Validating an evidence-based, self-rated fall risk questionnaire (FRQ) for older adults

Background

Falls are a common, serious, and often unrecognized problem facing older adults. The objective of this study was to provide an initial clinical and statistical validation for a public health strategy of fall risk self-assessment by older adults using a Fall Risk Questionnaire (FRQ).

Methods

Adults age 65 + (n = 40) were recruited at a Los Angeles Veterans Affairs (VA) medical facility and at a local assisted living facility. Participants completed the FRQ self-assessment and results were compared to a “gold standard” of a clinical evaluation of risks using the American/British Geriatrics Society guidelines to assess independent predictors of falls: history of previous falls, fear of falling, gait/balance, muscle weakness, incontinence, sensation and proprioception, depression, vision, and medications. For the comparison, we used an iterative statistical approach, weighing items based on relative risk.

Results

There was strong agreement between the FRQ and clinical evaluation (kappa = .875, p < .0001). Individual item kappa values ranged from .305-.832. After dropping one FRQ item (vision risk) because of inadequate agreement with the clinical evaluation (kappa = .139, p = .321), the final FRQ had good concurrent validity.

Conclusions

The FRQ goes beyond existing screening tools in that it is based on both evidence and clinical acceptability and has been initially validated with clinical examination data. A larger validation with longitudinal follow-up should determine the actual strength of the FRQ in predicting future falls.     

Modelling spills of water-reactive chemicals

This paper describes part of a programme of work undertaken at the Health and Safety Laboratory (HSL) to investigate the behaviour of selected water-reactive chemicals. Following an accidental release, such substances react exothermically with any water present, generating acidic vapours. The STAWaRS (Source Term Assessment of Water Reactive Substances) software was developed for the Health and Safety Executive (HSE) by ESR Technology to model this complex process. The aims of the study described here were to provide experimental validation of the heats of hydrolysis used within STAWaRS, and to perform sensitivity studies on selected STAWaRS input parameters.The heat of hydrolysis of acetyl chloride was measured and showed good correlation with the value used within STAWaRS. Some of the variables that influence the severity of acetyl chloride spills are examined, with reference to predictions made by the STAWaRS model. The heats of hydrolysis of titanium tetrachloride previously measured at HSL are also discussed, and the effect of adopting these experimentally derived values for modelling spills is shown for a hypothetical land use planning case. This study demonstrates the importance of using experimentally validated values for STAWaRS input parameters.     

Numerical simulation of propane detonation in medium and large scale geometries

A modelling strategy has been developed for consequence analysis of medium and large scale gaseous detonation. The model is based on the solution of Euler equations with one-step chemistry. The Van Leer flux limited method which is a total variation diminishing scheme is used for shock capturing. Preliminary calculations were firstly conducted for small domains with fine grids which resolve the wave, relatively coarse grids which have less than 10 grids across the wave and coarse grids in which the minimum grid size is larger than the wave thickness to ensure that the reaction scheme has been properly tuned to capture the correct detonation pressure, temperature and velocity in the resolutions used in the different cases. The model was firstly tested against a medium scale detonation test in a shock tube with U-bends. Reasonably good agreement is achieved on detonation pressure and mean shock wave velocities at different measuring segments of the tube. Following the validation, the detonation of a hypothetical planar propane-air cloud is simulated. The predictions uncovered some interesting features of such large scale detonation phenomena which are of significance in the safety context, especially for accidental investigations. The findings from the present analysis are in line with the forensic evidence on damages in some historic accidents and challenges previous analysis of a major accident in which forensic evidence suggested localised detonation but was considered as the consequence of fire storms by the investigation team.     

Effects of significant damage of flame gap surfaces in flameproof electrical apparatus on flame gap efficiency

Electrical apparatus for use in the presence of explosive gas atmospheres has to be specially designed to prevent the apparatus from igniting the gas. Flameproof design is one of several options, and one requirement is then that any holes and slits in the enclosure wall be designed to prevent a possible gas explosion inside the enclosure from being transmitted to an explosive gas cloud outside it. Current standards (IEC) require that joint surfaces have a surface roughness of <6.3 μm. Any damaged joint surface has be restored to this quality. The present investigation has demonstrated that flame gap surfaces in flameproof electrical apparatuses can suffer considerable mechanical and corrosive damage before the flame gaps no longer function satisfactorily. In some cases very significant mechanical surface damage in fact improves the gap performance. This indicates that current high costs of repairing and replacing flameproof electrical apparatus in process plants offshore and onshore can be reduced considerably without any increase of the explosion risk.     

Seismic risk assessment of storage tanks in Turkish industrial facilities

In 1999, two earthquakes in northwest Turkey caused heavy damage to a large number of industrial facilities. This region is the most industrialized in the country, and heavy damage has a significant economic influence. Industrial storage tanks, ruptured by earthquakes, exascerbate damage through the spread of fire. Storage tanks are uniquely structured, tall cylindrical vessels, some supported by relatively short reinforced concrete columns. The main aim of this study is to evaluate the earthquake performance of Turkish industrial facilities, especially storage tanks in terms of earthquake resistance. Modeling a typical storage tank of an industrial facility helps to understand the structure’s seismic response. A model tank structure was modelled as a solid with lumped mass and spring systems. Performance estimation was done with 40 different earthquake data through nonlinear time history analyses. After the time history analyses, fragility analyses produced probabilistic seismic assessment for the tank model. For the model structure, analysis results were evaluated and compared. In the study, vulnerability of storage tanks in Turkey was determined and the probabilistic risk was defined with the results of the analysis.     

Kinetic parameter estimation for decomposition of organic peroxides by means of DSC measurements

The thermal stability of organic peroxides (cumene hydroperoxide 80 wt% and dicumyl peroxide) was studied by means of calorimetric measurement (DSC, TA Q1000) in an isotherm mode and a dynamic mode. Analysis of power profiles released in the isothermal mode was combined with the analysis of the decomposed compounds by a gas chromatograph/mass spectrometer (GC/MS) to determine the reaction mechanisms corresponding to each of the two reactions. In this work, a methodology for estimating kinetic parameters was based on the comparison of the power profile (dynamic mode) given by the model to that obtained experimentally by changing the parameters values. Parameter estimation is achieved using the mixed estimation method where a genetic algorithm is combined with a locally convergent method.     

Biologie und Biochemie des Elements Selen

The importance of selenium as an essential trace element has progressively emerged during the last years due to the analysis of selenium deficiency diseases and to the identification and characterization of a number of selenoenzymes. Selenium is incorporated in the catalytic site of the enzymes as an integral selenocysteine residue. The pathway of selenocysteine biosynthesis and incorporation has been elucidated recently for Escherichia coli. This article presents an overview on these subjects and describes the mechanisms which confer selenocysteine specificity in the framework of protein biosynthesis. In addition, some considerations concerning the phylogeny of selenocysteine incorporation are presented and a model for the evolution of the selenocysteine pathway is proposed.