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Rating Scale, Standard Gamble, and Time Tradeoff for Persons with Traumatic Spinal Cord Injuries.
No full textA longitudinal study of risk factors for motorcycle crashes among junior college students in Taiwan
No full textThe effect of crash experience on changes in risk taking among urban and rural young people
No full textA 20-month prospective study was conducted to investigate the effect of motorcycle crash experience on changes in risk taking among 2514 urban and 2304 rural students in Taiwan. Risk taking was assessed using a 14-item self-administered questionnaire at the beginning and end of the study. A risk- taking score for each student at the initial and the last follow-up assessments was generated from adding up points across all 14 items. For exposure variables, the study documented past motorcycle crash history at the initial assessment and collected detailed information about any motorcycle crash involvement that occurred during the study period. A general linear mixed model was applied to assess the effects of prior and recent crash involvements on the path of risk-taking behavior. The results show that at the initial assessment, students with crash experience had higher risk-taking levels than those without crash experience. However, crash experience, irregardless of whether it was measured in terms of crash history prior to the study, crash frequency, time elapsed since the last crash, or crash severity, did not significantly change the risk-taking path among students, even though its effect differed between urban and rural areas. (C) 2003 Elsevier Science Ltd. All rights reserved
RATING SCALE, STANDARD GAMBLE, AND TIME TRADE-OFF FOR PEOPLE WITH TRAUMATIC SPINAL CORD INJURIES
No full textBackground and Purpose. The rating scale (RS), standard gamble (SG), and time trade-off (TTO) for people with traumatic spinal cord injuries (SCIs) have not been reported . This study compared psychometric performances of these preference-based measures among people with SCIs in Taiwan. Subjects and Methods. In total, 187 subjects from a nationwide registry of people with traumatic SCIs were interviewed by telephone. Score distributions, interrater reliability, discriminant ability, and convergent validity for the RS, SG, and TTO were compared. Results. The mean ( median) values of the RS, SG, and TTO were 0.67 (0.70), 0.64 (0.75), and 0.53 (0.50), respectively, and their corresponding intraclass correlation coefficients for intrarater and interrater test-retest reliability were 92 and .89, .78 and .73, and .91 and .78. Compared with the SG and TTO, the RS had fewer floor and ceiling values as well as percent changes, more missing observations, a larger effect size, and better discrimination ability. The results of Spearman correlation and factor analysis showed that the SG strongly converged with the TTO (r=.65, and in a single common factor), but they weakly converged with the RS (r=.33 with the SG and r=.27 with the TTO). In the linear regression models, the RS was significantly associated with neurological severity, employment, educational level, and self-care ability; the SG was associated with neurological severity and employment; and the TTO was associated only with neurological severity. Discussion and Conclusion. The RS generally performed better than the SG and TTO among people with traumatic SCIs; however, the underlying construct measured by the RS differed considerably from those measured by the SG and TTO
COMMUNITY-BASED TAI CHI AND ITS EFFECT ON INJURIOUS FALLS, BALANCE, GAIT, AND FEAR OF FALLING IN OLDER PEOPLE
No full textBackground and Purpose. It is important to determine the effect of adherence to a tai chi program on falls and related functional outcomes in older people. This study examined the effect of a community-based tai chi program on injurious falls, balance, gait, and fear of falling among people aged 65 years and older in Taiwan. Subjects and Methods. In 6 rural villages in Taichung County, 1,200 subjects participated in the initial assessment. During a 1- year intervention period, all study villages were provided with education on fall prevention. Two villages had been provided tai chi exercise (n=472 participants or "tai chi villagers"), and 4 villages served as control villages (n= 728 participants or "control villagers"). Injurious falls were ascertained by telephone interviews every 3 months over a 2-year study period; additionally, balance, gait, and fear of falling were assessed in 2 follow-up assessments. Results. Eighty-eight subjects, 83 from the tai chi villages and 5 from the control villages, participated and practiced in the tai chi program (the group labeled "tai chi practitioners"). After the tai chi program, injurious falls among the control villagers significantly declined by 44% ( adjusted rate ratio [RR] = 0.56; 95% confidence interval [CI ] = 0.36-0.92). Compared with the results for the control villagers, the decline was 31% greater (RR = 0.69; 95% CI = 0.30-1.56) among the tai chi villagers and 50% greater (RR = 0.5; 95% CI = 0.11-2.17) among the tai chi practitioners; the results did not reach statistical significance. Furthermore, compared with the scores for the control villagers, the scores for the tai chi practitioners increased by 1.8 points (95% CI = 0.2-3.4) on the Tinetti Balance Scale and increased by 0.9 point (95% CI = 0.1-1.8) on the Tinetti Gait Scale. No significant changes in the fear of falling were detected among the tai chi practitioners, tai chi villagers, and control villagers. Discussion and Conclusion. Tai chi can prevent a decline in functional balance and gait among older people. However, the reduction in injurious falls attained with tai chi did not reach statistical significance; the statistical inefficiency may have resulted partly from the large decline in injurious falls in control villagers. Finally, the unexpected effect of educational intervention on reducing injurious falls in different settings needs to be further examined
Effects of fall injury type and discharge placement on mortality, hospitalization, falls, and ADL changes among older people in Taiwan
No full textA longitudinal study was conducted to investigate the effects of injury type and discharge placement on mortality, falls, hospital admissions, and changes in activities of daily living (ADLs) over a 12-month period among older fallers. Of 762 community-dwelling people aged 65 years or older who visited an emergency department (ED) of a general hospital in Taiwan due to a fall, 273 sustained a hip fracture, 157 had a vertebral fracture, 47 had a distal forearm fracture, 102 had a traumatic brain injury, and 183 had soft-tissue injuries. Results showed that, compared to patients with a soft-tissue injury, those with TBI had significantly higher risks of dying (rate ratio (RR) = 3.59) and hospital admissions (RR = 3.23) and better improvement in ADLs (1.93 points) at 6 months post-injury, and those who sustained a hip fracture (4.26 and 4.41 points), a vertebral fracture (3.81 and 3.83 points), or a distal-forearm fracture (2.80 and 2.80 points) had significantly better improvement in ADLs at 6 and 12 months post-injury. Patients discharged to a nursing home had a significantly increased risk of death (RR = 2.08) and hospital admission (RR = 2.05) than those returning to their usual residence during the first year post-injury. No significant differences in the occurrence of falls during the first post-injury year were found among patients with different injury types or between those with different discharge placements. In conclusion, among the five major fall injury types in older people, TBIs result in the highest risk of death and hospital admissions, while hip and vertebral fractures exhibited the largest improvement during the first year after injury. Additionally, nursing home care may be associated with increased risks of death and hospital admissions than home care. In addition to primary prevention of falls, further research to investigate mechanisms leading to TBIs during a fall is needed to facilitate effective secondary fall-prevention programs for older people. (C) 2012 Elsevier Ltd. All rights reserved
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