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Preventing the next fall: Slips, stumbles and spills dangerous for seniors

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“All right,” instructs the teacher. “Standing nice and tall. Use your chair for support please. With your right leg, we’re going to lift it up to the side: one, two, three, four five. And again.”

Erin Harris goes through the movements: The 74-year-old stands behind a chair and slowly stretches her left leg, before repeating the movement with the right.

Harris is taking part in a falls-prevention class at the Toronto Rehabilitation Institute, along with about a half-dozen other seniors. Some in the room, like Harris, have experienced a bad fall and are here to try to prevent the next one from happening.

To do so, they learn about the benefits of exercise, how to get up from a fall, stair safety, healthy eating and overcoming the fear of falling. The 12-week program, which was first launched in 2013, is part group education, part exercise sessions.

Harris never thought she’d end up in a class like this. She was fit and active all her life. “I took four buses to go to skating lessons, one bus to go to ballet … played tennis, rode my bike, skied from the age of four.”

But a tumble down a flight of stairs later in life, at age 67, changed all of that. “I was walking five miles a day forever — and it went down to one street,” she said, recalling how much less she was able to walk after the fall.

Erin Harris says she has always lived an active lifestyle. But after her fall, she was walking a lot less. (Craig Chivers/CBC)

According to the Canadian Institute for Health Information (CIHI), unintentional falls were the most common form of injury across the country in 2017, resulting in nearly 1,800 emergency-room visits each day. In all, falling was responsible for 32 per cent of all reported ER visits that year, the agency says, costing the health-care system more than $2 billion. 

Seniors are the most vulnerable. In addition to being at a higher risk of falling, they also take a longer time to recover from their injuries.

Falls Intervention Team 

In Ontario’s Niagara region, the regional emergency medical services (EMS) says it has seen a rise in the number of calls related to seniors who’ve fallen. 

In response, officials have come up with an innovative approach to deal with the issue. Last July, a special mobile unit — called the Falls Intervention Team — was created. Pairing a paramedic with an occupational therapist, the team is dispatched exclusively to 911 calls from seniors who have fallen.

“By seeing our patients in the environment of the fall and seeing first-hand the circumstances that provoked the fall, the team can often better understand the root cause,” said Karen Lutz, quality assurance commander with Niagara EMS.

“Paramedics aren’t experts in falls prevention, but occupational therapists often are. By uniting the disciplines, we can do a better job of being more proactive when people fall in order to prevent the next one.” 

Paramedic Eric Huffman watches as his colleague, occupational therapist Leslie Yole, helps an elderly woman navigate her walker. Yole and Huffman are part of a unique team in Ontario’s Niagara region that addresses the increasing incidents of falls with older adults. (Craig Chivers/CBC)

When the falls team isn’t responding to emergency calls, it checks in on seniors who’ve fallen previously — so-called “frequent fallers.” During a recent visit with one woman, occupational therapist Leslie Yole used the opportunity to give the 71-year-old a few pointers on how to get up from a spill safely.

“She’s an older person,” said Yole. “She doesn’t have a lot of social support. She’s quite clear that she wants to stay in her home, but she appreciates that she wants to be safe in her home.”

It’s still early, but officials in Niagara feel they’re already making a difference: they say there have been fewer visits to the emergency rooms.

And while the program doesn’t promise to prevent the first fall, its goal is to make sure there are no further ones.

The science of falls

And beyond the hospital, researchers at Simon Fraser University in Burnaby, B.C., have been studying the science of falls in older adults.

“It’s a huge cause of injury and death,” said Stephen Robinovitch, an engineer and lead researcher with the school’s Injury Prevention and Mobility Laboratory. “That’s one of the things that motivates me.” 

The focus of Robinovitch’s work is on the two most important injuries related to falls: hip fractures and traumatic brain injury.

“We’re trying to prevent the next fall from happening, but maybe more specifically, we’re also trying to prevent injury in the event of a fall,” he said.

At Simon Fraser University, researcher Stephen Robinovitch and his team work on understand how and why seniors fall. Part of the research is looking at real-life videos of falls at nursing homes in the Vancouver area. (Leanne Hazon/CBC)

According to Robinovitch, falls are the cause of 90 per cent of hip fractures in older adults, and some of the work they’re doing is trying to solve that problem. For example, Robinovitch and his team have tested several kinds of protective padding, coming up with a design for a wearable hip protector for seniors that fits into an undergarment.

Seniors in 14 nursing homes in the Vancouver area already are wearing the hip protectors, Robinovitch says, and so far, it has reduced hip fractures by one-third in those facilities.

The researchers are also testing different textures of floor surfaces, with the aim of making them easier for seniors to navigate. They study real-life falls from long-term care facilities in the Vancouver area, providing valuable insight into how and why falls occur in older adults.

SFU researchers rely on footage from Vancouver’s care homes for insight into falls:  

Closed-circuit television footage from long-term care homes in the Vancouver area used to study falls by the Technology for Injury Prevention in Seniors program at Simon Fraser University in Burnaby, B.C. (SFU-TIPS Research Lab) 0:50

“A combination of real-life falls in those high-risk environments and our studies here in the lab … allows us to gain insight on why every fall is not a disaster,” said Robinovitch.

Bathroom ‘one of the most dangerous areas of home’

In 2017, falls in the home accounted for about 115,000 emergency department visits, making it the most common location for a fall, according to CIHI.

And one of the main culprits is the bathroom, with all of its hard and slippery surfaces: More than 70 per cent of falls happen getting in and out of the tub.

“The bathroom is such a high-risk environment,” said Alison Novak, a scientist with the Toronto Rehabilitation Institute, who also researches fall prevention. “It’s one of the most dangerous areas of the home.”

Making the bathroom safer for seniors is part of Novak’s work.

“Because we have declines in our physiological capacity, we have declines in balance control,” she explained. “So as you step over a large obstacle, like a bathtub rim, you are placed at a greater risk of fall.”

At the Toronto Rehabilitation Institute, researcher Alison Novak is working on making bathrooms fall-proof for seniors. (Craig Chivers/CBC )

Part of her research is focused on grab bars, asking questions like: Should they be present? Should they be mandatory? If they are mandatory, where should they be placed?

In a simulated bathroom, Novak and her team are trying to find answers to those questions, while also trying to quantify how many falls could potentially be avoided.

To conduct the research, a 73-year old volunteer is placed in a harness and then instructed to step in and out of a slippery tub. By inducing a shake in the floor, which forces the volunteer to slip, Novak can study how quickly he is able to recover by holding on to the bar.

“Bathing disability is a huge issue and it’s one of the primary reasons an older adult will have to leave their home. If we really do want to support the idea of aging in place, the bathroom is one of those areas we have to address,” said Novak.

As for Erin Harris, it took her several weeks to recover from the broken ankle she experienced after falling in her Toronto condo building. These days, she still relies on a cane to get around, but is determined not to fall ever again.

The classes she’s been taking at Toronto Rehab have helped her restore her self-confidence, she says.

“It allowed me to focus on my balance, my flexibility, my adaptability to change. And I was very grateful for that.”

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Health Ranger posts new microscopy photos of covid swabs, covid masks and mysterious red and blue fibers

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(Natural News) What follows is a series of microscopy photos of covid swabs (a synthetic swab, then a cotton swab), a covid mask and some zoomed-in photos of mysterious red and blue fibers found in the masks.

The magnification range for these photos is 50X to 200X. Most were taken with white light, but several (as indicated) were taken with UV light.

The images shown here are 600 pixels wide. We have higher resolution images available to researchers and indy media journalists; contact us for those hi-res images.

More microscopy investigations are under way, and new images will be posted as they are finalized.

First, this series shows the carbon fiber layer of a covid mask, illuminated with UV light:

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5,800 test positive, 74 die of coronavirus at least 14 days after getting fully vaccinated

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(Natural News) The Centers for Disease Control and Prevention (CDC) on Thursday, April 15, confirmed some 5,800 breakthrough coronavirus (COVID-19) cases in the U.S.

A breakthrough COVID-19 case is defined as someone who has detectable levels of SARS-CoV-2 – the virus that causes COVID-19 – at least 14 days after getting fully vaccinated against the disease.

Nearly 400 breakthrough cases required treatment at hospitals and 74 died. A little over 40 percent of the infections were in people 60 years and above and 65 percent were female. About 29 percent of the vaccine breakthrough infections were reportedly asymptomatic. The figures were for cases through April 13.

CDC Director Rochelle Walensky told a congressional hearing on Thursday that the causes of the breakthrough cases are being probed. “Some of these breakthroughs are, of course, failure of an immune response in the host. And then some of them we worry might be related to a variant that is circulating. So we’re looking at both,” she said.

The CDC is monitoring reported cases “for clustering by patient demographics, geographic location, time since vaccination, vaccine type or lot number, and SARS-CoV-2 lineage.” It has created a national COVID-19 vaccine breakthrough database, where state health departments can enter, store and manage data for cases in their region.

Where available, respiratory specimens that tested positive for COVID-19 will be collected for genomic sequencing “to identify the virus lineage that caused the infection.”

Positive test less than two weeks after getting fully vaccinated is not a breakthrough case

The number of cases the CDC has identified does not include people who contracted COVID-19 less than two weeks after their final dose. The two-week marker is important, said infectious disease expert Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

A human body should have enough time to develop antibodies to SARS-CoV-2 after that timeframe. Before then, a person won’t necessarily have the built-up immunity needed to fight off an infection. According to Dr. Adalja, cases that occur before the two-week mark are not considered breakthrough cases.

Dr. Adalja also noted that more research is needed to determine if highly infectious variants of the virus are behind the breakthrough cases. “It is crucial to study breakthrough cases to understand their severity, their contagiousness and what role variants may be playing,” Dr. Adalja said.

More than 78 million people have been fully vaccinated against COVID-19 in the U.S. as of April 15.

“To date, no unexpected patterns have been identified in case demographics or vaccine characteristics,” the CDC said in a statement. “COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control.”

But the CDC conceded that “thousands of vaccine breakthrough cases will occur even though the vaccine is working as expected.”

Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, agreed with the CDC. “These vaccines that we’re using are fabulous but they’re not perfect,” he said. “At best, they’re 95 percent effective in preventing serious illness, but minor illnesses can occur.”

According to U.S. drug regulators, Pfizer’s COVID-19 vaccine is 95 percent effective in preventing infection. Moderna’s was shown in a clinical trial to be 94.1 percent effective while Johnson & Johnson’s was 66.9 percent effective. Only Johnson & Johnson vaccine, which received its emergency use authorization from the Food and Drug Administration (FDA) on Feb. 27, was tested when variants were circulating.

The percentages are based on results from vaccine recipients two weeks after the final vaccination.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, stated in a briefing last week that the breakthrough cases are not a cause for concern.

“I think the important thing is to look at what the denominator of vaccinated people is. Because it is very likely that the number of breakthrough cases is not at all incompatible with the 90-plus percent vaccine efficacy,” he said. “So I don’t think that there needs to be concern about any shift or change in the efficacy of the vaccine.”

More info needed before drawing conclusions from breakthrough cases

The percentage of vaccine breakthroughs in a population depends on multiple factors, including vaccine efficacy, the amount of virus circulating and the length of time since vaccination, according to Natalie Dean, an assistant professor of biostatistics at the University of Florida.

“I love to see small numbers as much as anyone, but know that numbers like this cannot be directly interpreted as a measure of vaccine efficacy (although I have a feeling they will be). We can only interpret them against a background rate in unvaccinated people,” Dean wrote on Twitter.

“Similarly, ‘most breakthroughs have been in elderly adults’ should not be read as the vaccine is less effective in elderly adults. The majority of vaccinations (and the longest amount of follow-up time) have been in elderly adults. Again, we need more info to interpret.”

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More people died from fentanyl overdose than coronavirus in San Francisco last year

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(Natural News) More people died from fentanyl overdose than coronavirus (COVID-19) in San Francisco last year, a microcosm of a larger nationwide problem coinciding with the pandemic.

Data from San Francisco’s Office of the Chief Medical Examiner shows that 708 people were killed by fentanyl in 2020, an astonishing 118 times more since the introduction of the drug in the city just five years earlier.

That figure nearly tripled the 254 COVID-19 deaths recorded in the city for the whole of last year. More than 8 in 10 deaths were male, and just under half were white. People aged 55 to 64 made up nearly a quarter of the fatalities. Nearly 40 percent of the deaths occurred in open-air drug markets such as the Tenderloin and South of Market.

The number of overdose deaths in the city could have been far worse as more than 3,000 addicts suffering from an overdose were administered with naloxone, the lifesaving medication that reverses overdoses.

San Francisco’s death rate from fentanyl overdose continues to rise this year as 135 died by overdose in January and February, putting the city on pace for more than 800 deaths by the end of the year.

The city has become a significant part of a larger trend. The Centers for Disease Control and Prevention (CDC) released data on Wednesday, April 14, showing that more than 87,000 Americans died from drug overdose over the 12-month period that ended in September last year – the highest since the opioid epidemic began in the 1990s.

Lockdowns lead to more cases of drug overdose

The surge represents an increasingly urgent public health crisis that may be correlated to the government’s monotonous battle plan against the COVID-19 pandemic.

On March 19 last year, California became the first state in the U.S. to implement a stay-at-home order. It subsequently endured the longest lockdown of any state in the country.

The pandemic and accompanying lockdowns are believed to be partly responsible for the soaring number of drug deaths for obvious reasons. Lockdowns have badly disrupted the social services in the city, including drug addiction treatment. Drug experts say the isolation of the past 12 months is causing vulnerable residents to turn to opioids.

“We see the death and devastation getting worse right in front of us,” said Matt Haney, San Francisco Board of Supervisors member. “It’s an unprecedented spiraling, directly connected to the introduction of fentanyl in our city.”

Fentanyl first appeared on the streets of San Francisco in 2015. There were just six deaths from the synthetic opioid that year, 12 deaths in 2016 and 37 deaths in 2017. The figure skyrocketed when the drugs became widely available in the city in 2018.

Kristen Marshall, manager of the national drug harm reduction DOPE Project, noted the grim irony that while social isolation could save lives from COVID-19, it had undoubtedly contributed to the number of overdose deaths.

“Isolation is also the thing that puts people at the absolute highest risk of overdose death,” she said.

Pandemic exacerbates rise in deaths from drug overdose

The number of deaths from drug overdose started rising in the months leading up to the coronavirus pandemic, making it hard to gauge how closely the two phenomena are linked. But the pandemic unquestionably exacerbated the trend. The biggest jump in overdose deaths took place in April and May when fear and stress were rampant, job losses were multiplying and the strictest lockdown measures were in effect.

Many treatment programs closed during that time while drop-in centers, which provide support, clean syringes and naloxone, cut back services.

The data released by the CDC shows a 29 percent rise in overdose deaths from October 2019 through September 2020 compared with the previous 12-month period. Illicitly manufactured fentanyl and other synthetic opioids were the primary drivers, although many fatal overdoses have also involved stimulant drugs like methamphetamine.

Unlike in the early years of the opioid epidemic, when deaths were largely among white Americans in rural and suburban areas, the current crisis is affecting Black Americans disproportionately.

“The highest increase in mortality from opioids, predominantly driven by fentanyl, is now among Black Americans,” Dr. Nora Volkow, the director of the National Institute on Drug Abuse, said at a national addiction conference last week.

“And when you look at mortality from methamphetamine, it’s chilling to realize that the risk of dying from methamphetamine overdose is 12-fold higher among American Indians and Alaskan Natives than other groups.”

Dr. Volkow added that more deaths than ever involved drug combinations, typically of fentanyl or heroin with stimulants.

“Dealers are lacing these non-opioid drugs with cheaper, yet potent, opioids to make a larger profit,” she said. “Someone who’s addicted to a stimulant drug like cocaine or methamphetamine is not tolerant to opioids, which means they are going to be at high risk of overdose if they get a stimulant drug that’s laced with an opioid like fentanyl.”

The Drug Enforcement Administration (DEA) supported Dr. Volkow’s claim, saying that transnational criminal organizations cause a spike in overdoses by mixing fentanyl into illicit narcotics.

According to the DEA, Mexican cartels often purchase the drug components in China and use human mules to smuggle the narcotics to lucrative drug markets north of the border.

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