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Aim This paper reports on a study undertaken to test the sensitivity, specificity and feasibility of four fall risk assessment tools. Background Falls risk assessment tools have been developed based on literature and findings from empirical studies, but the instruments often lack further testing in the clinical setting. Method Four falls risk assessment tools were tested simultaneously in this study. The data was collected in May-June 2006. All assessment tools were completed on a total of 1546 patients. Descriptive statistics were used for data analysis. Results The use of the instruments was moderately consistent among registered nurses, but the education provided did not entirely eliminate problems with accuracy. The sensitivity of the instruments was 57.1-100% and specificity was 24.9-69.3%. Conclusion The sensitivity and specificity of the instruments are important factors to consider when choosing an instrument. However, the strategies to educate staff and to intervene appropriately are equally important for an organization undertaking a proactive stance in mitigating the risk of falls. Implications for Nursing Management It is important for managers to test instruments in their own organizations and specific populations. It is also critical to carefully assess that the chosen instrument is easy and accurate in use. Language: en

Aim To evaluate currently available pediatric falls assessments instruments and to build a predictive fall model while also evaluating injury risk as a predictor of fall likelihood within the paediatric inpatient population. Background There is lack of paediatric-specific fall assessment instruments and little information on the exploration of injury risk as related to falls in hospitalized children. Method An ambispective, matched case-control design conducted in a sample of 100 inpatient paediatric patients. Results Two out of five instruments performed well to classify children at risk of falls. Longer length of stay, bleeding cautions/blood disorders and temperament/behaviour issues were significant predictors of fall likelihood. Cognitive impairment or neurological disease was not related to an increased likelihood of fall or injury risk for this sample. Conclusions More research is required to institute and standardize pediatric fall and injury risk assessments for everyday use. The explicit approach of using predictive modelling is critical in creating a universal, baseline reference for the most reliable and valid measure of assessment in children. Implications for nursing management Findings of the present study increase awareness of nursing managers and leaders as to the necessity for fall and injury risk assessment as a safety and quality measure for inpatient pediatric populations. Language: en

Objective Our objective was to describe how active transportation can help meet health and greenhouse gas emissions goals, and the ability of urban form strategies to impact both issues. In addition, we wanted to assess if there is an inverse relationship between active and motorized forms of travel. Methods A cross-sectional analysis of travel diary data was used to measure relationships among energy (kcal) burned from walking, energy (kcal) burned from motorized transportation, and the ratio of the two (the transport energy index) with regional accessibility and local walkability when adjusting for demographic factors. Multiple linear regression and descriptive statistics were employed to estimate these relationships. Results Transit accessibility, residential density, and intersection density were positive predictors of walk energy and the energy index and inverse predictors of motorized energy. The land use mix variable was negatively and significantly associated with energy burned from walking and from motorized transportation, with no significant impact on the transport energy index. Because a mixed land use pattern places destinations closer together, it reduces distances and thus energy demands for both walking and driving. Conclusions The results support the concept, previously untested empirically, that similar urban form strategies can have cobenefits for both physical activity and climate change.

Firearm fatalities occurring in Yorkshire and Humberside between 1975-1991 were examined; 130 cases were found, 64 were homicides, 55 suicides and 11 were accidental or unclassifiable. All but two of the suicides were men. Shotguns were the most frequent weapon used in both suicides and homicides. Of the 55 suicides, 17 were by men who had murdered before committing suicide. In 15 of these cases the assailants knew their victims. The other two cases involved murder of police officers. These cases were mostly with shotguns. In both homicide and suicide, rifled weapons and handguns were infrequently used. Most suicides and homicides occurred at home. Alcohol was again shown to be a significant factor in suicides. Overall firearms account for less than 10% of homicides in England and Wales and less than 5% of suicides in men and is most unusual in women.

In many landscapes, an important fire management objective is to reduce the negative impacts from unplanned fires on people, property and ecological values. In Australia, there exists an inherent assumption that high spatial variability in fire ages and hence fuel loads will have negative effects on both the incidence and spread of subsequent fires, and will enhance ecological values. A recent study using the process-based computer simulation model FIRESCAPE-SWTAS predicted several relationships between prescribed burn treatment levels and spatial patterning and management objectives in south-west Tasmania, Australia. The present study extended this investigation to additionally explore the effects of prescribed burning treatment unit size on unplanned fire incidence and area burned both in the general landscape and specifically in fire-intolerant vegetation. Simulation results suggest that treatment level had the greatest influence on modifying fire effects, whereas treatment unit size had the least effect. The model predicted that all three parameters interacted to determine the mean annual area burnt by unplanned fires. In fire-intolerant vegetation, treatment unit size did not influence the incidence of unplanned fires and the area burnt by unplanned fires in these communities. Where significant differences were evident, fire risk was reduced by higher treatment levels, deterministic spatial patterns of burning units, and smaller burning unit sizes.