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Technology and falls prevention in practice, in the Netherlands

Authors' names
B Olij1; J Kuiper1; T van Hoesel2
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1. Introduction Falls among older people are a major public health concern, with one-third of individuals aged 65 and over experiencing at least one fall annually in the Netherlands. In 2023, a national chain approach to falls prevention was introduced to improve identification of older adults at risk of falling and reduce the incidence of fall-related injuries. The chain approach is comprised of four steps: 1) identifying older adults at risk of falling, 2) investigating individual fall risk factors, 3) participating in a falls prevention intervention, and 4) continuing regular physical

Virtual Wards for Older People Living with Frailty: A Review of Effectiveness

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Areej Bilal1, Victoria Wright2
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Introduction: Virtual wards have been increasingly implemented across the NHS to manage older people living with frailty in their own homes amid rising inpatient pressures. As this care model expands, it’s essential to determine whether virtual wards yield outcomes comparable to those of traditional inpatient care. This review aims to assess the success of virtual wards across key outcome domains. Methods: A literature review of ten studies published between 2014 and 2025 was conducted using electronic databases with relevant keywords. Studies examined multiple aspects of virtual wards
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Atypical Oral Presentation of Giant Cell Arteritis With Subsequent Middle Cerebral Artery Involvement

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Alamin Alkundi1; Christa Mathew2
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Giant cell arteritis (GCA), also known as Horton’s disease - a large‑vessel vasculitis characterized by granulomatous inflammation of medium and large-sized arteries - is the most common primary systemic vasculitis in adults over the age of 50 . It shows a strong predilection for women, particularly those of Northern European ancestry. The classical presentation includes new‑onset headache, scalp tenderness, jaw claudication and visual disturbance, though the clinical spectrum is heterogeneous and may overlap with other conditions common in older adults . Delayed diagnosis of giant cell

An MDT Approach to Reducing Clinical Deconditioning: Sitting Out

Authors' names
Millie Pierce, Chang Liu, Priyanka Bhakta, Arnold Kusi
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Introduction A Quality Improvement Project on UHCW’s largest Care of the Elderly ward, aiming to reduce deconditioning, by using intra-MDT education to improve the proportion of patients sitting out in a chair. Method We measured the proportion of patients who sat out in a chair across five weekdays. We did this by: 1) Observing the number of patients sat out, 2) Discussing with nursing/HCA staff whether patients had sat out and if not, the reason why and 3) Reviewing medical/nursing/physio documentation. We also reviewed baseline mobility, to understand what proportion of our patients we
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End of Life Care Audit and Quality Improvement Project in an Elderly Care Unit: Adherence to West Midlands Palliative Care Guidelines

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1.Dr Shivashankari Dakshina Moorthy; 2.Dr Ramsha Hussain; 3.Dr Prethi Rajendran; 4.Dr Ram Byravan
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Introduction High quality end of life (EOL) care is essential to ensure comfort, dignity, effective symptom control, and care aligned with patient wishes. The West Midlands Palliative Care guidelines emphasise early recognition of dying, anticipatory prescribing, communication with patients and families, deprescribing non-essential medications, and individualised care planning. Delayed recognition of dying and inconsistent documentation may negatively affect patient-centred care. `To evaluate whether EOL care within an elderly care unit was delivered in accordance with West Midlands Palliative
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Gait Through a Lens: Contextual Fall Risk Assessment in Parkinson’s

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Jason Moore1, Alan Godfrey2
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Introduction Free-living gait assessment for fall risk in Parkinson’s disease (PD) often uses inertial measurement units (IMUs) to extract gait characteristics. However, IMU-only approaches lack environmental and behavioural context, which can lead to inflated estimates of fall risk when gait changes are driven by extrinsic factors e.g., obstacles. We combine IMUs with wearable eye-tracking video glasses and AI-based computer vision (CV) to enrich free-living gait assessment with environmental and gaze information, enabling a robust interpretation of fall risk. Methods Seven individuals with
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Feasibility of a Contextually Adapted Fall Prevention Exercise Programme with Behaviour Change Support in Indonesia

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Fadhia Adliah12, Abigail J Hall1, Victoria A Goodwin1, Sarah E Lamb1
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Introduction: Falls are a leading cause of injury and loss of independence among older adults, with a particularly high prevalence in low- and middle-income countries (LMICs) such as Indonesia. Although exercise-based fall prevention programmes are effective globally, few have been contextually adapted or tested in LMIC settings. This study assessed the feasibility, acceptability, and safety of a contextually adapted fall prevention exercise programme incorporating behaviour change support for community-dwelling older adults in Indonesia. Method: A two-arm feasibility randomised controlled
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Healthcare professionals' experiences of managing turning difficulties in Parkinson's disease: A qualitative interview study

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J Das1, J Naisby1, G Barry1, T Finch1, E Stanmore2, L Rochester3, V Goodwin4, R Morris1
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Background: Turning difficulties are a disabling motor symptom in Parkinson’s disease (PD), often contributing to falls and reduced mobility. Despite their clinical significance, turning problems remain challenging to manage, with current interventions offering limited and inconsistent benefits. Pharmacological treatments rarely address complex gait impairments such as turning, while rehabilitation strategies - physiotherapy and cueing - show promise but vary widely in application and effectiveness. Understanding how these approaches are perceived and implemented in practice is essential for

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Lying Standing Blood Pressure Measurement following Hip Fracture

Authors' names
K Howick 1; A Kenda 1;M White 1
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Background: Frail patients are at risk of post-operative orthostatic hypotension. Measuring lying and standing blood pressure (LSBP) is a key part of comprehensive post-operative geriatric assessment. Method: Three cycles of data were collected from the National Hip Fracture Database on patients with neck of femur fractures at Leeds General Infirmary. Each cycle was discussed at local governance meetings, followed by implementation of novel interventions. First, information on LSBP was added to online induction resources. Then, a poster was distributed, and finally, an email template was

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Improving Lying and Standing Blood Pressure Measurement Recording

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E Scanu1; A Ray2; S Crickmore2; S Kumar2
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Introduction Falls are a common hospital patient presentation. NICE falls assessment and prevention guideline (NG249) includes lying and standing (L&S) blood pressure (BP). The Royal College of Physicians (RCP) outlines a standardised approach for L&S BP measurement; involving lying BP, standing BP within 1 minute and after 3 minutes. We aimed to improve postural BP recording on Cerner Electronic Patient Record (EPR) utilising Quality Improvement methodology to help clinicians make a correct diagnosis. Method Retrospective data was collected using EPR patient notes whereby 12 medical patients

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Avoiding Emergency Department Attendance After a Fall: Emergency Department in the Home Case Study

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Aoibheann O'Kane1, Cliona Doyle1, Finola Smith1, Arthur Doran2, Sarah McNally1, Dr Niamh Mitchell2
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Background The Emergency Department in the Home (EDITH) service provides an alternative to Emergency Department (ED) attendance for older adults by delivering acute emergency care in the person’s home. The service aims to support admission avoidance while promoting safety and functional independence through a multidisciplinary approach, including medical and Occupational Therapy (OT) assessment. Falls in older adults account for approximately 22% of EDITH referrals per month in 2025. Nationally, the cost of fall-related injuries in older adults in Ireland is projected to exceed €2 billion by
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Primary care led integrated falls prevention programme: early outcomes of the SAFE Pilot

Authors' names
Kai Ping Sze1, Yong Yang Oliver Leow1, Wei Liang David Ng1
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Introduction: Falls in older adults are prevalent, costly and frequently under-managed. We developed the Screening, Agility, Frailty & Falls prevention, Empowerment (SAFE) pathway to operationalise guideline-aligned multifactorial assessment, medication optimisation, osteoporosis risk trigger and rapid linkage to community rehabilitation at the first point of contact. We aim to describe implementation of SAFE in the pilot polyclinic, compare delivery of interventions pre- and post-implementation, and assess feasibility for scale-up with a focus on clinical effectiveness, patient safety and

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Incidence of Acute Post-zoledronic acid reactions following hip fractures at a National Orthopaedic centre.

Authors' names
Dr Benedict Moore; Dr Jessica Millar; Dr Philip Wilson - 1,2
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Introduction: Adverse effects(AE) of zoledronic acid(ZA) administration, including electrolyte abnormalities and pyrexia, are well documented in the literature. A retrospective audit of all hip fracture patients that underwent fixation at the Royal Victoria Hospital, Belfast between 01/06/25 and 31/08/25 was performed. Incidence of fragility-fracture patients who received IV ZA post-op and recording subsequent reactions during their inpatient stay was reported. Methodology. A total of 222 patients underwent fixation for hip fractures. 17 were excluded due to fracture eligibility e.g. high
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Translating evidence into practice: a Centre of Expertise as a Model for Advancing Falls and Fracture Prevention in Flanders (Belgium)

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J Meurrens1,2; G Belaen1,2; S Buelens1,2; S Vandervelde 1,2; K Milisen1,2,3
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Introduction Falls and fall-related fractures are a major and growing public health challenge among older adults. Their multifactorial nature requires an integrated approach combining prevention, clinical care, education and policy. Effective prevention depends on coordinated action tailored to diverse target groups, including older adults, healthcare professionals and policymakers. A dedicated centre of expertise offers a clear structure to align efforts, translate scientific evidence into practice and support large-scale implementation. By integrating evidence, clinical expertise, education
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Evaluating 13 Years of the Flemish Falls Prevention Awareness Week: Registration Data and Survey-Based Insights

Authors' names
S Buelens1,2; J Meurrens1,2; G Belaen1,2; S Vandervelde1,2; K Milisen1,2,3S Buelens1,2; J Meurrens1,2; G Belaen1,2; S Vandervelde1,2; K Milisen1,2,3
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Introduction Falls are a major cause of morbidity among older adults, with physical, psychological and economic consequences. Despite effective interventions, implementation remains limited, making awareness initiatives essential to encourage recognition of fall risks and effective falls prevention interventions. Method The Flemish Falls Prevention Awareness Week is coordinated by the Centre of Expertise for Falls and Fracture Prevention Flanders in collaboration with key stakeholders such as the Flemish Institute for Healthy Living and loco-regional healthcare networks. Campaign participation
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Vestibular assessment is a blind spot for England’s NHS Falls services

Authors' names
Ed Tank
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Background: Falls remain a major healthcare burden from an individual to societal level. Vestibular disorders are recognised as a significant risk factor for falls in older adults, but identification and assessment of such conditions has only recently been included in national and international guidance. The extent to which National Health Service (NHS) falls services in England are including vestibular assessment is not well known. Method: A freedom-of-information request was sent to 117 Falls Services run by NHS Trusts in England to identify if they included vestibular assessment/management
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Action Falls Lead (e-learning) Training: An Evaluation using the Kirkpatrick model

Authors' names
Joanne Ablewhite1; Fran Hallam-Bowles1 2 ; Janet Darby1 2; Peter Smith3; Pip Logan1; Fran Allen1
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Introduction: The Action Falls programme is a multifactorial falls-prevention programme shown in a randomised controlled trial (RCT) to reduce falls in care home residents by 43%. Action Falls has since been recommended as best practice by NHS England. In the original RCT, training was delivered by a member of the research team face-to-face to “Falls Leads” (registered NHS nurses or allied health professionals), using a train-the-trainer model. A subsequent implementation study indicated that an e-learning approach could offer greater flexibility and scalability. This study evaluated Falls
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Improving falls medication review in secondary care through introduction of a polypharmacy pharmacist

Authors' names
M Fawkes1, L Reid1, S Kirby1.
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Introduction: Problematic polypharmacy contributes to an increased risk of medicine-related harm, particularly in those living with frailty or multimorbidity [1]. This pilot aimed to evaluate the potential benefits of introducing a dedicated polypharmacy pharmacist to conduct enhanced falls medication reviews as part of consultant-led ward rounds for targeted cohorts at Wirral University Teaching Hospital NHS Foundation Trust. Method: An independent prescribing pharmacist conducted weekly medication reviews on a stepdown ward for older patients. Medications were reviewed for safety based on
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Building Staff Confidence Through a Shared Learning Model for Falls Management in Care Homes

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F Hallam-Bowles1,2; A Kilby3; AL Gordon4,5,6; S Timmons7; PA Logan2,8; L Rees9; K Robinson1,2
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Introduction Best practice guidance for falls management with care home residents recommends a proactive approach and care home staff require training to support this. The CHAFFINCH (Co-producing tHe implementAtion oF Falls management IN Care Homes) study co-produced a model for falls management. The second phase of the CHAFFINCH study evaluated the feasibility of delivering the model in real-world care home settings. Methods A shared learning model was delivered for 6 months in 10 care homes in Nottinghamshire, United Kingdom. The model included bespoke training and ongoing support, provided
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Designing accessible, scalable digital rehabilitation to reduce fall risk after stroke

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A Brown1; M Ambrens1,2; KS van Schooten1,2; K Butcher2; M Jennings3; SY Ooi4; N Lovell2; K Delbaere1,2
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Background: People recovering after stroke are at increased risk of falls due to impairments in balance, strength and functional mobility. Exercise-based rehabilitation is critical to fall risk reduction; however, access remains limited. Digitally delivered rehabilitation has potential to extend care beyond traditional service models, but successful uptake depends on real-world implementation. Using an integrated knowledge translation approach, this mixed-methods study aimed to inform and evaluate the codesign, delivery and implementation of a tailored digital exercise program after stroke
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