Cost of Inpatient Falls and Cost-Benefit Analysis of Implementation of an Evidence-Based Fall Prevention Program.

Importance: There is insufficient research on the costs of patient falls in health care systems, a leading source of nonreimbursable adverse events.

Objective: To report the costs of inpatient falls and the cost savings associated with implementation of an evidence-based fall prevention program.

Design, Setting, And Participants: In this economic evaluation, a matched case-control study used the findings from an interrupted time series analysis that assessed changes in fall rates following implementation of an evidence-based fall prevention program to understand the cost of inpatient falls.

Does fatigue influence joint-specific work and ground force production during the first steps of maximal acceleration?

During initial acceleration, the first steps of a maximal-effort (sprint) run often determine success or failure in the capture and evasion of an opponent, and is therefore a vital factor of success in many modern sports. However, accelerative events are commonly performed after having already run considerable distances, and the associated fatigue should impair muscle force production and thus reduce acceleration. Despite this, the effects of running-induced fatigue on our ability to accelerate as well as the running technique used to achieve it have received little attention.

Use of a perceived efficacy tool to evaluate the FallTIPS program.

Background/objectives: To assess nurses' opinions of the efficacy of using the FallTIPS (Tailoring Interventions for Patient Safety) fall prevention program.

Design: Survey research.

Setting: Seven adult acute-care hospitals in 2 hospital centers located in Boston and NYC.

Reassessing the disability divide: unequal access as the world is pushed online.

In a time when a global pandemic has forced people to use technology for almost every aspect of their day-to-day lives, it is important to determine if specific disadvantaged groups are appropriately connected to the digital world. This paper attempts to assess whether people with disabilities (PWD) own computers, connect to the Internet, and participate in online activities at the same rates as the general population. Using comprehensive data from the 2017 Current Population Survey we find that PWD still lag behind in computer ownership and Internet access.

Emergency department presentations in the Southern District of New Zealand during the 2020 COVID-19 pandemic lockdown.

Objective: To assess changes in presentations to EDs during the COVID-19 pandemic lockdown in the Southern Region of New Zealand.

Methods: We conducted a retrospective audit of patients attending EDs in the Southern District Health Board (SDHB), from 1 March to 13 May 2020. We made comparisons with attendances during the same period in 2019.

Development and Validation of a Fall Prevention Efficiency Scale.

Objectives: Fall TIPS (Tailoring Interventions for Patient Safety) is an evidence-based fall prevention program that led to a 25% reduction in falls in hospitalized adults. Because it would be helpful to assess nurses' perceptions of burdens imposed on them by using Fall TIPS or other fall prevention program, we conducted a study to learn benefits and burdens.

Methods: A 3-phase mixed-method study was conducted at 3 hospitals in Massachusetts and 3 in New York: (1) initial qualitative, elicited and categorized nurses' views of time spent implementing Fall TIPS; (2) second qualitative, used nurses' quotes to develop items, research team inputs for refinement and organization, and clinical nurses' evaluation and suggestions to develop the prototype scale; and (3) quantitative, evaluated psychometric properties.

Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries: A Nonrandomized Controlled Trial.

Importance: Falls represent a leading cause of preventable injury in hospitals and a frequently reported serious adverse event. Hospitalization is associated with an increased risk for falls and serious injuries including hip fractures, subdural hematomas, or even death. Multifactorial strategies have been shown to reduce falls in acute care hospitals, but evidence for fall-related injury prevention in hospitals is lacking.

Kinetically Controlled Sequential Seeded Growth: A General Route to Crystals with Different Hierarchies.

The organization of natural materials into hierarchical structures accounts for the amazing properties of many biological systems; however, translating the structural motifs present in such natural materials to synthetic systems remains difficult. Inspired by how nature creates materials, this work demonstrates that kinetically controlled sequential seeded growth is a general bottom-up strategy to prepare hierarchical inorganic crystals with distinct compositions and nanostructured forms. Specifically, 85 distinct hierarchical crystals with different shape-controlled features, compositions, and overall symmetries were readily achieved by altering the kinetics of metal deposition in sequential rounds of seeded growth.

Magnetoreception in fishes: the effect of magnetic pulses on orientation of juvenile Pacific salmon.

A variety of animals sense Earth's magnetic field and use it to guide movements over a wide range of spatial scales. Little is known, however, about the mechanisms that underlie magnetic field detection. Among teleost fish, growing evidence suggests that crystals of the mineral magnetite provide the physical basis of the magnetic sense.

Patient Activation Related to Fall Prevention: A Multisite Study.

Background: Falls are a major problem in hospitals. The fall prevention program Fall TIPS (Tailoring Interventions for Patient Safety) has been shown to be effective in preventing inpatient falls and related injuries. The purpose of this study was to examine the impact of the Fall TIPS program on patient activation related to fall prevention.

Classification of Injurious Fall Severity in Hospitalized Adults.

Background: Many hospital systems in the United States report injurious inpatient falls using the National Database of Nursing Quality Indicators categories: None, Minor, Moderate, Major, and Death. The Major category is imprecise, including injuries ranging from a wrist fracture to potentially fatal subdural hematoma. The purpose of this project was to refine the Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries.

Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study.

Background: Patient falls are a major problem in hospitals. The development of a Patient-Centered Fall Prevention Toolkit, Fall TIPS (Tailoring Interventions for Patient Safety), reduced falls by 25% in acute care hospitals by leveraging health information technology to complete the 3-step fall prevention process-(1) conduct fall risk assessments; (2) develop tailored fall prevention plans with the evidence-based interventions; and (3) consistently implement the plan. We learned that Fall TIPS was most effective when patients and family were engaged in all 3 steps of the fall prevention process.

Massive transfusion of low-titer cold-stored O-positive whole blood in a civilian trauma setting.

Background: Based on the improved outcomes achieved with fresh whole blood in cases of military trauma as well as with 1:1:1 transfusion strategies for massive traumatic hemorrhage in civilian settings, there has been resurgent interest in using whole blood for civilian trauma patients. There have been reports of giving up to 4 units of low-titer cold-stored O-positive to these patients. This is the first modern report of a massive transfusion with unrestricted low-titer group O whole blood (LTOWB) use in a civilian trauma patient.

Magnetic map in nonanadromous Atlantic salmon.

Long-distance migrants, including Pacific salmon ( spp), can use geomagnetic information to navigate. We tested the hypothesis that a "magnetic map" (i.e.

Geomagnetic field influences upward movement of young Chinook salmon emerging from nests.

Organisms use a variety of environmental cues to orient their movements in three-dimensional space. Here, we show that the upward movement of young Chinook salmon () emerging from gravel nests is influenced by the geomagnetic field. Fish in the ambient geomagnetic field travelled farther upwards through substrate than did fish tested in a field with the vertical component inverted.

Surface Passivation and Supersaturation: Strategies for Regioselective Deposition in Seeded Syntheses.

Crystal growth theory predicts that heterogeneous nucleation will occur preferentially at defect sites, such as the vertices rather than the faces of shape-controlled seeds. Platonic metal solids are generally assumed to have vertices with nearly identical chemical potentials, and also nearly identical faces, leading to the useful generality that heterogeneous nucleation preserves the symmetry of the original seeds in the final product. Herein, we test the limits of this generality in the extreme of low supersaturation, in an effort to expand the methods available for inducing anisotropic overgrowth.

Pilot Testing Fall TIPS (Tailoring Interventions for Patient Safety): a Patient-Centered Fall Prevention Toolkit.

Background: Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice.

Validating Fall Prevention Icons to Support Patient-Centered Education.

Introduction: Falls with injury are the most prevalent hospital adverse event. The objective of this project was to refine fall risk and prevention icons for a patient-centric bedside toolkit to promote patient and nurse engagement in accurately assessing fall risks and developing a tailored fall prevention plan.

Methods: Eighty-eight patients and 60 nurses from 2 academic medical centers participated in 4 iterations of testing to refine 6 fall risk and 10 fall prevention icons.

CHRONICALLY EMBEDDED LEAD PROJECTILES IN WILDLIFE: A CASE SERIES INVESTIGATING THE POTENTIAL FOR LEAD TOXICOSIS.

Research has demonstrated that intramuscularly embedded lead in humans and rats may cause direct plumbism, albeit rarely, and has identified risk factors to this end. To the authors' knowledge, this has not been investigated in wildlife, despite a high incidence of embedded lead in these animals secondary to cynegetic activities. Fourteen wildlife cases submitted to the National Fish and Wildlife Forensics Laboratory for cause-of-death determination had chronically embedded lead projectiles that were unrelated to the cause of death.

Spatial and temporal variation of algal assemblages in six Midwest agricultural streams having varying levels of atrazine and other physicochemical attributes.

Potential effects of pesticides on stream algae occur alongside complex environmental influences; in situ studies examining these effects together are few, and have not typically controlled for collinearity of variables. We monitored the dynamics of periphyton, phytoplankton, and environmental factors including atrazine, and other water chemistry variables at 6 agricultural streams in the Midwest US from spring to summer of 2011 and 2012, and used variation partitioning of community models to determine the community inertia that is explained uniquely and/or jointly by atrazine and other environmental factors or groups of factors. Periphyton and phytoplankton assemblages were significantly structured by year, day of year, and site, and exhibited dynamic synchrony both between site-years and between periphyton and phytoplankton in the same site-year.