Factors influencing fall prevention for patients with spinal cord injury from the perspectives of administrators in Canadian rehabilitation hospitals.

BACKGROUND: Fall prevention is a priority in Canadian tertiary rehabilitation hospitals. We aimed to understand the perspectives of hospital administrators on the challenges experienced when implementing fall prevention policies/procedures for patients with spinal cord injury (SCI) in tertiary rehabilitation hospitals. METHODS: Semi-structured interviews were conducted with 10 administrators employed in six Canadian tertiary rehabilitation hospitals. Guided by an interpretive description framework, interviews were analyzed using a constant comparison approach. RESULTS: Challenges with fall prevention experienced by administrators fell into the three categories: 1) fall prevention policy and procedural challenges (e.g. fall prevention policy not SCI-specific, expectation of zero falls, determining contributing factors, learning from falls, and overall effectiveness of the fall prevention policy), 2) clinician-related challenges (e.g. variable staff adherence with the organizations' fall prevention procedures, inconsistent delivery of fall prevention education, and integrating individualized fall risks to guide clinical practice), and 3) patient-related challenges (e.g. balancing risk vs independence and rehabilitation progress, responsibility for fall prevention, and non-preventable falls). CONCLUSIONS: Fall prevention policies/procedures required by the hospitals were insufficient for clinical practice in SCI rehabilitation.

Retrospective assessment of the validity and use of the community balance and mobility scale among individuals with subacute spinal cord injury.

STUDY DESIGN: This is a retrospective chart review. OBJECTIVES: The objective of this study was to evaluate the convergent validity, internal consistency and use of the Community Balance & Mobility Scale (CB&M) in individuals with incomplete spinal cord injury (iSCI) during inpatient rehabilitation. SETTING: This study was conducted in an SCI rehabilitation center in Canada. METHODS: Inpatient charts from January 2009 to October 2015 were screened. A chart was excluded if the inpatient was aged >65 years, did not complete a CB&M and/or had a comorbid condition. Demographics, CB&M score and injury-related characteristics were extracted. Berg Balance Scale (BBS), Six-Minute Walk Test (6 MWT) and Ten-Meter Walk Test (10 mWT) scores were obtained if completed within 1 week of the CB&M. χ2-Tests were used to identify CB&M items that were uniformly distributed, implying good discrimination between individuals. Convergent validity was assessed by correlating (Pearson's r) CB&M scores with BBS, 6 MWT and 10 mWT scores. Internal consistency (Cronbach's α) was evaluated. RESULTS: Thirty inpatients were included (23 male, 38.3±15.3 years old, three AIS C, 26 AIS D, C1-L4, 16 traumatic). BBS scores were ⩾51/56; however, CB&M scores showed a wider range (27-82/96). Unilateral Stance, Tandem Walking, Lateral Foot Scooting, Forward to Backward Walking and Descending Stairs showed uniform distributions. Scores on the CB&M correlated strongly with scores on the 6 MWT (r=0.72, P<0.001) and moderately strongly with 10 mWT and BBS scores (r=0.47-0.59, P=0.004-0.013). Cronbach's α=0.87. CONCLUSIONS: The CB&M is a valid measure in high-functioning individuals with iSCI. Prospective studies are required to further evaluate the psychometric properties of the CB&M as a measure of high-level balance for SCI.

Rapid open-air deposition of uniform, nanoscale, functional coatings on nanorod arrays.

Coating of high-aspect-ratio nanostructures has previously been achieved using batch processes poorly suited for high-throughput manufacturing. It is demonstrated that uniform, nanoscale coatings can be rapidly deposited on zinc oxide nanorod arrays in open-air using an atmospheric pressure spatial deposition system. The morphology of the metal oxide coatings is examined and good electrical contact with the underlying nanorods is observed. The functionality of the coatings is demonstrated in colloidal quantum dot and hybrid solar cells.

The selective fabrication of large-area highly ordered TiO2 nanorod and nanotube arrays on conductive transparent substrates via sol-gel electrophoresis.

Large-area free-standing arrays of TiO(2) nanorods and nanotubes were selectively synthesized on transparent conducting indium tin oxide substrates using sol-gel electrophoresis and anodic alumina (AAO) thin film templates. The effect of sol-gel ageing on the growth of TiO(2) was explained, providing a tailored ability to produce nanotubes and nanorods. An annular tungsten base electrode, stemming from the anodization of the AAO template, was found to be crucial to the growth of nanotubes. This was supported by a study of substrate annealing in a reducing atmosphere. The work can be readily adapted for the fabrication of free-standing arrays of other metal, metal oxide, and complex oxide nanorod and nanotube arrays on conducting substrates.