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  1. Barry Pless, Collected and edited by
  1. Correspondence to Dr Barry Ivan Pless, Retired, 434 Lansdowne, Westmount, Quebec H3Y2V2, Canada; barry.pless{at}

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Indians still waiting for anticollision devices on trains

Twelve years ago, a railway in India developed an anticollision device (ACD) to help prevent train crashes. These devices have still not been installed in all trains in spite of successful trials. An ACD is designed to prevent head-on, side and rear-end collisions. It is believed that ‘more than 50% of railway collisions are caused by driver lapses’ who require this technical aid to preventing collisions. In the Railway Budget 2010, the then railway minister Mamata Banerjee announced these measures. ‘To make railways safer, anti-collision devices (ACD) and Train Protection Warning Systems (TPWS) are … to be installed. Also, automatic fire and smoke detection systems were to be placed in long-distance trains.’

Lessons learnt from analysing fall prevention programmes

Even without a serious injury, especially in older people, the act of having fallen may limit activities out of fear of falling again. Preventing falls involves simple common sense actions (repeated constantly): appropriate footwear, removal of obstacles, good lighting, education regarding call systems, access to telephones and keeping personal items within easy reach. The emerging technology in this area is mostly not formally assessed. This technology includes shock absorbent pads in undergarments, low beds, pressure alarms, personal motion detectors, personal alarms, positioning strategies, pommel seats and traction surfaces for wheelchairs, and self-releasing restraints. Improving balance and increasing stamina are also recommended. Exercises directed to address these issues might include any of several group programmes (eg, tai chi), while other studies indicate a multidisciplinary team approach may be required. A review of the last 10 years of reports of fall intervention programmes indicate that 9–12% of falls can be prevented. The article by Hector and Choi titled ‘Effectiveness of intervention programs in preventing falls: a systematic review of recent 10 years and meta-analysis’ was …

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