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.     

A Decision‐Analytic Approach to Managing Climate Risks: Application to the Upper Great Lakes1

Brown, Casey, William Werick, Wendy Leger, and David Fay, 2011. A Decision‐Analytic Approach to Managing Climate Risks: Application to the Upper Great Lakes. Journal of the American Water Resources Association (JAWRA) 47(3):524‐534. DOI: 10.1111/j.1752‐1688.2011.00552.x Abstract: In this paper, we present a risk analysis and management process designed for use in water resources planning and management under climate change. The process incorporates climate information through a method called decision‐scaling, whereby information related to climate projections is tailored for use in a decision‐analytic framework. The climate risk management process begins with the identification of vulnerabilities by asking stakeholders and resource experts what water conditions they could cope with and which would require substantial policy or investment shifts. The identified vulnerabilities and thresholds are formalized with a water resources systems model that relates changes in the physical climate conditions to the performance metrics corresponding to vulnerabilities. The irreducible uncertainty of climate change projections is addressed through a dynamic management plan embedded within an adaptive management process. Implementation of the process is described as applied in the ongoing International Upper Great Lakes Study.     

Nutrient Sources and Transport in the Missouri River Basin,with Emphasis on the Effects of Irrigation and Reservoirs1

Brown, Juliane B., Lori A. Sprague, and Jean A. Dupree, 2011. Nutrient Sources and Transport in the Missouri River Basin, With Emphasis on the Effects of Irrigation and Reservoirs. Journal of the American Water Resources Association (JAWRA) 47(5):1034‐1060. DOI: 10.1111/j.1752‐1688.2011.00584.x Abstract: SPAtially Referenced Regressions On Watershed attributes (SPARROW) models were used to relate instream nutrient loads to sources and factors influencing the transport of nutrients in the Missouri River Basin. Agricultural inputs from fertilizer and manure were the largest nutrient sources throughout a large part of the basin, although atmospheric and urban inputs were important sources in some areas. Sediment mobilized from stream channels was a source of phosphorus in medium and larger streams. Irrigation on agricultural land was estimated to decrease the nitrogen load reaching the Mississippi River by as much as 17%, likely as a result of increased anoxia and denitrification in the soil zone. Approximately 16% of the nitrogen load and 33% of the phosphorus load that would have otherwise reached the Mississippi River was retained in reservoirs and lakes throughout the basin. Nearly half of the total attenuation occurred in the eight largest water bodies. Unlike the other major tributary basins, nearly the entire instream nutrient load leaving the outlet of the Platte and Kansas River subbasins reached the Mississippi River. Most of the larger reservoirs and lakes in the Platte River subbasin are upstream of the major sources, whereas in the Kansas River subbasin, most of the source inputs are in the southeast part of the subbasin where characteristics of the area and proximity to the Missouri River facilitate delivery of nutrients to the Mississippi River.     

Walking to school: Community design and child and parent barriers

The roles of community design and parent and child perceptions of walkability to school are tested for associations with walking in three communities: a walkable new urbanist community, a mixed community (standard suburban community where the walk to school traversed part of the new urbanist community), and less walkable standard suburban community. Perceived environmental barriers to walking to school are measured and compared for fifth graders (n = 193) and their parents (n = 177). Results showed that children and parents often agreed on walking barriers, except an interaction showed that — in the less walkable community — parents perceived worse barriers than did their children. Perceptions of barriers increased from walkable, to mixed, to less walkable communities. Students walked more when they attended the school in the walkable community, they lived near school, parents and children perceived fewer barriers to walking, and children had lower BMI scores, net of demographic controls. Thus the walk to school is embedded within multiple types of supports, all of which should be addressed to encourage walking to school.     

Spatial patterns reveal negative density dependence and habitat associations in tropical trees

Understanding how plant species coexist in tropical rainforests is one of the biggest challenges in community ecology. One prominent hypothesis suggests that rare species are at an advantage because trees have lower survival in areas of high conspecific density due to increased attack by natural enemies, a process known as negative density dependence (NDD). A consensus is emerging that NDD is important for plant-species coexistence in tropical forests. Most evidence comes from short-term studies, but testing the prediction that NDD decreases the spatial aggregation of tree populations provides a long-term perspective. While spatial distributions have provided only weak evidence for NDD so far, the opposing effects of environmental heterogeneity might have confounded previous analyses. Here we use a novel statistical technique to control for environmental heterogeneity while testing whether spatial aggregation decreases with tree size in four tropical forests. We provide evidence for NDD in 22% of the 139 tree species analyzed and show that environmental heterogeneity can obscure the spatial signal of NDD. Environmental heterogeneity contributed to aggregation in 84% of species. We conclude that both biotic interactions and environmental heterogeneity play crucial roles in shaping tree dynamics in tropical forests.     

Poor-data and data-poor species stock assessment using a Bayesian hierarchical approach

Appropriate inference for stocks or species with low-quality data (poor data) or limited data (data poor) is extremely important. Hierarchical Bayesian methods are especially applicable to small-area, small-sample-size estimation problems because they allow poor-data species to borrow strength from species with good-quality data. We used a hammerhead shark complex as an example to investigate the advantages of using hierarchical Bayesian models in assessing the status of poor-data and data-poor exploited species. The hammerhead shark complex (Sphyrna spp.) along the Atlantic and Gulf of Mexico coasts of the United States is composed of three species: the scalloped hammerhead (S. lewini), the great hammerhead (S. mokarran), and the smooth hammerhead (S. zygaena) sharks. The scalloped hammerhead comprises 70-80% of the catch and has catch and relative abundance data of good quality, whereas great and smooth hammerheads have relative abundance indices that are both limited and of low quality presumably because of low stock density and limited sampling. Four hierarchical Bayesian state-space surplus production models were developed to simulate variability in population growth rates, carrying capacity, and catchability of the species. The results from the hierarchical Bayesian models were considerably more robust than those of the nonhierarchical models. The hierarchical Bayesian approach represents an intermediate strategy between traditional models that assume different population parameters for each species and those that assume all species share identical parameters. Use of the hierarchical Bayesian approach is suggested for future hammerhead shark stock assessments and for modeling fish complexes with species-specific data, because the poor-data species can borrow strength from the species with good data, making the estimation more stable and robust.     

Application of an environmental impact assessment methodology to a site discharging low levels of radioactivity to a freshwater environment in Norway

Significant shifts in opinion regarding environmental protection from ionising radiation have resulted in the development and availability of bespoke approaches for the assessment of impacts on wildlife from radioactive contaminants. The application of such assessment methodologies to actual situations, however, remains relatively limited. This paper describes the implementation of the ERICA Integrated Approach and associated tools within the context of routine discharges of radioactive materials to a freshwater environment. The article follows the implementation through its relevant stages and discusses strengths and weaknesses of the approach in relation to the case study. For current discharge levels, ¹³⁷Cs and ⁶⁰Co constitute the main dose contributors to the majority of reference organisms studied, although ²⁴¹Am and ³H are the main contributors for the phyto- and zooplankton categories. Patterns are observed depending on whether the reference organism is sediment-associated or not. At current discharge levels, none of the reference organisms exceeded or approached the selected screening level, and impacts on biota could be regarded as negligible.     

Male tawny dragons use throat patterns to recognize rivals

The ability to distinguish between familiar and unfamiliar conspecifics is important for many animals, especially territorial species since it allows them to avoid unnecessary interactions with individuals that pose little threat. There are very few studies, however, that identify the proximate cues that facilitate such recognition in visual systems. Here, we show that in tawny dragons (Ctenophorus decresii), males can recognize familiar and unfamiliar conspecific males based on morphological features alone, without the aid of chemical or behavioural cues. We further show that it is the colour pattern of the throat patches (gular) that facilitates this recognition.     

Assessment of harbor seal predation on adult salmonids in a Pacific Northwest estuary.

The populations of many native species have increased or expanded in distribution in recent decades, sometimes with negative consequences to sympatric native species that are rarer or less adaptable to anthropogenic changes to the environment. An example of this phenomenon from the Pacific Northwest is predation by locally abundant pinnipeds (seals and sea lions) on threatened, endangered, or otherwise depleted salmonid (Oncorhynchus spp.) populations. We used survey sampling methodology, acoustic telemetry, and molecular genetics to quantify the amount of harbor seal (Phoca vitulina) predation on a depressed run of coho salmon (O. kisutch) and to determine whether some seals consumed a disproportionately higher number of salmonids than others. Based on a probability sample totaling 759.5 h of observation, we estimated that seals consumed 1161 adult salmonids (95% CI = 503-1818 salmonids) during daylight hours over an 18.9-km estuarine study area in Oregon during an 84-d period in fall 2002. Simultaneous tracking of 56 seals via an acoustic telemetry array indicated that a small proportion of marked seals (12.5%) exhibited behavior that was consistent with specialization on salmonids. These seals spent the majority of their time in the riverine portion of the study area and did so disproportionately more at night than day. Genetic analysis of 116 salmonid structures recovered from 11 seal fecal samples suggested that coho salmon accounted for approximately one-half of total salmonid consumption. Though subject to considerable uncertainty, the combined results lead us to infer that seals consumed 21% (range = 3-63%) of the estimated prespawning population of coho salmon. We speculate that the majority of the predation occurred upriver, at night, and was done by a relatively small proportion of the local seal population. Understanding the extent and nature of pinniped predation can provide important inputs into risk assessments and other modeling efforts designed to aid the conservation and recovery of salmonids in the Pacific Northwest. Such understanding may also help inform management actions designed to reduce the impact of pinniped predation on salmonids, which potentially range from short-term lethal removal programs to long-term ecosystem restoration and protection efforts.     

Is there a sustainability canon?

This paper identifies one possible set of appropriate disciplinary content for undergraduate programs in sustainability, based on a survey instrument employed at two international sustainability events in 2005. Undertaken to supplement the focus in the sustainability education literature on generic skills and pedagogical method via case-based or broadly conceptual work, it seeks to assist curriculum developers with planning disciplinary content. Findings indicate that a sustainability canon of sorts exists. A surprising amount of agreement existed from the two different specialist groups about core concepts, notably in ecology and—less unanimously—policy, economics and ethics. Studies about society were preferred as elective content. A 10-subject core was nominated, suggesting the need for broad foundational underpinnings.