Brookside Museum

Abstract BackgroundFalls are a common reason that persons with cognitive impairment or dementia (PwCID) cannot remain at home. FallsTalk is a one‐month evidence‐based falls prevention program that focuses attention on the individual causes of losses of balance or falls. FallsTalk encourages new falls prevention behaviors, which have been shown to decrease falls. We adapted FallsTalk for family Caregiver (FCG) administration to a PwCID with a recent history of falls to determine if FallsTalk‐Caregiver could influence the number of new falls prevention behaviors reported by the FCG or the number of falls.MethodThirty‐four Dyads (FCG+PwCID) were trained to conduct brief daily falls prevention discussions together. Dyads were randomly assigned to receive either standardized paper (FallsTalk,n = 14) or computer‐tailored (FallsTalk‐Caregiver,n = 20) discussion suggestions based on prior concerns expressed by the FCG. All Dyads had FallsTalk training, had daily discussions together and received weekly check‐in calls. The FCGs reported weekly on the number of falls and new falls prevention behaviors (#newFPBs); as well as any changes in the PwCID’s health, care or living arrangements during the intervention period. FCGs continued to enter the number of falls and status changes weekly into a secure web‐site using a subject ID, until medical (significant health status change) or residential (no longer living at home permanently) endpoint was reached, or 52 weeks were completed. Poisson regression models compared the number of new falls prevention behaviors and weekly fall rate between groups. Fall rates were annualized for comparison with published residential care fall rates.ResultDyads receiving FallsTalk‐Caregiver reported significantly more #newFPBs (MeanPaper = 5.34 (SEM = 0.68, CI = 3.48‐5.93), MeanComputer = 8.46 (SEM = 0.76, CI = 7.48‐10.40); p = .004) during the intervention month. FallsTalk‐Caregiver PwCIDs experienced a significantly lower fall rate (MeanPaper = 0.073/week (SEM = .015, CI = 0.049‐0.109), MeanComputer = 0.040/week (SEM = .008, CI = 0.027‐0.060); p = .047). Annualized fall rates (Falls/year for Dyads with > = 12 weeks) were (MeanPaper = 3.64/year, n = 13; MeanComputer = 2.08/year, n = 19.ConclusionFallsTalk‐Caregiver provides an effective means to encourage new falls prevention behaviors to prevent losses of balance and falls. Despite the diversity of the Dyad’s home environment and varied PwCID diagnoses, FCGs matched or bettered the annual fall rates achieved by professional caregivers in skilled nursing facilities (Resident Falls/year = 2.33 (Residents without a PwCID diagnosis); 4.05 (Residents with a PwCID diagnosis).

FallsTalk is a one-month evidence-based falls prevention (FP) program that focuses attention on causes of an individual’s falls and encourages new FP behaviors. We translated the program for family caregivers of persons with cognitive impairment or dementia (PwCID) to administer to the PwCID and examined the number of new FP behaviors (#newFPBs) reported during the intervention period by the Caregiver. Thirty-four Dyads (Caregiver+PwCID) were trained to conduct brief daily FP discussions together using paper (FTCGnoTech) or computerized (FTCGTech, n=20) guidance. Dyads had FallsTalk training, daily discussions and weekly check-in calls. FTCGTech included discussion suggestions tailored to Caregiver concerns. To examine the use of technology, Poisson regression models compared #newFPBs between FTCGnoTech and FTCGTech and included covariates age (<80 or >=80), Mini-Mental Status Exam (MMSE >25 or <=25) and interactions. To evaluate the influence of Caregiver participation, #newFPBs reported by 115 non-demented clinical trial participants (no Caregiver- FT-ClTrNoCG) were compared with the Caregiver outcomes. Dyads using technology reported significantly more #newFPBs (MeanFTCGnoTech=5.34(SEM=0.68), MeanFTCGTech=8.46(SEM=0.76); p=.004) during the intervention month. A significant interaction was observed whereby Dyads with MMSE<=25 using technology, reported significantly more #newFPBs than the non-technology group (MeanFTCGnoTech=4.23(SEM=0.72), MeanFTCGTech=9.01(SEM=0.90); p=.047). Caregiver (n=34) involvement substantially increased #newFPBs (MeanFT-ClTrNoCG=1.39(SEM=0.15), MeanCaregiver=7.21(SEM=0.49); p<.0001), independent of technology. Across studies, participants or Caregivers for those with MMSE<=25 and <80yo reported significantly more #newFMBs (Mean=4.38(SEM=0.55) than those 80+yo (Mean=2.06(SEM=0.30); p=.0026). FallsTalk Caregiver provides an effective means to promote new Dyad FP strategies. The influence of Caregiver involvement and technology show promise in encouraging behavioral change to prevent falls.

ABSTRACT Hydrovolcanic eruptions occur when rising magma violently fragments while mixing with shallow surface water or groundwater. These eruptions, among the most violent on Earth, generate hundreds to thousands of explosions throughout the course of an eruptive event. Each of these explosions ejects a mixture of juvenile and accidental clasts, gas, and water droplets. The solid materials either fall to the ground from tephra jets or collapse to form pyroclastic density currents (PDCs). The deposits of these eruptions build up rings of bedded tuff around the vent, recording both a wide variety of pyroclastic depositional mechanisms, and important changes in the eruptive style with time. This field trip will explore the deposits of basaltic, hydrovolcanic eruptions in the Fort Rock–Christmas Valley basin, the location of an intermittent, fluctuating, widespread Pleistocene lake (Fossil Lake). Basaltic volcanoes erupted in the center of the lake basin are characterized by Surtseyan eruptions (standing water), along the lake basin margins by maar eruptions (groundwater), and beyond the lake margin by scoria cones. The focus of the trip will be Fort Rock (Surtseyan) and the Table Rock Complex (large Surtseyan-tuff cone, large maar, and seven minor craters). This trip offers the opportunity to examine (1) settings under which explosive hydrovolcanic eruptions occur, (2) depositional characteristics that infer eruptive conditions, (3) a wide variety of pyroclastic deposits (i.e., fallout through air or a body of water, eruption-fed subaqueous sediment gravity current deposits, PDC deposits), and (4) mega-dunes (200 m wavelength dunes associated with large scale, dilute, PDCs from an energetic, mafic hydrovolcanic eruption).