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Robinson K, Logan P, Tucker C, Finlayson J, van der Wardt V, Kilby A, Knowles S, Vanhegan S, Hodgson S, Lidstone N. What are the views of adults with an intellectual disability (AWID), carers and healthcare professionals on a community falls management programme for AWID: a qualitative interview study in the UK. BMJ Open 2024; 14:e069588. [PMID: 38307531 PMCID: PMC10836373 DOI: 10.1136/bmjopen-2022-069588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/21/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES The aim of this study was to refine a draft of the ACTiON FALLS LD programme based on the views of adults with an intellectual disability (AWID), carers and healthcare professionals (HCPs). DESIGN, SETTING AND PARTICIPANTS The semistructured interview study included HCP as well as AWID and carers supporting AWID living in the community. Community settings included sheltered living, supported living, AWID living at home with family carers or independently. The interview study explored the first draft of the ACTiON FALLS LD programme as well as the wider falls management for AWID. Interviews with AWID were developed to include a range of approaches (eg, case studies, pictures) to support inclusive participation. Individual interviews were digitally recorded and transcribed. Researcher notes were used during interviews with AWID. All data were analysed using the principles of framework analysis. RESULTS 14 HCP, 8 carers and 13 AWID took part in the interview process. Five key themes were identified: programme components, programme design, programme approach, who would use the programme and programme delivery. CONCLUSIONS The views of AWID, HCP and carers showed the need to consider the impact of risk perception, anxiety and fear of falling in the adaption of the ACTiON FALLS programme. The programme needs to be accessible and support the inclusion of AWID in managing falls and ultimately fulfil the requirement for a proactive and educational tool by all.
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Affiliation(s)
- Katie Robinson
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Phillipa Logan
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK
- Nottingham CityCare Partnership CIC, Nottingham, UK
| | | | - Janet Finlayson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Veronika van der Wardt
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK
- University of Marburg, Department of General Practice, Marburg, Germany
| | - Alice Kilby
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | | | - Stuart Hodgson
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Nicola Lidstone
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Choi P, Motl RW, Agiovlasitis S. Feasibility of social cognitive theory-based fall prevention intervention for people with intellectual disabilities living in group-home. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:159-171. [PMID: 36530049 DOI: 10.1111/jir.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adults with intellectual disability (ID) have a higher rate of fall events than the general population. Consequently, interventions for reducing fall events and improving health are highly required for individuals with ID. One essential step towards effectively delivering fall prevention interventions among adults with ID involves evaluating their feasibility. This study examined the feasibility of a home-based exercise intervention, supplemented with behavioural change strategies, among individuals with ID living in residential settings. METHOD This study provided an 8-week intervention, consisting of a workshop for support workers and sessions for participants with ID, focusing on behavioural reward/s, education regarding fall prevention/exercise and exercise training. One week prior to and 1 week following such an intervention, such participants underwent measurements for (1) physical performance, (2) fall efficacy, (3) self-efficacy for activity and (4) social support. RESULTS Participants having ID (n = 33), support workers (n = 11) and one administrator participated in this study. There were no adverse events during the intervention, and the mean adherence rate was 70.8 ± 19.5%. Two participants with ID dropped out of the programme due to a lack of interest. The participants with ID significantly improved individual physical performance, self-efficacy for activity, fall efficacy and support from friends and support workers. CONCLUSIONS Fall prevention interventions for adults with ID living in group-homes were highly promising for eventual large-scale implementation within such communities.
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Affiliation(s)
- P Choi
- Department of Kinesiology, Sonoma State University, Rohnert Park, CA, USA
| | - R W Motl
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
| | - S Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
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Pope J, Truesdale M, Brown M. Risk factors for falls among adults with intellectual disabilities: A narrative review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:274-285. [PMID: 32945091 DOI: 10.1111/jar.12805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/17/2020] [Accepted: 08/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The prevalence of falls involving people with intellectual disabilities (ID) is high in comparison with the general population. There has been little evidence to date on the contributing risk factors. The objective of this review was to identify risk factors for people with intellectual disabilities. METHOD Literature searches were conducted using electronic databases to explore evidence on the subject, and narrative synthesis was employed to analyse the results. RESULTS Seven risk factors were identified: decreasing physical ability, epilepsy, paretic conditions, impulsiveness, previous falls, incontinence and non-use of assistive equipment. Thematic analysis identified factors across the four concepts: the person, the situation, ongoing and protective factors. CONCLUSION Factors for falls involving people with intellectual disabilities are dynamic and multifactorial. Some are specific to the population; however, further research is required to develop the understanding of the possible reasons. The findings have implications across policy, education, practice and research.
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Affiliation(s)
- John Pope
- Edinburgh Napier University, Edinburgh, UK
| | | | - Michael Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Ho P, Bulsara M, Downs J, Patman S, Bulsara C, Hill AM. Incidence and prevalence of falls in adults with intellectual disability living in the community: a systematic review. ACTA ACUST UNITED AC 2020; 17:390-413. [PMID: 30870331 DOI: 10.11124/jbisrir-2017-003798] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review was too synthesize the best available evidence on the incidence and prevalence of falls among adults with intellectual disability (ID). INTRODUCTION Falls among adults with ID frequently cause physical injury and may negatively impact on their quality of life. Studies investigating falls among people with ID have used differing methods and populations, making it difficult to determine the scope and extent of this problem. INCLUSION CRITERIA This review considered all studies that included adults with ID aged 18 years and over and which reported percentage/numbers of individuals who fell, and the total number of falls and injurious falls sustained from a fall. Studies were included if they were conducted within community or residential settings. Studies that were conducted in hospitals were excluded. Cohort studies, case-control and cross-sectional studies were included. Studies that used an experimental design, both randomized controlled and quasi experimental design, were also included. METHODS A three-step search strategy was undertaken for published and unpublished literature in English from 1990 to 2017. An initial search of MEDLINE and CINAHL was undertaken before a more extensive search was conducted using keywords and index terms across 11 electronic databases. Two independent reviewers assessed the methodological quality of the included studies using the Joanna Briggs Institute standardized critical appraisal instrument for prevalence studies (Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data).Data was extracted using the Joanna Briggs Institute's standardized extraction tool. Data that directly reported or could be used to calculate the incidence and prevalence of falls were extracted. Quantitative data for the number (proportion) of people who fell were pooled in statistical meta-analysis using STATA version 14 (Stata Corp LLC, Texas, USA). Data measuring incidence of falls (rate of falls for the duration of the study) and incidence of injurious falls (rate of falls resulting in one or more injuries for the duration of the study) could not be pooled in meta-analysis, hence results have been presented in a narrative form including tables. Standard GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence assessment of outcomes is also reported. RESULTS Nine studies were eligible for inclusion in this review. Eight articles were observational cohort studies which reported on the incidence/prevalence of falls as outcome measures, and one article was a quasi-experimental study design. Overall the methodological quality of the included studies was considered moderate. The pooled proportion of people with ID who fell (four studies, 854 participants) was 39% (95% CI [0.35%-0.43%], very low GRADE evidence). The rate of falls (eight studies, 782 participants) ranged from 0.54 to 6.29 per person year (very low GRADE evidence). The rate of injurious falls (two studies, 352 participants) ranged from 0.33 to 0.68 per person year (very low GRADE evidence). CONCLUSIONS Synthesized findings demonstrate that people with ID, who live in community or residential settings, may fall more frequently, and at a younger age, compared to general community populations. Studies should take a consistent approach to measuring and reporting falls outcomes. Further research is recommended to identify the impact of falls on health related outcomes for people with ID and subsequently evaluate falls interventions for their efficacy.
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Affiliation(s)
- Portia Ho
- School of Physiotherapy, the University of Notre Dame Australia, Fremantle, Australia.,The Western Australian Group for Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence
| | - Max Bulsara
- Institute for Health Research, the University of Notre Dame Australia, Fremantle, Australia
| | - Jenny Downs
- Telethon Kids Institute, Subiaco, Western Australia, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Shane Patman
- School of Physiotherapy, the University of Notre Dame Australia, Fremantle, Australia
| | - Caroline Bulsara
- Institute for Health Research, the University of Notre Dame Australia, Fremantle, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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Ho P, Bulsara C, Patman S, Downs J, Hill AM. Exploring enablers and barriers to accessing health services after a fall among people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:604-617. [PMID: 32039539 DOI: 10.1111/jar.12704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/09/2019] [Accepted: 01/15/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Adults with intellectual disability experience high rates of falls making falls prevention an important health need. The purpose of the study was to seek perspectives of older adults with intellectual disability and their caregivers to (a) explore the experiences of older adults with intellectual disability when seeking healthcare services after a fall and (b) identify enablers and barriers when taking up evidence-based falls recommendations. METHOD A qualitative exploratory study was undertaken as part of a prospective observational cohort study. Semi-structured interviews were conducted with a purposeful sample. Data were analysed thematically using Colaizzi's method. RESULTS Seventeen interviews were conducted (n = 21). Emergent themes demonstrated that participants had limited knowledge about falls prevention. Enablers included individualizing falls prevention strategies. Barriers included not being offered access to established falls prevention pathways. CONCLUSION There is an urgent need to develop high-quality falls prevention services for older adults with intellectual disability.
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Affiliation(s)
- Portia Ho
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Caroline Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Shane Patman
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Jenny Downs
- Telethon Kids Institute, Perth Children's Hospital, West Perth, WA, Australia.,Curtin University, Perth, WA, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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Ho P, Bulsara M, Patman S, Downs J, Bulsara C, Hill AM. Incidence and associated risk factors for falls in adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1441-1452. [PMID: 31497918 DOI: 10.1111/jir.12686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/03/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with intellectual disability (ID) experience age-related changes earlier in life, and as such, falls among people with ID are of serious concern. Falls can cause injury and consequently reduce quality of life. Limited studies have investigated the incidence of falls among people with ID and the associated risk factors. The purpose of this study was to investigate the incidence of falls and risk factors for falling in people with ID living in the community. METHODS A prospective observational cohort (n = 78) of community-dwelling adults with ID. Characteristics measured at baseline included falls history, medication use, balance and mobility. Falls were reported for 6 months using monthly calendars and phone calls. Data were analysed using univariate and multivariate logistic regression to identify risk factors associated with falling. RESULTS Participants [median (interquartile range) age 49 (43-60) years, female n = 32 (41%)] experienced 296 falls, with 36 (46.2%) participants having one or more falls. The incidence of falls was 5.7 falls (injurious falls = 0.8) per person year (one outlier removed from analysis). A history of falls [adjusted odds ratio (OR): 6.37, 95% confidence interval (CI) (1.90-21.34)] and being ambulant [adjusted OR: 4.50, 95% CI (1.15-17.67)] were associated with a significantly increased risk of falling. Falls were significantly less frequent among participants taking more than four medications [adjusted OR: 0.22, 95% CI (0.06-0.83)] and participants who were continent [adjusted OR: 0.25, 95% CI (0.07-0.91)]. CONCLUSIONS People with ID fall at a younger age compared with the broader community. The associated falls risk factors also differ to older community-dwelling adults. Health professionals should prioritise assessment and management of falls risk in this population.
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Affiliation(s)
- P Ho
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - M Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - S Patman
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - J Downs
- Telethon Kids Institute, Perth Children's Hospital, West Perth, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - C Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - A-M Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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Axmon A, Ahlström G, Sandberg M. Falls resulting in health care among older people with intellectual disability in comparison with the general population. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:193-204. [PMID: 30407691 PMCID: PMC7379981 DOI: 10.1111/jir.12564] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 09/25/2018] [Accepted: 10/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Falls are common among older people with intellectual disability (ID) and are also a major contributor to injuries in this population. Yet, fall characteristics have only been sparsely studied, and the results are inconsistent. The aim of the present study was to investigate type of falls, places where they occurred and activities that caused them, as well as health outcomes and health utilisation patterns after falls, among older people with ID in comparison with their age peers in the general population. METHODS We established an administrative cohort of people with ID aged 55 years, or more, and alive at the end of 2012 (ID cohort; n = 7936). A cohort from the general population, one-to-one matched by sex and year of birth, was used as referents. Data regarding fall-induced health care episodes in inpatient and outpatient specialist care were collected from the National Patient Register for the period 2002-2012. RESULTS With the exception of falls from one level to another (i.e. fall on and from stairs and steps, ladder and scaffolding; fall from, out of or through building or structure; fall from tree or cliff and diving or jumping into water; or other fall from one level to another), people in the ID cohort were more likely to fall and fall more often than those in the general population cohort. Falls during a vital activity (e.g. attending to personal hygiene or eating) were twice as common among people with ID compared with the general population. When falling, people with ID were more likely to injure their head and legs but less likely to sustain injuries to the thorax and elbow/forearm. They were more likely to have superficial injuries, open wounds and fractures but less likely to have dislocations, sprain and strains. Fall-related health care visits among people with ID were more likely to be in inpatient care and be unplanned. People with ID were also more likely than those in the general population to have a readmission within 30 days. CONCLUSIONS People with ID are more likely to require specialist care after a fall and also more likely to obtain injuries to the head, compared with the general population. This is important to consider when taking preventive measures to reduce falls and fall-related injuries.
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Affiliation(s)
- A. Axmon
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of MedicineLund UniversityLundSweden
- Department of Health Sciences, Faculty of MedicineLund UniversityLundSweden
| | - G. Ahlström
- Department of Health Sciences, Faculty of MedicineLund UniversityLundSweden
| | - M. Sandberg
- Department of Health Sciences, Faculty of MedicineLund UniversityLundSweden
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Ho P, Bulsara C, Patman S, Bulsara M, Downs J, Hill AM. Investigating falls in adults with intellectual disability living in community settings and their experiences of post-fall care services: protocol for a prospective observational cohort study. BMC Geriatr 2018; 18:171. [PMID: 30060735 PMCID: PMC6065066 DOI: 10.1186/s12877-018-0862-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 07/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain uncertain. Furthermore, people with ID rely heavily on familial and professional care support to address health problems, such as after having a fall. No studies have explored the post-fall care that people with ID receive. Method This research will be carried out in two phases using a convergent mixed methods design. The aim of Phase 1 is to estimate the falls rate by prospectively observing a cohort of older adults (≥ 35 years) with ID (n = 90) for six months. Phase 1 will be conducted according to STROBE guidelines. In Phase 2, participants from Phase 1 who have experienced a fall(s) will be asked to participate in a semi-structured interview to explore their post-fall experience. Discussion This study will determine the rate of falls among older adults with ID living in community based settings, which will assist to identify the extent of this problem. Data collected from the study will also aid in understanding the circumstance of falls and related falls risk factors in this cohort. This will include exploring any barriers that older adults with ID may encounter when seeking or undertaking recommended post-fall care advice. Findings from this research will potentially inform future development of falls prevention services for older adults with ID. This study has been approved by the University Human Research Ethics Committee. Trial registration The protocol for this study is registered with the Australian New Zealand Clinical Trial Registry (ACTRN12615000926538) on 7 September 2015. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368990&isReview=true
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Affiliation(s)
- Portia Ho
- School of Physiotherapy, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia.
| | - Caroline Bulsara
- Institute for Health Research, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia
| | - Shane Patman
- School of Physiotherapy, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia
| | - Max Bulsara
- Institute for Health Research, The University of Notre Dame Australia, 19 Mouat St, PO Box 1225, Fremantle, WA, 6959, Australia
| | - Jenny Downs
- Telethon Kids Institute, 100 Roberts Road, Subiaco, PO Box 855, West Perth, Western, 6872, Australia.,School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
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Bilik O, Damar HT, Karayurt O. Fall behaviors and risk factors among elderly patients with hip fractures. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700062] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Stack E. Falls are unintentional: Studying simulations is a waste of faking time. J Rehabil Assist Technol Eng 2017; 4:2055668317732945. [PMID: 31186938 PMCID: PMC6453082 DOI: 10.1177/2055668317732945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 08/31/2017] [Indexed: 11/15/2022] Open
Abstract
Researchers tend to agree that falls are, by definition, unintentional and that sensor algorithms (the processes that allows a computer program to identify a fall among data from sensors) perform poorly when attempting to detect falls 'in the wild' (a phrase some scientists use to mean 'in reality'). Algorithm development has been reliant on simulation, i.e. asking actors to throw themselves intentionally to the ground. This is unusual (no one studies faked coughs or headaches) and uninformative (no one can intend the unintentional). Researchers would increase their chances of detecting 'real' falls in 'the real world' by studying the behaviour of fallers, however, vulnerable, before, during and after the event: the literature on the circumstances of falling is more informative than any number of faked approximations. A complimentary knowledge base (in falls, sensors and/or signals) enables multidisciplinary teams of clinicians, engineers and computer scientists to tackle fall detection and aim for fall prevention. Throughout this paper, I discuss differences between falls, 'intentional falling' and simulations, and the balance between simulation and reality in falls research, finally suggesting ways in which researchers can access examples of falls without resorting to fakery.
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Affiliation(s)
- Emma Stack
- Faculty of Health Sciences, University
of Southampton, Southampton, UK
- SPHERE EPSRC Interdisciplinary Research
Collaboration, Universities of Bristol, Reading and Southampton, UK
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Skorpen S, Nicolaisen M, Langballe EM. Hospitalisation in adults with intellectual disabilities compared with the general population in Norway. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:365-377. [PMID: 26915087 DOI: 10.1111/jir.12255] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 10/16/2015] [Accepted: 12/02/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Previous studies have found that adults with intellectual disabilities (ID) are hospitalised more often than the general population (GP). This study investigates hospital discharge rates and main diagnostic causes for hospitalisation among administratively defined people with ID compared with the GP in Norway. METHOD Data from the Norwegian Labour and Welfare Service was combined with data from the Norwegian Patient Register (Ntotal = 1 764 072 and NID = 7573) for the period 2008-2011. Data from a Norwegian patient report generator and Statistics Norway are also analysed. RESULTS During the study period, 11% of people with ID and 11.5% of the GP were admitted to hospitals. The length of the average hospital stay was just over 4 days for both groups. Among those who were hospitalised, the majority were only admitted to hospital once during the study period: ID 66% and GP 70%. People with ID were admitted somewhat more often than people in the GP. Contrary to the GP, adults with ID were more frequently hospitalised at a younger age and less frequently at old age. The most common International Classification of Diseases diagnostic group for hospitalisation among people with ID is injury, poisoning and certain other consequences of external causes, whereas for the GP, it is diseases of the circulatory system. CONCLUSION This study finds that the proportion of people being hospitalised per year is statistically, but only slightly, different among adult people with ID and the GP. The results must be interpreted in light of the organisation of the health care system in Norway.
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Affiliation(s)
- S Skorpen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Norway
| | - M Nicolaisen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric Medicine, Oslo University Hospital, Norway
| | - E M Langballe
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric Medicine, Oslo University Hospital, Norway
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Finlayson J, Morrison J, Skelton DA, Ballinger C, Mantry D, Jackson A, Cooper SA. The circumstances and impact of injuries on adults with learning disabilities. Br J Occup Ther 2014. [DOI: 10.4276/030802214x14071472109833] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: People with learning disabilities experience higher rates of injury compared to the general population, but little is known about the circumstances and perceived impact of these injuries on people with learning disabilities themselves. Method: Content analysis was conducted from interviews with 113 adults with learning disabilities who had at least one injury in a 12-month period. Qualitative interviews were conducted with ten adults with learning disabilities (and their carers where appropriate) who had experienced serious or frequent injury or frequent falls with or without injury in a 12-month period. Findings: The most commonly reported contributory factors for injuries and/or falls were related to physical health status (for example, epilepsy) and the environment (for example, walking/banging into furniture or stairs/steps). In terms of perceived impact, the development of fear of walking outdoors unsupported or fear of crossing a road were highlighted. The non-use and misuse of assistive technology was also highlighted as a concern. Conclusion: These findings demonstrate that occupational therapists have a key role to play in tailoring injury and fall prevention strategies and interventions for people with learning disabilities. In particular, environmental assessment and monitored use of assistive technology is important.
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Affiliation(s)
- Janet Finlayson
- Senior Research Fellow, Glasgow Caledonian University, Institute of Applied Health Research, Glasgow
| | - Jillian Morrison
- Professor of General Practice, University of Glasgow, Institute of Health and Wellbeing, Glasgow
| | - Dawn Ann Skelton
- Professor of Health and Ageing, Glasgow Caledonian University, Institute of Applied Health Research, Glasgow
| | - Claire Ballinger
- Director NHIR Research Design Services, South Centre Faculty of Medicine, University of Southampton, National Institute for Health Research Design, Southampton
| | - Dipali Mantry
- Learning Disability Psychiatrist, NHS Greater Glasgow and Clyde, Glasgow
| | - Alison Jackson
- University Teacher, University of Glasgow, Institute of Health and Wellbeing, Glasgow
| | - Sally-Ann Cooper
- Professor of Learning Disabilities, University of Glasgow, Institute of Health and Wellbeing, Glasgow
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