Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design A randomised controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants 1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analysed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results The rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P < 0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions Group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduced vision management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.

the FROP-Com demonstrated good reliability and a moderate capacity to predict falls.

the FROP-Com screen has a relatively good capacity to predict falls. It can be used in time-limited situations to classify those at high risk of falls who require more detailed assessment and management.

This study does not support the use of a referral-based targeted multifactorial intervention program to reduce subsequent falls or fall injuries in older people who present to an ED after a fall.

Objective  To use established psychological scales to measure levels of distress, anxiety and depression in veterinarians, and compare these levels between different veterinary subgroups and other professional groups. Methods  A cohort of veterinarians was identified through contact with veterinary schools in Australia. Participants completed a self‐reporting questionnaire that included queries about general health and demographics, psychological well‐being, job‐specific perceptions of health, dispositional characteristics and social support. Results  Of the 2125 respondents who completed the psychological questionnaire, approximately one‐third reported poor psychological health. Increasing age, increasing time in current job, increasing years since graduation and male gender was associated with fewer signs of distress, anxiety and depression. Compared with the general population, veterinarians experienced more negative emotions at work, but were similar to other professional groups. Conclusions  Poor psychological health is common in the profession and professional veterinary bodies may wish to consider providing training in dealing with work‐related distress, anxiety and depression.

A high injury prevalence was found among Australian veterinarians with large animal practitioners at highest risk. This is the largest study of Australian veterinarians to have been reported and has shown that injuries are common and serious in the profession.

Older fallers discharged directly from the ED have a high prevalence of falls risk factors and are at risk of functional decline.

The selected studies provided no evidence that educational interventions are effective in decreasing injury rates among agricultural workers. Financial incentives could reduce injury rates. Legislation to ban pesticides could be effective. Legislation expanding the use of safety devices (ROPS) on new tractors was associated with a decrease in fatal injuries.