BackgroundFalls are a leading cause of mortality and morbidity in older people and the risk of falling is exacerbated by mental health conditions. Existing reviews have focused on people with dementia and cognitive impairment, but not those with other mental health conditions or in mental health settings. The objective of this review is to evaluate the effectiveness of fall prevention interventions for older people with mental health problems being cared for across all settings.MethodsA systematic review of fall prevention interventions for older people with mental health conditions. We undertook electronic database and lateral searches to identify studies reporting data on falls or fall related injuries. Searches were initially conducted in February 2011 and updated in November 2012 and October 2013; no date restrictions were applied. Studies were assessed for risk of bias. Due to heterogeneity results were not pooled but are reported narratively.ResultsSeventeen RCTs and four uncontrolled studies met the inclusion criteria; 11 involved single interventions and ten multifactorial. Evidence relating to fall reduction was inconsistent. Eight of 14 studies found a reduction in fallers (statistically significant in five), and nine of 14 reported a significant reduction in rate or number of falls. Four studies found a non-significant increase in falls. Multifactorial, multi-disciplinary interventions and those involving exercise, medication review and increasing staff awareness appear to reduce the risk of falls but evidence is mixed and study quality varied. Changes to the environment such as increased supervision or sensory stimulation to reduce agitation may be promising for people with dementia but further evaluation is needed. Most of the studies were undertaken in nursing and residential homes, and none in mental health hospital settings.ConclusionsThere is a dearth of falls research in mental health settings or which focus on patients with mental health problems despite the high number of falls experienced by this population group. This review highlights the lack of robust evidence to support practitioners to implement practices that prevent people with mental health problems from falling.

Zineb and ethylene thiourea (ETU) residues were monitored in Bartlett pears after spraying with zineb (5.04 kg a.i./ha). Zineb dissipated seven times faster in the first 10 days after application than in the subsequent days of the study; ETU residues ranged from 0.02 to 0.01 mg/kg over the 21 day trial. A 3-6% conversion of ethylenebisdithiocarbamate to ETU was found upon boiling treated pears. Analysis of randomly selected commercially canned pears and baby food pear purQ showed no zineb residues but ~0 . 0 5 mg ETU/kg was present in four of the six samples of baby food.

The role of smuggling in forced migration has been a leading policy challenge of the Syrian refugee crisis in Europe and the Middle East. This study investigates how anti‐smuggling government policies have shaped migratory risks for Syrian refugees in five countries: Jordan, Turkey, Greece, Serbia and Germany. Original evidence from in‐depth interviews (n=123), surveys (n=100), expert interviews (n=75) and ethnography reveal that government anti‐smuggler policies have: (a) endangered Syrian refugees by shifting risk from smugglers to their clients; (b) distorted refugees’ perceptions of risk, and; (c) decreased refugees’ confidence in government representatives while increasing dependence on smugglers. These data are unique in scope and topic, expanding the existing literature with an emphasis on understudied experiences during migration. The paper concludes with a policy recommendation that acknowledges the reality of smugglers’ role in forced migrants’ decisions, offering a pragmatic alternative of strategic pre‐emption of smugglers.

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