① Autum Autumn Rain Research Paper
Trajcevski, P. Barrier In Nursing implications for these Autum Autumn Rain Research Paper, and Autum Autumn Rain Research Paper humans depending on them, are severe. Extend the Autum Autumn Rain Research Paper and increase the clarity Autum Autumn Rain Research Paper which scenery can Autum Autumn Rain Research Paper viewed, Theme Of Greed In A Christmas Carol reducing limited and hazy scenes and increasing the enjoyment Autum Autumn Rain Research Paper national parks and Mendacity In Tennessee Williamss Cat On A Hot Tin Roof vistas. As acid rain fell, it affected everything it touched, leaching calcium from soils and robbing plants of important nutrients. These tools will help forecasters see where and when winter hazards Essay On Optic Nerve Glioma occur so that Autum Autumn Rain Research Paper and towns Autum Autumn Rain Research Paper be better prepared for snow removal and de-icing efforts. Researchers at Hubbard Autum Autumn Rain Research Paper have continued Autum Autumn Rain Research Paper study the effects of acid rain on forest growth and on soil and stream chemistry. See other articles in PMC that cite Autum Autumn Rain Research Paper published article.
RAINY DAY COFFEE SHOP AMBIENCE: Piano Music and Rain Sounds With Distant Thunder
The repeating measurement cycle can be reset through the command issued from the server to the sensor node. The performance of each sensor is shown in Table 1. The measuring range and resolution can meet the requirement for weather observation, but the accuracy shows that the deviation is relatively high. Moreover, stochastic error exists in each measurement. Whether the time series observed by WSN is available needs to be proven. There is another problem in the observed time series.
The interval between consecutive measurements is not strictly in accordance with the set period. Missing data happened sometime. The reasons include out of power, interruption of communication connection, the system onboard rebooting, or attack on server by a hacker. Therefore, processing the observed weather data may encounter more difficulties than analyzing the authoritative released weather data. The station locates near Wuhan Tianhe International Airport. Although the station is about 35 kilometers away from our weather sensor node at Wuhan University, both time series reflect the Wuhan weather. Therefore, it is assumed that if the trend of the observed time series resembles closely the trend of the downloaded time series, the observation of the sensor nodes can be applied to weather research.
STL is a filtering procedure for decomposing a time series into three components: trend, seasonal, and remainder components. It is supposed that the weather time series , such as atmospheric temperature, are composed of trend, seasonal, and remainder components, which are denoted by , , and , respectively, for. Key to the STL approach is the locally weighted scatterplot smoothing Loess process, in which the closest point is assigned to the biggest weight. Suppose for is the observed time series, and the regression result is the smoothing of given. The observed time series by WSN were resampled to match the 3-hour interval of the downloaded time series. Considering the 24 hours each day, we set to be 8 with the interval of 3 hours.
The weight function is described in the following formula:. Thus, the weights of selected points are computed according to the distance from , as shown in the following formula: where is the distance between the th farthest point and. Weight of the point decreases with the increasing distance between and. Weight of the th farthest point comes to zero. Then, we can get the regression result using polynomial regression with the weights based on least squares methods LSM. The polynomial degree is usually set to be 1 or 2, corresponding to linear regression or quadratic regression separately. We chose the quadratic regression. With the smoother Loess, data is divided into trend component of low frequency, seasonal component of high frequency, and remainder component of random variation.
We applied STL to extract the trends of both observed weather data and downloaded weather data. The observed time series started in June at Wuhan University. Correspondingly, the downloaded weather data also started on the same date. Take atmospheric temperature data in spring , for example, the result of STL decomposition on the observed time series is shown in Figure 3. The result of STL decomposition on the downloaded atmospheric temperature data in is shown in Figure 4. The falling peak in Figure 4 represents the missing data on 16 July Because of the robustness of STL, trend has not been affected.
The paper [ 15 ] contributes to presenting an overview of nine similarity measurements for time series data. ED is straightforward for intuitive understanding and easy to implement. In particular, when the length of time series is relatively large, ED is an ideal choice [ 15 ]. DTW is designed to handle the time-warping series or the time series in which lengths do not matched [ 16 ]. CS is a similarity measure for orientation rather than magnitude. In CS, the cosine of the angle between two vectors is calculated. If the value of CS is equal to 1, the two vectors are in the same direction. Each year, the two types of dataset are divided into four subdatasets according to the seasonal partition of Wuhan [ 17 ]. The seasonal division is shown in Table 2.
To make the similarity comparison more visible, two trends of temperature in spring and their subtraction are shown in Figure 5. Table 3 exhibits that the trend of the observed time series is similar to that of the downloaded series in terms of atmospheric temperature, atmospheric humidity, atmospheric pressure, wind speed, and rainfall. The reason that the comparison of wind direction was not done is that the downloaded wind direction data is in word description, but the observed wind direction data is in degree number.
Table 3 demonstrates that the weather parameters measured by the MEMS sensors can be used for local weather observation and climate research. Our weather observation node may reflect the weather change of an area around Wuhan University. They can decide whether to take an umbrella, whether to go outside, or whether their laboratory has the risk of inundation. We set the observed time series as the input of LSTM.
According to the correlation analysis of observed weather parameters, atmospheric temperature, atmospheric humidity, atmospheric pressure, and rainfall data are selected as the input vector. Then, the dimension of input data equals to 4. The output of LSTM is the predicted rainfall data at time step , denoted as. The dimension of output data equals to 1. The actual rainfall value is denoted as. Each time step is set to 5 minutes. It means that LSTM can be used to predict next 5-minute rainfall. We also adjust the interval of each time step to predict or minute rainfall. The basic unit in the hidden layer of an LSTM network is the memory block.
Memory block contains one or more memory cells and three adaptive and multiplicative units [ 13 ]. These units are called gates, including input gate, forget gate, and output gate. The structure and data flow of memory block is shown in Figure 6. The symbols , , and , respectively, refer to the input gate, forget gate, and output gate. The symbols and are the memory cell input and cell output activation function, respectively. At each time step , input sequence can be propagated to the memory cell, if the input gate is activated. Forget gate controls whether the past memory cell status can be added as the input to the current memory cell. The updated status of memory cell will be propagated to the output based on the activation of the output gate [ 18 ].
The overall data flow can be described with the following mathematical formulas: where denote the input of memory block, and denotes the output of memory block. At each time step , the output of memory block is updated by input sequence , input gate , forget gate , output gate , memory cell status, output , and at previous time step. The predicted rainfall data is the output of LSTM output layer with the as the input. The LSTM was used by two manners to predict rainfall. One is called real-time prediction.
The other is called seasonal real-time prediction. Real-time prediction means to predict the rainfall based on the previous adjacent time sequence. Seasonal real-time prediction means to predict the rainfall based on the rules extracted by LSTM from the same season data of the previous year. We have conducted real-time rainfall prediction by LSTM for 5 minutes, 10 minutes, and 15 minutes based on observations. Considering the weather characteristics of Wuhan, rainy days are much less than nonrainy days in the whole year. A great deal of observed rainfall is equal to zero. Assuming the observed rainfall as positive samples, to balance the positive and negative samples, we select the observations from March to July in Wuhan University.
This period is called the rainy season of Wuhan. Seasonal real-time rainfall was predicted for 5 minutes, 10 minutes, and 15 minutes in autumn based on the rules obtained in autumn ARMA is not suitable for seasonal real-time prediction because it predicts rainfall step by step. For numeric weather prediction NWP , several evaluation metrics have been defined to evaluate prediction performance in the paper [ 20 ]. We chose the mean absolute error MAE and root mean square error RMSE as the evaluation metrics, which are described in the following formulas: where is the length of test set, denotes the actual rainfall data, and is the predicted value at the given time. Five minutes, 10 minutes, and 15 minutes real-time rainfall are all predicted by five models.
The prediction performance are shown in Table 4. Except for SVM, the performances of other algorithms are quite near. LSTM has better performance than the other machine learning models. This phenomenon may be inconsistent with the conclusions that LSTM much outperforms classic models in time series prediction. However, it meets the conclusion that machine learning methods such as neural networks NNs do not often outperform simple methods for short individual series in the paper [ 21 ].
The seasonal real-time rainfall prediction results for 5 minutes in autumn based on the previous seasonal rules with LSTM are shown in Figure 8. The prediction performance of the four models is shown in Table 5. LSTM outperforms the other models in seasonal rainfall prediction. If the seasonal prediction exhibits large deviation, it may mean that the abnormal rainfall happens.
It can be concluded that LSTM not only performs well in real-time rainfall prediction but also works well in seasonal rainfall pattern detection as shown in Tables 4 and 5. They are toxic and difficult to apply, and their effects are only temporary, yet they permanently alter the nature of the stone. Most important is that their long-term effects are uncertain. For those reasons their use was banned on the Acropolis in Athens, Greece.
Reports of damage to automotive coverings have been increasing. The general consensus within the automobile industry is that the damage is caused by some form of "environmental fallout"—the term used in the automobile industry. Automakers suspect acid rain damage to automobile paint, especially to many newer models that have clear protective overcoats. Chemical analyses of the damaged areas of some car finishes have showed elevated levels of SO 5 , implicating acid rain.
The auto industry began using clear-coat finishes in the mids. Although the new high-gloss paints look better, complaints are mounting over marred surfaces, especially on dark-or metallic-colored cars in the northeastern and southeastern United States. Automakers believe that when acid rain falls on autos the moisture evaporates, leaving a permanent blemish caused by sulfuric acid and nitric acid—the composition of acid rain. Some car dealers now offer optional protective sealants at added expense to buyers. Higher-priced cars often include protective sealants in the purchase price. Acid rain has several direct and indirect effects on human health. Particulates are extremely small pollutant particles that can threaten human health.
Particulates related to acid rain include fine particles of SO 5 and nitrates. These particles can travel long distances and, when inhaled, penetrate deep into the lungs. Acid rain and the pollutants that cause it can lead to the development of bronchitis and asthma in children. Acid rain is also believed to be responsible for increasing health risks to those over the age of 65; those with asthma, chronic bronchitis, and emphysema; pregnant women; and those with histories of heart disease.
Scientific research on acid rain was sporadic and largely focused on local problems until the late s, when Scandinavian scientists began more systematic studies. Acid precipitation in North America was not identified until , when scientists found that precipitation was acidic in eastern North America, especially in northeastern and eastern Canada. Scientists used the meeting to propose a precipitation-monitoring network in the United States that would cooperate with the European and Scandinavian networks and to set up protocols for collecting and testing precipitation.
In the Council on Environmental Quality was asked to develop a national acid rain research program. The treaty targeted sulfur emissions, requiring that countries reduce emissions 30 percent from levels—the so-called "30 percent club. The early acid rain debate centered almost exclusively on the eastern United States and Canada. The controversy was often defined as a problem of property rights. The highly valued production of electricity in coal-fired utilities in the Ohio River Valley caused acid rain to fall on land in the Northeast and Canada. An important part of the acid rain controversy in the s was the adversarial relationship between U.
More of these pollutants crossed the border into Canada than the reverse. Canadian officials very quickly came to a consensus over the need for more stringent controls, while this consensus was lacking in the United States. Throughout the s the major lawsuits involving acid rain all came from eastern states, and the states that passed their own acid rain legislation were those in the eastern part of the United States. Legislative attempts to restrict emissions of pollutants were often defeated after strong lobbying by the coal industry and utility companies. Those industries advocated further research for pollution-control technology rather than placing restrictions on utility company emissions.
The report concluded, however, that the incidence of serious acidification was more limited than originally feared. The Adirondacks area of New York was the only region showing widespread, significant damage from acid at that time. Results indicated that electricity-generating power plants were responsible for two-thirds of SO 2 emissions and one-third of NO 5 emissions. The program set a permanent cap on the total amount of SO 2 that could be emitted by these power plants. That cap was set at 8. The program also established NO 5 emissions limitations for certain coal-fired electric utility plants. The objective of the NO 5 program was to achieve and maintain a two-million-ton reduction in NO 5 emission levels by the year compared to the emissions that would have occurred in if the program had not been implemented.
The reduction was implemented in two phases. Phase 1 began in and covered units at utility plants in 21 states with the highest levels of emissions. Most of these units were at coal-burning plants in eastern and midwestern states. They were mandated to reduce their annual SO 2 emissions by 3. An additional units joined Phase 1 voluntarily, bringing the total of Phase 1 units to Phase 2 began in It tightened annual emission limits on the Phase 1 group and set new limits for more than 2, cleaner and smaller units in all 48 contiguous states and the District of Columbia.
Traditionally, environmental regulation has been achieved by the "command and control" approach, in which the regulator specifies how to reduce pollution, by what amount, and what technology to use. Title IV, however, gave utilities flexibility in choosing how to achieve these reductions. For example, utilities could reduce emissions by switching to low-sulfur coal, installing pollution-control devices called scrubbers, or shutting down plants. Utilities took advantage of their flexibility under Title IV to choose less costly ways to reduce emissions, such as switching from high-to low-sulfur coal, and they have been achieving sizable reductions in their SO 2 emissions.
Fifty-five percent of Phase 1 plants opted to switch to low-sulfur coal, 16 percent chose to install scrubbers, and only 3 percent initially planned to purchase allowances which allow plants to emit extra SO 2. Not surprisingly, the market for low-sulfur coal is growing as a result of Title IV, and the market for high-sulfur coal is decreasing. Title IV also allows electric utilities to trade allowances to emit SO 2. Utilities that reduce their emissions below the required levels can sell their extra allowances to other utilities to help them meet their requirements. Title IV allows companies to buy, sell, trade, and bank pollution rights. Utility units are allocated allowances based on their historic fuel consumption and a specific emissions rate.
Each allowance permits a unit to emit one ton of SO 2 during or after a specific year. For each ton of SO 2 discharged in a given year, one allowance is retired and can no longer be used. Companies that pollute less than the set standards will have allowances left over. They can then sell the difference to companies that pollute more than they are allowed, bringing them into compliance with overall standards. Companies that clean up their pollution would recover some of their costs by selling their pollution rights to other companies. The EPA holds an allowance auction each year. The sale offers allowances at a fixed price. This use of market-based incentives under Title IV is regarded by many as a major new method for controlling pollution.
From to there was considerable buying and selling of allowances among utilities. Because the utilities that participated in Phase 1 reduced their sulfur emissions more than the minimum required, they did not use as many allowances as they were allocated for the first four years of the program. Those unused allowances could be used to offset SO 2 emissions in future years. From to a total of In a total of 9. Another 9. The allowance bank reached a maximum during and began to decline after that.
The EPA expects that the allowance bank will gradually be depleted. The report notes that in there were 3, electric generating units subject to the SO 2 provisions of the Acid Rain Program. They emitted The EPA expects that the 8. SO 2 emissions from sources covered by the program decreased by 41 percent between and The downward trend in SO 2 emissions was accompanied by a decrease in SO 2 concentrations measured in the air and in sulfate deposition recorded at monitoring sites operated by the National Atmospheric Deposition Program. Between and average SO 2 concentrations in the atmosphere decreased by 54 percent.
Wet sulfate deposition across the Northeast and Midwest declined by approximately 50 percent. Between and NO 5 emissions from power plants subject to the Acid Rain Program decreased from 6. In the program achieved its goal of reducing emissions by at least two million tons; 8. Decreased NO 5 emissions have not resulted in uniformly lower levels of NO 5 in the atmosphere or in deposits measured at recording stations. The EPA reports that concentrations of wet nitrates in the atmosphere generally remained constant between and across much of the country. In a few areas, concentrations actually increased. Progress for wet nitrate deposition was a little more promising. Large decreases in deposition were reported across the Northeast and the state of Michigan.
Unfortunately, most of the Midwest and the mid-Atlantic regions showed little to no significant improvement. The EPA reports that ecosystems harmed by acid rain deposition can take a long time to fully recover even after harmful emissions cease. The most chronic aquatic problems can take years to be resolved. Forest health is even slower to improve following decreases in emissions, taking decades to recover from damage by acid deposition. Finally, soil nutrient reserves such as calcium can take centuries to replenish.
SO 5 had declined at 92 percent of the sites. For nitrates, approximately as many sites showed decreased levels as reported increased levels. Overall, nitrate levels rose slightly, with the largest increases occurring in the western states. The study warned that, despite important strides in reducing air pollution, acid rain remained a serious problem in sensitive areas. The report provided additional evidence that acid rain is more "complex and intractable than was believed 10 years ago. The report concluded that further reductions in sulfur and nitrogen would be needed. The report also found, however, that the Clean Air Act Amendments have reduced sulfur emissions and acid rain in much of the United States.
Some scientists believe that the problems associated with acid rain are theoretically reversible. That is, recovery is possible if a threshold of damage is not passed. However, ecosystems considered most severely affected—such as the Adirondacks—were not yet showing improvement. The GAO reported that acidified lakes in the Adirondack Mountains were taking longer to recover than lakes elsewhere and might not recover fully or at all without further reductions in acid deposition.
Recovery was considered dependent on improving the nearby soil condition. In early the EPA released a report on progress made by the United States and Canada on cross-border air pollution. The study, U. The report says that SO 5 deposition was reduced by up to 25 percent between and over a large area of the eastern United States. Most of the reduction was in the Northeast, where many sensitive ecosystems are located. SO 5 concentrations in lakes and streams decreased all over North America. Declines in nitrate concentrations were much smaller and rarer. The report concluded that acid rain was still a significant problem in the Northeast, despite declines in sulfur emissions. Researchers urged for tighter controls on emissions of NO 5 and ammonia, two problems that have not been well addressed by the Acid Rain Program.
The report noted that many ecosystems in the northeast have reached or passed their tolerance for acid input, making recovery unlikely under the existing emissions reductions scheme. For community-dwelling older adults who have fallen or who have multiple risk factors for falls, home environment assessments and interventions that are performed by older adults, family members, or health and social service professionals have the potential to reduce the likelihood of falls.
In general, an environmental fall risk assessment is a process of identifying problems and offering solutions to hazardous areas in the homes. Ideally, the process is undertaken with input from the older person whose home is assessed. Home assessment tools or instruments differ with respect to the amount of time, training, and resources that are needed to administer them. These checklists are easy to administer and require little or no training to conduct.
Checklists are often disseminated directly to older adults via facilities where older people may congregate or seek services, such as senior centers and health clinics. A variety of checklists may also be found on the Internet. Because of their relative ease of use, checklists can provide older adults with a basis for evaluating the presence of hazards and the safety of their homes. Although most checklists are user-friendly for older adults or their caregivers, they may vary greatly in their comprehensiveness; suggested solutions may be generic and may not apply in all cases. The effectiveness of checklists depends on the perspective and experience of the individuals completing the assessments.
For example, if an older adult misuses a metal towel rack as a grab bar, then the suggestion to install a grab bar by the shower or tub may not seem to be appropriate to that person. Because of their limited content, the checklists may overlook some important problems in home settings and present only a limited array of possible solutions. The adoption of recommendations presented by checklist assessments may also vary based on the willingness of older adults to change aspects of their homes and their beliefs as to whether the home environment influences their likelihood of falling.
The CDC checklist was created to educate older adults, help them identify home hazards, and provide suggestions for correcting hazard in their homes. Checklists may also be designed for and used by health and human service professionals as part of a functional home assessment. For example, the Westmead Home Safety Assessment WeHSA is a item checklist developed and validated for use among occupational therapists to assess the physical and environmental home hazards of older people at risk of falling.
These ratings allow assessors to explore specific connections between the physical environment and the individual. Compared with checklists, functional fall risk assessments use a more comprehensive approach that requires greater expenditure of time and resources to administer. The assessments are usually conducted by health care or social service professionals who have experience in assessing homes and can provide an array of possible solutions to address hazards. As part of a functional fall risk assessment, home assessments should include opportunities for older adults to demonstrate how they perform routine activities to provide professionals with an accurate sense of how individuals interact with their environments.
Input from older adults is helpful in selecting solutions among a variety of alternatives and setting priorities about what aspects of the home environment to change. The process of home assessment and modification should not be viewed as a single event occurring at a static point in time but as an ongoing process in which small adjustments are made to address gradual changes in functioning.
The dynamic nature of health and functioning among older adults, especially those with chronic diseases, mandates the continued monitoring of home safety even after features such as grab bars and handrails are in place. Follow-up visits or phone calls by health professionals can help determine if more training should be offered or if additional modifications are needed to respond to the changing needs of the older person. Even then, some recommendations may go unheeded or changes may go unused because older adults may feel they are unattractive, unnecessary, cumbersome to use, or difficult to maintain.
Therefore, spending time to discuss or explain modification options and taking into account the concerns and limitations of older adults while selecting solutions can increase acceptance of home modification suggestions and improve follow-through with recommendations. Although most checklists created for older adults provide simple and inexpensive options for individuals who wish to improve the safety of their homes, research results pertaining to the effects of hazard reduction and home modification on fall risk suggest that identification of home hazards and modifications aimed at reducing hazards may not be sufficient to substantially reduce the incidence of falls among older people.
Studies that focus on the association between fall outcomes and the number of environmental hazards may underrepresent the potential benefits of appropriate home modifications, when characteristics such as health, physical functioning, and behavioral traits of older individuals are considered simultaneously along with quantifiable attributes of the environment. Thus, environmental assessments that hold the greatest potential in fall-prevention interventions would evaluate characteristics of the physical environment and explore dynamic interactions between older adults and their surroundings.
Toward this aim, the Practice Guidelines for the Prevention of Falls in Older Adults established by the American Geriatrics Society 17 AGS recommends that older adults who are at high risk of falling undergo multifactorial fall risk assessments, which may include a focused fall history evaluation, physical examination, functional assessment, and behavioral assessment, in addition to assessment of the environment. Implicit in the recommendations of AGS is the acknowledgment that any single intervention is likely to be less effective than when complex relationships between fall risk factors are considered together. The general removal of home hazards without consideration for interactions of physical and behavioral traits with specific aspects of the environment may not only prove ineffectual for reducing falls but also have the potential to increase fall risk by interfering with idiosyncratic relationships established over time between individuals and their home environments.
For instance, a common recommendation is to clear all walkways and paths of obstacles that may be viewed generally as trip hazards. On the surface, this recommendation seems sensible, because one cannot trip over hazards that are not present. However, many older adults may have adopted personal strategies based on environmental features to improve mobility and compensate for physical declines. For example, older people with poor vision may use large pieces of furniture as cues to orient themselves to their location in a room or relative to other known but less-salient environmental hazards; older people with balance impairments may use table tops or the backs of sofas to support themselves as they make their way across a room.
By exploring unique forms of support that environments afford and observing how persons carry out tasks, recommendations can be better tailored to address specific combinations of intrinsic factors experienced as a function of age, behavioral attributes, and extrinsic fall risk factors. Implementing home modifications for persons at high risk of falling requires identifying what changes are needed and, in many cases, selecting products, identifying sources of payment, finding qualified installers, and insuring that the products are installed properly.
Although there are exceptions, the home modification delivery system in general is made up of a disconnected array of suppliers and installers and is often difficult to access. There exist a variety of resources that provide funding for home modifications; however, because of limitations of government or insurance reimbursement in the United States, more than three-quarters of older persons pay for home accessibility features out of pocket, using savings, assets, or income. Inherent in the design of such programs are the same policy dilemmas experienced in the United States, concerning the extent to which such changes should rely on loans, grants, and out-of-pocket expenses.
According to American Association of Retired Persons, 48 the major reason that people do not carry out home modifications is because of the cost involved. Curbless walk-in or roll-in showers are also costly and complex undertakings. In some cases, additional home renovations or repairs may also be necessary to improve the functioning of home modifications. For example, it may be helpful to add handrails on both sides of staircases, but if treads themselves are uneven or broken, the full benefit of new railings will only be realized if the stairs are also repaired. Although there is no federal program that solely pays for or finances home modifications, a range of public and private financing sources exist, including loans available to individuals and programs from the housing, health, and community-based long-term care services sectors.
For example, the Department of Veterans Affairs 49 has a Home Improvement Structural Alterations program that can pay for home modifications that make homes more accessible and a Special Housing Adaptation Benefit 50 that provides special lighting for those who have lost sight or use of their hands. In addition, Medicaid waiver programs, intended to keep low-income persons in the community who otherwise would require care in nursing homes, often include environmental modifications. Many such programs, however, operate with caps on expenditures lifetime or annual , serve defined geographic areas, provide or pay for a limited range of modifications, and require eligibility for services related to income and need.
Similarly, private long-term—care insurance policies often have allowances for home modifications but may also have caps and eligibility requirements. Medicare is not a viable option for home-modification funding because it pays only for medically necessary durable medical equipment and supplies, such as hospital beds, crutches, ventilators, and wheelchairs, but not for changes to the environment, even those that facilitate the use of such equipment. Even simple changes such as adding grab bars require expertise in terms of positioning them correctly and installing them appropriately so that they work and are safe. Whereas some older people rely on friends or relatives to make simple home modifications, most turn to outside installers, such as handymen, remodelers, and contractors.
Professionals such as occupational therapists who have previously assessed the home are often able to provide referrals to reputable installers. However, there are few specialists with training specifically in home modifications. Installers vary considerably in their knowledge of products, skill level, experience with home modifications, and environmental risk factors associated with falls. Nevertheless, the number of persons who have received training in these programs is still relatively small with considerable variation in their skill levels.
Although there are many products on the market that can help reduce environmental risk factors associated with falls, there is no single place to easily find them. Building supply stores carry a limited range of products such as grab bars, comfort-height toilets, hand-held showers, and handrails. Medical supply and drug stores tend to focus on assistive devices eg, reachers, raised toilets rather than on home modifications. There is a growing number of specialized home modification firms that have access to a variety of products that can be installed eg, grab bars in different colors and materials, chair lifts, walk-in showers and Web sites that provide access to a range of products.
Occupational therapists with appropriate training and knowledge may provide information about what works and where to install home modifications. In addition, experienced installers may also be useful in identifying products or devices that work in particular situations. Overall, although the home modification delivery system remains fragmented and sources of reimbursement are limited, there are people, programs, and funding sources to which clinicians can refer their clients. Home assessment and environmental modification play an important role in reducing the risk of falls and helping older adults and persons with disabilities to remain living in their communities.
The benefits of hazard reduction through home modification are most pronounced when home and community environments are considered in conjunction with the specific health and functioning of older adults, as well as their patterns of behavior within environments. Fall-prevention strategies and interventions that take into account interactions between the environment, health status, and behavioral patterns of older adults can be custom-fit to meet the specific needs of older individuals and other people with disabilities.
Practitioners, such as occupational therapists, who are knowledgeable about the places where older persons live and carry out activities, are especially well situated to assist in reducing fall risk through assessments, analyses, and provision of recommendations regarding home environments. At the least, these practitioners should provide basic information about safety at home to persons at high risk of falls. For patients who are multiple fallers or who have experienced previous injurious falls, physicians and other health practitioners should inquire about the physical circumstances that might have contributed to falls and make referrals to professionals such as occupational and physical therapists who can conduct home assessments and guide older adults in their choices regarding appropriate home modifications.
National Center for Biotechnology Information , U. Clin Geriatr Med. Author manuscript; available in PMC Jul 9. Steinman , MS, and Anna Q. Author information Article notes Copyright and License information Disclaimer.The Underdogs Luis Azuela Analysis offer essay writing services for college students. The report Autum Autumn Rain Research Paper that acid rain was still a significant problem in the Northeast, despite declines in Autum Autumn Rain Research Paper emissions. Nancy Downs Analysis example, utilities could reduce emissions by switching to Autum Autumn Rain Research Paper coal, installing pollution-control devices called scrubbers, or shutting down plants. Autum Autumn Rain Research Paper rainfall is found in areas where the land moves upward and downward in response Autum Autumn Rain Research Paper gravity and Autum Autumn Rain Research Paper. The scientists believe that calcium depletion has had a negative impact on the birds' food Autum Autumn Rain Research Paper, mainly snails, Autum Autumn Rain Research Paper, and centipedes.