Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Ehrenreich H[original query] |
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Healthcare providers' perceptions and self-reported fall prevention practices: findings from a large New York health system
Smith ML , Stevens JA , Ehrenreich H , Wilson AD , Schuster RJ , Cherry CO , Ory MG . Front Public Health 2015 3 17 Among older adults, falls are the leading cause of injury-related deaths and emergency department visits, and the incidence of falls in the United States is rising as the number of older Americans increases. Research has shown that falls can be reduced by modifying fall-risk factors using multifactorial interventions implemented in clinical settings. However, the literature indicates that many providers feel that they do not know how to conduct fall-risk assessments or do not have adequate knowledge about fall prevention. To help healthcare providers incorporate older adult fall prevention (i.e., falls risk assessment and treatment) into their clinical practice, the Centers for Disease Control and Prevention's (CDC) Injury Center has developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool kit. This study was conducted to identify the practice characteristics and providers' beliefs, knowledge, and fall-related activities before they received training on how to use the STEADI tool kit. Data were collected as part of a larger State Fall Prevention Project funded by CDC's Injury Center. Completed questionnaires were returned by 38 medical providers from 11 healthcare practices within a large New York health system. Healthcare providers ranked falls as the lowest priority of five conditions, after diabetes, cardiovascular disease, mental health, and musculoskeletal conditions. Less than 40% of the providers asked most or all of their older patients if they had fallen during the past 12 months. Less than a quarter referred their older patients to physical therapists for balance or gait training, and <20% referred older patients to community-based fall prevention programs. Less than 16% reported they conducted standardized functional assessments with their older patients at least once a year. These results suggest that implementing the STEADI tool kit in clinical settings could address knowledge gaps and provide the necessary tools to help providers incorporate fall-risk assessment and treatment into clinical practice. |
Fall prevention in community settings: results from implementing tai chi: moving for better balance in three States
Ory MG , Smith ML , Parker EM , Jiang L , Chen S , Wilson AD , Stevens JA , Ehrenreich H , Lee R . Front Public Health 2014 2 258 Tai Chi: Moving for Better Balance (TCMBB) is an evidence-based fall prevention exercise program being disseminated in selected communities through state injury prevention programs. This study: (1) describes the personal characteristics of TCMBB participants; (2) quantifies participants' functional and self-reported health status at enrollment; and (3) measures changes in participants' functional and self-reported health status post-intervention. There were 421 participants enrolled in 36 TCMBB programs delivered in Colorado, New York, and Oregon. Of the 209 participants who completed both baseline enrollment and post-intervention surveys, the average age of participants was 75.3 (SD ± 8.2) years. Most participants were female (81.3%), non-Hispanic (96.1%), White (94.1%), and described themselves as in excellent or very good health (52.2%). Paired t-test and general estimating equation models assessed changes over the 3-month program period. Pre- and post-assessment self-reported surveys and objective functional data [Timed Up and Go (TUG) test] were collected. On average, TUG test scores decreased (p < 0.001) for all participants; however, the decrease was most noticeable among high-risk participants (mean decreased from 18.5 to 15.7 s). The adjusted odds ratio of reporting feeling confident that a participant could keep themselves from falling was five times greater after completing the program. TCMBB, which addresses gait and balance problems, can be an effective way to reduce falls among the older adult population. By helping older adults maintain their functional abilities, TCMBB can help community-dwelling older adults continue to live independently. |
Circumstances and outcomes of falls among high risk community-dwelling older adults
Stevens JA , Mahoney JE , Ehrenreich H . Inj Epidemiol 2014 1 (5) BACKGROUND: For older adults, falls threaten their health, independence, and quality of life. Knowing the circumstances surrounding falls is essential for understanding how behavioral and environmental factors interact in fall events. It is also important for developing and implementing interventions that are effective and acceptable to older adults. This study investigated the circumstances and injury outcomes of falls among community-dwelling older adults at high risk of falling. METHODS: In this secondary analysis, we examined the circumstances and outcomes of falls experienced by 328 participants in the Dane County (Wisconsin) Safety Assessment for Elders (SAFE) Research Study. SAFE was a randomized controlled trial of a community-based multifactorial falls intervention for older adults at high risk for falls, conducted from October 2002 to December 2007. Participants were community-dwelling adults aged ≥65 years who reported at least one fall during the year after study enrollment. Falls were collected prospectively using monthly calendars. Everyone who reported a fall was contacted by telephone to determine the circumstances surrounding the event. Injury outcomes were defined as none, mild (injury reported but no treatment sought), moderate (treatment for any injury except head injury or fracture), and severe (treatment for head injury or fracture). RESULTS: Data were available for 1,172 falls. A generalized linear mixed model analysis showed that being age ≥85 (OR = 2.1, 95% confidence interval [CI] = 1.2-3.9), female (OR = 2.1, 95% CI = 1.3-3.4), falling backward and landing flat (OR = 5.6, 95% CI = 2.9-10.5), sideways (OR = 4.6, 95% CI = 2.6-8.0) and forward (OR = 3.3, 95% CI = 2.0-5.7) were significantly associated with the likelihood of injury. Of 783 falls inside the home, falls in the bathroom were more than twice as likely to result in an injury compared to falls in the living room (OR = 2.4, 95% CI = 1.2-4.9). CONCLUSIONS: Most falls among these high risk older adults occurred inside the home. The likelihood of injury in the bathroom supports the need for safety modifications such as grab bars, and may indicate a need for assistance with bathing. These findings will help clinicians tailor fall prevention for their patients and have practical implications for retirement and assisted living communities and community-based fall prevention programs. |
Marijuana use from middle to high school: co-occurring problem behaviors, teacher-rated academic skills and sixth-grade predictors
Ehrenreich H , Nahapetyan L , Orpinas P , Song X . J Youth Adolesc 2014 44 (10) 1929-40 Rising marijuana use and its lowered perceived risk among adolescents highlight the importance of examining patterns of marijuana use over time. This study identified trajectories of marijuana use among adolescents followed from middle through high school, characterized these by co-occurring problem behaviors and teacher-rated academic skills (study skills, attention problems, and learning problems), and tested sixth-grade predictors of trajectory membership. The sample consisted of a randomly-selected cohort of 619 students assessed annually from sixth to twelfth grade. Using group-based modeling, we identified four trajectories of marijuana use: Abstainer (65.6 %), Sporadic (13.9 %), Experimental (11.5 %), and Increasing (9.0 %). Compared to Abstainers, students in the Sporadic, Experimental and Increasing trajectories reported significantly more co-occurring problem behaviors of alcohol use, cigarette smoking, and physical aggression. Sporadic and Experimental users reported significantly less smoking and physical aggression, but not alcohol use, than Increasing users. Teachers consistently rated Abstainers as having better study skills and less attention and learning problems than the three marijuana use groups. Compared to Abstainers, the odds of dropping out of high school was at least 2.7 times higher for students in the marijuana use trajectories. Dropout rates did not vary significantly between marijuana use groups. In sixth grade, being male, cigarette smoking, physical aggression and attention problems increased the odds of being in the marijuana use trajectories. Multiple indicators-student self-reports, teacher ratings and high school dropout records-showed that marijuana was not an isolated or benign event in the life of adolescents but part of an overall problem behavior syndrome. |
With graduation in sight: perceptions of high- and low-aggression students of the journey to high school completion
Ehrenreich H , Reeves PM , Corley S , Orpinas P . Sch Psychol Q 2012 27 (4) 198-209 This study explores students' perceptions of the paths to high school graduation using an ecological framework. Specifically, it identifies the challenges, influences, and motivations differentiating students who remained in school despite being at high risk for dropping out-defined as consistently high levels of aggression-from students at low risk of high school dropout. We analyzed inductively 16 focus groups conducted in Northeast Georgia with 81 eleventh graders participating in the Healthy Teens Longitudinal Study. Eight focus groups consisted of 11th graders who consistently scored high on aggression from 6th to 10th grade on the Problem Behaviors Frequency Scales (n = 40; 56% boys; 54% Caucasian, 39% African American; 7% Hispanic), and 8 groups consisting of students scoring low in aggression at all time points (n = 41; 40% boys; 45% Caucasian, 50% African American; 3% Hispanic). Findings derived from the constant comparative method revealed 4 distinguishing themes. High aggressive students highlighted a) the salience of structural barriers, b) stress due to external (vs. internal) factors, c) preference for concrete sources of motivation, and d) the strong influence of coaches. At the microsystem level of the ecological model, school psychologists can engage students through cognitive behavioral methods to foster realistic academic goals and to improve management of external sources of stress. At the mesosystem level, school policies can target 9th grade as a critical juncture for academic success. The final finding supports the involvement of adults at the mesosystem level, and coaches in particular, to promote positive social and academic development. (PsycINFO Database Record (c) 2013 APA, all rights reserved). |
The National Amyotrophic Lateral Sclerosis (ALS) registry
Antao VC , Horton DK . J Environ Health 2012 75 (1) 28-30 A myotrophic lateral sclerosis (ALS) is a progressive and often fatal neuromuscular disease. Most people die within 2–5 years of being diagnosed with ALS (Mitsumoto, Chad, & Pioro, 1998). Community concerns about perceived clusters of cases of ALS have challenged public health agencies to consider the possible contribution of environmental contaminants to the development of this disease. The general categories of possible environmental risk factors that have been investigated include heavy metals, trace elements, solvents and other volatile organic chemicals, ionizing and non-ionizing radiation, and agricultural chemicals. | Several investigations have been conducted of heavy metal exposure, particularly lead, as a risk factor for ALS. Some case-control studies demonstrated a positive association between past exposure to lead and risk of ALS (Armon, Kurland, Daube, & O’Brien, 1991; Kamel et al., 2002; Roelofs-Iverson, Mulder, Elveback, Kurland, & Molgaard, 1984). Also, the epidemiologic literature offers some support for an association between ALS and past exposure to organic solvents (Gunnarsson, Lindberg, Söderfeldt, & Axelson, 1991; McGuire et al., 1997). | In addition, certain occupations, such as military work, have been listed as a risk factor for ALS (Nicholas et al., 1998; Schulte, Burnett, Boeniger, & Johnson, 1996; Sutedja et al., 2009; Weisskopf et al., 2005). Several other potential risk factors have been evaluated in the scientific literature including infectious agents (Fang et al., 2011), nutritional intake (Okamoto, Kihira, Kobashi et al., 2009; Wang et al., 2011; Woolsey, 2008), physical activity, and trauma (Beghi et al., 2010; Okamoto, Kihira, Kondo et al., 2009; Piazza, Siren, & Ehrenreich, 2004; Strickland, Smith, Dolliff, Goldman, & Roelofs, 1996). | The uncertainty about the incidence and prevalence of ALS, as well as the lack of knowledge about the role of environmental exposures in the etiology of ALS, has created a need for structured data collection. In 2008, President Bush signed the ALS Registry Act into law, allowing the Agency for Toxic Substances and Disease Registry (ATSDR) to create the National ALS Registry. The purpose of the registry is to quantify the incidence and prevalence of ALS in the U.S., describe the demographics of persons with ALS, and examine risk factors for the disease. |
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