Search Results (2,678)

Whilst youth offending has been declining, there have been increases in serious youth violence in the last decade. Therefore, there is a pressing need to prevent youth crime and violence owing to its prevalence, harms and cost to society. Part of the effort to address this involves identifying and disseminating evidence-based practice. We explore key challenges in this endeavour and offer ideas for how to address them. These fall into two categories. The first concerns the focus and nature of interventions and the imperative to increase the effectiveness of our collective efforts. We start by considering neglected issues and groups in need of intervention responses, arguing that interventions too often do not consider relevant risk and contextual factors. Next, we explore emerging means of designing and delivering interventions that warrant greater investment, including those that extend beyond a traditional focus on programmes. Finally, we highlight cross-cutting issues affecting the delivery and uptake of interventions and therefore their success. The second set of challenges concerns intervention evaluation and the need to maximise the usefulness of our cumulative evaluation activity in this field. Here, we start by discussing common challenges involved in moving through the pipeline of feasibility, pilot and definitive (often trial-based) evaluations. We then explore issues concerning the actual design and conduct of such studies, before closing with thoughts on the potential value of underused (non-trial) methods of impact evaluation. Throughout the article, we draw on the scientific literature and our collective experience over many years of developing, adapting, evaluating and promoting interventions and other forms of evidence-based practice in this space. Full article

Background: Older adults, including those with Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD), face barriers in maintaining regular physical activity, which increases their fall risk and reduces their quality of life. The Activity Tracking, Care Partner Co-Participation, Text Reminders, Instructional Education, Video-Guided Physical Rehabilitation, and Exercise trial aims to improve physical activity among older adults. This pilot study aims to assess the feasibility and preliminary efficacy of the ACTIVE intervention. Methods: ACTIVE is a multi-method, two-arm randomized, analyst-blinded crossover pilot trial with an embedded qualitative component. We will recruit 50 community-dwelling dyads (older adult–care partner, n = 100), with and without mild AD/ADRD, in a 1:1 ratio. Each dyad will be randomized to the intervention or control arm, stratified by AD/ADRD diagnosis. The intervention arm will receive activity tracking, motivational texts, walking exercises, educational videos, and video-guided physical rehabilitation sessions, while the control arm will receive only activity tracking. The intervention will run in two halves: a three-week intervention/control, a one-week crossover phase, and a three-week control/intervention phase. The quantitative outcome measures will include feasibility measures (recruitment, adoption, adherence, acceptability, fidelity, and retention), and measures of preliminary efficacy (activity metrics, fall risk and fear of falling, functional limitations, and quality of life). Qualitatively, we will assess participants’ experiences, and facilitators and barriers to engagement in physical activity through semi-structured dyadic interviews and thematic analysis. Conclusions: This pilot study will generate data on the feasibility and preliminary efficacy of the ACTIVE trial. Findings will inform a full-scale implementation trial. Full article

Gait analysis plays a critical role in assessing mobility and identifying risks such as frailty and falls, where accurate spatiotemporal measurements are essential for early intervention, particularly in aging populations and clinical screening contexts. However, robust gait characterization remains challenging due to noise contamination and variability in sensor-based signals. To address these limitations, this study presents a stride-length estimation framework formulated as a modified processing-and-estimation pipeline integrated with Long Short-Term Memory (LSTM) networks. The pipeline includes wavelet-based denoising and cubic-spline interpolation as front-end preprocessing, followed by a Kalman-filtering stage with dynamic gain regulation guided by acceleration zero-crossing events to mitigate transient errors around abrupt turning points. Experimental data were collected from twelve healthy participants (seven females, mean age: 26.76 ± 3.01 years; five males, mean age: 25.81 ± 1.63 years) walking at self-selected speeds on a treadmill, using both an inertial sensor-based gait monitoring system and a motion capture system as the ground-truth reference. The proposed framework demonstrated a substantial improvement in stride-length estimation accuracy, reducing the absolute mean error from 29.78% to 7.77% and the standard deviation from 20.31 to 7.17. Furthermore, the LSTM models trained on Modified EKF-preprocessed data achieved superior performance metrics, with a Mean Absolute Error (MAE) of 0.0376 and a coefficient of determination (R²) of 0.7066. These results highlight the effectiveness of combining Modified EKF preprocessing with LSTM learning to enhance stride-length estimation reliability. This integrated approach offers a robust, noise-resilient solution for wearable gait analysis, providing valuable insights for clinical diagnostics, rehabilitation monitoring, and health management applications. Full article

Walking on compliant terrain presents a substantial challenge for individuals with lower-limb amputation, further elevating their already high risk of falling. While powered ankle–foot prostheses have demonstrated adaptability across speeds and rigid terrains, control strategies optimized for soft or compliant surfaces remain underexplored. This work experimentally validates an admittance-based control strategy that dynamically adjusts the quasi-stiffness of powered prostheses to enhance gait stability on compliant ground. Human subject experiments were conducted with three healthy individuals walking on two bilaterally compliant surfaces with ground stiffness values of 63 and $25{\displaystyle \frac{\mathrm{kN}}{\mathrm{m}}}$, representative of real-world soft environments. Controller performance was quantified using phase portraits and two walking stability metrics, offering a direct assessment of fall risk. Compared to a standard phase-variable controller developed for rigid terrain, the proposed admittance controller reduced short-term maximum Lyapunov exponents by an average of 7%, indicating improved local dynamic stability. These results support the potential of adaptive prostheses control to enhance gait stability on compliant surfaces, contributing to the development of more robust human–prosthesis interaction. Full article

Manufacturing industries are increasingly applying sustainable closed-loop supply chains (CLSCs) to meet economic, environmental, and societal goals. The increasing complexity and interdependence associated with the sustainability CLSCs make them highly vulnerable to disruption risks that threaten continuity and sustainability. However, prior studies fall short of guiding how disruption risks in sustainable CLSCs can be systematically prioritized under uncertainty in a stable and decision-relevant manner. To fill this literature void, this study develops a hybrid of the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (Fuzzy-TOPSIS) method and the genetic algorithm (GA) technique to prioritize disruption risks under uncertainty. Triangular fuzzy numbers are used to capture the imprecision of 13 experts from industry and academia, whereas the GA technique used aimed to improve stability and reduce the variability commonly observed in conventional fuzzy multi-criteria decision-making methods. The method is validated through a real-world case study, identifying supplier disruption risk, route disruption risk, and industrial accidents as the most critical risks. Moreover, sensitivity analysis is conducted to validate the robustness of GA-based Fuzzy-TOPSIS, demonstrating its superior stability and reliability compared to the classical Fuzzy-TOPSIS method in uncertain environments. The novelty of this study lies in embedding a GA-driven approach within the fuzzy-TOPSIS structure to explicitly address ranking instability under uncertainty in sustainable CLSCs. The study provides significant theoretical contributions by enhancing multi-attribute decision-making regarding disruption risk in sustainable CLSC literature, as well as practical insights for decision-makers to efficiently allocate resources by focusing mitigation investments on consistently high-priority risks instead of low-priority ones. Full article

Aging-related muscle dysfunction has been conceptualized through the model of sarcopenia, but it embraces several other characteristics, e.g., dynapenia, myosteatosis, and powerpenia. Our perspective reframes muscle aging from a different point of view, the Skeletal Muscle Function Deficit (SMFD), a unifying approach that integrates muscle quality and mass into a single functional definition. An SMFD score has been adopted in the InCHIANTI study against many geriatric outcomes, such as risk of disability, physical performance, hospitalizations and falls, and incidence of major diseases, highlighting its potential value as a primary indicator of muscle failure and/or of healthy aging. At the core of SMFD lies inflammaging, the chronic, low-grade, age-related inflammation, linking functional outcomes to muscular and neural aging. Inflammatory mediators alter the anabolic/catabolic balance, accelerate myosteatosis, impair neuromuscular junction, and influence denervation. These findings support the idea of a common pathway that links neuro-muscular deficit and inflammation, which simultaneously targets cortical motor circuits, spinal motor neurons, peripheral nerves, and muscle fibers. The SMFD approach facilitates early detection, risk stratification, and possible intervention for muscle deterioration with aging. Full article

This article presents the results of research into the operation of retractable-type fall arresters used for fall protection in conjunction with flexible anchor points. The purpose of these devices is to enable the user to move freely in the vertical direction and safely arrest any fall from the workstation. Reports from users of such protective equipment and previous studies have indicated the occurrence of specific situations in which retractable-type fall arresters did not work properly. It was manifested by the sudden locking and unlocking of the device’s retractable lanyard, which means that the falling person was not stopped at the required distance. This is a highly dangerous phenomenon known as “jump action” that can cause serious injury or even death. Therefore, three different designs of retractable-type fall arresters and three loading conditions were investigated to analyze the jump action phenomenon. Based on the experimental results, a modification of the retractable type fall arresters was proposed in the form of an added electronic control. The proposed programmable control system will make it possible to eliminate the risks associated with “jump action” and expand the functionality of the studied fall arresters. Full article

Purpose: This study aimed to quantify the severity of fear of falling (FOF) in people with low vision (LV) compared with age–gender-matched healthy individuals during gait initiation (GI). Methods: A total of 14 adults with LV and 14 age–gender-matched healthy adults were recruited from local communities. The Falls Efficacy Scale International was used to evaluate FOF. We compared temporal events between healthy and LV groups. For the healthy group, GI under normal vision was further compared to conditions using a low-vision sight simulator (SS) and an immersive virtual reality (VR) environment designed to simulate a fear-evoking experience. Independent t-test and one-way repeated measure ANOVA were conducted for statistical analysis (p < 0.05). Results: People with LV showed a significantly greater FOF than healthy individuals (p < 0.05). During GI, participants with LV exhibited significantly prolonged anticipatory postural adjustment (APA) durations compared to healthy normal and SS conditions (p < 0.05). While VR-evoked fear in healthy participants primarily prolonged the push-off (PO) phase, the delay in the LV group was characterized by a significantly extended initial anticipation (AP) phase. Notably, the APA duration in the LV group showed no significant difference compared to the healthy VR condition, indicating that the inherent fear in LV produces postural delays as severe as those induced by extreme VR-evoked fear of heights (p > 0.05). Conclusions: This study demonstrates that individuals with LV adopt a chronically conservative motor program during the transition from standing to walking. These postural hesitations are statistically comparable to those observed under fear-evoking, VR-induced environments. These findings suggest that LV is associated with a distinct biomechanical strategy that prioritizes static stability over dynamic movement. Accordingly, multidisciplinary rehabilitation approaches that emphasize sensory reweighting, including vestibular training, alongside interventions targeting FOF, may be essential for mitigating altered postural control and reducing fall risk in the LV population. Full article

Background: Advancing age is frequently associated with balance impairment, increased fall risk, and psychological distress, which together contribute to loss of independence and reduced quality of life. Yoga, as a mind–body practice, has the potential to enhance physical stability as well as mental well-being in older adults. Therefore, the objective of this study was to evaluate the effects of a structured yoga program on balance, fear of falling, mobility, and mental health outcomes among older adults. Methods: A quasi-experimental pretest–post-test study was conducted at Nagpur, India. A total of 64 eligible participants (65–85 years) were purposively assigned to a yoga intervention group (n = 32) or a waitlist control group (n = 32). The 12-week intervention comprised preparatory exercises, yoga postures, breathing practices, and meditation. Outcomes assessed at baseline and post-intervention included balance, fear of falling, mobility, depression, and anxiety. Results: Data from 50 participants (yoga: n = 26; control: n = 24) were analyzed. The yoga group showed significant improvements in balance (p < 0.001) and functional mobility (p < 0.001), with significant reductions in fear of falling (p = 0.009), anxiety (p = 0.0003), and depression (p = 0.004). In contrast, the control group exhibited deterioration in functional mobility (p = 0.001) and anxiety (p = 0.009), with no significant gains in other measures. Between-group comparisons confirmed significantly greater improvements in the yoga group across all outcomes. Conclusions: A 12-week yoga program was feasible and effective in improving balance, functional mobility, and mental health, while reducing fear of falling among older adults. Yoga may serve as a safe, non-pharmacological intervention to promote healthy aging in institutionalized populations. Trial registration: This study was prospectively registered with the Clinical Trial Registry of India (Registration No: CTRI/2023/10/058682; Registered on: 16 October 2023). Full article

Objectives: To improve the differentiation of borderline ovarian-adnexal tumours (BOTs) from malignant ovarian-adnexal masses, most of which fall into the indeterminate O-RADS MRI 4 category, by developing a multimodal predictive model that integrates clinical, analytic, and MRI parameters. Methods: This retrospective, single-centre study included 248 women who underwent standardised MRI for ovarian-adnexal mass characterisation between 2019 and 2024. Of these, 201 had true ovarian-adnexal masses (114 benign, 22 borderline, and 65 malignant), confirmed by histopathology or stability after ≥12-month follow-up. Forty-one clinical, laboratory, and imaging variables were initially assessed, and after a bivariate evaluation, 18 final predictors with clinical relevance were selected for model construction with thresholds learned from the data. A classification and regression tree (CART) model (“Full Model”) was applied as a second-stage tool after O-RADS MRI scoring, using 10-fold cross-validation to prevent overfitting. A pruned “Simplified Model” was also derived to enhance interpretability. Results: O-RADS MRI performed well at the extremes (scores 2–3 and 5) but showed limited discrimination between BOTs and malignancies within category 4 (PPV for borderline = 0.50). The decision-tree models significantly improved diagnostic performance, increasing overall accuracy from 0.856 with O-RADS MRI alone to 0.905 (Simplified Model) and 0.955 (Full Model). The PPV for BOTs within the intermediate O-RADS MRI 4 category increased from 0.49 with O-RADS MRI alone to 0.77 and 0.90 with the simplified and full models, respectively, while maintaining high accuracy for benign and malignant lesions. Conclusions: In this retrospective single-centre cohort, the addition of an interpretable rule-based predictive model as a second-line tool within O-RADS MRI category 4 was associated with improved discrimination between borderline and invasive malignant ovarian-adnexal tumours. These findings suggest that multimodal integration of clinical, laboratory, and MRI features may help refine risk stratification in indeterminate cases; however, external validation in prospective multicentre cohorts is required before clinical implementation. Full article

The liquid oxygen subcooler is a key unit for the deep cooling, storage, and transportation of liquid oxygen. Its frequent start–stop operation under liquid nitrogen bath conditions introduces potential risks to service reliability. This study employs a thermo-structural sequential coupling approach to evaluate the stress behavior of ABS components in a flat plate-fin heat exchanger during the pre-cooling, heat-exchange, and recovery stages. Based on the maximum shear stress (Tresca) criterion, the evolution of principal stresses in the brazed layer under liquid nitrogen bath conditions was analyzed, and a conservative assessment of the material’s fatigue behavior was conducted. The results indicate that the equivalent stress is governed by the third principal stress, originating from the thermal compression effect induced by low-temperature constraint shrinkage. During the heat exchange phase (2700 s), the inlet equivalent stress reached 93.49 MPa, which is below the 258 MPa limit, falling within Region 1. Local stress concentration is primarily driven by thermal loading, with brazing layer thickness, curvature radius, and liquid oxygen pressure serving as key control variables. Under a safety factor of 1.15 (107 MPa), fatigue testing exceeding 1.5 million cycles has confirmed the static safety and operational reliability of the ABS. Full article

Background/Objectives: People with Parkinson’s disease (PwPD) exhibit impairments in postural responses to perturbations, increasing their risk of falls. While transcranial direct current stimulation (tDCS) has been shown to enhance postural responses in PwPD, its effects considering history of falls remain unclear. Thus, we aimed to analyse the effect of tDCS on postural responses after external perturbation in PwPD with and without a history of falls. Methods: Twenty-two PwPD were distributed into two groups—faller (n = 12) and non-faller (n = 10)—based on their history of falls over the 12 months preceding the experiment. A 20 min anodal tDCS was applied to the primary motor cortex (M1) under two conditions (2 mA and sham), performed on two different visits (at least 2 weeks apart) with a randomised order. Seven trials with temporally unpredictable external perturbation (i.e., backward translation of the support base) were performed after tDCS. Electromyographic (i.e., medial gastrocnemius (MG) onset latency, magnitude of muscle activation of MG and tibialis anterior (TA), and MG/TA coactivation index) and centre of pressure (CoP) parameters (i.e., range of CoP, peak of CoP velocity, and recovery time) were analysed to assess postural response. A two-way ANOVA (Group × Stimulation Condition) was performed. Results: Both groups had shorter recovery time (determined by CoP) and MG onset latency in the active vs. sham condition. Conclusions: The results of our pilot study suggest that a single 20 min tDCS session (2 mA) applied over M1 enhances postural responses similarly in PwPD with and without a history of falls in the past year. Full article

Background: Older adult falls during step negotiation result in higher injury rates compared to level ground falls. Previous research on discrete events during step negotiations may not capture important age-related changes. Curve analysis techniques enable assessment of an entire time series and may further advance the understanding of older adult falls during step negotiation. The purpose of the current study was to investigate lower extremity kinematics during transition step negotiation in older women with fall history compared to young women using statistical parametric mapping (SPM). Methods: 15 older female adults with a fall history and 15 young female adults participated in the study. Participants performed walking trials along a 5.5 m raised walkway, descended a 17 cm step and continued walking 3 m. Data was processed from lead limb toe-off prior to the step, through lead limb weight acceptance of the transition step. SPM was used to perform independent t-test analysis of the three-dimensional lower extremity time series. Results: The older faller group showed significantly decreased lead hip abduction (9–19% of step negotiation, mean difference: 3.74°, p = 0.045), increased lead knee flexion (65–80% of step negotiation, mean difference: 5.8°, p = 0.012), and increased trail limb hip adduction (91–100% of step negotiation, mean difference: 3.92°, p = 0.046). Conclusions: The older faller group showed altered hip joint angles in the frontal plane and knee joint angles in the sagittal plane during early swing and late weight acceptance phases, which may reflect compensatory strategies for reduced strength and/or balance. Curve analysis provides additional insight into age-related kinematic changes during step negotiation that may be related to older adult fall risk. Full article

The Yazoo–Mississippi Delta is an agricultural production zone and flyway for migratory birds. During winter, agricultural field-flooding practices are routinely used to support bird conservation and local recreational hunting opportunities. In response to the 2010 Deepwater Horizon oil spill, federal agencies incentivized flooding in summer and fall to mitigate the risks to migratory bird populations. This funding ceased in 2017, yet the United States Department of Agriculture Natural Resources Conservation Service Environmental Quality Incentives Program Practice 644 and a local non-profit continue to incentivize flooding during fall. Ensuring that contractual water levels are met is challenging to determine. To that end, we developed the Field Inundation Tool/Survey, an integrated remote sensing approach using PlanetScope imagery (Planet Labs, San Francisco, CA, USA) to quantify associated hydrology patterns. We used the Normalized Difference Water Index and an Iso Cluster Unsupervised Classification to estimate field inundation and associated habitat types over a three-year period. The results indicate dynamic field inundation can be estimated via PlanetScope imagery. Derived inundation metrics were comparable with in situ sensor and digital elevation models among some treatment types. We documented future refinements for image quality and soil patterns. Our work can improve conservation incentivization by tracking spatial and temporal patterns in adoption and has applicability to other agroecosystems. Full article

Background and Objectives: Postural instability is a key feature of Parkinson’s disease (PD), contributing to disability and increased risk of falls. Pharmacological treatments are important, but it is necessary to integrate them with rehabilitation programs that provide benefits for gait and balance. Focal muscle vibration (fMV) has been proposed as a proprioceptive-oriented intervention to enhance postural control, but evidence in PD remains heterogeneous. This observational, retrospective, and controlled pilot study aimed to evaluate whether the integration of fMV into a standardized rehabilitation program provides additional benefits for balance, gait, and fall risk compared to standardized exercise alone in patients with PD. Materials and Methods: Medical records of 35 outpatients with Parkinson’s disease (Hoehn & Yahr stage II–III) were reviewed. All practiced a standardized rehabilitation exercise group program. Of these, 18 patients agreed to undergo fMV before the exercise sessions (fMV group); 17 patients did not accept fMV due to personal organizational reasons (EG) and were considered a retrospective control group. In detail, (i) the fMV group receivdc focal muscle vibration during the first three weeks in addition to a standardized group rehabilitation exercise program, and (ii) the EG underwent a standardized rehabilitation program only. Both groups then completed an identical 16-week standardized rehabilitation program. Functional outcomes were assessed at baseline (T0) and after one month (T1). Results: Groups were homogeneous at baseline. The fMV group showed significant improvements in SPPB (from 8.16 ± 1.6 to 10.2 ± 1.6 p < 0.001) in the Tinetti total (from 18.38 ± 3.2 to 21.5 ± 2.9 p < 0.05). Stabilometric analysis revealed a significant improvement in the Romberg Quotient in the fMV group (p < 0.005). Conclusions: A short time-limited fMV intervention may act as a sensory primer, enhancing the effects of a subsequent standardized rehabilitation program in PD. Full article