The Flooring for Injury Prevention (FLIP) Study of compliant flooring for the prevention of fall-related injuries in long-term care: A randomized trial.

BACKGROUND: Fall-related injuries exert an enormous health burden on older adults in long-term care (LTC). Softer landing surfaces, such as those provided by low-stiffness "compliant" flooring, may prevent fall-related injuries by decreasing the forces applied to the body during fall impact. Our primary objective was to assess the clinical effectiveness of compliant flooring at preventing serious fall-related injuries among LTC residents. METHODS AND FINDINGS: The Flooring for Injury Prevention (FLIP) Study was a 4-year, randomized superiority trial in 150 single-occupancy resident rooms at a single Canadian LTC site. In April 2013, resident rooms were block randomized (1:1) to installation of intervention compliant flooring (2.54 cm SmartCells) or rigid control flooring (2.54 cm plywood) covered with identical hospital-grade vinyl. The primary outcome was serious fall-related injury over 4 years that required an emergency department visit or hospital admission and a treatment procedure or diagnostic evaluation in hospital. Secondary outcomes included minor fall-related injury, any fall-related injury, falls, and fracture. Outcomes were ascertained by blinded assessors between September 1, 2013 and August 31, 2017 and analyzed by intention to treat. Adverse outcomes were not assessed. During follow-up, 184 residents occupied 74 intervention rooms, and 173 residents occupied 76 control rooms. Residents were 64.3% female with mean (SD) baseline age 81.7 (9.5) years (range 51.1 to 104.6 years), body mass index 25.9 (7.7) kg/m2, and follow-up 1.64 (1.39) years. 1,907 falls were reported; 23 intervention residents experienced 38 serious injuries (from 29 falls in 22 rooms), while 23 control residents experienced 47 serious injuries (from 34 falls in 23 rooms). Compliant flooring did not affect odds of ≥1 serious fall-related injury (12.5% intervention versus 13.3% control, odds ratio [OR]: 0.98, 95% CI: 0.52 to 1.84, p = 0.950) or ≥2 serious fall-related injuries (5.4% versus 7.5%, OR: 0.74, 95% CI: 0.31 to 1.75, p = 0.500). Compliant flooring did not affect rate of serious fall-related injuries (0.362 versus 0.422 per 1,000 bed nights, rate ratio [RR]: 1.04, 95% CI: 0.45 to 2.39, p = 0.925; 0.038 versus 0.053 per fall, RR: 0.81, 95% CI: 0.38 to 1.71, p = 0.560), rate of falls with ≥1 serious fall-related injury (0.276 versus 0.303 per 1,000 bed nights, RR: 0.97, 95% CI: 0.52 to 1.79, p = 0.920), or time to first serious fall-related injury (0.237 versus 0.257, hazard ratio [HR]: 0.92, 95% CI: 0.52 to 1.62, p = 0.760). Compliant flooring did not affect any secondary outcome in this study. Study limitations included the following: findings were specific to 2.54 cm SmartCells compliant flooring installed in LTC resident rooms, standard fall and injury prevention interventions were in use throughout the study and may have influenced the observed effect of compliant flooring, and challenges with concussion detection in LTC residents may have prevented estimation of the effect of compliant flooring on fall-related concussions. CONCLUSIONS: In contrast to results from previous retrospective and nonrandomized studies, this study found that compliant flooring underneath hospital-grade vinyl was not effective at preventing serious fall-related injuries in LTC. Future studies are needed to identify effective methods for preventing fall-related injuries in LTC. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01618786.

Modelling the cost-effectiveness of impact-absorbing flooring in Swedish residential care facilities.

OBJECTIVE: Fall-related injuries among the elderly, specifically hip fractures, cause significant morbidity and mortality as well as imposing a substantial financial cost on the health care system. Impact-absorbing flooring has been advocated as an effective method for preventing hip fractures resulting from falls. This study identifies the cost-effectiveness of impact-absorbing flooring compared to standard flooring in residential care facilities for the elderly in a Swedish setting. METHOD: An incremental cost-effectiveness analysis was performed comparing impact-absorbing flooring to standard flooring using a Markov decision model. A societal perspective was adopted and incremental costs were compared to incremental gains in quality-adjusted life years (QALYs). Data on costs, probability transitions and health-related quality of life measures were retrieved from the published literature and from Swedish register data. Probabilistic sensitivity analysis was performed through a Monte Carlo simulation. RESULTS: The base-case analysis indicates that the impact-absorbing flooring reduces costs and increases QALYs. When allowing for uncertainty we find that 60% of the simulations indicate that impact-absorbing flooring is cost-saving compared to standard flooring and an additional 20% that it has a cost per QALY below a commonly used threshold value CONCLUSIONS: : Using a modelling approach, we find that impact-absorbing flooring is a dominant strategy at the societal level considering that it can save resources and improve health in a vulnerable population.

Evaluation of litter type and dietary coarse ground corn inclusion on broiler live performance, gastrointestinal tract development, and litter characteristics.

Two 49 d floor pen studies were conducted to evaluate the effects of litter type and dietary coarse ground corn (CC) inclusion on broiler live performance, gastrointestinal tract (GIT) development, and litter characteristics. Experiment 1 was a 2×2 factorial arrangement of 2 genders (male or female) and 2 CC levels (0 or 50%). From 15 to 35 d, the addition of CC decreased feed intake (P<0.01) and BW gain (P<0.05) of males but not females. The inclusion of CC decreased feed intake (P<0.01) and BW gain (P<0.01) from 0 to 49 d but improved adjusted feed conversion ratio (AdjFCR) from 35 to 49 d (P<0.05). Male broilers exhibited better live performance than females during the study as evidenced by greater feed intake (P<0.01) and BW gain (P<0.01), and improved FCR (P<0.01), but with increased mortality (P<0.05). The inclusion of CC increased relative gizzard weight (P<0.01) and decreased relative proventriculus weight (P<0.01) at 49 d. Experiment 2 was a 2×2 factorial arrangement of 2 CC levels (0 or 50%) and 2 litter types (ground old litter or new wood shavings litter). The inclusion of CC decreased feed intake throughout the experiment without affecting final BW when only males were used and improved FCR after 25 d (P<0.01). New litter improved FCR from 1 to 14 d (P<0.01). At 49 d, the birds fed the CC diet had reduced excreta nitrogen (P<0.05) and litter moisture (P<0.05). In conclusion, 50% CC inclusion initially produced negative effects on live performance that became positive as BW increased. The effects of CC became evident at an earlier age for males. New litter had only a marginal benefit on broiler live performance.

Effects of dietary coarsely ground corn and litter type on broiler live performance, litter characteristics, gastrointestinal tract development, apparent ileal digestibility of energy and nitrogen, and intestinal morphology.

The objectives of this study were to evaluate the effects of the dietary inclusion of 2 coarsely ground corn (CC) levels (0 or 50%) in diets of broilers reared on 2 litter types (new wood shavings or used litter) on live performance, litter characteristics, gastrointestinal tract (GIT) development, apparent ileal digestibility (AID) of energy and nitrogen (N), and intestinal morphology. No interaction effects between CC level and litter type were observed on live performance. No litter effect was observed on live performance. Dietary inclusion of 50% CC increased BW at 35 d (P<0.01) and improved cumulative feed conversion ratio (FCR) at 35 and 49 d of age (P<0.01). The 50% CC treatment increased absolute and relative gizzard weight (P<0.01) and decreased jejunum unit weight (g/cm) (P<0.01). The new litter treatment (litter N) increased absolute and relative proventriculus weight (P<0.05) but did not affect gizzard weight. An interaction effect between CC level and litter type was observed for litter N, where the 50% CC treatment reduced litter N regardless of litter type (P<0.01), but litter N was reduced by new litter only among birds fed 0% CC (P<0.05). The 50% CC inclusion increased litter pH (P<0.05) and improved the AID of energy and N by 6.8% (P<0.01) and 3.5% (P<0.05), respectively. The 50% CC treatment increased jejunum villi tip width (P<0.05) and villi surface area (P<0.01), and decreased the muscularis layer thickness (P<0.01), whereas new litter increased jejunum villi and ileum villi height (P<0.05), jejunum villi surface area (P<0.01), and the ratio of jejunum villi height to crypt depth (P<0.01). This study showed that birds fed pelleted and screened diets containing 50% CC exhibited improved BW, FCR, and AID of energy and N, in conjunction with altered morphology of the GIT and intestinal mucosa. Litter type affected some GIT traits and functions but did not affect live performance.

Evaluation of two working methods for screed floor layers on musculoskeletal complaints, work demands and workload.

Screed floors are bound by sand-cement (SF) or by anhydrite (AF). Sand-cement floors are levelled manually and anhydrite floors are self-levelling and therefore differences in work demands and prevalences of musculoskeletal complaints might occur. The objective was to assess among SF layers and AF layers (1) the prevalence of musculoskeletal complaints and (2) the physical work demands, energetic workload, perceived workload and discomfort. A questionnaire survey and an observational field study were performed. Compared with AF layers (n = 35), SF layers (n = 203) had higher, however, not statistically significant different, prevalences of neck (20% vs. 7%), shoulder (27% vs. 13%), low back (39% vs. 26%) and ankles/feet (9% vs. 0%) complaints. Sand-cement-bound screed floor layers (n = 18) bent and kneeled significantly longer (Δ77 min and Δ94 min; respectively), whereas AF layers (n = 18) stood significantly longer (Δ60 min). The work demands of SF layers exceeded exposure criteria for low back and knee complaints and therefore new working measures should be developed and implemented. PRACTITIONER SUMMARY: In comparison with anhydrite-bound screed floor layers, sand-cement-bound screed floor layers exceeded exposure criteria for work-related low back and knee complaints. New working methods and measures for sand-cement-bound screed floor layers should be developed and implemented to reduce the risk for work-related musculoskeletal complaints.

The welfare of dairy cows is improved in relation to cleanliness and integument alterations on the hocks and lameness when sand is used as stall surface.

Lying down is a highly prioritized behavior in dairy cattle, and previous studies have shown that the type of stall surface has a great effect on the health and welfare of the cow. The objective of this study was to examine the effect of stall surface (rubber mats, mattresses, or sand) on cleanliness, integument alterations on the hocks, lameness, and milk yield of loosely housed dairy cows. Thirty-seven Danish dairy farms with Danish Holstein-Friesian cows were included in the study, and 2,593 cows were examined. Twelve of the farms used rubber mats, 17 of the farms used mattresses, and 8 used sand as the stall surface. Cows housed in facilities with sand in the freestalls were at lower risk of being dirty, had fewer integument alterations on the hocks (e.g., hairless patches, lesions, and swellings), and were less likely to be lame. The cows in facilities with sand in the freestalls also had a significantly higher milk yield compared with cows housed in facilities with mattresses. No differences in milk yield were found between cows housed in facilities with mattresses and rubber mats. Cleanliness, integument alterations, lameness, and milk yield are important indicators of cow welfare; this study showed that, compared with other stall surfaces, sand had a positive effect on these indicators. We therefore conclude that the use of sand as a stall surface is associated with improved welfare.

Household finished flooring and soil-transmitted helminth and Giardia infections among children in rural Bangladesh and Kenya: a prospective cohort study.

BACKGROUND: Soil-transmitted helminths and Giardia duodenalis are responsible for a large burden of disease globally. In low-resource settings, household finished floors (eg, concrete floors) might reduce transmission of soil-transmitted helminths and G duodenalis. METHODS: In a prospective cohort of children nested within two randomised trials in rural Bangladesh and Kenya, we estimated associations between household finished flooring and soil-transmitted helminths and G duodenalis prevalence. In 2015-16, we collected stool samples from children aged 2-16 years in rural Bangladesh and Kenya. We detected soil-transmitted helminth infection using quantitative PCR (qPCR; Bangladesh n=2800; Kenya n=3094), and G duodenalis using qPCR in Bangladesh (n=6894) and ELISA in Kenya (n=8899). We estimated adjusted prevalence ratios (aPRs) using log-linear models adjusted for potential confounders. FINDINGS: 7187 (92·2%) of 7795 children in Bangladesh and 9077 (93·7%) of 9686 children in Kenya provided stool specimens that were analysed by qPCR. At enrolment, 691 (10%) households in Bangladesh and 471 (5%) households in Kenya had finished floors. In both countries, household finished flooring was associated with lower Ascaris lumbricoides prevalence (Bangladesh aPR 0·33, 95% CI 0·14-0·78; Kenya 0·62, 0·39-0·98) and any soil-transmitted helminths (Bangladesh 0·73, 0·52-1·01; Kenya 0·57, 0·37-0·88). Household finished floors were also associated with lower Necator americanus prevalence in Bangladesh (0·52, 0·29-0·94) and G duodenalis prevalence in both countries (Bangladesh 0·78, 0·64-0·95; Kenya 0·82, 0·70-0·97). INTERPRETATION: In low-resource settings, living in households with finished floors over a 2-year period was associated with lower prevalence of G duodenalis and some soil-transmitted helminths in children. FUNDING: Bill & Melinda Gates Foundation and Task Force for Global Health.

Soil versus Pond Ash Surfacing of Feedlot Pens: Occurrence of Escherichia coli O157:H7 in Cattle and Persistence in Manure.

Reducing Escherichia coli O157:H7 in cattle and their manure is critical for reducing the risk for human foodborne and waterborne illness. The objective of this study was to evaluate the effects of soil and pond ash surfaces for feedlot pens on the prevalence, levels, and/or persistence of naturally occurring E. coli O157:H7 and total E. coli in cattle (feces and hides) and manure. Cattle (128 beef heifers) were sorted among 16 pens: 8 surfaced with soil and 8 surfaced with pond ash. The prevalence of E. coli O157:H7 in feces decreased (P < 0.0001) during the study from 57.0% on day 0 to 3.9% on day 84 but did not differ (P > or = 0.05) between cattle on soil and on pond ash pens at any sampling period. The prevalence of the pathogen on hides and in feedlot surface material (FSM) also decreased (P < 0.0001), with no effect of soil or pond ash surface (P > or = 0.05). Similarly, levels of E. coli in FSM did not differ (P > or = 0.05) at any sampling period, and there were no clear trends for survival differences of E. coli O157:H7 or E. coli in FSM between pond ash and soil surfaces, although E. coli populations survived at 5.0 log CFU/g of FSM on the pen surfaces 6 weeks after the cattle were removed. These results indicate that housing cattle on pens surfaced with pond ash versus pens surfaced with soil does not affect E. coli O157:H7 in cattle or their manure.

Protocol for the SAFEST review: the Shock-Absorbing Flooring Effectiveness SysTematic review including older adults and staff in hospitals and care homes.

INTRODUCTION: Falls in hospitals and care homes are a major issue of international concern. Inpatient falls are the most commonly reported safety incident in the UK's National Health Service (NHS), costing the NHS £630 million a year. Injurious falls are particularly life-limiting and costly. There is a growing body of evidence on shock-absorbing flooring for fall-related injury prevention; however, no systematic review exists to inform practice. METHODS AND ANALYSIS: We will systematically identify, appraise and summarise studies investigating the clinical and cost-effectiveness, and experiences of shock-absorbing flooring in hospitals and care homes. Our search will build on an extensive search conducted by a scoping review (inception to May 2016). We will search electronic databases (AgeLine, CINAHL, MEDLINE, NHS Economic Evaluation Database, Scopus and Web of Science; May 2016-present), trial registries and grey literature. We will conduct backward and forward citation searches of included studies, and liaise with study researchers. We will evaluate the influence of floors on fall-related injuries, falls and staff work-related injuries through randomised and non-randomised studies, consider economic and qualitative evidence, and implementation factors. We will consider risk of bias, assess heterogeneity and explore potential effect modifiers via subgroup analyses and sensitivity analyses. Where appropriate we will combine studies through meta-analysis. We will use the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach to evaluate the quality of evidence and present the results using summary of findings tables, and adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. ETHICS AND DISSEMINATION: We will follow the ethical principles of systematic review conduct, by attending to publication ethics, transparency and rigour. Our dissemination plan includes peer-reviewed publication, presentations, press release, stakeholder symposium, patient video and targeted knowledge-to-action reports. This review will inform decision-making around falls management in care settings and identify important directions for future research. PROSPERO REGISTRATION NUMBER: CRD42019118834.

Effects of Compliant Flooring on Dynamic Balance and Gait Characteristics of Community-dwelling Older Persons.

BACKGROUND: Compliant flooring while providing the impact force attenuation in the event of falls, its low stiffness characteristic might impair balance and gait which consequently resulted in an increase in the risk of falling. OBJECTIVE: To investigate the effects of compliant flooring on dynamic balance and gait performance of older adults under challenging conditions. DESIGN AND PARTICIPANTS: A cross-sectional designed with repeated measured. Thirty five community-dwelling older adults (mean age 74.91 ± 6.51 yrs) participated in this study. MEASUREMENT: Modified Dynamic Gait Index (mDGI) and Timed Up and Go (TUG) were used to assess dynamic balance. Spatio-temporal gait parameters were measured under comfortable and maximal speed. All tests were administered on the vinyl and compliant flooring in random order. RESULTS: The time taken to complete TUG and the mDGI scores were similar between the two flooring types (p ≥ 0.05). Overall, gait characteristics were comparable when walking on the compliant and vinyl flooring for both speeds except for swing time, step time, and cadence. CONCLUSION: The present study demonstrated that compliant flooring did not significantly affect dynamic balance and had minimal effects on gait characteristics. The compliant flooring appears to be safe for installing in self-ambulating older adult's home.

Protective role of dryland rearing on netting floors against mortality through gut microbiota-associated immune performance in Shaoxing ducks.

Dryland rearing on netting floors (DRNF) is a new rearing method for ducks, which could prevent duck excreta from polluting water bodies. However, the influence of DRNF on duck production and immune performance remains poorly understood. In this study, 2,280 Shaoxing ducks, an egg-type breed of Sheldrake in China, were chosen and randomly divided into 2 groups to investigate the effects of DRNF on duck farming. During the experimental laying rates, feed-egg ratios, and mortality rates of the 2 groups were calculated and recorded. Serum immune parameters, including thymus index, spleen index, levels of immunoglobulin G (IgG), interleukin 1ß (IL-1ß), and tumor necrosis factor α (TNF-α), were determined. Sequencing of the 16S rRNA gene was used to analyze the variability of gut microbiota in the duck ileum and cecum. The results showed that DRNF significantly reduced the mortality rate of the ducks and increased the thymus index (P < 0.05), compared to the control. No other significant differences were detected in productional and immune indices (P > 0.05). The 16S rRNA sequencing results revealed differentially enriched microbial compositions in the ileum and cecum, which might be responsible for the improved immune function of Shaoxing ducks. For example, an increase in Lactobacillaceae (family), Anaerotruncus (genus), Saccharibacteria (phylum), Flavobacteriaceae (family), and a reduction in Anaerobiospirillum (genus), Lachnospiraceae (family), Blautia (genus) was revealed in the DRNF ducks. In conclusion, DRNF could alter gut microflora, enhance duck immune system, and reduce mortality in Shaoxing ducks.

Poultry rearing on perforated plastic floors and the effect on air quality, growth performance, and carcass injuries-Experiment 1: Thermal Comfort.

The present study investigated the use of perforated plastic floors in the rearing of male and female poultry under thermal comfort conditions. The study was conducted in 2 climate chambers, in one was conventional poultry litter (wood shavings) and in the other was a perforated plastic floor. The experimental design was a completely randomized design with the factors wood shavings and plastic floor. In each chamber, the animals were divided into 16 experimental pens (8 with males and 8 with females) with a density of 12 birds/m2. The poultry rearing effect was evaluated in terms of air quality (% concentration of ammonia [NH3] and carbon dioxide [CO2]); broiler performance, e.g., weight gain (kg), feed intake (kg), feed conversion, carcass yield and parts (%), meat production (kg/m2), and viability (% of live birds at d 42); scores of hygiene and mobility; and injuries in the chest, hocks, and footpads. Treatments affected air quality, with higher concentrations of NH3 on d 42 (25 ppm vs. 2 ppm) and CO2 (1,400 ppm vs. 1,000 ppm) for wood shavings than for perforated plastic floor, respectively. Males showed a better performance (weight gain, feed intake and feed conversion) than females on d 42 in both floor types (wood shavings and plastic floor). Males reared on wood shavings showed a higher meet production (35.992 kg/m2) than females (32.257 kg/m2). On the plastic floor, males showed a better viability (100%) than females (94.05%), as well better meet production for males (38.55 kg·m-2) than females (31.64 kg/m2). There was no incidence of breast lesions in any of the studied systems. The birds reared on the plastic floor had better hygiene scores and lower hock injury rates than birds reared in the wood shavings chambers. The results of the present study show that the use of perforated plastic floors in chicken farming is an efficient method, which promotes a better-quality environment, superior production rates, and reduced incidence of injuries.

Effects of dietary coarsely ground corn and 3 bedding floor types on broiler live performance, litter characteristics, gizzard and proventriculus weight, and nutrient digestibility.

The effects of zero or 50% dietary coarsely ground corn (CC) in pelleted and screened grower and finisher diets on broilers reared on 3 bedding floor types (plastic net [NET], new pine wood shavings litter [NEW], or old pine wood shavings litter [OLD]) on broiler live performance, litter characteristics, gizzard and proventriculus weight, and apparent ileal digestibility (AID) were studied in a 2 × 3 factorial arrangement of treatments. Fine corn was produced with a hammermill (271 µm) and CC with a roller mill (1145 µm). Utilization of CC reduced milling cost by 9.47 cents per MT with similar nutrient content of screened pellets. The 50% CC treatment exhibited improved (P ≤ 0.05) feed intake at 42 d (2.5%) and 49 d (3.0%), and BW (5.4%) and FCR from 28 d (1.4%). Birds on NEW litter exhibited improved (P < 0.05) BW at 28 and 35 d and 42 d FCR as compared to NET and 49 d FCR compared to NET and OLD. The 50% CC treatment exhibited increased (P < 0.05) gizzard weight but decreased proventriculus weight at 49 d. NEW litter birds exhibited increased (P ≤ 0.05) gizzard weight at 28 d and 49 d and decreased proventriculus weight as compared to NET at 49 days. The 50% CC treatment exhibited decreased (P ≤ 0.05) litter moisture at 35 and 42 d, litter N at 35 and 49 d, and litter pH at 49 days. OLD litter birds exhibited greater (P < 0.05) litter N at 14, 35, and 49 d, as well as litter moisture, pH, and ammonia concentration at 49 days. The 50% CC group also exhibited improved AID of nitrogen (P < 0.05). Broilers fed pelleted and screened diets containing 50% CC exhibited improved live performance and reduced litter moisture while use of NEW litter resulted in a somewhat similar effect, which indicated that consumption of NEW litter also facilitated gastric development and function.

Comparison of sow welfare in the Swedish deep-bedded system and the US crated-sow system.

The author estimates that the cost of swine production in the United States would increase by > $1 billion if the Swedish deep-bedded system were adopted as the only system in this country. The question is whether the added cost results in proportionately improved pig welfare.

Effect of cardboard under a sleeping bag on sleep stages during daytime nap.

Fourteen healthy male subjects slept from 13:30 to 15:30 under ambient temperature and relative humidity maintained at 15 °C and 60%, respectively. They slept under two conditions: in a sleeping bag on wooden flooring (Wood) and in a sleeping bag with corrugated cardboard between the bag and the flooring (CC). Polysomnography, skin temperature (Tsk), microclimate, bed climate, and subjective sensations were obtained. The number of awakenings in the CC had significantly decreased compared to that in the Wood. The mean, back, and thigh Tsk, and bed climate temperature were significantly higher in the CC than that in the Wood. Subjective thermal sensations were warmer in the CC than in the Wood. These results suggest that using corrugated cardboard under a sleeping bag may reduce cold stress, thereby decreasing the number of awakenings and increasing subjective warmth; the mean, back, and thigh Tsk; and bed climate temperature.

Can we make a carpet smart enough to detect falls?

In this paper, we have enhanced smart carpet, which is a floor based personnel detector system, to detect falls using a faster but low cost processor. Our hardware front end reads 128 sensors, with sensors output a voltage due to a person walking or falling on the carpet. The processor is Jetson TK1, which provides more computing power than before. We generated a dataset with volunteers who walked and fell to test our algorithms. Data obtained allowed examining data frames (a frame is a single scan of the carpet sensors) read from the data acquisition system. We used different algorithms and techniques, and varied the windows size of number of frames (WS ≥ 1) and threshold (TH) to build our data set, which later used machine learning to help decide a fall or no fall. We then used the dataset obtained from applying a set of fall detection algorithms and the video recorded for the fall pattern experiments to train a set of classifiers using multiple test options using the Weka framework. We measured the sensitivity and specificity of the system and other metrics for intelligent detection of falls. Results showed that Computational Intelligence techniques detect falls with 96.2% accuracy and 81% sensitivity and 97.8% specificity. In addition to fall detection, we developed a database system and web applications to retain these data for years. We can display this data in realtime and for all activities in the carpet for extensive data analysis any time in the future.

Effects of flooring on required coefficient of friction: Elderly adult vs. middle-aged adult barefoot gait.

The aim of this study was to investigate the effect of flooring on barefoot gait according to age and gender. Two groups of healthy subjects were analyzed: the elderly adult group (EA; 10 healthy subjects) and the middle-aged group (MA; 10 healthy subjects). Each participant was asked to walk at his or her preferred speed over two force plates on the following surfaces: 1) homogeneous vinyl (HOV), 2) carpet, 3) heterogeneous vinyl (HTV) and 4) mixed (in which the first half of the pathway was covered by HOV and the second by HTV). Two force plates (Kistler 9286BA) embedded in the data collection room floor measured the ground reaction forces and friction. The required coefficient of friction (RCOF) was analyzed. For the statistical analysis, a linear mixed-effects model for repeated measures was performed. During barefoot gait, there were differences in the RCOF among the flooring types during the heel contact and toe-off phases. Due to better plantar proprioception during barefoot gait, the EA and MA subjects were able to distinguish differences among the flooring types. Moreover, when the EA were compared with the MA subjects, differences could be observed in the RCOF during the toe-off phase, and gender differences in the RCOF could also be observed during the heel contact phase in barefoot gait.

The influence of flooring on environmental stressors: a study of three flooring materials in a hospital.

OBJECTIVE: Three flooring materials, terrazzo, rubber, and carpet tile, in patient unit corridors were compared for absorption of sound, comfort, light reflectance, employee perceptions and preferences, and patient satisfaction. BACKGROUND: Environmental stressors, such as noise and ergonomic factors, effect healthcare workers and patients, contributing to increased fatigue, anxiety and stress, decreased productivity, and patient safety and satisfaction. METHODS: A longitudinal comparative cohort study comparing three types of flooring assessed sound levels, healthcare worker responses, and patient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings over 42 weeks. A linear mixed model analysis was conducted to determine significant differences between the means for participant responses and objective sound meter data during all three phases of the study. RESULTS: A significant difference was found for sound levels between flooring type for equivalent continuous sound levels. Carpet tile performed better for sound attenuation by absorption, reducing sound levels 3.14 dBA. Preferences for flooring materials changed over the course of the study. The HCAHPS ratings aligned with the sound meter data showing that patients perceived the noise levels to be lower with carpet tiles, improving patient satisfaction ratings. CONCLUSIONS: Perceptions for healthcare staff and patients were aligned with the sound meter data. Carpet tile provides sound absorption that affects sound levels and influences occupant's perceptions of environmental factors that contribute to the quality of the indoor environment. Flooring that provides comfort underfoot, easy cleanability, and sound absorption influence healthcare worker job satisfaction and patient satisfaction with their patient experience.

Ecological relationships between the prevalence of cattle shedding Escherichia coli O157:H7 and characteristics of the cattle or conditions of the feedlot pen.

This study was designed to describe the percentage of cattle shedding Escherichia coli O157:H7 in Midwestern U.S. feedlots and to discover relationships between the point prevalence of cattle shedding the organism and the characteristics of those cattle or the conditions of their pens. Cattle from 29 pens of five Midwestern feedlots were each sampled once between June and September 1999. Feces were collected from the rectum of each animal in each pen. Concurrently, samples of water were collected from the water tank, and partially consumed feed was collected from the feedbunk of each pen. Characteristics of the cattle and conditions of each pen that might have affected the prevalence of cattle shedding E. coli O157:H7 were recorded. These factors included the number of cattle; the number of days on feed; and the average body weight, class, and sex of the cattle. In addition, the temperature and pH of the tank water were determined, and the cleanliness of the tank water and the condition of the pen floor were subjectively assessed. The samples of feces, feed, and water were tested for the presence of E. coli O157:H7. E. coli O157:H7 was isolated from the feces of 719 of 3,162 cattle tested (23%), including at least one animal from each of the 29 pens. The percentage of cattle in a pen shedding E. coli O157:H7 did not differ between feedyards, but it did vary widely within feedyards. A higher prevalence of cattle shed E. coli O157:H7 from muddy pen conditions than cattle from pens in normal condition. The results of this study suggest that E. coli O157:H7 should be considered common to groups of feedlot cattle housed together in pens and that the condition of the pen floor may influence the prevalence of cattle shedding the organism.