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BackgroundProhibiting falls and fall-related injuries is a major challenge for health care systems worldwide, as a substantial proportion of falls occur in older adults who are previously known to be either frail or at high risk for falls. Hence, preventive measures are needed to educate and minimize the risk for falls rather than just minimize older adults’ fall risk. Health apps have the potential to address this problem, as they enable users to self-assess their individual fall risk. ObjectiveThe objective of this study was to identify product features of a fall prevention smartphone app, which increase or decrease users’ satisfaction. In addition, willingness to pay (WTP) was assessed to explore how much revenue such an app could generate. MethodsA total of 96 participants completed an open self-selected Web-based survey. Participants answered various questions regarding health status, subjective and objective fall risk, and technical readiness. Seventeen predefined product features of a fall prevention smartphone app were evaluated twice: first, according to a functional (product feature is implemented in the app), and subsequently by a dysfunctional (product feature is not implemented in the app) question. On the basis of the combination of answers from these 2 questions, the product feature was assigned to a certain category (must-be, attractive, one-dimensional, indifferent, or questionable product feature). This method is widely used in user-oriented product development and captures users’ expectations of a product and how their satisfaction is influenced by the availability of individual product features. ResultsFive product features were identified to increase users’ acceptance, including (1) a checklist of typical tripping hazards, (2) an emergency guideline in case of a fall, (3) description of exercises and integrated workout plans that decrease the risk of falling, (4) inclusion of a continuous workout program, and (5) cost coverage by health insurer. Participants’ WTP was assessed after all 17 product features were rated and revealed a median monthly payment WTP rate of €5.00 (interquartile range 10.00). ConclusionsThe results show various motivating product features that should be incorporated into a fall prevention smartphone app. Results reveal aspects that fall prevention and intervention designers should keep in mind to encourage individuals to start joining their program and facilitate long-term user engagement, resulting in a greater interest in fall risk prevention.

Abstract Background Several large studies have identified factors associated with long-term outcome after orthopaedic injuries. However, long-term social and economic implications have not been published so far. The aim of this investigation is to study the long-term socio-economic consequences of patients sustaining severe trauma. Methods Patients treated at a level one trauma center were invited for a follow-up (at least 10 years) examination. There were 637 patients who responded and were examined. Inclusion criteria included injury severity score (ISS) ≥ 16 points, presence of lower and upper extremity fractures, and age between 3 and 60 years. Exclusion criteria included the presence of amputations and paraplegia. The socio-economic outcome was evaluated in three age groups: group I (< 18 years), group II (19 - 50 years), and group III (> 50 years). The following parameters were analyzed using a standardized questionnaire: financial losses, net income losses, pension precaution losses, need for a bank loan, and the decrease in number of friends. Results 510 patients matched all study criteria, and breakdown of groups were as follows: 140 patients in group I, 341 patients in group II, and 29 patients in group III. Financial losses were reported in all age groups (20%-44%). Younger patients (group I) were associated with less income losses when compared with other groups (p < 0.05). Financial deterioration was more frequently reported in age group II (p < 0.05). Social consequences (number of friends decreased) were predominantly stated in patients younger than 18 years old (p < 0.05). Conclusions Economic consequences are reported by polytraumatized patients even ten or more years after injury. Financial losses appear to be common in patients between 19 and 50 years. In contrast, social deprivation appears to be most pronounced in the younger age groups. Early socio-economic support and measures of injury prevention should focus on these specific age groups.

Background: In the current literature, the outcome of paediatric brain injury is controversially discussed. According to the majority of the studies, there seems to be a decreased mortality but worse recovery in paediatric, traumatic brain injury in comparison with adults. However, there is a lack of information concerning the differences in various stages of development in patients younger than 18 years. The aim of our study was to verify the in-hospital outcome of different paediatric age groups in comparison to adults with respect to the treatment strategy. Methods: We performed a retrospective analysis of the TraumaRegister DGU® from 2002 to 2012. Inclusion criteria were an Abbreviated Injury Scale (AIS) head ≥3 points and an AIS ≤2 points of the remaining body regions. The collective was divided into different subgroups according to age (1-3, 4-6, 7-10, 11-14, 15-17) and an adult control group aged between 18 and 55 years. We descriptively analysed the endpoint rate of sepsis, multiple organ failure, and mortality. Additionally, the Glasgow Outcome Scale (GOS) at discharge was observed. Results: Overall, 1110 children and 6491 adult control patients were included. Comparing the rate of intubation on-scene, the rate of cranial CT scans, the rate of craniotomies, and the rate and length of intensive care treatment, we could only identify minor differences between the age groups. The treatment after discharge from hospital was markedly different due to a very low rate of in-patient rehabilitation treatment in children. On one hand, the rate of systemic complications, such as sepsis and multiple organ failure increased with increasing age. On the other hand, we found a significantly increased mortality in children younger than 7 years after very (AIS head = 5) severe brain injury. The in-hospital functional outcome in survivors, according to the GOS, was beneficial for younger children in comparison to adolescents and adults. Conclusions: We were unable to identify marked age-related differences in the therapeutic approach. Nevertheless, we were able to demonstrate marked differences of outcome. Children younger than 7 years significantly die more often due to direct impact of severe trauma. But if they survive, they seem to develop less systemic complications and profit from a better functional outcome. [ABSTRACT FROM AUTHOR]

Tibial shaft fractures are common injuries in the pediatric and adolescent populations. Elastic stable intramedullary nailing (ESIN) is the treatment of choice for cases that require surgical stabilization. A new intramedullary device, BoneHelix® (BH), may be an alternative for use with fractures that cannot be satisfactorily stabilized with ESIN. This study aimed to assess the biomechanical performance of BH compared with ESIN in a porcine tibia fracture model, observing cyclic fatigue and load to failure. Computed tomography was used to monitor the implant position and to rule out unintended damage. No implant or bone failure occurred during the fatigue testing. An increase in the cumulative plastic displacement was observed in both test groups over the loading cycles applied. Both implant–bone constructs displayed a trend toward closure of the osteotomy gap. During the load-to-failure test, the average loads at failure in specimens instrumented with ESIN and BH were 5364 N (±723) and 4350 N (±893), respectively, which were not statistically significant (p = 0.11). The values of both groups were two to three times higher than the estimated maximal load (2000 N) during physiological weight bearing. The biomechanical results thus indicate equivalent performance and stability by the implants tested. [ABSTRACT FROM AUTHOR]