Reducing fall risk by improving balance control: development, evaluation and knowledge-translation of new approaches

Problem

Falling is a leading cause of serious injury, loss of independence, and nursing-home admission in older adults. Impaired balance control is a major contributing factor.

Methods

Results from our balance-control studies have been applied in the development of new and improved interventions and assessment tools. Initiatives to facilitate knowledge-translation of this work include setting up a new network of balance clinics, a research-user network and a research-user advisory board.

Results

Our findings support the efficacy of the developed balance-training methods, balance-enhancing footwear, neuro-prosthesis, walker design, handrail-cueing system, and handrail-design recommendations in improving specific aspects of balance control.

Impact on Knowledge Users

A new balance-assessment tool has been implemented in the first new balance clinic, a new balance-enhancing insole is available through pharmacies and other commercial outlets, and handrail design recommendations have been incorporated into 10 Canadian and American building codes. Work in progress is expected to have further impact.     

Underground mine Refuge Chamber Expectations Training: Program development and evaluation

Refuge chambers are new devices for underground coal mines that provide approximately 96 h of breathable air, water, food, and supplies in the event of an emergency where miners are unable to escape. Researchers at the National Institute for Occupational Safety and Health (NIOSH) developed a training program to prepare miners for what to expect psychologically and physiologically inside of a refuge chamber. The field tests of this training revealed that it was received very positively by miners and helped impart realistic views about the physical discomforts and psychological stresses of being inside a refuge chamber.     

Enhancing older driver safety: A driving survey and evaluation of the CarFit program

Objective

To evaluate CarFit, an educational program designed to promote optimal alignment of driver with vehicle.

Methods

A driving activity survey was sent to 727 randomly selected participants living in retirement communities. Drivers (n = 195) were assigned randomly to CarFit intervention (n = 83, M age = 78.1) or Comparison (n = 112, M age = 79.6) groups. After 6 months, participants completed a post-test of driving activity and CarFit recommendations.

Results

Nonconsenting drivers were older and participated in fewer driving activities. CarFit participation was moderate (71%) with 86% of the participants receiving recommendations. 60% followed the recommendations at the 6-month re-evaluation). The CarFit (67.6%) and Comparison (59.3%) groups reported at least one type of self-regulation of driving activity at baseline. There was no significant change in the driving behaviors at the six-month follow-up.

Conclusion

CarFit was able to detect addressable opportunities that may contribute to the safety of older drivers.

Impact on industry

CarFit recommendations may need stronger reinforcement in order to be enacted by a participant.     

Evaluating the implementation of cleaner production audit demonstration projects

Cleaner production audit demonstration projects were carried out in two Chinese case factories as part of a project co-sponsored by the Illinois Environmental Protection Agency and China's State Environmental Protection Administration. Audit results at both factories were characterized by implementation of predominantly low- or no-cost options, notable reductions in water pollution, and incomplete financial benefit analyses. Two reasons explain the financial benefit analyses' apparent weakness. First, factory audit teams were inexperienced in the techniques and procedures used to determine the economic benefits of cleaner production options. Second, motivations project personnel had for participating in the demonstration projects were not centered on attaining the monetary benefits of implementing cleaner production. Instead, other factors related to the international nature of the project, such as a high degree of state level oversight and prestige, were more influential in affecting the behavior of project personnel.     

Effect of root death and decay on dissipation of polycyclic aromatic hydrocarbons in the rhizosphere of yellow sweet clover and tall fescue

A 12-mo greenhouse study was conducted to evaluate the contribution of root death and decay on the dissipation of polycyclic aromatic hydrocarbons (PAHs) in rhizosphere soil. The contaminated soil was previously treated by land-farming, but residual PAHs remained after treatment. Tall fescue (Festuca arundinacea Schreb.) and yellow sweet clover (Melilotus officinalis Lam.) were the target plants. To specifically evaluate the effect of root decay on contaminant dissipation, plants were treated with glyphosate, a broad spectrum herbicide, to induce root decay. Although tall fescue treatments had the highest root and shoot biomass and root surface area, this plant did not result in the highest contaminant degradation rates. Significant differences were noted between treatments for seven PAHs, with the active yellow sweet clover resulting in 60 to 75% degradation of these compounds. Induced root death and decay did not produce a significant enhancement of PAH degradation. The PAH microbial degrader populations in the vegetated treatments were more than 100 times greater than those in the unvegetated control. The phospholipid fatty acid (PLFA) structural group profile shifted over the growing period, indicating a change in the community structure. In conclusion, phytoremediation was shown to be an effective polishing tool for PAH-affected soil previously subjected to biological treatment.     

Trade‐offs and efficiencies in optimal budget‐constrained multispecies corridor networks

Conservation biologists recognize that a system of isolated protected areas will be necessary but insufficient to meet biodiversity objectives. Current approaches to connecting core conservation areas through corridors consider optimal corridor placement based on a single optimization goal: commonly, maximizing the movement for a target species across a network of protected areas. We show that designing corridors for single species based on purely ecological criteria leads to extremely expensive linkages that are suboptimal for multispecies connectivity objectives. Similarly, acquiring the least‐expensive linkages leads to ecologically poor solutions. We developed algorithms for optimizing corridors for multispecies use given a specific budget. We applied our approach in western Montana to demonstrate how the solutions may be used to evaluate trade‐offs in connectivity for 2 species with different habitat requirements, different core areas, and different conservation values under different budgets. We evaluated corridors that were optimal for each species individually and for both species jointly. Incorporating a budget constraint and jointly optimizing for both species resulted in corridors that were close to the individual species movement‐potential optima but with substantial cost savings. Our approach produced corridors that were within 14% and 11% of the best possible corridor connectivity for grizzly bears (Ursus arctos) and wolverines (Gulo gulo), respectively, and saved 75% of the cost. Similarly, joint optimization under a combined budget resulted in improved connectivity for both species relative to splitting the budget in 2 to optimize for each species individually. Our results demonstrate economies of scale and complementarities conservation planners can achieve by optimizing corridor designs for financial costs and for multiple species connectivity jointly. We believe that our approach will facilitate corridor conservation by reducing acquisition costs and by allowing derived corridors to more closely reflect conservation priorities.     

Changing weather and climate in Northern Ghana: comparison of local perceptions with meteorological and land cover data

Regional Environmental Change - Local perspectives on changing weather and climate and analyses of meteorological data represent two different but potentially complementary ways of knowing about...     

Mechanosensitivity in the model sea anemone <Emphasis Type="Italic">Nematostella vectensis</Emphasis>

Tentacles of the sea anemone, Nematostella vectensis, are covered with hair bundles. Hair bundles were deflected by water jets to test whether they are mechanoreceptors. Electrophysiological recordings confirm that deflections of hair bundles induce transients in membrane current. In a different species of anemone, hair bundle mechanoreceptors are known to change shape and responsiveness according to the activity of chemoreceptors that bind prey-derived compounds including N-acetylated sugars. In Nematostella, hair bundles significantly elongate upon exposure to NANA, an N-acetylated sugar. Based on a bioassay in which discharged nematocysts are counted in gelatin-coated test probes touched to tentacles, we find that NANA shifts vibration dependent discharge of basitrich nematocysts to lower frequencies overlapping those produced during swimming by known prey including planktonic crustaceans. Furthermore, we find for the first time that vibration detection extends at least 2.5 cm beyond the tentacle tips. Thus, Nematostella likely employs its hair bundles to detect swimming movements of nearby prey.     

Drinking and driving and perceptions of arrest risk among California drivers: Relationships with DUI arrests in their city of residence

Objective: Addressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).

Methods: This study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California. City DUI arrest rates for 2009–2011 were used as an indicator of local enforcement efforts. Population average logistic modeling was conducted modeling the odds of perceived high arrest likelihood for DUI and drinking and driving behavior within the past year.

Results: As the DUI arrest rates for the city in which the driver lives increased, perceived high risk of DUI arrest increased. There was no significant relationship between either city DUI arrest rates or perceived high risk of DUI arrest with self-reported drinking and driving behavior in the full sample. Among a much smaller sample of those most likely to drink outside the home, self-reported drinking and driving behavior was negatively associated with DUI arrests rates in their city of residence but this was not mediated by perceptions.

Conclusion: The results of the present study suggest that perceptions are correlated with one aspect of DUI efforts in one's community. Those who were more likely to drink outside the home could be behaviorally influenced by these efforts.     

Growth of the Decision Tree: Advances in Bottom‐Up Climate Change Risk Management

There has recently been a return in climate change risk management practice to bottom‐up, robustness‐based planning paradigms introduced 40 years ago. The World Bank's decision tree framework (DTF) for “confronting climate uncertainty” is one incarnation of those paradigms. In order to better represent the state of the art in climate change risk assessment and evaluation techniques, this paper proposes: (1) an update to the DTF, replacing its “climate change stress test” with a multidimensional stress test; and (2) the addition of a Bayesian network framework that represents joint probabilistic behavior of uncertain parameters as sensitivity factors to aid in the weighting of scenarios of concern (the combination of conditions under which a water system fails to meet its performance targets). Using the updated DTF, water system planners and project managers would be better able to understand the relative magnitudes of the varied risks they face, and target investments in adaptation measures to best reduce their vulnerabilities to change. Next steps for the DTF include enhancements in: modeling of extreme event risks; coupling of human‐hydrologic systems; integration of surface water and groundwater systems; the generation of tradeoffs between economic, social, and ecological factors; incorporation of water quality considerations; and interactive data visualization.