Preventing Head Injuries
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Consensus-Based Clinical Practice Recommendations for the Examination and Management of Falls in Patients with Parkinson’S Diseaseq
Parkinsonism and Related Disorders 20 (2014) 360e369 Contents lists available at ScienceDirect Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis Editor’s comment: In this thoughtful and provocative Point-of-View contribution, van der Eijk and colleagues address the shortcomings of the classical model of “professional physician-centered care” and describe an alternative “collaborative patient-centered care” approach that involves, among many other things, shared decision making with patients in the context of a multidisciplinary care setting. They propose that this alternative approach may improve quality of care and produce better outcomes for individuals with disorders such as Parkinson’s disease, while also being cost-effective. The authors discuss their experience with such an approach and describe both the benefits and barriers they have encountered. Whether one agrees or disagrees with the authors’ proposals, this article will provide much food for thought and reflection. Ronald F. Pfeiffer, Editor-in-Chief Department of Neurology, University of Tennessee HSC, 855 Monroe Avenue, Memphis, TN 38163, USA Point of view Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson’s diseaseq Marjolein A. van der Marck a, Margit Ph.C. Klok a, Michael S. Okun b, Nir Giladi c, Marten Munneke a,d, Bastiaan R. Bloem e,*, on behalf of the NPF Falls Task Force1 a Radboud university medical center, Nijmegen Centre for Evidence Based Practice, Department -
The Brain That Changes Itself
The Brain That Changes Itself Stories of Personal Triumph from the Frontiers of Brain Science NORMAN DOIDGE, M.D. For Eugene L. Goldberg, M.D., because you said you might like to read it Contents 1 A Woman Perpetually Falling . Rescued by the Man Who Discovered the Plasticity of Our Senses 2 Building Herself a Better Brain A Woman Labeled "Retarded" Discovers How to Heal Herself 3 Redesigning the Brain A Scientist Changes Brains to Sharpen Perception and Memory, Increase Speed of Thought, and Heal Learning Problems 4 Acquiring Tastes and Loves What Neuroplasticity Teaches Us About Sexual Attraction and Love 5 Midnight Resurrections Stroke Victims Learn to Move and Speak Again 6 Brain Lock Unlocked Using Plasticity to Stop Worries, OPsessions, Compulsions, and Bad Habits 7 Pain The Dark Side of Plasticity 8 Imagination How Thinking Makes It So 9 Turning Our Ghosts into Ancestors Psychoanalysis as a Neuroplastic Therapy 10 Rejuvenation The Discovery of the Neuronal Stem Cell and Lessons for Preserving Our Brains 11 More than the Sum of Her Parts A Woman Shows Us How Radically Plastic the Brain Can Be Appendix 1 The Culturally Modified Brain Appendix 2 Plasticity and the Idea of Progress Note to the Reader All the names of people who have undergone neuroplastic transformations are real, except in the few places indicated, and in the cases of children and their families. The Notes and References section at the end of the book includes comments on both the chapters and the appendices. Preface This book is about the revolutionary discovery that the human brain can change itself, as told through the stories of the scientists, doctors, and patients who have together brought about these astonishing transformations. -
Interventions for Reducing Falls and Harm from Falls in Older People with Cognitive Impairment
Interventions for reducing falls and harm from falls in older people with cognitive impairment April 2019 Contents Key messages ..................................................................................................................... 3 Useful links .......................................................................................................................... 3 1. Introduction ..................................................................................................................... 4 What is cognitive impairment? ........................................................................................... 4 Cognitive impairment increases falls and fracture risk ....................................................... 4 Interventions to reduce harm from falls for all older people ................................................ 5 Reviews of the evidence in those with cognitive impairment .............................................. 5 2. In the community ............................................................................................................ 6 Exercise ............................................................................................................................ 6 Home safety ...................................................................................................................... 7 Nutrition ............................................................................................................................. 7 Bone health ...................................................................................................................... -
Preventing Falls in Hospitals: a Toolkit for Improving Quality of Care
Preventing Falls in Hospitals A Toolkit for Improving Quality of Care The information in this toolkit is intended to assist service providers and hospitals in developing falls prevention protocols. This toolkit is intended as a reference and not as a substitute for professional judgment. The opinions expressed in this document are those of the authors and do not necessarily reflect the views of AHRQ. No statement in this toolkit should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services. In addition, AHRQ or U.S. Department of Health and Human Services endorsement of any derivative product may not be stated or implied. Preventing Falls in Hospitals A Toolkit for Improving Quality of Care Prepared for: Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Prepared by: RAND Corporation Boston University School of Public Health ECRI Institute Contract No. HHSA290201000017I TO #1 AHRQ Publication No. 13-0015-EF January 2013 Authors RAND Corporation David A. Ganz, M.D., Ph.D., VA Greater Los Angeles Healthcare System, University of California at Los Angeles, and RAND Corporation Christina Huang, M.P.H., RAND Corporation Debra Saliba, M.D., M.P.H., VA Greater Los Angeles Healthcare System, UCLA/JH Borun Center for Gerontological Research, and RAND Corporation Victoria Shier, M.P.A., RAND Corporation Boston University School of Public Health Dan Berlowitz, M.D., M.P.H., Bedford VA Hospital and Boston University School of Public Health Carol VanDeusen Lukas, Ed.D., VA Boston Healthcare System and Boston University School of Public Health ECRI Institute Kathryn Pelczarski, B.S. -
Spinal Cord Injury Cord Spinal on Perspectives International
INTERNATIONAL PERSPECTIVES ON SPINAL CORD INJURY “Spinal cord injury need not be a death sentence. But this requires e ective emergency response and proper rehabilitation services, which are currently not available to the majority of people in the world. Once we have ensured survival, then the next step is to promote the human rights of people with spinal cord injury, alongside other persons with disabilities. All this is as much about awareness as it is about resources. I welcome this important report, because it will contribute to improved understanding and therefore better practice.” SHUAIB CHALKEN, UN SPECIAL RAPPORTEUR ON DISABILITY “Spina bi da is no obstacle to a full and useful life. I’ve been a Paralympic champion, a wife, a mother, a broadcaster and a member of the upper house of the British Parliament. It’s taken grit and dedication, but I’m certainly not superhuman. All of this was only made possible because I could rely on good healthcare, inclusive education, appropriate wheelchairs, an accessible environment, and proper welfare bene ts. I hope that policy-makers everywhere will read this report, understand how to tackle the challenge of spinal cord injury, and take the necessary actions.” TANNI GREYTHOMPSON, PARALYMPIC MEDALLIST AND MEMBER OF UK HOUSE OF LORDS “Disability is not incapability, it is part of the marvelous diversity we are surrounded by. We need to understand that persons with disability do not want charity, but opportunities. Charity involves the presence of an inferior and a superior who, ‘generously’, gives what he does not need, while solidarity is given between equals, in a horizontal way among human beings who are di erent, but equal in their rights. -
Life-After-Stroke-Guide 7819.Pdf
A GUIDE FOR PATIENTS AND CAREGIVERS LIFE AFTER STROKE Our Path Forward Encompass Health is a national sponsor of Together to End Stroke. TABLE OF CONTENTS 04 What is a stroke? 24 Rehabilitation setting options 06 About my stroke 25 Tips for choosing a rehabilitation facility 07 Diagnosis and early treatment 26 What to expect in rehabilitation 10 Common physical changes after a stroke 29 My rehabilitation goals 13 Common communication and cognitive changes 30 Preventing another after stroke stroke 18 Common emotional and 33 Signs and symptoms of personality changes after stroke stroke 34 Resources 22 Why rehabilitation is important INTRODUCTION THERE IS LIFE – AND HOPE – AFTER STROKE. WITH TIME, NEW ROUTINES WILL BECOME SECOND NATURE. REHABILITATION CAN BUILD YOUR STRENGTH, CAPABILITY AND CONFIDENCE. IT CAN HELP YOU CONTINUE YOUR DAILY ACTIVITIES DESPITE THE EFFECTS OF YOUR STROKE. If you are the caregiver, family member or friend of a stroke survivor, your role is vital. You should know the prevention plan and help your loved one to comply with the plan. With a committed health care team and a rehabilitation plan specific to their needs, most stroke survivors can prevent another stroke and thrive. We hope this guide will help you and your loved ones understand the effects of stroke and how to maximize your rehabilitation and recovery. 03 WHAT IS A STROKE? Stroke is an event that affects the arteries of the brain. A stroke occurs when a blood vessel bringing blood to the brain gets blocked or ruptures (bursts). This means that the area of the brain the blocked or ruptured blood vessel supplies can’t get the oxygen and nutrients it needs. -
History of Falls, Dementia, Lower Education Levels, Mobility Limitations, and Aging Are Risk Factors for Falls Among the Community-Dwelling Elderly: a Cohort Study
International Journal of Environmental Research and Public Health Article History of Falls, Dementia, Lower Education Levels, Mobility Limitations, and Aging Are Risk Factors for Falls among the Community-Dwelling Elderly: A Cohort Study Yan-Yuh Lee 1, Chien-Liang Chen 2,3, I-Chen Lee 4, I-Ching Lee 5 and Nai-Ching Chen 6,* 1 Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; [email protected] 2 Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; [email protected] 3 Department of Medicine, National Yang-Ming University School of Medicine, Taipei 112, Taiwan 4 Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] 5 Ever Blessing Clinic, Kaohsiung 804, Taiwan; [email protected] 6 Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan * Correspondence: [email protected]; Tel.: +886-7-731-7123 (ext. 3304); Fax: +886-7-7318762 Abstract: Background: Falling is a serious issue among elderly community dwellers, often resulting in disability. We aimed to investigate the risk factors for falls among elderly community dwellers. Citation: Lee, Y.-Y.; Chen, C.-L.; Methods: We recruited 232 participants from multiple community learning and care centers, who Lee, I.-C.; Lee, I.-C.; Chen, N.-C. provided their information through questionnaires. They were divided into two groups, according to History of Falls, Dementia, Lower their falling events after a 1-year follow-up. Univariate and multivariate logistic regressions were Education Levels, Mobility used for statistical analysis. -
Brain Facts Book.Pdf
A Companion Publication to BrainFacts.org A PRIMER ON THE BRAIN AND NERVOUS SYSTEM A PRIMER ON THE BRAIN AND NERVOUS SYSTEM A companion to BrainFacts.org A PUBLIC INFORMATION INITIATIVE OF: PREFACE Over the past two decades, scientific knowledge about the structure and function of the brain and nervous system and understanding of brain-based disorders have increased exponentially. Neuroscientists are using remarkable new tools and technologies to learn how the brain controls and responds to the body, drives behavior, and forms the foundation for the mind. Research is also essential for the development of therapies for more than 1,000 nervous system disorders that affect more than 1 billion people worldwide. As these strides occur, it is crucial that scientists communicate with the general public, helping students, teacher, parents, medical caregivers, policymakers, and others stay informed of developments in neuroscience. In particular, students — the scientists, policymakers and scientifically literate citizens of the future — need access to clear, easy-to-use information on this important topic. As part of its enduring commitment to public education and outreach, the Society for Neuroscience (SfN) is pleased to present the seventh edition of Brain Facts: A Primer on the Brain and Nervous System. This edition has been substantially revised. Research progress has been updated throughout the publication, and a new section on animal research added. The information also has been reorganized into six sections to make it easier for readers to glean the “big ideas” covered, and the specific topics that fall under each category. The publication of the Brain Facts seventh edition coincides with the launch of BrainFacts.org, a public information initiative of The Kavli Foundation, The Gatsby Charitable Foundation, and SfN. -
Fall Prevention Resource Guide
Fall Prevention Resource Guide A guide of the Vermont Department of Health Injury Prevention Program Fall Prevention Resource Guide The Vermont Fall Prevention Resource Guide features facts about falls both nationally and in Vermont, information about free online resources, screening and assessment suggestions as well as services available to Vermonters around the state. This guide was assembled for use for midlife and older adults, health care providers, community organizations, family members, and individuals interested in learning about fall prevention. 2 Table of Contents Introduction……………………………….……………………………….….…4 The Status of Falls in Vermont.…………………………………….…….…..6 Guide Inclusion Criteria.…….…………………………………………………8 Open-Access Materials.….…………………………………………………….9 Falls Risk Assessment…...………………………………….……………….10 Fall Prevention Programs and Resources in Vermont….……………...14 3 Introduction Most falls are not caused by a single factor, but are the result of multiple different factors happening at once. The ordinary choices people make as well as the actions they take may increase their chance of falling. The causes of falls can be either intrinsic (the individual’s general physical condition, occurring naturally) or extrinsic (environmental and behavioral hazards, occurring unnaturally). Shown below are some of the risk factors that can increase an individual’s risk of a fall. What Causes Falls? Risk Factors Age Gender Medications • The natural process of aging • While falls are more common • The most common categories of seems to put older -
Managing the Elderly with Dementia and Frequent Falls Si Ching LIM* Senior Consultant, Department of Geriatric Medicine, Changi General Hospital, Singapore
General Medicine Open Research Article ISSN: 2515-4737 Managing the elderly with dementia and frequent falls Si Ching LIM* Senior Consultant, Department of Geriatric Medicine, Changi General Hospital, Singapore Abstract The elderly living with dementia are increasing all over the world. Falls and fall related injuries are common among the elderly with dementia. The elderly with dementia are often more likely to sustain injuries after a fall and are more likely to have recurrent fallers. Once an elderly with dementia is admitted to an acute hospital, they are at risk of falls in the hospital because of delirium, unfamiliar environment, changes in their daily routine and caregivers. The usual fall prevention strategies recommended are ineffective among the elderly with dementia. Introduction Table 1. Factors predisposing to falls among the elderly with dementia. Dementia Type and severity of dementia The incidence of dementia worldwide continues to increase as Depression Slow gait, cognitive symptoms, unstable gait the world’s population ages. According to the Alzheimer Association Cognitive deficits Attention, executive dysfunction, orientation, judgement International, someone in the world develops dementia every 3 seconds. Gait abnormalities Gait speed, stride length, extrapyramidal signs There are currently close to 50 million people living with dementia Polypharmacy, anticholinergic properties, drugs which and this number will reach 131.5 million by 2050 with much of the Drugs cause gait instability, sedation, cognitive dysfunction, people with dementia living in the developing countries. [1] Dementia orthostatic hypotension. is a syndrome caused by chronic neurodegenerative diseases resulting Delirium New onset of falls in progressive decline in function, cognition and the emergence of Neuropsychiatric symptoms Wandering, restlessness, psychotropic medications neuropsychiatric symptoms. -
Falls Risk: the Impact of Aging and Dementia Andrea Berg, MD November 8, 2018 Falls Are NOT a Part of Normal Aging Facts About Falls
Falls Risk: The Impact of Aging and Dementia Andrea Berg, MD November 8, 2018 Falls are NOT a part of normal aging Facts About Falls • Every 19 minutes, an older adult dies from a fall-related injury. • One out of five falls leads to a fracture, concussion, or other serious injury • Estimated one in three people over 65 who live outside of a nursing home will fall each year. • Injuries from falls are growing faster than the U.S. population, especially for people 65 and older • Many falls are preventable! Types of Balance Visual Somatosensory Ves bular / S~ti Balance // Dyo m c Balan e openi.nlm.nih.gov/ detailedresult.php?img=PMC5324311_12883_2017_812_Fig1 . Ot.itft'•ar . Mh1dttter . ,M.rMr Maintaining Balance Impact and Implications of Falls NYS Department of Health • Leading cause of accident-related hospitalizations for people over 25 • Leading cause of accidental death for those over 45 • Single most disabling event likely to result in nursing home placement for those over 65 Worldwide • Second leading cause accidental death Impact and Implications of Falls • Fractures • Traumatic brain injury • Neck injuries • Back injuries • Eye injuries • Fear of falling Age and Falling Medications Muscle Poor sleep Falls atrophy • Chronic pain Fall Risk in Men and Women • More likely to die from falls • More likely to fall • Greater heights • More likely to be injured • Take more risks • 75%-95% hip fractures • Dangerous occupations/hobbies Environmental Hazards • Poor lighting • Slippery floors • Loose rugs, cords • Moveable furniture • Stairs • Poorly fitting shoes Alcohol Medical Conditions That Effect Balance Vestibular Disorders • Infections • Allergies • Head injuries • Benign paroxysmal positional vertigo (BPPV) • Labyrinthitis -~,,., ..... -
Fall Hazard Recognition, Prevention & Control –
Fall Hazard Recognition, Prevention & Control – Students’ Manual A Program of the Health & Safety Department International Union, UAW This material was revised under grant number SH-22230-11-60-F-26 from the Occupational If you have suggestions or questions, contact: Safety and Health Administration, U.S. Education and Health & Safety Department, UAW Department of Labor. It does not necessarily 8000 E. Jefferson reflect the views or policies of the U.S. Detroit, MI 48214 Department of Labor, nor does mention of trade names, commercial products, or organizations Phone: 313. 926.5563 imply endorsement by the U.S. Government. December - 2011 Fall Hazard Recognition, Prevention and Control Course Goal Course Goal – The aim of this program is to provide comprehensive on-site training to high-risk workers (i.e. skilled trades and maintenance workers) and management on Fall Hazards: Recognition, Prevention & Control and the prevention of serious fall injuries at their worksites. Participants will develop an understanding of the hazards associated with falls and how to eliminate or control them. Section Content Objective Introduction to Fall Participants will be able to: Hazards 1 Identify potential factors that contribute to fall hazards. Explain the issues (statistics) associated with falls in the workplace., Describe the intent of a Fall Hazard Identification Program and list the essential elements of an effective program. Identifying Participants will be able to: Potential Fall 2 Hazards Process for identifying potential fall hazards List types of potential hazards to workers during non-routine maintenance work. o Trip hazards (extension cords, air hoses, tools, etc…) o Proximity to fall hazard during work.