Impact of fear of falling for patients and caregivers: perceptions before and after participation in vestibular and balance rehabilitation therapy.

PURPOSE: The purpose of this study was to investigate the impact of fear of falling (FoF) on older patients with dizziness history and their caregivers to better determine holistic needs when developing a patient-family centered approach to falling risk reduction. METHOD: A mixed-method design was used, incorporating a phenomenological qualitative approach to explore the impact of FoF in 14 patients and a family member or spouse of each patient. Quantitative analysis was used to further interpret results of interviews conducted before and after participation in a vestibular and balance rehabilitation program designed to reduce falling risk and improve balance confidence. RESULTS: Qualitative analysis of participant interviews pre and post vestibular rehabilitation revealed lifestyle changes for both participants and family caregivers due to FoF and the need for reducing falling concerns. Patient age showed statistically significant differences in levels of balance confidence, with younger participants (≤ 65 years) showing more concerns about the consequences of falling, even after rehabilitation, than older participants (> 65 years). CONCLUSION: The study highlights the impact of FoF on participation and activity levels of patients and family caregivers, as well as the need to thoroughly evaluate falling fears to achieve a holistic rehabilitation outcome.

Noise impacts from professional dog grooming forced-air dryers.

This study was designed to measure the sound output of four commonly used brands of forced-air dryers used by dog groomers in the United States. Many dog groomers have questions about the effect of this exposure on their hearing, as well as on the hearing of the dogs that are being groomed. Readings taken from each dryer at 1 meter (the likely distance of the dryer from the groomer and the dog) showed average levels ranging from 105.5 to 108.3 dB SPL or 94.8 to 108.0 dBA. Using the 90 dBA criterion required by the US Occupational Safety and Health Administration, dog groomers/bathers are at risk if exposure to the lowest intensity dryer (94.8 dBA) exceeds 4 hours per day. If the more stringent 85 dBA criterion and 3 dB tradeoff is applied, less than one hour of exposure is permissible in an 8 hour day. Cautions are recommended for any persons exposed to noise from forced-air dryers.

Introduction to Clinical Forum.

The issues presented in this forum concerning the development of communication and literacy abilities in school-age children who are deaf or hard of hearing are introduced in this article. The author organized this forum in an effort to renew conversation on the topics of teacher talk, the contemporary assessment of communication, best practices in the mainstream, interpersonal and school discourse as organizers for intervention, choosing sign language and sign systems, and working with marginal/at-risk students who are deaf or hard of hearing. The benefits of qualitative research to clinicians and teachers who seek local answers regarding these topics is stressed in the conclusion.