Implementing the evidence for preventing falls among community-dwelling older people: a systematic review

Problem and objective

The translation of the evidence-base for preventing falls among community-dwelling older people into practice has been limited. This study systematically reviewed and synthesised the effectiveness of methods to implement falls prevention programmes with this population.

Methods

Articles published between 1980 and May 2010 that evaluated the effects of an implementation strategy. No design restrictions were imposed. A narrative synthesis was undertaken.

Results

15 studies were identified. Interventions that involved the active training of healthcare professionals improved implementation. The evidence around changing the way people who fall are managed within primary care practices, and, layperson, peer or community delivered models was mixed.

Impact on industry

Translating the evidence-base into practice involves changing the attitudes and behaviours of older people, healthcare professionals and organisations. However, there is a need for further evaluation on how this can be best achieved.     

Melting and incineration plants of municipal waste. Chemical and biochemical diagnosis of thermal processing samples (emission,residues)

Control of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in emissions and thermal residues from incinerators has been a cause of public concern for more than one decade. Recently, several studies showed that other persistent organic pollutants (POPs) such as coplanar polychlorinated biphenyls (co-PCBs) also have dioxin-like activity and are released from incinerators. Therefore, the present study was aimed at making a risk assessment about dioxin-like activity in extracts of thermal waste residues (e.g. combustion gas; fly ash, slag) from incineration and melting processes in Germany and Japan. For this purpose, polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs), coplanar polychlorinated biphenyls (co-PCBs), polychlorinated naphthalenes (PCNs) and polyaromatic hydrocarbons (PAHs) were analyzed by chemical analysis. Additionally, 2, 3, 7, 8-TCDD equivalents (EROD-TEQs) were determined by in vitro Micro-EROD bioassay using rat H4IIE hepatoma cells. EROD-TEQs could be correlated to I-TEQ values (from PCDD/Fs/co-PCBs) analyzed by chemical analysis resulting in a maximal sixfold higher estimate. Our study indicates minor influences of co-PCBs, PAHs and PCNs to the sum of dioxin-like toxicity in the extracts of thermal waste residues as determined here. Furthermore, we showed that the levels of dioxins and co-PCBs contained in slag from melting processes and bottom ashes from incineration processes were lower by 1-2 orders of magnitude than that in fly ash.     

Stingless bee response to spider webs is dependent on the context of encounter

In the course of their foraging bouts, bees frequently encounter spider webs among the vegetation. The ability to see and avoid these webs is vital for the success of the individual bee’s foraging bout. In this study, we report on the response of stingless bees (Trigona carbonaria) towards the webs of the St. Andrew’s Cross spider (Argiope keyserlingi). We studied the ability of bees to avoid webs in different contexts: when bees were on their foraging path or when they were returning to the hive as well as when they were flying North or South. We show that the probability of a bee being able to avoid a web depends on the context of the bee’s flight rather than the visual appearance of the web. Furthermore, the presence of the spider seems to alert the bee to the web, resulting in bees being more able to avoid capture. We show, specifically, that the probability of being captured is higher when the bee is returning to the hive compared with when the bee is foraging. The likelihood of avoiding a web is also influenced by the compass direction of the flight, although to a lesser extent. Our results indicate that the context of the predator–prey encounter has a significant influence on a bee’s ability to escape interception by a spider web.     

Teaching industrial ecology and environmental management in Second Life

Second Life is a virtual, open-access, and user-generated environment that has served as a platform for hosting everything from rock concerts to scientific conferences. Many institutions have also used Second Life as an educational tool, for example by, showcasing scientific exhibits or embedding video and images for learning purposes. Here we discuss the creation and use of an interactive, virtual industrial facility - the Elihu Paper Company - as a way to complement a traditional facility tours in a course in industrial environmental management. Virtual facilities offer a number of educational advantages over real-life ones: they are always open and available for tours, they can be accessed instantaneously from anywhere where there is an adequate internet connection, and most importantly, tours and embedded information can be tailored to specific educational objectives. Our experience in using Elihu Paper as a formal facility visit for the past several years shows that students had significantly more time than usual to ask questions, could and did explore the facility independently, and were still able to produce facility reports that fulfilled the educational objectives of the visits, including mapping material flows and explaining pollution prevention and sustainability opportunities.     

Preferences and tradeoffs in nectar temperature and nectar concentration in the Asian hive bee Apis cerana

Honey bee foragers need to asses and make trade-offs between a number of potentially conflicting floral attributes. Here, we investigate multi-attribute decision making in the eastern honey bee, Apis cerana, when foraging on food sources that varied in warmth and sucrose concentration. We show that foragers prefer warm (30 °C) sucrose solution over cool (10 °C) sucrose solution and concentrated (30 % w/w) sucrose solution over dilute (15 % w/w) sucrose solution. When we offered the preferred sucrose concentration (30 % w/w) at the less-preferred temperature (10 °C), and the less-preferred sucrose concentration (15 % w/w) at the preferred temperature (30 °C), foragers prioritized warmth by choosing the warmer, but lower concentration solution. When the temperature difference was less extreme, bees preferred more concentrated cooler syrup (30 % ww at 15 °C over 15 % 30 °C). However, the addition of a decoy item to the choice set had a significant effect on the bees' preferences. Our results highlight the critical importance of considering context effects when measuring the foraging preferences of animals.     

Diphenylmethane diisocyanate self-polymerization: Thermal hazard evaluation and proof of runaway reaction in gram scale

Thermal analysis by differential scanning calorimetry and thermogravimetric/differential thermal analysis mass spectrometry, adiabatic calorimetry, a gram-scale heating test, and infrared spectroscopy were performed to evaluate the thermal hazards of diphenylmethane diisocyanate (MDI) and prove the occurrence of a runaway reaction. The self-polymerization of MDI was found to occur at about 340 °C under rapid heating conditions. Carbon dioxide was eliminated and heat was generated to allow polymerization. Under adiabatic and closed conditions, the runaway reaction of MDI can begin at least from 220 °C. Besides it is highly probable that the runaway reaction of MDI can begin from a lower temperature in an actual process scale. More heat was generated than in the previous case and the pressure rose rapidly. A closed 2-mm-thick glass vessel exploded because of the runaway reaction of MDI even if the temperature was lower than 300 °C. Therefore, MDI could cause fatal runaway reactions below 300 °C, where MDI had been assumed to self-polymerize by eliminating carbon dioxide previously.     

Ocean fertilization for geoengineering: A review of effectiveness,environmental impacts and emerging governance

Dangerous climate change is best avoided by drastically and rapidly reducing greenhouse gas emissions. Nevertheless, geoengineering options are receiving attention on the basis that additional approaches may also be necessary. Here we review the state of knowledge on large-scale ocean fertilization by adding iron or other nutrients, either from external sources or via enhanced ocean mixing. On the basis of small-scale field experiments carried out to date and associated modelling, the maximum benefits of ocean fertilization as a negative emissions technique are likely to be modest in relation to anthropogenic climate forcing. Furthermore, it would be extremely challenging to quantify with acceptable accuracy the carbon removed from circulation on a long term basis, and to adequately monitor unintended impacts over large space and time-scales. These and other technical issues are particularly problematic for the region with greatest theoretical potential for the application of ocean fertilization, the Southern Ocean. Arrangements for the international governance of further field-based research on ocean fertilization are currently being developed, primarily under the London Convention/London Protocol.     

Temporal variations of 90Sr and 137Cs concentrations and the 137Cs/90Sr activity ratio in marine brown algae, Undaria pinnatifida and Laminaria longissima, collected in coastal areas of Japan

The anthropogenic radionuclides, 90Sr and 137Cs, were measured in two marine algal species, wakame seaweed (Undaria pinnatifida) and edible kelp (Laminaria longissima), collected in four coastal areas of Japan during 1998-2008. Although 90Sr and 137Cs could be detected at all sampling sites, the concentrations of 90Sr and 137Cs were at low levels and those in some samples were below the detection limit. These low concentrations and the small variation of both concentrations and the 137Cs/90Sr activity ratio indicate that the source of 90Sr and 137Cs detected in this study originated from the global fallout deposition following atmospheric nuclear-bomb tests in the past. There were no significant differences in both concentrations of 90Sr and 137Cs in wakame seaweed among three sampling sites. Although wakame seaweed is extensively distributed in southern and central Japan, it does not occur in northern areas and so edible kelp was monitored. The concentrations of 90Sr and 137Cs in edible kelp were significantly different from those in wakame seaweed in some sampling sites. These differences could be due to the difference in the concentrations of 90Sr and 137Cs in the surrounding seawater or the difference in species. The combined data with data from the previous report and the preexisting database showed that wakame seaweed incorporated 137Cs through a different pathway from that of 90Sr. The combined data also suggested that wakame seaweed responded differently to the source of 137Cs.