This study examines positive social support,

This study assesses the relationship between fear of falling and avoidance of nine everyday activities critical to independence among community-dwelling older adults in the United States. Secondary data analysis was performed with National Survey of Self-Care and Aging interview data from 3474 respondents age 65 years or older. Falls were reported by 24 percent of respondents, fear of falling was reported by 22 percent of respondents, and both increased with age. Fear of falling was the most important factor in predicting activity avoidance among older adults; the number of falls experienced increases the impact that fear of falling has on activity avoidance. Other factors were as follows: needing help with activities of daily living and the number of prescriptions taken. Assessments of older individuals should include fear of falling and fall history. Reductions in fear of falling and increases in activity level could provide significant benefits by helping older adults to maintain functioning and the ability to live independently.

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The purpose of this study was to adapt the twenty-six-item Communication Skills Attitude Scale (CSAS) developed for medical students for use among dental students and to test the psychometric properties of the modiied instrument. The sample consisted of 250 students (an 80.1 percent response rate) in years D1 to D4 at a dental school in Washington, DC. The mean age of participants was 26.6 years with a range from twenty-one to forty-two years. Slightly more than half of the participants were female (52.4 percent) and were African American or of African descent (51.7 percent). Principal components analysis was used to test the psychometric properties of the instrument. The index that resulted measured both positive and negative attitudes toward learning communications skills. The inal twenty-four-item scale had good internal consistency (Cronbach's alpha=0.87), and the study obtained four important factors-Learning, Importance, Quality, and Success-that explained a signiicant portion of the variance (49.1 percent). Stratiied analysis by demographic variables suggested that there may be gender and ethnic differences in the students' attitudes towards learning communication skills. The authors conclude that the CSAS modiied for dental students, or DCSAS, is a useful tool to assess attitudes towards learning communication skills among dental students. G ood communication skills are essential for effective clinical practice in dentistry. As Hannah et al. noted, "An ability to communicate effectively with patients-in particular, to use active listening skills, to gather and impart information effectively, to handle patient emotions sensitively, and to demonstrate empathy, rapport, ethical awareness, and professionalism-is crucial." 1 In addition, research has found that good communication skills can increase the health care providers' diagnostic eficiency and decision making ability, as well as lead to improved patient satisfaction, greater adherence to provider recommendations, decreased anxiety, and lower rates of complaints and malpractice claims. [2][3][4][5][6][7] Professional associations and governmental organizations, acknowledging the central role of communication in attaining improved quality dental health care for an increasingly diverse population, have established objectives for the profession and the nation. In 2008, the American Dental Education Association (ADEA) House of Delegates approved communication and interpersonal skills as one of the domains of competencies for new general dentists. 8

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