Sample records for action institutionalizing transit

  1. The Avahan Transition: Effects of Transition Readiness on Program Institutionalization and Sustained Outcomes

    PubMed Central

    Singh, Suneeta; Singh, Kriti; Chhabra, Vibha; Bennett, Sara

    2016-01-01

    Background With declines in development assistance for health and growing interest in country ownership, donors are increasingly faced with the task of transitioning health programs to local actors towards a path to sustainability. Yet there is little available guidance on how to measure and evaluate the success of a transition and its subsequent effects. This study assesses the transition of the Avahan HIV/AIDS prevention program in India to investigate how preparations for transition affected continuation of program activities post-transition. Methods Two rounds of two surveys were conducted and supplemented by data from government and Avahan Computerized Management Information Systems (CMIS). Exploratory factor analysis was used to develop two measures: 1) transition readiness pre-transition, and 2) institutionalization (i.e. integration of initial program systems into organizational procedures and behaviors) post-transition. A fixed effects model was built to examine changes in key program delivery outcomes over time. An ordinary least square regression was used to assess the relationship between transition readiness and sustainability of service outcomes both directly, and indirectly through institutionalization. Results Transition readiness data revealed 3 factors (capacity, alignment and communication), on a 15-item scale with adequate internal consistency (alpha 0.73). Institutionalization was modeled as a unidimensional construct, and a 12-item scale demonstrated moderate internal consistency (alpha 0.60). Coverage of key populations and condom distribution were sustained compared to pre-transition levels (p<0.01). Transition readiness, but not institutionalization, predicted sustained outcomes post-transition. Transition readiness did not necessarily lead to institutionalization of key program elements one year after transition. Conclusion Greater preparedness prior to transition is important to achieve better service delivery outcomes post-transition. This paper illustrates a methodology to measure transition readiness pre-transition to identify less ready organizations or program components in advance, improving the likelihood of service sustainability. Further research is needed around the conceptualization and development of measures of institutionalization and its effects on long-term program sustainability. PMID:27434542

  2. Institutionalization of community action projects to reduce alcohol-use related problems: systematic facilitators.

    PubMed

    Holder, H D; Moore, R S

    2000-01-01

    This article reviews papers from a recent conference on community action research in order to identify factors that contribute to long-term maintenance, sustainability, or institutionalization of community project interventions. The descriptions of long-term outcomes and aftereffects of projects that emerged in the conference are valuable because relatively few instances of institutionalization have been documented in the scientific literature. After a general theoretical discussion of institutionalization in communities, the article identifies characteristics of successful community action programs that outlived their original funding. These characteristics include honoring community values and cultural relevance, cultivating key leader support, and utilizing indigenous staff. They also include developing local resources, maintaining flexibility, and leveraging prior success. The paper concludes by noting that aiming for policy and structural changes is a goal for an institutionalization of measures positively affecting desired health outcomes, even if the programs which created them are not themselves sustained.

  3. From Pilot to Permanent: A Case Study of the Institutionalization of A Grant-Funded Transition Program for Individuals with Intellectual Disabilities in A Public Research Institution in the Midwest of the United States

    ERIC Educational Resources Information Center

    Kavulic, Michael A.

    2017-01-01

    This qualitative intrinsic case study explored the institutionalization of a Transition and Postsecondary Education for Students with Intellectual Disabilities (TPSID) grant-funded program into a public four-year university in the Midwestern U.S. The study employed an ecological framework, and analyzed interview data from program stakeholders and…

  4. Institutional Placement: Phases of the Transition.

    ERIC Educational Resources Information Center

    Zarit, Steven H.; Whitlatch, Carol J.

    1992-01-01

    Examined consequences of institutionalization for 555 caregivers of dementia patients. Consistent with stress process model, institutionalization was hypothesized to have large impact on primary effects of caregiving and lesser influence on secondary effects and well-being. Following placement, caregivers experienced relief from primary effects of…

  5. Long-Term Adaptation to Institutionalization in Dementia Caregivers

    ERIC Educational Resources Information Center

    Gaugler, Joseph E.; Pot, Anne Margriet; Zarit, Steven H.

    2007-01-01

    Purpose: Longitudinal research in dementia has acknowledged the importance of transitions during the course of family caregiving. However, long-term adaptation to institutionalization has received little attention. This study attempts to describe caregivers' adaptation (changes in stress, well-being, and psychosocial resources) to placement up to…

  6. Caregivers' Reasons for Nursing Home Placement: Clues for Improving Discussions with Families Prior to the Transition

    ERIC Educational Resources Information Center

    Buhr, Gwendolen T.; Kuchibhatla, Maragatha; Clipp, Elizabeth C.

    2006-01-01

    Purpose: This study identifies the relative importance of reasons for institutionalization endorsed by caregivers of patients with dementia; examines the relationship between caregivers' reasons for institutionalization and indicators of caregiver and patient physical and emotional functioning measured in the prior year; and compares, on these…

  7. Engineering of the institutionalization of the circular economy at the level of casting production

    NASA Astrophysics Data System (ADS)

    Vescan, M. M.; Soporan, V. F.; Crișan, D. M.; Lehene, T. R.; Pădurețu, S.; Samuila, V.

    2017-06-01

    This paper is motivated by the necessity of introducing the principles of circular economy at the level of different social - economic activities, and from this point of view one of the fields with a special potential is that of the manufacture of castings. Objective: to connect to the organizing and application of the methodology of the circular economy principles. The proposed method is an innovating one, being connected to the use of institutionalization engineering. Formulating the subject: The subject formulated to be solved aims at the introduction of new approaches, defined through institutionalization engineering, which proposes to set the correlation of actions between the specifics of the circular economy and the specific elements of the manufacture of castings. Research method: An institutional structuring operation was imposed for the optimization of the research method, in which different versions interact at the following levels: the level of public policies, the level of the regulatory framework, the level of technical solutions and the level of financing solutions and financial instruments. The determination of the optimal solution established in a dynamic context, favorable for the requirements of the different actors present within the process, appeals to the elements of critical thinking, specific for the engineer’s actions. Achievement of the research activity: The research activity structures a methodology of quantifying the contributions of each stage of the manufacturing process for castings at the fulfilling of the specific conditions of the circular economy, indicating the critical areas of action for more efficient actions of the circular economy, according to the market economy requirements, where there is a potential of implementing the technical solutions by quantizing the financial solutions and the opportunity of using the financial instruments. The major contribution of the research: The proposed methodology, with examples at the level of castings manufacture, sets the bases of a new field of action of the engineering thinking, namely, that of circular economy institutionalization functioning. Conclusions of the research activity: The proposed methodology represents the bases of establishing a new instrument of action at the level of institutionalized functioning of the circular economy.

  8. Postmaterialism and young people's political participation in a time of austerity.

    PubMed

    Henn, Matt; Oldfield, Ben; Hart, James

    2017-08-30

    Recent trends suggest that young people in Britain are refraining from engaging in formal political processes. At the same time, they are increasingly expressing support for, and turning toward, a new and diverse range of non-institutionalized forms of political action in order to actualize their interests. Using Inglehart's ideas on postmaterialism, we consider whether this apparent rejection of mainstream politics in favour of less conventional - and sometimes radical - forms of political action is changing over time in Britain, reflecting fluctuating economic conditions witnessed over the last two decades. We do this by comparing results from surveys of British 18 year olds conducted in 2002 during an era of relative global prosperity, and then in 2011 at the height of the current global crisis. The findings suggest that British young postmaterialists are considerably more likely than materialists to participate in and support both institutionalized and non-institutionalized forms of political action. © London School of Economics and Political Science 2017.

  9. Monitoring and evaluating transition and sustainability of donor-funded programs: Reflections on the Avahan experience.

    PubMed

    Bennett, Sara; Ozawa, Sachiko; Rodriguez, Daniela; Paul, Amy; Singh, Kriti; Singh, Suneeta

    2015-10-01

    In low and middle-income countries, programs funded and implemented by international donors frequently transition to local funding and management, yet such processes are rarely evaluated. We reflect upon experience evaluating the transition of a large scale HIV/AIDS prevention program in India, known as Avahan, in order to draw lessons about transition evaluation approaches and implementation challenges. In terms of conceptualizing the transition theory, the evaluation team identified tensions between the idea of institutionalizing key features of the Avahan program, and ensuring program flexibility to promote sustainability. The transition was planned in three rounds allowing for adaptations to transition intervention and program design during the transition period. The assessment team found it important to track these changes in order to understand which strategies and contextual features supported transition. A mixed methods evaluation was employed, combining semi-structured surveys of transitioning entities (conducted pre and post transition), with longitudinal case studies. Qualitative data helped explain quantitative findings. Measures of transition readiness appeared robust, but we were uncertain of the robustness of institutionalization measures. Finally, challenges to the implementation of such an evaluation are discussed. Given the scarceness of transition evaluations, the lessons from this evaluation may have widespread relevance. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Impact of early institutionalization on attention mechanisms underlying the inhibition of a planned action.

    PubMed

    Lamm, Connie; Troller-Renfree, Sonya; Zeanah, Charles H; Nelson, Charles A; Fox, Nathan A

    2018-06-14

    Institutional rearing is associated with deficits in executive functions, such as inhibitory control, and may contribute to later externalizing behavior problems. In the current study, we explored the impact of institutional rearing on attention in the context of inhibiting a planned action. As part of the Bucharest Early Intervention Project (BEIP), children were randomized to either remain in the institutions in which they lived (Care as Usual Group) or be placed into foster family homes (Foster Care Group). We also recruited age and gender matched never-institutionalized (NIG) children from the Bucharest community. We examined differences in behavioral and Event Related Potentials (ERPs) during a go-no-go task when children were 12 years old. Results revealed that the ever-institutionalized group (CAUG and FCG combined) showed slower reaction times, worse performance accuracy, larger P2 activation, and smaller (less negative) N2 activation than the NIG group. Results of a moderation analysis revealed that children who spent more time in institutions and had small N2s showed more externalizing symptoms. These results have implications for the design of treatment approaches for previously institutionalized children with externalizing behavior problems. Copyright © 2018. Published by Elsevier Ltd.

  11. Fitness and Hygiene Programming for the Severely Handicapped: A Curriculum-Embedded Assessment Guide. User Manual. Project Transition.

    ERIC Educational Resources Information Center

    Jansma, Paul

    Developed by Project Transition, a 3-year project at Ohio State University, this resource guide deals with physical fitness and personal hygiene training of institutionalized mentally retarded adults, to prepare them for transition into community living environments. Included in the guide are recommended teaching strategies, an assessment system,…

  12. 34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

  13. 34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

  14. 34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

  15. 34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...

  16. The influence of institutionalization on the perception of autonomy and quality of life in old people.

    PubMed

    Cobo, Carmen María Sarabia

    2014-12-01

    To evaluate the influence exercised by institutionalization on the autonomy and perception of quality of life among the institutionalized elderly. The study is quasi-experimental (interrupted time series) and longitudinal. The sample is composed for 104 elderly people who went into a three nursing home in Santander, Spain. To assess the quality of life and dependence two scales were used: the Barthel Index and Lawton Index. There was an important relationship between autonomy and independence and their deterioration due to their institutionalisation, such as the physical and social aspects. It´s important to point out that the dependence of the elderly is a complex phenomenon, which admits many types of intervention, including the customary ones referring to more classic welfare actions which tend to supplant the absence of autonomy in everyday life by facilitating services and attention to make up for this need, without having to resort to institutionalization.

  17. Predicting Nursing Facility Transition Candidates Using AID: A Case Study

    ERIC Educational Resources Information Center

    James, Mary L.; Wiley, Elizabeth; Fries, Brant E.

    2007-01-01

    Purpose: Although the nursing facility transition literature is growing, little research has analyzed the characteristics of individuals so assisted or compared participants to those who remain institutionalized. This article describes an analytic method that researchers can apply to address these knowledge gaps, using the Arkansas Passages…

  18. A methodological framework to support the initiation, design and institutionalization of participatory modeling processes in water resources management

    NASA Astrophysics Data System (ADS)

    Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan

    2018-01-01

    Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.

  19. Affirmative Action, the Academy and Compromised Standards: Does Affirmative Action Lower Standards in University Hiring, Tenure and Promotion?

    ERIC Educational Resources Information Center

    Hanks, Lawrence J.; Sullivan, Jas; Spencer, Sara B.; Rogers, Elgin

    2008-01-01

    The literature opposed to affirmative action in hiring, granting tenure and promotion in the university claims that it lowers standards. However, anecdotal evidence suggests that in the decades prior to the institutionalization of affirmative action in the Academy, hiring, tenure and promotion standards were quite lax--resembling an "old boys…

  20. Leadership for Evidence-Based Practice: Strategic and Functional Behaviors for Institutionalizing EBP

    PubMed Central

    Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P

    2014-01-01

    Background Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. Aims To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Methods Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Results Participants’ descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel “themes,” 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework “Leadership Behaviors Supportive of EBP Institutionalization” (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Linking Evidence to Action Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should “support” EBP. PMID:24986669

  1. Leadership for evidence-based practice: strategic and functional behaviors for institutionalizing EBP.

    PubMed

    Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P

    2014-08-01

    Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Participants' descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel "themes," 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework "Leadership Behaviors Supportive of EBP Institutionalization" (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should "support" EBP. © 2014 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International.

  2. [The experience of adult Korean children caring for parents institutionalized with dementia].

    PubMed

    Kwon, Suhye; Tae, Young Sook

    2014-02-01

    The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.

  3. Nursing Home Admission: When, Why, Where?

    PubMed Central

    Bergman, H.; Clarfield, A. M.

    1985-01-01

    The decision to institutionalize older patients puts stress on both them and their families. This option should be carefully considered and alternatives explored before a final decision is made. The physician must seek and treat reversible diseases, and try to optimize the patient's functional status. Once the decision to institutionalize is made, careful preparation and follow-up of both family and patient must occur in the pre-, peri-, and post-admission periods. In this way, the physician can ease an otherwise traumatic transition, and ensure that the move is appropriate, well planned, and properly executed. PMID:20469437

  4. The Influence of Community Context on How Coalitions Achieve HIV-Preventive Structural Change

    ERIC Educational Resources Information Center

    Reed, Sarah J.; Miller, Robin Lin; Francisco, Vincent T.

    2014-01-01

    Community coalition action theory (CCAT) depicts the processes and factors that affect coalition formation, maintenance, institutionalization, actions, and outcomes. CCAT proposes that community context affects coalitions at every phase of development and operation. We analyzed data from 12 "Connect to Protect" coalitions using inductive…

  5. Study of School-to-Work Reform Initiatives. [Volume I: Findings and Conclusions.] Studies of Education Reform.

    ERIC Educational Resources Information Center

    Charner, Ivan

    The United States is the only industrialized nation in the world that has no institutionalized school-to-work transition system for helping young people move from education to employment. The Academy for Educational Development's National Institute for Work and Learning (AED/NIWL) undertook a 4-year study of school-to-work transition education…

  6. The Engaged Community College: Supporting the Institutionalization of Engagement through Collaborative Action Inquiry

    ERIC Educational Resources Information Center

    Purcell, Jennifer W.

    2014-01-01

    The purpose of this action research study was to explore how community colleges increase their capacity for community engagement. Faculty and staff members who were identified as community engagement leaders within a public community college participated in a series of interventions to improve community engagement practices within the college. The…

  7. Survey of drug use by the elderly and possible impact of drugs on nutritional status.

    PubMed

    Chen, L H; Liu, S; Newell, M E; Barnes, K

    1985-01-01

    The drug consumption of institutionalized and noninstitutionalized elderly in the central Kentucky area was surveyed. The 259 subjects above age 60 were randomly selected and consisted of 122 institutionalized and 137 noninstitutionalized subjects. Individual data on age, sex, drug intake, dosage, and health status were recorded. The drugs taken were categorized by their pharmacological action, and the number of subjects on each drug was recorded. Institutionalized elderly subjects had a significantly higher drug intake (average 5.2 drugs a day) than noninstitutionalized elderly subjects (average 1.6 drugs a day). A consistent increase was found in the average number of drugs used with increasing age. The results also showed that the medications most frequently used were drugs used for cardiovascular disease, for the central nervous system, and for constipation. Aspirin and Tylenol were also commonly used. Institutionalized elderly subjects had especially high intakes of these drugs. The possible impact of these drugs on the nutritional status of the elderly was discussed. Some medications for long-term use may exert serious adverse effects on the nutritional status.

  8. Institutionalizing the evaluation of health programs and policies in France: "cuisine internationale" over fast food and "sur mesure" over ready-made.

    PubMed

    Hartz, Z M

    1999-01-01

    The purpose of this article is to describe several chronological milestones in institutionalizing the evaluation of public programs and policies in France from a governmental perspective and in the health sector, situating such references in the international context. The institutional nature of evaluation implies integrating it into an action-oriented model, linking analytical activities to management, thus constituting the formulation of an evaluation policy for policy evaluation. The study focuses on issues related to the structure, practice, and utilization of evaluation results as well as other characteristics providing the French model with a certain resistance to traditional "fast-food" or "ready-made" methodological approaches. The institutionalization of sectorial evaluation appears more promising than that of the government's centralized channel, despite the work developed by a Scientific Evaluation Council, and suggests avenues for reflection and debate pertaining to the Brazilian Unified Health System.

  9. Children without Permanent Parents: Research, Practice, and Policy

    ERIC Educational Resources Information Center

    Bakermans-Kranenburg, Marian J.; Bos, Karen; Bunkers, Kelley McCreery; Dobrova-Krol, Natasha A.; Engle, Patrice L.; Fox, Nathan A.; Gamer, Gary N.; Goldman, Philip; Groark, Christina J.; Greenberg, Aaron; Grotevant, Harold D.; Groza, Victor K.; Gunnar, Megan R.; Johnson, Dana E.; Juffer, Femmie; Kreppner, Jana M.; Le Mare, Lucy; McCall, Robert B.; Muhamedrahimov, Rifkat J.; Nelson, Charles A., III; Palacios, Jesus; Sonuga-Barke, Edmund J. S.; Steele, Howard; Steele, Miriam; Tieman, Wendy; van IJzendoorn, Marinus H.; Verhulst, Frank C.; Vorria, Panayiota; Zeanah, Charles H.

    2011-01-01

    This monograph reviews literature pertaining to children without permanent parents. Chapters review (1) the development of children while institutional residents; (2) the development of postinstitutionalized children transitioned to family environments (i.e., adoption); the effects of institutionalization on (3) attachment behaviors, (4) physical…

  10. Counseling Juvenile Offenders in Institutional Settings.

    ERIC Educational Resources Information Center

    Chaneles, Sol, Ed.

    1982-01-01

    Reviews several aspects of counseling services for institutionalized juvenile offenders. The six articles include studies on the functional analysis of behavior in detention, vocational and social rehabilitation, the impact of a juvenile awareness program on personality traits, and the effectiveness of a juvenile transition center. (JAC)

  11. [Hospital San Juan de Dios: actor and victim of the public policies in Colombia].

    PubMed

    Pinilla, María Y; Abadía, César E

    2017-01-01

    In this article, we narrate and analyze the historical configuration that a group of female workers and a collective of social organizations made about the Hospital San Juan de Dios (HSJD) and Instituto Materno Infantil (IMI) in Bogotá, Colombia, within the neoliberal crisis in health. Our ethnographic research intersects the Latinamerican traditions of collaborative ethnography and historic anthropology. The research was conducted in two sites. In the first one, from 2005 until 2015, we had informal conversations and conducted workshops and semi-structured interviews with IMI workers. The second site corresponds to our participation in the deliberations of the Mesa Jurídica por el San Juan de Dios (2008-2009), which aimed to elevate a class action to defend the hospitals. We found that workers and social organizations made use of the colonial origin of the hospitals and their institutionalization as center of welfare policies in the country as a way to highlight their patrimonial, historical, educational and social importance. This historical construction critiques efforts that negate or transform the public character of the hospitals and helped them carry on different actions to denounce the neoliberal health care reform as the cause of the hospitals most important crisis and closing. The different actors denounce the change in the hospitals-state relationship, which transited from being central for the development of social policies to reflecting a symbolic and material elimination of the hospitals. Such transition benefits the market interests established by the neoliberal model.

  12. Women Prisoners: Reintegration into Family and Community.

    ERIC Educational Resources Information Center

    Banks, Martha E.; Ackerman, Rosalie J.

    Little research exists that addresses the issue of rehabilitation of women prisoners. To examine the effectiveness of a group psychotherapy program in assisting women prisoners to make the transition to the community and their families, 16 institutionalized women participated in a workshop. The program involved both individual and group…

  13. Comprehensive Health Assessments During De-Institutionalization: An Observational Study

    ERIC Educational Resources Information Center

    Lennox, N.; Rey-Conde, T.; Cooling, N.

    2006-01-01

    Background: People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both…

  14. Restructuring: A School-Based Plan of Action.

    ERIC Educational Resources Information Center

    Rothberg, Robert A.; Bozeman, William C.

    The processes by which school leaders can institutionalize staff and organizational development, with a focus on initiating school restructuring through team development, are described. Three features are necessary for implementing school restructuring through team development: a deliberate plan for staff involvement, a positive work environment,…

  15. Institutionalizing Inclusion in the In-Between

    ERIC Educational Resources Information Center

    Felten, Peter

    2017-01-01

    Author Peter Felten reflects on the shifting of his institutional position over the past seven years or so away from the teaching center into the provost's office at Elon University. In this article he discusses the fact that the transition has challenged his assumptions about the most effective ways of cultivating inclusive learning environments…

  16. Integrating Outcomes Assessment into Optometry Education: A Strategic Guide for Enhancing Student Learning.

    ERIC Educational Resources Information Center

    Beck, Diane E.; Daum, Kent M.

    2003-01-01

    Outlines eight steps that will help optometry schools transition a faculty from "denial" of the need for assessment to "institutionalization": establish a collaborative environment, establish an infrastructure that makes assessment an integral activity, recruit a leader for full implementation of outcomes assessment, conduct a needs assessment,…

  17. Professional Development in Action: Improving Teaching for English Learners

    ERIC Educational Resources Information Center

    Casteel, Catherine J., Ed.; Ballantyne, Keira Gebbie, Ed.

    2010-01-01

    This monograph showcases professional development projects by school districts and colleges of education that train teachers to work successfully with English learners (ELs) across the nation. The papers presented in this monograph offer real-life examples of successful and innovative practices, including institutionalized mentoring programs, new…

  18. Acquisition Review Quarterly (ARQ) Vol. 4, No. 4.

    DTIC Science & Technology

    1997-01-01

    served. Truly, as the African proverb has it, when elephants fight, the grass suffers. In a sinister twist, there is now a big push to get...institutionalizing a formal structure for reporting issues, problems, required actions, and successes. The re- ports were consolidated into a keystone

  19. Enrollment Logics and Discourses: Toward Developing an Enrollment Knowledge Framework

    ERIC Educational Resources Information Center

    Snowden, Monique L.

    2013-01-01

    This article brings attention to a typology of enrollment knowledge possessed and enacted by contemporary chief enrollment officers. Interview narratives are used to reveal enrollment principles and associated actions--enrollment logics--that form enrollment discourses, which in turn shape the institutionalized presence of strategic enrollment…

  20. Problematizing Service-Learning: Critical Reflections for Development and Action

    ERIC Educational Resources Information Center

    Stewart, Trae, Ed.; Webster, Nicole, Ed.

    2010-01-01

    Interest in and research on civic engagement and service-learning have increased exponentially. In this rapid growth, efforts have been made to institutionalize pedagogies of engagement across both K-12 and higher education. As a result, increased positive attention has been complemented equally by well-founded critiques complicating experiential…

  1. Design of PREVENCION: a population-based study of cardiovascular disease in Peru.

    PubMed

    Medina-Lezama, Josefina; Chirinos, Julio A; Zea Díaz, Humberto; Morey, Oscar; Bolanos, Juan F; Munoz-Atahualpa, Edgar; Chirinos-Pacheco, Julio

    2005-11-02

    Latin America is undergoing the epidemiologic transition that occurred earlier in developed countries, and is likely to face a gigantic epidemic of heart disease in the next few years unless urgent action is taken. The first essential component of any effective cardiovascular disease (CVD) control program is to establish reliable estimates of cardiovascular disease-related morbidity and mortality. However, such data from population-based studies in Latin America are still lacking. In this paper, we present the design and operation of PREVENCION (Estudio Peruano de Prevalencia de Enfermedades Cardiovasculares, for Peruvian Study of the Prevalence of Cardiovascular diseases). PREVENCION is an ongoing population-based study on a representative sample of the civilian non-institutionalized population of the second largest city in Peru. Its population is comparable to the rest of the Peruvian urban population and closely resembles other Latin American populations in countries such as Bolivia and Ecuador. Our study will contribute to the enormous task of understanding and preventing CVD in Latin America.

  2. Nature cure treatment in the context of India's epidemiological transition.

    PubMed

    Alter, Joseph Stewart; Sharma, Chandrashekar

    2016-07-01

    Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medicine. In this essay we focus on nature cure in the context of India's contemporary epidemiological transition as an example of why engaged integrative medicine is important for public health, and how the institutionalization of nature cure treatment in India provides a critical framework for the development of programs focused on holistic treatment and prevention. After providing an overview of the epidemiological transition in contemporary India, we develop this argument through an examination of illustrative cases in a clinic that operates within the structure of India's Central Council for Research on Yoga and Naturopathy. Based on a review of recent history and contemporary practice we describe how a system of medicine that makes use exclusively of air, earth, sunlight, water and food has been institutionalized and professionalized in India. Whereas biomedical treatment for chronic non-communicable diseases is focused on the problem of curing individual diseases, nature cure establishes a regimen of personalized public healthcare for the integrated management of symptoms. We argue that nature cure is based on an ecological understanding of health, thus providing treatment that reflects a broad appreciation for the risk factors that characterize India's current crises of public health.

  3. Palm Beach Community College Strategic Plan, 1999-2004.

    ERIC Educational Resources Information Center

    Samuels, Seymour

    This report addresses strategies and action plans for Palm Beach Community College (PBCC) (Florida) between 1999-2004. As part of a commitment to achieve specific, measurable end results, the college has set various objectives, including: (1) develop, implement and institutionalize a mission driven strategic budget for the 1999-2000 fiscal year;…

  4. Crafting Legitimate Identities: Promotional Strategies in the Ontario Non-Elite Private School Sector

    ERIC Educational Resources Information Center

    Milian, Roger Pizarro; Quirke, Linda

    2017-01-01

    Conventional wisdom within the sociology of education and organizations posits that schools achieve legitimacy by conforming to institutionalized norms and mimicking the actions of successful peers. Recent work on non-elite private schools (NEPS) shows that this institutional type may serve as an exception to this logic, generally adopting what…

  5. Institutionalization in Action: Interactive Science Center Interactivity and Materiality from the Family Perspective

    ERIC Educational Resources Information Center

    Crain, Rhiannon Lorraine

    2009-01-01

    Interactive science centers are unique players in the science education community, but their positioning as both authorities on science and providers of "free choice" learning presents learning researchers with a problematic contradiction rooted in the complexities of trying to be both "scientific" and "education" organizations. Using insight from…

  6. Women Secondary Principals in Texas: A Longitudinal Study of Differences in Personal, Professional, Leadership, and School Characteristics

    ERIC Educational Resources Information Center

    Marczynski, Jean Christina

    2011-01-01

    Despite movement toward equity given the institutionalization of affirmative action programs and policies, researchers document continued underrepresentation of women principals in secondary schools. Gender equity in the high school principalship possesses the key to unlocking many problems including poor outcomes for high school students to low…

  7. A Gallery of Portraits in Service-Learning: Action Research in Teacher Education.

    ERIC Educational Resources Information Center

    Duckenfield, Marty, Ed.; Swick, Kevin J., Ed.

    This book presents papers by teacher educators who describe how they foster the integration of service learning into their teacher education programs, with the eventual goal of institutionalization. The papers are: "Introduction" (Marty Duckenfield and Kevin J. Swick); "An Experiment in Implementation" (Bill Yost); "Pathways to Partnership:…

  8. 3 CFR 13595 - Executive Order 13595 of December 19, 2011. Instituting a National Action Plan on Women, Peace...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... institutionalize a gender-responsive approach to its diplomatic, development, and defense-related work in conflict... Executive Departments and Agencies. (a) Executive departments and agencies (agencies) shall maintain a..., interpretation, and enforcement of Federal law. (b) The Secretary of State, the Secretary of Defense, and the...

  9. Stability and Change of Mentoring Practices in a Capricious Policy Environment: Opening the "Black Box of Institutionalization"

    ERIC Educational Resources Information Center

    März, Virginie; Kelchtermans, Geert; Dumay, Xavier

    2016-01-01

    This article addresses how institutional logics are translated, maintained, or disrupted by actors and their (inter)actions within schools. The changing policy environment for mentoring beginning teachers in Flanders (Belgium) provides a fertile context for answering this question. Combining neoinstitutional and sensemaking lenses and analyzing…

  10. The Institutionalization of Service-Learning at the Independent Colleges and Universities of the Gulf Coast Region

    ERIC Educational Resources Information Center

    Lewing, Morgan; Shehane, Melissa

    2017-01-01

    Service-learning is a high-impact educational practice that benefits the community, the university, and students (Jacoby, 2015). It also represents an educational practice that specifically supports the integration of Christian thought and action within Christian institutions (Schaffer, 2004). The purpose of the study was to determine the level of…

  11. The Role of the Principal in the Implementation of a Gifted Education Program in a School.

    ERIC Educational Resources Information Center

    Taylor, C. A.

    1987-01-01

    The degree to which a principal provides appropriate and sufficient support for implementation of a gifted education program will determine the success of the program. Actions that can facilitate implementation, teacher use, and institutionalization and the effects of various managerial styles are discussed. Components of a gifted program are…

  12. Reform from Within: An Ecological Analysis of Institutionalized Feminism at Our University

    ERIC Educational Resources Information Center

    Howton, Amy Johnson

    2011-01-01

    As an insider-action research project, there are really two projects at work in this study (Coghlan & Brannick, 2010)--the core project and the dissertation project. The aim of the core project is to promote organizational change for my organization, the Women's Center, by facilitating the first iteration of a participatory evaluation with our…

  13. Transforming School Leadership and Management to Support Student Learning and Development: The Field Guide to Comer Schools in Action

    ERIC Educational Resources Information Center

    Joyner, Edward T., Ed.; Ben-Avie, Michael, Ed.; Comer, James P., Ed.

    2004-01-01

    For more than 35 years, the Yale School Development Program (SDP) has been pioneering the Comer Process for planned change in schools. From initial planning and preparation, through foundation building, transformation, institutionalization, and renewal, the Comer Process provides school leaders with a comprehensive and effective framework for…

  14. Improving the seniors' transition from hospital to the community: a case for intensive geriatric service workers.

    PubMed

    McAiney, Carrie A; Hillier, Loretta M; Paul, Janice; McKinnon Wilson, Jane; Tersigni Phelan, Anna; Wagner, Fred; O'Connor, Sheli

    2017-01-01

    Limited continuity of care, poor communication between healthcare providers, and ineffective self-management are barriers to recovery as seniors transition back to the community following an Emergency Department (ED) visit or hospitalization. The intensive geriatric service worker (IGSW) role is a new service developed in southern Ontario, Canada to address gaps for seniors transitioning home from acute care to prevent rehospitalization and premature institutionalization through the provision of intensive support and follow-up to ensure adherence to care plans, facilitate communication with care providers, and promote self-management. This study describes the IGSW role and provides preliminary evidence of its impact on clients, caregivers and the broader health system. This mixed methods evaluation included a chart audit of all clients served, tracking of the achievement of goals for IGSW involvement, and interviews with clients and caregivers and other key informants. During the study period, 632 clients were served. Rates of goal achievement ranged from 25%-87% and in cases where achieved, the extent of IGSW involvement mostly exceeded recommendations. IGSWs were credited with improving adherence with treatment recommendations, increasing awareness and use of community services, and improving self-management, which potentially reduced ED visits and hospitalizations and delayed institutionalization. The IGSW role has the potential to improve supports for seniors and facilitate more appropriate use of health system resources, and represents a promising mechanism for improving the integration and coordination of care across health sectors.

  15. Sustainable institutionalized punishment requires elimination of second-order free-riders

    NASA Astrophysics Data System (ADS)

    Perc, Matjaž

    2012-03-01

    Although empirical and theoretical studies affirm that punishment can elevate collaborative efforts, its emergence and stability remain elusive. By peer-punishment the sanctioning is something an individual elects to do depending on the strategies in its neighborhood. The consequences of unsustainable efforts are therefore local. By pool-punishment, on the other hand, where resources for sanctioning are committed in advance and at large, the notion of sustainability has greater significance. In a population with free-riders, punishers must be strong in numbers to keep the ``punishment pool'' from emptying. Failure to do so renders the concept of institutionalized sanctioning futile. We show that pool-punishment in structured populations is sustainable, but only if second-order free-riders are sanctioned as well, and to a such degree that they cannot prevail. A discontinuous phase transition leads to an outbreak of sustainability when punishers subvert second-order free-riders in the competition against defectors.

  16. Should social psychologists create a disciplinary affirmative action program for political conservatives?

    PubMed

    Shweder, Richard A

    2015-01-01

    Freely staying on the move between alternative points of view is the best antidote to dogmatism. Robert Merton's ideals for an epistemic community are sufficient to correct pseudo-empirical studies designed to confirm beliefs that liberals (or conservatives) think deserve to be true. Institutionalizing the self-proclaimed political identities of social psychologists may make things worse.

  17. A Policy of Individualization and Flexibility Ignoring the Situation of Non-Self-Reliant Individuals: The Example of Swedish Basic Adult Education

    ERIC Educational Resources Information Center

    Loeb, Ingrid Henning; Wass, Karin Lumsden

    2014-01-01

    Based on a case study in Swedish municipal basic adult education this article addresses current policies for providing individualized and flexible learning, which have been reinforced in recent adult education reforms. Concepts from the organization theory of "action nets" have been used. Institutionalized procedures and a number of…

  18. Risk of malnutrition among Brazilian institutionalized elderly: a study with the Mini Nutritional Assessment (MNA) questionnaire.

    PubMed

    Pereira Machado, R S; Santa Cruz Coelho, M A

    2011-08-01

    Brazilian population has passed for a process of demographic transition throughout latest years, characterized for the increase of the elderly population. Malnutrition is a serious problem to frail elderly. The objective of this study was o evaluate the risk of malnutrition among institutionalized elderly resident in municipal shelters in the city of Rio de Janeiro, Brazil, using the tool Mini Nutritional Assessment (MNA). 344 institutionalized elderly aged over 60 years old were tested in a cross-sectional study using MNA. This tool classifies the nutricional status of the elderly in three groups: malnutrition (score < 17), risk of malnutrition (score 17 - 23,5) and well-nourished (score > = 24). Anthropometric measurements such as calf circumference (CC), mid-arm circumference (MAC) and Body mass index (BMI) were also evaluated. The variables were evaluated using the chi-square or ANOVA test. To correlate it was used Pearson's Correlation Coefficient (r). Mean age were 75.4 (+- 9.4) years old. Most of the elderly were female gender (59.6%). According to MNA 8.3% were with malnutrition, 55.6% at risk of malnutrition and 36.1% well-nourished. BMI classified 10.0% of the elderly as underweight. CC classified 10.0 % of them as inadequate in muscular mass. MNA was well correlated to BMI (r=0.412 p=0.000), age (r=-0.124 p=0.031), CC (r=0.399 p = 0.000) and MAC (r=0.391 p=0.000). Risk of malnutrition was high among the institutionalized elderly from public shelters in Rio de Janeiro - Brazil. MNA is a useful diagnostic tool for the identification on the frail elderly at risk of malnutrition.

  19. On the Production of China Universities' Non-Institutionalized Power Structure and the Dialectical Analysis

    ERIC Educational Resources Information Center

    Liu, Yuting

    2011-01-01

    By analyzing reasons for and problems in China universities' non-institutionalized power structure, this paper tries to prove the limits of non-institutionalized power structure making up for institutionalized power structure in universities, with the hope of revealing the deep reasons for the institutionalized structure imbalance in universities.

  20. Transits of Venus and Colonial India

    NASA Astrophysics Data System (ADS)

    Kochhar, Rajesh

    2012-09-01

    Astronomical expeditions during the colonial period had a political and national significance also. Measuring the earth and mapping the sky were activities worthy of powerful and power- seeking nations. Such was the sanctity of global astronomical activity that many other agendas could be hidden under it. An early astronomy-related expedition turned out to be extremely beneficial, to botany. The expedition sent by the French Government in 1735 to South America under the leadership of Charles Marie de la Condamine (1701--1774) ostensibly for the measurement of an arc of the meridian at Quito in Ecuador surreptitiously collected data that enabled Linnaeus to describe the genus cinchona in 1742. When the pair of transits of Venus occurred in 1761 and 1769, France and England were engaged in a bitter rivalry for control of India. The observation of the transits became a part of the rivalry. A telescope presented by the British to a South Indian King as a decorative toy was borrowed back for actual use. Scientifically the transit observations were a wash out, but the exercise introduced Europe to details of living Indian tradition of eclipse calculations. More significantly, it led to the institutionalization of modern astronomy in India under the auspices of the English East India Company (1787). The transits of Venus of 1874 and 1882 were important not so much for the study of the events as for initiating systematic photography of the Sun. By this, Britain owned most of the world's sunshine, and was expected to help European solar physicists get data from its vast Empire on a regular basis. This and the then genuinely held belief that a study of the sun would help predict failure of monsoons led to the institutionalization of solar physics studies in India (1899). Of course, when the solar physicists learnt that solar activity did not quite determine rainfall in India, they forgot to inform the Government.

  1. An Analytical Evaluation of Contingency Contracting Operations in Iraq and Afghanistan: Capturing Critical Corporate Knowledge for the Future

    DTIC Science & Technology

    2013-01-07

    Contingency Operations Task Force, 2011, p. 4)...........................68  Figure 25.  Original Organizational Makeup for the CASO (After Deputy...Workforce CAP Civilian Augmentation Program CAP Crisis Action Planning CASO Contingency Acquisition Support Office CBP Capability-Based...its inclusion in joint exercises;  Identify and assign responsibilities to institutionalize OCS lesson development, analysis, documentation and use

  2. Institutionalization in Taiwan. The role of caregiver gender.

    PubMed

    Kao, Hsueh-Fen Sabrina

    2003-10-01

    The role of caregiver gender in the likelihood of institutionalization of Taiwanese older adults was explored in this study. A sample of 78 male and 69 female primary caregivers of elderly patients who had experienced a stroke at least 6 months prior to the study were interviewed. Logistic regression analyses were applied to examine direct and interaction effects of the elderly adult's functioning the caregiver's available resources, the degree of caregiver burden, perceived public opinion toward institutionalization, and precipitating events on the likelihood of institutionalization among Taiwanese male and female caregivers. Women were more likely to institutionalize the older adult for whom they cared. The proposed model correctly predicted the likelihood of institutionalization of an elderly adult based on male versus female caregivers at the 92% level. Perceived public opinion toward institutionalization was the most significant predictor of institutionalization for both genders. Perceived public opinion toward institutionalization has a strong influence on whether or not caregivers institutionalize an elderly relative. This is consistent with Chinese culture in which public opinion has a much stronger effect on individual behavior than in the United States. American concepts of "minding one's own business" do not exist in Taiwan. It is logical that the older adults' level of functioning would predict the likelihood of institutionalization regardless of caregiver gender. In terms of caregiver characteristics, working hours in male caregivers is more predictive, and the quality of the relationship with the older adult was more predictive of institutionalization for female caregivers.

  3. Violence and Institutionalization in Islamic Activism: Explaining Moderation

    DTIC Science & Technology

    2006-12-01

    participation be so attractive to Islamists they eschew non-democratic methods of achieving their goals? Islamic activism refers to collective action...48 Martin Kramer , “Hizbullah: The Calculus of Jihad,” www.martinkramer.org (accessed 15 February 2006), 11. 49 Hamzeh, 44. 50 Ibid. 51...become a member of Hizbullah - horizontal or vertical method .60 The vertical method is to enter through the party’s regional reinforcement and

  4. Encouraging Democratic Transitions: The Problematic Impact of United States’ Involvement

    DTIC Science & Technology

    1991-06-20

    more abstractly, democracy is consolidated when uncertainty is institutionalized: nobody can control the outcomes of the political process ex post ...for Change in Cuba", Miami Herald, May 27, 1990. See also, Al Kamen, "US Encourages Soviets to Aid Salvadoran Talks". Washington Post , October 18, 1990...Report, September 13, 1990, p. 10, and "Cuba Cuts Fuel Consumption as Soviet Oil Deliveries Fall", Washington Post , August 30, 1990. 20 not even call

  5. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Slunge, Daniel, E-mail: daniel.slunge@economics.gu.se; Tran, Trang Thi Huyen, E-mail: trang2k@yahoo.com

    Building on new institutional theory, this paper develops an analytical framework for analyzing constraints to the institutionalization of strategic environmental assessment (SEA) at four different institutional levels. The framework is tested in an empirical analysis of the environmental assessment system in Vietnam, which is a frontrunner among developing countries regarding the introduction and use of SEA. Building on interviews with Vietnamese and international experts, as well as an extensive literature review, we identify institutional constraints which challenge the effective use of SEA in Vietnam. We conclude that commonly identified constraints, such as inadequate training, technical guidelines, baseline data and financialmore » resources, are strongly linked to constraints at higher institutional levels, such as incentives to not share information between ministries and severe restrictions on access to information and public participation. Without a thorough understanding of these institutional constraints, there is a risk that attempts to improve the use of SEA are misdirected. Thus, a careful institutional analysis should guide efforts to introduce and improve the use of SEA in Vietnam and other developing countries. The analytical framework for analyzing constraints to institutionalization of SEA presented in this paper represents a systematic effort in this direction. - Highlights: • A framework for analyzing constraints to institutionalizing SEA is developed • Empirical analysis of the strategic environmental assessment system in Vietnam • Constraints in the action arena linked to deeper institutional constraints • Institutional analysis needed prior to introducing SEA in developing countries.« less

  6. Is the level of education associated with transitions between care settings in older adults near the end of life? A nationwide, retrospective cohort study.

    PubMed

    Kelfve, Susanne; Wastesson, Jonas; Fors, Stefan; Johnell, Kristina; Morin, Lucas

    2018-02-01

    End-of-life transitions between care settings can be burdensome for older adults and their relatives. To analyze the association between the level of education of older adults and their likelihood to experience care transitions during the final months before death. Nationwide, retrospective cohort study using register data. Older adults (⩾65 years) who died in Sweden in 2013 ( n = 75,722). Place of death was the primary outcome. Institutionalization and multiple hospital admissions during the final months of life were defined as secondary outcomes. The decedents' level of education (primary, secondary, or tertiary education) was considered as the main exposure. Multivariable analyses were stratified by living arrangement and adjusted for sex, age at time of death, illness trajectory, and number of chronic diseases. Among community-dwellers, older adults with tertiary education were more likely to die in hospitals than those with primary education (55.6% vs 49.9%; odds ratio (OR) = 1.21, 95% confidence interval (CI) = 1.14-1.28), but less likely to be institutionalized during the final month before death (OR = 0.83, 95% CI = 0.76-0.91). Decedents with higher education had greater odds of remaining hospitalized continuously during their final 2 weeks of life (OR = 1.12, 95% CI = 1.02-1.22). Among older adults living in nursing homes, we found no association between the decedents' level of education and their likelihood to be hospitalized or to die in hospitals. Compared with those who completed only primary education, individuals with higher educational attainment were more likely to live at home until the end of life, but also more likely to be hospitalized and die in hospitals.

  7. Rehabilitation in home care is associated with functional improvement and preferred discharge.

    PubMed

    Cook, Richard J; Berg, Katherine; Lee, Ker-Ai; Poss, Jeffrey W; Hirdes, John P; Stolee, Paul

    2013-06-01

    To investigate the impact of physiotherapy (PT) and occupational therapy (OT) services on long-stay home care patients with musculoskeletal disorders. Observational study. Home care programs. All long-stay home care patients between 2003 and 2008 (N=99,764) with musculoskeletal disorders who received a baseline Resident Assessment Instrument for Home Care assessment, 1 follow-up assessment, and had discharge or death records. PT and OT. The effects of PT and OT services on transitions in functional state, discharge from home care with service plans complete, institutionalization, and death were assessed via multistate Markov models. Home care patients with deficiencies in instrumental activities of daily living and/or activities of daily living at baseline and who received home-based rehabilitation had significantly increased odds of showing functional improvements by their next assessment (for a state 3 to state 2 transition: odds ratio [OR]=1.17; 95% confidence interval [CI], 1.10-1.26; P<.0001; for a state 2 to state 1 transition: OR=1.36; 95% CI, 1.14-1.61; P=.0005). Receipt of PT/OT also significantly reduced the odds of mortality and institutionalization in this group. With increasing numbers of older adults with chronic conditions and limited funding for health care services, it is essential to provide the right services at the right time in a cost-effective manner. Long-stay home care patients who receive rehabilitation at home have improved outcomes and lower utilization of costly health services. Our findings suggest that investment in PT and OT services for relatively short periods may provide savings to the health care system over the longer term. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Power and action in critical theory across disciplines: implications for critical community psychology.

    PubMed

    Davidson, Heather; Evans, Scot; Ganote, Cynthia; Henrickson, Jorie; Jacobs-Priebe, Lynette; Jones, Diana L; Prilleltensky, Isaac; Riemer, Manuel

    2006-09-01

    Although critical scholarship and community psychology share similar aspirations, the links between them remain unexplored and under-theorized. In this article we explore the implications of critical scholarship in various specialties for the field of community psychology. To understand the contributions of critical scholarship to a theory of power and action for social change, we conducted a systematic analysis of a ten-year period of publications in seven journals associated with the critical scholarship tradition. We created precise criteria for the concepts of power and action and applied them to the publications. Results indicate an interesting paradox at play. Whereas community psychology is more action oriented than critical scholarship, its actions fall short of challenging institutionalized power structures and the status quo; and whereas critical scholarship is more challenging of the status quo than community psychology in theory, it has failed to produce viable actions that challenge the status quo. We discuss the implications of this state of affairs for the development of a more critical community psychology.

  9. A Case Study of the Institutionalization of Service-Learning at a Baptist College

    ERIC Educational Resources Information Center

    Long, Jody Thomas

    2013-01-01

    This qualitative study, utilizing the case study method, sought to address the issues associated with the lack of institutionalization of service-learning practices on college campus by describing the institutionalization of service-learning practices at a Baptist-affiliated college. The study describes the development and institutionalization of…

  10. Institutionalizing Sustainability in Community Colleges: The Role of the College President

    ERIC Educational Resources Information Center

    Williams, Peter G.

    2009-01-01

    The purpose of this research study was to describe and improve understanding of the meaning of institutionalized sustainability and the role that a college president plays in institutionalizing sustainability on a community college campus. The following questions guided the research: (a) What does it mean to have sustainability "institutionalized"…

  11. Potential consequences of abandonment in preschool-age: neuropsychological findings in institutionalized children.

    PubMed

    Cardona, Juan F; Manes, Facundo; Escobar, Josefina; López, Jéssica; Ibáñez, Agustín

    2012-01-01

    Several longitudinal studies had shown that early deprivation and institutionalization during the first six months of life affects the emotional, cognitive, social and neurophysiologic development. Nevertheless, our understanding of possible similar effects of delayed institutionalization, in preschool-age remains unclear to this day. The goal of this study is to evaluate the cognitive performance of institutionalized children with history of preschool-age physical abandonment. 18 male institutionalized children with history of abandonment during the preschool-age (2-5 years old) and comparison group matched by age, handedness, gender, educational and socioeconomic level were tested on multiple tasks of attention, memory and executive functions. We found a cognitive impairment in the institutionalized children in several measures of attention, memory and executive functions. This is the first report of cognitive impairment related to late abandonment and institutionalization effects (after 2 years old), extending the already known effects on early institutionalization. This preliminary study suggests that environmental factors including abandonment and institutional care, can affect not only the infancy period, but also the preschool period providing new insights into our understanding of neurocognitive development.

  12. Strengths and Difficulties as Correlates of Attachment Style in Institutionalized and Non-Institutionalized Children with Below-Average Intellectual Abilities

    ERIC Educational Resources Information Center

    Muris, Peter; Maas, Anneke

    2004-01-01

    The current study examined attachment style, strengths, and difficulties in institutionalized and non-institutionalized children with below-average intellectual abilities. Parents/caregivers and teachers of the children completed a brief measure of attachment style and the Strengths and Difficulties Questionnaire, which assesses the most important…

  13. 42 CFR 441.254 - Mentally incompetent or institutionalized individuals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... APPLICABLE TO SPECIFIC SERVICES Sterilizations § 441.254 Mentally incompetent or institutionalized individuals. FFP is not available for the sterilization of a mentally incompetent or institutionalized...

  14. Understanding micro-processes of institutionalization: stewardship contracting and national forest management

    Treesearch

    Cassandra Moseley; Susan Charnley

    2014-01-01

    This paper examines micro-processes of institutionalization, using the case of stewardship contracting within the US Forest Service. Our basic premise is that, until a new policy becomes an everyday practice among local actors, it will not become institutionalized at the macro-scale. We find that micro-processes of institutionalization are driven by a mixture of large-...

  15. The Effects of Early Experience on Face Recognition: An Event-Related Potential Study of Institutionalized Children in Romania

    ERIC Educational Resources Information Center

    Moulson, Margaret C.; Westerlund, Alissa; Fox, Nathan A.; Zeanah, Charles H.; Nelson, Charles A.

    2009-01-01

    Data are reported from 3 groups of children residing in Bucharest, Romania. Face recognition in currently institutionalized, previously institutionalized, and never-institutionalized children was assessed at 3 time points: preintervention (n = 121), 30 months of age (n = 99), and 42 months of age (n = 77). Children watched photographs of caregiver…

  16. Analyzing after-action reports from Hurricanes Andrew and Katrina: repeated, modified, and newly created recommendations.

    PubMed

    Knox, Claire Connolly

    2013-01-01

    Thirteen years after Hurricane Andrew struck Homestead, FL, Hurricane Katrina devastated the Gulf Coast of Mississippi, Alabama, and southeastern Louisiana. Along with all its destruction, the term "catastrophic" was redefined. This article extends the literature on these hurricanes by providing a macrolevel analysis of The Governor's Disaster Planning and Response Review Committee Final Report from Hurricane Andrew and three federal after-action reports from Hurricane Katrina, as well as a cursory review of relevant literature. Results provide evidence that previous lessons have not been learned or institutionalized with many recommendations being repeated or modified. This article concludes with a discussion of these lessons, as well as new issues arising during Hurricane Katrina.

  17. [Stock based medicine: the patient waiting in a weary medical procedure].

    PubMed

    Casas Patiño, Donovan; Rodriguez Torres, Alejandra; Casas Patiño, Isaac

    2015-03-24

    This essay attempts to bring on a new perspective for healthcare professionals regarding the problems that surround this institutionalized profession, based on a system of stock balances and not on the real needs of patients and their community. The healthcare professional not only engages in biomedical healing but also possesses knowledge and expertise regarding the dialectical process of health/disease. Thus, his or her practice and actions should be centered on social practices and not just the healing process.

  18. A Serious Game to Improve Cognitive Functions in Schizophrenia: A Pilot Study

    PubMed Central

    Amado, Isabelle; Brénugat-Herné, Lindsay; Orriols, Eric; Desombre, Colombe; Dos Santos, Maxine; Prost, Zelda; Krebs, Marie-Odile; Piolino, Pascale

    2016-01-01

    Cognitive deficits in schizophrenia impair everyday functioning and instrumental daily living activities. These disabilities can be partly responsible for chronicity and institutionalization. We present here a virtual reality (VR) tool in which patients with schizophrenia performed a virtual game in an imaginary town during a 3-month program. In a pilot study, seven patients with schizophrenia (DSM-5), institutionalized for many years, attended weekly 1-h-and-a-half sessions organized by two clinicians. During the first sessions, they listed together the difficulties they experienced in everyday organization and planning. After being familiarized with the joystick and the VR environment, they navigated in the town, and planned actions that were difficult for them to carry out in their usual life (e.g., shopping, memorizing the way to the supermarket or being on time at a meeting point). They had to look for alternative routes and practice a switch from a 2D Map to the 3D Map. They also gathered their efforts to share strategies for each action, or discussed the action plan they could generate to solve concrete problems. The pre/post-neuropsychological evaluations showed attention, working memory, prospective, and retrospective memory benefits, but no improvement in planning as assessed by the Zoo map test and the action program subtest of Behavioral Assessment of the Dysexecutive Syndrome. Patients also clinically and functionally improved, gaining autonomy. Pragmatically, they reported a strong energy to elaborate concrete plans to search for jobs, or return to activities in the community. Qualitative assessments showed a benefit in sparing time, planning better, enriched relatedness, and better management of their housework. This VR game opens avenue to rehabilitation for patients with schizophrenia experiencing chronicity in their life, less attendance in daycare units, and a better community living. This program might reduce neurocognitive difficulties and might evolve into a true method for cognitive remediation (trial n° 2011-A00988-33). PMID:27148093

  19. Examining how youth of color engage youth participatory action research to interrogate racism in their science experiences

    NASA Astrophysics Data System (ADS)

    Sato, Takumi C.

    While many researchers have worked to address the unequal educational outcomes between White and non-White students, there are few signs of progress for people of color seeking entry into a STEM career trajectory. Starting from high school, the number of students who persist to complete a STEM bachelor's degree and obtaining a job in science or engineering continues to indicate that people of color are underrepresented. I suggest that research must consider the role of race and racism in the education of youth of color. Especially in science education, there is very little work addressing how racism may present barriers that impede progress for students along the STEM trajectory. This study is informed by critical race theory (CRT) that posits racism is endemic in society. White privilege enables the dominant group to maintain inequitable advantages that marginalizes populations of color. CRT also puts forth that counter narratives of the marginalized groups is essential to challenge the institutionalized forms of oppression. Using CRT and youth participatory action research (YPAR), this investigation re-imagines youth as capable of transforming their own social and political condition through research and action. This project asked youth of color to interrogate their own experiences as science learners, engage in research on structural inequities of STEM trajectories, plan strategic moves to challenge power structures, and take action for social justice. The youth started by exploring the concept of race and instances where racism was found in public spaces and in their personal experiences. They examined their experiences in science as a student more generally and then for racism. Then, the focus turned to conducting research with peers, observing science classrooms in another school, and using online information to compare schools. The youth planned strategic action against the racism they found in the analysis of the data that included conference presentations, using social media to communicate with peers, and teaching a science unit for middle grades peers using lessons that incorporated engaging teaching practices lacking in their student experiences. YPAR resulted in counternarratives that exposed youth encounters with systemic racism and their efforts to positively change STEM trajectories for themselves and their peers. Through YPAR, youth gained research tools and skills to critically examine the world and expose racism. While schools are purported to be places of equal opportunity for all students to learn and find success, the youth showed that institutionalized racism in schools created barriers to STEM aspirations. By planning and teaching a food and nutrition unit, the youth took aim at the institutionalized racism by taking on the role of teacher and expert while improving the science learning opportunities for their middle grades peers and themselves. In addition, planning the unit enabled the youth to conduct all of the activities before teaching the unit. Thus, the youth supplemented their own science learning. YPAR provided an empowering opportunity to challenge racism along their STEM trajectories and fight for social justice.

  20. An organizational perspective on the long-term sustainability of a nursing best practice guidelines program: a case study.

    PubMed

    Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

    2015-12-03

    Many healthcare innovations are not sustained over the long term, wasting costly implementation efforts and often desperately-needed initial improvements. Although there have been advances in knowledge about innovation implementation, there has been considerably less attention focused on understanding what happens following the early stages of change. Research is needed to determine how to improve the 'staying power' of healthcare innovations. As almost no empirical knowledge exists about innovation sustainability in nursing, the purpose of our study was to understand how a nursing best practice guidelines (BPG) program was sustained over a long-term period in an acute healthcare centre. We conducted a qualitative descriptive case study to examine the program's sustainability at the nursing department level of the organization. The organization was a large, urban, multi-site acute care centre in Canada. The patient safety-oriented BPG program, initiated in 2004, consisted of an organization-wide implementation of three BPGs: falls prevention, pressure ulcer prevention, and pain management. Data were collected eight years following program initiation through 14 key informant interviews, document reviews, and observations. We developed a framework for the sustainability of healthcare innovations to guide data collection and content analysis. Program sustainability entailed a combination of three essential characteristics: benefits, institutionalization, and development. A constellation of 11 factors most influenced the long-term sustainability of the program. These factors were innovation-, context-, leadership-, and process-related. Three key interactions between factors influencing program sustainability and characteristics of program sustainability accounted for how the program had been sustained. These interactions were between: leadership commitment and benefits; complementarity of leadership actions and both institutionalization and development; and a reflection-and-course-correction strategy and development. Study findings indicate that the successful initial implementation of an organizational program does not automatically lead to longer-term program sustainability. The persistent, complementary, and aligned actions of committed leaders, in a variety of roles across a health centre department, seem necessary. Organizational leaders should consider a broad conceptualization of sustainability that extends beyond program institutionalization and/or program benefits. The development of an organizational program may be necessary for its long-term survival.

  1. Transitioning a Large Scale HIV/AIDS Prevention Program to Local Stakeholders: Findings from the Avahan Transition Evaluation

    PubMed Central

    Bennett, Sara; Singh, Suneeta; Rodriguez, Daniela; Ozawa, Sachiko; Singh, Kriti; Chhabra, Vibha; Dhingra, Neeraj

    2015-01-01

    Background Between 2009–2013 the Bill and Melinda Gates Foundation transitioned its HIV/AIDS prevention initiative in India from being a stand-alone program outside of government, to being fully government funded and implemented. We present an independent prospective evaluation of the transition. Methods The evaluation drew upon (1) a structured survey of transition readiness in a sample of 80 targeted HIV prevention programs prior to transition; (2) a structured survey assessing institutionalization of program features in a sample of 70 targeted intervention (TI) programs, one year post-transition; and (3) case studies of 15 TI programs. Findings Transition was conducted in 3 rounds. While the 2009 transition round was problematic, subsequent rounds were implemented more smoothly. In the 2011 and 2012 transition rounds, Avahan programs were well prepared for transition with the large majority of TI program staff trained for transition, high alignment with government clinical, financial and managerial norms, and strong government commitment to the program. One year post transition there were significant program changes, but these were largely perceived positively. Notable negative changes were: limited flexibility in program management, delays in funding, commodity stock outs, and community member perceptions of a narrowing in program focus. Service coverage outcomes were sustained at least six months post-transition. Interpretation The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage. Notwithstanding, there were substantive program changes post-transition. Five key lessons for transition design and implementation are identified. PMID:26327591

  2. Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review.

    PubMed

    Hardeman, Rachel R; Murphy, Katy A; Karbeah, J'Mag; Kozhimannil, Katy Backes

    Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being.

  3. The role of emergency physicians in the institutionalization of emergency medicine.

    PubMed

    van Schothorst, Jannine; van den Brand, Crispijn L; Gaakeer, Menno I; Wallenburg, Iris

    2017-08-01

    Emergency medicine is a fast-growing medical profession. Nevertheless, the clinical activities emergency physicians (EPs) carry out and the responsibilities they have differ considerably between hospitals. This article addresses the question how the role of EPs is shaped and institutionalized in the everyday context of acute care in hospitals. A cross-case ethnographic study was conducted, comprising observations, document analysis, and in-depth interviews in three emergency departments in the Netherlands. Drawing on the theoretical concept of institutional work, we show that managers, already established medical specialties, and EPs all conduct institutional work to enhance private interests, which both restricts and enlarges EPs' work domain. These actions are strategic and intentional, as well as unintentional and part of EPs' everyday work in acute care delivery. It is in this very process that tasks and responsibilities are redistributed and the role of the EP is shaped. In contemporary literature it is often argued that the role and status of EPs should be enhanced by strengthening regulation and improving training programs. This article shows that attention should also be paid to the more subtle everyday processes of role development.

  4. The educative practice of professional caregivers at shelters: coping with violence lived by female adolescents.

    PubMed

    Penna, Lucia Helena Garcia; Carinhanha, Joana Iabrudi; Leite, Ligia Costa

    2009-01-01

    This study aimed to identify strategies caregiving professionals at shelters discuss and use in care delivery to violence situations lived by female adolescents; and to discuss educative practice as a care technology for coping with violence. Based on qualitative research, the data were produced through interviews with caregivers at a municipal adolescent shelter and were interpreted according to content analysis. The results evidenced individual and institutional strategies for care delivery to the adolescents. In conclusion, educative actions are care technologies in the reframing process of life's value by female adolescents living on the streets or in shelters, considering the cultural diversity - a dialogical action systemized and institutionalized for coping with the violence they experience.

  5. 45 CFR 605.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Education of institutionalized persons. 605.54 Section 605.54 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... ASSISTANCE Health, Welfare, and Social Services § 605.54 Education of institutionalized persons. A recipient...

  6. 45 CFR 605.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Education of institutionalized persons. 605.54 Section 605.54 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... ASSISTANCE Health, Welfare, and Social Services § 605.54 Education of institutionalized persons. A recipient...

  7. 45 CFR 605.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Education of institutionalized persons. 605.54 Section 605.54 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... ASSISTANCE Health, Welfare, and Social Services § 605.54 Education of institutionalized persons. A recipient...

  8. Program for Institutionalized Children, 1974-75.

    ERIC Educational Resources Information Center

    Ramsay, James G.

    This program for institutionalized children, funded under the Elementary Secondary Education Act of 1965, involved approximately 2181 children in 35 institutions in the New York City metropolitan area. Children were institutionalized for a variety of reasons: they were orphaned, neglected, dependent, in need of supervision, or emotionally…

  9. Disruptions of working memory and inhibition mediate the association between exposure to institutionalization and symptoms of attention deficit hyperactivity disorder.

    PubMed

    Tibu, F; Sheridan, M A; McLaughlin, K A; Nelson, C A; Fox, N A; Zeanah, C H

    2016-02-01

    Young children raised in institutions are exposed to extreme psychosocial deprivation that is associated with elevated risk for psychopathology and other adverse developmental outcomes. The prevalence of attention deficit hyperactivity disorder (ADHD) is particularly high in previously institutionalized children, yet the mechanisms underlying this association are poorly understood. We investigated whether deficits in executive functioning (EF) explain the link between institutionalization and ADHD. A sample of 136 children (aged 6-30 months) was recruited from institutions in Bucharest, Romania, and 72 never institutionalized community children matched for age and gender were recruited through general practitioners' offices. At 8 years of age, children's performance on a number of EF components (working memory, response inhibition and planning) was evaluated. Teachers completed the Health and Behavior Questionnaire, which assesses two core features of ADHD, inattention and impulsivity. Children with history of institutionalization had higher inattention and impulsivity than community controls, and exhibited worse performance on working memory, response inhibition and planning tasks. Lower performances on working memory and response inhibition, but not planning, partially mediated the association between early institutionalization and inattention and impulsivity symptom scales at age 8 years. Institutionalization was associated with decreased EF performance and increased ADHD symptoms. Deficits in working memory and response inhibition were specific mechanisms leading to ADHD in previously institutionalized children. These findings suggest that interventions that foster the development of EF might reduce risk for psychiatric problems in children exposed to early deprivation.

  10. 34 CFR 104.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Education of institutionalized persons. 104.54 Section 104.54 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS... FEDERAL FINANCIAL ASSISTANCE Health, Welfare, and Social Services § 104.54 Education of institutionalized...

  11. 34 CFR 104.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Education of institutionalized persons. 104.54 Section 104.54 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS... FEDERAL FINANCIAL ASSISTANCE Health, Welfare, and Social Services § 104.54 Education of institutionalized...

  12. 34 CFR 104.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Education of institutionalized persons. 104.54 Section 104.54 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS... FEDERAL FINANCIAL ASSISTANCE Health, Welfare, and Social Services § 104.54 Education of institutionalized...

  13. 34 CFR 104.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Education of institutionalized persons. 104.54 Section 104.54 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS... FEDERAL FINANCIAL ASSISTANCE Health, Welfare, and Social Services § 104.54 Education of institutionalized...

  14. Institutionalizing Equitable Policies and Practices for Contingent Faculty

    ERIC Educational Resources Information Center

    Kezar, Adrianna; Sam, Cecile

    2013-01-01

    This study is a qualitative inquiry into the institutionalization of equitable policies for non-tenure-track faculty. Through the theoretical framework of institutionalization, we examine factors and strategies forwarding various policies and practices and the challenges that arise. The results highlight themes throughout the stages of…

  15. Institutionalization of Gerontological Curricular Change in Schools of Social Work

    ERIC Educational Resources Information Center

    Wernet, Stephen P.; Singleton, Judy L.

    2010-01-01

    This study addresses factors associated with sustainability and institutionalization of change in the 67 Geriatric Enrichment in Social Work Education (GeroRich) projects, and the ways innovations introduced became institutionalized at the respective colleges and universities. An unobtrusive qualitative-descriptive research design was used to…

  16. Early Adverse Experiences and the Neurobiology of Facial Emotion Processing

    ERIC Educational Resources Information Center

    Moulson, Margaret C.; Fox, Nathan A.; Zeanah, Charles H.; Nelson, Charles A.

    2009-01-01

    To examine the neurobiological consequences of early institutionalization, the authors recorded event-related potentials (ERPs) from 3 groups of Romanian children--currently institutionalized, previously institutionalized but randomly assigned to foster care, and family-reared children--in response to pictures of happy, angry, fearful, and sad…

  17. Institutionalizing Continuing Professional Education (CPE): Toward a Definition of the University Situation.

    ERIC Educational Resources Information Center

    Toombs, William; Lindsay, Carl A.

    Issues related to the institutionalization of continuing professional education (CPE) within the university are considered. The components of marginality, the possible obstacles and incentives to institutionalization, and some of the support necessities are addressed, along with insights gained by a Pennsylvania State University effort to link the…

  18. 43 CFR 17.252 - Education of institutionalized persons.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Education of institutionalized persons. 17... § 17.252 Education of institutionalized persons. A recipient that operates or supervises a program or... activity is provided an appropriate education, as defined in the regulation set forth by the Department of...

  19. 45 CFR 605.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Education of institutionalized persons. 605.54... ASSISTANCE Health, Welfare, and Social Services § 605.54 Education of institutionalized persons. A recipient... appropriate education, as defined in § 605.33(b). Nothing in this section shall be interpreted as altering in...

  20. 45 CFR 84.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Education of institutionalized persons. 84.54..., Welfare, and Social Services § 84.54 Education of institutionalized persons. A recipient to which this... its program or activity is provided an appropriate education, as defined in § 84.33(b). Nothing in...

  1. 45 CFR 84.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Education of institutionalized persons. 84.54..., Welfare, and Social Services § 84.54 Education of institutionalized persons. A recipient to which this... its program or activity is provided an appropriate education, as defined in § 84.33(b). Nothing in...

  2. 43 CFR 17.252 - Education of institutionalized persons.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Education of institutionalized persons. 17... § 17.252 Education of institutionalized persons. A recipient that operates or supervises a program or... activity is provided an appropriate education, as defined in the regulation set forth by the Department of...

  3. 43 CFR 17.252 - Education of institutionalized persons.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Education of institutionalized persons. 17... § 17.252 Education of institutionalized persons. A recipient that operates or supervises a program or... activity is provided an appropriate education, as defined in the regulation set forth by the Department of...

  4. 45 CFR 84.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Education of institutionalized persons. 84.54..., Welfare, and Social Services § 84.54 Education of institutionalized persons. A recipient to which this... its program or activity is provided an appropriate education, as defined in § 84.33(b). Nothing in...

  5. 43 CFR 17.252 - Education of institutionalized persons.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Education of institutionalized persons. 17... § 17.252 Education of institutionalized persons. A recipient that operates or supervises a program or... activity is provided an appropriate education, as defined in the regulation set forth by the Department of...

  6. 45 CFR 84.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Education of institutionalized persons. 84.54..., Welfare, and Social Services § 84.54 Education of institutionalized persons. A recipient to which this... its program or activity is provided an appropriate education, as defined in § 84.33(b). Nothing in...

  7. 42 CFR 435.1009 - Institutionalized individuals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Institutionalized individuals. 435.1009 Section 435... Institutionalized individuals. (a) FFP is not available in expenditures for services provided to— (1) Individuals who are inmates of public institutions as defined in § 435.1010; or (2) Individuals under age 65 who...

  8. 45 CFR 84.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Education of institutionalized persons. 84.54..., Welfare, and Social Services § 84.54 Education of institutionalized persons. A recipient to which this... its program or activity is provided an appropriate education, as defined in § 84.33(b). Nothing in...

  9. 45 CFR 605.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Education of institutionalized persons. 605.54... ASSISTANCE Health, Welfare, and Social Services § 605.54 Education of institutionalized persons. A recipient... appropriate education, as defined in § 605.33(b). Nothing in this section shall be interpreted as altering in...

  10. 43 CFR 17.252 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Education of institutionalized persons. 17... § 17.252 Education of institutionalized persons. A recipient that operates or supervises a program or... activity is provided an appropriate education, as defined in the regulation set forth by the Department of...

  11. Comparison of health-promoting behaviors of noninstitutionalized and institutionalized older adults in Korea.

    PubMed

    Kim, Sook-Young; Jeon, Eun-Young; Sok, Sohyune R; Kim, Kwuy-Bun

    2006-01-01

    To compare the health-promoting behaviors of noninstitutionalized and institutionalized Korean older adults. Descriptive survey. The study sample included 214 Korean older adults (108 noninstitutionalized and 106 institutionalized) aged 65 years or over living in Seoul and Daegu, Korea. Data were collected from April to August, 2003. Measures were the Health Promoting Lifestyle Profile (HPLP), the Rosenberg Self-Esteem Scale (RSES), and the General Self-Efficacy Scale. The average scores for HPLP, self-esteem, and self-efficacy of noninstitutionalized older adults were higher than those of institutionalized participants. Noninstitutionalized participants also scored significantly higher than did the institutionalized participants on self-esteem and self-efficacy. Studies were focused on the effects of various nursing interventions for health promotion are needed for older adults, especially those in institutions.

  12. Predictors of institutionalization in patients with dementia in Korea.

    PubMed

    Kim, Jae-Min; Shin, Il-Seon; Jeong, Seong-Joo; Gormley, Niall; Yoon, Jin-Sang

    2002-02-01

    Many studies have sought to determine the predictors of institutionalization of patients with dementia. Such studies, performed in developed western societies, have come to various conclusions which may not be supported in an East Asian culture such as that found in Korea. This study aimed to determine the factors that predict institutionalization of patients in Korea diagnosed with dementia. Seventy-nine cases (37 institutionalized, 42 community-dwelling) in the Kwangju area were evaluated for patient characteristics, severity of dementia symptoms, caregiver characteristics, burden and distress. Logistic regression was performed to determine predictors of actual institutionalization. Six predictors of institutionalization were identified. Of these, three were patient-related factors: higher score on the Clinical Dementia Rating, higher score on the Brief Psychiatric Rating Scale, and shorter duration of dementia. The other three were caregiver-related factors: younger age, higher education (formal schooling), and higher cost of home care. As seen in previous western studies, institutionalization of dementia sufferers was influenced by both patient and caregiver factors. But, the specific predictors and their relative influences might be explained best by the particular social, cultural and economic situation in Korea. This study was the first of its kind in Korea and, as such, could serve as a reference for future intra-cultural and cross-cultural comparisons. Copyright 2002 John Wiley & Sons, Ltd.

  13. Longitudinal Predictors of Institutionalization in Old Age.

    PubMed

    Hajek, André; Brettschneider, Christian; Lange, Carolin; Posselt, Tina; Wiese, Birgitt; Steinmann, Susanne; Weyerer, Siegfried; Werle, Jochen; Pentzek, Michael; Fuchs, Angela; Stein, Janine; Luck, Tobias; Bickel, Horst; Mösch, Edelgard; Wagner, Michael; Jessen, Frank; Maier, Wolfgang; Scherer, Martin; Riedel-Heller, Steffi G; König, Hans-Helmut

    2015-01-01

    To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach. In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional fixed-effects logistic regressions (with 201 individuals and 960 observations) were performed to estimate the effects of marital status, depression, dementia, and physical impairments (mobility, hearing and visual impairments) on the risk of admission to old-age home or nursing home. By exploiting the longitudinal data structure using panel econometric models, we were able to control for unobserved heterogeneity such as genetic predisposition and personality traits. The probability of institutionalization increased significantly with occurrence of widowhood, depression, dementia, as well as walking and hearing impairments. In particular, the occurrence of widowhood (OR = 78.3), dementia (OR = 154.1) and substantial mobility impairment (OR = 36.7) were strongly associated with institutionalization. Findings underline the strong influence of loss of spouse as well as dementia on institutionalization. This is relevant as the number of old people (a) living alone and (b) suffering from dementia is expected to increase rapidly in the next decades. Consequently, it is supposed that the demand for institutionalization among the elderly will increase considerably. Practitioners as well as policy makers should be aware of these upcoming challenges.

  14. [Socio-demographic and health factors associated with the institutionalization of dependent people].

    PubMed

    Ayuso Gutiérrez, Mercedes; Pozo Rubio, Raúl Del; Escribano Sotos, Francisco

    2010-01-01

    The analysis of the effect that different variables have in the probability that dependent people are institutionalized is a topic scantily studied in Spain. The aim of the work is to analyze as certain socio-demographic and health factors can influence probability of dependent person living in a residence. A cross-section study has been conducted from a representative sample of the dependent population in Cuenca (Spain) in February, 2009. We have obtained information for people with level II and III of dependence. A binary logit regression model has been estimated to identify those factors related to the institutionalization of dependent people. People with ages between 65-74 years old are six times more likely to be institutionalized than younger people (< 65 years old); this probability increases sixteen times for those individuals with ages equal or higher than 95 years. The probability of institutionalization of people who live in an urban area is three times the probability of people who live in a rural area. People who need pharmacological, psychotherapy or rehabilitation treatments have between two and four times more probability of being institutionalized that those who do not need those. Age, marital status, place of residence, cardiovascular and musculoskeletal diseases and four times of medical treatment are the principal variables associated with the institutionalization of dependent people.

  15. The association between physical dependency and the presence of neuropsychiatric symptoms, with the admission of people with dementia to a long-term care institution: a prospective observational cohort study.

    PubMed

    Risco, Ester; Cabrera, Esther; Jolley, David; Stephan, Astrid; Karlsson, Staffan; Verbeek, Hilde; Saks, Kai; Hupli, Maija; Sourdet, Sandrine; Zabalegui, Adelaida

    2015-05-01

    Dementia is a progressive neurological disorder that causes a high degree of dependency. This dependency has been defined as an increased need for assistance due to deterioration in cognition and physical functioning, and changes in behavior. Highly dependent people with dementia are more likely to be institutionalized. To investigate the association between specific categories of physical dependency and the presence of neuropsychiatric symptoms in people with dementia admitted to a long-term care institution. A prospective observational cohort study. Home care and long-term care institutions in eight European countries. People with dementia living at home but at risk of institutionalization and recently institutionalized people with dementia. Baseline and 3-month follow-up interviews were performed between November, 2010 and April, 2012. The sample consisted of 116 recently institutionalized dementia sufferers and 949 people with dementia still living at home. Physical dependency was measured using the Katz Activity of Daily Living index, and neuropsychiatric symptoms were assessed through The Neuropsychiatric Inventory. Specific categories of dependency were analyzed by performing a logistic regression analysis. This followed examination of baseline characteristics to define the degree of physical dependency, as factors associated with institutionalization, and evaluation of the same characteristics at 3-month follow-up to detect changes in the degree of physical dependency and neuropsychiatric symptoms associated with recent admission to a long-term care institution. Toileting, dressing and continence dependency was higher in institutionalized people than in those receiving home-care. Delusion, hallucination, agitation, anxiety, apathy, motor-disturbances, night-time behavior and eating disorders were also worse in the institutionalized. Logistic regression analysis showed that independent factors significantly associated with being recently institutionalized were toileting (odds ratio=2.3; 95% confidence interval=1.43-3.71) and motor disturbances (odds ratio=1.81; 95% confidence interval=1.15-2.87). This study supports the association between type and degree of physical dependency in people with dementia and long-term institutionalization. Institutionalization is associated with physical dependency and the presence of neuropsychiatric symptoms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. The development of postinstitutionalized versus parent-reared Russian children as a function of age at placement and family type.

    PubMed

    McCall, Robert B; Muhamedrahimov, Rifkat J; Groark, Christina J; Palmov, Oleg I; Nikiforova, Natalia V; Salaway, Jennifer; Julian, Megan M

    2016-02-01

    A total of 149 children, who spent an average of 13.8 months in Russian institutions, were transferred to Russian families of relatives and nonrelatives at an average age of 24.7 months. After residing in these families for at least 1 year (average = 43.2 months), parents reported on their attachment, indiscriminately friendly behavior, social-emotional competencies, problem behaviors, and effortful control when they were 1.5-10.7 years of age. They were compared to a sample of 83 Russian parents of noninstitutionalized children, whom they had reared from birth. Generally, institutionalized children were rated similarly to parent-reared children on most measures, consistent with substantial catch-up growth typically displayed by children after transitioning to families. However, institutionalized children were rated more poorly than parent-reared children on certain competencies in early childhood and some attentional skills. There were relatively few systematic differences associated with age at family placement or whether the families were relatives or nonrelatives. Russian parent-reared children were rated as having more problem behaviors than the US standardization sample, which raises cautions about using standards cross-culturally.

  17. 7 CFR 15b.39 - Education of institutionalized persons.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Education of institutionalized persons. 15b.39 Section... § 15b.39 Education of institutionalized persons. A recipient to which this subpart applies that operates...)(2), in its program or activity is provided an appropriate education, as defined in § 15b.22(b...

  18. Suicide Experiences among Institutionalized Older Veterans in Taiwan

    ERIC Educational Resources Information Center

    Ku, Yan-Chiou; Tsai, Yun-Fang; Lin, Yan-Chiou; Lin, Yea-Pyng

    2009-01-01

    Purpose: Institutionalized veterans in Taiwan are a high-risk group for completing suicide due to their institutionalization and social minority status. The purpose of this study was to understand the suicide experiences, especially the triggers of suicide in this group. Design and Methods Data: about suicide experiences were collected from 19…

  19. 7 CFR 15b.39 - Education of institutionalized persons.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 1 2012-01-01 2012-01-01 false Education of institutionalized persons. 15b.39 Section... § 15b.39 Education of institutionalized persons. A recipient to which this subpart applies that operates...)(2), in its program or activity is provided an appropriate education, as defined in § 15b.22(b...

  20. 7 CFR 15b.39 - Education of institutionalized persons.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Education of institutionalized persons. 15b.39 Section... § 15b.39 Education of institutionalized persons. A recipient to which this subpart applies that operates...)(2), in its program or activity is provided an appropriate education, as defined in § 15b.22(b...

  1. 7 CFR 15b.39 - Education of institutionalized persons.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 1 2013-01-01 2013-01-01 false Education of institutionalized persons. 15b.39 Section... § 15b.39 Education of institutionalized persons. A recipient to which this subpart applies that operates...)(2), in its program or activity is provided an appropriate education, as defined in § 15b.22(b...

  2. 7 CFR 15b.39 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Education of institutionalized persons. 15b.39 Section... § 15b.39 Education of institutionalized persons. A recipient to which this subpart applies that operates...)(2), in its program or activity is provided an appropriate education, as defined in § 15b.22(b...

  3. Institutionalization: How Can We Continue Good Practices and Functions When Funding Ends? Part I: A Synthesis of Findings.

    ERIC Educational Resources Information Center

    Emory, Ruth

    Prepared for a meeting of the Northwest Regional Exchange (NWRx) Advisory Board and its staff and consultants, this document first reviews nine reports' findings on nine hypotheses concerning the institutionalization of educational change or innovation, especially as institutionalization relates to the dissemination functions of state…

  4. Deepening the Institutionalization of Service-Learning: The Added Value of Assessing the Social Return of Investment

    ERIC Educational Resources Information Center

    Stanton-Nichols, Kathleen; Hatcher, Julie; Cecil, Amanda

    2015-01-01

    Strategies to institutionalize service-learning are well documented (Furco 1996; Holland, 2000). Using Kecskes (2009) Community-Engaged Department Rubric we evaluated service-learning institutionalization within a school at a metropolitan campus. As a result, we propose adding an additional dimension, social return on investment. This added…

  5. Theorizing Teacher Agency and Reform: How Institutionalized Instructional Practices Change and Persist

    ERIC Educational Resources Information Center

    Bridwell-Mitchell, E. N.

    2015-01-01

    One reason reform does not dramatically change public schools is because instructional practices are highly institutionalized. This article advances a theory for how teacher agency can both change and maintain institutionalized instructional practices in schools. Based on findings from one U.S. urban public school undergoing state-mandated reform,…

  6. Power Exercise in the Institutionalization of an eProcurement System in Indonesian Local Government

    NASA Astrophysics Data System (ADS)

    Wahid, Fathul

    2017-03-01

    Power possessed by institutional entrepreneur is believed to have an influential role in navigating the institutionalization process of an idea. However, only few studies that have examined how the institutional entrepreneur exercise his power throughout the institutionalization process. This study aims at examining this phenomenon in the context of developing countries with special reference to the implementation of an eProcurement system in Indonesia. It finds that the power has been exercised by the institutional entrepreneur differently along the process. Smart power was exercised by combining soft power at the early stage of institutionalization process. At this stage level of reluctance among organizational members was high, no authorization from higher-level agencies, and the benefits of adopting the system were opaque. Hard power was then exercised at the later stage, when the legal support was well formulated, and the system’s benefits were confirmed. The study also reveals that value-based power that is used wisely make organization change runs smoothly until it becomes institutionalized. Keywords: Institutionalization, smart power, soft power, hard power, value-guided power, eGovernment, eProcurement, Indonesia, developing countries.

  7. A resolution expressing the sense of the Senate that children should have a safe, loving, nurturing, and permanent family and that it is the policy of the United States that family reunification, kinship care, or domestic and intercountry adoption promotes permanency and stability to a greater degree than long-term institutionalization and long-term, continually disrupted foster care.

    THOMAS, 112th Congress

    Sen. Landrieu, Mary L. [D-LA

    2012-02-15

    Senate - 02/15/2012 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

  8. Predicting institutionalization after traumatic brain injury inpatient rehabilitation.

    PubMed

    Eum, Regina S; Seel, Ronald T; Goldstein, Richard; Brown, Allen W; Watanabe, Thomas K; Zasler, Nathan D; Roth, Elliot J; Zafonte, Ross D; Glenn, Mel B

    2015-02-15

    Risk factors contributing to institutionalization after inpatient rehabilitation for people with traumatic brain injury (TBI) have not been well studied and need to be better understood to guide clinicians during rehabilitation. We aimed to develop a prognostic model that could be used at admission to inpatient rehabilitation facilities to predict discharge disposition. The model could be used to provide the interdisciplinary team with information regarding aspects of patients' functioning and/or their living situation that need particular attention during inpatient rehabilitation if institutionalization is to be avoided. The study population included 7219 patients with moderate-severe TBI in the Traumatic Brain Injury Model Systems (TBIMS) National Database enrolled from 2002-2012 who had not been institutionalized prior to injury. Based on institutionalization predictors in other populations, we hypothesized that among people who had lived at a private residence prior to injury, greater dependence in locomotion, bed-chair-wheelchair transfers, bladder and bowel continence, feeding, and comprehension at admission to inpatient rehabilitation programs would predict institutionalization at discharge. Logistic regression was used, with adjustment for demographic factors, proxy measures for TBI severity, and acute-care length-of-stay. C-statistic and predictiveness curves validated a five-variable model. Higher levels of independence in bladder management (adjusted odds ratio [OR], 0.88; 95% CI 0.83, 0.93), bed-chair-wheelchair transfers (OR, 0.81 [95% CI, 0.83-0.93]), and comprehension (OR, 0.78 [95% CI, 0.68, 0.89]) at admission were associated with lower risks of institutionalization on discharge. For every 10-year increment in age was associated with a 1.38 times higher risk for institutionalization (95% CI, 1.29, 1.48) and living alone was associated with a 2.34 times higher risk (95% CI, 1.86, 2.94). The c-statistic was 0.780. We conclude that this simple model can predict risk of institutionalization after inpatient rehabilitation for patients with TBI.

  9. Increased Physical Activity and Fitness above the 50(th) Percentile Avoid the Threat of Older Adults Becoming Institutionalized: A Cross-sectional Pilot Study.

    PubMed

    Pereira, Catarina; Fernandes, Jorge; Raimundo, Armando; Biehl-Printes, Clarissa; Marmeleira, José; Tomas-Carus, Pablo

    2016-02-01

    The objective of this study was to analyze the impact of physical fitness and physical activity on the threat of older adults without cognitive impairment becoming institutionalized. This cross-sectional study involved 195 non-institutionalized (80.1 ± 4.4 years) and 186 institutionalized (83.8 ± 5.2years) participants. Cognitive impairment was assessed using Mini-Mental State Examination, measures of physical fitness were determined by the Senior Fitness Test, and physical activity was assessed using the International Physical Activity Questionnaire. Multivariate binary logistic analysis selected four main determinants of institutionalization in both genders: The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, whereas it decreased by -24.8% by each fewer kg/m(2) in body mass index (BMI), by -0.9% for each additional meter performed in the aerobic endurance test, and by -2.0% for each additional 100 metabolic equivalent of task (MET)-min/week of physical activity expenditure (p < 0.05). Values ≤50(th) percentile (age ≥81 years, BMI ≥26.7 kg/m(2), aerobic endurance ≤367.6 meters, and physical activity ≤693 MET-min/week) were computed using receiver operating characteristics analysis as cutoffs discriminating institutionalized from non-institutionalized older adults. The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance), may avoid the threat of institutionalization of older adults without cognitive impairment only if they are above the 50(th) percentile. The following parameters are highly recommended: Expending ≥693 MET-min/week on physical activity, having a BMI ≤26.7 kg/m(2), and being able to walk ≥367.6 meters in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cutoffs in old and very old adults.

  10. Predictors and Effects of Knowledge Management in U.S. Colleges and Schools of Pharmacy

    NASA Astrophysics Data System (ADS)

    Watcharadamrongkun, Suntaree

    Public demands for accountability in higher education have placed increasing pressure on institutions to document their achievement of critical outcomes. These demands also have had wide-reaching implications for the development and enforcement of accreditation standards, including those governing pharmacy education. The knowledge management (KM) framework provides perspective for understanding how organizations evaluate themselves and guidance for how to improve their performance. In this study, we explore knowledge management processes, how these processes are affected by organizational structure and by information technology resources, and how these processes affect organizational performance. This is done in the context of Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (Standards 2007). Data were collected using an online census survey of 121 U.S. Colleges and Schools of Pharmacy and supplemented with archival data. A key informant method was used with CEO Deans and Assessment leaders serving as respondents. The survey yielded a 76.0% (92/121) response rate. Exploratory factor analysis was used to construct scales (and scales) describing core KM processes: Knowledge Acquisition, Knowledge Integration, and Institutionalization; all scale reliabilities were found to be acceptable. Analysis showed that, as expected, greater Knowledge Acquisition predicts greater Knowledge Integration and greater Knowledge Integration predicts greater Institutionalization. Predictive models were constructed using hierarchical multiple regression and path analysis. Overall, information technology resources had stronger effects on KM processes than did characteristics of organizational structure. Greater Institutionalization predicted better outcomes related to direct measures of performance (i.e., NAPLEX pass rates, Accreditation actions) but Institutionalization was unrelated to an indirect measure of performance (i.e., USNWR ratings). Several organizational structure characteristics (i.e., size, age, and being part of an academic health center) were significant predictors of organizational performance; in contrast, IT resources had no direct effects on performance. Findings suggest that knowledge management processes, organizational structures and IT resources are related to better performance for Colleges and Schools of Pharmacy. Further research is needed to understand mechanisms through which specific knowledge management processes translate into better performance and, relatedly, to establish how enhancing KM processes can be used to improve institutional quality.

  11. Study of American and Chinese family members' evaluations on institutionalized care for their older parents: potential development in the future.

    PubMed

    Li, Yushi; Buechel, Annie

    2007-01-01

    The evaluations on institutionalized care facilities from family members, after their loved ones moved into such services, are very different from culture to culture, family to family and person to person. According to a recent survey in the United States and China, it is found that different cultures and the different health conditions of the residents strongly influence family member's viewpoints on institutionalized care services. It is also found that the availability of the institutionalized care facilities plays a significant role, which strongly affects family members' evaluations on nursing home services.

  12. Imitation of transitive and intransitive actions in healthy individuals.

    PubMed

    Carmo, Joana C; Rumiati, Raffaella I

    2009-04-01

    A handful of patients have been described as being impaired in performing transitive gestures, despite being still able to perform intransitive gestures. This impairment need not be explained by assuming different mechanisms; rather, it can be due to transitive actions being more difficult. In this study we tested whether neurologically healthy participants had greater difficulties in imitating transitive actions with respect to intransitive actions. Consistent with the prediction, subjects imitated intransitive better than transitive gestures. The ease of imitation of intransitive actions supports the complexity account of apraxic impairments.

  13. [The relationship between depressive symptoms and family functioning in institutionalized elderly].

    PubMed

    de Oliveira, Simone Camargo; dos Santos, Ariene Angelini; Pavarini, Sofia Cristina Iost

    2014-02-01

    The present study aimed to investigate the relationship between family functioning and depressive symptoms among institutionalized elderly. This is a descriptive, cross-sectional study of quantitative character. A total of 107 institutionalized elderly were assessed using a sociodemographic questionnaire, the Geriatric Depression Scale (to track depressive symptoms) and the Family APGAR (to assess family functioning). The correlation coefficient of Pearson's, the chi-square test and the crude and adjusted logistic regression were used in the data analysis with a significance level of 5 %. The institutionalized elderly with depressive symptoms were predominantly women and in the age group of 80 years and older. Regarding family functioning, most elderly had high family dysfunctioning (57 %). Family dysfunctioning was higher among the elderly with depressive symptoms. There was a significant correlation between family functioning and depressive symptoms. The conclusion is that institutionalized elderly with dysfunctional families are more likely to have depressive symptoms.

  14. It's Been Mostly about Money! A Multi-Method Research Approach to the Sources of Institutionalization

    ERIC Educational Resources Information Center

    Bértoa, Fernando Casal

    2017-01-01

    Although much has been written about the process of party system institutionalization in different regions, the reasons why some party systems institutionalize while others do not still remain a mystery. Seeking to fill this lacuna in the literature, and using a mixed-methods research approach, this article constitutes a first attempt to answer…

  15. Leadership Behavior and Job Performance of Teachers in Public and Private Kindergartens: The Perspectives of Institutionalization, Reason, and Feeling

    ERIC Educational Resources Information Center

    Chen, Yigean; Cheng, Jaonan

    2012-01-01

    Chinese society is accustomed to using feelings, reasons, and institutionalizations to determine how to deal with events, which raises a number of questions. How can the directors of early education institutions incorporate feelings, reasons, and institutionalizations into their management? How can they enhance the job performance of teachers?…

  16. Early adverse experiences and the neurobiology of facial emotion processing.

    PubMed

    Moulson, Margaret C; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A

    2009-01-01

    To examine the neurobiological consequences of early institutionalization, the authors recorded event-related potentials (ERPs) from 3 groups of Romanian children--currently institutionalized, previously institutionalized but randomly assigned to foster care, and family-reared children--in response to pictures of happy, angry, fearful, and sad facial expressions of emotion. At 3 assessments (baseline, 30 months, and 42 months), institutionalized children showed markedly smaller amplitudes and longer latencies for the occipital components P1, N170, and P400 compared to family-reared children. By 42 months, ERP amplitudes and latencies of children placed in foster care were intermediate between the institutionalized and family-reared children, suggesting that foster care may be partially effective in ameliorating adverse neural changes caused by institutionalization. The age at which children were placed into foster care was unrelated to their ERP outcomes at 42 months. Facial emotion processing was similar in all 3 groups of children; specifically, fearful faces elicited larger amplitude and longer latency responses than happy faces for the frontocentral components P250 and Nc. These results have important implications for understanding of the role that experience plays in shaping the developing brain.

  17. The disorganized family: institutions, practices and normativity.

    PubMed

    Smyth, Lisa

    2016-12-01

    This paper considers the value of a normative account of the relationship between agents and institutions for contemporary efforts to explain ever more complex and disorganized forms of social life. The character of social institutions, as they relate to practices, agents and norms, is explored through an engagement with the common claim that family life has been de-institutionalized. The paper argues that a normative rather than empirical definition of institutions avoids a false distinction between institutions and practices. Drawing on ideas of social freedom and creative action from critical theory, the changes in family life are explained not as an effect of de-institutionalization, but as a shift from an organized to a disorganized institutional type. This is understood as a response to changes in the wider normative structure, as a norm of individual freedom has undermined the legitimacy of the organized patriarchal nuclear family, with gender ascribed roles and associated duties. Contemporary motherhood is drawn on to illustrate the value of analysing the dynamic interactions between institutions, roles and practices for capturing both the complexity and the patterned quality of social experience. © London School of Economics and Political Science 2016.

  18. U.S. Command Relationships in the Conduct of Cyber Warfare: Establishment, Exercise, and Institutionalization of Cyber Coordinating Authority

    DTIC Science & Technology

    2010-05-03

    FINAL 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE U.S. Command Relationships in the Conduct of Cyber Warfare : Establishment...U.S. Command Relationships in the Conduct of Cyber Warfare : Establishment, Exercise, and Institutionalization of Cyber Coordinating Authority...Relationships in the Conduct of Cyber Warfare : Establishment, Exercise, and Institutionalization of Cyber Coordinating Authority The character of

  19. Where's the Justice in Service-Learning? Institutionalizing Service-Learning from a Social Justice Perspective at a Jesuit University

    ERIC Educational Resources Information Center

    Cuban, Sondra; Anderson, Jeffrey B.

    2007-01-01

    We attempt to answer "where" the social justice is in service-learning by probing "what" it is, "how" it looks in the process of being institutionalized at a Jesuit university, and "why" it is important. We develop themes about institutionalizing service-learning from a social justice perspective. Our themes were developed through an analysis of…

  20. The Self-Concept and Academic Performance of Institutionalized and Non-Institutionalized HIV/AIDS Orphaned Children in Kisumu Municipality

    ERIC Educational Resources Information Center

    Kimani, Chege Gabriel; Cheboswony, M.; Kodero, H. M.; Misigo, Benard L.

    2009-01-01

    The HIV/AIDS pandemic has increasingly become a major factor in the emergence of orphans in the developing countries. These orphans are usually traumatized due to the multiple losses, isolation, stigma and grief. The study sought to investigate the effect of institutionalization of children on the self-concept of the AIDS-orphaned children and to…

  1. Achievements and future path of Tehran municipality in urban health domain: An Iranian experience

    PubMed Central

    Damari, Behzad; Riazi-Isfahani, Sahand

    2016-01-01

    Background: According to national laws and world experiences; provision, maintenance, and improving citizens’ health are considered to be the essential functions of municipalities as a "social institute". In order to equitably promote health conditions at urban level, particularly in marginal areas, since 2004 targeted efforts have been implemented in the municipality of Tehran metropolis. This study was intended to identify and analyze these targeted measures and tries to analyze health interventions in a conceptual framework and propose a future path. Methods: This is a qualitative study with content analysis approach. Reviewing documents and structured interviews with national health policy making and planning experts and executive managers of 22-region municipalities of Tehran metropolis were used to collect data. The data were analyzed on the basis of conceptual framework prepared for urban health in 4 domains including municipal interventions, goal achievements, drivers and obstacles of success, and the way forward. Results: From the viewpoint of interviewees, these new health actions of Tehran municipality are more based on public participation and the municipality was able to prioritize health issue in the programs and policies of Tehran city council. Tehran municipality has accomplished three types of interventions to improve health, which in orders of magnitude are: facilitative, promotional, and mandatory interventions. Development and institutionalization of public participation is the greatest achievement in health-oriented actions; and expansion of environmental and physical health-oriented facilities and promoting a healthy lifestyle are next in ranks. Conclusion: Since management alterations seriously challenges institutionalization of actions and innovations especially in the developing countries, it is suggested that mayors of metropolitan cities like Tehran document and review municipal health measures as soon as possible and while eliminating overlapping of interventions with other sectors, design and approve the charter of "health promoting municipality". The most important role of municipalities in this charter would be coordinating health improvement of citizens. This charter, when approved as a national policy could be used for other cities too. PMID:27390693

  2. Practical and affordable ways to cultivate leadership in your organization.

    PubMed

    Gaufin, Joyce R; Kennedy, Kathy I; Struthers, Ellen D

    2010-01-01

    Leadership can be cultivated through the intentional actions of managers and others in public health organizations. This article provides a rationale for taking innovative and proactive steps to build leadership, discusses four general strategies for doing so, and presents seven practical, creative, and affordable actions that can have a positive influence on efforts to cultivate leadership qualities in the public health workforce. Each action is illustrated with an actual contemporary example from a local public health agency. The actions include providing formal or informal coaching/mentoring opportunities; assigning staff to lead new projects or collaborations, projects outside their disciplines, projects that cause growth in their information technology capacity, or orphan or struggling projects; facilitating a book club; and institutionalizing reflection. The best way to ensure that effective leadership is available when the organization needs it is to intentionally develop it through an ongoing process. Leadership growth can be supported during the ordinary course of business in a public health organization through thoughtful challenges, sharing ideas and experiences, and especially through the example set by managers and those in positions of authority.

  3. Association between leprosy and hepatitis B infection. A survey in Goiânia, central Brazil.

    PubMed

    Rosa, H; Costa, A P; Ferraz, M L; Pedroza, S C; Andrade, A L; Martelli, C M; Zicker, F

    1992-01-01

    This investigation presents the results of hepatitis B virus screening among leprosy patients conducted in central Brazil as a preliminary information for a HBV vaccination programme. The main objectives were to assess the seroprevalence of HBV serum markers among lepromatous patients and to analyse institutionalization as risk factor for HBV infection in this population. Two groups of lepromatous patients were studied, 83 outpatients and 171 institutionalized ones. Screening for HBV serum markers included the detection of HBsAg, anti-HBc by radioimmune assay (RIA). The prevalence of carrier state (HBsAg) was 4.8% and 8.8% among outpatients and institutionalized, respectively, (p > 0.05). Seroprevalence of exposure (all markers) was statistically significant different between outpatients (16.9%) and institutionalized ones (50.3%). Institutionalized patients had an almost four fold risk of HBV infection when compared to the outpatients, and the highest risks were among patients with more than 21 years of residence in the colony, after adjusting for age and sex.

  4. [An integrative model of the psychological benefits of gardening in older adults].

    PubMed

    Tournier, Isabelle; Postal, Virginie

    2014-12-01

    This review of the literature tackles the question of the psychological benefits linked to gardening in older adults. First, the current data on these benefits are reviewed, and the findings reveal that gardening is linked to feelings of accomplishment, well-being and peace, a decrease of depressive symptoms, a protective effect on cognitive functions as well as to the development of social links for community living older adults. In institutionalized older adults, gardening promotes internal locus of control and well-being, and is related to a decrease of sadness and anxiety. Second, several explanatory theories are discussed. All of them postulate an action on the cognitive and/or emotional spheres, which were included into a integrated model that must be tested in future research. In conclusion, gardening appears to be a beneficial activity for promoting older adults' functioning but the current knowledge still has to be extended to understand the specific mechanisms of action. This deeper understanding is necessary in order to improve the future actions depending on this activity.

  5. Influence of the length of institutionalization on older adults' postural balance and risk of falls: a transversal study.

    PubMed

    Batista, Wagner Oliveira; Alves Junior, Edmundo de Drummond; Porto, Flávia; Pereira, Fabio Dutra; Santana, Rosimere Ferreira; Gurgel, Jonas Lírio

    2014-01-01

    to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls. to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (α<0.05) were used. there was no significant correlation between the length of institutionalization and the tests for evaluation of risk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups. this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged.

  6. The State of Alaska's early experience with institutionalization of health impact assessment.

    PubMed

    Anderson, Paul J; Yoder, Sarah; Fogels, Ed; Krieger, Gary; McLaughlin, Joseph

    2013-01-01

    Many nations routinely include health impact assessments (HIA) in public policy decisions. Institutionalization of HIA formally integrates health considerations into a governmental decision-making process. We describe an example of institutionalization in the United States through Alaska's early experience with institutionalization of HIA. HIA arose from a series of health conferences in the 1970s that affirmed the importance of "health for all." A number of key milestones eventually defined HIA as a unique field of impact assessment. There are several approaches to institutionalization, and one common approach in the United States is through the National Environmental Policy Act (NEPA). NEPA formed the basis for the earliest HIAs in Alaska. Early HIAs in Alaska led to conferences, working groups, a state guidance document and the institutionalization of a HIA program within the Department of Health and Social Services in 2010. A medical epidemiologist staffs the program, which utilizes contractors to meet rising demand for HIA. The HIA program has sustainable funding from the state budget and from the state's natural resource permitting process. The HIA document is the main deliverable, but the program performs other tasks, including fieldwork and technical reviews. The HIA program works closely with a host of collaborative partners. Alaska's institutionalized HIA program benefits from sustainable funding that promotes continuous quality improvement and involves the program in the entire life cycle of a development project. The program structure adapts well to variations in workflow and supports a host of quality control activities. Currently, the program focuses on HIAs for natural resource development projects.

  7. Predictors of hyperphagia in institutionalized patients with dementia.

    PubMed

    Wu, Hua-Shan

    2014-12-01

    Hyperphagia, a common eating behavioral change in patients with dementia, is one of the risk factors for institutional placement. No study of hyperphagia has yet been conducted on institutionalized patients with dementia. There is currently no academic consensus over the correlations among hyperphagic behaviors, agitated behaviors, cognitive function, and demographic characteristics in this patient group. This study explores the prevalence and predictors of hyperphagic behaviors in institutionalized patients with dementia. A cross-sectional and correlational design was used. The participants were recruited from seven dementia special care units and assisted living facilities in Taiwan. One hundred seventy-nine patients with dementia agreed to participate. Two research assistants were trained to collect data using the subscale for hyperphagic behaviors, the Cohen-Mansfield Agitation Inventory, the Cognitive Abilities Screening Instrument, and a dementia patient demographic characteristics datasheet. The prevalence of hyperphagic behaviors in institutionalized patients with dementia was 50.8% (91/179). After excluding the variables from the long-term memory, short-term memory, attention, abstraction and judgment, and verbally nonaggressive behavior subscales scores, we found gender, length of institutionalization, category fluency, and physically nonaggressive behavior subscale scores to be significant predictors of hyperphagic behaviors (p < .05). Findings suggest that institutionalized male patients with dementia with longer institutionalization who have either a relatively low-fluency task score or a relatively high frequency of physically nonaggressive behaviors are at greater risk for exhibiting hyperphagic behaviors. Once hyperphagic behaviors are found in a patient, a transdisciplinary case meeting should be held to develop an appropriate dietary management plan, and further identification and treatment should be done by a neurologist or a psychiatrist.

  8. Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care.

    PubMed

    Souza, Gisélia Santana; Costa, Ediná Alves; Barros, Rafael Damasceno de; Pereira, Marcelo Tavares; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Álvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

    2017-11-13

    To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees' answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05. Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the "organization, structure, and financing" dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services' finalistic activities.

  9. Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care

    PubMed Central

    Souza, Gisélia Santana; Costa, Ediná Alves; de Barros, Rafael Damasceno; Pereira, Marcelo Tavares; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Álvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

    2017-01-01

    ABSTRACT OBJECTIVE To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees’ answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05. RESULTS Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the “organization, structure, and financing” dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. CONCLUSION The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services’ finalistic activities. PMID:29160459

  10. Information ranks highest: Expectations of female adolescents with a rare genital malformation towards health care services

    PubMed Central

    Simoes, Elisabeth; Sokolov, Alexander N.; Kronenthaler, Andrea; Hiltner, Hanna; Schaeffeler, Norbert; Rall, Katharina; Ueding, Esther; Rieger, Monika A.; Wagner, Anke; Poesch, Leonie S.; Baur, Marie-Christin; Kittel, Judith; Brucker, Sara Y.

    2017-01-01

    Background Access to highly specialized health care services and support to meet the patient’s specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important respects. Long distances to dedicated institutions and scarcity of knowledge, even among medical doctors, may present major obstacles for proper access to health care services and health chances. This study is part of the BMBF funded TransCareO project examining in a mixed-method design health care provisional deficits, preferences, and barriers in health care access as perceived by female adolescents affected by the Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), a rare (orphan) genital malformation. Methods Prior to a communicative validation workshop, critical elements of MRKHS related care and support (items) were identified in interviews with MRKHS patients. During the subsequent workshop, 87 persons involved in health care and support for MRKHS were asked to rate the items using a 7-point Likert scale (7, strongly agree; 1, strongly disagree) as to 1) the elements’ potential importance (i.e., health care expected to be “best practice”, or priority) and 2) the presently experienced care. A gap score between the two was computed highlighting fields of action. Items were arranged into ten separate questionnaires representing domains of care and support (e.g., online-portal, patient participation). Within each domain, several items addressed various aspects of “information” and “access”. Here, we present the outcome of items’ evaluation by patients (attended, NPAT = 35; respondents, NRESP = 19). Results Highest priority scores occurred for domains “Online-Portal”, “Patient participation”, and “Tailored informational offers”, characterizing them as extremely important for the perception as best practice. Highest gap scores yielded domains “Tailored informational offers”, reflecting perceived lack of disease-related information for affected persons, medical experts, and health insurance companies, “Online-Portal” (with limited information available on specialist clinics and specialized doctors), and regarding insufficient support offers (e.g., in school and occupational settings). Conversely, lowest gap scores were found with group offers for MRKHS patients (“Transition programs”) and MRKHS self-help days (“Patient participation”), suggesting satisfaction or good solutions in place. Discussion The importance assigned to disease-related information indicates that informational deficits are perceived by patients as barriers, hindering proper access to health care, especially in an orphan disease. Access to health-related information plays a role for all persons seeking help and care. However, the overwhelmingly high scores attributed to these elements in the context of an orphan disease reveal that here improved information policies are crucial, demanding for institutionalized solutions supported by the health care system. Implications for practice The disparity between experience of care and attribution as best practice detected describes areas of action in all domains involved, highlighting information related fields. New concepts and structures for health care in orphan diseases could draw upon these patient-oriented results a) regarding orphan-disease specific elements demanding institutionalized reimbursement, b) essential elements for center care and corresponding networks, and c) elements reflecting patients´ participation in the conception of centers for rare diseases. PMID:28426677

  11. Using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for Predicting Institutionalization of Patients With Dementia in Taiwan

    PubMed Central

    Huang, Shih-Wei; Chang, Kwang-Hwa; Escorpizo, Reuben; Hu, Chaur-Jong; Chi, Wen-Chou; Yen, Chia-Feng; Liao, Hua-Fang; Chiu, Wen-Ta; Liou, Tsan-Hon

    2015-01-01

    Abstract World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is an assessment tool and it has been applied for disability status assessment of Taiwanese dementia patients since July 2012. The aim of this study was to investigate the predicting accuracy of WHODAS 2.0 for institutionalization of dementia patients. Of these patients, 13,774 resided in a community and 4406 in a long-term care facility. Demographic data and WHODAS 2.0 standardized scores were analyzed using the Chi-square test and independent t test to compare patients with dementia in an institution with those in a community. The receiver operating characteristic (ROC) curve was applied to investigate accuracy in predicting institutionalization, and the optimal cutoff point was determined using the Youden index. Binary logistic regression was used to analyze variables to determine risk factors for the institutionalization of patients with dementia. WHODAS 2.0 scores in all domains were higher in patients with dementia in a long-term care facility than in those in a community (P < 0.01). The ROC curve showed moderate accuracy for all domains of WHODAS 2.0 (area under curve 0.6∼0.8). Binary logistic regression revealed that the male gender, severity of disease, and standardized WHODAS 2.0 scores surpassing the cutoff values were risk factors for the institutionalization of patients with dementia. Although the accuracy of WHODAS 2.0 in predicting institutionalization is not considerably high for patients with dementia, our study found that the WHODAS 2.0 scores, the male gender, education status, urbanization level, and severity of disease were risk factors for institutionalization in long-term care facilities. PMID:26632747

  12. Dialysis in the Elderly and Impact of Institutionalization in the United States Renal Data System.

    PubMed

    Brar, Amarpali; Mallappallil, Mary; Stefanov, Dimitre G; Kau, David; Salifu, Moro O

    2017-01-01

    We hypothesized that in the very elderly dialysis patients in the United States, institutionalization in nursing homes would increase mortality in addition to age alone. Incident dialysis patients from 2001 to 2008 above the age of 70 were included. Patients above 70 were categorized into 4 groups according to age as 70-75, 76-80, 81-85, and >85 years and further divided into institutionalized and noninstitutionalized. Kaplan-Meier survival curves were plotted to assess patient survival. A total of 349,440 patients were identified above the age of 70 at the time of initiation of dialysis. For institutionalized patients, the mean survival was significantly lower, 1.71 ± 0.03 years for those in the age range 70-75, 1.44 ± 0.02 years for those in the age range 76-80, 1.25 ± 0.02 years for those in the age range 81-85, and 1.04 ± 0.02 for those in the >85 years age group (p = 0.0001). The hazard ratio for mortality in institutionalized elderly patients on dialysis was 1.80 ([95% CI 1.77-1.83]; p = 0.0001). After adjustment for other variables (multivariate Cox regression), to be institutionalized was still an independent risk factor for mortality (adjusted hazard ratio = 1.57 [95% CI 1.54-1.60]; p = 0.0001). There was increased mortality in institutionalized elderly patients as compared to noninstutionalized elderly patients in the same age group. In accordance with the increased frailty and decreased benefits of therapies in the very elderly, especially in those with additional co-morbidities besides age, palliative and end-of-life care should be considered. © 2017 S. Karger AG, Basel.

  13. [Predictors of institutionalization of elderly persons in dependency situation in Andalusia].

    PubMed

    Pinzón-Pulido, Sandra; Garrido Peña, Francisco; Reyes Alcázar, Víctor; Lima-Rodríguez, Joaquín Salvador; Raposo Triano, María Fernanda; Martínez Domene, Manuel; Alonso Trujillo, Federico

    2016-01-01

    Identifying preferences regarding type of care and risk factors for institutionalization of elderly persons in dependency situations in Andalusia. The data on 200,039 persons registered in the System for Autonomy and Dependency Care over the period 2007-2012 were analysed. The study population was described in terms of: age, dependency situation, preferences, support network and clinical factors at the time of inclusion in the study. Separate analysis was made for men and women. A logistic regression model was designed to determine the risk factors for institutionalization for each sex. 87,4% of women and 85,9% of men expressed their wish to receive care in their own home. The risk of institutionalization is three times higher among men than among women. Among women, the risks of institutionalization are: level of dependency, wishing to move into a residential care home, medium consistency and fragility of support network and being diagnosed with dementia. Among men, the risks are: wishing to move into a residential care home and low or medium consistency of support network. Care in the home is the preferred alternative for elderly persons in dependency situations. The risk of institutionalization is conditioned more by the preferences of the person and their family and the characteristics of the support network than by individual's clinical condition. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  14. Influence of the length of institutionalization on older adults' postural balance and risk of falls: a transversal study1

    PubMed Central

    Batista, Wagner Oliveira; Alves, Edmundo de Drummond; Porto, Flávia; Pereira, Fabio Dutra; Santana, Rosimere Ferreira; Gurgel, Jonas Lírio

    2014-01-01

    OBJECTIVE: to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls. METHOD: to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (α<0.05) were used. RESULTS: there was no significant correlation between the length of institutionalization and the tests for evaluation of risk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups. CONCLUSION: this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged. PMID:25296149

  15. Institutionalization and indiscriminate social behavior: Differential-susceptibility versus diathesis-stress models for the 5-HTTLPR and BDNF genotypes.

    PubMed

    Mesquita, A R; Belsky, J; Li, Z; Baptista, J; Carvalho-Correia, E; Maciel, P; Soares, I

    2015-12-01

    Institutionalization adversely impacts children's emotional functioning, proving related to attachment disorders, perhaps most notably that involving indiscriminate behavior, the subject of this report. In seeking to extend work in this area, this research on gene X environment (GXE) interplay investigated whether the serotonin transporter (5-HTTLPR) and val66met Brain-Derived Neurotrophic Factor (BDNF) polymorphisms moderated the effect of institutional care on indiscriminate behavior in preschoolers. Eighty-five institutionalized and 135 home-reared Portuguese children were assessed using Disturbances of Attachment Interview (DAI). GXE results indicated that s/s homozygotes of the 5-HTTLPR gene displayed significantly higher levels of indiscriminate behavior than all other children if institutionalized, something not true of such children when family reared. These findings proved consistent with the diathesis-stress rather than differential-susceptibility model of person×environment interaction. BDNF proved unrelated to indiscriminate behavior. Results are discussed in relation to previous work on this subject of indiscriminate behavior, institutionalization and GXE interaction. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Institutionalization of Older Adults After the Death of a Spouse

    PubMed Central

    Nihtilä, Elina; Martikainen, Pekka

    2008-01-01

    Objectives. We investigated the risk of entering long-term institutional care after the death of a spouse in relation to the duration of widowhood among older Finnish men and women. We also examined whether high levels of education or household income buffered the effects of bereavement on institutionalization. Methods. We used linked register-based data on Finnish adults 65 years or older who were living with a spouse at the beginning of the study period (n=140902) and were followed from January 1998 to December 2002. Results. The excess risk of institutionalization was highest during the first month following a spouse’s death compared with still living with a spouse (adjusted hazard ratio=3.31 for men, 3.62 for women). This risk decreased over time among both men and women. The relative effect of the duration of widowhood on institutionalization did not significantly vary according to the level of education or income. Conclusions. Risk of institutionalization is particularly high immediately after the death of a spouse, demonstrating the importance of loss of social and instrumental support. PMID:18511726

  17. Estuary ecosystem restoration: implementing and institutionalizing adaptive management: Institutionalizing adaptive management

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ebberts, Blaine D.; Zelinsky, Ben D.; Karnezis, Jason P.

    We successfully implemented and institutionalized an adaptive management (AM) process for the Columbia Estuary Ecosystem Restoration Program, which is a large-scale restoration program focused on improving ecosystem conditions in the 234-km lower Columbia River and estuary. For our purpose, “institutionalized” means the AM process and restoration program are embedded in the work flow of the implementing agencies and affected parties. While plans outlining frameworks, processes, or approaches to AM of ecosystem restoration programs are commonplace, establishment for the long term is not. This paper presents the basic AM framework and explains how AM was implemented and institutionalized. Starting with amore » common goal, we pursued included a well-understood governance and decision-making structure, routine coordination and communication activities, data and information sharing, commitment from partners and upper agency management to the AM process, and meaningful cooperation among program managers and partners. The overall approach and steps to implement and institutionalize AM for ecosystem restoration explained here are applicable to situations where it has been less than successful or, as in our case, the restoration program is just getting started.« less

  18. Attachment security representations in institutionalized children and children living with their families: links to problem behaviour.

    PubMed

    Torres, Nuno; Maia, Joana; Veríssimo, Manuela; Fernandes, Marilia; Silva, Filipa

    2012-01-01

    The present work analyses differences in the attachment representations of institutionalized children as compared with children from low and high educational level living with their natural families. Participants were 91 Portuguese children, 52% girls, aged 48-96 months. There were three different groups: 19 institutionalized children, 16 low educational level families' children and 56 from high educational level families'. Attachment representations were assessed for Security of the narratives of the Attachment Story Completion Task (ASCT). Psychopathological symptoms were assessed using the Child Behaviour Checklist for parents and caretakers. Verbal skills were assessed using the Wechsler Preschool and Primary Scale of Intelligence--Revised. Results show that institutionalized children have significantly lower security of attachment representations, less verbal skills and higher aggressive behaviour than the other two groups. Attachment representations were associated with social/withdrawal and aggression, independently of age, verbal skills and parents' education. The main effect of institutionalization on externalizing aggressive behaviour was completely mediated by the security of attachment representations.  Copyright © 2010 John Wiley & Sons, Ltd.

  19. Interventions to delay institutionalization of frail older persons: design of a longitudinal study in the home care setting.

    PubMed

    De Almeida Mello, Johanna; Van Durme, Therese; Macq, Jean; Declercq, Anja

    2012-08-06

    Older people usually prefer staying at home rather than going into residential care. The Belgian National Institute for Health and Disability Insurance wishes to invest in home care by financing innovative projects that effectively help older people to stay at home longer. In this study protocol we describe the evaluation of 34 home care projects. These projects are clustered according to the type of their main intervention such as case management, night care, occupational therapy at home and psychological/psychosocial support. The main goal of this study is to identify which types of projects have the most effect in delaying institutionalization of frail older persons. This is a longitudinal intervention study based on a quasi-experimental design. Researchers use three comparison strategies to evaluate intervention--comparison among different types of projects, comparisons between older persons in the projects and older persons not benefiting from a project but who are still at home and between older persons in the projects and older persons who are already institutionalized. Projects are asked to include clients who are frail and at risk of institutionalization. In the study we use internationally validated instruments such as the interRAI Home Care instrument, the WHO-QOL-8 and the Zarit Burden Interview-12. These instruments are filled out at baseline, at exit from the project and 6 months after baseline. Additionally, caregivers have to do a follow-up every 6 months until exit from the project. Criteria to exit the cohort will be institutionalization longer than 3 months and death. The main analysis in the study consists of the calculation of incidence rates, cumulative incidence rates and hazard rates of definitive institutionalization through survival analyses for each type of project. This research will provide knowledge on the functional status of frail older persons who are still living at home. This is important information to identify determinants of risk for institutionalization. The identification of effective home care projects in delaying institutionalization will be useful to inform and empower home care providers, policy and related decision makers to manage and improve home care services.

  20. Institutionalizing and sustaining social change in health systems: the case of Uganda.

    PubMed

    Hage, Jerald; Valadez, Joseph J

    2017-11-01

    The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used to change health services, and the four separate indicators being used to measure women's health and child survival services. We conclude that the two C's (competent evaluators and control mechanisms) have been critical for sustaining programme evaluation in Uganda. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  1. Institutionalizing and sustaining social change in health systems: the case of Uganda

    PubMed Central

    Hage, Jerald; Valadez, Joseph J

    2017-01-01

    Abstract The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C’s: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized ‘stability’, whereas in global health, the issue is determining how to improve the impact of services by ‘changing’ programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0–11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used to change health services, and the four separate indicators being used to measure women's health and child survival services. We conclude that the two C’s (competent evaluators and control mechanisms) have been critical for sustaining programme evaluation in Uganda. PMID:28981663

  2. Does cognitive/physical screening in an outpatient setting predict institutionalization after hip fracture?

    PubMed

    Hongisto, Markus T; Nuotio, Maria; Luukkaala, Tiina; Väistö, Olli; Pihlajamäki, Harri K

    2016-10-22

    Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively. A telephone interview with a structured inquiry was performed at 1, 4, and 12 months after hip fracture. Age-adjusted univariate logistic regression analysis revealed that IADL and MMSE scores measured at the outpatient clinic were significantly associated with living arrangements 1 year after hip fracture. Multivariate logistic regression analysis established that institutionalization 1 year after hip fracture was significantly predicted by institutionalization at 4 months (odds ratio [OR] 16.26, 95 % confidence interval [CI] 7.37-35.86), IADL <5 (OR 12.96, 95 % CI 1.62-103.9), and MMSE <20 (OR 4.19, 95 % CI 1.82-9.66). A cut-off value of 5 was established for IADL with 100 % (95 % CI 96 %-100 %) sensitivity and 38 % (95 % CI 33 %-43 %) specificity and for MMSE, a cut-off value of 20 had 83 % (95 % CI 74 %-91 %) sensitivity and 65 % (95 % CI 60 %-70 %) specificity for institutionalization. During the time period from 4 to 12 months, 66 (11 %) patients changed living arrangements, and 36 (55 %) of these patients required more supportive accommodations. IADL and MMSE scores obtained 4 to 6 months after hospital discharge may be applicable for predicting institutionalization among fragility hip fracture patients ≥65 years of age at 1 year after hip fracture. An IADL score of ≥5 predicted the ability to remain in the community. Changes in living arrangements also often occur after 4 months.

  3. Family functionality: a study of Brazilian institutionalized elderly individuals.

    PubMed

    de Oliveira, Simone Camargo; Pavarini, Sofia Cristina Iost; Orlandi, Fabiana de Souza; de Mendiondo, Marisa Silvana Zazzeta

    2014-01-01

    This study presents an analysis of a potential association between family functionality and the variables of gender, length of institutionalization, family composition, depressive symptoms, and cognitive disorders in elderly individuals living in Long-Term Care Facilities (LTCF) in a city in the interior of São Paulo, Brazil. This is a quantitative, cross-sectional study with a descriptive-correlational design. A total of 107 institutionalized elderly individuals were interviewed. Data were analyzed through raw and adjusted Logistic Regression. The results indicate that most elderly individuals experience family dysfunction, 57% present a high level of family dysfunction, 21% present moderate family dysfunction and 22% present good family functionality. There was a statistical association between the Family APGAR and the variables of length of institutionalization, depressive symptoms, family composition and cognitive disorders. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Speaking from the Inside: Challenges Faced by Communication Researchers Investigating Disease-Related Issues in a Hospital Setting.

    PubMed

    Bourquin, Céline; Stiefel, Friedrich; Singy, Pascal

    2015-09-01

    This commentary came from within the framework of integrating the humanities in medicine and from accompanying research on disease-related issues by teams involving clinicians and researchers in medical humanities. The purpose is to reflect on the challenges faced by researchers when conducting emotionally laden research and on how they impact observations and subsequent research findings. This commentary is furthermore a call to action since it promotes the institutionalization of a supportive context for medical humanities researchers who have not been trained to cope with sensitive medical topics in research. To that end, concrete recommendations regarding training and supervision were formulated.

  5. Language acquisition with limited input: Romanian institution and foster care.

    PubMed

    Windsor, Jennifer; Glaze, Leslie E; Koga, Sebastian F

    2007-10-01

    To provide the first detailed information about native language abilities of children who are or had been institutionalized. The language of ten 30-month-old children raised in Romanian orphanages was compared with that of 30 chronological-age-matched peers: 10 children who had moved recently from orphanages to foster care, 10 children in foster families for at least 1 year, and 10 children raised in their biological families. Ten language measures were obtained from communication during play and from parent/caregiver report. Children who were institutionalized and children in foster care for a brief time showed substantial language delays, with some of these children not yet producing intelligible words. Children in foster care for at least 1 year approximated the expressive output and receptive language of children who had never been institutionalized; however, they showed lower expressive grammatical abilities. Within the group of children who were institutionalized, the presence of a preferred caregiver and a measure of development, greater height, were associated with greater language output. Although children in orphanages produced fewer complex forms than children in biological families, there were no systematic qualitative differences in language structure across groups. Foster care facilitated language growth after substantial language delays associated with institutionalization.

  6. Depressive symptoms in institutionalized older adults

    PubMed Central

    Santiago, Lívia Maria; Mattos, Inês Echenique

    2014-01-01

    OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals. PMID:24897042

  7. Risk Factors for Institutionalization After Traumatic Brain Injury Inpatient Rehabilitation.

    PubMed

    Eum, Regina S; Brown, Allen W; Watanabe, Thomas K; Zasler, Nathan D; Goldstein, Richard; Seel, Ronald T; Roth, Elliot J; Zafonte, Ross D; Glenn, Mel B

    To create a profile of individuals with traumatic brain injury (TBI) who received inpatient rehabilitation and were discharged to an institutional setting using characteristics measured at rehabilitation discharge. The Traumatic Brain Injury Model Systems National Database is a prospective, multicenter, longitudinal database for people with moderate to severe TBI. We analyzed data for participants enrolled from January 2002 to June 2012 who had lived in a private residence before TBI. This cross-sectional study used logistic regression analyses to identify sociodemographic factors, lengths of stay, and cognitive and physical functioning levels that differentiated patients discharged to institutional versus private settings. Older age, living alone before TBI, and lower levels of function at rehabilitation discharge (independence in locomotion, bladder management, comprehension, and social interaction) were significantly associated with higher institutionalization rates and provided the best models identifying factors associated with institutionalization. Institutionalization was also associated with decreased independence in bed-chair-wheelchair transfers and increased duration of posttraumatic amnesia. Individuals institutionalized after inpatient rehabilitation for TBI were older, lived alone before injury, had longer posttraumatic amnesia durations, and were less independent in specific functional characteristics. Research evaluating the effect of increasing postdischarge support and improving treatment effectiveness in these functional areas is recommended.

  8. Bureaucracy, institutional theory and institutionaucracy: applications to the hospital industry.

    PubMed

    Bolon, D S

    1998-01-01

    The health care industry is experiencing rapid change and uncertainty. Hospitals, in particular, are redesigning structures and processes in order to maximize efficiencies and remain economically viable. This article uses two organizational theory perspectives (bureaucracy and institutional theory) to examine many of the trends and transitions which are occurring throughout the hospital industry. It suggests that many of the key tenets of bureaucracy (rationality, efficiency, productivity, control, etc.) have been incorporated into the institutional environment as normative expectations. This synthesis or blending of these two perspectives is labeled institutionaucracy, implying that, as productivity and efficiency considerations become institutionalized, hospitals conforming to such operational standards will gain legitimacy and additional resources from their environment.

  9. In-Space Manufacturing: Pioneering a Sustainable Path to Mars

    NASA Technical Reports Server (NTRS)

    Werkheiser, Niki

    2015-01-01

    ISM is responsible for developing the on-demand manufacturing capabilities that will be required for affordable, sustainable operations during Exploration Missions (in-transit and on-surface) to destinations such as Mars. This includes advancing the needed technologies, as well as establishing the skills & processes (such as certification and characterization) that will enable the technologies to go from novel to institutionalized. These technologies are evolving rapidly due to terrestrial markets. ISM is leveraging this commercial development to develop these capabilities within a realistic timeframe and budget. ISM utilizes the International Space Station (ISS) as a test-bed to adapt these technologies for microgravity operations and evolve the current operations mindset from earth-reliant to earth-independent.

  10. Institutionalizing Support for Undocumented Latino/a Students in American Higher Education

    ERIC Educational Resources Information Center

    Gildersleeve, Ryan Evely; Vigil, Darsella

    2015-01-01

    This chapter investigates the institutionalization of support for undocumented students across states that either extend or deny in-state resident tuition (ISRT) benefits. In their review, the authors highlight promising practices.

  11. Durability of Effects of Group Counseling with Institutionalized Delinquent Females

    ERIC Educational Resources Information Center

    Redfering, David L.

    1973-01-01

    The current study is a one-year follow-up of an earlier report that group counseling with institutionalized delinquent females resulted in significant gains in the connotative meanings of several concepts. (Author)

  12. Language development of internationally adopted children: Adverse early experiences outweigh the age of acquisition effect.

    PubMed

    Rakhlin, Natalia; Hein, Sascha; Doyle, Niamh; Hart, Lesley; Macomber, Donna; Ruchkin, Vladislav; Tan, Mei; Grigorenko, Elena L

    2015-01-01

    We compared English language and cognitive skills between internationally adopted children (IA; mean age at adoption=2.24, SD=1.8) and their non-adopted peers from the US reared in biological families (BF) at two time points. We also examined the relationships between outcome measures and age at initial institutionalization, length of institutionalization, and age at adoption. On measures of general language, early literacy, and non-verbal IQ, the IA group performed significantly below their age-peers reared in biological families at both time points, but the group differences disappeared on receptive vocabulary and kindergarten concept knowledge at the second time point. Furthermore, the majority of children reached normative age expectations between 1 and 2 years post-adoption on all standardized measures. Although the age at adoption, age of institutionalization, length of institutionalization, and time in the adoptive family all demonstrated significant correlations with one or more outcome measures, the negative relationship between length of institutionalization and child outcomes remained most robust after controlling for the other variables. Results point to much flexibility and resilience in children's capacity for language acquisition as well as the potential primacy of length of institutionalization in explaining individual variation in IA children's outcomes. (1) Readers will be able to understand the importance of pre-adoption environment on language and early literacy development in internationally adopted children. (2) Readers will be able to compare the strength of the association between the length of institutionalization and language outcomes with the strength of the association between the latter and the age at adoption. (3) Readers will be able to understand that internationally adopted children are able to reach age expectations on expressive and receptive language measures despite adverse early experiences and a replacement of their first language with an adoptive language. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Services to Status Offenders and Delinquents under Title XX.

    ERIC Educational Resources Information Center

    Nelson, Gary M.

    1982-01-01

    Found that states prohibiting institutionalization of status offenders and juvenile delinquents were no more likely to provide high levels of child foster care and protective services under Title XX than states not prohibiting institutionalization. (Author)

  14. Self-Perception of Intrinsic and Extrinsic Motivation: Effects on Institutionalized Mentally Retarded Adolescents

    ERIC Educational Resources Information Center

    Lee, Dong Yul; And Others

    1977-01-01

    The self-perception theory which predicts that the introduction of extrinsic rewards for behavior that was intrinsically rewarding may decrease overall motivation was tested on 44 mildly retarded institutionalized adolescents. (Author/CL)

  15. Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country.

    PubMed

    Sinha, Preeti; Yohannan, Sherin; Thirumoorthy, A; Sivakumar, Palanimuthu Thangaraju

    2017-08-01

    Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn't affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.

  16. Relation between functional mobility and dynapenia in institutionalized frail elderly.

    PubMed

    Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

    2017-01-01

    To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test.

  17. Transit green building action plan : report to congress

    DOT National Transportation Integrated Search

    2009-06-04

    The explanatory statement accompanying the fiscal year 2009 Omnibus appropriations : act1 directed the Federal Transit Administration (FTA) to submit a transit facility green : building action plan to the House and Senate Committees on Appropriati...

  18. A framework for institutionalizing quality assurance.

    PubMed

    Silimperi, Diana R; Franco, Lynne Miller; Veldhuyzen van Zanten, Tisna; MacAulay, Catherine

    2002-12-01

    To develop a framework to support the institutionalization of quality assurance (QA). The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.

  19. Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adults.

    PubMed

    Salguero, Alfonso; Martínez-García, Raquel; Molinero, Olga; Márquez, Sara

    2011-01-01

    This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. CAREGIVER-CHILD INTERACTION, CAREGIVER TRANSITIONS, AND GROUP SIZE AS MEDIATORS BETWEEN INTERVENTION CONDITION AND ATTACHMENT AND PHYSICAL GROWTH OUTCOMES IN INSTITUTIONALIZED CHILDREN.

    PubMed

    Warner, Hilary A; McCall, Robert B; Groark, Christina J; Kim, Kevin H; Muhamedrahimov, Rifkat J; Palmov, Oleg I; Nikiforova, Natalia V

    2017-09-01

    This report describes a secondary analysis of data from a comprehensive intervention project which included training and structural changes in three Baby Homes in St. Petersburg, Russian Federation. Multiple mediator models were tested according to the R.M. Baron and D.A. Kenny () causal-steps approach to examine whether caregiver-child interaction quality, number of caregiver transitions, and group size mediated the effects of the intervention on children's attachment behaviors and physical growth. The study utilized a subsample of 163 children from the original Russian Baby Home project, who were between 11 and 19 months at the time of assessment. Results from comparisons of the training and structural changes versus no intervention conditions are presented. Caregiver-child interaction quality and number of caregiver transitions fully mediated the association between intervention condition and attachment behavior. No other mediation was found. Results suggest that the quality of interaction between caregivers and children in institutional care is of primary importance to children's development, but relationship context may play a less direct mediational role, supporting caregiver-child interactions. © 2017 Michigan Association for Infant Mental Health.

  1. Effects of early intervention and the moderating effects of brain activity on institutionalized children's social skills at age 8.

    PubMed

    Almas, Alisa N; Degnan, Kathryn A; Radulescu, Anca; Nelson, Charles A; Zeanah, Charles H; Fox, Nathan A

    2012-10-16

    The present study examined the social skills of previously institutionalized, 8-y-old Romanian children from the Bucharest Early Intervention Project and the influence of attachment security and brain electrical activity (alpha power) on these skills. Participants included children randomized to an intervention involving foster care [Foster Care Group (FCG)], children randomized to remain in institutions [Care As Usual Group (CAUG)], and never-institutionalized children living with their families in the Bucharest community [Never-Institutionalized Group (NIG)]. A continuous rating of children's attachment security to their primary caregiver was assessed at 42 mo of age. When children were 8 y old, teachers rated their social skills, and the children's resting electroencephalogram alpha power was recorded. Teachers rated social skills of FCG children who were placed into foster care before 20 mo of age as no different from NIG children, and both of these groups were higher than CAUG children and FCG children placed after 20 mo. Electroencephalogram alpha power at age 8 significantly moderated the relations between attachment security and social skills. These findings characterize institutionalized children's social skills in middle childhood within the context of a randomized intervention while highlighting the roles of both relational and biological factors in these developmental trajectories.

  2. Institutionalized Adolescents' Perceptions of a Summer Camp Program

    ERIC Educational Resources Information Center

    Herr, David E.

    1977-01-01

    Describes the use of the facilities of Camp Easter Seal, Virginia, for institutionalized adolescents from different hospitals in Virginia. Also includes the attitudes of the patients toward their camping experience, their camp counselors, and what they learned from their camping experience. (Author/RK)

  3. 42 CFR 436.1005 - Institutionalized individuals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Institutionalized individuals. 436.1005 Section 436.1005 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Federal...

  4. 42 CFR 436.1005 - Institutionalized individuals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Institutionalized individuals. 436.1005 Section 436.1005 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Federal...

  5. Career Salience of Institutionalized Adolescent Offenders.

    ERIC Educational Resources Information Center

    Munson, Wayne W.; Strauss, Christine F.

    1993-01-01

    Investigated self-esteem and career salience of institutionalized male adolescent offenders (n=185) in context of Super's lifespan career development theory. Results indicated that participation, commitment, and values expectations in home-family roles contributed significantly to self-esteem in adolescent offenders. Adolescent offenders differed…

  6. People in Institutions in Europe.

    ERIC Educational Resources Information Center

    Hatton, Chris; And Others

    1995-01-01

    Statistical data indicate that Scandinavia and the United Kingdom have lower rates of institutionalization of people with mental retardation/developmental disabilities than do other European Community countries and East European countries. A table shows total institutional populations, institutionalization rates, and average annual rates of change…

  7. Teaching Community Skills to Formerly Institutionalized Adults: Eating Nutritionally Balanced Diets.

    ERIC Educational Resources Information Center

    Reitz, Andrew L.

    1984-01-01

    Three formerly institutionalized adults increased their rate of appropriate food serving when cash reinforcement was made contingent on their meeting specified daily criteria. Instructions and self-monitoring and praise had little or no effect on the men's diets. (CL)

  8. Orofacial pain symptoms and associated disability and psychosocial impact in community-dwelling and institutionalized elderly in Hong Kong.

    PubMed

    Wan, K Y; McMillan, A S; Wong, M C M

    2012-03-01

    The study investigated the experience of orofacial pain (OFP) symptoms and associated disability and psychosocial impact in community dwelling and institutionalized elderly people in Hong Kong. A community-based cross-sectional survey involving elders aged 60 years and above. Participants were recruited at social centres for the elderly and homes for the aged throughout Hong Kong. Elders who reported OFP symptoms in the previous four weeks took part. Standard questions were asked about OFP conditions in the previous month and the Manchester Orofacial Pain Disability Scale (MOPDS), the Oral Health Impact Profile (OHIP-14) and the General Health Questionnaire (GHQ-12) were administered. The MOPDS was translated and validated for use in Chinese elders. 200 community dwelling and 200 institutionalized elders participated. Toothache was the most common symptom (62.0%) and burning sensation in the tongue was least common (0.5%). The distribution of pain symptoms, pain duration and severity and pain ratings were similar in both groups. The MOPDS (Chinese elders version) had good reliability and construct validity. The MOPDS and OHIP-14 summary scores was significantly higher in the institutionalized elderly (p < 0.001 and p < 0.013, respectively). Psychological distress (GHQ-12 score > or = 4) was more common among the institutionalized elderly (11%) than the community dwelling elderly (4.0%, p = 0.002). Orofacial pain symptoms were associated with significant disability and had a detrimental impact on psychological distress level and quality of life, particularly in the institutionalized elderly. There is a need to improve access to professional care and health-related outreach services generally for elderly people in Hong Kong.

  9. High Intake of Nonmilk Extrinsic Sugars Is Associated With Protein and Micronutrient Dilution in Home-Dwelling and Institutionalized Older People.

    PubMed

    Jyväkorpi, Satu K; Pitkälä, Kaisu H; Puranen, Taija M; Björkman, Mikko P; Kautiainen, Hannu; Strandberg, Timo E; Soini, Helena; Suominen, Merja H

    2017-04-01

    High dietary sugar intake may compromise protein and micronutrient intakes in people with low energy intakes. The results of micronutrient dilution studies in older people have been few and conflicting. We examined the nutritional status and nutrient intakes associated with nonmilk extrinsic sugars (NMES) intakes in older people representing a broad spectrum of both healthy and vulnerable older populations. This cross-sectional study combined five Finnish data sets covering home-dwelling (n = 526) and institutionalized (n = 374) older people. Their nutritional status was assessed using Mini Nutritional Assessment (MNA) and nutrient intakes retrieved from 1- to 3-day food records. The participants were divided into quartiles corresponding to the proportions of energy received from NMES. Energy, nutrient, and fiber intakes were classified according to the NMES quartiles, and the participants were divided according to their places of residence (home, institution). High NMES intakes were associated with older age, female sex, poor cognition, low MNA scores, immobility, and institutionalization. In all, 90% of the participants in the highest NMES quartile (Q4) were institutionalized. In the institutionalized individuals, low protein and micronutrient intakes were observed in both those with low energy intake (Q1) and in those with very high NMES intakes (Q4). In home-dwelling individuals, the nutrient intakes tended to decline linearly with increasing NMES intakes in protein and most micronutrients. Institutionalized older people consumed diets high in NMES, compared with those living at home, and their low energy and high NMES intakes were associated with low protein and micronutrient intakes. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. Experience, Knowledge, and Concerns About Long-Term Services and Supports: Implications for Financing Reform.

    PubMed

    Khatutsky, Galina; Wiener, Joshua M; Greene, Angela M; Thach, Nga T

    2017-01-01

    Using the 2014 Survey of Long-Term Care Awareness and Planning, this article examines Americans' experiences, knowledge, and concerns about long-term services and supports (LTSS) and actions they are willing to take if they become disabled. The survey included 15,298 non-institutionalized respondents aged 40 to 70 years drawn from a nationally representative sample. Although many reported some experience with LTSS, knowledge of how LTSS worked was low. Respondents reported widespread concerns about becoming disabled. They preferred informal care over paid care, with a strong desire to remain in their homes. These results can be used to design reform initiatives and to motivate political support.

  11. The view from everywhere: disciplining diversity in post-World War II international social science.

    PubMed

    Selcer, Perrin

    2009-01-01

    This paper explores the attempt of social scientists associated with Unesco to create a system of knowledge production to provide the international perspective necessary for democratic governance of a world community. Social scientists constructed a federal system of international associations that institutionalized American disciplines on an international scale. An international perspective emerged through the process of interdisciplinary international research. I call this ideal of coordinating multiple subjectivities to produce objectivity the "view from everywhere." Influenced by social psychological "action-research," collaborative research was group therapy. The attempt to operationalize internationalists' rallying slogan, "unity in diversity," illuminated tensions inherent in the mobilization of science for social and political reform.

  12. PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean

    PubMed Central

    Vogus, Abigail; Graff, Kylie

    2015-01-01

    The US President’s Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country’s readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor support for targeted capacity building and long-term monitoring and evaluation efforts. PMID:26085023

  13. Neuropsychological Differences Among Subtypes of Schizophrenia

    ERIC Educational Resources Information Center

    Goldstein, Gerald; Halperin, Keith M.

    1977-01-01

    A common pool of schizophrenic subjects was subdivided and analyzed three separate times on the basis of three sets of criteria: paranoid versus nonparanoid, neurologically normal versus neurologically abnormal, and long-term institutionalization versus short-term institutionalization. Differences in ability levels and patterns were determined for…

  14. Reshaping Institutional Boundaries to Accommodate an Engagement Agenda

    ERIC Educational Resources Information Center

    Sandmann, Lorilee R.; Weerts, David J.

    2008-01-01

    Key voices influencing higher education are increasingly aware of engagement in effecting change. Public research universities have missions compatible with engagement, but efforts to institutionalize it may conflict with their underlying values. Using boundary expansion as the analytical framework, this study compared the institutionalization of…

  15. Changing District Priorities for School-Business Collaboration: Superintendent Agency and Capacity for Institutionalization

    ERIC Educational Resources Information Center

    Bennett, Jeffrey V.; Thompson, Hugh C.

    2011-01-01

    Background: School district superintendents continue to favor collaborative relationships with their local business communities amid concerns over free-market competition, maintaining public legitimacy, and scarce financial resources. Prior research is inadequate regarding the development, implementation, and institutionalization of school and…

  16. Institutionalizing Educational Productivity.

    ERIC Educational Resources Information Center

    Kean, Michael H.

    The success of Philadelphia's "What Works in Reading?" report shows how educational research can be a catalyst for school change and indicates a way for school districts to institutionalize this process. Ten factors were associated with the report's immediate impact on educational policy: identification of the research clients, topical…

  17. Piagetian Object Permanence in Severely Mentally Retarded Adults.

    ERIC Educational Resources Information Center

    Brekke, Beverly; And Others

    The measurability of sensorimotor development in 60 severely retarded, institutionalized adults was studied, using the Piagetian concept of object permanence in a delayed recall paradigm that involved special apparatus. Results suggested, among other things, that severely retarded, institutionalized adults learn most efficiently when trained with…

  18. Relation between functional mobility and dynapenia in institutionalized frail elderly

    PubMed Central

    Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

    2017-01-01

    ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Results Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). Conclusion A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test. PMID:29091148

  19. The effects of foster care intervention on socially deprived institutionalized children's attention and positive affect: results from the BEIP study.

    PubMed

    Ghera, Melissa M; Marshall, Peter J; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A; Smyke, Anna T; Guthrie, Donald

    2009-03-01

    We examined the effects of a foster care intervention on attention and emotion expression in socially deprived children in Romanian institutions. Institutionalized children were randomized to enter foster care or to remain under institutional care. Subsequently, the institutionalized and foster care groups, along with a community-based comparison group, were evaluated on emotion tasks at 30 and 42 months of age. Behaviors reflecting positive and negative affect and attention were coded from videotapes. Data indicated that at both age points, children who received the foster care intervention showed higher levels of attention and positive affect compared to children who remained institutionalized. Compared to the community sample, children in the foster care intervention showed higher levels of attention to the emotion-eliciting tasks at 42 months of age. The results of this randomized trial demonstrate the impact of a family-based intervention on the development of attention and positive affect.

  20. 'Health psychology' or 'psychology for health'? A history of psychologists' engagement with health in South Africa.

    PubMed

    Yen, Jeffery; Vaccarino, Oriana

    2018-03-01

    In contrast to the institutionalization of health psychology in North America and Europe, much psychological work on health issues in South Africa emerged as part of a critical revitalization of South African psychology as a whole, coinciding with the dismantling of Apartheid and global shifts in health discourse. The field's development reflects attempts to engage with urgent health problems in the context of rapid sociopolitical changes that followed democratic transition in the 1990s, and under new conditions of knowledge production. We provide an account of these issues, as well as reflections on the field's future, as inflected through the experiences of 12 South African psychologists whose careers span the emergence of health-related psychology to the present day.

  1. Institutionalizing evidence-based practice: an organizational case study using a model of strategic change

    PubMed Central

    2009-01-01

    Background There is a general expectation within healthcare that organizations should use evidence-based practice (EBP) as an approach to improving the quality of care. However, challenges exist regarding how to make EBP a reality, particularly at an organizational level and as a routine, sustained aspect of professional practice. Methods A mixed method explanatory case study was conducted to study context; i.e., in terms of the presence or absence of multiple, inter-related contextual elements and associated strategic approaches required for integrated, routine use of EBP ('institutionalization'). The Pettigrew et al. Content, Context, and Process model was used as the theoretical framework. Two sites in the US were purposively sampled to provide contrasting cases: i.e., a 'role model' site, widely recognized as demonstrating capacity to successfully implement and sustain EBP to a greater degree than others; and a 'beginner' site, self-perceived as early in the journey towards institutionalization. Results The two sites were clearly different in terms of their organizational context, level of EBP activity, and degree of institutionalization. For example, the role model site had a pervasive, integrated presence of EBP versus a sporadic, isolated presence in the beginner site. Within the inner context of the role model site, there was also a combination of the Pettigrew and colleagues' receptive elements that, together, appeared to enhance its ability to effectively implement EBP-related change at multiple levels. In contrast, the beginner site, which had been involved for a few years in EBP-related efforts, had primarily non-receptive conditions in several contextual elements and a fairly low overall level of EBP receptivity. The beginner site thus appeared, at the time of data collection, to lack an integrated context to either support or facilitate the institutionalization of EBP. Conclusion Our findings provide evidence of some of the key contextual elements that may require attention if institutionalization of EBP is to be realized. They also suggest the need for an integrated set of receptive contextual elements to achieve EBP institutionalization; and they further support the importance of specific interactions among these elements, including ways in which leadership affects other contextual elements positively or negatively. PMID:19948064

  2. Assessing How Participators Combine Acts in Their "Political Tool Kits": A Person-Centered Measurement Approach for Analyzing Citizen Participation.

    PubMed

    Oser, Jennifer

    2017-01-01

    Scholars have recognized that a recent increase in the ways citizens participate beyond the electoral arena may be a promising avenue of renewal for citizen participation. In this article we test the theory that different kinds of citizenship norms motivate some citizens to specialize in electoral-oriented activities (e.g. voting), while others specialize in non-institutionalized activities (e.g. protest). The latent class analysis of data from the U.S. Citizen, Involvement and Democracy Survey (2005) in the current study assesses how actors combine a variety of acts in their "political tool kits" of participation, and facilitates a comparison to prior findings that analyze single political behaviors. Results indicate a participatory type that specializes in non-institutionalized acts, but the group's high probability of voting does not align with the expectations in the literature. An electoral-oriented specialist type is not identified; instead, the findings show that a majority of the population is best characterized as disengaged, while a small group of all-around activists embrace all possible opportunities for political action. The actor-centered theoretical and measurement approach in this study identifies caveats to the theory that changing citizenship norms are leading to civic and political renewal. We discuss the implications of these findings for measuring different aspects of democratic (dis)engagement and participatory (in)equality.

  3. [Human resources for local health systems].

    PubMed

    Linger, C

    1989-01-01

    The economic and social crises affecting Latin America have had a profound social and political effect on its structures. This paper analyzes this impact from 2 perspectives: 1) the impact on the apparatus of the state, in particular on its health infra-structures; and 2) the direction of the democratic process in the continent and the participatory processes of civil societies. The institutionalization of the Local Health Systems (SILOS) is an effort to analyze the problem from within the health sector and propose solutions. This paper discusses the issues of human resource development in health systems; training in human resource development and human resource development in local health care systems. There are 3 strategies used to change health systems: 1) The judicial-political system: The state's apparatus 2) The political-administrative system: the national health care system; and 3) the political-operative system: local health care systems. To assure implementation of SILOS there are 4 steps to be followed: 1) create political conditions that allow the transformation and development of local health systems; 2) development of high-level institutional and political initiatives to develop health care networks; 3) offer key players institutional space and social action to develop the SILOS process; 4) rapidly develop SILOS in regions to assure its integration with other development efforts. The labor force in the health sector and organized communities play critical roles in proposing and institutionalizing health programs.

  4. Health Professional Advice and Adult Action to Reduce Sodium Intake.

    PubMed

    Jackson, Sandra L; Coleman King, Sallyann M; Park, Soyoun; Fang, Jing; Odom, Erika C; Cogswell, Mary E

    2016-01-01

    Excessive sodium intake is a key modifiable risk factor for hypertension and cardiovascular disease. Although 95% of U.S. adults exceed intake recommendations, knowledge is limited regarding whether doctor or health professional advice motivates patients to reduce intake. Our objectives were to describe the prevalence and determinants of taking action to reduce sodium, and to test whether receiving advice was associated with action. Analyses, conducted in 2014, used data from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey representative of non-institutionalized adults. Respondents (n=173,778) from 26 states, the District of Columbia, and Puerto Rico used the new optional sodium module. We estimated prevalence ratios (PRs) based on average marginal predictions, accounting for the complex survey design. Fifty-three percent of adults reported taking action to reduce sodium intake. Prevalence of action was highest among adults who received advice (83%), followed by adults taking antihypertensive medications, adults with diabetes, adults with kidney disease, or adults with a history of cardiovascular disease (range, 73%-75%), and lowest among adults aged 18-24 years (29%). Overall, 23% of adults reported receiving advice to reduce sodium intake. Receiving advice was associated with taking action (prevalence ratio=1.59; 95% CI=1.56, 1.61), independent of sociodemographic and health characteristics, although some disparities were observed across race/ethnicity and BMI categories. Our results suggest that more than half of U.S. adults in 26 states and two territories are taking action to reduce sodium intake, and doctor or health professional advice is strongly associated with action. Published by Elsevier Inc.

  5. Deciding to institutionalize: caregiving crisis, intergenerational communication, and uncertainty management for elders and their children in Shanghai.

    PubMed

    Chen, Lin

    2015-01-01

    This phenomenological study integrated crisis theory, social identity theory, and uncertainty management theory to conceptualize the decision-making process around institutionalization among nursing home residents and their children in Shanghai. I conducted face-to-face, semistructured interviews with 12 dyads of matched elders and their children (N = 24). The findings suggest that caregiving crises triggered intergenerational communication about caregiving alternatives and new arrangements, although each generation had different stances and motivations. Children finalized the decision by helping their parents to manage the uncertainties pertaining to institutionalization. This study sheds light on caregiving decision-making dynamics for the increasing aging population across cultures.

  6. A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study

    PubMed Central

    2012-01-01

    Background Health care policies in many countries aim to enable people with dementia to live in their own homes as long as possible. However, at some point during the disease the needs of a significant number of people with dementia cannot be appropriately met at home and institutional care is required. Evidence as to best practice strategies enabling people with dementia to live at home as long as possible and also identifying the right time to trigger admission to a long-term nursing care facility is therefore urgently required. The current paper presents the rationale and methods of a study generating primary data for best-practice development in the transition from home towards institutional nursing care for people with dementia and their informal caregivers. The study has two main objectives: 1) investigate country-specific factors influencing institutionalization and 2) investigate the circumstances of people with dementia and their informal caregivers in eight European countries. Additionally, data for economic evaluation purposes are being collected. Methods/design This paper describes a prospective study, conducted in eight European countries (Estonia, Finland, France, Germany, Netherlands, Sweden, Spain, United Kingdom). A baseline assessment and follow-up measurement after 3 months will be performed. Two groups of people with dementia and their informal caregivers will be included: 1) newly admitted to institutional long-term nursing care facilities; and 2) receiving professional long-term home care, and being at risk for institutionalization. Data will be collected on outcomes for people with dementia (e.g. quality of life, quality of care), informal caregivers (e.g. caregiver burden, quality of life) and costs (e.g. resource utilization). Statistical analyses consist of descriptive and multivariate regression techniques and cross-country comparisons. Discussion The current study, which is part of a large European project 'RightTimePlaceCare', generates primary data on outcomes and costs of long-term nursing care for people with dementia and their informal caregivers, specifically focusing on the transition from home towards institutional care. Together with data collected in three other work packages, knowledge gathered in this study will be used to inform and empower patients, professionals, policy and related decision makers to manage and improve health and social dementia care services. PMID:22269343

  7. Institutionalization of Higher Vocational Education in China: A Neoinstitutionalist Perspective

    ERIC Educational Resources Information Center

    Xiong, Jie

    2013-01-01

    From the perspective of neoinstitutionalism, higher vocational education has become an emerging institution in Chinese society. Its development over three decades entails a trend of institutionalization of higher vocational education. In such a process, higher vocational education is gaining legitimacy and experiencing isomorphic changes. Various…

  8. Institutionalizing Diversity: Transforming Higher Education

    ERIC Educational Resources Information Center

    McRae-Yates, Velda

    2009-01-01

    This case study examines plausible efforts to institutionalize diversity in a higher education setting so it becomes part of the strategic mission, and permeates the interactions, discussions, and operations. Review of literature, surveys, and in-depth interviews are conducted at a Massachusetts institution to gather information from faculty,…

  9. 34 CFR 104.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Education of institutionalized persons. 104.54 Section 104.54 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING...

  10. The International Institutionalization of Education.

    ERIC Educational Resources Information Center

    Goodman, Norman G.

    A study of student opinions in a developing country--Malaysia--shows that the institutionalization of education in developed countries has been transferred to developing countries in the status given to Western degrees. Ideas about what constitutes knowledge and professionalism, disseminated by universities of the Western world, have come to…

  11. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): summary and future directions.

    PubMed

    Kumanyika, S

    2013-10-01

    This supplement presents the foundational elements for INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support). As explained in the overview article by Swinburn and colleagues, INFORMAS has a compelling rationale and has set forth clear objectives, outcomes, principles and frameworks for monitoring and benchmarking key aspects of food environments and the policies and actions that influence the healthiness of food environments. This summary highlights the proposed monitoring approaches for the 10 interrelated INFORMAS modules: public and private sector policies and actions; key aspects of food environments (food composition, labelling, promotion, provision, retail, prices, and trade and investment) and population outcomes (diet quality). This ambitious effort should be feasible when approached in a step-wise manner, taking into account existing monitoring efforts, data sources, country contexts and capacity, and when adequately resourced. After protocol development and pilot testing of the modules, INFORMAS aims to be a sustainable, low-cost monitoring framework. Future directions relate to institutionalization, implementation and, ultimately, to leveraging INFORMAS data in ways that will bring key drivers of food environments into alignment with public health goals. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  12. Institutionalizing Lessons Learned

    NASA Technical Reports Server (NTRS)

    McBrayer, Robert O.; Thomas, Dale

    2001-01-01

    The NASA Integrated Action Team (NIAT) was formed by the NASA Administrator in March 2000. The purpose of this team was to identify the actions that NASA must take to address systemic findings reported in 4 different anomaly investigations. Team membership represented senior managers from all the field centers and NASA Headquarters. NIAT report addressed 165 findings and developed 17 action plans that are described in five themes: people and teams, technology, risk, formulation rigor, and communications. The NIAT actions present a systems solution for strengthening formulation and implementation of programs and improving the environment for their support. NIAT results included: enhancing success by avoiding failures that could have been prevented through good planning and sound practice; ensuring that prudent risks do not compromise safety; and ensuring that mission risks are objectively assessed, appropriately mitigated and consciously accepted by the program team and customers. Definitions of Faster, Better, Cheaper and Success Criteria were also developed and included as part of the NIAT report. As a result of the NIAT report, program and project management process changes were incorporated into NASA's quality system documentation, including NPG 7120.513, "NASA Program and Project Management Processes and Requirements. This paper describes the NIAT results and the resulting updates to NPG 7120.5 that keep this program and project management description a living process.

  13. Predicting desire for institutional placement among racially diverse dementia family caregivers: the role of quality of care.

    PubMed

    Sun, Fei; Durkin, Daniel W; Hilgeman, Michelle M; Harris, Grant; Gaugler, Joseph E; Wardian, Jana; Allen, Rebecca S; Burgio, Louis D

    2013-06-01

    Literature on institutionalization of patients with dementia has not considered the role of caregivers' quality of care, which encompasses caregivers' exemplary care (EC) behaviors and caregivers' potentially harmful behaviors (PHBs) toward care recipients. This study sought to understand the role of quality of care in mediating between caregiving stressors and caregiver desire to institutionalize (DTI) a patient with dementia. A sample of 612 family caregivers from diverse racial/ethnic backgrounds was drawn from the baseline data of the Resources for Enhancing Alzheimer's Caregiver Heath (REACH II) project. Multiple mediator models were run using Preacher and Hayes asymptotic and resampling strategies to assess direct and indirect effects of caregiver stressors (daily care bother, behavioral bother, and burden) on caregiver desire to institutionalize a patient with dementia. Overall, PHB was positively related to caregiver desire to institutionalize their care recipients. Specifically, PHB was found to mediate the relationship between caregiving stressors and DTI in the Caucasian and Latino groups, whereas only the mediation effect of EC was significant in the African American group. Caregivers' perceptions of quality of care helped explain their desire to institutionalize their care recipients with dementia. Including assessment of EC and PHB in clinical and social service settings is recommended for all ethnic groups. Interventions should facilitate EC behaviors among African American caregivers and address concerns of PHBs in Caucasian and Latino caregivers.

  14. 49 CFR 630.9 - Notice of FTA action.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Notice of FTA action. 630.9 Section 630.9 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.9 Notice of FTA action. Before taking final...

  15. 49 CFR 630.9 - Notice of FTA action.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Notice of FTA action. 630.9 Section 630.9 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.9 Notice of FTA action. Before taking final...

  16. 49 CFR 630.9 - Notice of FTA action.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Notice of FTA action. 630.9 Section 630.9 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.9 Notice of FTA action. Before taking final...

  17. 49 CFR 630.9 - Notice of FTA action.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Notice of FTA action. 630.9 Section 630.9 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.9 Notice of FTA action. Before taking final...

  18. 49 CFR 630.9 - Notice of FTA action.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Notice of FTA action. 630.9 Section 630.9 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.9 Notice of FTA action. Before taking final...

  19. 38 CFR 18.454 - Education of institutionalized persons.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Education of... Social Services § 18.454 Education of institutionalized persons. A recipient that operates or supervises... is provided an appropriate education, as defined in § 18.433(b). Nothing in this section shall be...

  20. The Attribution of Universal or Personal Helplessness in Nondepressed and Depressed Elderly Females.

    ERIC Educational Resources Information Center

    Maiden, Robert J.

    The potential for feelings of hopelessness and depression in the aged is well documented. Although studies have examined the role of perceived control in ameliorating depression in the institutionalized elderly, no research has actually measured the perceived causal attributions among depressed, hopeless and/or institutionalized elderly…

  1. A Contigency Model for Predicting Institutionalization of Innovation Across Divergent Organizations.

    ERIC Educational Resources Information Center

    Howes, Nancy J.

    This study was undertaken to compare the variables related to the successful institutionalization of changes across divergent organizations, and to design, through cross-validation, an interorganization model of change. Descriptive survey questionnaires and structured interviews were the instruments used. The respondent sample consisted of 1,500…

  2. False Belief and Emotion Understanding in Post-Institutionalized Children

    ERIC Educational Resources Information Center

    Tarullo, Amanda R.; Bruce, Jacqueline; Gunnar, Megan R.

    2007-01-01

    Deficits in social cognition may impair the ability to negotiate social transactions and relationships and contribute to socio emotional difficulties experienced by some post-institutionalized children. We examined false belief and emotion understanding in 40 institutional care-adopted children, 40 foster care-adopted children and 40 birth…

  3. 38 CFR 18.454 - Education of institutionalized persons.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Education of... Social Services § 18.454 Education of institutionalized persons. A recipient that operates or supervises... is provided an appropriate education, as defined in § 18.433(b). Nothing in this section shall be...

  4. 38 CFR 18.454 - Education of institutionalized persons.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Education of... Social Services § 18.454 Education of institutionalized persons. A recipient that operates or supervises... is provided an appropriate education, as defined in § 18.433(b). Nothing in this section shall be...

  5. 38 CFR 18.454 - Education of institutionalized persons.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Education of... Social Services § 18.454 Education of institutionalized persons. A recipient that operates or supervises... is provided an appropriate education, as defined in § 18.433(b). Nothing in this section shall be...

  6. Factors Influencing Title VII Bilingual Program Institutionalization.

    ERIC Educational Resources Information Center

    Lewis, Gerald R.; And Others

    1985-01-01

    This study of the primary restraining and driving forces that influence Title VII bilingual education programs found the external environment, the local community, to be the main factor influencing institutionalization and self-renewal. The internal environment--the local school, and the local school's organization or central office, school board,…

  7. 38 CFR 18.454 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Education of... Social Services § 18.454 Education of institutionalized persons. A recipient that operates or supervises... is provided an appropriate education, as defined in § 18.433(b). Nothing in this section shall be...

  8. How Does Ethics Institutionalization Reduce Academic Cheating?

    ERIC Educational Resources Information Center

    Popoola, Ifeoluwa; Garner, Bart; Ammeter, Anthony; Krey, Nina; Beu Ammeter, Danielle; Schafer, Stuart

    2017-01-01

    Extant research on academic cheating primarily focuses on the impact of honor codes on academic cheating. However, the influence of ethics institutionalization is curiously missing in past research. The authors developed and validated a structural equations model in the R programming language to examine the impact of formal (explicit) and informal…

  9. Title I, Part B, Institutionalized Facilities Program, Summer 1982. Annual Evaluation Report.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

    This 1982 summer Title I, Part B, Institutionalized Facilities Program provided supplementary career instruction to 188 students residing in facilities for neglected and delinquent children and youth. This report briefly describes the program, providing information on methodology, physical setting, equipment, and supplies; population and class…

  10. Institutionalization of Information Security: Case of the Indonesian Banking Sector

    ERIC Educational Resources Information Center

    Nasution, Muhamad Faisal Fariduddin Attar

    2012-01-01

    This study focuses on the institutionalization of information security in the banking sector. This study is important to pursue since it explicates the internalization of information security governance and practices and how such internalization develops an organizational resistance towards security breach. The study argues that information…

  11. Cognitive Changes among Institutionalized Elderly People

    ERIC Educational Resources Information Center

    Navarro, Jose I.; Menacho, Inmaculada; Alcalde, Concepcion; Marchena, Esperanza; Ruiz, Gonzalo; Aguilar, Manuel

    2009-01-01

    The efficiency of different cognitive training procedures in elderly people was studied. Two types of methods to train cognitive and memory functions were compared. One method was based on new technologies and the other one on pencil-and-paper activities. Thirty-six elderly institutionalized people aged 68-94 were trained. Quantitative and memory…

  12. Under Constriction: Colonization and Synthetic Institutionalization of Web Space.

    ERIC Educational Resources Information Center

    Killoran, John B.

    2002-01-01

    Draws on a study of 106 personal homepages in order to present a theoretical model of how citizens' potentials as Web publishers are being compromised by the leadership of institutional discourses. Proposes an analogous process of synthetic institutionalization, in which personal homepage publishers affect institutional poses by adapting Norman…

  13. Attachment Representation of Institutionalized Children in Japan

    ERIC Educational Resources Information Center

    Katsurada, Emiko

    2007-01-01

    This exploratory study represents one of the first attachment investigations of Japanese children who have been institutionalized. Mental representation of attachment was assessed using George and Solomon's (1990, 1996, 2000) Attachment Doll Play Classification System of the Bretherton et al. (1990) doll play story stems. Participants were 32…

  14. Institutionalized Racism and the Education of Blacks

    ERIC Educational Resources Information Center

    Spears, Arthur K.

    1978-01-01

    Research into the causes of the unsatisfactory educational performance of many black students has focused on linguistic and cultural differences of blacks. Institutionalized racism, however, should be recognized as the major factor affecting black academic achievement. Black students should not be evaluated by the same criteria as white students.…

  15. The Effects of Group Work with Institutionalized Elderly Persons

    ERIC Educational Resources Information Center

    Duyan, Veli; Sahin-Kara, Gülay; Camur Duyan, Gülsüm; Özdemir, Burcu; Megahead, Hamido A.

    2017-01-01

    Objectives: This research article aims to measure the effects of group therapy on institutionalized elderly in terms of reducing depression and improving psychosocial functioning. Methods: Thirty elderly nursing home residents were recruited, and 16 of them elected to receive group treatment for depression and 14 declined treatment. The…

  16. Ethical Considerations for People Who Are Homeless and Mentally Ill

    ERIC Educational Resources Information Center

    Waggoner, Elizabeth A.; Howard, Richard; Markos, Patricia A.

    2004-01-01

    This article presents an ethical analysis of the important issues surrounding the involuntary institutionalization of people who are homeless and mentally ill (HMI) in the United States. The legal, economic, and moral implications of state-sponsored involuntary institutionalization of people who are HMI are considered. An ethical decision-making…

  17. Institutionalization of Rural Credit in India: A Focus on the Cooperative Credit Movement.

    DTIC Science & Technology

    1980-05-01

    Primarily the Government of India has relied on the Cooperative Movement in its effort to institutionalize the supply of rural credit. This thesis...examines some of the major problems and obstacles encountered as well as corrective measures taken with respect to the cooperative movement . (Author)

  18. The Action Observation System when Observing Hand Actions in Autism and Typical Development.

    PubMed

    Pokorny, Jennifer J; Hatt, Naomi V; Colombi, Costanza; Vivanti, Giacomo; Rogers, Sally J; Rivera, Susan M

    2015-06-01

    Social impairments in individuals with autism spectrum disorders (ASD) may be in part due to difficulty perceiving and recognizing the actions of others. Evidence from imitation studies, which involves both observation and execution of an action, suggests differences, in individuals with ASD, between the ability to imitate goal-directed actions involving objects (transitive actions) and the ability to imitate actions that do not involve objects (intransitive actions). In the present study, we examined whether there were differences in how ASD adolescents encoded transitive and intransitive actions compared to typically developing (TD) adolescents, by having participants view videos of a hand reaching across a screen toward an object or to where an object would be while functional magnetic resonance images were collected. Analyses focused on areas within the action observation network (AON), which is activated during the observation of actions performed by others. We hypothesized that the AON would differentiate transitive from intransitive actions only in the ASD group. However, results revealed that object presence modulated activity in the right inferior frontal gyrus and supramarginal gyrus of the TD group, a differentiation that was not seen in the ASD group. Furthermore, there were no significant group differences between the TD and ASD groups in any of the conditions. This suggests that there is not a global deficit of the AON in individuals with ASD while observing transitive and intransitive actions. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  19. 76 FR 81011 - Notice of Final Federal Agency Actions on Proposed Light Rail Project in Washington

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... on Proposed Light Rail Project in Washington AGENCY: Federal Highway Administration (FHWA... Light Rail Transit Project in King County Washington. These actions grant licenses, permits, and... Light Rail Transit Project, King County, WA. Federal Lead Agency: Federal Transit Administration (FTA...

  20. Aquatic exercise for residential aged care adults with dementia: benefits and barriers to participation.

    PubMed

    Henwood, Timothy; Neville, Christine; Baguley, Chantelle; Beattie, Elizabeth

    2017-09-01

    Pilot work by our group has demonstrated that aquatic exercise has valuable functional and psychosocial benefits for adults living in the residential aged care setting with dementia. The aim of the currents study was to advance this work by delivering the Watermemories Swimming Club aquatic exercise program to a more representative population of older, institutionalized adults with dementia. The benefits of 12 weeks of twice weekly participation in the Watermemories Swimming Club aquatic exercise program were assessed among an exercise and usual care control group of residential aged care adults with advanced dementia. A battery of physical and psychosocial measures were collected before and after the intervention period, and program implementation was also investigated. Seven residential aged care facilities of 24 approached, agreed to participate and 56 residents were purposefully allocated to exercise or control. Twenty-three participants per group were included in the final analysis. Both groups experienced decreases in skeletal muscle index and lean mass (p < 0.001), but exercise stifled losses in muscle strength and transition into sarcopenic. Behavioral and psychological symptoms of dementia and activities of daily living approached significance (p = 0.06) with positive trends observed across other psychosocial measures. This study demonstrates the value of exercise participation, and specifically aquatic exercise in comparison to usual care for older, institutionalized adults with advanced dementia. However, it also highlights a number of barriers to participation. To overcome these barriers and ensure opportunity to residents increased provider and sector support is required.

  1. Enhancement of Productive Thinking in Institutionalized Mental Retardates. Final Report.

    ERIC Educational Resources Information Center

    Ladner, Judith L.

    The purpose of the study was to evaluate the effectiveness of a supplementary program of 30 lessons to increase the productive thinking abilities (divergent thinking) of educable mentally handicapped students. An experimental group of 30 institutionalized children were given the supplementary lessons at a rate of three per week. The lessons, based…

  2. Neurobiological Correlates of Psychosocial Deprivation in Children: A Systematic Review of Neuroscientific Contributions

    ERIC Educational Resources Information Center

    Perego, Gaia; Caputi, Marcella; Ogliari, Anna

    2016-01-01

    Background: Institutionalization from birth offers a unique opportunity to investigate the effects on brain and endocrine system of psychosocial deprivation in early infancy. Nonetheless, a systematic review about institutionalization and biological anomalies does not exist. Objective: The purpose of this paper was to systematize all the studies…

  3. Towards an Understanding of an Institution: The Perceived Legitimacy of Online Business Degree Programs

    ERIC Educational Resources Information Center

    Keller, Roy Heath

    2011-01-01

    Organizational forms can become institutionalized in the sense that their existence and application is taken-for-granted and perceived as legitimate by stakeholders. Over time, new organizational forms can emerge that challenge perceived legitimacy of the established form. From this perspective, this dissertation examined institutionalization in…

  4. The Research Paper and Postmodernist Pedagogy.

    ERIC Educational Resources Information Center

    McDonald, James C.

    The freshman research paper is the most institutionalized writing assignment in the academy, with the possible exception of the dissertation, and the research paper in general (of which the dissertation may be a species) is the most institutionalized genre of student writing, at least in the humanities. First, the research paper is the most…

  5. Retrospective Study of Lithium Use for Institutionalized Mentally Retarded Individuals with Behavior Disorders.

    ERIC Educational Resources Information Center

    Langee, Harvey R.

    1990-01-01

    Severely and profoundly mentally retarded institutionalized residents (N=74) who received lithium carbonate for behavior disorders were followed in a 10-year retrospective study. Thirty-one subjects demonstrated a sustained major reduction or elimination of behavioral symptoms. Lithium responders were likely to be older and to present symptoms of…

  6. Toward a Model of Academic Integrity Institutionalization: Informing Practice in Postsecondary Education

    ERIC Educational Resources Information Center

    Gallant, Tricia Bertram; Drinan, Patrick

    2008-01-01

    The strategic choices facing higher education in confronting problems of academic misconduct need to be rethought. Using institutional theory, a model of academic integrity institutionalization is proposed that delineates four stages and a pendulum metaphor. A case study is provided to illustrate how the model can be used by postsecondary…

  7. The Political Construction of Mass Schooling: European Origins and Worldwide Institutionalization.

    ERIC Educational Resources Information Center

    Ramirez, Francisco O.; Boli, John

    1987-01-01

    Examines the origins of state educational systems in Europe in the nineteenth century and the institutionalization of mass education throughout the world in the twentieth century. Shows how construction of mass educational systems became a major and indispensable component of every modern state's nation building activity. Discusses the usefulness…

  8. Placement in Foster Care Enhances Quality of Attachment among Young Institutionalized Children

    ERIC Educational Resources Information Center

    Smyke, Anna T.; Zeanah, Charles H.; Fox, Nathan A.; Nelson, Charles A.; Guthrie, Donald

    2010-01-01

    This study examined classifications of attachment in 42-month-old Romanian children (N = 169). Institutionalized since birth, children were assessed comprehensively, randomly assigned to care as usual (CAU) or to foster care, and compared to family-reared children. Attachment classifications for children in foster care were markedly different from…

  9. Vitamin/Mineral Supplements and Intelligence of Institutionalized Mentally Retarded Adults.

    ERIC Educational Resources Information Center

    Ellis, Norman R.; Tomporowski, Phillip D.

    1983-01-01

    Vitamin/mineral supplements were administered to 19 institutionalized mentally retarded adults in a double-blind study over a seven-month period. No changes were observed in IQ nor in adaptive behavior. This was a replication with adults of a previous study of children that had obtained positive results. (Author/CL)

  10. Towards a Novel Conceptual Framework for Understanding Mergers in Higher Education

    ERIC Educational Resources Information Center

    Cai, Yuzhuo; Pinheiro, Rómulo; Geschwind, Lars; Aarrevaara, Timo

    2016-01-01

    This paper tries to develop a conceptual framework for a comprehensive understanding of the merger process, which is regarded as a matter of institutionalization of organizational innovation. In the framework, a number of factors affecting merger process or institutionalization of merger are identified, such as those related to environmental…

  11. Institutionalization of Technology Transfer Organizations in Chinese Universities

    ERIC Educational Resources Information Center

    Cai, Yuzhuo; Zhang, Han; Pinheiro, Rómulo

    2015-01-01

    There is a lack of in-depth studies on how technology transfer organizations (TTOs) are organized and developed. This paper examines the evolution/institutionalization of TTOs in Tsinghua University (TU), as a microcosm of the development of TTOs in Chinese universities. It explores two issues in particular: what kinds of TTOs have been developed…

  12. Post-Institutionalized Chinese and Eastern European Children: Heterogeneity in the Development of Emotion Understanding

    ERIC Educational Resources Information Center

    Camras, Linda A.; Perlman, Susan B.; Fries, Alison B. Wismer; Pollak, Seth D.

    2006-01-01

    Post-institutionalized Chinese and Eastern European children participated in two emotion understanding tasks. In one task, children selected facial expressions corresponding to four emotion labels (happy, sad, angry, scared). The second task required children to match facial expressions to stories describing situations for these emotions. While…

  13. Filipino Arts among Elders in Institutionalized Care Settings

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Satuito, James Cyril B.; Satumba, Miko Anne E.; Segui, Diego Rey A.; Serquina, Faith Evelyn C.; Serrano, Lawrence Jan P.; Sevilla, Madelyn D.

    2011-01-01

    The use of traditional art in recreational therapies is unexplored. This paper, thus, attempts to surface the unique power of traditional Filipino arts (TFA) as synergizing lens in capturing the individual and the collective experiences of a select group of Filipino elderly in an institutionalized care setting relative to their feelings of…

  14. The Effects of Duration of Caregiving on Institutionalization

    ERIC Educational Resources Information Center

    Gaugler, Joseph E.; Kane, Robert L.; Kane, Rosalie A.; Clay, Ted; Newcomer, Robert C.

    2005-01-01

    Purpose: Our objective in this analysis was to determine how the duration of caregiving interacts with key care demands (i.e., severity of problem behaviors) to influence the institutionalization of individuals suffering from dementia. Methods: We utilized multiregional data from 4,761 caregivers of individuals with dementia over a 3-year period.…

  15. Mechanisms for Institutionalizing Service-Learning and Community Partner Outcomes

    ERIC Educational Resources Information Center

    Stater, Keely Jones; Fotheringham, Eric

    2009-01-01

    Using data on service-learning partnerships from 255 universities receiving Learn and Serve America Grants in 2005, we ask (1) how different strategies used to institutionalize service-learning shape the perceived impact of the partnership on community groups, (2) how the level of service-learning program formality affects the perceived impact of…

  16. 34 CFR 461.32 - What are programs for corrections education and education for other institutionalized adults?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... education for other institutionalized adults? 461.32 Section 461.32 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION STATE-ADMINISTERED BASIC GRANT PROGRAM How Does a State Make an Award to an...

  17. 34 CFR 461.32 - What are programs for corrections education and education for other institutionalized adults?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... education for other institutionalized adults? 461.32 Section 461.32 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION STATE-ADMINISTERED BASIC GRANT PROGRAM How Does a State Make an Award to an...

  18. 34 CFR 461.32 - What are programs for corrections education and education for other institutionalized adults?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... education for other institutionalized adults? 461.32 Section 461.32 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION STATE-ADMINISTERED BASIC GRANT PROGRAM How Does a State Make an Award to an...

  19. 34 CFR 461.32 - What are programs for corrections education and education for other institutionalized adults?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... education for other institutionalized adults? 461.32 Section 461.32 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION STATE-ADMINISTERED BASIC GRANT PROGRAM How Does a State Make an Award to an...

  20. E.C.I.A. Chapter 1, Part B, Institutionalized Facilities Program, 1989-90. OREA Report.

    ERIC Educational Resources Information Center

    Miller, Ronald C.

    This report evaluates a program funded under the Educational Consolidation and Improvement Act (ECIA), Chapter 1, Part B, in New York (New York). The Program for Neglected and Delinquent Children, District 75/Citywide Institutionalized Facilities Program provides after-school supplementary instruction in prevocational skills, activities of daily…

  1. Sources of heterogeneity in developmental outcomes of children with past and current experiences of institutionalization in Russia: A four-group comparison.

    PubMed

    Rakhlin, Natalia; Hein, Sascha; Doyle, Niamh; Hart, Lesley; Koposov, Roman; Macomber, Donna; Ruchkin, Vladislav; Strelina, Anastasia; Tan, Mei; Grigorenko, Elena L

    2017-01-01

    The present study sought to compare 4 groups of age- and gender-matched children-(a) those reared in institutions for children without parental care in Russia; (b) those raised by their biological parents in Russia; (c) those adopted to the United States from Russian institutions; and (d) those born in the United States and raised by their biological parents-on indicators of cognition, language, and early learning. In addition, we aimed to compare the effects of the length of time spent in an institution, the age of initial placement in an institution, the age at adoption, and pre-institutional risk factors (i.e., prenatal substance exposure and prematurity and low birth weight) on the above-mentioned outcomes in the 2 groups of children with institutionalization experiences. Our results confirm previous reports demonstrating negative consequences of institutionalization and substantial ameliorating effects of adoption. They also underscore the complexity of the effects of institutionalization and adoption, showing that they are intertwined with the effects of pre-institutional risk factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Deterioration and cost information for bridge management.

    DOT National Transportation Integrated Search

    2012-05-01

    This study applies contract bid tabulations and elementlevel condition records to develop elementlevel actions, : costs for actions, transition probabilities for models of deterioration of bridge elements, and transition probabilities : for imp...

  3. Factors associated with contraceptive use in late- and post-apartheid South Africa.

    PubMed

    Burgard, Sarah

    2004-06-01

    In 1994, South Africa underwent a transition from the institutionalized racism of an apartheid state to a nonracial democracy. This study uses data from two surveys conducted in the style of the Demographic and Health Surveys to compare patterns and predictors of racial differences in modern contraceptive use in the late- and post-apartheid periods. Age-group-specific logistic regression models show that despite strong state family planning programs targeting black women, these women were less likely than nonblacks to practice modern contraception both before and after the political transition, even after controlling for large racial-group differences in sociodemographic characteristics and the distribution of socioeconomic resources. Black, colored, Indian, and white women show different patterns of contraceptive use across their reproductive careers; in particular, young, unmarried black and colored women show high levels of use. Use of injectable contraceptives is also high among black and colored women, whereas injectables are not the primary method used by Indian or white women. These findings are discussed in light of their research and policy implications.

  4. Social Communication Difficulties and Autism in Previously Institutionalized Children

    PubMed Central

    Levin, April R.; Fox, Nathan A.; Zeanah, Charles H.; Nelson, Charles A.

    2015-01-01

    Objective To determine the risk of difficulties with social communication and restricted/repetitive behaviors as well as the rate of autism in children institutionalized in early infancy and to assess the impact of a foster care intervention on ameliorating this risk. Method Children abandoned at birth and raised in institutions in Bucharest, Romania were randomly assigned to a care-as-usual group (institutional care, CAUG), or placed in family-centered foster care (FCG) as part of the Bucharest Early Intervention Project (BEIP). At approximately 10 years of age, the Social Communication Questionnaire (SCQ) was administered to caregivers of children in both groups, as well as to parents of a typically developing community sample (Never Institutionalized group, NIG) residing in Bucharest, Romania. Children scoring ≥ 12 on the SCQ underwent clinical evaluation for autism spectrum disorder (ASD). Results Caregivers of children with a history of institutionalization reported that these children had significantly more deviant behavior than never institutionalized children on all subdomains of the SCQ (all p<0.001). Children in the FCG had significantly lower scores on the SCQ than children in the CAUG (p<.001), particularly in the reciprocal social interaction domain, indicating that the intervention reduced problems in social communication. Three of 60 CAUG children, 2 of 57 FCG children, and none of the NIG children received a formal ASD diagnosis. Conclusion Early institutional rearing was associated with an increased risk of social communication difficulties and ASD. A family-centered foster care intervention improved social communication skills. PMID:25617251

  5. Effect of Early Referral to Specialist in Dementia on Institutionalization and Functional Decline: Findings from a Population-Based Study.

    PubMed

    Pimouguet, Clément; Le-Goff, Mélanie; Rizzuto, Debora; Berr, Claudine; Leffondré, Karen; Pérès, Karine; Dartigues, Jean FranÇois; Helmer, Catherine

    2016-01-01

    Although early diagnosis has been hypothesized to benefit both patients and caregivers, until now studies evaluating the effect of early dementia diagnosis are lacking. To investigate the influence of early specialist referral for dementia on the risk of institutionalization and functional decline in Activity of Daily Living (ADL). Incident dementia cases were screened in a prospective population-based cohort, the Three-City Study, and initial specialist consultation for cognitive complaint was assessed at dementia diagnosis. Proportional hazard regression and illness-death models were used to test the association between specialist referral and, respectively, institutionalization and functional decline. Only one third of the incident individuals with dementia had consulted a specialist for cognitive problems early (36%). After adjustment on potential confounders (including cognitive and functional decline) and competing risk of death, participants who had consulted a specialist early in the disease course presented a higher rate of being institutionalized than those who did not (Hazard Ratio = 2.00, 95% Confidence Interval (CI): 1.09- 3.64). But early specialist referral was not associated with further functional decline (HR = 1.09, 95% CI: 0.71- 1.67). Early specialist referral in dementia is associated with increased risk of institutionalization but not with functional decline in ADL. These findings suggest that early care referral in dementia may be a marker of concern for patients and/or caregivers; subsequent medical and social care could be suboptimal or inappropriate to allow patients to stay longer at home.

  6. Institutionalization of evidence-informed practices in healthcare settings

    PubMed Central

    2012-01-01

    Background The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Discussion Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. Summary KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs. PMID:23171660

  7. Institutionalization of evidence-informed practices in healthcare settings.

    PubMed

    Novotná, Gabriela; Dobbins, Maureen; Henderson, Joanna

    2012-11-21

    The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs.

  8. Factors affecting institutionalization in older Hong Kong Chinese patients after recovery from acute medical illnesses.

    PubMed

    Luk, James Ka Hay; Chiu, Patrick Ka Chun; Chu, Leung Wing

    2009-01-01

    Older patients with medical illnesses are at risk of institutionalization. The purpose of this study is to investigate the factors leading to institutionalization in older patients after recovery from medical illnesses. We studied 535 older patients in two convalescence hospitals in Hong Kong. Of them, 116 patients (21.7%) needed to move to nursing homes upon discharge. Univariate analysis showed that age, single/divorced/widowed status, longer length of stay, pressure sores, urinary incontinence, urinary catheterization, falls, dementia, diabetes mellitus, Barthel index (100), Elderly Mobility Score (EMS), Chinese version of the mini-mental state examination (C-MMSE) and albumin levels were significant factors associated with institutionalization. Multivariate analysis showed that being single/divorced/widowed (odds ratio=OR=2.74, 95% confidence interval=CI=1.36-5.53, p=0.0048), having urinary incontinence on discharge (OR=5.13, CI=2.66-10.6, p<0.001) and admission due to falls (OR=2.4, CI=1.03-5.57, p=0.04) were independent risk factors for nursing home admission. Higher admission EMS (OR=0.91, CI=0.84-0.97, p=0.009), admission C-MMSE (OR=0.93, CI=0.87-0.98, p=0.019), and discharge albumin levels (OR=0.93, CI=0.88-0.99, p=0.02) were independent protecting factors against nursing home admission. Knowledge of these factors can allow us to predict accommodation outcome and develop intervention strategy to reduce institutionalization in the older patients.

  9. Adverse Outcomes After Hospitalization and Delirium in Persons With Alzheimer Disease

    PubMed Central

    Fong, Tamara G.; Jones, Richard N.; Marcantonio, Edward R.; Tommet, Douglas; Gross, Alden L.; Habtemariam, Daniel; Schmitt, Eva; Yap, Liang; Inouye, Sharon K.

    2012-01-01

    Background Hospitalization, frequently complicated by delirium, can be a life-changing event for patients with Alzheimer disease (AD). Objective To determine risks for institutionalization, cognitive decline, or death associated with hospitalization and delirium in patients with AD. Design Prospective cohort enrolled between 1991 and 2006 into the Massachusetts Alzheimer’s Disease Research Center (MADRC) patient registry. Setting Community-based. Participants 771 persons aged 65 years or older with a clinical diagnosis of AD. Measurements Hospitalization, delirium, death, and institutionalization were identified through administrative databases. Cognitive decline was defined as a decrease of 4 or more points on the Blessed Information-Memory-Concentration test score. Multivariate analysis was used to calculate adjusted relative risks (RRs). Results Of 771 participants with AD, 367 (48%) were hospitalized and 194 (25%) developed delirium. Hospitalized patients who did not have delirium had an increased risk for death (adjusted RR, 4.7 [95% CI, 1.9 to 11.6]) and institutionalization (adjusted RR, 6.9 [CI, 4.0 to 11.7]). With delirium, risk for death (adjusted RR, 5.4 [CI, 2.3 to 12.5]) and institutionalization (adjusted RR, 9.3 [CI, 5.5 to 15.7]) increased further. With hospitalization and delirium, the adjusted RR for cognitive decline for patients with AD was 1.6 (CI, 1.2 to 2.3). Among hospitalized patients with AD, 21% of the incidences of cognitive decline, 15% of institutionalization, and 6% of deaths were associated with delirium. Limitations Cognitive outcome was missing in 291 patients. Sensitivity analysis was performed to test the effect of missing data, and a composite outcome was used to decrease the effect of missing data. Conclusion Approximately 1 in 8 hospitalized patients with AD who develop delirium will have at least 1 adverse outcome, including death, institutionalization, or cognitive decline, associated with delirium. Delirium prevention may represent an important strategy for reducing adverse outcomes in this population. Primary Funding Source National Institute on Aging and the MADRC. PMID:22711077

  10. Teaching Students to Attain Annual Transition Goals Using the Take Action Goal Attainment Lessons

    ERIC Educational Resources Information Center

    Martin, Jodie D.; Martin, James E.; Osmani, Kimberly J.

    2014-01-01

    This study used the Take Action goal attainment lesson package and assistive technology to teach nine high school students with mild to moderate disabilities to attain annual transition goals. The Take Action lessons increased students' goal attainment knowledge, and this knowledge generalized to improved Plan Organizers, and slightly increased…

  11. [Factors related to the demand of caregivers for institutionalization of disabled persons living at home].

    PubMed

    Tanikake, Chisato

    2005-03-01

    Recently, there has been an increase in the number of caregivers who are demanding institutionalization of the disabled, despite having taken care of them at home since their birth. It is important to clarify the background of this demand in order to help develop plans aimed at socially supporting the caregivers. This study was aimed at elucidating the factors related to demands of caregivers to have disabled persons living at home institutionalized. To caregivers of 410 home-living disabled persons, we handed out and collected questionnaires asking for the following information: age of the disabled persons and their caregivers, severity of the disability, status and level of manageability of the caregivers, and the place where the caregivers wanted the disabled to live in the future. The demand for institutionalization of the disabled and the attributes of the responders were analyzed by multiple logistic regression. From the responses of 297 people who replied to the questions, univariate analysis revealed that the demand for institutionalization significantly correlated with the labels of "severe" in the mental disability certificate, "incapable of conversation" according to the Office of Population Censuses and Surveys (OPCS) scale, "severe disability" in Oshima's classification and "unfit" and "unable to give daily care." The results analyzed by multiple logistic regression revealed that older caregivers had a significantly higher odds ratio (18.3 for those in their 40s and 37.2 for those in their 50s), indicating a strong correlation between the demand for institutionalization and the age of the caregivers. According to the mental disability certificate, the odds ratio of those with "A" was 5.0 relative to "other than A," while the odds ratio was 3.8 for those "unable to give care" against "able to give care," in both cases statistically significant. As for suffering in daily life, a majority of the caregivers aged 50 years or older claimed "a limit to home caring" and "aging". Regarding the shortage of public welfare services, a large percentage pointed out the inconveniences of emergency short stay, short stay, day care, and bathing services. The factors related to demand for institutionalization of disabled care receivers at home were aging of the caregivers, incapability of giving daily care, and severe mental impairment. The age of the caregivers was identified as an explicit factor.

  12. Previous Institutionalization Is Followed by Broader Amygdala-Hippocampal-PFC Network Connectivity during Aversive Learning in Human Development.

    PubMed

    Silvers, Jennifer A; Lumian, Daniel S; Gabard-Durnam, Laurel; Gee, Dylan G; Goff, Bonnie; Fareri, Dominic S; Caldera, Christina; Flannery, Jessica; Telzer, Eva H; Humphreys, Kathryn L; Tottenham, Nim

    2016-06-15

    Early institutional care can be profoundly stressful for the human infant, and, as such, can lead to significant alterations in brain development. In animal models, similar variants of early adversity have been shown to modify amygdala-hippocampal-prefrontal cortex development and associated aversive learning. The current study examined this rearing aberration in human development. Eighty-nine children and adolescents who were either previously institutionalized (PI youth; N = 46; 33 females and 13 males; age range, 7-16 years) or were raised by their biological parents from birth (N = 43; 22 females and 21 males; age range, 7-16 years) completed an aversive-learning paradigm while undergoing functional neuroimaging, wherein visual cues were paired with either an aversive sound (CS+) or no sound (CS-). For the PI youth, better aversive learning was associated with higher concurrent trait anxiety. Both groups showed robust learning and amygdala activation for CS+ versus CS- trials. However, PI youth also exhibited broader recruitment of several regions and increased hippocampal connectivity with prefrontal cortex. Stronger connectivity between the hippocampus and ventromedial PFC predicted significant improvements in future anxiety (measured 2 years later), and this was particularly true within the PI group. These results suggest that for humans as well as for other species, early adversity alters the neurobiology of aversive learning by engaging a broader prefrontal-subcortical circuit than same-aged peers. These differences are interpreted as ontogenetic adaptations and potential sources of resilience. Prior institutionalization is a significant form of early adversity. While nonhuman animal research suggests that early adversity alters aversive learning and associated neurocircuitry, no prior work has examined this in humans. Here, we show that youth who experienced prior institutionalization, but not comparison youth, recruit the hippocampus during aversive learning. Among youth who experienced prior institutionalization, individual differences in aversive learning were associated with worse current anxiety. However, connectivity between the hippocampus and prefrontal cortex prospectively predicted significant improvements in anxiety 2 years following scanning for previously institutionalized youth. Among youth who experienced prior institutionalization, age-atypical engagement of a distributed set of brain regions during aversive learning may serve a protective function. Copyright © 2016 the authors 0270-6474/16/366421-11$15.00/0.

  13. New graduate transition to practice: how can the literature inform support strategies?

    PubMed

    Moores, Alis; Fitzgerald, Cate

    2017-07-01

    Objective The transition to practice for new graduate health professionals has been identified as challenging, with health services typically adopting a range of support and management strategies to assist safe professional practice. Queensland's state-wide Occupational Therapy Clinical Education Program supporting new graduates within public sector health facilities conducted a narrative literature review to identify evidence-based recommended actions that would assist new graduate occupational therapists' to transition from student to practitioner. Method Searches of Medline, CINAHL and PubMed databases were used to locate articles describing or evaluating occupational therapy new graduate support actions. Results The themes of supervision, support and education emerged from the literature. Additionally, four interactions were identified as factors potentially influencing and being influenced by the processes and outcomes of supervision, support and education actions. The interactions identified were professional reasoning, professional identity, an active approach to learning and reflective practice. Conclusions The interactions emerging from the literature will serve to inform the delivery and focus of supervision, support and education for new graduate occupational therapists as they transition to practice. The results may have application for other health professions. What is known about the topic? The transition to practice for new graduate occupational therapists has been reported as challenging with health services implementing various actions to support and assist this transition. A previous literature review of recommended support strategies could not be found providing an impetus for this enquiry. What does this paper add? This narrative literature review identified three themes of actions supporting the transition of new graduates from student to practitioner. In addition to these themes of supervision, support and education, also emerging from the literature were factors identified as important to facilitating the transition of new graduates to the workplace. These factors, or interactions, are identified in this paper as professional reasoning, professional identity, an active approach to learning, and reflective practice. It is proposed that these interactions have an effect on and can be effected by supervision, support and education actions. The articulation between the interactions and the themes was a notable outcome emerging from this literature review. What are the implications for practitioners? This literature review will assist those planning actions to guide new graduates' transition into practice. It is proposed that the methods of implementing supervision, support and education actions are optimised by the identified interactions.

  14. Classics in Chemical Neuroscience: Memantine.

    PubMed

    Alam, Shahrina; Lingenfelter, Kaelyn Skye; Bender, Aaron M; Lindsley, Craig W

    2017-09-20

    Memantine was the first breakthrough medication for the treatment of moderate to severe Alzheimer's disease (AD) patients and represents a fundamentally new mechanism of action (moderate-affinity, uncompetitive, voltage-dependent, N-methyl-d-aspartate (NMDA) receptor antagonist that exhibits fast on/off kinetics) to modulate glutamatergic dysfunction. Since its approval by the FDA in 2003, memantine, alone and in combination with donepezil, has improved patient outcomes in terms of cognition, behavioral disturbances, daily functioning, and delaying time to institutionalization. In this review, we will highlight the historical significance of memantine to AD (and other neuropsychiatric disorders) as well as provide an overview of the synthesis, pharmacology, and drug metabolism of this unique NMDA uncompetitive antagonist that clearly secures its place among the Classics in Chemical Neuroscience.

  15. [Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

    PubMed

    Boidin, B

    2015-02-01

    This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

  16. The Effects of Early Institutionalization on the Discrimination of Facial Expressions of Emotion in Young Children

    ERIC Educational Resources Information Center

    Jeon, Hana; Moulson, Margaret C.; Fox, Nathan; Zeanah, Charles; Nelson, Charles A., III

    2010-01-01

    The current study examined the effects of institutionalization on the discrimination of facial expressions of emotion in three groups of 42-month-old children. One group consisted of children abandoned at birth who were randomly assigned to Care-as-Usual (institutional care) following a baseline assessment. Another group consisted of children…

  17. Oral Health and Nutritional Status of Semi-Institutionalized Persons with Mental Retardation in Brazil

    ERIC Educational Resources Information Center

    Batista, Luciana Rodrigues Vieira; Moreira, Emilia Addison Machado; Rauen, Michelle Soares; Corso, Arlete Catarina Tittoni; Fiates, Giovanna Medeiros Rataichesck

    2009-01-01

    Association between oral health status and nutritional status was investigated in 200 semi-institutionalized persons with mental retardation aged 5-53 years, 45.5% female, in the cities of Florianopolis and Sao Jose, province of Santa Catarina, Brazil. In this cross-sectional study, clinical-odontological examination revealed a high percentage of…

  18. Iron Deficiency and the Cognitive and Psychomotor Development of Children: A Pilot Study with Institutionalized Children.

    ERIC Educational Resources Information Center

    Driva, A.; And Others

    1985-01-01

    Describes a pilot study, involving 48 institutionalized infants and toddlers, which aimed to treat iron deficiency anemia and to discover other factors contributing to the problem. Results indicate improvement in cognitive development after the administration of iron among three groups, while no significant differences were observed in psychomotor…

  19. 42 CFR 435.725 - Post-eligibility treatment of income of institutionalized individuals in SSI States: Application...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) $60 a month for an institutionalized couple if both spouses are aged, blind, or disabled and their...) Optional deduction: Allowance for home maintenance. For single individuals and couples, an amount (in addition to the personal needs allowance) for maintenance of the individual's or couple's home if— (1) The...

  20. 42 CFR 435.733 - Post-eligibility treatment of income of institutionalized individuals in States using more...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Medicaid on the basis of blindness or disability; (ii) $60 a month for an institutionalized couple if both... home maintenance. For single individuals and couples, an amount (in addition to the personal needs allowance) for maintenance of the individual's or couple's home if— (1) The amount is deducted for not more...

  1. 42 CFR 436.832 - Post-eligibility treatment of income of institutionalized individuals: Application of patient...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Medicaid on the basis of blindness or disability; (ii) $60 a month for an institutionalized couple if both... deduction: Allowance for home maintenance. For single individuals and couples, an amount (in addition to the personal needs allowance) for maintenance of the individual's or couple's home if— (1) The amount is...

  2. Educational Support Group in Changing Caregivers' Psychological Elder Abuse Behavior toward Caring for Institutionalized Elders

    ERIC Educational Resources Information Center

    Hsieh, Hsiu-Fang; Wang, Jing-Jy; Yen, Maiofen; Liu, Tzu-Ti

    2009-01-01

    Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver's…

  3. Peer Attachment, Coping, and Self-Esteem in Institutionalized Adolescents: The Mediating Role of Social Skills

    ERIC Educational Resources Information Center

    Mota, Catarina Pinheiro; Matos, Paula Mena

    2013-01-01

    This study analyzes the contribution of peer attachment in predicting active coping and self-esteem in a sample of 109 institutionalized adolescents. It also explores the mediating role of social skills in the association between peer attachment, coping, and self-esteem. Structural equation modeling identified a model able to predict a positive…

  4. Reactions to the Labels "Institutionalized" and "Mentally Retarded" by Retarded and Nonretarded Persons.

    ERIC Educational Resources Information Center

    Gibbons, Frederick X.; Gibbons, Barbara N.

    The effects of labels, "mentally retarded" and "institutionalized" on the evaluations and causal attributions of nonretarded persons, and on the social distance preferences of EMR persons, were assessed. In addition, each group was asked to predict the likelihood of a labeled (mentally retarded) or a nonlabeled target person achieving success at a…

  5. How Institutionalized Are Model License Use Terms? An Analysis of E-Journal License Use Rights Clauses from 2000 to 2009

    ERIC Educational Resources Information Center

    Eschenfelder, Kristin R.; Tsai, Tien-I; Zhu, Xiaohua; Stewart, Brenton

    2013-01-01

    This paper explored the degree to which use terms proposed by model licenses have become institutionalized across different publishers' licenses. It examined model license use terms in four areas: downloading, scholarly sharing, interlibrary loan, and electronic reserves. Data collection and analysis involved content analysis of 224 electronic…

  6. Institutionalizing in Loco Parentis after Gott v. Berea College (1913)

    ERIC Educational Resources Information Center

    Loss, Christopher P.

    2014-01-01

    Background/Context: The institutionalization of in loco parentis in the wake of Gott v. Berea College (1913) marked a major turning point in the evolution of student management theory and practice. Focusing on the crucial decade of the 1920s, when American higher education first became a mass enterprise, this study explores the interaction of…

  7. Institutionalization of Lifelong Learning in Europe and East Asia: From the Complexity Systems Perspective

    ERIC Educational Resources Information Center

    Han, SoongHee

    2017-01-01

    East Asia shows newly emerging experiments in lifelong learning that contrast with European experiences. The concepts and ideas share a similar platform, while the trajectories of institutionalization reveal great differences. It is because the idea of lifelong learning was coined by international agencies, like UNESCO, to share, it rather shows…

  8. Corporate social policy - problems of institutionalization and experience of Russian oil and gas companies

    NASA Astrophysics Data System (ADS)

    Nekhoda, E.; Kolbysheva, Yu; Makoveeva, V.

    2015-11-01

    The article examines a range of problems related to the process of institutionalization in the corporate social policy, characterizing the social responsibility of business and representing a part of the general strategy of corporate social responsibility. The experience of the social policy implementation in oil and gas companies is analyzed.

  9. Toward a model for improved targeting of aged at risk of institutionalization.

    PubMed Central

    Weissert, W G; Cready, C M

    1989-01-01

    A national sample of institutionalized and noninstitutionalized aged was created by merging the 1977 National Nursing Home Survey and its counterpart, the National Health Interview Survey for the same year. A weighted logistic regression analysis was conducted to identify factors that might be useful in calculating home- and community-based long-term care clients' risk of institutionalization. A model containing patient characteristics, nursing home bed supply, and a climate variable correctly classified 98.2 percent of cases residing in nursing homes or the community. Physical dependency, mental disorder and degenerative disease, lack of spouse, being white, poverty, old age, unoccupied nursing home beds, and climate all appear to be determinants of institutional residency among the aged. PMID:2807934

  10. Computation of rare transitions in the barotropic quasi-geostrophic equations

    NASA Astrophysics Data System (ADS)

    Laurie, Jason; Bouchet, Freddy

    2015-01-01

    We investigate the theoretical and numerical computation of rare transitions in simple geophysical turbulent models. We consider the barotropic quasi-geostrophic and two-dimensional Navier-Stokes equations in regimes where bistability between two coexisting large-scale attractors exist. By means of large deviations and instanton theory with the use of an Onsager-Machlup path integral formalism for the transition probability, we show how one can directly compute the most probable transition path between two coexisting attractors analytically in an equilibrium (Langevin) framework and numerically otherwise. We adapt a class of numerical optimization algorithms known as minimum action methods to simple geophysical turbulent models. We show that by numerically minimizing an appropriate action functional in a large deviation limit, one can predict the most likely transition path for a rare transition between two states. By considering examples where theoretical predictions can be made, we show that the minimum action method successfully predicts the most likely transition path. Finally, we discuss the application and extension of such numerical optimization schemes to the computation of rare transitions observed in direct numerical simulations and experiments and to other, more complex, turbulent systems.

  11. Social communication difficulties and autism in previously institutionalized children.

    PubMed

    Levin, April R; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A

    2015-02-01

    To determine the risk of difficulties with social communication and restricted/repetitive behaviors as well as the rate of autism in children institutionalized in early infancy and to assess the impact of a foster care intervention on ameliorating this risk. Children abandoned at birth and raised in institutions in Bucharest, Romania were randomly assigned to a care-as-usual group (institutional care, CAUG), or placed in family-centered foster care (FCG) as part of the Bucharest Early Intervention Project (BEIP). At approximately 10 years of age, the Social Communication Questionnaire (SCQ) was administered to caregivers of children in both groups as well as to parents of a typically developing community sample (Never-Institutionalized group [NIG]) residing in Bucharest, Romania. Children scoring ≥12 on the SCQ underwent clinical evaluation for autism spectrum disorder (ASD). Caregivers of children with a history of institutionalization reported that these children had significantly more deviant behavior than never-institutionalized children on all subdomains of the SCQ (all p < 0.001). Children in the FCG had significantly lower scores on the SCQ than children in the CAUG (p < .001), particularly in the reciprocal social interaction domain, indicating that the intervention reduced problems in social communication. Three of 60 CAUG children, 2 of 57 FCG children, and none of the NIG children received a formal ASD diagnosis. Early institutional rearing was associated with an increased risk of social communication difficulties and ASD. A family-centered foster care intervention improved social communication skills. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  12. 42 CFR 435.832 - Post-eligibility treatment of income of institutionalized individuals: Application of patient...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) $60 a month for an institutionalized couple if both spouses are aged, blind, or disabled and their... individuals and couples, an amount (in addition to the personal needs allowance) for maintenance of the individual's or couple's home if— (1) The amount is deducted for not more than a 6-month period; and (2) A...

  13. Political Party System Institutionalization and Democracy: The Case of Panama

    DTIC Science & Technology

    1998-03-01

    United States foreign policy have, historically, significantly affected Panamanian politics. Giovanni Sartori has emphasized that political parties...This thesis investigates that relationship, the level of 16 Giovanni Sartori , Parties and Party Systems; A Framework for Analysis (Cambridge...analyze the level of political party institutionalization in Panama. As Giovanni Sartori succinctly states in his excellent book on parties and

  14. Institutionalization: How Can We Continue Good Practices and Functions When Funding Ends? Part II.

    ERIC Educational Resources Information Center

    Emory, Ruth

    Based on the conference for which the related document (EA 015 290) was prepared, this document reports the discussions and results of the meeting of the Northwest Regional Exchange (NWRx) Advisory Board with its staff and several consultants on the problem of how to institutionalize dissemination functions in the region's states--that is, how to…

  15. District 75/Citywide E.C.I.A. Chapter 1, Part B, Institutionalized Facilities Program. Summer 1989. OREA Report.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Research, Evaluation, and Assessment.

    This report evaluates a program funded under Chapter 1, Part B, of the Education Consolidation and Improvement Act in New York (New York). The New York City Division of Special Education administers the Institutionalized Facilities Program to provide instruction to neglected and delinquent children and adolescents residing in group homes and…

  16. Institutionalizing Sex Education in Diverse U.S. School Districts.

    PubMed

    Saul Butler, Rebekah; Sorace, Danene; Hentz Beach, Kathleen

    2018-02-01

    This paper describes the Working to Institutionalize Sex Education (WISE) Initiative, a privately funded effort to support ready public school districts to advance and sustain comprehensive sexuality programs, and examines the degree to which WISE has been successful in increasing access to sex education, removing barriers, and highlighting best practices. The data for this study come from a set of performance indicators, guidance documents, and tools designed for the WISE Initiative to capture changes in sex education institutionalization at WISE school districts. The evaluation includes the analysis of 186 school districts across 12 states in the U.S. As a result of the WISE Initiative, 788,865 unique students received new or enhanced sex education in school classrooms and 88 school districts reached their sex education institutionalization goals. In addition to these school district successes, WISE codified the WISE Method and toolkit-a practical guide to help schools implement sex education. Barriers to implementing sexuality education can be overcome with administrative support and focused technical assistance and training, resulting in significant student reach in diverse school districts nationwide. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. [Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial].

    PubMed

    Cebrià I Iranzo, Maria Dels Àngels; Tortosa-Chuliá, M Ángeles; Igual-Camacho, Celedonia; Sancho, Patricia; Galiana, Laura; Tomás, José Manuel

    2014-01-01

    The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  18. Effects of an intervention to promote socioemotional development in terms of attachment security: a study in early institutionalization in Chile.

    PubMed

    Lecannelier, Felipe; Silva, Jaime R; Hoffmann, Marianela; Melo, Rolando; Morales, Raquel

    2014-01-01

    The Chilean government commissioned a quasi-experimental study with a pre-/postintervention design that had two general aims: (a) to assess infants' psychoaffective developmental levels (pre-intervention phase) and (b) to evaluate whether an intervention based on the promotion of socioemotional development modifies the infant's psychoaffective development. Sixty-two institutionalized infants and their alternative caregivers were evaluated at a pre-intervention stage. An intervention then took place, with the caregivers trained according to an "attachment sensitivity manual." Results showed normal ranges of psychomotor development (64% normal, 9% delayed) and a very high frequency of attachment insecurity, as compared to the normative population (53%).The intervention significantly improved social orientation and object orientation as well as activity and reactivity levels. We conclude that although institutionalized infants in Chile do not exhibit high levels of atypical attachment, socioemotional deterioration may lead to vulnerability in present and future development. Finally, the scope of this study affected public policies regarding children, initiating a change to a foster family system and a variety of modifications in the strategies for adopting institutionalized infants. © 2014 Michigan Association for Infant Mental Health.

  19. Institutionalizing Health Impact Assessment: A consultation with experts on the barriers and facilitators to implementing HIA in Italy.

    PubMed

    Linzalone, Nunzia; Ballarini, Adele; Piccinelli, Cristiano; Viliani, Francesca; Bianchi, Fabrizio

    2018-07-15

    A Health Impact Assessment (HIA) is an evidence-based methodology that includes health promotion and protection goals in decision-making. HIA has been introduced and/or institutionalized to various extents in different countries. In order to promote HIA and preventive health assessments in Italy, a research methodology was followed to identify specific obstacles or facilitators. The experiences of various countries reported in the literature were analyzed in terms of facilitating or hindering the introduction and institutionalization of HIA. A consultation with the proponents of projects and plans in Italy was carried out with a multi-approach methodology in order to characterize the national context. A general implementation plan was drawn up from the international experiences. In Italy this is not yet in place. Specific areas of intervention need to be addressed, including: 1) data availability; 2) tools and methods; 3) engagement of stakeholders; 4) capacity building. The research suggests that the institutionalization of HIA in Italy rests on the government's commitment to providing specific legislation regarding HIA so that skills, intersectoral coordination and dedicated budgets can be built and maintained. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. A matter of attachment? How adoptive parents foster post-institutionalized children's social and emotional adjustment.

    PubMed

    Barone, Lavinia; Lionetti, Francesca; Green, Jonathan

    2017-08-01

    The current study investigates the contribution of children's age at adoption (M = 46.52 months, SD = 11.52 months) and parents' attachment on post-institutionalized children's attachment and social-emotional adjustment. A total of 132 subjects, 48 post-institutionalized children aged 3-5 years, and their adoptive parents, took part in the study. One year from adoption, children's attachment distribution was as follows: 31% secure, 42% disorganized, and 27% insecure. Parents' secure attachment increased children's probability of presenting a secure attachment pattern; specifically, mothers' attachment patterns were most strongly associated with those of their adopted children, with fathers' making an additional contribution. Two years from adoption, secure children showed more adequate social competences than their insecure and disorganized peers and presented better emotional comprehension. The effect of age at adoption was delimited to a marginal association with behavioral problems. This pattern of associations suggests that attachment - both of adoptive parents and of children - substantially fosters social-emotional adjustment of post-institutionalized children who have experienced a period in emotionally neglecting environments beyond their first year of life, regardless of their age at adoption. Implications for policies and practices are discussed.

  1. [Effect of a physiotherapy exercise program on physical performance in institutionalized elderly].

    PubMed

    Chávez-Pantoja, Mariana; López-Mendoza, Mariella; Mayta-Tristán, Percy

    2014-01-01

    To evaluate changes in physical performance in institutionalized older adults through a program of physiotherapy exercises. A quasi-experimental study was conducted on adults over 60 years-old, institutionalized in Lima, Peru. The exercise program was implemented in 45minutes sessions included warming-up, muscle strengthening exercises, balance, gait training and cooling phase, three times a week for 12 weeks. Physical performance was measured with the Short Physical Performance Battery (SPPB) one week before and after the intervention. It included 45 participants, of whom 16 did not attend any of the sessions and was used as a control group. The mean age was 77.6±7.1 years, and 62.2% were women. The mean baseline SPPB was 7.0±1.6 in the intervention group, and 6.9±1.9 in the control group (P=.90). A change of 2.6±1.8 was observed in the SPPB of the intervention group versus -1.4±2.0 in the control group (P<.001). The development of a physiotherapy exercise program for institutionalized elderly increases physical performance, which could be implemented in care centers for elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  2. PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean.

    PubMed

    Vogus, Abigail; Graff, Kylie

    2015-06-17

    The US President's Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country's readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor support for targeted capacity building and long-term monitoring and evaluation efforts. © Vogus et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

  3. Evacuation effect on excess mortality among institutionalized elderly after the fukushima daiichi nuclear power plant accident.

    PubMed

    Yasumura, Seiji

    2014-01-01

    The Great East Japan Earthquake hit Fukushima Prefecture on March 11, 2011, just over 3 years ago and it continues to affect our lives. In Fukushima, many people are confirmed dead or still missing due to the earthquake and/or tsunami. Additional "disaster-related deaths" have been attributed to the Fukushima Daiichi Nuclear Power Plant (NPP) accident. Mortality among the institutionalized elderly rates after the NPP accident were exceptionally high during the first 3 months, and persisted at a lower level for 9 months, in comparison with similar periods before the accident. This study demonstrates the great impact of evacuation on mortality of institutionalized elderly, excluding inpatients. We need to pay special attention to evacuation of the elderly, regardless of whether voluntary or forced.

  4. The Use of Physical Exercise in the Modification of Ward Behavior in Institutionalized Hyperactive Boys: A Preliminary Investigation.

    ERIC Educational Resources Information Center

    Boyd, Joe K.; Hensley, J. Higgins

    The effects of a structured physical exercise program on the ward behavior of 16 institutionalized hyperactive children (6 to 13 years old) was investigated. Ss were randomly assigned to conditions in which they ran, engaged in calesthenics, or both, for 20 minutes per day, 5 days a week, for 4 weeks. Data from daily behavioral measures were…

  5. Low Bone Mineral Density Risk Factors and Testing Patterns in Institutionalized Adults with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Hess, Mailee; Campagna, Elizabeth J.; Jensen, Kristin M.

    2018-01-01

    Background: Adults with intellectual or developmental disability (ID/DD) have multiple risks for low bone mineral density (BMD) without formal guidelines to guide testing. We sought to identify risk factors and patterns of BMD testing among institutionalized adults with ID/DD. Methods: We evaluated risk factors for low BMD (Z-/T-score < -1) and…

  6. P.L. 89-313 Supplementary Services for Previously Non-Public-School Institutionalized Students, 1982-1983. O.E.E. Evaluation Report.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

    The Supplementary Services for Previously Non-Public-School Institutionalized Students in New York City was designed to assist students who were formerly educated at state-operated or state-supported schools to adapt to public school education. The 1982-83 program served 1054 students in 367 sites, which included community schools, high schools, a…

  7. DSM-III Diagnoses Compared with Factor Structure of the Psychopathology Instrument for Mentally Retarded Adults (PIMRA), in an Institutionalized, Mostly Severely Retarded Population.

    ERIC Educational Resources Information Center

    Linaker, Olav

    1991-01-01

    The Psychopathology Instrument for Mentally Retarded Adults was used to diagnose 163 mentally retarded institutionalized adults according to the Diagnostic and Statistical Manual-III axis 1 categories. Nine factors were extracted which contained 49.3 percent of the data variance and categorized correctly 69.3 percent of the cases. Factors included…

  8. Relationship of Level of Functioning of Institutionalized Women on a Task Analysis of Personal Care for Menstruation and the Adaptive Behavior Scale.

    ERIC Educational Resources Information Center

    Brekke, Beverly W.; And Others

    A 40-item behavior analysis task, the Menstrual Care Scale, was developed and tested with 75 randomly selected institutionalized severely retarded women (13-59 years old). The need for developing personal care skills in menstruation habits had been identified as a priority area for sexuality instruction by staff and confirmed by analysis of…

  9. High School E.C.I.A. Chapter 1, Part B, Institutionalized Facilities Program 1989-90. State Report. OREA Report.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Research, Evaluation, and Assessment.

    This report describes and evaluates high school programs funded under Chapter 1, Part B, of the Education Consolidation and Improvement Act (ECIA) and administered by the Institutionalized Facilities Program of the New York City Public Schools in 1989-90. The program is designed to address the educational needs of students in facilities for…

  10. Individualized and institutionalized residential place-based discrimination and self-rated health: a cross-sectional study of the working-age general population in Osaka city, Japan

    PubMed Central

    2014-01-01

    Background Several studies have reported that individualized residential place-based discrimination (PBD) affects residents’ health. However, studies exploring the association between institutionalized PBD and health are scarce, especially in Asian countries including Japan. Methods A cross-sectional study was conducted with random two-stage sampling of 6191 adults aged 25–64 years in 100 census tracts across Osaka city in 2011. Of 3244 respondents (response rate 52.4%), 2963 were analyzed using multilevel logistic regression to examine the association of both individualized and institutionalized PBD with self-rated health (SRH) after adjustment for individual-level factors such as socioeconomic status (SES). An area-level PBD indicator was created by aggregating individual-level PBD responses in each tract, representing a proxy for institutionalized PBD, i.e., the concept that living in a stigmatized neighborhood affects neighborhood health. 100 tracts were divided into quartiles in order. The health impact of area-level PBD was compared with that of area-level SES indicators (quartile) such as deprivation. Results After adjustment for individual-level PBD, the highest and third area-level PBD quartiles showed odds ratio (OR) 1.57 (95% credible interval: 1.13-2.18) and 1.38 (0.99-1.92), respectively, for poor SRH compared with the lowest area-level PBD quartile. In a further SES-adjusted model, ORs of area-level PBD (highest and third quartile) were attenuated to 1.32 and 1.31, respectively, but remained marginally significant, although those of the highest area-level not-home-owner (census-based indicator) and deprivation index quartiles were attenuated to 1.26 and 1.21, respectively, and not significant. Individual-level PBD showed significant OR 1.89 (1.33-2.81) for poor SRH in an age, sex, PBD and SES-adjusted model. Conclusion Institutionalized PBD may be a more important environmental determinant of SRH than other area-level SES indicators such as deprivation. Although it may have a smaller health impact than individualized PBD, attention should be paid to invisible and unconscious aspects of institutionalized PBD to improve residents’ health. PMID:24885239

  11. The evolution of the federal funding policies for the public health surveillance component of Brazil's Unified Health System (SUS).

    PubMed

    Pinto, Vitor Laerte; Cerbino Neto, José; Penna, Gerson Oliveira

    2014-12-01

    Health surveillance (HS) is one of the key components of the Brazilian Unified Health System (SUS). This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years.

  12. Promoting health and happiness in the Brazilian Amazon.

    PubMed

    Scannavino, Caetano; Anastácio, Rui

    2007-01-01

    With the motto "Health, happiness of the body. Happiness, health of the soul", the Health & Happiness Project (PSA) works to promote integrated and sustainable community development in parts of the Brazilian Amazon. PSA grew out of local workers' personal experience in collaborating with communities and the need for sustainable actions for their future development. PSA was established as a not-for-profit organization in 1987 It started off by implementing strategies that would increase the health status of the population, which was identified as the biggest challenge, to then extend to other areas of development. Education, training and community participation were key elements of the project's actions, which included basic sanitation, reproductive health and child health, technical assistance in agricultural practices and youth empowerment through communications, among others. Once the health structure was established, the work moved on to new priorities related to education, economic production, protection of the environment and community management in the medium and long terms. The project's success has helped to institutionalize the practices and today it reaches a total of approximately 5,000 families distributed across 150 rural communities in the mid- and low-Amazon region.

  13. Murder by structure: dominance relations and the social structure of gang homicide.

    PubMed

    Papachristos, Andrew V

    2009-07-01

    Most sociological theories consider murder an outcome of the differential distribution of individual, neighborhood, or social characteristics. And while such studies explain variation in aggregate homicide rates, they do not explain the social order of murder, that is, who kills whom, when, where, and for what reason. This article argues that gang murder is best understood not by searching for its individual determinants but by examining the social networks of action and reaction that create it. In short, the social structure of gang murder is defined by the manner in which social networks are constructed and by people's placement in them. The author uses a network approach and incident-level homicide records to recreate and analyze the structure of gang murders in Chicago. Findings demonstrate that individual murders between gangs create an institutionalized network of group conflict, net of any individual's participation or motive. Within this network, murders spread through an epidemic-like process of social contagion as gangs evaluate the highly visible actions of others in their local networks and negotiate dominance considerations that arise during violent incidents.

  14. Motor Decisions Are Not Black and White: Selecting Actions in the “Gray Zone”

    PubMed Central

    Comalli, D. M.; Persand, D.; Adolph, K. E.

    2017-01-01

    In many situations, multiple actions are possible to achieve a goal. How do people select a particular action among equally possible alternatives? In six experiments, we determined whether action selection is consistent and biased toward one decision by observing participants’ decisions to go over or under a horizontal bar set at varying heights. We assessed the height at which participants transitioned from going over to under the bar within a “gray zone”—the range of bar heights at which going over and under were both possible. In Experiment 1, participants’ transition points were consistently located near the upper boundary of the gray zone, indicating a bias to go over rather than under the bar. Moreover, transitional behaviors were clustered tightly into a small region, indicating that decisions were highly consistent. Subsequent experiments examined potential influences on action selection. In Experiment 2, participants wore ankle weights to increase the cost of going over the bar. In Experiment 3, they were tested on a padded surface that made crawling under the bar more comfortable. In Experiment 4, we introduced a secondary task that required participants to crawl immediately after navigating the bar. None of these manipulations altered participants’ decisions relative to Experiment 1. In Experiment 5, participants started in a crawling position, which led to significantly lower transition points. In Experiment 6, we tested 5- to 6-year-old children as in Experiment 1 to determine the effects of social pressure on action selection. Children displayed lower transition points, larger transition regions, and reduced ability to go over the bar compared to adults. Across experiments, results indicate that adults have a strong and robust bias for upright locomotion. PMID:28293691

  15. Socio-demographic, behavioral and functional characteristics of groups of community and institutionalized elderly Quechua Indians of Peru, and their association with nutritional status.

    PubMed

    Fortunato, Laura; Drusini, Andrea G

    2005-06-01

    Socio-demographic, behavioral, functional and anthropometric data for groups of elderly Quechua Indians of Peru were used to investigate the effects of gender and lifestyle patterns on nutritional status. Two community-dwelling samples were selected for study, representative of divergent lifestyles in terms of their combination of socio-economic, demographic and cultural contexts, plus an ad-hoc sample of institutionalized individuals with controlled food intake and reduced physical activity. Results suggest that differences in socio-demographic, behavioral and functional characteristics exist between the sexes and across settings (low- vs. highland) and lifestyles (institutionalized vs. community-dwelling; semi-urban vs. rural). These factors are likely to be related to diverging dietary and physical activity patterns, and have considerable effects on the nutritional status of the respondents.

  16. 76 FR 46357 - Notice of Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-02

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Notice of Limitation on Claims Against Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice... that FTA has taken final agency actions by issuing certain approvals for the public transportation...

  17. 77 FR 26818 - Notice of Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-07

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Notice of Limitation on Claims Against Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice... public transportation projects listed below. The actions on these projects, as well as the laws under...

  18. P.L. 89-313 Supplementary Services for Previously Non-Public-School Institutionalized Students. O.E.E. Evaluation Report, 1981-82.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

    Results of an evaluation of the 1981-82 Public Law 89-313 program, "Supplementary Services for Previously Non-Public-School Institutionalized Students," are presented in this report. The program was operated by the Division of Special Education of the New York City public schools and served 527 students (6-21 years old) in 227 schools,…

  19. Quality circles: Organizational adaptations, improvements and results

    NASA Technical Reports Server (NTRS)

    Tortorich, R.

    1985-01-01

    The effective application in industry and government of quality circles work was demonstrated. The results achieved in quality and productivity improvements and cost savings are impressive. The circle process should be institutionalized within industry and government. The stages of circle program growth, innovations that help achieve circle process institutionalization, and the result achieved at Martin Marietta's Michoud Division and within the National Aeronautics and Space Administration (NASA) are addressed.

  20. Active ageing and quality of life: factors associated with participation in leisure activities among institutionalized older adults, with and without dementia.

    PubMed

    Fernández-Mayoralas, Gloria; Rojo-Pérez, Fermina; Martínez-Martín, Pablo; Prieto-Flores, Maria-Eugenia; Rodríguez-Blázquez, Carmen; Martín-García, Salomé; Rojo-Abuín, José-Manuel; Forjaz, Maria-Joao

    2015-01-01

    Active ageing, considered from the perspective of participation in leisure activities, promotes life satisfaction and personal well-being. The aims of this work are to define and explain leisure activity profiles among institutionalized older adults, considering their sociodemographic characteristics and objective and subjective conditions in relation to their quality of life. Two samples of institutionalized people aged 60 and over were analysed together: 234 older adults without dementia and 525 with dementia. Sociodemographic, economic, family and social network, and health and functioning variables were selected. Cluster analysis was applied to obtain activity profiles according to the leisure activities, and ordinal regression models were performed to analyse factors associated to activity level. The sample was clustered into three groups of people: active (27%), moderately active (35%) and inactive people (38%). In the final regression model (Nagelkerke pseudo R(2) = 0.500), a higher level of activity was associated with better cognitive function (Pfeiffer scale), self-perceived health status and functional ability, as well as with a higher frequency of gathering with family and friends, and higher educational level. The decline in physical and mental health, the loss of functional capabilities and the weakening of family and social ties represent a significant barrier to active ageing in a context of institutionalization.

  1. Factors associated to suggestive signs of oropharyngeal dysphagia in institutionalized elderly women.

    PubMed

    Bomfim, Fernanda Maria Santana; Chiari, Brasília Maria; Roque, Francelise Pivetta

    2013-01-01

    To identify the factors associated to suggestive signs of oropharyngeal dysphagia (OD) in institutionalized elderly women. A cross-sectional, study with 30 institutionalized elderly women (mean age: 83,73±10,56 years) was carried out in Maceió. From August 2007 to July 2008, social, demographic and cultural data was collected, as well as data on general health and deglutition from their medical records and follow-up (both in person and by video) of one meal of each elderly woman. Those with signs suggestive of OD were compared to those with no signs of it and the factors associated with signs suggestive of orophayngeal dysphagia and changes in the feeding dynamics were considered. Regarding the factors associated to changes in feeding dynamics, the elderly with dementia were more likely to require assistance during mealtime and to present four or more changes in feeding dynamics. The elderly that required assistance were more likely to eat in bed, at an inadequate position and to have three or more changes in feeding dynamics. For institutionalized elderly women, the factors associated to signs suggestive of oropharyngeal dysphagia were use of medication, absence of depression, number of teeth and number of changes in feeding dynamics. The factors associated to changes in feeding dynamics are related to dementia and need of special care.

  2. Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

    PubMed

    Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

    2016-11-01

    The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. 76 FR 78332 - Amended Notice of Limitation on Claims Against Proposed Public Transportation Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-16

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Amended Notice of Limitation on Claims Against Proposed Public Transportation Project AGENCY: Federal Transit Administration (FTA), DOT. ACTION... actions announced herein for the listed public transportation project will be barred unless the claim is...

  4. 78 FR 33890 - Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Limitation on Claims Against Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... advising the public of final agency actions subject to Section 139(l) of Title 23, United States Code (U.S...

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    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Limitation on Claims Against Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... advising the public of final agency actions subject to Section 139(l) of Title 23, United States Code (U.S...

  6. 78 FR 16764 - Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Limitation on Claims Against Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... advising the public of final agency actions subject to Section 139(l) of Title 23, United States Code (U.S...

  7. 75 FR 57103 - Agency Information Collection Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

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  8. Malnutrition in older adults - urgent need for action: a plea for improving the nutritional situation of older adults.

    PubMed

    Volkert, Dorothee

    2013-01-01

    During the past decades, malnutrition has attracted increasing scientific attention and is by now regarded as a true geriatric syndrome characterized by multifactorial causality, identified by symptoms and accompanied by frailty, disability and poor outcome. This viewpoint summarizes our present knowledge and the usual current handling of malnutrition in older people and highlights the urgent need for action in this field. Age-related changes in the complex system of appetite regulation, resulting in the so-called anorexia of aging, predispose older adults to a decrease in food intake which may lead to malnutrition, if additional risk factors like health or social problems occur. Consequently, malnutrition is widespread in the older population, notably in those who are institutionalized. Despite the fact that effective interventions are available, prevention and treatment of malnutrition do not currently receive appropriate attention. As an important first step towards better awareness, screening for malnutrition should become a mandatory integral part of the comprehensive geriatric assessment. Furthermore, practical local guidelines should be implemented in all geriatric hospital wards and nursing homes in order to improve nutritional care in the daily routine. Important to note is that reasonable nutritional management is not possible without qualified staff in adequate numbers allowing appropriate individual nutritional care. Regarding future research, studies at the cellular, metabolic and clinical levels and the linking of information from different research approaches are required to better understand the transition from good nutritional health and independence of old people to malnutrition, functional impairment and poor health. In parallel to well-designed observational and intervention studies, standardized documentation of nutritional information in daily routine would enable the uniform collection of data for research as well as for political decisions. In summary, the time is ripe for better inclusion of nutrition in geriatric health care. This will not only bring about improved nutritional status and outcome, and thus individual benefit for the affected person, but also economic benefits both for the institution and the health-care system. Copyright © 2013 S. Karger AG, Basel.

  9. Dual embedded agency: physicians implement integrative medicine in health-care organizations.

    PubMed

    Keshet, Yael

    2013-11-01

    The paradox of embedded agency addresses the question of how embedded agents are able to conceive of new ideas and practices and then implement them in institutionalized organizations if social structures exert so powerful an influence on behavior, and agents operate within a framework of institutional constraints. This article proposes that dual embedded agency may provide an explanation of the paradox. The article draws from an ethnographic study that examined the ways in which dual-trained physicians, namely medical doctors trained also in some modality of complementary and alternative medicine, integrate complementary and alternative medicine into the biomedical fortress of mainstream health-care organizations. Participant observations were conducted during the years 2006-2011. The observed physicians were found to be embedded in two diverse medical cultures and to have a hybrid professional identity that comprised two sets of health-care values. Seeking to introduce new ideas and practices associated with complementary and alternative medicine to medical institutions, they maneuvered among the constraints of institutional structures while using these very structures, in an isomorphic mode of action, as a platform for launching complementary and alternative medicine practices and values. They drew on the complementary and alternative medicine philosophical principle of interconnectedness and interdependency of seemingly polar opposites or contrary forces and acted to achieve change by means of nonadversarial strategies. By addressing the structure-agency dichotomy, this study contributes to the literature on change in institutionalized health-care organizations. It likewise contributes both theoretically and empirically to the study of integrative medicine and to the further development of this relatively new area of inquiry within the sociology of medicine.

  10. Practical recommendations to help students bridge the research-implementation gap and promote conservation.

    PubMed

    Pietri, Diana M; Gurney, Georgina G; Benitez-Vina, Nancy; Kuklok, Audrey; Maxwell, Sara M; Whiting, Libby; Vina, Michael A; Jenkins, Lekelia D

    2013-10-01

    Seasoned conservation researchers often struggle to bridge the research-implementation gap and promote the translation of their work into meaningful conservation actions. Graduate students face the same problems and must contend with obstacles such as limited opportunities for relevant interdisciplinary training and a lack of institutional support for application of research results. However, students also have a crucial set of opportunities (e.g., access to academic resources outside their degree programs and opportunities to design research projects promoting collaboration with stakeholders) at their disposal to address these problems. On the basis of results of breakout discussions at a symposium on the human dimensions of the ocean, a review of the literature, and our own experiences, we devised recommendations on how graduate students can create resources within their academic institutions, institutionalize resources, and engage with stakeholders to promote real-world conservation outcomes. Within their academic institutions, graduate students should foster links to practitioners and promote knowledge and skill sharing among students. To institutionalize resources, students should cultivate student leaders and faculty sponsors, systematically document their program activities, and engage in strategic planning to promote the sustainability of their efforts. While conducting research, students should create connections to and engage actively with stakeholders in their relevant study areas and disseminate research results both to stakeholders and the broader public. Our recommendations can serve as a template for graduate students wishing to bridge the research-implementation gap, both during their current studies and in their future careers as conservation researchers and practitioners. © 2013 Society for Conservation Biology.

  11. Advancing urban sustainability theory and action: Challenges and opportunities

    Treesearch

    Daniel L. Childers; Steward T.A. Pickett; J. Morgan Grove; Laura Ogden; Alison Whitmer

    2014-01-01

    Urban ecology and its theories are increasingly poised to contribute to urban sustainability, through both basic understanding and action. We present a conceptual framework that expands the Industrial → Sanitary → Sustainable City transition to include non-sanitary cities, "new cities", and various permutations of transition options for...

  12. The role of Caspar Bartholin the Elder in the evolution of the terminology of the cranial nerves.

    PubMed

    Porzionato, Andrea; Macchi, Veronica; De Caro, Raffaele

    2013-01-01

    In the 17th century, the Bartholin family contributed greatly to the advancement of anatomical and medical science. Caspar Bartholin the Elder (1585-1629) introduced the terms nervus olfactorius and nervus vagus in 1611 in the Institutiones Anatomicae. Thomas Bartholin (1616-1680) extended their use to figures added to later revised editions of Institutiones Anatomicae. Copyright © 2012 Elsevier GmbH. All rights reserved.

  13. Residential Academic-Year Programs for Prospective Unit Leaders, Building Principals, and Reading Staff Teachers in Multiunit Schools--Elementary. Report from the Project on Multiunit Schools--Elementary. Technical Report No. 267.

    ERIC Educational Resources Information Center

    Klausmeier, Herbert J.; Fruth, Marvin J.

    This technical report provides summary information and evaluation of the activities that were carried out in the institutionalization phase of the implementation of the Individually Guided Education (IGE) Project in the Multiunit School--Elementary (MUS-E). The institutionalization phase, the last of four, is defined as the introduction of IGE…

  14. Institutionalizing the Human Domain: Achieving Cross Domain Synergy for Every Day Missions

    DTIC Science & Technology

    2017-04-06

    AIR WAR COLLEGE AIR UNIVERSITY INSTITUTIONALIZING THE HUMAN DOMAIN: ACHIEVING CROSS DOMAIN SYNERGY FOR “EVERY DAY ” MISSIONS by...war. Next, this paper will focus on the importance of the Human Domain as it relates to success within every day missions of the U.S. Military and...socially complex environment. History demonstrates that the U.S. Military has and will continue to conduct these every day missions amongst the

  15. From institutionalization of user fees to their abolition in West Africa: a story of pilot projects and public policies

    PubMed Central

    2015-01-01

    This article analyzes the historical background of the institutionalization of user fees and their subsequent abolition in West Africa. Based on a narrative review, we present the context that frames the different articles in this supplement. We first show that a general consensus has emerged internationally against user fees, which were imposed widely in Africa in the 1980s and 1990s; at that time, the institutionalization of user fees was supported by evidence from pilot projects funded by international aid agencies. Since then there have been other pilot projects studying the abolition of user fees in the 2000s, but these have not yet had any real influence on public policies, which are often still chaotic. This perplexing situation might be explained more by ideologies and political will than by insufficient financial capacity of states. PMID:26559564

  16. A multicomponent exercise program for institutionalized older adults.

    PubMed

    Justine, Maria; Hamid, Tengku Aizan

    2010-10-01

    This study examined the effects of a multicomponent exercise program on depression and quality of life in institutionalized older adults. A quasi-experimental pretest-posttest design was used. Participants were recruited from a publicly funded shelter home in Seremban, Negeri Sembilan Malaysia. The experimental group consisted of 23 volunteers 60 or older who performed 60 minutes of supervised exercise three times per week for 12 weeks. The control group consisted of 20 volunteers who continued with a sedentary lifestyle. At 12 weeks, the exercise group demonstrated an improvement in quality of life by 10.74% (p > 0.05) but not depression (-1.6%, p > 0.05). The control group demonstrated a decrease in both quality of life by 11.26% (p > 0.05) and level of depression by 17.7% (p > 0.05). This study suggests a multicomponent exercise program is a feasible intervention to improve quality of life in institutionalized older adults. Copyright 2010, SLACK Incorporated.

  17. [Consequences of an institutionalized childhood: the case of the "Duplessis orphans"].

    PubMed

    Boucher, Sophie; Paré, Nikolas; Perry, J Christopher; Sigal, John J; Ouimet, Marie-Claude

    2008-01-01

    Whereas the immediate consequences of institutionalized placements on children have been documented, no study has investigated adults who were raised in orphanages or institutions. In Quebec, les enfants de Duplessis offer a unique testimony of the long term consequences of an institutionalized childhood. Stories collected from 40 men and 41 women who grew up in institution in Duplessis'era indicate a high number of abuse and aversive experiences, including physical, psychological and sexual aggressions. In addition, the environment was poor in stimulation and opportunities to develop positive attachment relationships with adults. When matched and compared to adults from the Santé-Québec survey, les enfants de Duplessis report a higher number of health problems associated with stress and more psychological distress. Moreover, our results indicate that those who had fewer strengths and aptitudes in childhood are the most affected by unfavourable experiences.

  18. A study of associations among attachment patterns, maltreatment, and behavior problem in institutionalized children in Japan.

    PubMed

    Katsurada, Emiko; Tanimukai, Mitsue; Akazawa, Junko

    2017-08-01

    The present study investigates the relationships among children's history of maltreatment, attachment patterns, and behavior problems in Japanese institutionalized children. Twenty-nine children (12 boys and 17 girls) from three different institutions in the Kinki area (Western part of Japan) participated in this study. Their average age was 6. 41-years (ranging from 4 to 10). Thirteen of the children (44.8%) had history of maltreatment before they were institutionalized. Children's attachment was assessed by the Attachment Doll Play Assessment (George & Solomon, 1990, 1996, 2000). The child's main caregiver answered the Child Behavior Checklist (CBCL; Archenbach, 1991) to identify children's behavior problems. Results indicated a significant relationship between maltreatment history and attachment pattern. The relationship between attachment pattern and behavior problem was also confirmed. Implications and limitations of this study were discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. [Institutionalized elderly: functional capacity and physical fitness].

    PubMed

    Gonçalves, Lúcia Hisako Takase; Silva, Aline Huber da; Mazo, Giovana Zarpsellon; Benedetti, Tânia R Bertoldo; dos Santos, Silvia Maria Azevedo; Marques, Sueli; Rodrigues, Rosalina A Partezani; Portella, Marilene Rodrigues; Scortegagna, Helenice de Moura; Santos, Silvana Sidney C; Pelzer, Marlene Teda; Souza, Andrea dos Santos; Meira, Edmeia Campos; Sena, Edite Lago da Silva; Creutzberg, Marion; Resende, Thais de Lima; Rezende, Tais de Lima

    2010-09-01

    This study analyzed the relationship between physical fitness and functional capacity in 78 residents of long-stay institutions for low-income elderly located in five regions of Brazil. The majority of the sample consisted of women, and mean age was 77.4 years (SD = 7.9). Physical fitness was assessed with the AAHPERD test, adjusted for institutionalized elderly. The Katz scale was used for functional capacity. The five components of physical fitness rated fair for flexibility, coordination, agility, and aerobic endurance and good for strength. The mean general physical fitness (GPF) index was fair. According to the findings, the greater the degree of dependency in institutionalized elderly, the lesser their strength and GPF level; meanwhile, better coordination and agility are associated with greater independence for performing activities of daily living. The results can contribute to appropriate physical exercise programs for maintenance and/or recovery of functionality.

  20. Power and ambivalence in intergenerational communication: Deciding to institutionalize in Shanghai.

    PubMed

    Chen, Lin

    2017-04-01

    China's tradition of taking care of one's aging parents continues to evolve, as evidenced by the growth in nursing home residents in Shanghai. However, how these families make the decision to institutionalize remains unclear. To fill this gap, this study draws on power relations to examine communication dynamics when oldest-old and their adult children decide to institutionalize. This study used a phenomenological approach. Twelve dyads of matched elderly residents and their children participated in face-to-face, in-depth interviews (N=24). The format and content of intergenerational communication indicated that both conflicts and compromises took place. Adult children achieved greater decision-making power than their frail parents, which evoked older adults' ambivalent feelings. A discrepancy in perceived filial piety between generations also emerged. These dynamics of caregiving decision-making offer insight in understanding evolving filial piety in urban China. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Conspiracy theories as quasi-religious mentality: an integrated account from cognitive science, social representations theory, and frame theory.

    PubMed

    Franks, Bradley; Bangerter, Adrian; Bauer, Martin W

    2013-01-01

    Conspiracy theories (CTs) can take many forms and vary widely in popularity, the intensity with which they are believed and their effects on individual and collective behavior. An integrated account of CTs thus needs to explain how they come to appeal to potential believers, how they spread from one person to the next via communication, and how they motivate collective action. We summarize these aspects under the labels of stick, spread, and action. We propose the quasi-religious hypothesis for CTs: drawing on cognitive science of religion, social representations theory, and frame theory. We use cognitive science of religion to describe the main features of the content of CTs that explain how they come to stick: CTs are quasi-religious representations in that their contents, forms and functions parallel those found in beliefs of institutionalized religions. However, CTs are quasi-religious in that CTs and the communities that support them, lack many of the institutional features of organized religions. We use social representations theory to explain how CTs spread as devices for making sense of sudden events that threaten existing worldviews. CTs allow laypersons to interpret such events by relating them to common sense, thereby defusing some of the anxiety that those events generate. We use frame theory to explain how some, but not all CTs mobilize collective counter-conspiratorial action by identifying a target and by proposing credible and concrete rationales for action. We specify our integrated account in 13 propositions.

  2. Conspiracy theories as quasi-religious mentality: an integrated account from cognitive science, social representations theory, and frame theory

    PubMed Central

    Franks, Bradley; Bangerter, Adrian; Bauer, Martin W.

    2013-01-01

    Conspiracy theories (CTs) can take many forms and vary widely in popularity, the intensity with which they are believed and their effects on individual and collective behavior. An integrated account of CTs thus needs to explain how they come to appeal to potential believers, how they spread from one person to the next via communication, and how they motivate collective action. We summarize these aspects under the labels of stick, spread, and action. We propose the quasi-religious hypothesis for CTs: drawing on cognitive science of religion, social representations theory, and frame theory. We use cognitive science of religion to describe the main features of the content of CTs that explain how they come to stick: CTs are quasi-religious representations in that their contents, forms and functions parallel those found in beliefs of institutionalized religions. However, CTs are quasi-religious in that CTs and the communities that support them, lack many of the institutional features of organized religions. We use social representations theory to explain how CTs spread as devices for making sense of sudden events that threaten existing worldviews. CTs allow laypersons to interpret such events by relating them to common sense, thereby defusing some of the anxiety that those events generate. We use frame theory to explain how some, but not all CTs mobilize collective counter-conspiratorial action by identifying a target and by proposing credible and concrete rationales for action. We specify our integrated account in 13 propositions. PMID:23882235

  3. Plasma zinc in institutionalized elderly individuals: Relation with immune and cardiometabolic biomarkers.

    PubMed

    Sales, Márcia Cristina; de Oliveira, Larissa Praça; de Araújo Cabral, Natalia Louise; de Sousa, Sara Estéfani Soares; das Graças Almeida, Maria; Lemos, Telma Maria Araújo Moura; de Oliveira Lyra, Clélia; de Lima, Kenio Costa; Sena-Evangelista, Karine Cavalcanti Mauricio; de Fatima Campos Pedrosa, Lucia

    2018-04-24

    Changes in zinc metabolism caused by aging and the institutionalization process may contribute to zinc deficiency in elderly individuals. Hypozincemia results in changes in glycemic, lipid, and inflammatory profiles. The aim of this study was to evaluate plasma zinc concentrations and their relationships with sociodemographic, dietary, inflammatory, and cardiometabolic biomarkers in institutionalized elderly individuals. A cross-sectional study was carried out including 255 elderly adults living in nursing homes. The associations between plasma zinc and dietary zinc intake, sociodemographic indicators, and glycemic, lipid, and inflammatory biomarkers were evaluated. Independent variables were analyzed according to quartiles of plasma zinc concentrations (Q1: <71.1 μg/dL; Q2: 71.1-83.3 μg/dL; Q3: <83.3-93.7 μg/dL; Q4: >93.7 μg/dL). The relationship between plasma zinc concentrations and predictor variables was also tested. In Q1, higher concentrations of the following variables were observed, compared with those in other quartiles: total cholesterol and low-density lipoprotein cholesterol (LDL-c; Q1 > Q2, Q3, Q4; all p <0.001); triglycerides (Q1 > Q3, Q4; all p < 0.001); interleukin (IL)-6 (Q1 > Q3, Q4; p = 0.024 and p = 0.010, respectively); tumor necrosis factor (TNF)-α (Q1 > Q3, p = 0.003). A significant reduction in plasma zinc concentrations was observed with increasing age-adjusted institutionalization time (Δ = - 0.10; 95% confidence interval [CI]: -0.18 to -0.01). The concentrations of total cholesterol (Δ = - 0.19; 95% CI: -0.23 to -0.15), LDL-c (Δ = - 0.19; 95% CI: -0.23 to -0.15), triglycerides (Δ = - 0.11; 95% CI: -0.16 to -0.06), IL-6 (Δ = - 1.41; 95% CI: -2.64 to -0.18), and TNF-α (Δ = - 1.04; 95% CI: -1.71 to -0.36) were also significantly increased. In conclusion, decreased plasma zinc concentrations were associated with longer institutionalization time and worse lipid and inflammatory profiles in elderly institutionalized individuals. Published by Elsevier GmbH.

  4. 76 FR 30997 - National Transit Database: Amendments to Urbanized Area Annual Reporting Manual

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... Transit Database: Amendments to Urbanized Area Annual Reporting Manual AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice of Amendments to 2011 National Transit Database Urbanized Area Annual... Administration's (FTA) 2011 National Transit Database (NTD) Urbanized Area Annual Reporting Manual (Annual Manual...

  5. High School to College Transition among Black Males: An Action Research Project

    ERIC Educational Resources Information Center

    Jewett, Orval Albert

    2017-01-01

    A participatory action research project involving social workers as stakeholders from high schools and the local community college in Nassau County, New York, provided the basis for an inquiry that addressed the effectiveness and implementation of clinical social work practice with Black male students transitioning to community college from high…

  6. Facilitating Systemic Research and Learning and the Transition to Agricultural Sustainability

    ERIC Educational Resources Information Center

    Eksvard, Karin

    2010-01-01

    This article focuses on how a facilitated process of triple loop learning can enable transition toward more sustainable forms of farming. The article is a case-based study of Participatory Learning and Action Research with organic tomato growers in Malardalen, Sweden. The importance of negotiating learning and action, capacity building, and…

  7. A Process for Transition to Sustainability: Implementation

    ERIC Educational Resources Information Center

    Wooltorton, Sandra; Palmer, Marilyn; Steele, Fran

    2011-01-01

    This paper reports the outcomes of the second action cycle of an ongoing project at Edith Cowan University (ECU) called "Transition to Sustainability: ECU South West" which is located in a small, single faculty regional university campus. The overall project has comprised three action research cycles, the first of which was the planning…

  8. Project ASSIST: Action Strategies for Implementing Social Transition.

    ERIC Educational Resources Information Center

    Urban League of Greater New Orleans, LA.

    Project ASSIST (Action Strategies for Implementing Social Transition) is an attempt to assess the needs, concerns, problems, strengths, and preferences of low income area residents within the city of New Orleans by developing primary based data. This report presents the findings of two major surveys, in which 1,306 households in eight low income…

  9. Pacific Armies Management Seminar IV, Held at Honolulu, Hawaii, on 3-7 November 1980. Addendum to Final Report.

    DTIC Science & Technology

    1980-11-07

    qualifications, stepped in to fill the shoes of mentors for the less privileged and this program was later institutionalized as the Army literacy ...program was later institutionalized as the Army literacy patrol program. Conclusion The acceptance of a "protracted struggle" and the commitment of the...other administrative officials can all provide informacion about known or suspected insurgents, organizations, and plans. The intelligence officer does

  10. Innovation by coercion: Emerging institutionalization of university-industry collaborations in Russia.

    PubMed

    Bychkova, Olga

    2016-08-01

    This article explores the emerging institutionalization of collaborative university-industry networks in Russia. The Russian government has attempted to use a top-down public policy scheme to stimulate and promote network-building in the R&D sector. In order to understand the initial organizational responses that universities and companies select while structuring collaborations, the article utilizes conceptual perspectives from institutional theory, especially drawing on arguments from strategic choice, network-building, and network failure studies.

  11. The origins of scientific psychology in Spain: the process of institutionalization.

    PubMed

    Lafuente, Enrique

    2006-01-01

    The development of psychological science in Spain, as in other countries, was closely associated with the creation of institutions that sheltered and promoted its activities. Contrary to the case of German psychology, however, whose origins have been usefully epitomized by the foundation of Wundt's laboratory in Leipzig, no single institutional event can similarly be properly said to mark the beginning of Spanish scientific psychology. The institutionalization of modern psychology in Spain was instead a long, eventful process, often hindered by political uneasiness, difficult social conditions, and ideological confrontation. In this paper, the institutionalizing process of Spanish scientific psychology will be dealt with, from the beginning of the Restoration period in the last quarter of the nineteenth century, to the early decades of the twentieth century. Three crucial stages will be distinguished. Firstly, the reception of psychological ideas through "protopsychological"--or, at least, not specifically psychological--institutions. Secondly, the attempt at institutionalizing psychological training at the university through the creation of a Chair of Experimental Psychology at the University of Madrid in 1900. Thirdly, the expansion of psychology as an applied science through numerous institutions specifically devised to deal with practical problems of a basically educational and industrial nature. The Civil War prevented the final consolidation of this process, which only years later, in the second half of the twentieth century, could be reinitiated and completed.

  12. Toward human resource management in inter-professional health practice: linking organizational culture, group identity and individual autonomy.

    PubMed

    Tataw, David

    2012-01-01

    The literature on team and inter-professional care practice describes numerous barriers to the institutionalization of inter-professional healthcare. Responses to slow institutionalization of inter-professional healthcare practice have failed to describe change variables and to identify change agents relevant to inter-professional healthcare practice. The purpose of this paper is to (1) describe individual and organizational level barriers to collaborative practice in healthcare; (2) identify change variables relevant to the institutionalization of inter-professional practice at individual and organizational levels of analysis; and (3) identify human resource professionals as change agents and describe how the strategic use of the human resource function could transform individual and organizational level change variables and therefore facilitate the healthcare system's shift toward inter-professional practice. A proposed program of institutionalization includes the following components: a strategic plan to align human resource functions with organizational level inter-professional healthcare strategies, activities to enhance professional competencies and the organizational position of human resource personnel, activities to integrate inter-professional healthcare practices into the daily routines of institutional and individual providers, activities to stand up health provider champions as permanent leaders of inter-professional teams with human resource professionals as consultants and activities to bring all key players to the table including health providers. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Psychiatry and Military Conscription in Brazil: The Search for Opportunity and Institutionalized Therapy

    PubMed Central

    Béhague, Dominique Pareja

    2010-01-01

    Since the fall of the Brazilian military dictatorship in 1984, a number of structural and ideological changes associated with demilitarization and democracy have changed the face of psychiatric theory and practice. Around the country, pockets of innovative, politically sensitive and Marxist-inspired community-based forms of “psi” practice are developing. This emergent psi movement is making a range of positive contributions to the lives of average citizens, including those of poor disenfranchized youth. This paper, however, explores one particular dimension of the work of psi practitioners that has proven antithetical to the psi community’s current politicized community-based aims. Based on qualitative and quantitative longitudinal ethnographic fieldwork with therapists and young men in Pelotas, this paper analyzes how certain kinds of psi interventions being carried out in schools for a subset of lower-class young men during their early teen years are encouraging some youth to seek military training as a life option. Although these young men initially had quite captivating, engaged and politicized—if also conflicting—interactions with therapists, their eventual disillusionment with their therapeutic and scholastic experiences resulted in high levels of social alienation and depoliticization. In these young men’s search for what can best be described as formulaic solutions to troubling psychological experiences associated with a tumultuous institutionalized transition to adulthood, military training came to represent a form of self-cultivation and self-therapy. Several youth also hoped military training would enable them to actively disengage with local political processes and find shelter from troubling social inequities and injustice. The paper ends by reviewing the implications of these results for the future of psi knowledge and practice in Brazil. PMID:18347961

  14. Lamont-Doherty's Secondary School Field Research Program: Institutionalizing outreach to secondary school students at a soft-money research institute

    NASA Astrophysics Data System (ADS)

    Sambrotto, R.

    2015-12-01

    The Secondary School Field Research Program is a field and laboratory internship for high school students at the Lamont-Doherty Earth Observatory. Over the past 11 years it has grown into a significant program, engaging approximately 50 high school and college students each summer, most of them from ethnic and economic groups that are under-represented in the STEM fields. The internships are based on research-driven science questions on estuarine physics, chemistry, ecology and the paleo-environment. Field studies are linked to associated laboratory analyses whose results are reported by the students as a final project. For the past two years, we have focused on the transition to an institutional program, with sustainable funding and organizational structures. At a grant-driven institution whose mission is largely restricted to basic research, institutionalization has not been an easy task. To leverage scarce resources we have implemented a layered structure that relies on near-peer mentoring. So a typical research team might include a mix of new and more experienced high school students, a college student, a high school science teacher and a Lamont researcher as a mentor. Graduates of the program are employed to assist with administration. Knowledge and best practices diffuse through the organization in an organic, if not entirely structured, fashion. We have found that a key to long-term funding has been survival: as we have sustained a successful program and developed a model adapted to Lamont's unique environment, we have attracted longer term core financing on which grant-driven extensions can be built. The result is a highly flexible program that is student-centered in the context of a broader research culture connecting our participants with the advantages of working at a premier soft-money research institution.

  15. Psychiatry and military conscription in Brazil: the search for opportunity and institutionalized therapy.

    PubMed

    Béhague, Dominique Pareja

    2008-06-01

    Since the fall of the Brazilian military dictatorship in 1984, a number of structural and ideological changes associated with demilitarization and democracy have changed the face of psychiatric theory and practice. Around the country, pockets of innovative, politically sensitive and Marxist-inspired community-based forms of "psi" practice are developing. This emergent psi movement is making a range of positive contributions to the lives of average citizens, including those of poor disenfranchized youth. This paper, however, explores one particular dimension of the work of psi practitioners that has proven antithetical to the psi community's current politicized community-based aims. Based on qualitative and quantitative longitudinal ethnographic fieldwork with therapists and young men in Pelotas, this paper analyzes how certain kinds of psi interventions being carried out in schools for a subset of lower-class young men during their early teen years are encouraging some youth to seek military training as a life option. Although these young men initially had quite captivating, engaged and politicized-if also conflicting-interactions with therapists, their eventual disillusionment with their therapeutic and scholastic experiences resulted in high levels of social alienation and de-politicization. In these young men's search for what can best be described as formulaic solutions to troubling psychological experiences associated with a tumultuous institutionalized transition to adulthood, military training came to represent a form of self-cultivation and self-therapy. Several youth also hoped military training would enable them to actively disengage with local political processes and find shelter from troubling social inequities and injustice. The paper ends by reviewing the implications of these results for the future of psi knowledge and practice in Brazil.

  16. Fluor Hanford (FH) River Corridor Transition Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MCBRIDE, D.J.

    2002-08-28

    This Transition Plan defines the scope and schedule for actions that are critical for a smooth transition of the River Corridor scope of work and to ensure the achievement of transition as planned, with minimal or no impact to ongoing baseline activities.

  17. Transition from an open-plan to a two-cot neonatal intensive care unit: a participatory action research approach.

    PubMed

    Broom, Margaret; Gardner, Anne; Kecskes, Zsuzsoka; Kildea, Sue

    2017-07-01

    To facilitate staff transition from an open-plan to a two-cot neonatal intensive care unit design. In 2012, an Australian regional neonatal intensive care unit transitioned from an open-plan to a two-cot neonatal intensive care unit design. Research has reported single- and small-room neonatal intensive care unit design may negatively impact on the distances nurses walk, reducing the time they spend providing direct neonatal care. Studies have also reported nurses feel isolated and need additional support and education in such neonatal intensive care units. Staff highlighted their concerns regarding the impact of the new design on workflow and clinical practice. A participatory action research approach. A participatory action group titled the Change and Networking Group collaborated with staff over a four-year period (2009-2013) to facilitate the transition. The Change and Networking Group used a collaborative, cyclical process of planning, gathering data, taking action and reviewing the results to plan the next action. Data sources included meeting and workshop minutes, newsletters, feedback boards, subgroup reports and a staff satisfaction survey. The study findings include a description of (1) how the participatory action research cycles were used by the Change and Networking Group: providing examples of projects and strategies undertaken; and (2) evaluations of participatory action research methodology and Group by neonatal intensive care unit staff and Change and Networking members. This study has described the benefits of using participatory action research to facilitate staff transition from an open-plan to a two-cot neonatal intensive care unit design. Participatory action research methodology enabled the inclusion of staff to find solutions to design and clinical practice questions. Future research is required to assess the long-term effect of neonatal intensive care unit design on staff workload, maintaining and supporting a skilled workforce as well as the impact of a new neonatal intensive care unit design on the neonatal intensive care unit culture. A supportive work environment for staff is critical in providing high-quality health care. © 2016 John Wiley & Sons Ltd.

  18. Institutionalizing community-focused maternal, newborn, and child health strategies to strengthen health systems: A new framework for the Sustainable Development Goal era.

    PubMed

    Story, William T; LeBan, Karen; Altobelli, Laura C; Gebrian, Bette; Hossain, Jahangir; Lewis, Judy; Morrow, Melanie; Nielsen, Jennifer N; Rosales, Alfonso; Rubardt, Marcie; Shanklin, David; Weiss, Jennifer

    2017-06-26

    Stronger health systems, with an emphasis on community-based primary health care, are required to help accelerate the pace of ending preventable maternal and child deaths as well as contribute to the achievement of the Sustainable Development Goals (SDGs). The success of the SDGs will require unprecedented coordination across sectors, including partnerships between public, private, and non-governmental organizations (NGOs). To date, little attention has been paid to the distinct ways in which NGOs (both international and local) can partner with existing national government health systems to institutionalize community health strategies. In this paper, we propose a new conceptual framework that depicts three primary pathways through which NGOs can contribute to the institutionalization of community-focused maternal, newborn, and child health (MNCH) strategies to strengthen health systems at the district, national or global level. To illustrate the practical application of these three pathways, we present six illustrative cases from multiple NGOs and discuss the primary drivers of institutional change. In the first pathway, "learning for leverage," NGOs demonstrate the effectiveness of new innovations that can stimulate changes in the health system through adaptation of research into policy and practice. In the second pathway, "thought leadership," NGOs disseminate lessons learned to public and private partners through training, information sharing and collaborative learning. In the third pathway, "joint venturing," NGOs work in partnership with the government health system to demonstrate the efficacy of a project and use their collective voice to help guide decision-makers. In addition to these pathways, we present six key drivers that are critical for successful institutionalization: strategic responsiveness to national health priorities, partnership with policymakers and other stakeholders, community ownership and involvement, monitoring and use of data, diversification of financial resources, and longevity of efforts. With additional research, we propose that this framework can contribute to program planning and policy making of donors, governments, and the NGO community in the institutionalization of community health strategies.

  19. Attachment security as a mechanism linking foster care placement to improved mental health outcomes in previously institutionalized children

    PubMed Central

    McLaughlin, Katie A.; Zeanah, Charles H.; Fox, Nathan A.; Nelson, Charles A.

    2011-01-01

    Background Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC and evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. Methods A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n=68) or to care as usual (CAU; n=68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Results Girls in FC had fewer internalizing disorders than girls in CAU (OR=0.17, p=006). The intervention had no effect on internalizing disorders in boys (OR=0.47, p=.150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR=12.5, p<.001), but no difference was observed in boys (OR=2.0, p=.205). Greater attachment security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Conclusion Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization. PMID:21733136

  20. What drives young children to over-imitate? Investigating the effects of age, context, action type, and transitivity.

    PubMed

    Clay, Zanna; Over, Harriet; Tennie, Claudio

    2018-02-01

    Imitation underlies many traits thought to characterize our species, which includes the transmission and acquisition of language, material culture, norms, rituals, and conventions. From early childhood, humans show an intriguing willingness to imitate behaviors, even those that have no obvious function. This phenomenon, known as "over-imitation," is thought to explain some of the key differences between human cultures as compared with those of nonhuman animals. Here, we used a single integrative paradigm to simultaneously investigate several key factors proposed to shape children's over-imitation: age, context, transitivity, and action type. We compared typically developing children aged 4-6years in a task involving actions verbally framed as being instrumental, normative, or communicative in function. Within these contexts, we explored whether children were more likely to over-imitate transitive versus intransitive actions and manual versus body part actions. Results showed an interaction between age and context; as children got older, they were more likely to imitate within a normative context, whereas younger children were more likely to imitate in instrumental contexts. Younger children were more likely to imitate transitive actions (actions on objects) than intransitive actions compared with older children. Our results show that children are highly sensitive to even minimal cues to perceived context and flexibly adapt their imitation accordingly. As they get older, children's imitation appears to become less object bound, less focused on instrumental outcomes, and more sensitive to normative cues. This shift is consistent with the proposal that over-imitation becomes increasingly social in its function as children move through childhood and beyond. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Partnership Bound: Using MAPS with Transitioning Students and Families from All Backgrounds

    ERIC Educational Resources Information Center

    Haines, Shana J.; Francis, Grace L.; Shepherd, Katharine G.; Ziegler, Meg; Mabika, Goma

    2018-01-01

    The McGill Action Planning System (also referred to as Making Action Plans or MAPS) is a supportive, strengths-based process that enables teams to understand each other and work together to support students in achieving their dreams. This process can work very well with all transitioning students with disabilities and their families, including…

  2. The Role of Law in Adaptive Governance | Science Inventory ...

    EPA Pesticide Factsheets

    The term “governance” encompasses both governmental and nongovernmental participation in collective choice and action. Law dictates the structure, boundaries, rules, and processes within which governmental action takes place, and in doing so becomes one of the focal points for analysis of barriers to adaptation as the effects of climate change are felt. Adaptive governance must therefore contemplate a level of flexibility and evolution in governmental action beyond that currently found in the heavily administrative governments of many democracies. Nevertheless, over time, law itself has proven highly adaptive in western systems of government, evolving to address and even facilitate the emergence of new social norms (such as the rights of women and minorities) or to provide remedies for emerging problems (such as pollution). Thus, there is no question that law can adapt, evolve, and be reformed to make room for adaptive governance. In doing this, not only may barriers be removed, but law may be adjusted to facilitate adaptive governance and to aid in institutionalizing new and emerging approaches to governance. The key is to do so in a way that also enhances legitimacy, accountability, and justice, or else such reforms will never be adopted by democratic societies, or if adopted, will destabilize those societies. By identifying those aspects of the frameworks for adaptive governance reviewed in the introduction to this special feature relevant to the legal sy

  3. A Tale of Two Trails: Exploring Different Paths to Success

    PubMed Central

    Walker, Jennifer G.; Evenson, Kelly R.; Davis, William J.; Bors, Philip; Rodríguez, Daniel A.

    2016-01-01

    Background This comparative case study investigates 2 successful community trail initiatives, using the Active Living By Design (ALBD) Community Action Model as an analytical framework. The model includes 5 strategies: preparation, promotion, programs, policy, and physical projects. Methods Key stakeholders at 2 sites participated in in-depth interviews (N = 14). Data were analyzed for content using Atlas Ti and grouped according to the 5 strategies. Results Preparation Securing trail resources was challenging, but shared responsibilities facilitated trail development. Promotions The initiatives demonstrated minimal physical activity encouragement strategies. Programs Community stakeholders did not coordinate programmatic opportunities for routine physical activity. Policy Trails’ inclusion in regional greenway master plans contributed to trail funding and development. Policies that were formally institutionalized and enforced led to more consistent trail construction and safer conditions for users. Physical Projects Consistent standards for way finding signage and design safety features enhanced trail usability and safety. Conclusions Communities with different levels of government support contributed unique lessons to inform best practices of trail initiatives. This study revealed a disparity between trail development and use-encouragement strategies, which may limit trails’ impact on physical activity. The ALBD Community Action Model provided a viable framework to structure cross-disciplinary community trail initiatives. PMID:21597125

  4. Oral condition and its relationship to nutritional status in the institutionalized elderly population.

    PubMed

    Rauen, Michelle Soares; Moreira, Emília Addison Machado; Calvo, Maria Cristina Marino; Lobo, Adriana Soares

    2006-07-01

    The objective of this study was to identify the relationship between the oral condition and nutritional status of all institutionalized elderly people in Florianópolis, Brazil. Of the population of 232 institutionalized individuals, the sample consisted of 187 elderly people. In the oral evaluation, the criteria used was the number of functional units present in the oral cavity, classifying the participants as those with highly compromised dentition (48%) and those with less-compromised dentition (52%). Diagnosis of nutritional status was carried out according to body mass index, observing a prevalence of 14% thin, 45% eutrophic, 28% overweight, and 13% obese. Statistical analysis of the variables studied was carried out by means of chi(2) association tests. There was a statistically significant association between highly compromised dentition and thinness (P=0.007) and among those who presented less-compromised dentition and the nutritional status of overweight, including obesity (P=0.014). It was concluded that compromising of the teeth could contribute to a tendency toward inadequate nutritional status.

  5. Sustainability of the prevention of passive infant smoking within well-baby clinics.

    PubMed

    Crone, M R; Verlaan, M; Willemsen, M C; van Soelen, P; Reijneveld, S A; Sing, R A Hira; Paulussen, T G W M

    2006-04-01

    This study assessed the antecedents of continued use of an education program to prevent passive smoking in infants. It consists of a booklet for parents and a manual for health professionals describing a five-step procedure for discussing passive smoking. A questionnaire was sent to 67 managers, 670 nurses, and 335 physicians working in well-baby clinics (response rate: 70%, 53%, 47% respectively). Questions concerned the completeness of use, level of institutionalization, and characteristics of the organization, the user, and the dissemination strategy. Seventy-one percent of nurses and 42% of physicians worked with the program. They foremost provided the first three steps of the five-step procedure. Physicians' completeness of use was related to their perceived responsibility in providing this education, and nurses' use was related to their perceived self-efficacy, responsibility, training attendance, participation in the adoption decision, and level of institutionalization. Diffusion efforts should focus on improving the completeness of use and level of institutionalization.

  6. Chronic conditions and medical expenditures among non-institutionalized adults in the United States.

    PubMed

    Lee, De-Chih; Shi, Leiyu; Pierre, Geraldine; Zhu, Jinsheng; Hu, Ruwei

    2014-11-26

    This study sought to examine medical expenditures among non-institutionalized adults in the United States with one or more chronic conditions. Using data from the 2010 Medical Expenditure Panel Survey (MEPS) Household Component (HC), we explored total and out-of-pocket medical, hospital, physician office, and prescription drug expenditures for non-institutionalized adults 18 and older with and without chronic conditions. We examined relationships between expenditure differences and predisposing, enabling, and need factors using recent, nationally representative data. Individuals with chronic conditions experienced higher total spending than those with no chronic conditions, even after controlling for confounding factors. This relationship persisted with age. Out-of-pocket spending trends mirrored total expenditure trends across health care categories. Additional population characteristics that were associated with high health care expenditures were race/ethnicity, marital status, insurance status, and education. The high costs associated with having one or more chronic conditions indicates a need for more robust interventions to target population groups who are most at risk.

  7. Roles of attachment and self-esteem: impact of early life stress on depressive symptoms among Japanese institutionalized children.

    PubMed

    Suzuki, Hanako; Tomoda, Akemi

    2015-02-05

    Although exposure to early life stress is known to affect mental health, the underlying mechanisms of its impacts on depressive symptoms among institutionalized children and adolescents have been little studied. To investigate the role of attachment and self-esteem in association with adverse childhood experiences (ACEs) and depressive symptoms, 342 children (149 boys, 193 girls; age range 9-18 years old, mean age = 13.5 ± 2.4) living in residential foster care facilities in Japan completed questionnaires related to internal working models, self-esteem, and depressive symptoms. Their care workers completed questionnaires on ACEs. Structural equation modeling (SEM) was created and the goodness of fit was examined (CMIN = 129.223, df = 1.360, GFI = .959, AGFI = .936, CFI = .939, RMSEA = .033). Maltreatment negatively predicted scores on secure attachment, but positively predicted scores on avoidant and ambivalent attachment. The secure attachment score negatively predicted depressive symptoms. The ambivalent attachment score positively predicted depressive symptoms both directly and through self-esteem, whereas the avoidant attachment score positively predicted depressive symptoms only directly. Maltreatment neither directly predicts self-esteem nor depressive symptoms, and parental illness/death and parental sociopathic behaviors did not predict any variables. Results show that the adversity of child maltreatment affects depression through attachment styles and low self-esteem among institutionalized children. Implications of child maltreatment and recommendations for child welfare services and clinical interventions for institutionalized children are discussed.

  8. The effect of cognitive-motor dual task training with the biorescue force platform on cognition, balance and dual task performance in institutionalized older adults: a randomized controlled trial

    PubMed Central

    Delbroek, Tom; Vermeylen, Wietse; Spildooren, Joke

    2017-01-01

    [Purpose] This study investigates whether cognition, balance and dual task performance in institutionalized older adults improves by a virtual reality dual task training. [Subjects and Methods] Randomized controlled trial; Twenty institutionalized older adults with mild cognitive impairment (13 female, 7 male; average age, 87.2 ± 5.96 years) were randomized to the intervention (i.e. Virtual reality dual-task training using the BioRescue) or control group (no additional training). The intervention group took part in a 6-week training program while the elderly in the control group maintained their daily activities. Balance was measured with the Instrumented Timed Up-and-Go Test with and without a cognitive task. The Observed Emotion Rating Scale and Intrinsic Motivation Inventory were administered to evaluate the emotions and motivation regarding the exergaming program. [Results] The intervention group improved significantly on the total Timed Up-and-Go duration and the turn-to-sit duration during single-task walking in comparison to the control group who received no additional training. Participants found the virtual reality dual task training pleasant and useful for their concentration, memory and balance. Pleasure and alertness were the two emotions which were mostly seen during the intervention. [Conclusion] The BioRescue is a pleasant and interesting treatment method, well suited for institutionalized older adults in need of lifelong physical therapy. PMID:28744033

  9. Emotional intelligence and depressive symptoms in Spanish institutionalized elders: does emotional self-efficacy act as a mediator?

    PubMed Central

    2016-01-01

    Background. This work examines the relationship between emotional intelligence (EI) and depressive symptomatology in institutionalized older adults, delving into the mechanisms underlying this relationship. Considering that previous evidence of the variation of the EI-depression relationship depending on whether the emotional ability or the perception of that ability is evaluated, a model of multiple mediation was tested in which the dimensions of emotional self-efficacy (ESE) act as mediators in the relationship between ability EI and depressive symptomatology. Methods. The sample consisted of 115 institutionalized older adults (47.82% women; 80.3 ± 7.9 years of age) from the province of Jaén (Spain) who completed a test of ESE, a measure of ability EI, and a self-administered questionnaire of depressive symptoms. Results. The results showed a positive association between older adults’ emotional performance and depressive symptomatology, finding stronger associations with ESE than with EI abilities. In addition, multiple mediation analyses showed that two of the four dimensions of ESE fully mediated the relationship between ability EI and depressive symptoms. Discussion. These findings suggest that older adults’ high levels of emotional competence generate a feeling of ESE which can protect them against depressive symptoms. This work supports the predictive validity of emotional abilities and ESE for the mental health of a group that is particularly vulnerable to depression, institutionalized older adults. The limitations of the work are discussed, and future lines of research were considered. PMID:27547553

  10. The challenge of sustaining effectiveness over time: the case of the global network to stop tuberculosis

    PubMed Central

    Quissell, Kathryn; Walt, Gill

    2016-01-01

    Where once global health decisions were largely the domain of national governments and the World Health Organization, today networks of international organizations, governments, private philanthropies and other entities are actively shaping public policy. However, there is still limited understanding of how global networks form, how they create institutions, how they promote and sustain collective action, and how they adapt to changes in the policy environment. Understanding these processes is crucial to understanding their effectiveness: whether and how global networks influence policy and public health outcomes. This study seeks to address these gaps through the examination of the global network to stop tuberculosis (TB) and the factors influencing its effectiveness over time. Drawing from ∼200 document sources and 16 interviews with key informants, we trace the development of the Global Partnership to Stop TB and its work over the past decade. We find that having a centralized core group and a strategic brand helped the network to coalesce around a primary intervention strategy, directly observed treatment short course. This strategy was created before the network was formalized, and helped bring in donors, ministries of health and other organizations committed to fighting TB—growing the network. Adaptations to this strategy, the creation of a consensus-based Global Plan, and the creation of a variety of participatory venues for discussion, helped to expand and sustain the network. Presently, however, tensions have become more apparent within the network as it struggles with changing internal political dynamics and the evolution of the disease. While centralization and stability helped to launch and grow the network, the institutionalization of governance and strategy may have constrained adaptation. Institutionalization and centralization may, therefore, facilitate short-term success for networks, but may end up complicating longer-term effectiveness. PMID:26282859

  11. Minimum Action Path Theory Reveals the Details of Stochastic Transitions Out of Oscillatory States

    NASA Astrophysics Data System (ADS)

    de la Cruz, Roberto; Perez-Carrasco, Ruben; Guerrero, Pilar; Alarcon, Tomas; Page, Karen M.

    2018-03-01

    Cell state determination is the outcome of intrinsically stochastic biochemical reactions. Transitions between such states are studied as noise-driven escape problems in the chemical species space. Escape can occur via multiple possible multidimensional paths, with probabilities depending nonlocally on the noise. Here we characterize the escape from an oscillatory biochemical state by minimizing the Freidlin-Wentzell action, deriving from it the stochastic spiral exit path from the limit cycle. We also use the minimized action to infer the escape time probability density function.

  12. Minimum Action Path Theory Reveals the Details of Stochastic Transitions Out of Oscillatory States.

    PubMed

    de la Cruz, Roberto; Perez-Carrasco, Ruben; Guerrero, Pilar; Alarcon, Tomas; Page, Karen M

    2018-03-23

    Cell state determination is the outcome of intrinsically stochastic biochemical reactions. Transitions between such states are studied as noise-driven escape problems in the chemical species space. Escape can occur via multiple possible multidimensional paths, with probabilities depending nonlocally on the noise. Here we characterize the escape from an oscillatory biochemical state by minimizing the Freidlin-Wentzell action, deriving from it the stochastic spiral exit path from the limit cycle. We also use the minimized action to infer the escape time probability density function.

  13. An Even Distribution of Protein Intake Daily Promotes Protein Adequacy but Does Not Influence Nutritional Status in Institutionalized Elderly.

    PubMed

    Tieland, Michael; Beelen, Janne; Laan, Anna C M; Poon, Shirley; de Groot, Lisette C P G M; Seeman, Ego; Wang, Xiaofang; Iuliano, Sandra

    2018-01-01

    Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of malnutrition. Therefore, we aim to determine the association between protein intake distribution and nutritional status in institutionalized elderly people. Cross-sectional study among 481 institutionalized older adults. Dietary data from 481 ambulant elderly people (68.8% female, mean age 87.5 ± 6.3 years) residing in 52 aged-care facilities in Victoria, Australia, were assessed over 2 days using plate waste analysis. Nutritional status was determined using the Mini-Nutritional Assessment tool and serum (n = 208) analyzed for albumin, hemoglobin, and IGF-1. Protein intake distribution was classified as: spread (even distribution across 3 meals, n = 65), pulse (most protein consumed in one meal, n = 72) or intermediate (n = 344). Regression analysis was used to investigate associations. Mean protein intakes were higher in the spread (60.5 ± 2.0 g/d) than intermediate group (56.0 ± 0.8 g/d, P = .037), and tended to be higher than those in the pulse group (55.9 ± 1.9 g/d, P = .097). Residents with an even distribution of protein intake achieved a higher level of the recommended daily intake for protein (96.2 ± 30.0%) than the intermediate (86.3 ± 26.2%, P = .008) and pulse (87.4 ± 30.5%, P = .06) groups, and also achieved a greater level of their estimated energy requirements (intermediate; P = .039, pulse; P = .001). Nutritional status (Mini-Nutritional Assessment score) did not differ between groups (pulse; 20.5 ± 4.5, intermediate; 21.0 ± 2.5, spread; 20.5 ± 3.5), nor did any other indices of nutritional status. Meeting protein requirements is required before protein distribution may influence nutritional status in institutionalized elderly. Achieving adequate protein and energy intakes is more likely when protein is distributed evenly throughout the day. Provision of high protein foods especially at breakfast, and in the evening, may support protein adequacy and healthy aging, especially for institutionalized elderly. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. The role of law in adaptive governance.

    PubMed

    Cosens, Barbara A; Craig, Robin K; Hirsch, Shana Lee; Arnold, Craig Anthony Tony; Benson, Melinda H; DeCaro, Daniel A; Garmestani, Ahjond S; Gosnell, Hannah; Ruhl, J B; Schlager, Edella

    2017-03-01

    The term "governance" encompasses both governmental and nongovernmental participation in collective choice and action. Law dictates the structure, boundaries, rules, and processes within which governmental action takes place, and in doing so becomes one of the focal points for analysis of barriers to adaptation as the effects of climate change are felt. Adaptive governance must therefore contemplate a level of flexibility and evolution in governmental action beyond that currently found in the heavily administrative governments of many democracies. Nevertheless, over time, law itself has proven highly adaptive in western systems of government, evolving to address and even facilitate the emergence of new social norms (such as the rights of women and minorities) or to provide remedies for emerging problems (such as pollution). Thus, there is no question that law can adapt, evolve, and be reformed to make room for adaptive governance. In doing this, not only may barriers be removed, but law may be adjusted to facilitate adaptive governance and to aid in institutionalizing new and emerging approaches to governance. The key is to do so in a way that also enhances legitimacy, accountability, and justice, or else such reforms will never be adopted by democratic societies, or if adopted, will destabilize those societies. By identifying those aspects of the frameworks for adaptive governance reviewed in the introduction to this special feature relevant to the legal system, we present guidelines for evaluating the role of law in environmental governance to identify the ways in which law can be used, adapted, and reformed to facilitate adaptive governance and to do so in a way that enhances the legitimacy of governmental action.

  15. From Movements to Actions: Two Mechanisms for Learning Action Sequences

    ERIC Educational Resources Information Center

    Endress, Ansgar D.; Wood, Justin N.

    2011-01-01

    When other individuals move, we interpret their movements as discrete, hierarchically-organized, goal-directed actions. However, the mechanisms that integrate visible movement features into actions are poorly understood. Here, we consider two sequence learning mechanisms--transitional probability-based (TP) and position-based encoding…

  16. Mass Transit: Actions Needed for the BART Airport Extension

    DOT National Transportation Integrated Search

    1996-05-31

    The Bay Area Rapid Transit District (BART) intends to spend over $1.1 billion, including $750 million in federal funds, to extend mass transit service to the San Francisco International Airport. The project is controversial, encountering both widespr...

  17. 75 FR 18942 - FY 2010 Discretionary Sustainability Funding Opportunity; Transit Investments for Greenhouse Gas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration FY 2010 Discretionary Sustainability... Transit Administration (FTA), DOT. ACTION: Notice of availability of FTA environmental sustainability.... Department of Transportation's (DOT) environmental sustainability efforts. This notice includes priorities...

  18. Knowledge and power in integrated coastal management. For a political anthropology of the sea combined with the sciences of the marine environment

    NASA Astrophysics Data System (ADS)

    Mazé, Camille; Dahou, Tarik; Ragueneau, Olivier; Danto, Anatole; Mariat-Roy, Emilie; Raimonet, Mélanie; Weisbein, Julien

    2017-10-01

    This article presents an innovative collaborative approach, which aims to reinforce and institutionalize the field of the political anthropology of the sea combined with the natural sciences. It begins by relating the evolution in coastal areas, from integrated coastal zone management to the notion of adaptive co-management. It then sets out what contribution the social sciences of politics may bring to our understanding of the government/governance of the sea in terms of sustainable development, starting with political science and then highlighting the importance of a deep anthropological and socio-historical approach. Finally, it gives us a glimpse of the benefits of combining the human and social sciences with the natural sciences to produce a critical analysis of the categories of thought and action associated with the systemic management of the environment, especially the coastal areas.

  19. "It's like Tuskegee in reverse": a case study of ethical tensions in institutional review board review of community-based participatory research.

    PubMed

    Malone, Ruth E; Yerger, Valerie B; McGruder, Carol; Froelicher, Erika

    2006-11-01

    Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.

  20. The DSM and Professional Practice: Research, Clinical, and Institutional Perspectives.

    PubMed

    Halpin, Michael

    2016-06-01

    How mental illnesses are defined has significant ramifications, given the substantial social and individual repercussions of these conditions. Using actor-network theory, I analyze how mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) in their work. Drawing on observations of a neuropsychological laboratory and interviews with 27 professionals (i.e., psychiatrists, psychologists), I investigate how the DSM is used in research, clinical, and institutional work. In research, the DSM influences study design and exclusion/inclusion criteria. In the clinic, the DSM influences how disorders are conceptualized and diagnosed. Institutionally, the DSM aligns the patient-professional encounter to insurance and pharmaceutical interests. I conclude that the DSM operates as multiple, context-specific taxonomies that pervasively influence professional practices, such that all possible actions must orient to DSM criteria, with professionals both a source and an object of institutionalized gaze. © American Sociological Association 2016.

  1. National Oceanic and Atmospheric Administration's Cetacean and Sound Mapping Effort: Continuing Forward with an Integrated Ocean Noise Strategy.

    PubMed

    Harrison, Jolie; Ferguson, Megan; Gedamke, Jason; Hatch, Leila; Southall, Brandon; Van Parijs, Sofie

    2016-01-01

    To help manage chronic and cumulative impacts of human activities on marine mammals, the National Oceanic and Atmospheric Administration (NOAA) convened two working groups, the Underwater Sound Field Mapping Working Group (SoundMap) and the Cetacean Density and Distribution Mapping Working Group (CetMap), with overarching effort of both groups referred to as CetSound, which (1) mapped the predicted contribution of human sound sources to ocean noise and (2) provided region/time/species-specific cetacean density and distribution maps. Mapping products were presented at a symposium where future priorities were identified, including institutionalization/integration of the CetSound effort within NOAA-wide goals and programs, creation of forums and mechanisms for external input and funding, and expanded outreach/education. NOAA is subsequently developing an ocean noise strategy to articulate noise conservation goals and further identify science and management actions needed to support them.

  2. [The Vargas Dictatorship in Brazil (1937-1945) and the Primer Franquismo in Spain (1939-1945): power and counter-power of nurses].

    PubMed

    Santos, Tânia Cristina Franco; Gomes, Maria da Luz Barbosa; Oliveira, Alexandre Barbosa de; Almeida Filho, Antonio José de

    2012-01-01

    This is a historical and social study, which aimed to describe the main characteristics of the Vargas and Franco dictatorships, and to analyze the implications of these to the institutionalization of nursing in Brazil and Spain. As fonts, it was used written documents located in the historical Brazilian and Spanish archives, in addition to the literature on the subject. Data analysis, supported by concepts of Pierre Bourdieu's World Social Theory, showed that, in Brazil and Spain, in referring to the social division of labor, the meeting point between Church and the State was the seclusion of women in private space. It is concluded that the feminine qualities were capitalized by the nurses to legitimize their actions in public space, even to reproduce in that space, consented to by the State and Church, occupations appropriate to femininity.

  3. 77 FR 64586 - Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... actions announced herein for the listed public transportation project will be barred unless the claim is... actions by issuing certain approvals for the public transportation projects listed below. The actions on...

  4. Dimensional crossover of effective orbital dynamics in polar distorted He 3 -A : Transitions to antispacetime

    NASA Astrophysics Data System (ADS)

    Nissinen, J.; Volovik, G. E.

    2018-01-01

    Topologically protected superfluid phases of He 3 allow one to simulate many important aspects of relativistic quantum field theories and quantum gravity in condensed matter. Here we discuss a topological Lifshitz transition of the effective quantum vacuum in which the determinant of the tetrad field changes sign through a crossing to a vacuum state with a degenerate fermionic metric. Such a transition is realized in polar distorted superfluid He 3 -A in terms of the effective tetrad fields emerging in the vicinity of the superfluid gap nodes: the tetrads of the Weyl points in the chiral A-phase of He 3 and the degenerate tetrad in the vicinity of a Dirac nodal line in the polar phase of He 3 . The continuous phase transition from the A -phase to the polar phase, i.e., the transition from the Weyl nodes to the Dirac nodal line and back, allows one to follow the behavior of the fermionic and bosonic effective actions when the sign of the tetrad determinant changes, and the effective chiral spacetime transforms to antichiral "anti-spacetime." This condensed matter realization demonstrates that while the original fermionic action is analytic across the transition, the effective action for the orbital degrees of freedom (pseudo-EM) fields and gravity have nonanalytic behavior. In particular, the action for the pseudo-EM field in the vacuum with Weyl fermions (A-phase) contains the modulus of the tetrad determinant. In the vacuum with the degenerate metric (polar phase) the nodal line is effectively a family of 2 +1 d Dirac fermion patches, which leads to a non-analytic (B2-E2)3/4 QED action in the vicinity of the Dirac line.

  5. A vulnerability and risk assessment of SEPTA's regional rail : a transit climate change adaptation assessment pilot.

    DOT National Transportation Integrated Search

    2013-08-01

    This final report for the Federal Transit Administration (FTA) Transit Climate Change Adaptation Assessment Pilot describes the actions : taken, information gathered, analyses performed, and lessons learned throughout the pilot project. This report d...

  6. Transitions, Risks, and Actions in Coronary Events--Center for Outcomes Research and Education (TRACE-CORE): design and rationale.

    PubMed

    Waring, Molly E; McManus, Richard H; Saczynski, Jane S; Anatchkova, Milena D; McManus, David D; Devereaux, Randolph S; Goldberg, Robert J; Allison, Jeroan J; Kiefe, Catarina I

    2012-09-01

    Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality. TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, and development of a nucleus of early stage investigators. We are currently enrolling 2500 adults hospitalized for acute coronary syndromes at 6 hospitals in the northeastern and southeastern United States. We will follow these patients for 24 months after hospitalization through medical record abstraction and 5 patient interviews focusing on quality of life, cardiac events, rehospitalizations, mortality, and medical, behavioral, and psychosocial characteristics. The Transitions Project studies determinants of and disparities in outcomes of the quality of patients' transition from hospital to community. Focusing on potentially modifiable factors, the Action Scores Project will develop and validate action scores to predict recurrent cardiac events, death, and quality of life, describe longitudinal variation in these scores, and develop a dashboard for patient and provider action on the basis of these scores. In TRACE-CORE, sound methodologic principles of observational studies converge with outcomes and effectiveness research approaches. We expect that our data, research infrastructure, and research projects will inform the development of novel secondary prevention approaches and underpin the careers of cardiovascular outcomes researchers.

  7. Near 16 micron CO.sub.2 laser system

    DOEpatents

    Krupke, William F.

    1977-01-01

    Method and apparatus for inducing laser action in CO.sub.2 at a wavelength of 16 microns involving the transition between the 02.sup.0 0 and 01.sup.1 0 states. The population inversion between these two states is achieved by pumping to the 00.sup.0 1 level, suppressing the usual 10.6 micron transition to the 10.sup.0 0 level and encouraging the 9.6 micron transition, thereby populating the 02.sup.0 0 level, as the principal prerequisite for 16 micron laser action between the 02.sup.0 0 and 01.sup.1 0 levels.

  8. Attachment security as a mechanism linking foster care placement to improved mental health outcomes in previously institutionalized children.

    PubMed

    McLaughlin, Katie A; Zeanah, Charles H; Fox, Nathan A; Nelson, Charles A

    2012-01-01

    Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17, p = .006). The intervention had no effect on internalizing disorders in boys (OR = 0.47, p = .150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR = 12.5, p < .001), but no difference was observed in boys (OR = 2.0, p = .205). Greater attachment security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

  9. The Action Event (Notes on the Development of Object-Oriented Actions II)

    ERIC Educational Resources Information Center

    Elkonin, B. D.

    2015-01-01

    The article critically rethinks and refashions conceptions of object-oriented actions. The author introduces the concept of an action event, which relies on the work of D. B. Elkonin. The essence of an action event lies in its transition to a new form of activity, that is, an action mediated by a pattern that is given to a child by an adult. An…

  10. Self-concept in institutionalized children with disturbed attachment: The mediating role of exploratory behaviours.

    PubMed

    Vacaru, V S; Sterkenburg, P S; Schuengel, C

    2018-05-01

    Self-concept is seen as both an outcome of sociocognitive and emotional development, and a factor in social and mental health outcomes. Although the contribution of attachment experiences to self-concept has been limited to quality of primary attachment relationships, little is known of the effects of disturbed attachment on self-concept in institutionalized children. Thus, the current study examined associations between disturbed attachment behaviours in institutionalized children and self-concept, testing limited exploration as an explanatory factor. Thirty-three institutionalized children, aged 4-12, participated in a multimethod and multi-informant assessment of disturbed attachment behaviours (i.e., Disturbances of Attachment Interview and Behavioral Signs of Disturbed Attachment in Young Children), self-concept (i.e., Pictorial Scale of Perceived Competence and Social Acceptance for Young Children), and exploratory behaviours (i.e., Student Exploratory Behaviours Observation Scale). Analyses were conducted using bootstrapping techniques. Global self-concept converged with teacher-rated children's self-concept, except for physical competence domain. Disturbed attachment behaviours were identified in 62.5% of the children, and this was associated with lower levels of exploration and lower scores on self-concept, compared with children without disturbed attachment behaviours. Furthermore, exploratory behaviours mediated the effects of disturbed attachment behaviours on self-concept. Institution-reared children with disturbed attachment behaviours were likely to have a negative perception of self and one's own competences. Limited exploratory behaviours explained this linkage. Targeting disordered attachment in children reared in institutions and their caregivers should become a high priority as a means for preventing socioemotional development issues. © 2017 John Wiley & Sons Ltd.

  11. Body mass index as discriminator of the lean mass deficit and excess body fat in institutionalized elderly people.

    PubMed

    Barbosa, Maria Helena; Bolina, Alisson F; Luiz, Raíssa B; de Oliveira, Karoline F; Virtuoso, Jair S; Rodrigues, Rosalina A P; Silva, Larissa C; da Cunha, Daniel F; De Mattia, Ana Lúcia; Barichello, Elizabeth

    2015-01-01

    The objective of this study was to identify the discriminating criterion for body mass index (BMI) in the prediction of low fat free mass and high body fat percentage according to sex among older people. Observational analytical study with cross-sectional design was used for this study. All institutionalized older people from the city of Uberaba (Minas Gerais, Brazil) who fit within the inclusion and exclusion criteria were approached. Sixty-five institutionalized older people were evaluated after signing a Free and Informed Consent Form. Descriptive and inferential statistical procedures were employed for the analysis, using Student's t-test and multiple linear regression. Receiver Operating Characteristic (ROC) curves were constructed to determine the BMI (kg/m(2)) cut-off points. The study complied with all the ethical norms for research involving human beings. In comparing the anthropometric measurements obtained via bioimpedance, elder male had higher mean height and body water volume than females. However, women had higher mean triceps skinfold and fat free mass than men. The BMI cut-off points, as discriminators of low fat free mass percentage and high body fat percentage in women, were ≤22.4 kg/m(2) and >26.6 kg/m(2), respectively; while for men they were ≤19.2 kg/m(2) and >23.8 kg/m(2). The results of this study indicate the need for multicenter studies aimed at suggesting BMI cut-off points for institutionalized older people, taking into account specific sex characteristics. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Effects of a long-term aerobic exercise intervention on institutionalized patients with dementia.

    PubMed

    Cancela, José M; Ayán, Carlos; Varela, Silvia; Seijo, Manuel

    2016-04-01

    Long-term interventions aimed at analyzing the impact of physical exercise on important health markers in institutionalized individuals with dementia are relatively scarce. This longitudinal study intends to identify the effects of a physical exercise program on cognitive decline, memory, depression, functional dependence and neuropsychiatric disturbances in institutionalized individuals with dementia. Randomized controlled trial. Homecare residents with dementia were assigned to an exercise (EG) or to a control group (CG). Participants in the EG cycled for at least 15min daily during 15 months, while those in the CG performed alternative sedentary recreational activities. The Mini-Mental State Examination (MEC), the Timed "Up & Go" Test, the Neuropsychiatric Inventory, the Katz Index, the Cornell Scale for Depression in Dementia and the Fuld Object Memory Evaluation were administered before and after the intervention. Sixty-three individuals in the CG and 51 individuals in the EG completed the intervention. A statistically significant decline in cognitive function was observed in individuals included in the CG (p=0.015), while a slight improvement was observed in those included in the EG. Significant improvement was observed in the neuropsychiatric symptoms (p=0.020), memory function (p=0.028) and functional mobility (p=0.043) among those who exercised. Exercise seemed to have a greater effect in those suffering from severe cognitive impairment. This study provides evidence that aerobic physical exercise has a significant impact on improving cognitive functioning, behavior, and functional mobility in institutionalized individuals with dementia. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. [Understanding homicides in Latin America: poverty or institutionalization?].

    PubMed

    Briceño-León, Roberto

    2012-12-01

    Homicides occur the world over, but they are not homogeneously distributed by geographical areas (continents, countries, regions), either over long or short periods of time, or in social groups, namely age, gender, social class or ethnicity. Why are there more homicides in some countries than in others? Why do killings increase in some countries, while they decrease in others? There are two fundamental schools of thought for social explanations of crime and violence: those attributing its origins to poverty and inequality and those blaming institutionalization or social norms. To discuss these theories, this paper analyzes and compares the changes in Colombia, Venezuela and Brazil in the first decade of the twenty-first century, where the homicide rate has decreased, increased and remained the same, respectively. Using the measurement of six variables (poverty, inequality, unemployment, national wealth, human development and the rule of law) and the technique of trajectory analysis, the results revealed that institutionalization is more to blame for the change than poverty and inequality. The text concludes that poverty and inequality affect crime and homicides, although not directly, but mediated by the institutions instead.

  14. A patient mobility framework that travels: European and United States-Mexican comparisons.

    PubMed

    Laugesen, Miriam J; Vargas-Bustamante, Arturo

    2010-10-01

    To develop a framework that parsimoniously explains divergent patient mobility in the United States and Europe. Review of studies of patient mobility; data from the 2007 Flash Eurobarometer and the 2001 California Health Interview Survey was analyzed; and we reviewed government policies and documents in the United States and Europe. Four types of patient mobility are defined: primary, complementary, duplicative, and institutionalized. Primary exit occurs when people without comprehensive insurance travel because they cannot afford to pay for health insurance or directly finance care, as in the United States and Mexico. Second, people will exit to buy complementary services not covered, or partially covered by domestic health insurance, in both the United States and Europe. Third, in Europe, patient mobility for duplicative services provides faster or better quality treatment. Finally, governments and insurers can encourage institutionalized exit through expanded delivery options and financing. Institutionalized exit is developing in Europe, but uncoordinated and geographically limited in the United States. This parsimonious framework explains patient mobility by considering domestic health system characteristics relating to cost and quality. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  15. The Ciência & Saúde Coletiva journal and the process of institutionalization of a field of knowledge and practices.

    PubMed

    Nunes, Everardo Duarte

    2015-07-01

    This paper takes as its starting point the concepts that make up the process of institutionalization of a field of knowledge in the following phases: 1. Differentiation of subjects, methods and techniques of knowledge or existing disciplines, 2. The subject previously considered as peripheral is now seem as part of a particular field of knowledge, 3. The new field becomes significant in the set of an area and starts the standardization of recruitment of human resources, selection of experts and financial resources, and 4. Consolidation of the new field, building its culture within the scientific community, with its social networks of communication, scientific associations and its own publications. Our central objective is to analyze the role of the Ciência e Saúde Coletiva Journal in the process of institutionalization of the Collective Health; we situate the Collective Health and its stages, make a brief report on the history of scientific publications by emphasizing the Brazilian studies on the public health field, and work the early stages of the Journal.

  16. Institutionalize Reciprocity to Overcome the Public Goods Provision Problem

    PubMed Central

    2016-01-01

    Cooperation is fundamental to human societies, and one of the important paths for its emergence and maintenance is reciprocity. In prisoner’s dilemma (PD) experiments, reciprocal strategies are often effective at attaining and maintaining high cooperation. In many public goods (PG) games or n-person PD experiments, however, reciprocal strategies are not successful at engendering cooperation. In the present paper, we attribute this difficulty to a coordination problem against free riding among reciprocators: Because it is difficult for the reciprocators to coordinate their behaviors against free riders, this may lead to inequality among players, which will demotivate them from cooperating in future rounds. We propose a new mechanism, institutionalized reciprocity (IR), which refers to embedding the reciprocal strategy as an institution (i.e., institutionalizing the reciprocal strategy). We experimentally demonstrate that IR can prevent groups of reciprocators from falling into coordination failure and achieve high cooperation in PG games. In conclusion, we argue that a natural extension of the present study will be to investigate the possibility of IR to serve as a collective punishment system. PMID:27248493

  17. Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution

    PubMed Central

    Marcos-Tejedor, Félix; Iglesias-Sánchez, María José

    2018-01-01

    Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal pathologies of the foot of institutionalized people with psychiatric disorders compared to people without these disorders. A transversal and observational study was conducted on 107 participants, divided into two groups who have used different types of shoes throughout their lives. The control group comprised 63 autonomous people who mainly use leather footwear and a study group of 44 institutionalized people with intellectual disabilities and psychiatric disorders who mainly use textile footwear. There were significant differences between populations. The group with psychiatric disorders presented more xerosis and hyperkeratosis. Footwear with inappropriate characteristics is a possible causal agent of skin alterations. Wearing footwear with quality textile uppers, e.g., fabric or felt, could influence the appearance of these alterations. Leather footwear is recommended for institutionalized people to reduce symptoms of xerosis and improve their quality of life. PMID:29587357

  18. Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution.

    PubMed

    Pérez-Pico, Ana María; Marcos-Tejedor, Félix; Iglesias-Sánchez, María José; Acevedo, Raquel Mayordomo

    2018-03-24

    Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal pathologies of the foot of institutionalized people with psychiatric disorders compared to people without these disorders. A transversal and observational study was conducted on 107 participants, divided into two groups who have used different types of shoes throughout their lives. The control group comprised 63 autonomous people who mainly use leather footwear and a study group of 44 institutionalized people with intellectual disabilities and psychiatric disorders who mainly use textile footwear. There were significant differences between populations. The group with psychiatric disorders presented more xerosis and hyperkeratosis. Footwear with inappropriate characteristics is a possible causal agent of skin alterations. Wearing footwear with quality textile uppers, e.g., fabric or felt, could influence the appearance of these alterations. Leather footwear is recommended for institutionalized people to reduce symptoms of xerosis and improve their quality of life.

  19. Developing proper mealtime behaviors of the institutionalized retarded.

    PubMed

    O'brien, F; Azrin, N H

    1972-01-01

    The institutionalized mentally retarded display a variety of unsanitary, disruptive, and improper table manners. A program was developed that included (1) acquisition-training of a high standard of proper table manners and (2) maintenance procedures to provide continued motivation to maintain proper mealtime behaviors and decrease improper skills. Twelve retardates received acquisition training, individually, by a combination of verbal instruction, imitation, and manual guidance. The students then ate in their group dining arrangement where the staff supervisor provided continuing approval for proper manners and verbal correction and timeout for improper manners. The results were: (1) the trained retardates showed significant improvement, whereas those untrained did not; (2) the trained retardates ate as well in the institution as non-retarded customers did in a public restaurant; (3) proper eating was maintained in the group dining setting; (4) timeout was rarely needed; (5) the program was easily administered by regular staff in a regular dining setting. The rapidity, feasibility, and effectiveness of the program suggests the program as a solution to improper mealtime behaviors by the institutionalized mentally retarded.

  20. Partnership: The Missing Link in the Process of De-Institutionalization of Mental Health Care.

    PubMed

    Quah, Stella R

    2017-07-01

    This study discusses the main barriers to partnership between family and health services in the context of schizophrenia and de-institutionalization (reduction of the length of hospitalization whenever possible and returning the patient to the community) addressed to deal with the increasing costs and demand for health care services. Thus, in de-institutionalization the burden of care is not resolved but shared with the family, under the assumption that the patient has someone-a family caregiver-who can take up the responsibility of care at home. Despite the high burden of care faced by the family caregiver in mental illness, the necessary systematic partnership between the medical team and the family caregiver is missing. Subjects were 47 family caregivers of persons living with schizophrenia. Data were collected using in-depth interviews, structured questionnaires and attitudinal scales. Data analysis included factor analysis and odds ratios. Two types of barriers to partnership are identified in the literature: health services barriers and barriers attributed to the family. The findings confirm the health services barriers but reject the assumed family barriers.

  1. 78 FR 11268 - Notice of Establishment of Emergency Relief Docket for Calendar Year 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration [Docket FTA-2013-0001] Notice of Establishment of Emergency Relief Docket for Calendar Year 2013 AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice SUMMARY: The Federal Transit Administration (FTA) is establishing an Emergency...

  2. 77 FR 1779 - Meeting and Webinar on Integrated Dynamic Transit Operations; Notice of Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-11

    .... Transit- oriented Connected Vehicle for Mobility applications support dynamic system operations and... DEPARTMENT OF TRANSPORTATION Meeting and Webinar on Integrated Dynamic Transit Operations; Notice... Transportation. ACTION: Notice. The U.S. Department of Transportation (USDOT) Intelligent Transportation System...

  3. Transitions to School: Reframing Professional Relationships

    ERIC Educational Resources Information Center

    Boyle, Tess; Petriwskyj, Anne

    2014-01-01

    Systemic splits between pre-compulsory and compulsory early years education impact on transitions to school through discontinuities in children's experience. This paper presents data from a critical participatory action research project about transitions between pre-compulsory and compulsory early education schooling in Australia. The project aim…

  4. Formal and informal decision making on water management at the village level: A case study from the Office du Niger irrigation scheme (Mali)

    NASA Astrophysics Data System (ADS)

    Vandersypen, Klaartje; Keita, Abdoulaye C. T.; Coulibaly, Y.; Raes, D.; Jamin, J.-Y.

    2007-06-01

    Water Users Associations (WUAs) are all too often considered a panacea for improving water management in irrigation schemes. Where grassroots movements are absent, they are usually imposed on farmers by national governments, NGOs, and international donors, without fully considering existing forms of organization. This also happened in the Office du Niger irrigation scheme in Mali, where after a partial irrigation management transfer, WUAs were created to fill the resulting power vacuum. This paper demonstrates that, despite active efforts to organize farmers in WUAs, informal patterns of decision making remain dominant. Given the shortcomings of these informal patterns, WUAs could provide a much-needed platform for institutionalizing collective action, on the condition that farmers accept them. Therefore WUAs should adopt some crucial characteristics of informal patterns of decision making while avoiding their weaknesses. First, making use of the existing authority of village leadership and the central management can improve the credibility of WUAs. Second, allowing flexibility in procedures and rules can make them more appropriate for dealing with collective action problems that are typically temporary and specific. Last, formalizing the current pattern of conflict management and sanctioning might enhance its sphere of action and tackle the current absence of firm engagement with respect to some informal management decisions. In addition, WUAs should represent and be accountable to all farmers, including those residing outside the village community.

  5. Transitioning to a More Sustainable Society: Unpacking the Role of the Learning-Action Nexus

    ERIC Educational Resources Information Center

    Moyer, Joanne M.; Sinclair, A. John; Quinn, Lisa

    2016-01-01

    In recent years, action on sustainability has been highly influential around the globe and many now recognize the importance of individual and social learning for inspiring action and achieving sustainability outcomes. Transformative learning theory has been criticized, however, for insufficient development of the link between learning and action.…

  6. Modelling Team Adversarial Actions in UAV Operations

    DTIC Science & Technology

    2007-11-01

    support for the dynamic creation and destruction of entities is the history dependent automata ( HDA ) [9] which evolved from an algorithmic structure for...checking bi-similarity of π- calculus agents. The authors define HDA as automata which perform actions that can carry information generated in the...past history of the system. The states, transitions and labels of the HDA are enriched with sets of local names. Thus, each transition can refer to the

  7. Automatic Imitation of Intransitive Actions

    ERIC Educational Resources Information Center

    Press, Clare; Bird, Geoffrey; Walsh, Eamonn; Heyes, Cecilia

    2008-01-01

    Previous research has indicated a potential discontinuity between monkey and human ventral premotor-parietal mirror systems, namely that monkey mirror systems process only transitive (object-directed) actions, whereas human mirror systems may also process intransitive (non-object-directed) actions. The present study investigated this discontinuity…

  8. Workshop on the preparation of climate change action plans. Workshop summary

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1999-05-24

    Over 130 participants from more than 27 countries shared experiences of developing and transition countries in preparation and development of their climate change national action plans. International experts guided countries in preparation of their climate change national action plans.

  9. 77 FR 20094 - Intent To Prepare an Environmental Impact Statement on the Durham-Orange Light Rail (LRT) Project...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... Administration (FTA) and the Research Triangle Regional Public Transportation Authority, dba ``Triangle Transit... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Intent To Prepare an Environmental...: Federal Transit Administration (FTA), United States Department of Transportation (USDOT). ACTION: Notice...

  10. Reorganization of mental health services: from institutional to community-based models of care.

    PubMed

    Saraceno, B; Gater, R; Rahman, A; Saeed, K; Eaton, J; Ivbijaro, G; Kidd, M; Dowrick, C; Servili, C; Funk, M K; Underhill, C

    2015-09-28

    Mental health services in the Eastern Mediterranean Region are predominantly centralized and institutionalized, relying on scarce specialist manpower. This creates a major treatment gap for patients with common and disabling mental disorders and places an unnecessary burden on the individual, their family and society. Six steps for reorganization of mental health services in the Region can be outlined: (1) integrate delivery of interventions for priority mental disorders into primary health care and existing priority programmes; (2) systematically strengthen the capacity of non-specialized health personnel for providing mental health care; (3) scale up community-based services (community outreach teams for defined catchment, supported residential facilities, supported employment and family support); (4) establish mental health services in general hospitals for outpatient and acute inpatient care; (5) progressively reduce the number of long-stay beds in mental hospitals through restricting new admissions; and (6) provide transitional/bridge funding over a period of time to scale up community-based services and downsize mental institutions in parallel.

  11. Teaching for Democracy in the Absence of Transitional Justice: The Case of Northern Ireland

    ERIC Educational Resources Information Center

    Worden, Elizabeth Anderson; Smith, Alan

    2017-01-01

    In many cases, political circumstances do not allow formal for transitional justice processes to occur in countries undergoing a transition from a violent past. In this paper, we ask if education can become a default front line of transitional justice work in the absence of explicit action by the state to address past injustices. Drawing from…

  12. The role of law in adaptive governance

    PubMed Central

    Cosens, Barbara A.; Craig, Robin K.; Hirsch, Shana Lee; Arnold, Craig Anthony (Tony); Benson, Melinda H.; DeCaro, Daniel A.; Garmestani, Ahjond S.; Gosnell, Hannah; Ruhl, J.B.; Schlager, Edella

    2018-01-01

    The term “governance” encompasses both governmental and nongovernmental participation in collective choice and action. Law dictates the structure, boundaries, rules, and processes within which governmental action takes place, and in doing so becomes one of the focal points for analysis of barriers to adaptation as the effects of climate change are felt. Adaptive governance must therefore contemplate a level of flexibility and evolution in governmental action beyond that currently found in the heavily administrative governments of many democracies. Nevertheless, over time, law itself has proven highly adaptive in western systems of government, evolving to address and even facilitate the emergence of new social norms (such as the rights of women and minorities) or to provide remedies for emerging problems (such as pollution). Thus, there is no question that law can adapt, evolve, and be reformed to make room for adaptive governance. In doing this, not only may barriers be removed, but law may be adjusted to facilitate adaptive governance and to aid in institutionalizing new and emerging approaches to governance. The key is to do so in a way that also enhances legitimacy, accountability, and justice, or else such reforms will never be adopted by democratic societies, or if adopted, will destabilize those societies. By identifying those aspects of the frameworks for adaptive governance reviewed in the introduction to this special feature relevant to the legal system, we present guidelines for evaluating the role of law in environmental governance to identify the ways in which law can be used, adapted, and reformed to facilitate adaptive governance and to do so in a way that enhances the legitimacy of governmental action. PMID:29780426

  13. 78 FR 65756 - Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... review of the FTA actions announced herein for the listed public transportation project will be barred... taken final agency actions by issuing certain approvals for the public transportation project listed...

  14. 78 FR 45287 - Limitation on Claims against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... FTA action announced herein for the listed public transportation project will be barred unless the... final agency action by issuing a certain approval for the public transportation project listed below...

  15. Expert Opinions on Improving Femicide Data Collection across Europe: A Concept Mapping Study.

    PubMed

    Vives-Cases, Carmen; Goicolea, Isabel; Hernández, Alison; Sanz-Barbero, Belen; Gill, Aisha K; Baldry, Anna Costanza; Schröttle, Monika; Stöckl, Heidi; Stoeckl, Heidi

    2016-01-01

    Femicide, defined as the killings of females by males because they are females, is becoming recognized worldwide as an important ongoing manifestation of gender inequality. Despite its high prevalence or widespread prevalence, only a few countries have specific registries about this issue. This study aims to assemble expert opinion regarding the strategies which might feasibly be employed to promote, develop and implement an integrated and differentiated femicide data collection system in Europe at both the national and international levels. Concept mapping methodology was followed, involving 28 experts from 16 countries in generating strategies, sorting and rating them with respect to relevance and feasibility. The experts involved were all members of the EU-Cost-Action on femicide, which is a scientific network of experts on femicide and violence against women across Europe. As a result, a conceptual map emerged, consisting of 69 strategies organized in 10 clusters, which fit into two domains: "Political action" and "Technical steps". There was consensus among participants regarding the high relevance of strategies to institutionalize national databases and raise public awareness through different stakeholders, while strategies to promote media involvement were identified as the most feasible. Differences in perceived priorities according to the level of human development index of the experts' countries were also observed.

  16. 78 FR 75446 - Notice of Availability of Draft Guidance on the Application of United States Code to Corridor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-11

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration [Docket Number: FTA-2013-0019] Notice... and Request for Comment AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice of availability; request for comment. SUMMARY: The Federal Transit Administration (FTA) announces the availability...

  17. 76 FR 57044 - Announcement of Requirements and Registration for “Ensuring Safe Transitions From Hospital to Home”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Announcement of Requirements and Registration for... Coordinator for Health Information Technology, HHS. ACTION: Notice. SUMMARY: The ``Ensuring Safe Transitions... discharged patients to take charge of their health care during transitions of places of care. Innovative...

  18. 77 FR 52134 - Notice of Request To Rescind Buy America Waiver for Minivans and Minivan Chassis; Extension of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ..., on the Vehicle Production Group LLC's (VPG) request for the Federal Transit Administration (FTA) to... DEPARTMENT OF TRANSPORTATION Federal Transit Administration [Docket No. FTA-2012-0029 ] Notice of...: Federal Transit Administration, DOT. ACTION: Notice of extension of comment period. SUMMARY: Chrysler...

  19. 42 CFR 460.52 - Transitional care during termination.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.52 Transitional care...

  20. 42 CFR 460.52 - Transitional care during termination.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Sanctions, Enforcement Actions, and Termination § 460.52 Transitional care...

  1. Socio-demographics, spirituality, and quality of life among community-dwelling and institutionalized older adults: A structural equation model.

    PubMed

    Soriano, Christian Albert F; Sarmiento, Winona D; Songco, Francis Justin G; Macindo, John Rey B; Conde, Alita R

    2016-01-01

    The increasing life expectancy of the population prompts an array of health conditions that impair an older adults' quality of life (QoL). Although demographics and spirituality have been associated with QoL, limited literature elucidated the exact mechanisms of their interactions, especially in a culturally-diverse country like Philippines. Hence, this study determined the relationship among socio-demographics, spirituality, and QoL of Filipino older adults in a community and institutional setting. A predictive-correlational study among 200 randomly-selected community-dwelling and institutionalized older adults was conducted, with a 99% power and a medium effect size. Data were collected using a three-part questionnaire from September to November 2015. The questionnaire was composed of the robotfoto, Spirituality Assessment Scale, and modified Older People's Quality of Life which assessed socio-demographics, spirituality, and QoL. Analysis showed that institutionalization in a nursing home positively and negatively affected spirituality and QoL, generating an acceptable model (χ(2)/df=2.12, RMSEA=0.08, and CFI=0.95). The negative direct effect of institutionalization on social relationship, leisure, & social activities QoL (β=-0.42, p<0.01) also initiates a cascade of indirect negative effects on both spirituality and QoL dimensions. The development of a structural model illustrating the interrelationship of socio-demographics, spirituality, and QoL helps healthcare professionals in predicting facets of spirituality and QoL that can be compromised by living in a nursing home. This understanding provides impetus in evaluating and refining geriatric healthcare programs, policies, and protocols to render individualized, holistic care in a socially-cohesive environment among older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up

    PubMed Central

    Dias E Dias de Macedo, Liliane; De Oliveira, Thaís Cristina Galdino; Soares, Fernanda Cabral; Bento-Torres, João; Bento-Torres, Natáli Valim Oliver; Anthony, Daniel Clive; Picanço-Diniz, Cristovam Wanderley

    2015-01-01

    We previously demonstrated the beneficial effects of a multisensory and cognitive stimulation program, consisting of 48 sessions, twice a week, to improve the cognition of elderly subjects living either in long-term care institutions (institutionalized – I) or in communities with their families (noninstitutionalized – NI). In the present study, we evaluated these subjects after the end of the intervention and compared the rate of age-related cognitive decline of those living in an enriched community environment (NI group, n=15, 74.1±3.9 years old) with those living in the impoverished environment of long-term care institutions (I group, n=20, 75.1±6.8 years old). Both groups participated fully in our stimulation program. Over 1 year, we conducted revaluations at five time points (2 months, 4 months, 6 months, 8 months, and 12 months) after the completion of the intervention. Both elderly groups were evaluated with the mini-mental state examination and selected language tests. Progressive cognitive decline was observed in both groups over the period. Indeed, it took only 4–6 months after the end of the stimulation program for significant reductions in language test scores to become apparent. However, earlier reductions in test scores were mainly associated with I group, and linguistic prosody test scores were significantly affected by institutionalization and time, two variables that interacted and reduced these scores. Moreover, I group reduced the Montréal cognitive assessment battery language tests scores 4 months before NI group. It remains to be investigated what mechanisms may explain the earlier and more intense language losses in institutionalized elderly. PMID:26316730

  3. Delayed Maturation in Brain Electrical Activity Partially Explains the Association Between Early Environmental Deprivation and Symptoms of Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    McLaughlin, Katie A.; Fox, Nathan A.; Zeanah, Charles H.; Sheridan, Margaret A.; Marshall, Peter; Nelson, Charles A.

    2010-01-01

    Background Children raised in institutional settings are exposed to social and environmental circumstances that may deprive them of expected environmental inputs during sensitive periods of brain development that are necessary to foster healthy development. This deprivation is thought to underlie the abnormalities in neurodevelopment that have been found in previously institutionalized children. It is unknown whether deviations in neurodevelopment explain the high rates of developmental problems evident in previously institutionalized children, including psychiatric disorders. Methods We present data from a sample of children raised in institutions in Bucharest, Romania (n = 117) and an age- and sex-matched sample of community control subjects (n = 49). Electroencephalogram data were acquired following entry into the study at age 6 to 30 months, and a structured diagnostic interview of psychiatric disorders was completed at age 54 months. Results Children reared in institutions evidenced greater symptoms of attention-deficit/hyperactivity disorder, anxiety, depression, and disruptive behavior disorders than community controls. Electroencephalogram revealed significant reductions in alpha relative power and increases in theta relative power among children reared in institutions in frontal, temporal, and occipital regions, suggesting a delay in cortical maturation. This pattern of brain activity predicted symptoms of hyperactivity and impulsivity at age 54 months, and significantly mediated the association between institutionalization and attention-deficit/hyperactivity disorder symptoms. Electroencephalogram power was unrelated to depression, anxiety, or disruptive behaviors. Conclusions These findings document a potential neurodevelopmental mechanism underlying the association between institutionalization and psychiatric morbidity. Deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life. PMID:20497899

  4. Effects of a multicomponent exercise program in institutionalized elders with Alzheimer's disease.

    PubMed

    Sampaio, Arnaldina; Marques, Elisa A; Mota, Jorge; Carvalho, Joana

    2016-10-18

    This study examined the effect of a Multicomponent Training (MT) intervention on cognitive function, functional fitness and anthropometric variables in institutionalized patients with Alzheimer's disease (AD). Thirty-seven institutionalized elders (84.05 ± 5.58 years) clinically diagnosed with AD (mild and moderate stages) were divided into two groups: Experimental Group (EG, n = 19) and Control Group (CG, n = 18). The EG participated in a six-month supervised MT program (aerobic, muscular resistance, flexibility and postural exercises) of 45-55 minutes/session, twice/week. Cognitive function (MMSE), physical fitness (Senior Fitness Test) and anthropometric variables (Body Mass Index and Waist Circumference), were assessed before (M1), after three months (M2) and after six months (M3) of the experimental protocol. A two-way ANOVA, with repeated measures, revealed significant group and time interactions on cognitive function, chair stand, arm curl, 2-min step, 8-foot up-and-go (UG), chair sit-and-reach (CSR) and back scratch tests as well as waist circumference. Accordingly, for those variables a different response in each group was evident over the time, supported by a significantly better EG performance in chair stand, arm curl, 2-min step, UG, CSR and back scratch tests from M1 to M3, and a significant increase in MMSE from M1 to M2. The CG's performance decreased over time (M1 to M3) in chair stand, arm curl, 2-min step, UG, CSR, back scratch and MMSE. Results suggest that MT programs may be an important non-pharmacological strategy to improve physical and cognitive functions in institutionalized AD patients. © The Author(s) 2016.

  5. Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level.

    PubMed

    Gálvez-Barrón, César; Narvaiza, Leire; Dapena, María D; Macho, Oscar; Rodríguez-Molinero, Alejandro

    2016-04-01

    In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population. To explore prevalence and considered pharmacological treatments for pain in this population. Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews. Pain's prevalence was 52.5 % (CI 95 % 48.28-56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93-1.02) in females and 0.99 (CI 95 % 0.92-1.06) in males]. The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline's recommendations are probably not being considered to select the analgesic therapy.

  6. Acute effects of exergames on cognitive function of institutionalized older persons: a single-blinded, randomized and controlled pilot study.

    PubMed

    Monteiro-Junior, Renato Sobral; da Silva Figueiredo, Luiz Felipe; Maciel-Pinheiro, Paulo de Tarso; Abud, Erick Lohan Rodrigues; Braga, Ana Elisa Mendes Montalvão; Barca, Maria Lage; Engedal, Knut; Nascimento, Osvaldo José M; Deslandes, Andrea Camaz; Laks, Jerson

    2017-06-01

    Improvements on balance, gait and cognition are some of the benefits of exergames. Few studies have investigated the cognitive effects of exergames in institutionalized older persons. To assess the acute effect of a single session of exergames on cognition of institutionalized older persons. Nineteen institutionalized older persons were randomly allocated to Wii (WG, n = 10, 86 ± 7 year, two males) or control groups (CG, n = 9, 86 ± 5 year, one male). The WG performed six exercises with virtual reality, whereas CG performed six exercises without virtual reality. Verbal fluency test (VFT), digit span forward and digit span backward were used to evaluate semantic memory/executive function, short-term memory and work memory, respectively, before and after exergames and Δ post- to pre-session (absolute) and Δ % (relative) were calculated. Parametric (t independent test) and nonparametric (Mann-Whitney test) statistics and effect size were applied to tests for efficacy. VFT was statistically significant within WG (-3.07, df = 9, p = 0.013). We found no statistically significant differences between the two groups (p > 0.05). Effect size between groups of Δ % (median = 21 %) showed moderate effect for WG (0.63). Our data show moderate improvement of semantic memory/executive function due to exergames session. It is possible that cognitive brain areas are activated during exergames, increasing clinical response. A single session of exergames showed no significant improvement in short-term memory, working memory and semantic memory/executive function. The effect size for verbal fluency was promising, and future studies on this issue should be developed. RBR-6rytw2.

  7. The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people.

    PubMed

    Manders, M; De Groot, L C P G M; Hoefnagels, W H L; Dhonukshe-Rutten, R A M; Wouters-Wesseling, W; Mulders, A J M J; Van Staveren, W A

    2009-11-01

    To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Homes for the elderly and nursing homes in the Netherlands. Institutionalized elderly people older than 60 years, with a BMI < or = 30 kg/m2, and a Mini-Mental State Examination score of at least 10 points. In addition to their usual diet the participants (n=176) received either a nutrient dense drink or a placebo drink twice a day during 24 weeks. The functionality measures included cognitive function, mood, physical performance and the ability to perform activities of daily living. In the supplement group a favorable effect of the intervention drink on body weight (1.6 kg difference in change; P = .035), calf circumference (0.9 cm difference in change; P = .048), and blood values (e.g. Hcy decreased from 16.8 to 11.2 mumol/L in the supplement group) was found. In the total group no significant effect was found on functionality outcomes. However, a subgroup of participants with BMI at baseline below 24.4 kg/m2 performed better on the cognitive subscale of Alzheimer's Disease Assessment Scale (P = .09), and its language sub score (P = .01) after 24 weeks of intervention. The results in the total group of this trial suggest that the nutritional supplement used in this study improves nutritional status. Furthermore, the results of this trial suggest that it is effective as treatment for decreasing function in a subgroup of institutionalized elderly people with low BMI.

  8. Can Doll therapy preserve or promote attachment in people with cognitive, behavioral, and emotional problems? A pilot study in institutionalized patients with dementia

    PubMed Central

    Pezzati, Rita; Molteni, Valentina; Bani, Marco; Settanta, Carmen; Di Maggio, Maria Grazia; Villa, Ivan; Poletti, Barbara; Ardito, Rita B.

    2014-01-01

    Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the Bowlby’s theory of attachment to investigate the effectiveness of Doll therapy. The hypothesis that we here propose is that the emotional experience of the person with dementia during Doll therapy activates caregiving and exploration systems together with the attachment one. To test this hypothesis we compared institutionalized patients with dementia undergoing Doll therapy with a control group and assessed measures of the relational dimension with the environment, such as gaze direction, behaviors of exploration, and behaviors of caregiving. We used an experimental protocol consisting of 10 non-consecutive sessions structured with the goal of recreating a situation of (1) separation from a known figure and (2) interaction with the environment in order to partially recreate the prototypical phases of the “Strange situation.” All sessions were videotaped and analyzed through an observational grid. Results support the effectiveness of Doll therapy in promoting and maintaining the affective-relational dimension of attachment-caregiving and the attentive dimension of exploration in patients with advanced stage of dementia. Thus, our results suggest that the use of Doll therapy promotes clinically significant improvements in the ability to relate with the surrounding world. This may be important for managing and caring for patients with dementia in institutionalized context. PMID:24795682

  9. Association of nutritional status as measured by the Mini-Nutritional Assessment Short Form with changes in mobility, institutionalization and death after hip fracture.

    PubMed

    Nuotio, M; Tuominen, P; Luukkaala, T

    2016-03-01

    We examined the association of nutritional status as measured by the Mini-Nutritional Assessment Short Form (MNA-SF) with changes in mobility, institutionalization and death after hip fracture. Population-based prospective data were collected on 472 out of 693 consecutive hip fracture patients aged 65 years and over between January 2010 and December 2012. Declined vs same or improved mobility level, institutionalization and death during the 4-month follow-up were the outcomes. Age, gender, American Society of Anesthesiologists scores, pre-fracture diagnosis of a memory disorder, mobility level, living arrangements and MNA-SF scores at baseline were the independent variables. Age-adjusted and multivariate logistic regression and Cox proportional hazards models were conducted. At baseline, 41 (9%) patients were malnourished and 200 (42%) patients at risk of malnutrition according to the MNA-SF. During the follow-up, 90 (19%) had died. In the multivariate Cox proportional hazards model, malnutrition (hazard ratio 2.16; 95% confidence interval (CI) 1.07-4.34) was associated with mortality. In the multivariate binary logistic regression analyses, risk of malnutrition (odds ratios (OR) 2.42; 95% CI 1.25-4.66) and malnutrition (OR 6.10;95% CI 2.01-18.5) predicted institutionalization. Risk of malnutrition (OR 2.03; 95% CI 1.24-3.31) was associated with decline in the mobility level. Malnutrition or risk of malnutrition as measured by the MNA-SF were independent predictors of negative outcomes after hip fracture. Patients classified as being at risk of malnutrition by the MNA-SF may constitute a patient population with mild-to-moderate malnutrition and may require specific attention when nutritional interventions are designed after hip fracture.

  10. Can Doll therapy preserve or promote attachment in people with cognitive, behavioral, and emotional problems? A pilot study in institutionalized patients with dementia.

    PubMed

    Pezzati, Rita; Molteni, Valentina; Bani, Marco; Settanta, Carmen; Di Maggio, Maria Grazia; Villa, Ivan; Poletti, Barbara; Ardito, Rita B

    2014-01-01

    Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the Bowlby's theory of attachment to investigate the effectiveness of Doll therapy. The hypothesis that we here propose is that the emotional experience of the person with dementia during Doll therapy activates caregiving and exploration systems together with the attachment one. To test this hypothesis we compared institutionalized patients with dementia undergoing Doll therapy with a control group and assessed measures of the relational dimension with the environment, such as gaze direction, behaviors of exploration, and behaviors of caregiving. We used an experimental protocol consisting of 10 non-consecutive sessions structured with the goal of recreating a situation of (1) separation from a known figure and (2) interaction with the environment in order to partially recreate the prototypical phases of the "Strange situation." All sessions were videotaped and analyzed through an observational grid. Results support the effectiveness of Doll therapy in promoting and maintaining the affective-relational dimension of attachment-caregiving and the attentive dimension of exploration in patients with advanced stage of dementia. Thus, our results suggest that the use of Doll therapy promotes clinically significant improvements in the ability to relate with the surrounding world. This may be important for managing and caring for patients with dementia in institutionalized context.

  11. 77 FR 76597 - Limitation on Claims against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... actions announced herein for the listed public transportation project will be barred unless the claim is... issuing certain approvals for the public transportation project listed below. The actions on this project...

  12. 77 FR 34122 - Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... claim seeking judicial review of the FTA actions announced herein for the listed public transportation... given that FTA has taken final agency actions by issuing certain approvals for the public transportation...

  13. 76 FR 2950 - Notice of Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice... judicial review of the FTA actions announced herein for the listed public transportation projects will be... final agency actions by issuing certain approvals for the public transportation projects listed below...

  14. 75 FR 71181 - Notice of Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice... judicial review of the FTA actions announced herein for the listed public transportation projects will be... issuing certain approvals for the public transportation projects listed below. The actions on these...

  15. 77 FR 51106 - Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-23

    ... Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY... claim seeking judicial review of the FTA actions announced herein for the listed public transportation... given that FTA has taken final agency actions by issuing certain approvals for the public transportation...

  16. Gestural Imitation and Limb Apraxia in Corticobasal Degeneration

    ERIC Educational Resources Information Center

    Salter, Jennifer E.; Roy, Eric A.; Black, Sandra E.; Joshi, Anish; Almeida, Quincy

    2004-01-01

    Limb apraxia is a common symptom of corticobasal degeneration (CBD). While previous research has shown that individuals with CBD have difficulty imitating transitive (tool-use actions) and intransitive non-representational gestures (nonsense actions), intransitive representational gestures (actions without a tool) have not been examined. In the…

  17. 49 CFR 659.39 - Oversight agency reporting to the Federal Transit Administration.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... accidents, status of corrective actions, updates and modifications to rail transit agency program...-year safety review has been completed since the last annual report was submitted. (3) Program standard...

  18. 49 CFR 659.39 - Oversight agency reporting to the Federal Transit Administration.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... accidents, status of corrective actions, updates and modifications to rail transit agency program...-year safety review has been completed since the last annual report was submitted. (3) Program standard...

  19. 49 CFR 659.39 - Oversight agency reporting to the Federal Transit Administration.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... accidents, status of corrective actions, updates and modifications to rail transit agency program...-year safety review has been completed since the last annual report was submitted. (3) Program standard...

  20. 49 CFR 659.39 - Oversight agency reporting to the Federal Transit Administration.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... accidents, status of corrective actions, updates and modifications to rail transit agency program...-year safety review has been completed since the last annual report was submitted. (3) Program standard...

  1. Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry

    PubMed Central

    Park, Young Su; Park, Sang Min; Jun, Jin Yong

    2014-01-01

    Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea. PMID:25395966

  2. Squatting and urban renewal: the interaction of squatter movements and strategies of urban restructuring in Berlin.

    PubMed

    Holm, Andrej; Kuhn, Armin

    2011-01-01

    Squatting as a housing strategy and as a tool of urban social movements accompanies the development of capitalist cities worldwide. We argue that the dynamics of squatter movements are directly connected to strategies of urban renewal in that movement conjunctures occur when urban regimes are in crisis. An analysis of the history of Berlin squatter movements, their political context and their effects on urban policies since the 1970s, clearly shows how massive mobilizations at the beginning of the 1980s and in the early 1990s developed in a context of transition in regimes of urban renewal. The crisis of Fordist city planning at the end of the 1970s provoked a movement of "rehab squatting" ('Instandbesetzung'), which contributed to the institutionalization of "cautious urban renewal" ('behutsame Stadterneuerung') in an important way. The second rupture in Berlin's urban renewal became apparent in 1989 and 1990, when the necessity of restoring whole inner-city districts constituted a new, budget-straining challenge for urban policymaking. Whilst in the 1980s the squatter movement became a central condition for and a political factor of the transition to "cautious urban renewal," in the 1990s large-scale squatting — mainly in the eastern parts of the city — is better understood as an alien element in times of neoliberal urban restructuring.

  3. 20 CFR 627.902 - Governor's actions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Governor's actions. 627.902 Section 627.902... PROGRAMS UNDER TITLES I, II, AND III OF THE ACT Transition Provisions § 627.902 Governor's actions. The...) Modify the Governor's coordination and special services plan in accordance with instructions issued by...

  4. 77 FR 322 - Notice of Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-04

    ... Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice... judicial review of the FTA actions announced herein for the listed public transportation project will be... FTA has taken final agency actions by issuing certain approvals for the public transportation projects...

  5. 75 FR 13335 - Notice of Limitation on Claims Against Proposed Public Transportation Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-19

    ... Proposed Public Transportation Projects AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice... judicial review of the FTA actions announced herein for the listed public transportation projects will be... FTA has taken final agency actions by issuing certain approvals for the public transportation projects...

  6. 78 FR 50323 - Amendment of Class E Airspace; Lexington, OK

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ...-0272; Airspace Docket No. 13-ASW-10] Amendment of Class E Airspace; Lexington, OK AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: This action amends Class E airspace at... Class E surface area to a Class E transition area. This action enhances the safety and management of...

  7. Current update on portable dental equipment.

    PubMed

    Charlton, David G; Ehrlich, A D; Miniotis, Nicholas J

    2007-02-01

    The dental care needs of the elderly are increasing as their population grows. For some of the elderly (eg, the nonambulatory, homebound, institutionalized), accessing dental care is a problem because they are unable to visit a traditional dental clinic. In the past, dental care has been taken to the homebound or institutionalized elderly by dentists using portable dental equipment. However, the perception that such equipment is difficult or impossible to obtain has limited the availability of on-site care. The purpose of this article is to describe various types of portable dental equipment and their features so that dentists interested in providing care to this group of patients are aware of them.

  8. Patterns of family caregiving and support provided to older psychiatric patients in long-term care.

    PubMed

    Beeler, J; Rosenthal, A; Cohler, B

    1999-09-01

    Data on patterns of relationships and caregiving between older, institutionalized chronically mentally ill patients and their families were gathered in brief face-to-face interviews with 109 patients randomly selected from residents age 45 or older in a large intermediate care facility in Chicago. Three-fourths of the sample maintained some form of family contact. One-third had been married or had children. Siblings were the most frequently identified family contact and support. The results suggests that older, institutionalized psychiatric patients continue to have family contact and that siblings and offspring become increasingly important as patients age.

  9. Interface between intellectual disability and mental health: hermeneutic review.

    PubMed

    Surjus, Luciana Togni de Lima e Silva; Campos, Rosana Teresa Onocko

    2014-06-01

    A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population. 

  10. Validation of the Italian version of the Apathy Evaluation Scale (AES-I) in institutionalized geriatric patients.

    PubMed

    Borgi, Marta; Caccamo, Floriana; Giuliani, Alessandro; Piergentili, Alessandro; Sessa, Sonia; Reda, Emilia; Alleva, Enrico; Cirulli, Francesca; Miraglia, Fabio

    2016-01-01

    Apathy is a very common symptom in the institutionalized elderly and represents a condition of both clinical and public health importance. The Apathy Evaluation Scale (AES) has been shown to be a valid and reliable tool for characterizing, quantifying and differentiating apathy in various health conditions. The aims of this study were to establish the validity and reliability of the Italian version of the AES, and to assess the severity of apathy in a sample of Italian institutionalized geriatric patients. Data were collected from clinical interviews using the AES informant version (AES-I). Associations between measures of apathy and depression, cognitive functioning and perceived quality of life were evaluated, as well as the effects of the living environment on apathetic symptoms. Multiple forms of reliability and validity (i.e. test-retest, internal consistency, discriminability of apathy rating from a standard measure of depression) were satisfied. Our results also show that the characteristics of the care setting may affect the severity of apathetic symptoms. The AES-I Italian version is a reliable and valid instrument for measuring apathy in Italian patients, also allowing a direct comparison with data gathered in other countries.

  11. [The Impact of Sunlight Exposure on the Health of Older Adults].

    PubMed

    Lin, Tzu-Chia; Liao, Yen-Chi

    2016-08-01

    Appropriate exposure to sunlight not only contributes to the production of vitamin D, which has been associated with enhanced bone health, mood, and cognitive functions, but also regulates the secretion of melatonin, which has been associated with the mediation of circadian rhythms, improved sleep quality, and optimized physical and social activity in the elderly. However, damage to the skin, eyes, and immune system has also been widely associated with long-term exposure to sunlight. Several studies have shown that many elderly, especially those that reside in institutions, do not receive sufficient sunlight exposure. Institutionalized elderly tend to participate in indoor activities and spend significant periods of time alone and asleep in front of the television. Furthermore, factors such as poor health, environmental design, indoor/outdoor preference, and activity design may impact the access of institutionalized elderly to sunlight more than their non-institutionalized peers. Therefore, we suggest that in addition to obtaining sufficient levels of vitamin D from their diet and from supplements, the elderly should perform outdoor activities for 20-30 minutes a day for five days each week. Furthermore, we suggest that the environment of the care facility should be made be more accessible and that some activities should be held outdoors.

  12. Factors associated with sarcopenia in institutionalized elderly.

    PubMed

    Mesquita, Alice Ferreira; Silva, Emanuelle Cruz da; Eickemberg, Michaela; Roriz, Anna Karla Carneiro; Barreto-Medeiros, Jairza Maria; Ramos, Lílian Barbosa

    2017-03-30

    The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.

  13. Center for Science and Technology Policy Research

    Science.gov Websites

    Expect Surprise: Hurricanes Harvey, Irma, Maria, and Beyond Ten Essentials for Action-Oriented and Second Goldstein Bruce Goldstein Ten Essentials for Action-Oriented and Second Order Energy Transitions

  14. Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data

    PubMed Central

    2013-01-01

    Background Dementia patients are often cared for in institutional arrangements, which are associated with substantial spending on professional long-term care services. Nevertheless, there is little evidence on the exact cost differences between community-based and institutional dementia care, especially when it comes to the distinct health care services. Adopting the perspective of the German social security system, which combines Statutory Health Insurance and Compulsory Long-Term Care Insurance (payer perspective), our study aimed to compare community-living and institutionalized dementia patients regarding their health care service utilization profiles and to contrast the respective expenditures. Methods We analysed 2006 claims data for 2,934 institutionalized and 5,484 community-living individuals stratified by so-called care levels, which reflect different needs for support in activities of daily living. Concordant general linear models adjusting for clinical and demographic differences were run for each stratum separately to estimate mean per capita utilization and expenditures in both settings. Subsequently, spending for the community-living and the institutionalized population as a whole was compared within an extended overall model. Results Regarding both settings, health and long-term care expenditures rose the higher the care level. Thus, long-term care spending was always increased in nursing homes, but health care spending was comparable. However, the underlying service utilization profiles differed, with nursing home residents receiving more frequent visits from medical specialists but fewer in-hospital services and anti-dementia drug prescriptions. Altogether, institutional care required additional yearly per capita expenses of ca. €200 on health and ca. €11,200 on long-term care. Conclusion Community-based dementia care is cost saving from the payer perspective due to substantially lower long-term care expenditures. Health care spending is comparable but community-living and institutionalized individuals present characteristic service utilization patterns. This apparently reflects the existence of setting-specific care strategies. However, the bare economic figures do not indicate whether these different concepts affect the quality of care provision and disregard patient preferences and caregiver-related aspects. Hence, additional research combining primary and secondary data seems to be required to foster both, sound allocation of scarce resources and the development of patient-centred dementia care in each setting. PMID:23286826

  15. Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data.

    PubMed

    Schwarzkopf, Larissa; Menn, Petra; Leidl, Reiner; Graessel, Elmar; Holle, Rolf

    2013-01-03

    Dementia patients are often cared for in institutional arrangements, which are associated with substantial spending on professional long-term care services. Nevertheless, there is little evidence on the exact cost differences between community-based and institutional dementia care, especially when it comes to the distinct health care services. Adopting the perspective of the German social security system, which combines Statutory Health Insurance and Compulsory Long-Term Care Insurance (payer perspective), our study aimed to compare community-living and institutionalized dementia patients regarding their health care service utilization profiles and to contrast the respective expenditures. We analysed 2006 claims data for 2,934 institutionalized and 5,484 community-living individuals stratified by so-called care levels, which reflect different needs for support in activities of daily living. Concordant general linear models adjusting for clinical and demographic differences were run for each stratum separately to estimate mean per capita utilization and expenditures in both settings. Subsequently, spending for the community-living and the institutionalized population as a whole was compared within an extended overall model. Regarding both settings, health and long-term care expenditures rose the higher the care level. Thus, long-term care spending was always increased in nursing homes, but health care spending was comparable. However, the underlying service utilization profiles differed, with nursing home residents receiving more frequent visits from medical specialists but fewer in-hospital services and anti-dementia drug prescriptions. Altogether, institutional care required additional yearly per capita expenses of ca. €200 on health and ca. €11,200 on long-term care. Community-based dementia care is cost saving from the payer perspective due to substantially lower long-term care expenditures. Health care spending is comparable but community-living and institutionalized individuals present characteristic service utilization patterns. This apparently reflects the existence of setting-specific care strategies. However, the bare economic figures do not indicate whether these different concepts affect the quality of care provision and disregard patient preferences and caregiver-related aspects. Hence, additional research combining primary and secondary data seems to be required to foster both, sound allocation of scarce resources and the development of patient-centred dementia care in each setting.

  16. Goal Engagement during the School-Work Transition: Beneficial for All, Particularly for Girls

    ERIC Educational Resources Information Center

    Haase, Claudia M.; Heckhausen, Jutta; Koller, Olaf

    2008-01-01

    The school-to-work transition presents a substantial regulatory challenge for youth in modern societies. Based on the action-phase model of developmental regulation, we investigated the effects of goal engagement on transition outcomes in a high-density longitudinal study of noncollege-bound German adolescents (N = 362). Career-related goal…

  17. Cross-Age Mentoring to Support A-Level Pupils' Transition into Higher Education and Undergraduate Students' Employability

    ERIC Educational Resources Information Center

    James, Alana I.

    2014-01-01

    Two challenges identified for psychology higher education are supporting entry students' transition, and supporting graduates' transition into employment. The evaluation of the first phase of a cross-age mentoring action research project targeting these issues is presented; eight psychology undergraduates mentored 20 A-level psychology pupils in…

  18. 40 CFR 71.4 - Program implementation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Transition plan for initial permits issuance. If a full or partial part 71 program becomes effective in a... action on initial permit applications for all part 71 sources in accordance with the following transition... part 71 and will assess and collect fees in accordance with the provisions of § 71.9. (l) Transition to...

  19. 40 CFR 71.4 - Program implementation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Transition plan for initial permits issuance. If a full or partial part 71 program becomes effective in a... action on initial permit applications for all part 71 sources in accordance with the following transition... part 71 and will assess and collect fees in accordance with the provisions of § 71.9. (l) Transition to...

  20. 40 CFR 71.4 - Program implementation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Transition plan for initial permits issuance. If a full or partial part 71 program becomes effective in a... action on initial permit applications for all part 71 sources in accordance with the following transition... part 71 and will assess and collect fees in accordance with the provisions of § 71.9. (l) Transition to...

  1. Supporting Students in Military Families during Times of Transition: A Call for Awareness and Action

    ERIC Educational Resources Information Center

    Cole, Rebekah F.

    2017-01-01

    Throughout their time in school, students in military families face many challenging periods of transition, which include deployments, relocations, and the family's separation from the military. During these transitions, students in military families may be especially susceptible to social, emotional, and academic challenges both in their home…

  2. The transition to adulthood of young adults with IDD: Parents' joint projects.

    PubMed

    Young, Richard A; Marshall, Sheila K; Stainton, Tim; Wall, Jessie M; Curle, Deirdre; Zhu, Ma; Munro, David; Murray, John; El Bouhali, Asmae; Parada, Filomena; Zaidman-Zait, Anat

    2018-03-01

    Parents have found the transition to adulthood for their sons or daughters with intellectual and/or developmental disabilities (IDD) particularly challenging. The literature has not examined how parents work together and with others in face of this transition nor has it highlighted parental goals in this process. This study used a perspective based on joint, goal-direct action to describe the projects that Canadian parents engaged in together and with others relative to this transition. Using the qualitative action-project method, joint projects between parents and with others were identified from their conversations and followed for 6 months. Three groups of projects were described: equipping the young adult for adult life, connecting for personal support and managing day-to-day while planning for the future. Parents act together and with others relative to the transition to adulthood of their young adult children with IDD. These projects are complex and differ in goals, steps, resources and emotional regulation and motivation. © 2017 John Wiley & Sons Ltd.

  3. Greenhouse gas emissions from transit projects : programmatic assessment.

    DOT National Transportation Integrated Search

    2017-01-01

    The National Environmental Policy Act (NEPA) requires federal agencies to disclose and analyze the environmental effects of their proposed actions. The Federal Transit Administration (FTA) currently believes that assessing the effects of greenhouse g...

  4. 23 CFR 810.208 - Action by the Federal Highway Administrator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TRANSPORTATION MASS TRANSIT AND SPECIAL USE HIGHWAY PROJECTS Making Highway Rights-of-Way Available for Mass... may authorize the State to make available to the publicly-owned mass transit authority the land needed...

  5. Draft greenhouse gas emissions from transit projects : programmatic assessment

    DOT National Transportation Integrated Search

    2016-11-01

    The National Environmental Policy Act (NEPA) requires federal agencies to disclose and analyze the environmental effects of their proposed actions. The Federal Transit Administration (FTA) currently believes that assessing the effects of greenhouse g...

  6. Greenhouse gas emissions from transit projects : programmatic assessment

    DOT National Transportation Integrated Search

    2017-01-01

    The National Environmental Policy Act (NEPA) requires federal agencies to disclose and analyze the environmental effects of their proposed actions. The Federal Transit Administration (FTA) currently believes that assessing the effects of greenhouse g...

  7. A remark on the phase transitions of modified action spin and gauge models

    NASA Astrophysics Data System (ADS)

    Seiberg, Nathan; Solomon, Sorin

    1983-06-01

    We consider the phase diagrams of modified action gauge and spin models and concentrate on their periphery - infinitely far from their origins (zero temperature - β-1 = 0). In this limit the exact positions of the phase transitions are found by looking for the global minimum of the single plaquette action (for a spin system - the single link energy). As the parameters of the model are varied, the position of such a global minimum is in general changed. When this changed is non-analytic, a phase transition takes place. The phase structure for finite β is clearly similar, but not identical to the infinite β one. We discuss several finite β corrections that should be applied to the exactly known infinite β picture. We confront our analysis for infinite β2 = ∑ iβ2i with the Monte Carlo simulations for two four-dimensional gauge systems: an SU(3) gauge model with action S=-Re∑ p( β1tr Up+ β2(tr Up) 2) and an SU(2) model with S=- Re Σ p[β 1{1}/{2}trU p+β 2( {1}/{2}trU p) 2+β 3( {1}/{2}trU p) 3] .

  8. Transit Operator Guidelines for Transfer Policy Design

    DOT National Transportation Integrated Search

    1980-06-01

    This report provides guidelines to aid transit operators in the design of policies to accomodate bus and/or rail transfers policy may range from a complete set of operator actions involving vehicle routing and scheduling, transfer charges, passenger ...

  9. The Prosody of Topic Transition in Interaction: Pitch Register Variations.

    PubMed

    Riou, Marine

    2017-12-01

    In conversation, speakers can mobilize a variety of prosodic cues to signal a switch in topics. This paper uses a mixed-methods approach combining Conversation Analysis and Instrumental Prosody to investigate the prosody of topic transition in American English, and analyzes the ways in which speakers can play on register level and on register span. A cluster of three prosodic parameters was found to be predictive of transitions: a higher maximum fundamental frequency (F0), a higher median F0 (key), and an expanded register span. Relative to speakers' habitual profiles, the mobilization of such prosodic cues corresponds to a marked upgraded prosodic design. This finding is consistent with the general assumption that continuation constitutes the norm in conversation, and that departing from it, as in the case of a topic transition, requires a marked action and marked linguistic design. The disjunctive action of opening a new topic corresponds to the use of a marked prosodic cue.

  10. Project Management Framework to Organizational Transitions

    NASA Technical Reports Server (NTRS)

    Kotnour, Tim; Barton, Saul

    1996-01-01

    This paper describes a project management framework and associated models for organizational transitions. The framework contains an integrated set of steps an organization can take to lead an organizational transition such as downsizing and change in mission or role. The framework is designed to help an organization do the right work the right way with the right people at the right time. The underlying rationale for the steps in the framework is based on a set of findings which include: defining a transition as containing both near-term and long-term actions, designing actions which respond to drivers and achieve desired results, aligning the organization with the external environment, and aligning the internal components of the organization. The framework was developed based on best practices found in the literature, lessons learned from heads of organizations who have completed large-scale organizational changes, and concerns from employees at the Kennedy Space Center (KSC). The framework is described using KSC.

  11. 77 FR 4858 - Culturally Significant Objects Imported for Exhibition Determinations: “Byzantium and Islam: Age...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... Determinations: ``Byzantium and Islam: Age of Transition (7th-9th Century)'' AGENCY: Department of State. ACTION... to the exhibition ``Byzantium and Islam: Age of Transition (7th-9th Century). The referenced notice... objects to be included in the exhibition ``Byzantium and Islam: Age of Transition (7th-9th Century...

  12. Special population planner 4 : an open source release.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kuiper, J.; Metz, W.; Tanzman, E.

    2008-01-01

    Emergencies like Hurricane Katrina and the recent California wildfires underscore the critical need to meet the complex challenge of planning for individuals with special needs and for institutionalized special populations. People with special needs and special populations often have difficulty responding to emergencies or taking protective actions, and emergency responders may be unaware of their existence and situations during a crisis. Special Population Planner (SPP) is an ArcGIS-based emergency planning system released as an open source product. SPP provides for easy production of maps, reports, and analyses to develop and revise emergency response plans. It includes tools to manage amore » voluntary registry of data for people with special needs, integrated links to plans and documents, tools for response planning and analysis, preformatted reports and maps, and data on locations of special populations, facility and resource characteristics, and contacts. The system can be readily adapted for new settings without programming and is broadly applicable. Full documentation and a demonstration database are included in the release.« less

  13. Foundations for value education in engineering: the Indian experience.

    PubMed

    Gupta, Amitabha

    2015-04-01

    The objective of this paper is to discuss some of the foundational issues centering around the question of integrating education in human values with professional engineering education: its necessity and justification. The paper looks at the efforts in 'tuning' the technical education system in India to the national goals in the various phases of curriculum development. The contribution of the engineering profession in national development and India's self-sufficiency is crucially linked with the institutionalization of expertise and the role of morality and responsibility. This linkage can be created through a proper understanding of the social role of the profession-what motivates the professionals and what makes professional life meaningful. Value education facilitates the process of moral maturity and the development of a 'holistic' mindset. This paper deals with the need to create such a mindset, the human values associated with it and gives examples of efforts to impart such education through 'action-oriented' programmes introduced in some institutes of engineering in India.

  14. The skeptic's guide to a movement for universal health insurance.

    PubMed

    Nathanson, Constance A

    2003-01-01

    The social movement has become institutionalized as a form of political action. The aim of this article is to evaluate the possibilities presented by this form as a strategy to bring about universal health insurance in the United States. I draw on the work of social movement theorists, on the substantial body of empirical research on health-related social movements, and on relevant comparative work from Canada to develop a template for this evaluation. Using that template I compare the failed campaign for President Bill Clinton's health insurance plan with a recent, more successful campaign in the state of New York. I conclude that the keys to success are, first, a broad-based coalition that combines an ideologically and/or grievance-motivated grass roots with financially and politically well-endowed mainstream organizations; second, a "master frame" that resonates with the American people; and, third, a political window of opportunity. The prospects for such a conjunction are not hopeless, but they are not high.

  15. [Participants recruitment in ELSA-Brasil (Brazilian Longitudinal Study for Adult Health)].

    PubMed

    Aquino, Estela M L; Araujo, Maria Jenny; Almeida, Maria da Conceição C; Conceição, Patrícia; Andrade, Célia Regina de; Cade, Nágela Valadão; Carvalho, Marilia Sá; Figueiredo, Roberta Carvalho de; Fonseca, Maria de Jesus M da; Giatti, Luana; Menezes, Greice Maria de Souza; Nunes, Maria Angélica; Souza, Angelita Gomes de; Vasconcellos-Silva, Paulo R; Vigo, Alvaro

    2013-06-01

    To present the recruitment and communication strategies of the ELSA-Brasil (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health). The strategies were directed at dissemination, institutionalization and recruitment. The communication actions intended to promote the strengthening of a positive institutional image for the study, knowledge management and an effective dialogue with its target audience. An official website was created in order to communicate with different audiences, to disseminate scientific knowledge, and to contribute to consolidate the image of the study within society. We recruited 16,435 men and women, active employees and retirees of six public institutions of education and research, to constitute the cohort of 15,105 participants. The recruitment goals were fully achieved in the six centers, with a slight predominance of women and of younger adults, and slightly fewer employees with lower level of schooling. The strategies used were adequate and essential to the successful inclusion and participation of the employees.

  16. Primary care in the United States and its precarious future.

    PubMed

    Starfield, Barbara; Oliver, Thomas

    1999-09-01

    Primary care has not secured a firm place within the US health services system. Since primary care lacks a strong research base, is not institutionalized in medical education or in policy-making and is marginalized in both proposed and actual reforms, it has not developed into a central component of the health care infrastructure. We discuss recent efforts that promised modest improvements, including the Clinton health care reform proposals and subsequent federal and state actions, in the role of primary care within the health services system. We also assess the likely fate of primary care given the accelerated growth of managed care and market competition, the dissatisfaction of large segments of the population with managed care and misperceptions of managed care as synonymous with primary care. We highlight how managed care fails to achieve the cardinal functions of primary care and summarize initiatives that, at a minimum, would be required to secure a stronger position for primary care in the future.

  17. Application of strengths, weaknesses, opportunities and threats analysis in the development of a health technology assessment program.

    PubMed

    Gibis, B; Artiles, J; Corabian, P; Meiesaar, K; Koppel, A; Jacobs, P; Serrano, P; Menon, D

    2001-10-01

    There has been recent interest in developing a health technology assessment (HTA) function in Estonia. A group of individuals knowledgeable about HTA in Canada, Germany, Romania and Spain, along with representatives of the University of Tartu, Estonia, was convened by the Institute of Health Economics in Edmonton, Canada, to consider options for such a function. In a one-day workshop strengths, weaknesses, opportunities and threats (SWOT) analyses of HTA were conducted, first at a 'global' level, and then of the Estonian situation. The 'global' SWOT analysis yielded a large number of items that pertain to institutionalized HTA in a generic sense, i.e. not based on any individual HTA agency. The 'Estonian' SWOT yielded a subset of items, which pertain to development of HTA in that country. Ten actionable steps were then developed on the basis of this subset, which could be used to initiate the creation of an HTA body in Estonia.

  18. Parity-Time Symmetry Breaking in Spin Chains.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Galda, Alexey; Vinokur, Valerii M.

    We investigate nonequilibrium phase transitions in classical Heisenberg spin chains associated with spontaneous breaking of parity-time (PT) symmetry of the system under the action of Slonczewski spin-transfer torque (STT) modeled by an applied imaginary magnetic field. We reveal the STT-driven PT symmetry-breaking phase transition between the regimes of precessional and exponentially damped spin dynamics and show that its several properties can be derived from the distribution of zeros of the system's partition function, the approach first introduced by Yang and Lee for studying equilibrium phase transitions in Ising spin chains. The physical interpretation of imaginary magnetic field as describing themore » action of nonconservative forces opens the possibility of direct observations of Lee-Yang zeros in nonequilibrium physical systems.« less

  19. Parity-time symmetry breaking in spin chains

    NASA Astrophysics Data System (ADS)

    Galda, Alexey; Vinokur, Valerii M.

    2018-05-01

    We investigate nonequilibrium phase transitions in classical Heisenberg spin chains associated with spontaneous breaking of parity-time (PT ) symmetry of the system under the action of Slonczewski spin-transfer torque (STT) modeled by an applied imaginary magnetic field. We reveal the STT-driven PT symmetry-breaking phase transition between the regimes of precessional and exponentially damped spin dynamics and show that its several properties can be derived from the distribution of zeros of the system's partition function, the approach first introduced by Yang and Lee for studying equilibrium phase transitions in Ising spin chains. The physical interpretation of imaginary magnetic field as describing the action of nonconservative forces opens the possibility of direct observations of Lee-Yang zeros in nonequilibrium physical systems.

  20. The challenge of sustaining effectiveness over time: the case of the global network to stop tuberculosis.

    PubMed

    Quissell, Kathryn; Walt, Gill

    2016-04-01

    Where once global health decisions were largely the domain of national governments and the World Health Organization, today networks of international organizations, governments, private philanthropies and other entities are actively shaping public policy. However, there is still limited understanding of how global networks form, how they create institutions, how they promote and sustain collective action, and how they adapt to changes in the policy environment. Understanding these processes is crucial to understanding their effectiveness: whether and how global networks influence policy and public health outcomes. This study seeks to address these gaps through the examination of the global network to stop tuberculosis (TB) and the factors influencing its effectiveness over time. Drawing from ∼ 200 document sources and 16 interviews with key informants, we trace the development of the Global Partnership to Stop TB and its work over the past decade. We find that having a centralized core group and a strategic brand helped the network to coalesce around a primary intervention strategy, directly observed treatment short course. This strategy was created before the network was formalized, and helped bring in donors, ministries of health and other organizations committed to fighting TB-growing the network. Adaptations to this strategy, the creation of a consensus-based Global Plan, and the creation of a variety of participatory venues for discussion, helped to expand and sustain the network. Presently, however, tensions have become more apparent within the network as it struggles with changing internal political dynamics and the evolution of the disease. While centralization and stability helped to launch and grow the network, the institutionalization of governance and strategy may have constrained adaptation. Institutionalization and centralization may, therefore, facilitate short-term success for networks, but may end up complicating longer-term effectiveness. © Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

  1. Identification of the Fire Threat in Urban Transit Vehicles

    DOT National Transportation Integrated Search

    1980-06-01

    To improve mass transportation, UMTA tasked the Transportation Systems Center (TSC) to assess the overall fire threat in transit systems and to identify and recommend suitable remedial actions. This report presents the identification of the fire thre...

  2. 78 FR 44399 - Semiannual Regulatory Flexibility Agenda

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ... of Basel III, Minimum Regulatory Capital Ratios, Capital Adequacy, and Transition Provisions. (Docket... Further Action........ 12/00/13 Regulatory Flexibility Analysis Required: Yes. Agency Contact: Dena... Regulatory Capital Ratios, Capital Adequacy, and Transition Provisions. (Docket No. R-1442) Legal Authority...

  3. 77 FR 42354 - Designation of Transportation Management Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Federal Highway Administration Designation of Transportation Management Areas AGENCIES: Federal Transit Administration (FTA), Federal Highway... Management Areas (TMAs). The FTA and FHWA are taking this action in compliance with the agencies' authorizing...

  4. Bus transportation in Connecticut : data for planning, agenda for action

    DOT National Transportation Integrated Search

    1974-03-01

    Presents the conclusions and recommendations of the Connecticut Public Expenditure Council regarding the present status of bus transit service throughout Connecticut; operational and funding issues; status of bus transit elsewhere in the U. S. and se...

  5. [The history of the institutionalization of medical psychology in Austria].

    PubMed

    Hirnsperger, Hans; Mundschütz, Reinhard; Sonneck, Gernot

    2011-01-01

    Beginning with Freudian psychoanalysis and the Zürich school of psychiatry, which in the early 20th century were the first to call for studies in medical psychology at universities, the article traces the path to the institutionalization of medical psychology in Austria especially in Vienna. Particular attention is devoted to the Academic Society for Medical Psychology (Akademischer Verein für Medizinische Psychologie) which held lectures and courses at the University of Vienna from 1926 to 1938. The Society can thus be viewed as a predecessor of the foundation of the institutes for medical psychology and psychotherapeutic clinics, starting in the late 1960s and continuing into the early 1980s.

  6. Interface between Intellectual Disability and Mental Health: hermeneutic review

    PubMed Central

    Surjus, Luciana Togni de Lima e Silva; Campos, Rosana Teresa Onocko

    2014-01-01

    A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population.  PMID:25119948

  7. An Exploration into the Expansion of the Transition Program to Meet the Needs of Students with Cognitive Impairments

    ERIC Educational Resources Information Center

    Codey, Emily

    2013-01-01

    The purpose of this mixed methods action research study was to collect data in order to expand the current transition program in place for students with cognitive impairments. Qualitative and quantitative data was collected from district stakeholders regarding the current transition program in place for students with cognitive impairments. In…

  8. Crossing the Cultural Boundary from Home to Kindergarten in Hong Kong: A Case Study of a Child's Strategic Actions

    ERIC Educational Resources Information Center

    Lam, Mei Seung

    2009-01-01

    Transition from home to kindergarten is the first and major ecological transition in children's educational lives in Hong Kong. In this transition, children cross a cultural boundary from home to kindergarten and start to learn about "school" as a place to learn and about themselves as "pupils" in kindergarten. The conceptual…

  9. 78 FR 26112 - Limitation on Claims Against Proposed Public Transportation Projects; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Limitation on Claims Against Proposed Public Transportation Projects; Correction AGENCY: Federal Transit Administration (FTA), DOT. ACTION... Register on April 22, 2013, concerning a limitation on claims for certain specified public transportation...

  10. 76 FR 39151 - Agency Information Collection Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration [FTA Docket No. FTA-2011-0038 ] Agency Information Collection Activity Under OMB Review AGENCY: Federal Transit Administration, DOT. ACTION: Notice... authorities for financing mass transportation projects. Grant recipients are required to make information...

  11. Person-Centered Transition Planning.

    ERIC Educational Resources Information Center

    Miner, Craig A.; Bates, Paul E.

    1997-01-01

    Describes a person-centered planning approach for involving students with disabilities and their families in the transition planning process. Components of person-centered planning are discussed, including development of a personal profile, identification of future lifestyle preferences, action steps and responsible parties, and necessary changes…

  12. The transition from event reports to measurable organizational impact : workshop proceedings report.

    DOT National Transportation Integrated Search

    2014-03-01

    Collecting, analyzing, and transitioning data into actionable solutions is one of the most critical endeavors : in aviation. There are a number of challenges that plague event reporting and analysis. This report describes : the top 10 challenges: : 1...

  13. Validity, efficacy and reliability of 3 nutritional screening tools regarding the nutritional assessment in different social and health areas.

    PubMed

    Castro-Vega, Iciar; Veses Martín, Silvia; Cantero Llorca, Juana; Barrios Marta, Cristina; Bañuls, Celia; Hernández-Mijares, Antonio

    2018-03-09

    Nutritional screening allows for the detection of nutritional risk. Validated tools should be implemented, and their usefulness should be contrasted with a gold standard. The aim of this study is to discover the validity, efficacy and reliability of 3 nutritional screening tools in relation to complete nutritional assessment. A sub-analysis of a cross-sectional and descriptive study on the prevalence of disease-related malnutrition. The sample was selected from outpatients, hospitalized and institutionalized patients. MUST, MNAsf and MST screening were employed. A nutritional assessment of all the patients was undertaken. The SENPE-SEDOM consensus was used for the diagnosis. In the outpatients, both MUST and MNAsf have a similar validity in relation to the nutritional assessment (AUC 0.871 and 0.883, respectively). In the institutionalized patients, the MUST screening method is the one that shows the greatest validity (AUC 0.815), whereas in the hospitalized patients, the most valid methods are both MUST and MST (AUC 0.868 and 0.853, respectively). It is essential to use nutritional screening to invest the available resources wisely. Based on our results, MUST is the most suitable screening method in hospitalized and institutionalized patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Institutionalizing Telemedicine Applications: The Challenge of Legitimizing Decision-Making

    PubMed Central

    Lettieri, Emanuele

    2011-01-01

    During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements— rationality, fairness, and efficiency—that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications—benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators’ perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed. PMID:21955510

  15. The role of civil society organizations in the institutionalization of indigenous medicine in Bolivia.

    PubMed

    Babis, Deby

    2014-12-01

    December 2013 marked a significant shift in Bolivia with the enactment of a law for the inclusion of indigenous doctors in the National Health System. This article traces the constellation of forces that led to the institutionalization of indigenous medicine in Bolivia. It identifies three factors contributing to this health policy change. The first factor is the crystallization of a strong indigenous movement fighting for the recognition of cultural rights through the foundation of civil society organizations. Second is the rise to power of Evo Morales, the first Latin American president of indigenous origin, who has promoted multicultural policies, formally supported through the promulgation of a new constitution. Lastly is the influence of the global acceptance of alternative medicine. Indigenous doctor organizations in Bolivia have been highly involved throughout the entire process of institutionalization and have played a crucial role in it. An analysis of the relationship between these civil society organizations and the Bolivian government reveals a strong partnership. This dynamic can be described in terms of Interdependence Theory, as each party relied on the other in the promotion and practice of the law to achieve the integration of indigenous medicine as part of the Bolivian Health System. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

    PubMed Central

    Wright, John; Parry, Jayne; Scully, Edward

    2005-01-01

    European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device. PMID:15976899

  17. Institutionalizing telemedicine applications: the challenge of legitimizing decision-making.

    PubMed

    Zanaboni, Paolo; Lettieri, Emanuele

    2011-09-28

    During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements--rationality, fairness, and efficiency--that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications--benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators' perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.

  18. Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

    PubMed

    Wright, John; Parry, Jayne; Scully, Edward

    2005-06-01

    European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device.

  19. Atypical EEG Power Correlates With Indiscriminately Friendly Behavior in Internationally Adopted Children

    PubMed Central

    Tarullo, Amanda R.; Garvin, Melissa C.; Gunnar, Megan R.

    2012-01-01

    While effects of institutional care on behavioral development have been studied extensively, effects on neural systems underlying these socioemotional and attention deficits are only beginning to be examined. The current study assessed electroencephalogram (EEG) power in 18-month-old internationally adopted, post-institutionalized children (n = 37) and comparison groups of non-adopted children (n = 47) and children internationally adopted from foster care (n = 39). For their age, post-institutionalized children had an atypical EEG power distribution, with relative power concentrated in lower frequency bands compared to non-adopted children. Both internationally adopted groups had lower absolute alpha power than non-adopted children. EEG power was not related to growth at adoption or to global cognitive ability. Atypical EEG power distribution at 18 months predicted indiscriminate friendliness and poorer inhibitory control at 36 months. Both post-institutionalized and foster care children were more likely than non-adopted children to exhibit indiscriminate friendliness. Results are consistent with a cortical hypoactivation model of the effects of early deprivation on neural development and provide initial evidence associating this atypical EEG pattern with indiscriminate friendliness. Outcomes observed in the foster care children raise questions about the specificity of institutional rearing as a risk factor and emphasize the need for broader consideration of the effects of early deprivation and disruptions in care. PMID:21171750

  20. The socioeconomic health gradient across the life cycle: what role for selective mortality and institutionalization?

    PubMed Central

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-01-01

    Several studies have documented the now fairly stylized fact that health inequalities by income differ across the age distribution: in cross-sections the health gap between rich and poor tends to widen until about age 50 and then declines at higher ages. It has been suggested that selective mortality and institutionalization could be important factors driving the convergence at higher ages. We use eight waves of a health survey linked to four registries (on mortality, hospitalizations, (municipal) residence status and taxable incomes) to test this hypothesis. We construct life cycle profiles of health for birth year/gender/income groups from the health surveys (based on 128,689 observations) and exploit the registries to obtain precise estimates of individual probabilities of mortality and institutionalization using a seven year observation period for 2,521,122 individuals. We generate selection corrected health profiles using an inverse probability weighting procedure and find that attrition is indeed not random: older, poorer and unhealthier individuals are significantly more likely not to survive the next year and to be admitted to an institution. While these selection effects are very significant, they are not very large. We therefore reject the hypothesis that selective dropout is an important determinant of the differential health trajectories by income over the life course in the Netherlands. PMID:24161090

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