The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults.

Study Question: Are fall prevention exercise interventions for older people living in the community effective in preventing different types of fall related injuries?

Summary Answer: Exercise programmes designed to prevent falls in older adults seem also to prevent injuries caused by falls, including the most severe injuries. Such programmes also reduce the rate of falls leading to medical care.

Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial.

Objective: To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community.

Design: Pragmatic multicentre, two arm, parallel group, randomised controlled trial.

Setting: 20 study sites in 16 medium to large cities throughout France.

The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials.

Objective: To determine whether, and to what extent, fall prevention exercise interventions for older community dwelling people are effective in preventing different types of fall related injuries.

Data Sources: Electronic databases (PubMed, the Cochrane Library, Embase, and CINAHL) and reference lists of included studies and relevant reviews from inception to July 2013.

Study Selection: Randomised controlled trials of fall prevention exercise interventions, targeting older (>60 years) community dwelling people and providing quantitative data on injurious falls, serious falls, or fall related fractures.

Use of calcium supplements, vitamin D supplements and specific osteoporosis drugs among French women aged 75-85 years: patterns of use and associated factors.

Background: Despite the availability of effective preventive and curative medications for osteoporosis, and guidelines for its diagnosis and management, few individuals are treated for osteoporosis, even among those who have already had a fracture.

Objectives: Our objective was to describe the patterns of use of medication for osteoporosis, i.e.

Mobility impairment is associated with urge but not stress urinary incontinence in community-dwelling older women: results from the Ossébo study.

Objective: To assess the association between functional limitations related to mobility and urinary incontinence (UI) in elderly women.

Design: An observational cross-sectional study.

Setting: Nine 'balance' workshops in France.

The 'Ossebo' intervention for the prevention of injurious falls in elderly women: background and design.

Unlabelled: This paper reviews the literature that contributed to the design of the 'Ossébo' intervention and describes the study that is underway.

Background: Falls and fall-related injuries are a major cause of morbidity and mortality among older people. Extensive research into falls prevention has established physical exercise as an efficient method to reduce falls, but the effect of exercise on serious injuries caused by falls remains unclear.

The course of physical functional limitations and occupational conditions in a middle-aged working population in France.

Background: Physical functional limitations (PFL) have mainly been studied in older populations. The aim of this study was to better understand the course of PFL and associations with occupational factors by gender in a middle-aged working population.

Methods: The data came from 16,950 workers in the ESTEV (Enquête Santé Travail et Vieillissement) cohort in France.

[A gerontological network as an interface between healthcare professionals and homecare professionals].

The increase in the number of elderly people requires a reorganization of patient care based on integrated networks of healthcare and community services. These services enable patients to remain at home, thus avoiding the significant costs incurred as a result of long hospital stays and numerous visits to emergency departments. Despite the interest of policy-makers in integrated services, the real impact of gerontological networks remains unknown.

Diagnostic study, design and implementation of an integrated model of care in France: a bottom-up process with continuous leadership.

Background: Sustaining integrated care is difficult, in large part because of problems encountered securing the participation of health care and social service professionals and, in particular, general practitioners (GPs).

Purpose: To present an innovative bottom-up and pragmatic strategy used to implement a new integrated care model in France for community-dwelling elderly people with complex needs.

Results: In the first step, a diagnostic study was conducted with face-to-face interviews to gather data on current practices from a sample of health and social stakeholders working with elderly people.

A novel model of integrated care for the elderly: COPA, Coordination of Professional Care for the Elderly.

Despite strong evidence for the efficacy of integrated systems, securing the participation of health professionals, particularly primary care physicians (PCPs), has proven difficult. Novel approaches are needed to resolve these problems. We developed a model - COPA - that is based on scientific evidence and an original design process in which health professionals, including PCPs, and managers participated actively.

Healthcare professionals and managers' participation in developing an intervention: a pre-intervention study in the elderly care context.

Background: In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention.

In vivo performance evaluation of bi-directional ultrasonic axial transmission for cortical bone assessment.

Our objective was to assess a new quantitative ultrasound device suitable for the measurement of speed of sound in radius. The so-called "bidirectional" technique allows an accurate estimation of velocity based on a compensation for soft tissue effects implemented directly inside the probe. Velocity measurements at 1 MHz of the first arriving signal were performed at the one third distal radius in 358 enrolled women.

Work-related factors associated with age at natural menopause in a generation of French gainfully employed women.

This study's purpose was to identify occupational factors that may influence the age at natural menopause in a random sample of gainfully employed French women born in 1938 (n=1,594). Occupational physicians selected the subjects from their files and interviewed them during their annual visits in 1990 and 1995. The authors used Kaplan-Meier survival curves to estimate median age at menopause (52 years) and multiple Cox models to estimate associations among women's characteristics, occupational factors, and age at menopause separately within two strata distinguished by a self-reported history of depression.

[Evaluation of a multifaceted intervention for implementing national guidelines: the case of physical restraint in geriatric care].

Background: There is a growing interest in developing guidelines. The French Agency for accreditation and Evaluation (Anaes) published in October 2000 guidelines on the use of restraint in geriatric care settings because in spite of the risks this practice remains widespread in that type of care setting. A multifaceted intervention was conducted in a Parisian geriatric hospital in order to improve the implementation of the published guidelines.

[Nosocomial infections in geriatric facilities].

Epidemiology: In long term geriatric facilities, the prevalence of nosocomial infections (to the order of 10% in the surveys) is greater than that observed in short-term medical care centers. An endemia of methicillin-resistant Staphylococcus aureus, of between 24 and 57% of hospitalized patients, is noted in many geriatric facilities. In decreasing order, the infections that predominate are: urinary (1/3), lower respiratory tract (1/4) and cutaneous tissue infections (1/5).

Chronic neck and shoulder pain, age, and working conditions: longitudinal results from a large random sample in France.

Aims: To analyse the effects of age and occupational factors on both the incidence and the disappearance of chronic neck and shoulder pain after a five year follow up period.

Methods: A prospective longitudinal investigation (ESTEV) was carried out in 1990 and 1995 in seven regions of France. A random sample of male and female workers born in 1938, 1943, 1948, and 1953 was selected from the occupational physicians' files.

Nosocomial infections in geriatric long-term-care and rehabilitation facilities: exploration in the development of a risk index for epidemiological surveillance.

Objective: To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities.

Design: Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly.

Social prognostic factors of mortality in a random cohort of Geneva subjects followed up for a period of 12 years.

Study Objective: To analyse the relative risk (RR) of mortality related to social factors independent of health status and occupational category.

Setting: Subjects were Swiss men and women aged 40-65 years.

Design: A random sample of 820 people living in Geneva were followed up prospectively between 1984 and 1996.

[Control of nosocomial infections by multiresistant bacteria in geriatric services].

Geriatric wards have a higher prevalence of infection than surgical or acute medical wards, and multiresistant organisms contribute a nonnegligeable proportion of infections in elderly inpatients. The measures used to prevent nosocomial infections in geriatric wards are the same as in other types of wards. They include identifying and ensuring the technical and geographic isolation of colonized and infected patients.

Relation between locomotion impairment, functional independence in retirement, and occupational strain resulting from work carried out during working life. Study of a sample population of 350 miners in the Loire valley in France.

Study Objectives: To analyse long term effects of working conditions experienced at an advanced age, and after retirement by quantifying occupational strain, impairment, and disability to establish their interrelation.

Design: Retrospective study.

Participants: Retired miners from The French Coal Board who had worked in the coal fields of the Loire valley.

[Age, work and spinal pain].

Background: To examine whether the relationship between age and musculoskeletal disorders in the spine is specific to one localization (cervical, dorsal, lumbar) or due to the accumulation of lesions with age.

Methods: Data were gathered from the ESTEV study among a randomly selected sample of 21,378 French workers, followed by 390 occupational physicians during the year 1990. The subjects, males or females, were born in 1938, 1943, 1948, 1953.