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.     

Organochlorines and polybrominated diphenyl ethers in four geographically separated populations of Atlantic salmon (Salmo salar)

Atlantic salmon (Salmon salar) populations from four locations, two from isolated Swedish lake systems, one of the Baltic Sea and one of the North Atlantic, were analyzed to determine the concentrations and spatial variations of polybrominated diphenyl ethers (PBDEs) and organochlorines (DDT, PCB and HCH). Levels in both liver and muscle were in the same range as previously reported in Atlantic salmon, except for elevated concentrations found per lipid weight (lw) in the muscle samples of salmon from the North Atlantic ( summation PBDE 263 ng g(-1) lw, summation PCB 3262 ng g(-1) lw, summation DDT 4063 ng g(-1) lw summation HCH 131 ng g(-1)). In general, elevated concentrations in the muscles compared to the liver were observed, especially in lipid depleted migrating salmon, possibly caused by a faster lipid depletion compared with the redistribution of PBDEs, PCBs and DDTs. These findings indicated that the life stage and thereby the lipid dynamics of the fish must be considered prior to comparison based on lipid weight, especially as Atlantic salmon experience large variations in lipid content during periods of migration. The dominating PBDE congener was BDE-47, representing more than 25% in all fish. The PBDE pattern changed between locations, with a significant separation of the fish from the freshwater and marine environment when analyzed using principal component analysis.     

Persistent organochlorine compounds in soils and sediments of European high altitude mountain lakes

The composition of persistent organochlorine compounds (OC) in soils and sediments from two high altitude European mountain lakes, Redon in the Pyrenees and Ladove in the Tatra mountains, has been studied. Sediment cores from two additional lakes in the Tatra mountains, Starolesnianske Pleso and Dlugi Staw, have also been examined. DDTs (1.7-13 ng g(-1)) were the most abundant OC in soils followed by total polychlorobiphenyls (PCBs; 0.41-1.5 ng g(-1)) and hexachlorobenzene (HCB; 0.15-0.91 ng g(-1)). In sediments, the dominant OC were also DDTs (3.3-28 ng g(-1)) and PCBs (2.3-15 ng g(-1)). These concentrations are low, involving absence of major pollution sources in these high mountain regions. The downcore OC profiles in soils and sediments were similar but higher concentrations and steeper vertical gradients were observed in the latter. Radiometric determinations showed absence of significant OC transport from catchment to lake. The sediment-soil difference points therefore to a better retention of the OC load in sediments than soils which may be related to the low temperatures that are currently encountered at the bottom of the lake water column and the depletion of sediment bioturbation in these cold environments. Significant qualitative changes in the soil PCB distributions are observed downcore. These involve a dominance of the high molecular weight congeners in the top core sections and those of lower weight (i.e. less chlorinated) in the bottom. Anaerobic dechlorination of higher molecular weight congeners occurring in microsites, e.g. as observed in flooded or poorly drained soils, could be responsible for these changes. This process could be concurrent to bioturbation.     

Age dependence of the accumulation of organochlorine pollutants in brown trout (Salmo trutta) from a remote high mountain lake (Redó, Pyrenees)

Polychlorobiphenyls (PCBs), hexachlorocyclohexanes (HCHs), hexachlorobenzene (HCB) and DDT were examined in the muscle of brown trout (Salmo trutta) from a high mountain lake located in the Pyrenees (Catalonia, Spain) that was used as a model of these lacustrine environments. Results indicate that fish age is the main factor of variability among specimens in this population that is subjected to atmospheric inputs of the organochlorine compounds (OC). Increases of 2- and 20-fold between fish aged 1 year and 15 years old are found. The observed pattern cannot be explained in terms of fish size, condition factor, or muscle lipid content. Higher molecular weight compounds (higher lipophilicity) are better correlated with fish age than low molecular weight compounds. A transformation from 4,4'-DDT to 4,4'-DDE occurs in fish after ingestion; this results in amplified age-dependent signals, especially in male specimens. In contrast, PCB congener #180 has lower age dependence than the general OC group, which could be due to its high hydrophobicity (log K(ow) > 7). In any case, selective accumulation of hydrophobic compounds is already observed among younger fish (age, 1 year). Due to this effect, the relative OC composition does not reflect the main OC pollutants in the lake waters.     

Importance of considering pesticide stereoisomerism--proposal of a scheme to apply Directive 91/414/EEC framework to pesticide active substances manufactured as isomeric mixtures

An important gap has been detected in the application of the European framework for the evaluation of pesticide active substances constituted by enantiomeric and other kind of stereoisomeric mixtures. Up to date, little attention has been paid to the different biological properties of these compounds. Considering efficacy, toxicity, environmental fate and behaviour and ecotoxicity of separated isomers is necessary to fulfil Directive 91/414/EEC objectives of health and environment protection. Here, a critical review of this question for pesticide active substances is presented. An evaluative scheme for considering this question in the framework of Directive 91/414/EEC is also proposed.     

Organochlorine compounds in soils and sediments of the mountain Andean Lakes

Semi-volatile organochlorine compounds (OC) were analyzed in remote Andean soils and lake sediments. The sampling sites covered a wide latitudinal gradient from 18 degrees S to 46 degrees S along Chile and an altitudinal gradient (10-4500 m). The concentrations were in the order of background levels, involving absence of major pollution sources in the high mountain areas. Significant correlations were found between log-transformed concentrations of hexachlorobenzene, alpha- and gamma-hexachlorocyclohexane in soils and total organic content (TOC). In addition, TOC-normalized concentrations of the most volatile OC showed a significant linear dependence with air temperature. This good agreement points to temperature as a significant factor for the retention of long range transported OC in remote ecosystems such as the Andean mountains, although other variables should not be totally excluded. The highest concentrations of OCs were achieved in the sites located at highest altitude and lowest temperature of the dataset.     

聚合物改性粉煤灰制备多孔复合材料及其性能研究

制备了高掺量粉煤灰为基质的聚乙烯醇/纤维素复合多孔材料。该复合材料制备过程简单易行,不需高温高压。通过XRF、XRD、FT-IR、SEM以及压汞法对该粉煤灰复合材料进行了表征和结构分析,探索了原料混合比例、干燥温度对样品结构和性能的影响。研究发现:聚乙烯醇可以有效提高该复合材料的无侧限抗压强度,纤维素可有效改善材料的孔隙结构;材料的孔隙主要来自水分蒸发过程中的气泡聚合,在外部不加压的条件下制备样品,需控制干燥温度对样品内部孔隙结构的影响。当粉煤灰含量为80%,聚乙烯醇含量为10%,纤维素含量为10%时,复合材料具有较好的孔隙率、孔隙结构、抗压强度和吸水性及保水性。有一定强度的以粉煤灰为基质的亲水性材料也适合作为吸附材料或滤料,未来可以进一步通过改善材料内部结构,以及活化功能性官能团以提高材料的综合性能,为粉煤灰的综合利用拓展途径。     

Species richness and stand stability in conifer forests of the Sierra Nevada

Theoretical and empirical studies have long suggested that stability and complexity are intimately related, but evidence from long-lived systems at large scales is lacking. Stability can either be driven by complex species interactions, or it can be driven by the presence/absence and abundance of a species best able to perform a specific ecosystem function. We use 64 years of stand productivity measures in forest systems composed of four dominant conifer tree species to contrast the effect of species richness and abundance on three stability measures. To perform this contrast, we measured the annual growth increments of > 900 trees in mixed and pure forest stands to test three hypotheses: increased species richness will (1) decrease stand variance, (2) increase stand resistance to drought events, and (3) increase stand resilience to drought events. In each case, the alternate hypothesis was that species richness had no effect, but that species composition and abundance within a stand drove variance, resistance, and resilience. In pure stands, the four species demonstrated significant differences in productivity, and in their resistance and resilience to drought events. The two pine species were the most drought resistant and resilient, whereas mountain hemlock was the least resistant and resilient, and red fir was intermediate. For community measures we found a moderately significant (P = 0.08) increase in the community coefficient of variation and a significant (P = 0.03) increase in resilience with increased species richness, but no significant relationship between species richness and community resistance, though the variance in community resistance to drought decreased with species richness. Community resistance to drought was significantly (P = 0.001) correlated to the relative abundance of lodgepole pine, the most resistant species. We propose that resistance is driven by competition for a single limiting resource, with negative diversity effects. In contrast resilience measures the capacity of communities to partition resources in the absence of a single limiting resource, demonstrating positive diversity effects.     

Attitudes Toward Wilderness Study Areas: A Survey of Six Southeastern Utah Counties

Southeastern Utah is a region of world-renowned red-rock sandstone formations, large tracts of federal public land, rural communities centered on agriculture and extractive industries, and is often at the epicenter of environmental protection efforts in the western United States. Environmental groups have proposed formal Wilderness designations for much of the regions public land—proposals that have been actively fought by rural community leaders who do not want large areas locked-up from traditional livelihood and recreational uses. The debate over wilderness designation in the region has been characterized in the media as one that is particularly contentious and polarizing. A survey of southeastern Utah residents was conducted in order to better understand this conflict. The survey focused on attitudes toward wilderness designation and management. We found that residents of southeastern Utah have negative attitudes towards the designation and management of Wilderness Study Areas. We propose that these attitudes should be carefully considered and engaged in future policy and management decisions. We suggest that negative opinions expressed by residents of southeastern Utah are not directed primarily at the concept of environmental protection but rather at the strong perception that these programs and initiatives have been carried out in a heavy-handed manner and dominated by outside influences that have overwhelmed local voices.