour, mobility, or activities of daily living (ADL) should be considered at increased risk of falls.

Fall armyworm (Spodoptera frugiperda Smith), a serious pest of cereals from the Americas, has spread across sub-Saharan Africa and Asia since 2016, threatening the food security and incomes of millions of smallholder farmers. To measure the impact of S. frugiperda under different management approaches, we established on-farm trials across 12 landscapes (615–1,379 mm mean annual rainfall) in Malawi and Zambia during the 2019/2020 and 2020/2021 seasons. Here we present the results from our conventional tillage, monocrop maize, no pesticide treatment, which served to monitor the background S. frugiperda impact in the absence of control measures. Median plot-level S. frugiperda incidence ranged between 0.00 and 0.52 across landscapes. Considering severe leaf damage (Davis score ≥5), the proportion of affected plants varied between 0.00 and 0.30 at the plot scale, but only 3% of plots had ≥10% severely damaged plants. While incidence and damage severity varied substantially among sites and seasons, our models indicate that they were lower in high tree cover landscapes, in the late season scouting, and in the 2020/2021 season. Yield could not be predicted from S. frugiperda incidence or leaf damage. Our results suggest S. frugiperda impacts may have been overestimated at many sites across sub-Saharan Africa. S. frugiperda incidence and damage declined through the cropping season, indicating that natural mortality factors were limiting populations, and none of our plots were heavily impacted. Long-term S. frugiperda management should be based on Integrated Pest Management (IPM) principles, including minimising the use of chemical pesticides to protect natural enemies.