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

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

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...

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...

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...

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...

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…

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...

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...

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...

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...

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…

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.

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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"…

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…

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…

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.

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-...

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.

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…

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...

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...

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...

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...

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...

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…

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…

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.

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

[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.

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

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.

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.

[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.

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,…

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…

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

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

[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.

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.

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.

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.

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…

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...

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...

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…

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

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.

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,…

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.

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.

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

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.

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.

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…

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

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

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.

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…

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.

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.

[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.

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.

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…

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,…

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…

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…

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…

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,…

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…

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.…

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…

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] .

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.

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)

Emerging Early Actions to Bend the Curve in Sub-Saharan Africa's Nutrition Transition.

PubMed

Haggblade, Steven; Duodu, Kwaku G; Kabasa, John D; Minnaar, Amanda; Ojijo, Nelson K O; Taylor, John R N

2016-06-01

Sub-Saharan Africa is the last region to undergo a nutrition transition and can still avoid its adverse health outcomes. The article explores emerging responses to "bend the curve" in sub-Saharan Africa's nutrition transition to steer public health outcomes onto a healthier trajectory. Early responses in 3 countries at different stages of food system transformation are examined: South Africa-advanced, Ghana-intermediate, and Uganda-early. By comparing these with international experience, actions are proposed to influence nutrition and public health trajectories as Africa's food systems undergo rapid structural change. Arising from rapid urbanization and diet change, major public health problems associated with overweight are taking place, particularly in South Africa and among adult women. However, public health responses are generally tepid in sub-Saharan Africa. Only in South Africa have policy makers instituted extensive actions to combat overweight and associated noncommunicable diseases through regulation, education, and public health programs. Elsewhere, in countries in the early and middle stages of transition, public health systems continue to focus their limited resources primarily on undernutrition. Related pressures on the supply side of Africa's food systems are emerging that also need to be addressed. Three types of intervention appear most feasible: maternal and child health programs to simultaneously address short-term undernutrition problems while at the same time helping to reduce future tendencies toward overweigh; regulatory and fiscal actions to limit access to unhealthy foods; and modernization of Africa's agrifood food system through job skills training, marketing reforms, and food industry entrepreneurship. © The Author(s) 2016.

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.

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

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.

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...

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.

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...

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...

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...

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...

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...

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…

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.

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)

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…

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.…

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.

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.

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…

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.

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.

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

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…

Action reflections: a client-centered technique to bridge the WHY-HOW transition in Motivational Interviewing.

PubMed

Resnicow, Ken; McMaster, Fiona; Rollnick, Stephen

2012-07-01

When using Motivational Interviewing (MI), once resistance or ambivalence are resolved and motivation is solidified, many practitioners struggle with how best to transition the discussion toward action planning, while still retaining the spirit and style of client centeredness, i.e., moving from the WHY phase to the HOW phase of counseling in a style that is MI-consistent. For many, there is a perception that the counseling style, skills, and strategies used to build motivation are distinct from those used in the action planning phase. The WHY to HOW transition does not, however, necessitate abandoning a client-centered style for a more overtly educational or directive style. Goal setting, action planning, provision of advice, and relapse prevention can be implemented from an autonomy supportive, MI consistent framework. To this end, this article will present a new class of reflection, which we have termed "action reflections", that can be used to help bridge the WHY-HOW gap. Action reflections (AR) allow the clinician to maintain a tone and orientation that are consistent with MI, i.e. autonomy support; guiding versus directing, during the action phase of counseling. They differ from reflecting change talk as they focus not on the WHY of change, but the HOW, WHEN, or WHERE. Action Reflections (ARs) also differ from the more common type of reflections such as those that focus on client feelings, rolling with resistance, or acknowledging ambivalence as ARs usually contain a potential concrete step that the client has directly or obliquely mentioned. Like any type of reflection, ARs represent the clinician's best guess for what the client has said or, more apropos here, where the conversation might be heading. This article describes the various types of ARs and provides examples of each to help clinicians incorporate them into their behavior change counseling.

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.

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…

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…

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.

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.

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…

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…

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.

[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.

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.

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…

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.

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

[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.

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.

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…

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

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

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…

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)

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…

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.

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.

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

Prioritizing bird conservation actions in the Prairie Hardwood transition of the Midwestern United States

USGS Publications Warehouse

Thogmartin, Wayne E.; Crimmins, Shawn M.; Pearce, Jennie

2014-01-01

Large-scale planning for the conservation of species is often hindered by a poor understanding of factors limiting populations. In regions with declining wildlife populations, it is critical that objective metrics of conservation success are developed to ensure that conservation actions achieve desired results. Using spatially explicit estimates of bird abundance, we evaluated several management alternatives for conserving bird populations in the Prairie Hardwood Transition of the United States. We designed landscapes conserving species at 50% of their current predicted abundance as well as landscapes attempting to achieve species population targets (which often required the doubling of current abundance). Conserving species at reduced (half of current) abundance led to few conservation conflicts. However, because of extensive modification of the landscape to suit human use, strategies for achieving regional population targets for forest bird species would be difficult under even ideal circumstances, and even more so if maintenance of grassland bird populations is also desired. Our results indicated that large-scale restoration of agricultural lands to native grassland and forest habitats may be the most productive conservation action for increasing bird population sizes but the level of landscape transition required to approach target bird population sizes may be societally unacceptable.

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

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

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.

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?…

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)

[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

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.

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.

[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.

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.

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

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…

[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.

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…

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.

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…

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

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

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.

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…

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)

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

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.

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.

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.

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.

Dental survey of institutionalized children with autistic disorder.

PubMed

Mohinderpal Chadha, Gagandeep; Kakodkar, Pradnya; Chaugule, Vishwas; Nimbalkar, Vidya

2012-01-01

The objective of this study was to assess the oral hygiene practices, dietary pattern, dental caries status and needs of institutionalized autistic children. The sample consisted of 35 children (28 males and 7 females) in the age group of 5 to 10 years from two institutions in Maharashtra, India. The parents of the children were interviewed regarding oral hygiene practices of their respective ward and instructed to maintain a 4-day diet chart for their children. A clinical examination was conducted using WHO dentition status and treatment needs index and a simplified oral hygiene index for ages 4 to 6 years and 7 to 10 years (deciduous and mixed dentition) was used to assess the oral hygiene. The results of diet chart analysis according to Nizel AE and Papas AS score showed the 'at meal' sugar exposure close to nil, while the 'in between' meal sugar exposure was observed to be more than three times per day among maximum children. The oral hygiene status was poor with abundance of soft debris and fair calculus accumulation. The mean caries experience (deft) in these children was 6.4. The present study provided baseline data which has been used for planning a comprehensive oral health care program. How to cite this article: Chadha GM, Kakodkar P, Chaugule V, Nimbalkar V. Dental Survey of Institutionalized Children with Autistic Disorder. Int J Clin Pediatr Dent 2012;5(1):29-32.

Dental Survey of Institutionalized Children with Autistic Disorder

PubMed Central

Kakodkar, Pradnya; Chaugule, Vishwas; Nimbalkar, Vidya

2012-01-01

ABSTRACT The objective of this study was to assess the oral hygiene practices, dietary pattern, dental caries status and needs of institutionalized autistic children. The sample consisted of 35 children (28 males and 7 females) in the age group of 5 to 10 years from two institutions in Maharashtra, India. The parents of the children were interviewed regarding oral hygiene practices of their respective ward and instructed to maintain a 4-day diet chart for their children. A clinical examination was conducted using WHO dentition status and treatment needs index and a simplified oral hygiene index for ages 4 to 6 years and 7 to 10 years (deciduous and mixed dentition) was used to assess the oral hygiene. The results of diet chart analysis according to Nizel AE and Papas AS score showed the ‘at meal’ sugar exposure close to nil, while the ‘in between’ meal sugar exposure was observed to be more than three times per day among maximum children. The oral hygiene status was poor with abundance of soft debris and fair calculus accumulation. The mean caries experience (deft) in these children was 6.4. The present study provided baseline data which has been used for planning a comprehensive oral health care program. How to cite this article: Chadha GM, Kakodkar P, Chaugule V, Nimbalkar V. Dental Survey of Institutionalized Children with Autistic Disorder. Int J Clin Pediatr Dent 2012;5(1):29-32. PMID:25206131

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…

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.

Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

PubMed

Herrmann, Nathan; Eryavec, Goran

1994-01-01

Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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.

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…

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…

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

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.

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…

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.

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.

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)

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…

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.

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.

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…

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…

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.

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…

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.

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.

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.

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…

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…

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.

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…

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.

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.

Fears of institutionalized mentally retarded adults.

PubMed

Sternlicht, M

1979-01-01

The patterns of fears of institutionalized mentally retarded adults were studied in a sample of i2 moderately retarded men and women between the ages of 21-49. The direct questioning method was employed. Two interviews were held, two weeks apart; the first interview elicited the Ss' fears, while the second concerned the fears of their friends. A total of 146 responses were obtained, and these were categorized according to the types of fears: supernatural-natural events, animals, physical injury, psychological stress, egocentric responses, and no fears. The Ss displayed a higher percentage of fears in the preoperational stage than in the concrete operational stage. In a comparison of male to female fears, only one category, that of fears of animals, reached significance. The study suggested that the same developmental trend of fears that appears in normal children appears in the retarded as well, and these fears follow Piaget's level of cognitive development, proceeding from egocentric perceptions of causality to realistic cause and effect thinking.

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.

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

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

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…

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…

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.

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

[Changes in depression and loneliness after laughter therapy in institutionalized elders].

PubMed

Quintero, Ángela; Henao, María Eucaris; Villamil, María Mercedes; León, Jairo

2015-01-01

Old age is a stage characterized by a number of factors, such as loneliness and depression, that have a negative effect on people´s lives. To evaluate the impact of laughter therapy on the level of depression and loneliness in a group of institutionalized elders. Exploratory research with quasi-experimental design applying Yesavage depression scale and the ESTE scale of loneliness, both validated for Colombia. The target population consisted of 49 men and women who were 59 years old or over, and lived in the Gerontological Home ´´Colonia de Belencito´´ in the city of Medellín (Antioquia); they were contacted between April and July 2013, and they received eight sessions of laughter therapy performed by the group "Hospital Clowns" of the Mediclaun Foundation from Medellín. There was a significant decrease in the level of depression especially in those with initial depression established (p<0,032). The most receptive were institutionalized elders who did not have a couple, they were between 65 and 75 years of age, and they belonged to socioeconomic level 2 and did not receive visits. No significant changes in the level of loneliness were recorded. The importance of laughter therapy in reducing the level of depression in elders is highlighted. These results agree with the statement indicating that the construct of loneliness is independent from depression.

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.

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…

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…

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.

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...

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...

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...

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...

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...

Oral health care activities performed by caregivers for institutionalized elderly in Barcelona-Spain

PubMed Central

Cornejo-Ovalle, Marco; Costa-de-Lima, Kenio; Pérez, Glória; Borrell, Carme; Casals-Peidro, Elías

2013-01-01

Objectives: To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. Methods: A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. Results: 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95%: 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). Conclusion: The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons. Key words:Institutionalized elderly

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).

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...

Virtual Morality: Transitioning from Moral Judgment to Moral Action?

PubMed Central

Francis, Kathryn B.; Howard, Charles; Howard, Ian S.; Gummerum, Michaela; Ganis, Giorgio; Anderson, Grace; Terbeck, Sylvia

2016-01-01

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. PMID:27723826

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...

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…

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.

Institutionalization of a Retention Model

NASA Astrophysics Data System (ADS)

Davis, E. J.; Campbell, A.

2006-05-01

Bowie State University and NASA Goddard Space Flight Center have, for the past 10 years, worked diligently together to enhance the science, mathematics, engineering and technology (SMET) domain. Efforts made, because of a Model Institutions for Excellence (MIE) Award, have changed the landscape of the SMET domain by increasing the retention and graduation rates, the number of students entering graduate and professional schools, and the number of students entering SMET related careers for minorities and women. Several initiatives a Scholarship Program, PRISEM Tutoring Center, Safety-net Program, Research emphasis, Focused Mentoring, a Summer Academy for accepted incoming students, a Bridge Program for students needing assistance being admitted to the University, the RISE Program and the Bowie State Satellite Operations and Control Center (BSOCC) provide the nurturing, mentoring, and opportunities for our students. As a result of efforts made, the retention rate has increase to approximately 80%, the graduation rate has increased 40%, and 85% of the SMET students are now interested or entering graduate and professional schools. Successes that have been documented by various assessment activities have led to the institutionalization of the Retention Model of the MIE Initiative. It is anticipated that University-wide application of the retention model will prove the incentives necessary to obtain similar results as the MIE Initiative.

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

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…

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

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

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...

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...

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...

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...

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.

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...

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…

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...

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.

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.

Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65.

PubMed

Buatois, Séverine; Gueguen, René; Gauchard, Gérome C; Benetos, Athanase; Perrin, Philippe P

2006-01-01

A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to

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…

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...

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.

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…

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.

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.

Child Maltreatment and Social Connectedness Among Formerly Institutionalized Females: Links With Depression.

PubMed

van Delft, Ivanka; Finkenauer, Catrin; Verbruggen, Janna

2016-05-01

This study aimed to examine the effects of child maltreatment subtypes (physical abuse, sexual abuse, neglect, and exposure to domestic violence) and cumulative child maltreatment on depressive symptoms in adulthood, and examine the protective effects of social connectedness in a sample of formerly institutionalized females. The sample consisted of 124 females who were institutionalized in a Dutch juvenile justice institution during adolescence and were followed-up when they were on average 32 years old. Information about child maltreatment was extracted from treatment files. Retrospective data on social connectedness in young adulthood were established during interviews using a Life History Calendar. Relationship quality at follow-up was assessed with items derived from the Rochester Youth Development Study. The Center for Epidemiological Studies Scale for Depression (CES-D) was used to measure depressive symptoms in adulthood. Results showed that 85.5% of the females experienced child maltreatment, and co-occurrence of subtypes was high. Cumulative child maltreatment increased the risk of depression in adulthood. Furthermore, social connectedness, that is, more employment over time and the quality of the romantic relationship at follow-up, protected against the development of depression. However, social connectedness did not buffer the effect of maltreatment on depression. Our findings indicate that treatment of these girls should focus on improving the social-emotional development to promote positive interpersonal relationships and include educational and vocational components to guide these girls toward increased opportunities on the labor market. © The Author(s) 2015.

Apathy among institutionalized stroke patients: prevalence and clinical correlates.

PubMed

van Almenkerk, Suzanne; Smalbrugge, Martin; Depla, Marja F I A; Eefsting, Jan A; Hertogh, Cees M P M

2015-02-01

Apathy is a frequent neuropsychiatric consequence of stroke. In the under-researched population of institutionalized stroke patients, we aimed to explore the prevalence of apathy, its clinical correlates, and the relation to the amount of stimulating activities in the nursing home (NH). A cross-sectional, observational study. Dutch NHs. 274 chronic stroke patients. Data were collected through observation lists that were filled out in structured interviews with qualified nurse assistants who knew the residents well. The lists comprised the NH-version of the Apathy Evaluation Scale (AES10), the Barthel Index, the Neuropsychiatric Inventory Questionnaire, and sections of the Resident Assessment Instrument for Long-Term Care Facilities. Attending physicians and therapists provided additional information. Apathy (AES10 score ≥30) was present in 28% of residents. Multilevel regression analyses revealed that this apathy was independently related to (moderate, severe) cognitive impairment (odds ratio [OR] 11.30 [95% confidence interval (CI): 4.96-25.74], OR 5.54 [95% CI: 2.48-12.40]), very severe ADL-dependency (OR 12.10 [95% CI: 1.35-108.66]), and being >12 hours per day in bed (OR 2.10 [95% CI: 1.07-4.13]). It was not related to depressive mood symptoms (OR 1.75 [95% CI: 0.91-3.37]). Only in residents aged less than 80 years were a higher amount of activities independently related to a lower AES10 score (-0.70 [95% CI: -1.18 to -0.20] points per four extra activities in a 4-week period). Apathy is prevalent in largely one-quarter of institutionalized stroke patients, and that is most strongly related to cognitive impairment in this explorative study. We discuss the need for research on the relation with distinct dimensions of depression and fatigue as partly overlapping constructs, and on (individualized) stimulating activities as a possible intervention method. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

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

[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.

Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

PubMed

Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

2014-01-01

In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

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.

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.

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.

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

[Evaluation of growth and development of institutionalized children].

PubMed

Chaves, Caroline Magna Pessoa; Lima, Francisca Elisângela Teixeira; Mendonça, Larissa Bento de Araújo; Custódio, Ires Lopes; Matias, Erica Oliveira

2013-01-01

The study aimed to evaluate the growth and development of institutionalized children from 0-6 years old. It had a descriptive, transversal and quantitative approach, and was held in a shelter from the Bureau of Labor and Social Development of the Government of the State of Ceará, in the months of March and April 2011. The sample comprised 44 children. It the sample prevailed male children (59.1%), aged 24 to 72 months (56.8%) and with time of sheltering more than one year (72.7%). It was found that the children were in the normal range of nutrition; however, 65.9% of children did not achieve at least one of the development milestones proposed by the Ministry of Health. The study suggests a reflection on how children living in shelters are being assisted by the health team, making it necessary follow up their growth and development, in order to intervene on the alterations.

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.

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

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

[The institutionalization of health impact assessment in Quebec: a feasible model in Spain?].

PubMed

Boldo, Elena; St-Pierre, Louise; Mendell, Anika; Benoit, François

2011-01-01

In Canada, the province of Quebec has institutionalized Health Impact Assessment (HIA) by including it in its Public Health Act (PHA). In Spain, the Ministry of Health, Social Policy and Equality is in the process of reforming its PHA, and plans to include HIA in this legislation. This study reviews the factors that have led to the effective implementation of HIA in Quebec and discusses the possible applications of the Quebec model in the Spanish context. Information was gathered through interviews conducted in various public health institutions in Quebec. The Quebec model was compared to the Spanish situation, to identify potential needs associated with the practice of HIA in Spain. In Quebec, public health institutions have developed a strategy for effective implementation of HIA. This strategy is based on several measures: creation of a network of ministerial representatives, development of an internal procedure at the Ministry of Health and Social Services to respond to requests, preparation of methodological guidelines, establishment of a research program, strengthening of knowledge transfer mechanisms, and establishment of communication and participation tools. HIA legislation does not guarantee its successful implementation. The institutionalization of HIA requires establishing a well-designed structure, as well as the allocation of adequate resources. The Quebec experience offers one model of HIA implementation that could be adapted to our country, taking into account elements of Spanish idiosyncrasies. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature.

PubMed

Mahieu, Lieslot; Gastmans, Chris

2012-03-01

Admission to a nursing home might challenge the way in which individuals experience their own sexuality, but it does not automatically diminish their need and desire for sexual fulfillment. Despite the fact that sexuality proves to be an intrinsic part of human existence, the sexual expression of geriatric residents remains a sensitive subject for many caregivers and family members. It evokes a variety of ethical issues and concerns, especially when dementia patients are involved. The overall objective of this review was to examine the ethical arguments and concepts about the debate on sexuality within a nursing home environment. We conducted a systematic search for argument-based ethics literature focusing on sexuality in institutionalized elderly people. Twenty-five appropriate studies were identified. A thematic analysis of the included literature led us to distinguish two major groups of ethical arguments: (i) principles and (ii) care. Ethics arguments on sexuality in institutionalized elderly are particularly guided by the principle of respect for autonomy and the concomitant notion of informed consent. Arguments related to care were also apparent within the research literature although they received considerably less attention than the arguments related to the principles of respect for autonomy, beneficence, nonmaleficence and justice. The lack of clarity in the conceptualization of the arguments referred to in the research literature indicates that there is a pressing need for a better defined, more fundamental philosophical-ethical analysis of the values at stake.

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.

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.

Correlates of institutionalized senior veterans' quality of life in Taiwan

PubMed Central

2010-01-01

Background Senior veterans living in government sponsored, long-term care (LTC) facilities, known as veterans' homes (VHs), are a special minority group in Taiwan. These seniors came from different provinces of mainland China during their teenage years at the end of civil wars in 1945. The situation of institutionalized senior veterans shares many characteristics with the concept of "total institution". Very little quality of life (QOL) research has involved senior veterans. This study aimed to explore the QOL and related factors of VH-dwelling senior veterans in Taiwan. Methods Chronic conditions and socio-demographic characteristics of 260 male VH residents were recorded. The Brief Form of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF, Taiwanese version); Short-Form 36; Inventory of Socially Supportive Behavior questionnaire; Geriatric Depression Scale-short form; Barthel Index; and instrumental activities of daily living were used. Data analyses including descriptive and inferred statistics were performed using SPSS, version 17. Results WHOQOL-BREF showed acceptable reliability in this study. Compared to Taiwanese male norms, WHOQOL-BREF physical, psychological, and social relationship domain scores were around the 25th percentile, and the environment domain was about the 75th percentile. Our participants scored low in all concepts of SF-36. Although these residents rated the social support of their children, relatives, friends, social and medical staff as low, they gave high satisfaction ratings to their social supports. On multiple stepwise linear regression analysis, depressive symptoms, number of chronic conditions, retired military rank, and relatives' support correlated with QOL in both the physical and psychological domains. Friends' support and depressive symptoms correlated with the social relationships domain. Friends' support and instrumental activities of daily living correlated with the environment domain. Conclusions In

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…

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…

Institutionalization of Migration Policy Frameworks in Armenia, Azerbaijan and Georgia

PubMed Central

Makaryan, Shushanik; Chobanyan, Haykanush

2015-01-01

This article is a comparative study of the institutionalization of the migration policy frameworks of post-Soviet states Armenia, Azerbaijan and Georgia since the collapse of the Soviet Union in 1991. All three countries share common historical legacies: a Soviet past, wars and conflicts, unemployment, high emigration, and commitment to integration into European bodies. To what extent do the migration policies of these three countries (driven by contextual forces, i.e. domestic challenges) address country-specific migration dynamics? Or are they imposed by the European Union? In which dimensions have the national policies on migration of Armenia, Azerbaijan and Georgia evolved, and around which issues have they converged or diverged? Have these trends led to an integration of migration policymaking at the regional level in the South Caucasus? PMID:26435548

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

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.

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...

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.

Prospective observational study to evaluate risk factors for falls in institutionalized elderly people: the role of cystatin C.

PubMed

Peláez, Verónica Centeno; Ausín, Lourdes; Mambrilla, Marta Ruiz; Gonzalez-Sagrado, Manuel; Pérez Castrillón, José Luis

2015-08-01

To evaluate the role of balance and gait disorders, comorbidities and laboratory abnormalities in the occurrence of falls in an institutionalized elderly population. We made a non-interventional, prospective, observational study in elderly institutionalized people. Comorbidities and information on treatments were obtained. Function and cognition were measured using the Katz Index, the Tinetti Balance and Gait, lower extremity function tests and the Mini-Mental test. At the inclusion, the analytical was made including cystatin C. Falls were recorded for 20 months after inclusion. Patients with falls were older (85 ± 7 vs. 82 ± 8, p = 0.04) and more often female (88 vs. 12 %, p = 0.01). Dyslipidemia, hypertension and antihypertensive treatment were associated with an increased risk of falls. Cystatin C was higher in patients with falls (0.96 ± 0.21 vs. 1.12 ± 0.29, p = 0.02). Functional tests showed differences in the Tinetti balance test (15 ± 2 vs. 13 ± 3, p = 0.04) and lower extremity function balance test (2.8 ± 1.2 vs. 2.2 ± 1.2, p = 0.05). The Mini-Mental State Examination (MMSE) scores were worse in patients with falls (22 ± 4 vs. 25 ± 4, p = 0.01). Only female status (6.2, p = 0.03), the MMSE scores (1.2, p = 0.02) and cystatin C (5.3, p = 0.02) were independent risk factors for falls after logistic regression. Female sex, cognitive impairment and cystatin C were risk factors for falls in non-dependent institutionalized elderly people.

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…

Older residents' perspectives on aged sexuality in institutionalized elderly care: a systematic literature review.

PubMed

Mahieu, Lieslot; Gastmans, Chris

2015-12-01

The aim of this systematic literature review is to investigate older residents' thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Systematic literature review. We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential

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

[The institutionalization of the elders in Argentina. Imaginary and realities].

PubMed

Fassio, Adriana

2007-01-01

The institutionalization is an alternative to the social and health policy to gather for vulnerable frail elderly needs. Despite the low numbers of old people in nursing homes, long term care is associated by the public and, in particular, by old people as a common solution to the latter's special needs of care. This article examines the proposals of international organisations regarding old people's care. Then, from the analysis of the Survey Health, Wellbeing and Ageing in Latin America and Caribbean (SABE), carried out in Buenos Aires in 2001 the views of elderly about nursing homes are examined. Finally, using data gathered by the National Census of Population and Housing (2001), we compare and contrast some key socio-demographic characteristics and living conditions of old people who live in households, those who live in the streets, and those who live in nursing homes.

A rapid method of toilet training the institutionalized retarded1

PubMed Central

Azrin, N. H.; Foxx, R. M.

1971-01-01

Incontinence is a major unsolved problem in the institutional care of the profoundly retarded. A reinforcement and social analysis of incontinence was used to develop a procedure that would rapidly toilet train retardates and motivate them to remain continent during the day in their ward setting. Nine profoundly retarded adults were given intensive training (median of four days per patient), the distinctive features of which were artificially increasing the frequency of urinations, positive reinforcement of correct toileting but a delay for “accidents”, use of new automatic apparatus for signalling elimination, shaping of independent toileting, cleanliness training, and staff reinforcement procedures. Incontinence was reduced immediately by about 90% and eventually decreased to near-zero. These results indicate the present procedure is an effective, rapid, enduring, and administratively feasible solution to the problem of incontinence of the institutionalized retarded. PMID:16795291

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…

[Steps towards the institutionalization of health impact assessment in Spain: perception of public health professionals].

PubMed

Sanz, E; Esnaola, S; Aldasoro, E; Bacigalupe, A; Zuazagoitia, J

2012-01-01

The current normative reform of public health policy in Spain envisages the inclusion of Health Impact Assessment (HIA). This study contributes the vision of public health and planning professionals on the usefulness and applicability of HIA in their daily work and thus reflects on how best to institutionalize it. Three training workshop were carried out with public health professionals. Participants were specialists in different branches: epidemiological surveillance, environmental health, food safety and health promotion. In this HIA workshop, a questionnaire was given to the attendees to be completed. Forty-one percent of the people attending answered the questionnaire; 92% of the staff considered that the model of social determinants of health is useful in the field of public health. The principal routes for introducing HIA were: mandatory rules (85%), integration into other existing assessment tools (65%) and the systematization of this methodology (40%). Concerning the applicability of HIA, specific strategies ere proposed for its introduction into the different branches of public health. The successful institutionalization of HIA will require the opinion and collaboration of the technical personnel. A widespread approval of this tool for its utilization in the administration was verified. To guarantee the viability of its implementation, it will be necessary to raise the awareness of professionals about the model of the social determinants of health, as well as to attend to their demands and suggestions.

Validation Analysis of a Geriatric Dehydration Screening Tool in Community-Dwelling and Institutionalized Elderly People

PubMed Central

Rodrigues, Susana; Silva, Joana; Severo, Milton; Inácio, Cátia; Padrão, Patrícia; Lopes, Carla; Carvalho, Joana; do Carmo, Isabel; Moreira, Pedro

2015-01-01

Dehydration is common among elderly people. The aim of this study was to perform validation analysis of a geriatric dehydration-screening tool (DST) in the assessment of hydration status in elderly people. This tool was based on the DST proposed by Vivanti et al., which is composed by 11 items (four physical signs of dehydration and seven questions about thirst sensation, pain and mobility), with four questions extra about drinking habits. The resulting questionnaire was evaluated in a convenience sample comprising institutionalized (n = 29) and community-dwelling (n = 74) elderly people. Urinary parameters were assessed (24-h urine osmolality and volume) and free water reserve (FWR) was calculated. Exploratory factor analysis was used to evaluate the scale’s dimensionality and Cronbach’s alpha was used to measure the reliability of each subscale. Construct’s validity was tested using linear regression to estimate the association between scores in each dimension and urinary parameters. Two factors emerged from factor analysis, which were named “Hydration Score” and “Pain Score”, and both subscales showed acceptable reliabilities. The “Hydration Score” was negatively associated with 24-h urine osmolality in community-dwelling; and the “Pain Score” was negatively associated with 24-h urine osmolality, and positively associated with 24-h urine volume and FWR in institutionalized elderly people. PMID:25739005

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

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.

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

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…

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…

Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.

PubMed

Patel, P P; Russell, J; Allden, K; Betancourt, T S; Bolton, P; Galappatti, A; Hijazi, Z; Johnson, K; Jones, L; Kadis, L; Leary, K; Weissbecker, I; Nakku, J

2011-12-01

The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples. The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development. The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States). The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance. The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

Biologically inspired band-edge laser action from semiconductor with dipole-forbidden band-gap transition.

PubMed

Wang, Cih-Su; Liau, Chi-Shung; Sun, Tzu-Ming; Chen, Yu-Chia; Lin, Tai-Yuan; Chen, Yang-Fang

2015-03-11

A new approach is proposed to light up band-edge stimulated emission arising from a semiconductor with dipole-forbidden band-gap transition. To illustrate our working principle, here we demonstrate the feasibility on the composite of SnO2 nanowires (NWs) and chicken albumen. SnO2 NWs, which merely emit visible defect emission, are observed to generate a strong ultraviolet fluorescence centered at 387 nm assisted by chicken albumen at room temperature. In addition, a stunning laser action is further discovered in the albumen/SnO2 NWs composite system. The underlying mechanism is interpreted in terms of the fluorescence resonance energy transfer (FRET) from the chicken albumen protein to SnO2 NWs. More importantly, the giant oscillator strength of shallow defect states, which is served orders of magnitude larger than that of the free exciton, plays a decisive role. Our approach therefore shows that bio-materials exhibit a great potential in applications for novel light emitters, which may open up a new avenue for the development of bio-inspired optoelectronic devices.

The Role of Nurse Leaders in Advancing Carer Communication Needs across Transitions of Care: A Call to Action.

PubMed

Udod, Sonia A; Lobchuk, Michelle

2017-01-01

This paper focuses on the central role of senior nurse leaders in advancing organizational resources and support for communication between healthcare providers and carers that influences patient and carer outcomes during the transition from hospital to the community. A Think Tank (Lobchuk 2012) funded by the Canadian Institutes of Health Research (CIHR) gathered interdisciplinary and intersectoral stakeholders from local, national and international levels to develop a Family Carer Communication Research Collaboration. Workshop stakeholders addressed critical challenges in meeting communication needs of carers as partners with clinicians in promoting safe care for the elderly, chronically or seriously ill or disabled individuals in the community. Key priority areas identified the need to uncover nurse leader perspectives at the system, nurse leader, healthcare provider and patient levels where communication with carers occurs. The overarching outcome from the workshop focuses on the need for nurse leaders to advocate for patients and their families in meeting carer communication needs. The authors' "call to action" requires commitment and investment from nurse leaders in the critical juncture of healthcare delivery to strengthen communication between healthcare providers and carers that influence patient and carer outcomes in seamless transitions of care.

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.

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.

Why are antibiotics prescribed for asymptomatic bacteriuria in institutionalized elderly people? A qualitative study of physicians' and nurses' perceptions.

PubMed

Walker, S; McGeer, A; Simor, A E; Armstrong-Evans, M; Loeb, M

2000-08-08

Antibiotic therapy for asymptomatic bacteriuria in institutionalized elderly people has not been shown to be of benefit and may in fact be harmful; however, antibiotics are still frequently used to treat asymptomatic bacteriuria in this population. The aim of this study was to explore the perceptions, attitudes and opinions of physicians and nurses involved in the process of prescribing antibiotics for asymptomatic bacteriuria in institutionalized elderly people. Focus groups were conducted among physicians and nurses who provide care to residents of long-term care facilities in Hamilton, Ont. A total of 22 physicians and 16 nurses participated. The focus group discussions were tape-recorded, and the transcripts of each session were analysed for issues and themes emerging from the text. Content analysis using an open analytic approach was used to explore and understand the experience of the focus group participants. The data from the text were then coded according to the relevant and emergent themes and issues. We observed that the ordering of urine cultures and the prescribing of antibiotics for residents with asymptomatic bacteriuria were influenced by a wide range of nonspecific symptoms or signs in residents. The physicians felt that the presence of these signs justified a decision to order antibiotics. Nurses played a central role in both the ordering of urine cultures and the decision to prescribe antibiotics through their awareness of changes in residents' status and communication of this to physicians. Education about asymptomatic bacteriuria was viewed as an important priority for both physicians and nurses. The presence of non-urinary symptoms and signs is an important factor in the prescription of antibiotics for asymptomatic bacteriuria in institutionalized elderly people. However, no evidence exists to support this reason for antibiotic treatment. Health care providers at long-term care facilities need more education about antibiotic use and

Institutionalizing dissent: a proposal for an adversarial system of pharmaceutical research.

PubMed

Biddle, Justin

2013-12-01

There are serious problems with the way in which pharmaceutical research is currently practiced, many of which can be traced to the influence of commercial interests on research. One of the most significant is inadequate dissent, or organized skepticism. In order to ameliorate this problem, I develop a proposal that I call the "Adversarial Proceedings for the Evaluation of Pharmaceuticals," to be instituted within a regulatory agency such as the Food and Drug Administration for the evaluation of controversial new drugs and controversial drugs already in the market. This proposal is an organizational one based upon the "science court" proposal by Arthur Kantrowitz in the 1960s and 1970s. The primary benefit of this system is its ability to institutionalize dissent, thereby ensuring that one set of interests does not dominate all others.

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.

Developing effective animal-assisted intervention programs involving visiting dogs for institutionalized geriatric patients: a pilot study.

PubMed

Berry, Alessandra; Borgi, Marta; Terranova, Livia; Chiarotti, Flavia; Alleva, Enrico; Cirulli, Francesca

2012-09-01

An ever increasing interest in the therapeutic aspects of the human-animal bond has led to a proliferation of animal-assisted interventions (AAI) involving dogs. However, most of these programs lack a solid methodological structure, and basic evaluative research is needed. The purpose of this study was to test the value of dog-assisted interventions as an innovative tool to increase quality of life in the geriatric population. Nineteen patients (men and women) with a mean age of 85 years participated in the study. Interactions between patients and visiting dogs occurred either in a social situation (socialization sessions) or in a therapeutic context (physical therapy sessions). We derived and characterized a specific ethogram of elderly-dog interactions aimed at evaluating the effectiveness of visiting dogs in improving mood, catalyzing social interactions and reducing their everyday apathetic state. Cortisol levels were also measured in the saliva, and depressive state was evaluated. Overall, results show a time-dependent increase in social behaviour and spontaneous interactions with the dogs. Dog-mediated interactions affected the daily increase in cortisol levels, thus having an 'activational effect', in contrast to the apathetic state of institutionalized elderly. Dog-mediated intervention programs appear to be promising tools to improve the social skills and enrich the daily activities of the institutionalized elderly. © 2012 The Authors. Psychogeriatrics © 2012 Japanese Psychogeriatric Society.

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

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…

The institutionalization of River Basin Management as politics of scale - Insights from Mongolia

NASA Astrophysics Data System (ADS)

Houdret, Annabelle; Dombrowsky, Ines; Horlemann, Lena

2014-11-01

River Basin Management (RBM) as an approach to sustainable water use has become the dominant model of water governance. Its introduction, however, entails a fundamental realignment and rescaling of water-sector institutions along hydrological boundaries. Creating such a new governance scale is inherently political, and is being described as politics of scale. This paper analyzes how the politics of scale play out in the institutionalization of RBM in Mongolia. It furthermore scrutinizes the role of the broader political decentralization process in the introduction of RBM, an issue that has so far received little attention. Finally, it assesses whether the river basin is an adequate water management scale in Mongolia. This article finds that institutionalizing RBM in Mongolia is indeed a highly political negotiation process that does not only concern the choice of the governance scale, but also its detailed institutional design. It furthermore reveals that Mongolia's incomplete political decentralization process has for a long time negatively impacted the decentralization of water-related tasks and the implementation of RBM. However, the 2011 Budget Law and the 2012 Water Law provide for a fiscal strengthening of local governments and clearer sharing of responsibilities among the various different institutions involved in water management. Nevertheless, only if the 2012 Water Law is complemented by adequate by-laws - and if the newly created river basin institutions are adequately equipped - can RBM be effectively put into practice. This article confirms the usefulness of a politics-of-scale approach to understand scalar practices and changes in water management. However, the article also argues for a broadening of the analytical perspective to take the interdependencies between changes in water governance and other political processes, such as decentralization, into account.

Changes in the provision of institutionalized mental health care in post-communist countries.

PubMed

Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as

[Beginning of the institutionalization of physical therapy in a Swiss canton: 1928-1945].

PubMed

Hasler, Véronique

2013-01-01

The institutionalization of physical therapy in Switzerland took place in the inter-war period. This article aims to relate the initiation of this process in the Canton of Vaud, as a specific example that will nevertheless be compared with the Swiss and international contexts. This story occurs around three major events between 1928 and 1945: the massage becomes a regulated profession, followed by the emergence of a professional association and a specialized school. The intention is first to identify the social actors, then the interests, issues, and interactions that have contributed to model the modern physical therapy. Finally, the techniques used by the masseurs--the first professional physical therapists--and their working environment are evoked.

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.

Preventive Home Visits for Mortality, Morbidity, and Institutionalization in Older Adults: A Systematic Review and Meta-Analysis

PubMed Central

Mayo-Wilson, Evan; Grant, Sean; Burton, Jennifer; Parsons, Amanda; Underhill, Kristen; Montgomery, Paul

2014-01-01

Background Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. Methods and Findings Data Sources: Ten databases including CENTRAL and Medline searched through December 2012. Study Selection: Randomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. Data Extraction and Synthesis: Two authors independently extracted data. Outcomes were pooled using random effects. Main Outcomes and Measures: Mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. Results Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [−0.01 to 0.00]). There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18]) or hospitalized (RR = 0.96 [0.91 to 1.01]). There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01]), but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = −0.06 [−0.11 to −0.01]) and physical functioning (SMD = −0.10 [−0.17 to −0.03]) respectively, but these may not be clinically important. Conclusions Home visiting is not consistently associated with differences in mortality or

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,…

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…

Institutionalization: A Model of Retention Through Student Engagement

NASA Astrophysics Data System (ADS)

Davis, E. J.; Campbell, A.; Strand, D.

2005-12-01

Bowie State University and NASA Goddard Space Flight Center have, for the past 10 years, worked diligently together to enhance the science, mathematics, engineering and technology (SMET) domain. Efforts made because of a Model Institutions for Excellence (MIE) Award have changed the landscape of the SMET domain by increasing the retention and graduation rates, the number of students entering graduate and professional schools, and the number of students entering SMET related careers. Several initiatives - a Scholarship program, PRISEM Tutoring Center, Safenet Program, Research Emphasis, Focused Mentoring, a Summer Academy for accepted and enrolled incoming students, a Bridge Program for students needing assistance being admitted to the University, the RISE Program and the Bowie State Satellite Operations and Control Center - provides the nurturing and mentoring focus, and opportunities that have resulted in a retention rate of approximately 80%, a 40% increase in the graduation rate, and an 85% increase in the number of students interested/entering graduate school. Successes that have documented by various assessment activities have led to the institutionalization of the retention model of the MIE Initiative. It is anticipated that University-wide application of the retention model will provide the incentives necessary to obtain similar results as has the MIE Initiative.

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…

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…

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

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

The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia.

PubMed

Mohammadi, Fatemeh; Momtaz, Yadollah Abolfathi; Motallebi, Seyedeh Ameneh; Boosepasi, Shahnaz

2017-01-01

There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group. The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Independence, institutionalization, death and treatment costs 18 months after rehabilitation of older people in two different primary health care settings.

PubMed

Johansen, Inger; Lindbak, Morten; Stanghelle, Johan K; Brekke, Mette

2012-11-14

The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202) versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100). 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Primary: Independence, assessed by Sunnaas ADL Index(SI). Secondary: Hospital and short-term nursing home length of stay (LOS); institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson's χ2, ANCOVA, Regression and Kaplan-Meier analyses. Overall SI scores were 26.1 (SD 7.2) compared to 27.0 (SD 5.7) at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5)). The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7)). Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6), p=0.05). The institutionalization increased in PCNHR (from 12%-28%, p=0.001), but not in PCDIR (from 16.9%-19.3%, p= 0.45). The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient was 3528€ for rehabilitation (p<0.001, 95%CI(2455-4756)), and 10134€ for

Independence, institutionalization, death and treatment costs 18 months after rehabilitation of older people in two different primary health care settings

PubMed Central

2012-01-01

Background The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Methods Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202) versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100). Participants: 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Outcome measures: Primary: Independence, assessed by Sunnaas ADL Index(SI). Secondary: Hospital and short-term nursing home length of stay (LOS); institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson’s χ2, ANCOVA, Regression and Kaplan-Meier analyses. Results Overall SI scores were 26.1 (SD 7.2) compared to 27.0 (SD 5.7) at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5)). The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7)). Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6), p=0.05). The institutionalization increased in PCNHR (from 12%-28%, p=0.001), but not in PCDIR (from 16.9%-19.3%, p= 0.45). The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient was 3528€ for

Lack of synergistic interaction between the two mechanisms of action of tapentadol in gastrointestinal transit.

PubMed

Cowan, A; Raffa, R B; Tallarida, C S; Tallarida, R J; Christoph, T; Schröder, W; Tzschentke, T M

2014-09-01

A multi-mechanistic approach offers potential enhancement of analgesic efficacy, but therapeutic gain could be offset by an increase in adverse events. The centrally acting analgesic tapentadol [(-)-(1R,2R)-3-(3-dimethylamino-1-ethyl-2-methyl-propyl)-phenol hydrochloride] combines μ-opioid receptor (MOR) agonism and neuronal noradrenaline reuptake inhibition (NRI), both of which contribute to its analgesic effects. Previously, isobolographic analysis of occupation-effect data and a theoretically equivalent methodology determining interactions from the effect scale demonstrated pronounced synergistic interaction between the two mechanisms of action of tapentadol in two models of antinociception (low-intensity tail-flick and spinal nerve ligation). The present study investigated the nature of interaction of the two mechanisms on a surrogate measure for gastrointestinal adverse effect (inhibition of gastrointestinal transit). Dose-response curves were generated in rats for tapentadol alone or in combination with the opioid receptor antagonist, naloxone, or the α2 -adrenoceptor antagonist, yohimbine, to reveal the effect of tapentadol based upon MOR agonism, NRI, and combined mechanisms. The dose-effect curve of tapentadol was shifted to the right by both antagonists, thereby providing data to distinguish between MOR agonism and NRI. Analysis revealed a simple additive interaction between the two mechanisms on this endpoint, in contrast to the synergistic interaction previously demonstrated for antinociception. We believe this is the first published evaluation of mechanistic interaction for a surrogate measure of adverse effect of a single compound with two mechanisms of action, and the results suggest that there is a greater separation between the analgesic and gastrointestinal effects of tapentadol than expected based upon its analgesic efficacy. © 2014 European Pain Federation - EFIC®

Training model to institutionalize population education in the in-service education programme for elementary school teachers.

PubMed

Dugenia, M E

1982-12-01

The goal of the Philippine Population Education Program (PEP) since its inception in 1972 is to institutionalize population education in the formal educational system. The PEP Training Section views institutionalization of population education in the inservice education program for elementary school teachers as part of the process of making it an integral part of that program. In practice elementary school teachers periodically attend training programs organized by division or district supervisors and school principals. This is the usual modality through which teachers are updated on or informed about new thrusts and recent developments in teaching content, strategies, and methodologies. In this context, the PEP Training Section convened a seminar workshop in December 1981 for 10 subject area supervisors from the 3 large geographic island groups of Luzon, Visayas, and Mindanao. They represented 10 school divisions and subject areas where population education is integrated. The specific objectives of the 5 day activity were to: discuss existing inservice training programs in the school divisions; prepare a training model incorporating population education in the overall division inservice training program; and develop a content chart or a listing of topical areas on population education for the training model. 1 of the outputs of the seminar workshop was a training model incorporating population education in the regular inservice training programs using 3 delivery schemes, i.e., seminar workship on the teaching of specific subject areas; district staff meeting and/or echo seminars organized by district supervisors following division seminars; and regular teachers' meeting at the school level organized by school principals. Another output was a content chart listing suggested topics in population education classified according to subject areas into which they will be incorporated. The semninar workshop concluded with a plan to try out the model using the identified

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...

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...

Psychiatric Outcomes in Young Children with a History of Institutionalization

PubMed Central

Bos, Karen; Zeanah, Charles H.; Fox, Nathan A.; Drury, Stacy S.; McLaughlin, Katie A.; Nelson, Charles A.

2012-01-01

Children raised in institutions, considered an extreme example of social deprivation, are one group through which we can better understand the impact of neglect on child health and development. The Bucharest Early Intervention Project (BEIP) is the first randomized, controlled trial of foster care as an intervention for institutionalized children. In this review we describe the mental health outcomes from the BEIP. Specifically, we report findings on attachment styles, attachment disorders, emotional reactivity, and psychiatric symptomatology for children in the BEIP. We describe the impact of the foster care intervention on these outcomes and also describe how outcomes differ by gender and by length of time spent in the institution. In addition, we explore the influence of genetic variation on individual outcomes and recovery from early severe social deprivation, as well as the role of differences in brain development in mediating later psychiatric morbidity. The results from the BEIP confirm and extend the previous findings on the negative sequelae of early institutional care on mental health. The results also underscore the benefit of early family placement for children living in institutions. PMID:21250893

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…

To Trust or Not to Trust: Social Decision Making in Post-institutionalized, Internationally Adopted Youth

PubMed Central

Pitula, Clio E.; Wenner, Jennifer A.; Gunnar, Megan R.; Thomas, Kathleen M.

2015-01-01

Chronic parental maltreatment has been associated with lower levels of interpersonal trust, and depriving environments have been shown to predict shortsighted, risk-averse decision-making. The present study examined whether a circumscribed period of adverse care occurring only early in life was associated with biases in trust behavior. Fifty-three post-institutionalized (PI) youth, adopted internationally on average by one year of age, and 33 never-institutionalized, non-adopted youth (M age = 12.9 years) played a trust game. Participants decided whether or not to share coins with a different anonymous peer in each trial with the potential to receive a larger number of coins in return. Trials were presented in blocks that varied in the degree to which the peers behaved in a trustworthy (reciprocal) or untrustworthy (non-reciprocal) manner. A comparison condition consisted of a computerized lottery with the same choices and probabilistic risk as the peer trials. Non-adopted comparison youth showed a tendency to share more with peers than to invest in the lottery and tended to maintain their level of sharing across trials despite experiencing trials in which peers failed to reciprocate. In contrast, PI children, particularly those who were adopted over a year of age, shared less with peers than they invested in the lottery and quickly adapted their sharing behavior to peers' responses. These results suggest that PI youth were more mistrusting, more sensitive to both defection and reciprocation, and potentially more accurate in their trusting decisions than comparison youth. Results support the presence of a sensitive period for the development of trust in others, whereby conditions early in life may set long-term biases in decision-making. PMID:27089448

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.

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

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.

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.

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.

Oral health care activities performed by caregivers for institutionalized elderly in Barcelona-Spain.

PubMed

Cornejo-Ovalle, Marco; Costa-de-Lima, Kenio; Pérez, Glória; Borrell, Carme; Casals-Peidro, Elías

2013-07-01

To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95% 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons.

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…

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

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.

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,…

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

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.

Problematic topic transitions in dysarthric conversation.

PubMed

Bloch, Steven; Saldert, Charlotta; Ferm, Ulrika

2015-01-01

This study examined the nature of topic transition problems associated with acquired progressive dysarthric speech in the everyday conversation of people with motor neurone disease. Using conversation analytic methods, a video collection of five naturally occurring problematic topic transitions was identified, transcribed and analysed. These were extracted from a main collection of over 200 other-initiated repair sequences and a sub-set of 15 problematic topic transition sequences. The sequences were analysed with reference to how the participants both identified and resolved the problems. Analysis revealed that topic transition by people with dysarthria can prove problematic. Conversation partners may find transitions problematic not only because of speech intelligibility but also because of a sequential disjuncture between the dysarthric speech turn and whatever topic has come prior. In addition the treatment of problematic topic transition as a complaint reveals the potential vulnerability of people with dysarthria to judgements of competence. These findings have implications for how dysarthria is conceptualized and how specific actions in conversation, such as topic transition, might be suitable targets for clinical intervention.

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

To trust or not to trust: social decision-making in post-institutionalized, internationally adopted youth.

PubMed

Pitula, Clio E; Wenner, Jennifer A; Gunnar, Megan R; Thomas, Kathleen M

2017-05-01

Chronic parental maltreatment has been associated with lower levels of interpersonal trust, and depriving environments have been shown to predict short-sighted, risk-averse decision-making. The present study examined whether a circumscribed period of adverse care occurring only early in life was associated with biases in trust behavior. Fifty-three post-institutionalized (PI) youth, adopted internationally on average by 1 year of age, and 33 never-institutionalized, non-adopted youth (M age  = 12.9 years) played a trust game. Participants decided whether or not to share coins with a different anonymous peer in each trial with the potential to receive a larger number of coins in return. Trials were presented in blocks that varied in the degree to which the peers behaved in a trustworthy (reciprocal) or untrustworthy (non-reciprocal) manner. A comparison condition consisted of a computerized lottery with the same choices and probabilistic risk as the peer trials. Non-adopted comparison youth showed a tendency to share more with peers than to invest in the lottery and tended to maintain their level of sharing across trials despite experiencing trials in which peers failed to reciprocate. In contrast, PI children, particularly those who were adopted over 1 year of age, shared less with peers than they invested in the lottery and quickly adapted their sharing behavior to peers' responses. These results suggest that PI youth were more mistrusting, more sensitive to both defection and reciprocation, and potentially more accurate in their trusting decisions than comparison youth. Results support the presence of a sensitive period for the development of trust in others, whereby conditions early in life may set long-term biases in decision-making. © 2016 John Wiley & Sons Ltd.

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...

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...

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...

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...

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

Toxocariasis: seroprevalence in abandoned-institutionalized children and infants.

PubMed

Archelli, Susana; Santillan, Graciela I; Fonrouge, Reinaldo; Céspedes, Graciela; Burgos, Lola; Radman, Nilda

2014-01-01

Toxocariasis is an infection that has worldwide distribution. Toxocara canis is the most relevant agent due to its frequent occurrence in humans. Soil contamination with embryonated eggs is the primary source of T. canis. This study aimed to determine the seroprevalence of toxocariasis in 10-month to 3 year-old abandoned infants, considered to be at high risk because of their orphanhood status and early age. Blood samples were collected from 120 children institutionalized in an orphanage in the city of La Plata. In this study, we observed 38.33% of seropositive cases for T. canis by ELISA and 45% by Western blot techniques; significant differences among groups A (<1 year), B (1-2 years) and C (>2 years) were also found. In research group A, children presented a seropositivity rate of 23.91%, in group B of 42.85% and in group C of 56%, which indicates an increase in frequency as age advances, probably because of greater chances of contact with infective forms of the parasite since canines and soil are frequently infected with T. canis eggs. Abandoned children come from poor households, under highly unsanitary conditions resulting from inadequate or lack of water supply and sewer networks, and frequent promiscuity with canines, which promotes the occurrence of parasitic diseases. These children are highly vulnerable due to their orphanhood status and age. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Suicidal Ideation, Depressive Symptomatology, and Self-Concept: A Comparison Between Mexican Institutionalized and Noninstitutionalized Children.

PubMed

Chavez-Hernandez, Ana-Maria; Correa-Romero, Fredi-Everardo; Acosta-Rojas, Irma-Beatriz; Cardoso-Espindola, Karen-Viviana; Padilla-Gallegos, Gustavo M; Valadez-Figueroa, Isabel

2018-04-01

Previous research reports a significant prevalence of child depression worldwide and self-concept as a predictor of depression and suicide behavior. Although suicide in children is an increasing problem in Mexico, there are scarce studies reporting risk factors and none of children in foster care institutions. This was a comparative, ex post facto study whose aim was to analyze associations between suicidal ideation, depression, and self-concept in two paired samples of Mexican children (83 institutionalized and 83 noninstitutionalized). Results show 16% of the children reported suicidal ideation and statistically significant differences among variables in both samples. Suggestions are made to address this problem from early ages. © 2017 The American Association of Suicidology.

Self-perception of intrinsic and extrinsic motivation: effects on institutionalized mentally retarded adolescents.

PubMed

Lee, D Y; Syrnyk, R

1977-01-01

Self-perception theory predicts that the introduction of extrinsic rewards for behavior that was intrinsically rewarding may decrease rather than enhance overall motivation. This hypothesis was tested on a group of institutionalized mentally retarded adolescents (34 boys, 10 girls). Intrinsic (high and low task interest) and extrinsic (high- and low-incentive objects) motivation were both manipulated as independent variables, and the dependent variable was task persistence during a free-play period. Results indicated that for a high intrinsically interesting task, the task persistence was greater under the external reward of low- rather than high-incentive value conditions. The opposite trend was revealed for the low intrinsically interesting task. The results provided some evidence that the greater the amount of the reward for an interesting activity, the greater the degree to which the intrinsic interest is undermined.

Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: an empirical study.

PubMed

Karimi, H; Dolatshahee, B; Momeni, K; Khodabakhshi, A; Rezaei, M; Kamrani, A A

2010-09-01

Reminiscence therapy is a psychological intervention which is specifically designed to address issues of particular relevance to older adults, such as depression. The latest approach to the research on therapeutic utility of reminiscence is gaining popularity among researchers and practitioners, and has yielded promising results. Specifying different types of reminiscence is a crucial component of the approach. The aim of this study was to examine the therapeutic effectiveness of integrative and instrumental types of reminiscence for the treatment of depression in institutionalized older adults dwelling in a nursing home. The study employed a three-group pre-post-test design with random allocation to instrumental or integrative reminiscence or an active social discussion control condition. Twenty-nine institutionalized older adults (12 men and 17 women) with depressive symptoms varying from mild to severe constituted the sample. The interventions were implemented in a short-form group format. Analysis of changes from pre-test to post-test revealed that integrative reminiscence therapy led to statistically significant reduction in symptoms of depression in contrast with the control group. Although instrumental reminiscence therapy also reduced depressive symptoms, this improvement was not statistically significant compared to the control group. This study provides additional support for the effectiveness of integrative reminiscence therapy as an intervention for depressed older adults living in residential care settings. This study also provides support for the hypothesis that certain types of reminiscence produce their own specific effects.

Early Combinations of Words and Actions.

ERIC Educational Resources Information Center

Shore, Cecilia

Previous research has shown a similar starting time for early combinations of words and play actions in children and has suggested that similar cognitive processes underlie the transition to combining activities in language, symbolic play, and manipulative play. A study was undertaken to investigate combining activities in these three domains and…

Action simulation: time course and representational mechanisms

PubMed Central

Springer, Anne; Parkinson, Jim; Prinz, Wolfgang

2013-01-01

The notion of action simulation refers to the ability to re-enact foreign actions (i.e., actions observed in other individuals). Simulating others' actions implies a mirroring of their activities, based on one's own sensorimotor competencies. Here, we discuss theoretical and experimental approaches to action simulation and the study of its representational underpinnings. One focus of our discussion is on the timing of internal simulation and its relation to the timing of external action, and a paradigm that requires participants to predict the future course of actions that are temporarily occluded from view. We address transitions between perceptual mechanisms (referring to action representation before and after occlusion) and simulation mechanisms (referring to action representation during occlusion). Findings suggest that action simulation runs in real-time; acting on newly created action representations rather than relying on continuous visual extrapolations. A further focus of our discussion pertains to the functional characteristics of the mechanisms involved in predicting other people's actions. We propose that two processes are engaged, dynamic updating and static matching, which may draw on both semantic and motor information. In a concluding section, we discuss these findings in the context of broader theoretical issues related to action and event representation, arguing that a detailed functional analysis of action simulation in cognitive, neural, and computational terms may help to further advance our understanding of action cognition and motor control. PMID:23847563

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.…

Specific Features of the Response of Cerium to Pulsed Actions

NASA Astrophysics Data System (ADS)

Atroshenko, S. A.; Zubareva, A. N.; Morozov, V. A.; Savenkov, G. G.; Utkin, A. V.

2018-02-01

Experimental studies of cerium at high rates and nanosecond durations of action have been performed. The isomorphic phase transition was studied upon shock compression. The spall strength of cerium has been determined. Cerium demonstrates anomalous compressibility upon dynamic loading. Stress waves dampen under action of a high-current electron beam due to the energy dissipation during fragmentation and twinning.

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...

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...

Health care transition in Germany – standardization of procedures and improvement actions

PubMed Central

Pieper, Claudia; Kolankowska, Izabela

2011-01-01

Previous studies have assessed an increase in the number of people in need and emphasized the advantages of structured discharge management and health care transition. Therefore, our study evaluated the status quo of transition in a major German city after standardization of procedures and implementation of standard forms. Satisfaction with handling of standard forms and improvement of procedures was evaluated. Additionally, patients who had recently been hospitalized were asked about the hospital discharge process. The results show that the recent efforts of standardization helped to improve interface management for health care workers and patients and showed further improvement options. PMID:21811388

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...

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 ...

The incompetent developmentally disabled person's right of self-determination: right-to-die, sterilization and institutionalization.

PubMed

Krais, W A

1989-01-01

The developmentally disabled, specifically those mentally incompetent from birth, are entitled to a full panoply of constitutional rights and protections. These rights include the right to terminate life-sustaining treatment, the right of procreative integrity and the right not to be involuntarily institutionalized. However, the mentally incompetent developmentally disabled are generally unable to exercise these rights. This Note asserts first that proper procedural safeguards are necessary to guarantee the exercise of these constitutional rights by the incompetent disabled individual. Second, the Note focuses upon how best to preserve the disabled person's autonomy. The Note subsequently rejects the substituted judgment standard as a legal fiction, and endorses the best interest test which necessarily comports with the evidence, and properly accounts for the disabled person's incompetency.

Protein Enrichment of Familiar Foods as an Innovative Strategy to Increase Protein Intake in Institutionalized Elderly.

PubMed

Beelen, J; de Roos, N M; de Groot, L C P G M

2017-01-01

To increase the protein intake of older adults, protein enrichment of familiar foods and drinks might be an effective and attractive alternative for oral nutritional supplements (ONS). We performed a pilot study to test whether these products could help institutionalized elderly to reach a protein intake of 1.2 gram per kg body weight per day (g/kg/d). Intervention study with one treatment group (no control group). Dietary assessment was done before and at the end of a 10-day intervention. Two care facilities in Gelderland, the Netherlands: a residential care home and a rehabilitation center. 22 elderly subjects (13 women, 9 men; mean age 83.0±9.4 years). We used a variety of newly developed protein enriched regular foods and drinks, including bread, soups, fruit juices, and instant mashed potatoes. Dietary intake was assessed on two consecutive days before and at the end of the intervention, using food records filled out by research assistants. Energy and macronutrient intake was calculated using the 2013 Dutch food composition database. Changes in protein intake were evaluated using paired t-tests. Protein intake increased by 11.8 g/d (P=0.003); from 0.96 to 1.14 g/kg/d (P=0.002). This increase is comparable to protein provided by one standard portion of ONS. The intake of energy and other macronutrients did not change significantly. At the end of the intervention more elderly reached a protein intake level of 1.2 g/kg/d than before (9 vs 4). Protein intake significantly increased during breakfast (+3.7 g) and during the evening (+2.2 g). Including familiar protein enriched foods and drinks in the menu helped to meet protein recommendations in institutionalized elderly.

Effect of timed bright light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease.

PubMed

Dowling, Glenna A; Mastick, Judy; Hubbard, Erin M; Luxenberg, Jay S; Burr, Robert L

2005-08-01

Disturbances in rest-activity rhythm are prominent and disabling symptoms in Alzheimer's disease (AD). Nighttime sleep is severely fragmented and daytime activity is disrupted by multiple napping episodes. In most institutional environments, light levels are very low and may not be sufficient to entrain the circadian clock to the 24-hour day. The purpose of this randomized clinical trial was to test the effectiveness of timed bright light therapy in reducing rest-activity (circadian) disruption in institutionalized patients with AD. The experimental groups received either morning (9.30-10.30 am) or afternoon (3.30-4.30 pm) bright light exposure ( > or = 2500 lux in gaze direction) Monday through Friday for 10 weeks. The control group received usual indoor light (150-200 lux). Nighttime sleep, daytime wake, and rest-activity parameters were determined by actigraphy. Repeated measures analysis of variance was employed to test the primary study hypotheses. Seventy institutionalized subjects with AD (mean age 84) completed the study. No significant differences in actigraphy-based measures of nighttime sleep or daytime wake were found between groups. Subjects in either experimental light condition evidenced a significantly (p < 0.01) more stable rest-activity rhythm acrophase over the 10-week treatment period compared to the control subjects whose rhythm phase delayed by over two hours. One hour of bright light, administered to subjects with AD either in the morning or afternoon, did not improve nighttime sleep or daytime wake compared to a control group of similar subjects. However, exposure to one-hour of bright light in either the morning or afternoon may provide sufficient additional input to the circadian pacemaker to facilitate entrainment to the 24-hour day. (c) 2005 John Wiley & Sons, Ltd.

Influence of upper limb disability, manual dexterity and fine motor skill on general self-efficacy in institutionalized elderly with osteoarthritis.

PubMed

Pérez-Mármol, Jose Manuel; Ortega-Valdivieso, María Azucena; Cano-Deltell, Enrique Elías; Peralta-Ramírez, María Isabel; García-Ríos, M Carmen; Aguilar-Ferrándiz, María Encarnación

2016-01-01

Descriptive, cross-sectional. The impact of upper limb (UL) disability, dexterity and fine motor skill on self-efficacy in older adults with osteoarthritis (OA) is not well known yet. To evaluate the self-efficacy and its relationship with UL function/disability in institutionalized OA. Institutionalized adults (n = 45) over the age of 65 years with OA were evaluated in a single session, to determine pinch strength, active range of motion of the hand and UL disability and functionality. They were classified as self-efficacious or not based on their general self-efficacy level. The influence on self-efficacy on upper limb function was statistically analyzed using bivariate and multivariate regression analyses. Self-effective older adults showed significantly lower scores in disability and higher scores in pinch strength, dexterity and motion of thumb than those who were classified as non-self-effective. Self-efficacy was associated with pinch strength (p ≤ 0.038), disability (p < 0.001) and dexterity (p ≤ 0.048). Multiple regression analyses showed that disability explained almost 40% of the variability of self-efficacy. Older adults classified as non-self-effective have higher UL disability and less pinch strength, manual dexterity and thumb motion than those who are self-effective, suggesting a relationship between impairment and perceived ability. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Covert Action: A Systems Approach

DTIC Science & Technology

2014-12-01

consider a covert action to support rebels within the Colombian province of Panama. The objective was relatively simple: support the creation of an...prevented Colombian reinforcements from either landing ashore or transiting from Colon to Panama City. The junta declared...154 He also exerted a significant level of control over the event by immediately deploying gunboats to the port which ensured that Colombian forces

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.

Bridging analytical approaches for low-carbon transitions

NASA Astrophysics Data System (ADS)

Geels, Frank W.; Berkhout, Frans; van Vuuren, Detlef P.

2016-06-01

Low-carbon transitions are long-term multi-faceted processes. Although integrated assessment models have many strengths for analysing such transitions, their mathematical representation requires a simplification of the causes, dynamics and scope of such societal transformations. We suggest that integrated assessment model-based analysis should be complemented with insights from socio-technical transition analysis and practice-based action research. We discuss the underlying assumptions, strengths and weaknesses of these three analytical approaches. We argue that full integration of these approaches is not feasible, because of foundational differences in philosophies of science and ontological assumptions. Instead, we suggest that bridging, based on sequential and interactive articulation of different approaches, may generate a more comprehensive and useful chain of assessments to support policy formation and action. We also show how these approaches address knowledge needs of different policymakers (international, national and local), relate to different dimensions of policy processes and speak to different policy-relevant criteria such as cost-effectiveness, socio-political feasibility, social acceptance and legitimacy, and flexibility. A more differentiated set of analytical approaches thus enables a more differentiated approach to climate policy making.

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...

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...

Dilemmas of the institutionalization of social policies in twenty years of the Brazilian Constitution of 1988.

PubMed

Lobato, Lenaura de Vasconcelos Costa

2009-01-01

The objective is to discuss and analyze some elements of the process of institutionalization of social policies in Brazil after the Constitution of 1988, especially those of social welfare (social security, health and social assistance). It is assumed that this process present hybrids that compromise the results prescribed by the Constitution. From one hand, there are important advances in political and organizational apparatus and in the concept of the social question (treated here through three elements: constitutionalization, scope and expansion). Moreover, obstacles remain, particularly in universalization, financing and quality of services, which are contradictory to the advances achieved. The permanence of these hybrids prevents the fairness and citizenship aimed by the 1988 Constitution.

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...

Antiepileptic drug use and the occurrence of pressure ulcers among bedridden institutionalized elderly patients: a retrospective chart review.

PubMed

Arinzon, Zeev; Zeilig, Gabriel; Berner, Yitshal N; Adunsky, Abraham

2005-09-01

Phenytoin (PH) is indicated primarily for the control of grand mal and psychomotor seizures. However, topical PH has been used for the treatment of various types of ulcers, including pressure ulcers. The aim of this study was to investigate the possibility of a relationship between the use of oral PH and the prevalence of pressure ulcers among bedridden institutionalized elderly patients. This retrospective chart review was conducted in a state-run urban geriatric medical center in Israel and involved long-term bedridden institutionalized patients who were receiving chronic antiepileptic medication during the 7-year period between January 1996 and December 2003. The prevalence of pressure ulcers in patients who received treatment with PH alone or in combination with other antiepileptic drugs was compared with that in patients who received antiepileptic agents other than PH. The study analyzed data from the medical charts of 153 patients, 72 of whom received PH alone or in combination with other antiepileptic drugs, and 81 of whom received antiepileptic agents other than PH. Patients' mean (SD) age was 78.5 (7.2) years; 106 (69.3%) were women. All patients were totally dependent with respect to activities of daily living (mean Katz score, 2.0 [2.0]) and had severe cognitive decline (mean Mini-Mental State Examination score, 3.5 [3.3]). Pressure ulcers occurred in 9.7% of PH recipients and 27.2% of non-PH recipients (P = 0.006; chi2 = 7.55). In PH recipients, 85.7% of pressure ulcers were of mild to moderate severity (stage I or II), compared with 59.1% of ulcers in non-PH recipients; the difference between groups was not statistically significant. Four (18.2%) non-PH recipients and no PH recipients had stage IV pressure ulcers. In the PH group, 71.4% of patients had a pressure ulcer in only 1 anatomic location, compared with 22.7% of the non-PH group (P = 0.023; chi2 = 5.13); 28.6% of PH recipients and 63.6% of non-PH recipients had pressure ulcers in 2 or 3

Liquid-vapor transition on patterned solid surfaces in a shear flow

NASA Astrophysics Data System (ADS)

Yao, Wenqi; Ren, Weiqing

2015-12-01

Liquids on a solid surface patterned with microstructures can exhibit the Cassie-Baxter (Cassie) state and the wetted Wenzel state. The transitions between the two states and the effects of surface topography, surface chemistry as well as the geometry of the microstructures on the transitions have been extensively studied in earlier work. However, most of these work focused on the study of the free energy landscape and the energy barriers. In the current work, we consider the transitions in the presence of a shear flow. We compute the minimum action path between the Wenzel and Cassie states using the minimum action method [W. E, W. Ren, and E. Vanden-Eijnden, Commun. Pure Appl. Math. 57, 637 (2004)]. Numerical results are obtained for transitions on a surface patterned with straight pillars. It is found that the shear flow facilitates the transition from the Wenzel state to the Cassie state, while it inhibits the transition backwards. The Wenzel state becomes unstable when the shear rate reaches a certain critical value. Two different scenarios for the Wenzel-Cassie transition are observed. At low shear rate, the transition happens via nucleation of the vapor phase at the bottom of the groove followed by its growth. At high shear rate, in contrary, the nucleation of the vapor phase occurs at the top corner of a pillar. The vapor phase grows in the direction of the flow, and the system goes through an intermediate metastable state before reaching the Cassie state.

The relationship between action-effect monitoring and attention capture.

PubMed

Kumar, Neeraj; Manjaly, Jaison A; Sunny, Meera Mary

2015-02-01

Many recent findings suggest that stimuli that are perceived to be the consequence of one's own actions are processed with priority. According to the preactivation account of intentional binding, predicted consequences are preactivated and hence receive a temporal advantage in processing. The implications of the preactivation account are important for theories of attention capture, as temporal advantage often translates to attention capture. Hence, action might modulate attention capture by feature singletons. Experiment 1 showed that a motion onset and color change captured attention only when it was preceded by an action. Experiment 2 showed that the capture occurs only with predictable, but not with unpredictable, consequences of action. Experiment 3 showed that even when half the display changed color at display transition, they were all prioritized. The results suggest that action modulates attentional control.

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…

The course of early disinhibited social engagement among post-institutionalized adopted children

PubMed Central

Lawler, Jamie M.; Koss, Kalsea J.; Doyle, Colleen M.; Gunnar, Megan R.

2016-01-01

Background Approximately 20% of post-institutionalized (PI) children exhibit disinhibited social engagement (DSE) or the propensity to approach and engage strangers. There is little longitudinal research examining changes in DSE after adoption, or methods of identifying children with persistent behaviors. Methods DSE was assessed observationally four times during the first two years post-adoption in PI children 16-36 months at adoption (n=68) relative to same-age non-adopted children (n=52). At age 5, a validated interview determined which PI children met criteria for Disinhibited Social Engagement Disorder (DSED). Results DSE trajectories initially increased and then stabilized. PIs had higher DSE levels initially and a steeper increase rate than NAs. When separated into physical and non-physical DSE components, group differences arose in initial physical DSE and the rate of change of non-physical DSE. DSE rate of increase predicted DSED diagnosis, as did longer institutional duration and poorer institutional care. Conclusions The rate of increase in DSE post-adoption, rather than the level observed at adoption, is predictive of disordered social engagement by age 5 years. PMID:27460336

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.

Binding of transcriptional activators to sigma 54 in the presence of the transition state analog ADP–aluminum fluoride: insights into activator mechanochemical action

PubMed Central

Chaney, Matthew; Grande, Ricardo; Wigneshweraraj, Siva R.; Cannon, Wendy; Casaz, Paul; Gallegos, Maria-Trinidad; Schumacher, Jorg; Jones, Susan; Elderkin, Sarah; Dago, Angel Ernesto; Morett, Enrique; Buck, Martin

2001-01-01

Conformational changes in sigma 54 (ς54) and ς54-holoenzyme depend on nucleotide hydrolysis by an activator. We now show that ς54 and its holoenzyme bind to the central ATP-hydrolyzing domains of the transcriptional activators PspF and NifA in the presence of ADP–aluminum fluoride, an analog of ATP in the transition state for hydrolysis. Direct binding of ς54 Region I to activator in the presence of ADP–aluminum fluoride was shown and inferred from in vivo suppression genetics. Energy transduction appears to occur through activator contacts to ς54 Region I. ADP–aluminum fluoride-dependent interactions and consideration of other AAA+ proteins provide insight into activator mechanochemical action. PMID:11544185

School-to-Work Transition and Counseling Psychology.

ERIC Educational Resources Information Center

Lent, Robert W.; O'Brien, Karen M.; Fassinger, Ruth E.

1998-01-01

Reports on recommendations and action plans conceived at the November 1997 conference School-to-Work Transition: Defining the Role of Vocational Psychology. Topics discussed: theory and research; marketing and dissemination; funding; assessment and evaluation; schools and communities; and professional advocacy. Urges the field of counseling…

Success-Factors in Transition to University Mathematics

ERIC Educational Resources Information Center

Bengmark, S.; Thunberg, H.; Winberg, T. M.

2017-01-01

This study examines different factors' relative importance for students' performance in the transition to university mathematics. Students' characteristics (motivation, actions and beliefs) were measured when entering the university and at the end of the first year. Principal component analysis revealed four important constructs:…

Inhibitory Control and Working Memory in Post-Institutionalized Children

PubMed Central

Merz, Emily C.; McCall, Robert B.; Wright, Amanda J.; Luna, Beatriz

2013-01-01

Inhibitory control and working memory were examined in post-institutionalized (PI) children adopted into United States families from Russian institutions. The PI sample originated from institutions that were less severely depriving than those represented in previous studies and approximated the level of psychosocial deprivation, which is characterized by adequate physical resources but a lack of consistent and responsive caregiving. PI children (N=75; 29 male) ranged in age from 8–17 years (M=12.97; SD=3.03) and were grouped according to whether they were adopted after 14 months or before 9 months. A non-adopted comparison group (N=133; 65 male) ranged in age from 8–17 years (M=12.26; SD=2.75). PI children adopted after 14 months of age displayed poorer performance on the stop-signal and spatial span tasks relative to PI children adopted before 9 months of age after controlling for age at assessment. The two PI groups did not differ in their performance on a spatial self-ordered search task. Older-adopted PI children also showed poorer spatial span task performance compared to non-adopted children, but younger-adopted PI children did not. Task performance was significantly associated with parent-rated hyperactive-impulsive behavior in everyday contexts. These findings suggest that exposure to prolonged early institutional deprivation may be linked with inhibitory control and working memory difficulties years after adoption. PMID:23519375

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…

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.

Topology of actions and homogeneous spaces

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

Kozlov, Konstantin L

2013-04-30

Topologization of a group of homeomorphisms and its action provide additional possibilities for studying the topological space, the group of homeomorphisms, and their interconnections. The subject of the paper is the use of the property of d-openness of an action (introduced by Ancel under the name of weak micro-transitivity) in the study of spaces with various forms of homogeneity. It is proved that a d-open action of a Cech-complete group is open. A characterization of Polish SLH spaces using d-openness is given, and it is established that any separable metrizable SLH space has an SLH completion that is a Polishmore » space. Furthermore, the completion is realized in coordination with the completion of the acting group with respect to the two-sided uniformity. A sufficient condition is given for extension of a d-open action to the completion of the space with respect to the maximal equiuniformity with preservation of d-openness. A result of van Mill is generalized, namely, it is proved that any homogeneous CDH metrizable compactum is the only G-compactification of the space of rational numbers for the action of some Polish group. Bibliography: 39 titles.« less

Estimation of State Transition Probabilities: A Neural Network Model

NASA Astrophysics Data System (ADS)

Saito, Hiroshi; Takiyama, Ken; Okada, Masato

2015-12-01

Humans and animals can predict future states on the basis of acquired knowledge. This prediction of the state transition is important for choosing the best action, and the prediction is only possible if the state transition probability has already been learned. However, how our brains learn the state transition probability is unknown. Here, we propose a simple algorithm for estimating the state transition probability by utilizing the state prediction error. We analytically and numerically confirmed that our algorithm is able to learn the probability completely with an appropriate learning rate. Furthermore, our learning rule reproduced experimentally reported psychometric functions and neural activities in the lateral intraparietal area in a decision-making task. Thus, our algorithm might describe the manner in which our brains learn state transition probabilities and predict future states.

Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial.

PubMed

Lam, Freddy Mh; Chan, Philip Fl; Liao, L R; Woo, Jean; Hui, Elsie; Lai, Charles Wk; Kwok, Timothy Cy; Pang, Marco Yc

2018-04-01

To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits. A single-blinded randomized controlled trial was conducted. This study was carried out in residential care units. In total, 73 older adults (40 women, mean age: 82.3 ± 7.3 years) were enrolled into this study. Participants were randomly allocated to one of the three groups: strength and balance program combined with whole-body vibration, strength and balance program without whole-body vibration, and social and recreational activities consisting of upper limb exercises only. All participants completed three training sessions per week for eight weeks. Assessment of mobility, balance, lower limb strength, walking endurance, and self-perceived balance confidence were conducted at baseline and immediately after the eight-week intervention. Incidences of falls requiring medical attention were recorded for one year after the end of the training period. A significant time × group interaction was found for lower limb strength (five-times-sit-to-stand test; P = 0.048), with the exercise-only group showing improvement (pretest: 35.8 ± 16.1 seconds; posttest: 29.0 ± 9.8 seconds), compared with a decline in strength among controls (pretest: 27.1 ± 10.4 seconds; posttest: 28.7 ± 12.3 seconds; P = 0.030). The exercise with whole-body vibration group had a significantly better outcome in balance confidence (pretest: 39.2 ± 29.0; posttest: 48.4 ± 30.6) than the exercise-only group (pretest: 35.9 ± 24.8; posttest: 38.2 ± 26.5; P = 0.033). The exercise program was effective in improving lower limb strength among institutionalized older adults but adding whole-body vibration did not enhance its effect. Whole-body vibration may improve balance confidence without enhancing actual balance performance.

Effect of timed bright light treatment for rest-activity disruption in institutionalized patients with Alzheimer’s disease

PubMed Central

Dowling, Glenna A.; Mastick, Judy; Hubbard, Erin M.; Luxenberg, Jay S.; Burr, Robert L.

2008-01-01

SUMMARY Background Disturbances in rest-activity rhythm are prominent and disabling symptoms in Alzheimer’s disease (AD). Nighttime sleep is severely fragmented and daytime activity is disrupted by multiple napping episodes. In most institutional environments, light levels are very low and may not be sufficient to entrain the circadian clock to the 24-hour day. Method The purpose of this randomized clinical trial was to test the effectiveness of timed bright light therapy in reducing rest-activity (circadian) disruption in institutionalized patients with AD. The experimental groups received either morning (9.30–10.30 am) or afternoon (3.30–4.30 pm) bright light exposure (≥ 2500 lux in gaze direction) Monday through Friday for 10 weeks. The control group received usual indoor light (150–200 lux). Nighttime sleep, daytime wake, and rest-activity parameters were determined by actigraphy. Repeated measures analysis of variance was employed to test the primary study hypotheses. Results Seventy institutionalized subjects with AD (mean age 84) completed the study. No significant differences in actigraphy-based measures of nighttime sleep or daytime wake were found between groups. Subjects in either experimental light condition evidenced a significantly (p < 0.01) more stable rest-activity rhythm acrophase over the 10-week treatment period compared to the control subjects whose rhythm phase delayed by over two hours. Conclusions One hour of bright light, administered to subjects with AD either in the morning or afternoon, did not improve nighttime sleep or daytime wake compared to a control group of similar subjects. However, exposure to one-hour of bright light in either the morning or afternoon may provide sufficient additional input to the circadian pacemaker to facilitate entrainment to the 24-hour day. PMID:16035127

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…

Productive Tensions in Youth Participatory Action Research

ERIC Educational Resources Information Center

Kirshner, Ben

2010-01-01

Youth participatory action research (YPAR) brings young people together with adult researchers to identify, study, and act on relevant social problems. In this chapter, the author draws on examples from a recent YPAR project, called Tracing Transitions, whose aim was to study the impact of school closure on students. After defining YPAR in terms…

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…

Joint action syntax in Japanese martial arts.

PubMed

Yamamoto, Yuji; Yokoyama, Keiko; Okumura, Motoki; Kijima, Akifumi; Kadota, Koji; Gohara, Kazutoshi

2013-01-01

Participation in interpersonal competitions, such as fencing or Japanese martial arts, requires players to make instantaneous decisions and execute appropriate motor behaviors in response to various situations. Such actions can be understood as complex phenomena emerging from simple principles. We examined the intentional switching dynamics associated with continuous movement during interpersonal competition in terms of their emergence from a simple syntax. Linear functions on return maps identified two attractors as well as the transitions between them. The effects of skill differences were evident in the second- and third-order state-transition diagrams for these two attractors. Our results suggest that abrupt switching between attractors is related to the diverse continuous movements resulting from quick responses to sudden changes in the environment. This abrupt-switching-quick-response behavior is characterized by a joint action syntax. The resulting hybrid dynamical system is composed of a higher module with discrete dynamics and a lower module with continuous dynamics. Our results suggest that intelligent human behavior and robust autonomy in real-life scenarios are based on this hybrid dynamical system, which connects interpersonal coordination and competition.

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...

Site transition framework for long-term surveillance and maintenance

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

None

2014-04-01

This document provides a framework for all U.S. Department of Energy (DOE) facilities and sites where DOE may have anticipated long-term surveillance and maintenance (LTSM) responsibilities. It is a tool to help facilitate a smooth transition from remediation to LTSM, providing a systematic process for affected parties to utilize in analyzing the baseline to understand and manage the actions from EM mission completion through a site’s transition into LTSM. The framework is not meant to provide an exhaustive list of the specific requirement and information that are needed. Sites will have unique considerations that may not be adequately addressed bymore » this tool, and it is anticipated that a team comprised of the transferring and receiving organization will use judgment in utilizing this augmenting with other DOE guidance. However the framework should be followed to the extent possible at each site; and adapted to accommodate unique site-specific requirements, needs, and documents. Since the objective of the tool is facilitate better understanding of the conditions of the site and the actions required for transfer, the transition team utilizing the checklist is expected to consult with management of both the receiving and transferring organization to verify that major concerns are addressed. Ideally, this framework should be used as early in the remediation process as possible. Subsequent applications of the Site Transition Framework (STF) to the site should be conducted periodically and used to verify that all appropriate steps have been or will be taken to close-out the site and that actions by both organization are identified to transfer the site to LTSM. The requirements are provided herein.« less

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…

Transition and Transfer of Remediated Formerly Utilized Sites Remedial Action Program (FUSRAP) Sites from U.S. Army Corps of Engineers (USACE) to U.S. Department of Energy (DOE)

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

Carpenter, Cliff; Castillo, Darina; Fatherly, Nicki

The US Department of Energy (DOE) expects to receive the transfer of 10 FUSRAP Sites from the US Army Corps of Engineers (USACE) over the next 10 years; however, the timing of the transfers is highly dependent upon federal funding of the ongoing remedial actions. When remediation for each site is complete and the 2-year operations and maintenance period has concluded, each site will transfer from USACE to DOE for long-term surveillance and maintenance (LTS&M). US DOE’s Office of Legacy Management (LM) will accept program responsibility for these sites and conduct LTS&M activities required to maintain protectiveness, preserve site-specific knowledge,more » and retain the cleanup and stewardship records while keeping stakeholders informed. Since the last FUSRAP site transfer occurred in 2007, LM in coordination with USACE intends to establish a transition process to promote the seamless transfer of sites from the time when the first record of decision is signed to the completion of FUSRAP activities. The approach to transfer active FUSRAP sites to completed sites status has been historically outlined in foundational documents such as the 1999 Memorandum of Understanding and supporting letters of agreement between the two agencies. As more complex FUSRAP sites are completed, this transition process will provide a model between the two agencies to communicate future long-term care liabilities. Ultimately, the FUSRAP transition process is structured to acquire and preserve site knowledge and information necessary for protecting the environment and public health. As of 2015, LM has transitioned and accepted programmatic responsibility for over 90 sites. From LM’s perspective, successful transition of any site includes understanding the long-term environmental liabilities. LM uses site transition framework requirements from past transitions to develop site-specific transition plans. Site-specific transition plans are developed by LM in coordination with USACE and

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...

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...

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...

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…

Nutritional challenges for children in societies in transition.

PubMed

Cai, Wei

2014-05-01

This review is to explore the childhood nutrition and health in relation to socioeconomic changes in transitional countries, and to describe the good experiences and policies in these countries to combat childhood nutritional challenges. Double burden of malnutrition - the coexistence of under-nutrition and over-nutrition in the same population - is a prominent public health concern in transitional countries. With rapid industrialization, these countries are facing a growing epidemic of overweight/obesity in children and adolescents. The increasing prevalence of childhood overweight/obesity is a likely consequence of behavioral changes, and accompanied with an increasing incidence of noncommunicable chronic diseases. Although remarkable improvement of childhood nutrition was achieved, the stunting growth and micronutrient deficiency remain to be child health issues in transitional countries. The social transition caused a broad range of nutrition-associated problems. Previous successful experiences indicated that if appropriate action is undertaken, the child nutritional problems accompanied with economic transition could be controlled to some extent. However, greater efforts are needed to improve the status of childhood nutrition in transitional countries.

24-hour pattern of falls in hospitalized and long-term care institutionalized elderly persons: A systematic review of the published literature.

PubMed

López-Soto, Pablo Jesús; Manfredini, Roberto; Smolensky, Michael H; Rodríguez-Borrego, María Aurora

2015-05-01

Falls are common among the elderly > 65 years of age and can result in both serious trauma and costly medical care. The epidemiology of falls in the elderly typically focuses on identifying contributory exogenous environmental and endogenous age-related physical, cognitive and other health status factors; however, one potentially important variable seldom considered is time of fall. We sought to determine if falls in hospitalized/institutionalized elderly persons exhibit 24 h and other temporal patterns, since knowledge of such could be useful in their prevention. We conducted a systematic review of the published literature to critically appraise and synthesize the methods and findings of previous reports addressing clock-time, day-of-week and month-of-year fall patterns of institutionalized elderly cohorts. Medline, SCOPUS, Ovid SP and Web of Knowledge were systematic assessed, entering search terms of "accidental fall", "circadian rhythm", "biological clocks", "circadian clocks", "activity cycles", "periodicity", and with databases accepting an age limiter, "age of 65(+) years". Methodological quality was assessed by STROBE and CONSORT checklists, respectively, in observational and clinical studies. Publications were reviewed if meeting inclusion criteria of: (i) being an empirical study, (ii) adopting circadian and/or other period rhythmicity as a fall risk, and (iii) focusing on hospitalized/institutionalized falls in those ≥ 65 years of age; plus exclusion criteria of: (i) cohort < 65 years of age and (ii) reports as dissertations or editorials. The search retrieved 170 publications; however, only nine met all inclusion/exclusion criteria. Typically, past studies disregarded the temporal aspects of fall incidents; the few that did varied in quality, institutional setting, and patient type, i.e. medical diagnoses. Overall, findings suggest a single or double-peak 24 h pattern of fall incidence, with time of greatest incidence seemingly associated

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.

Measurement characteristics of the levels of institutionalization scales: examining reliability and validity.

PubMed

Barab, S A; Redman, B K; Froman, R D

1998-01-01

The Level of Institutionalization (LoIn) scales were developed to assess the extent to which a health promotion program has become integrated into a health care organization. The instrument was designed specifically to measure the amount of routinization and niche saturation of four subsystems (production, maintenance, supportive, and managerial) believed to make up an organization. In this study, the LoIn scales were completed for diabetes programs in 102 general hospitals and 30 home health agencies in Maryland and Pennsylvania. Reliability estimates across the four subsystems for routines (alpha = .61) and for niche saturation (alpha = .44) were substandard. Average correlation among the four subsystems for routines was .67, and among the four subsystems for niche saturation was .38, indicating moderate to large amounts of shared variance among subsystems and challenging claims of discriminant validity. Given these large correlations and a poor fit when testing the eight-factor model, higher-order confirmatory factor analyses were carried out. Results supported the existence of two second-order factors. When collapsed into two factors, the reliabilities were adequate (routines alpha = .90; niche saturation alpha = .80). Criterion-related validity also was found between length of program existence and the routine factor.

Compromise, Well-Being, and Action Behaviors in Young Adults in Career Transition

ERIC Educational Resources Information Center

Creed, Peter A.; Blume, Kellie

2013-01-01

The authors surveyed 186 first-year university students and assessed their level of career compromise associated with making the transition to university. Compromise was operationalized as the discrepancy between the job characteristics of ideal and expected occupations. The authors also assessed career well-being (satisfaction, distress), action…

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…

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…

Biomarkers of Selenium Action in Prostate Cancer

DTIC Science & Technology

2006-03-01

without BPH) transition zone tissue of a 42-year-old man ac- cording to previously described methods [4]. The pre- sence of contaminating epithelial...protein secreted by cells using a sensitive ELISA method . Replicating the conditions used for the microarray analyses, cells were fed fresh medium...4 Introduction Biomarkers of selenium actions in prostate tissue would be of great value in stratifying patients

Nutritional status and dietary intake of institutionalized elderly in Turkey: a cross-sectional, multi-center, country representative study.

PubMed

Ongan, Dilek; Rakıcıoğlu, Neslişah

2015-01-01

To evaluate the nutritional status and dietary intake of institutionalized elderly in Turkey. Cross-sectional study. 25 institutions in 19 cities throughout Turkey. Elderly residents aged 65 years and older (n=554). Nutritional status using Mini Nutritional Assessment (MNA), food consumption with 24-h dietary recall and anthropometric measurements (body weight, height, body mass index (BMI), waist circumference (WC), hip circumference, waist/hip ratio, mid-upper arm circumference (MUAC)). The mean age of the elderly was 76.1±7.3 years. BMI of elderly men and women were found to be 26.59±4.58kg/m(2) and 30.07±6.32kg/m(2), respectively. WC of elderly men and women were found to be 98.90±1.33cm and 100.62±1.34cm, respectively. Most of the elderly were overweight based on BMI and at risk of metabolic diseases based on WC. According to MNA, 44.2% had normal nutritional status, 49.1% were at risk of malnutrition, 6.7% had malnutrition. All nutrients intake was favorable according to requirements, except for calcium and magnesium. Energy, protein, carbohydrate, fat, vitamins A, E, B1, B2, B6, C folat, iron, zinc intake of elderly who had normal nutritional status, who were at risk of malnutrition and malnourished were significantly different. Energy and nutrients intake of elderly who had normal nutritional status was found to be better than the others. Nutritional status should be periodically screened in the institutionalized elderly to prevent malnutrition. Also, it was noted that adequate energy and nutrients intake of the elderly played a crucial role in maintaining nutritional status and preventing malnutrition within residential homes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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…

Unifying role of dissipative action in the dynamic failure of solids

NASA Astrophysics Data System (ADS)

Grady, Dennis E.

2015-04-01

A fourth-power law underlying the steady shock-wave structure and solid viscosity of condensed material has been observed for a wide range of metals and non-metals. The fourth-power law relates the steady-wave Hugoniot pressure to the fourth power of the strain rate during passage of the material through the structured shock wave. Preceding the fourth-power law was the observation in a shock transition that the product of the shock dissipation energy and the shock transition time is a constant independent of the shock pressure amplitude. Invariance of this energy-time product implies the fourth-power law. This property of the shock transition in solids was initially identified as a shock invariant. More recently, it has been referred to as the dissipative action, although no relationship to the accepted definitions of action in mechanics has been demonstrated. This same invariant property has application to a wider range of transient failure phenomena in solids. Invariance of this dissipation action has application to spall fracture, failure through adiabatic shear, shock compaction of granular media, and perhaps others. Through models of the failure processes, a clearer picture of the physics underlying the observed invariance is emerging. These insights in turn are leading to a better understanding of the shock deformation processes underlying the fourth-power law. Experimental result and material models encompassing the dynamic failure of solids are explored for the purpose of demonstrating commonalities leading to invariance of the dissipation action. Calculations are extended to aluminum and uranium metals with the intent of predicting micro-scale dynamics and spatial structure in the steady shock wave.

Transition from Crawling to Walking and Infants' Actions with Objects and People

ERIC Educational Resources Information Center

Karasik, Lana B.; Tamis-LeMonda, Catherine S.; Adolph, Karen E.

2011-01-01

Associations between infants' transition to walking and object activities were examined. Fifty infants were observed longitudinally during home observations. At 11 months, all infants were crawlers; at 13 months, half became walkers. Over age, infants increased their total time with objects and frequency of sharing objects with mothers.…

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.

Mental models accurately predict emotion transitions.

PubMed

Thornton, Mark A; Tamir, Diana I

2017-06-06

Successful social interactions depend on people's ability to predict others' future actions and emotions. People possess many mechanisms for perceiving others' current emotional states, but how might they use this information to predict others' future states? We hypothesized that people might capitalize on an overlooked aspect of affective experience: current emotions predict future emotions. By attending to regularities in emotion transitions, perceivers might develop accurate mental models of others' emotional dynamics. People could then use these mental models of emotion transitions to predict others' future emotions from currently observable emotions. To test this hypothesis, studies 1-3 used data from three extant experience-sampling datasets to establish the actual rates of emotional transitions. We then collected three parallel datasets in which participants rated the transition likelihoods between the same set of emotions. Participants' ratings of emotion transitions predicted others' experienced transitional likelihoods with high accuracy. Study 4 demonstrated that four conceptual dimensions of mental state representation-valence, social impact, rationality, and human mind-inform participants' mental models. Study 5 used 2 million emotion reports on the Experience Project to replicate both of these findings: again people reported accurate models of emotion transitions, and these models were informed by the same four conceptual dimensions. Importantly, neither these conceptual dimensions nor holistic similarity could fully explain participants' accuracy, suggesting that their mental models contain accurate information about emotion dynamics above and beyond what might be predicted by static emotion knowledge alone.

Mental models accurately predict emotion transitions

PubMed Central

Thornton, Mark A.; Tamir, Diana I.

2017-01-01

Successful social interactions depend on people’s ability to predict others’ future actions and emotions. People possess many mechanisms for perceiving others’ current emotional states, but how might they use this information to predict others’ future states? We hypothesized that people might capitalize on an overlooked aspect of affective experience: current emotions predict future emotions. By attending to regularities in emotion transitions, perceivers might develop accurate mental models of others’ emotional dynamics. People could then use these mental models of emotion transitions to predict others’ future emotions from currently observable emotions. To test this hypothesis, studies 1–3 used data from three extant experience-sampling datasets to establish the actual rates of emotional transitions. We then collected three parallel datasets in which participants rated the transition likelihoods between the same set of emotions. Participants’ ratings of emotion transitions predicted others’ experienced transitional likelihoods with high accuracy. Study 4 demonstrated that four conceptual dimensions of mental state representation—valence, social impact, rationality, and human mind—inform participants’ mental models. Study 5 used 2 million emotion reports on the Experience Project to replicate both of these findings: again people reported accurate models of emotion transitions, and these models were informed by the same four conceptual dimensions. Importantly, neither these conceptual dimensions nor holistic similarity could fully explain participants’ accuracy, suggesting that their mental models contain accurate information about emotion dynamics above and beyond what might be predicted by static emotion knowledge alone. PMID:28533373

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…

Moments of action provide insight into critical times for advection-diffusion-reaction processes.

PubMed

Ellery, Adam J; Simpson, Matthew J; McCue, Scott W; Baker, Ruth E

2012-09-01

Berezhkovskii and co-workers introduced the concept of local accumulation time as a finite measure of the time required for the transient solution of a reaction-diffusion equation to effectively reach steady state [Biophys J. 99, L59 (2010); Phys. Rev. E 83, 051906 (2011)]. Berezhkovskii's approach is a particular application of the concept of mean action time (MAT) that was introduced previously by McNabb [IMA J. Appl. Math. 47, 193 (1991)]. Here, we generalize these previous results by presenting a framework to calculate the MAT, as well as the higher moments, which we call the moments of action. The second moment is the variance of action time, the third moment is related to the skew of action time, and so on. We consider a general transition from some initial condition to an associated steady state for a one-dimensional linear advection-diffusion-reaction partial differential equation (PDE). Our results indicate that it is possible to solve for the moments of action exactly without requiring the transient solution of the PDE. We present specific examples that highlight potential weaknesses of previous studies that have considered the MAT alone without considering higher moments. Finally, we also provide a meaningful interpretation of the moments of action by presenting simulation results from a discrete random-walk model together with some analysis of the particle lifetime distribution. This work shows that the moments of action are identical to the moments of the particle lifetime distribution for certain transitions.

Space-time thermodynamics of the glass transition

NASA Astrophysics Data System (ADS)

Merolle, Mauro; Garrahan, Juan P.; Chandler, David

2005-08-01

We consider the probability distribution for fluctuations in dynamical action and similar quantities related to dynamic heterogeneity. We argue that the so-called “glass transition” is a manifestation of low action tails in these distributions where the entropy of trajectory space is subextensive in time. These low action tails are a consequence of dynamic heterogeneity and an indication of phase coexistence in trajectory space. The glass transition, where the system falls out of equilibrium, is then an order-disorder phenomenon in space-time occurring at a temperature Tg, which is a weak function of measurement time. We illustrate our perspective ideas with facilitated lattice models and note how these ideas apply more generally. Author contributions: M.M., J.P.G., and D.C. performed research and wrote the paper.

23 CFR 810.208 - Action by the Federal Highway Administrator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Action by the Federal Highway Administrator. 810.208 Section 810.208 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PUBLIC TRANSPORTATION MASS TRANSIT AND SPECIAL USE HIGHWAY PROJECTS Making Highway Rights-of-Way Available for Mass...

23 CFR 810.208 - Action by the Federal Highway Administrator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Action by the Federal Highway Administrator. 810.208 Section 810.208 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PUBLIC TRANSPORTATION MASS TRANSIT AND SPECIAL USE HIGHWAY PROJECTS Making Highway Rights-of-Way Available for Mass...

23 CFR 810.208 - Action by the Federal Highway Administrator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Action by the Federal Highway Administrator. 810.208 Section 810.208 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PUBLIC TRANSPORTATION MASS TRANSIT AND SPECIAL USE HIGHWAY PROJECTS Making Highway Rights-of-Way Available for Mass...

The effects of early institutionalization on emotional face processing: evidence for sparing via an experience-dependent mechanism.

PubMed

Young, Audrey; Luyster, Rhiannon J; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A

2017-09-01

Early psychosocial deprivation has profound adverse effects on children's brain and behavioural development, including abnormalities in physical growth, intellectual function, social cognition, and emotional development. Nevertheless, the domain of emotional face processing has appeared in previous research to be relatively spared; here, we test for possible sleeper effects emerging in early adolescence. This study employed event-related potentials (ERPs) to examine the neural correlates of facial emotion processing in 12-year-old children who took part in a randomized controlled trial of foster care as an intervention for early institutionalization. Results revealed no significant group differences in two face and emotion-sensitive ERP components (P1 and N170), nor any association with age at placement or per cent of lifetime spent in an institution. These results converged with previous evidence from this population supporting relative sparing of facial emotion processing. We hypothesize that this sparing is due to an experience-dependent mechanism in which the amount of exposure to faces and facial expressions of emotion children received was sufficient to meet the low threshold required for cortical specialization of structures critical to emotion processing. Statement of contribution What is already known on this subject? Early psychosocial deprivation leads to profoundly detrimental effects on children's brain and behavioural development. With respect to children's emotional face processing abilities, few adverse effects of institutionalized rearing have previously been reported. Recent studies suggest that 'sleeper effects' may emerge many years later, especially in the domain of face processing. What does this study add? Examining a cumulative 12 years of data, we found only minimal group differences and no evidence of a sleeper effect in this particular domain. These findings identify emotional face processing as a unique ability in which relative sparing

Synchronization of action potentials during low-magnesium-induced bursting

PubMed Central

Johnson, Sarah E.; Hudson, John L.

2015-01-01

The relationship between mono- and polysynaptic strength and action potential synchronization was explored using a reduced external Mg2+ model. Single and dual whole cell patch-clamp recordings were performed in hippocampal cultures in three concentrations of external Mg2+. In decreased Mg2+ medium, the individual cells transitioned to spontaneous bursting behavior. In lowered Mg2+ media the larger excitatory synaptic events were observed more frequently and fewer transmission failures occurred, suggesting strengthened synaptic transmission. The event synchronization was calculated for the neural action potentials of the cell pairs, and it increased in media where Mg2+ concentration was lowered. Analysis of surrogate data where bursting was present, but no direct or indirect connections existed between the neurons, showed minimal action potential synchronization. This suggests the synchronization of action potentials is a product of the strengthening synaptic connections within neuronal networks. PMID:25609103

Synchronization of action potentials during low-magnesium-induced bursting.

PubMed

Johnson, Sarah E; Hudson, John L; Kapur, Jaideep

2015-04-01

The relationship between mono- and polysynaptic strength and action potential synchronization was explored using a reduced external Mg(2+) model. Single and dual whole cell patch-clamp recordings were performed in hippocampal cultures in three concentrations of external Mg(2+). In decreased Mg(2+) medium, the individual cells transitioned to spontaneous bursting behavior. In lowered Mg(2+) media the larger excitatory synaptic events were observed more frequently and fewer transmission failures occurred, suggesting strengthened synaptic transmission. The event synchronization was calculated for the neural action potentials of the cell pairs, and it increased in media where Mg(2+) concentration was lowered. Analysis of surrogate data where bursting was present, but no direct or indirect connections existed between the neurons, showed minimal action potential synchronization. This suggests the synchronization of action potentials is a product of the strengthening synaptic connections within neuronal networks. Copyright © 2015 the American Physiological Society.

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...

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...

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...

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...

Commentary on Seppänen and colleagues (2012): Institutionalization of brief alcohol intervention in primary health care-the Finnish case.

PubMed

Heather, Nick

2012-08-01

Despite good evidence for the effectiveness of brief intervention (BI) for hazardous and harmful drinking delivered in primary health care, the uptake of such interventions among physicians and other healthcare staff still leaves much to be desired. Seppänen and colleagues (2012) report an evaluation of efforts funded by the Finnish government to "institutionalize" BI among primary care physicians in Finland. The evaluation was based on 2 surveys of Finnish primary healthcare physicians, one conducted in 2002 before the government-funded implementation project had begun and the other in 2007 after it had ended. Major findings were that the proportion of physicians offering BI had increased between the 2 surveys from 59.2 to 78.5% and that, of those who said they offered BI in 2007, 52.4% reported increased activity compared with 5 years earlier. However, in the 2007 survey, regular BI activity was reported by 17.2% of the sample but 61.3% reported only occasional activity. Also, a separate survey of the Finnish general population indicated that the extent to which people are asked by health professionals about their alcohol consumption, and the extent to which heavy drinkers receive advice about it, still appears to be low. Thus, the claim that the institutionalization of BI in the Finnish primary care system has been successful is tentative. The clinical benefits of increased BI activity are unquestionable but it can be argued that, for a public health benefit to occur, a greater proportion of hazardous and harmful drinkers need to receive BI than is suggested in the data reported by Seppänen and colleagues. Copyright © 2012 by the Research Society on Alcoholism.

The Importance of Emotional Intelligence and Cognitive Style in Institutionalized Older Adults' Quality of Life.

PubMed

Luque-Reca, Octavio; Pulido-Martos, Manuel; Lopez-Zafra, Esther; Augusto-Landa, José M

2018-01-01

Despite previous evidence showing a positive relationship between emotional intelligence (EI) and quality of life (QoL), associating older adults' emotional processing with several health indicators, few studies have explored both the IE and the a mechanisms through which they affect QoL. This cross-sectional study analyzes the mediator role of optimistic and pessimistic cognitive styles in the relationship between perceived EI (PEI) and QoL in 115 institutionalized older adults from Southern Spain. Regression analyses showed, after controlling for cognitive style, that PEI predicted a significant percentage of variance in: Health (β = .25, p < .01), Functional abilities (β = .20, p < .05), Activity and leisure (β = .17, p < .05) and Life satisfaction (β = .21, p < .05). Additionally, multiple mediation analysis revealed that cognitive style partially mediated the relationship between PEI and Health, Activity and leisure and Life satisfaction. Thus, PEI could promote personal but not external or environmental QoL aspects, highlighting the importance of developing emotional skills for healthy aging.

Generalized group field theories and quantum gravity transition amplitudes

NASA Astrophysics Data System (ADS)

Oriti, Daniele

2006-03-01

We construct a generalized formalism for group field theories, in which the domain of the field is extended to include additional proper time variables, as well as their conjugate mass variables. This formalism allows for different types of quantum gravity transition amplitudes in perturbative expansion, and we show how both causal spin foam models and the usual a-causal ones can be derived from it, within a sum over triangulations of all topologies. We also highlight the relation of the so-derived causal transition amplitudes with simplicial gravity actions.

[Alcohol consumption--risk behavior in institutionalized teenagers of a Lugoj investment center].

PubMed

Petrescu, Cristina; Stoian, Iasmina Rodica; Suciu, Oana; Bredicean, Cristina; Olariu, T R

2010-01-01

In the performed study we investigated alcohol consumption--a frequent risk behavior that occurs in teenagers. The institutionalization of children from disturbed family could be a facilitator factor for alcohol consumption. A new group with different habits of the members is created and the information exchange could be useful or noxious. A transversal inquiry, with CORT (Comportamente cu Risc la Tineri--Risk Behaviors in Young People) questionnaire applying in a sample with 64 teenagers, which live in an Investment Center from Lugoj. We selected 16 items referring to alcohol consumption and the social environment. Obtained results showed frequent alcohol consumption in the social environment (group of friends--85% and disorganized family--debut of alcohol consumption under 8 years in boys group). The places of alcohol consumption are bars, restaurants (73% boys), in the Investment Center (59% boys and 29% girls), in the friends' houses, on the street. They consume alcohol in group and alone. The boys became drunk frequent (20% affirmed that became drunk more than 40 times in the last month). Discontent about relation inside the group increases the alcohol consumption outside the group. The alcohol consumption as a learned behavior in the origin disorganized family could be disseminated in the Centers for Children Protection.

Oral health and nutritional status of semi-institutionalized persons with mental retardation in Brazil.

PubMed

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 Florianópolis and São José, province of Santa Catarina, Brazil. In this cross-sectional study, clinical-odontological examination revealed a high percentage of individuals (68%) with heavily compromised dentition. The index of decayed, missing and filled deciduous and permanent teeth, which increased from 2.85+/-2.87 in children to 20.5+/-6.86 units in adults, was used to classify the individuals' oral health status. Anthropometric evaluation revealed the prevalence of suboptimal nutritional status in 52% of children and adolescents [22% underweight, 30% at risk of overweight or overweight], and in 60% of adults [7% underweight, 53% overweight or obese]. Significant association was found between unsatisfactory oral health status and overweight in children (chi(2)=4.627; p=0.031). Findings evidenced the existence of a relationship between oral health status and nutritional status in persons with mental retardation.

An Action Research Project Exploring the Psychology Curriculum and Transitions to Employment

ERIC Educational Resources Information Center

McMurray, Isabella; Roberts, Pat; Robertson, Ian; Teoh, Kevin

2011-01-01

Within the UK, traditional subject-specific areas are increasingly being complemented by the provision of opportunities to foster students' personal development planning as an aide to support their future employment and lifelong learning. This paper describes an action research project which examined employability skills within a psychology…

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...

Blended Learning in Action: A Practical Guide toward Sustainable Change

ERIC Educational Resources Information Center

Tucker, Catlin R.; Wycoff, Tiffany; Green, Jason T.

2017-01-01

Blended learning has the power to reinvent education, but transitioning to a blended model is challenging. Blended learning requires a fundamentally new approach to learning as well as a new skillset for both teachers and school leaders. Loaded with research, examples, and resources, "Blended Learning in Action" demonstrates the…

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…

High consumption foods and their influence on energy and protein intake in institutionalized older adults.

PubMed

Mila, R; Abellana, R; Padro, L; Basulto, J; Farran, A

2012-02-01

The elderly, and especially those attending nursing homes, are at great risk from certain nutritional deficiencies. The aim of this study was to determine which food groups present the highest rates of consumption among the institutionalized elderly and study the energy density of each food group and the number of calories and amount of protein in the total diet of each resident. This was a multicentre observational study of a sample of the institutionalized population over the age of 65. The sample of patients was drawn from four Spanish nursing homes (Santa Coloma Gramanet, Barcelona, Madrid and Bilbao). Our final sample comprised a total of 62 individuals, of whom 22 were men and 40 women, aged between 68 and 96 years. Dietary data were collected using the double weight method for each main meal (breakfast, lunch, afternoon snack and dinner), including food type, the quantity of food served and the amount of plate waste for each of the main meals served during 21 days. The characteristics of the study population were compared by Student's t-test and χ2 test. The results are expressed in terms of their median values and the interquartile range. To analyse the overall differences between sites, gender and food groups we used Kruskall-Wallis test combined with the Mann-Whitney U-test with Bonferroni correction for multiple comparisons. The food group that was served most was milk products (376.25 g/day). A large amount of potatoes were also served (109.64 g/day) as were sweets and pastries (62.14 g/day). The daily serving of fruit (138.34 g/day) and vegetables (239.47 g/day) was equivalent to no more than that of a daily ration in each case. Milk was the food group with the highest consumption (311 g/day). Most of the energy was provided by groups with a higher energy density like as fats and sauces, sweets and pastries and bread. The mean protein consumption was 82,6 g/day (Table 5) and no significant differences were recorded in this consumption between men and

Role transition in primary care settings.

PubMed

Holt, Ian G S

2008-01-01

This paper reports on research that explored how nurses who are engaged in advanced practice adapt and adjust to their roles in primary and community health settings. Successive government policy has highlighted how the changing roles of nurses, who are engaged in advanced practice, are crucial to delivering high-quality patient care. The paper offers a framework for role transition which is potentially generalisable to doctors, physiotherapists and other healthcare professionals. The aim of the study was to enable an understanding of role transition, from a study of nurses going through changes to their roles or moving to new roles. The intended purpose of the study was to explore what was going on within role transition, and considers by what process(es) role transition evolves or is experienced. Eleven nurses' actions, expectations, and experiences of role transition were explored, within three district nurse centres and two community NHS trusts. Data were collected from participant and non-participant observation, content analysis of job descriptions and from individual and group interviews, including semi-structured schedules and focus group techniques. Data were comparatively analysed to conceptualise and saturate core themes, which were discussed and developed with participants and healthcare managers. A theory of role transition is proposed through a model representing the 'who', 'what', 'where' and 'how' of role transition, through four concepts of centring identity(ies); focusing role(s); enacting role(s); and shaping role(s). Identity was regarded by the participants as being the role, the person, and as part of a group. Current and anticipated role foci directed enactment of role within given contexts and resources, while shaping of role involved a balance of role loss and role expansion. This article presents a theory of role transition for primary care professionals.

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.

A Spiral of Transitions Leading to Broader Influence and Action.

PubMed

Benton, David C

This article describes lessons learned through a reflective analysis of job transitions experienced by a registered nurse from the time of entry into the profession until the current point where the nurse is engaged in state, national, and international policy development work. The centrality and symbiotic nature of the link between policy and practice and the importance of evidence and leadership have emerged as key aspects of the expanding spiral of influence traversed as a result of various career moves. At every stage, lessons have been learned. Some of these are professional in nature, but on occasion, the lessons have been more personal. The importance of mentors cannot be underestimated in terms of the support and guidance they offer but also the challenges they bring to existing patterns of thought and behavior.

A pilot assessment tool of the need for oral health care and cost prediction in institutionalized elderly people.

PubMed

Miremadi, S R; Cosyn, J; Janssens, B; De Bruyn, H; Vanobbergen, J; De Visschere, L

2017-11-01

To assess the dental treatment backlog and associated costs among institutionalized elderly people using a novel composite index, called the oral health index. Despite numerous reports about oral health of old individuals, there is still lack of a systematic and practical method to estimate their treatment need covering all relevant aspects of oral health. In addition, little has been published on associated treatment costs and prediction of such costs. An observational study was performed on 143 dentate institutionalized elderly people, whereby several clinical parameters were registered. The collected data were included in the oral health index representing the need for oral health care. This covered the number of caries lesions, number of residual roots, periodontal health condition, plaque score and denture condition with a final score of 0-9. To investigate the validity of the index, the treatment costs were estimated using the measured clinical parameters and later compared with the actual expenditure of the patients for the following 2 years. The average score of the index was 4.6 (SD 1.4) with 65.1% of the individuals having a score between 3 and 6 and 27.3% having a score of 6 and more, exhibiting medium and high need for oral health care, respectively. Only 30% of the patients underwent all the indicated treatments. The major reason of non-completion of the treatment was patient's refusal. From the fully treated group, 61.5% of the subjects actually spent within the predicted range while 38.5% of them spent more than estimated. The underestimation was related to yearly calculus removals leading to repeated calculation of the same costs and newly emerging dental problems (33% developed new caries and 20% was confronted with tooth fracture within the 2-year period). The novel index can be helpful to determine oral treatment needs and associated costs. Further research is needed to extend the clinical applicability of the index. © 2016 John Wiley & Sons A

Seeking Social Inventions to Improve the Transition to Adulthood

ERIC Educational Resources Information Center

Hamilton, Mary Agnes; Hamilton, Stephen F.

2015-01-01

Social inventions are new ways of solving human problems. This article reports on an action research project designed to find social inventions to reduce structural lag in four programs that support the transition to adulthood of marginalized youth in Latin America. The investigators engaged youth and staff members in identifying important…

Corticotropin-releasing hormone: Mediator of vertebrate life stage transitions?

PubMed

Watanabe, Yugo; Grommen, Sylvia V H; De Groef, Bert

2016-03-01

Hormones, particularly thyroid hormones and corticosteroids, play critical roles in vertebrate life stage transitions such as amphibian metamorphosis, hatching in precocial birds, and smoltification in salmonids. Since they synergistically regulate several metabolic and developmental processes that accompany vertebrate life stage transitions, the existence of extensive cross-communication between the adrenal/interrenal and thyroidal axes is not surprising. Synergies of corticosteroids and thyroid hormones are based on effects at the level of tissue hormone sensitivity and gene regulation. In addition, in representative nonmammalian vertebrates, corticotropin-releasing hormone (CRH) stimulates hypophyseal thyrotropin secretion, and thus functions as a common regulator of both the adrenal/interrenal and thyroidal axes to release corticosteroids and thyroid hormones. The dual function of CRH has been speculated to control or affect the timing of vertebrate life history transitions across taxa. After a brief overview of recent insights in the molecular mechanisms behind the synergic actions of thyroid hormones and corticosteroids during life stage transitions, this review examines the evidence for a possible role of CRH in controlling vertebrate life stage transitions. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementation of Transition in Care and Relationship Based Care to Reduce Preventable Rehospitalizations.

PubMed

Burt, Susan; Berry, Donna; Quackenbush, Patricia

2015-01-01

Home healthcare agencies are accountable for preventing rehospitalization, yet many struggle to make progress with this metric. The purpose of this article is to share how our organization turned to two frameworks, Transitions in Care and Relationship-Based Care, to prevent unnecessary rehospitalizations. Appreciative inquiry, motivational interviewing, and action plans are used by our Transitional Care Nurses to engage and motivate patients to manage chronic diseases and achieve desirable health outcomes. Implementation of a Transitional Care Program has led our organization to improve the health of our patients and to decrease rehospitalization rates.

State Governance Action Annual 2004. Balancing Act: Public Higher Education in Transition

ERIC Educational Resources Information Center

Johnson, Neal C.; Longanecker, David A.

2004-01-01

In this annual report, AGB's Center for Public Trusteeship and Governance provides an up-to-date and insightful description of current state-level policy discussions and actions, many of which could significantly alter the nature of higher education governance in America. Some to the ideas presented in this report may not, on the surface, appear…

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:…

Consumption of yogurts fortified in vitamin D and calcium reduces serum parathyroid hormone and markers of bone resorption: a double-blind randomized controlled trial in institutionalized elderly women.

PubMed

Bonjour, Jean-Philippe; Benoit, Valérie; Payen, Flore; Kraenzlin, Marius

2013-07-01

Nutritional prevention of bone deterioration with fortified foods seems particularly suitable in institutionalized elderly women at risk of vitamin D deficiency, secondary hyperparathyroidism, increased bone resorption, and osteoporotic fracture. The objective was to evaluate whether fortification of yogurts with vitamin D and calcium exerts an additional lowering effect on serum PTH and bone resorption markers as compared with isocaloric and isoprotein dairy products in elderly women. A randomized double-blind controlled-trial, 56-day intervention was conducted in institutionalized women (mean age 85.5 years) consuming 2 125-g servings of either vitamin D- and calcium-fortified yogurt (FY) at supplemental levels of 10 μg/d vitamin D₃ and 800 mg/d calcium or nonfortified control yogurt (CY) providing 280 mg/d calcium. The endpoints were serum changes from baseline (day 0) to day 28 and day 56 in 25-hydroxyvitamin-D (25OHD), PTH, and bone resorption markers tartrate-resistant acid phosphatase isoform-5b (TRAP5b), the primary outcome, and carboxyl-terminal cross-linked telopeptide of type I collagen (CTX). At day 56, serum 25OHD increased (mean ± SEM) by 25.3 ± 1.8 vs 5.2 ± 2.5 nmol/L in FY (n = 29) and CY (n = 27), respectively (P < .0001). The corresponding changes in PTH were -28.6% ± 7.2% vs -8.0% ± 4.3% (P = .0003); in TRAP5b, -21.9% ± 4.3% vs 3.0% ± 3.2% (P < .0001); and in CTX, -11.0% ± 9.7% vs -3.0% ± 4.1% (P = .0146), in FY and CY, respectively. At day 28, these differences were less pronounced but already significant for 25OHD, PTH, and TRAP5b. This study in institutionalized elderly at high risk for osteoporotic fracture suggests that fortification of dairy products with vitamin D₃ and calcium provides a greater prevention of accelerated bone resorption as compared with nonfortified equivalent foods.

Spatiotemporal Phase Synchronization in Adaptive Reconfiguration from Action Observation Network to Mentalizing Network for Understanding Other's Action Intention.

PubMed

Zhang, Li; Gan, John Q; Zheng, Wenming; Wang, Haixian

2018-05-01

In action intention understanding, the mirror system is involved in perception-action matching process and the mentalizing system underlies higher-level intention inference. By analyzing the dynamic functional connectivity in α (8-12 Hz) and β (12-30 Hz) frequency bands over a "hand-cup interaction" observation task, this study investigates the topological transition from the action observation network (AON) to the mentalizing network (MZN), and estimates their functional relevance for intention identification from other's different action kinematics. Sequential brain microstates were extracted based on event-related potentials (ERPs), in which significantly differing neuronal responses were found in N170-P200 related to perceptually matching kinematic profiles and P400-700 involved in goal inference. Inter-electrode weighted phase lag index analysis on the ERP microstates revealed a shift of hub centrality salient in α frequency band, from the AON dominated by left-lateral frontal-premotor-temporal and temporal-parietooccipital synchronizations to the MZN consisting of more bilateral frontal-parietal and temporal-parietal synchronizations. As compared with usual actions, intention identification of unintelligible actions induces weaker synchronizations in the AON but dramatically increased connectivity in right frontal-temporal-parietal regions of the MZN, indicating a spatiotemporally complementary effect between the functional network configurations involved in mirror and mentalizing processes. Perceptual processing in observing usual/unintelligible actions decreases/increases requirements for intention inference, which would induce less/greater functional network reorganization on the way to mentalization. From the comparison, our study suggests that the adaptive topological changes from the AON to the MZN indicate implicit causal association between the mirror and mentalizing systems for decoding others' intentionality.

Swing- and support-related muscle actions differentially trigger human walk-run and run-walk transitions.

PubMed

Prilutsky, B I; Gregor, R J

2001-07-01

There has been no consistent explanation as to why humans prefer changing their gait from walking to running and from running to walking at increasing and decreasing speeds, respectively. This study examined muscle activation as a possible determinant of these gait transitions. Seven subjects walked and ran on a motor-driven treadmill for 40s at speeds of 55, 70, 85, 100, 115, 130 and 145% of the preferred transition speed. The movements of subjects were videotaped, and surface electromyographic activity was recorded from seven major leg muscles. Resultant moments at the leg joints during the swing phase were calculated. During the swing phase of locomotion at preferred running speeds (115, 130, 145%), swing-related activation of the ankle, knee and hip flexors and peaks of flexion moments were typically lower (P<0.05) during running than during walking. At preferred walking speeds (55, 70, 85%), support-related activation of the ankle and knee extensors was typically lower during stance of walking than during stance of running (P<0.05). These results support the hypothesis that the preferred walk-run transition might be triggered by the increased sense of effort due to the exaggerated swing-related activation of the tibialis anterior, rectus femoris and hamstrings; this increased activation is necessary to meet the higher joint moment demands to move the swing leg during fast walking. The preferred run-walk transition might be similarly triggered by the sense of effort due to the higher support-related activation of the soleus, gastrocnemius and vastii that must generate higher forces during slow running than during walking at the same speed.

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...

Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly

PubMed Central

Ferreira, Cristiane Batisti; Teixeira, Pâmela dos Santos; Alves dos Santos, Geiane; Dantas Maya, Athila Teles; Americano do Brasil, Paula; Souza, Vinícius Carolino; Córdova, Cláudio; Lima, Ricardo Moreno; Nóbrega, Otávio de Toledo

2018-01-01

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted. PMID:29593907

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

Fluctuation-induced continuous transition and quantum criticality in Dirac semimetals

DOE PAGES

Classen, Laura; Herbut, Igor F.; Scherer, Michael M.

2017-09-20

In this paper, we establish a scenario where fluctuations of new degrees of freedom at a quantum phase transition change the nature of a transition beyond the standard Landau-Ginzburg paradigm. To this end, we study the quantum phase transition of gapless Dirac fermions coupled to a Z 3 symmetric order parameter within a Gross-Neveu-Yukawa model in 2+1 dimensions, appropriate for the Kekulé transition in honeycomb lattice materials. For this model, the standard Landau-Ginzburg approach suggests a first-order transition due to the symmetry-allowed cubic terms in the action. At zero temperature, however, quantum fluctuations of the massless Dirac fermions have tomore » be included. We show that they reduce the putative first-order character of the transition and can even render it continuous, depending on the number of Dirac fermions N f. A nonperturbative functional renormalization group approach is employed to investigate the phase transition for a wide range of fermion numbers and we obtain the critical N f, where the nature of the transition changes. Furthermore, it is shown that for large N f the change from the first to second order of the transition as a function of dimension occurs exactly in the physical 2+1 dimensions. Finally, we compute the critical exponents and predict sizable corrections to scaling for N f = 2.« less

Transition from the spouse dementia caregiver role: A change for the better?

PubMed

Brown, Lynsey J; Bond, Malcolm J

2016-07-01

One in 15 Australians over 65 experience dementia, and are commonly supported by spouses. Evidence demonstrates declining wellbeing for these caregivers as their role continues. There are indications of improvement once caregivers transition out of the role (recovery) but alternate suggestions that caregiving stress may be too damaging to be appeased (wear and tear). It seems plausible that reason for transition (care recipient's move into residential care or death) will affect caregivers' outcomes. A synthetic cohort method compared caregivers' stress and wellbeing prior to, and one and two years post-transition. There was evidence of wear and tear for physical wellbeing but recovery for psychological wellbeing over time; with little difference based on reason for transition. Caregiver outcomes seem to be a function of the action rather than the reason for transition, but factors such as age must be considered when designing methods to support post-transition wellbeing. © The Author(s) 2014.

Trajectory description of the quantum–classical transition for wave packet interference

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

Chou, Chia-Chun, E-mail: ccchou@mx.nthu.edu.tw

2016-08-15

The quantum–classical transition for wave packet interference is investigated using a hydrodynamic description. A nonlinear quantum–classical transition equation is obtained by introducing a degree of quantumness ranging from zero to one into the classical time-dependent Schrödinger equation. This equation provides a continuous description for the transition process of physical systems from purely quantum to purely classical regimes. In this study, the transition trajectory formalism is developed to provide a hydrodynamic description for the quantum–classical transition. The flow momentum of transition trajectories is defined by the gradient of the action function in the transition wave function and these trajectories follow themore » main features of the evolving probability density. Then, the transition trajectory formalism is employed to analyze the quantum–classical transition of wave packet interference. For the collision-like wave packet interference where the propagation velocity is faster than the spreading speed of the wave packet, the interference process remains collision-like for all the degree of quantumness. However, the interference features demonstrated by transition trajectories gradually disappear when the degree of quantumness approaches zero. For the diffraction-like wave packet interference, the interference process changes continuously from a diffraction-like to collision-like case when the degree of quantumness gradually decreases. This study provides an insightful trajectory interpretation for the quantum–classical transition of wave packet interference.« less

The effect of physical restraints on fall rates in older adults who are institutionalized.

PubMed

Dunn, K S

2001-10-01

Since the Omnibus Budget Reconciliation Act (OBRA) of 1987, there has been a significant reduction in the use of physical restraints to prevent falls in older adults who are institutionalized because of the developing awareness of the physical and psychological problems associated with them. The purpose of this ex post facto descriptive study was to determine if there is a difference in falls when physical restraints are allowed or prohibited in one older adult population. Data from incident reports from a purposive sample of 97 older adults in one long-term care facility were analyzed before and after the implementation of a restraint-free policy. The results indicated no significant difference in the number of falls before and after the policy change. However, there was a significantly lower number of falls with injuries and a significantly higher number of falls without injuries. These findings suggest older adults will continue to fall with or without the use of physical restraints because of changes associated with the aging process and risk factors. Removing physical barriers from older adults and allowing freedom of movement may decrease the severity of injury sustained in a fall.

A university-based incentive program to increase safety belt use: Toward cost-effective institutionalization

PubMed Central

Rudd, James R.; Geller, E. Scott

1985-01-01

A cost-effective incentive program to increase safety belt use was implemented by the campus police of a large university. For each of the 3-week intervention periods during three consecutive academic quarters, the 22 campus police officers recorded the license plate numbers of vehicles with drivers wearing a shoulder belt. From these numbers, 10 raffle winners were drawn who received gift certificates donated by community merchants. Faculty and staff increased their belt usage markedly as a result of the “Seatbelt Sweepstakes,” whereas students increased their belt use only slightly. A cost-effectiveness analysis indicated that the sweepstakes cost an average of $0.98 per each newly buckled driver. During each sweepstakes intervention, officers' belt usage increased significantly, but diminished to initial baseline levels after the final withdrawal of the program. Surveys of officers' opinions indicated that the police would accept the program demands as a regular task requirement. This result and the fact that program promotion and coordination were eventually taken over by two student organizations suggest that institutionalization of the “Seatbelt Sweepstakes” is feasible. ImagesFigure 1 PMID:16795689

Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention.

PubMed

Silva, Cristina; Ramalho, Célia; Luz, Isabel; Monteiro, Joaquim; Fresco, Paula

2015-04-01

An aging population and the increasing prevalence of chronic diseases have led to the increased use of medicines. Portugal is one of the European countries where more medicines are consumed and the associated expense is higher. Medicines are associated with enormous health benefits but also with the potential to cause illness and death. A drug related problem (DRP) is an "an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes". In the U.S., they represent the 4th-6th leading cause of death and have an estimated cost of 130 billion dollars. Moreover, many of these DRP can be avoided. Elderly are at increased risk of DRP due to multiple factors: pluripathology and consequent polypharmacy, complex dosing regimens, pharmacokinetic/pharmacodynamic and functional/cognitive changes. Therefore, this population would be the one who would benefit most from the prevention, detection and control of DRP. The role of the pharmacist as an integral element of health care has been recognized by various international and European organizations. Providing pharmaceutical care as a patient-centered activity, focusing on their needs related to pharmacotherapy, contributes to guarantee that drug expenditure is a good investment, with benefits that outweigh potential risks. To evaluate the need for pharmaceutical care implementation in institutionalized, polymedicated elderly. Descriptive observational cross-sectional study carried out in six Portuguese nursing homes, selected by convenience, in November-December 2013. Each institution selected up to six patients, according to the following inclusion criteria: age ≥65 years, number of medications ≥5 and ability to respond to an interview. All participants signed an informed consent form. Pharmacists carried out a structured interview with each patient and consulted patient medical records to gather demographic data and information on health problems and medications used. To

From "Weak" to "Strong" Multifunctionality: Conceptualising Farm-Level Multifunctional Transitional Pathways

ERIC Educational Resources Information Center

Wilson, Geoff A.

2008-01-01

Building on normative conceptualisations of multifunctionality as a decision-making spectrum bounded by productivist and non-productivist action and thought, this paper analyses farm-level multifunctional agricultural transitions. First, the paper suggests that it may be possible to categorise different farm types along the…

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

Cholesteric-nematic transitions induced by a shear flow and a magnetic field

NASA Astrophysics Data System (ADS)

Zakhlevnykh, A. N.; Makarov, D. V.; Novikov, A. A.

2017-10-01

The untwisting of the helical structure of a cholesteric liquid crystal under the action of a magnetic field and a shear flow has been studied theoretically. Both factors can induce the cholesteric-nematic transition independently; however, the difference in the orienting actions of the magnetic field and the shear flow leads to competition between magnetic and hydrodynamic mechanisms of influence on the cholesteric liquid crystal. We have analyzed different orientations of the magnetic field relative to the direction of the flow in the shear plane. In a number of limiting cases, the analytic dependences are obtained for the pitch of the cholesteric helix deformed by the shear flow. The phase diagrams of the cholesteric-nematic transitions and the pitch of the cholesteric helix are calculated for different values of the magnetic field strength and the angle of orientation, the flow velocity gradient, and the reactive parameter. It is shown that the magnetic field stabilizes the orientation of the director in the shear flow and expands the boundaries of orientability of cholesterics. It has been established that the shear flow shifts the critical magnetic field strength of the transition. It is shown that a sequence of reentrant orientational cholesteric-nematic-cholesteric transitions can be induced by rotating the magnetic field in certain intervals of its strength and shear flow velocity gradients.

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.

The journey from precontemplation to action: Transitioning between electronic medical record systems.

PubMed

Bentley, Thomas; Rizer, Milisa; McAlearney, Ann Scheck; Mekhjian, Hagop; Siedler, Monica; Sharp, Karen; Teater, Phyllis; Huerta, Timothy

2016-01-01

Health care organizations, in response to federal programs, have sought to identify electronic medical record (EMR) strategies that align well with their visions for success. Little exists in the literature discussing the transition from one EMR strategy to another. The analysis and planning process used by a major academic medical center in its journey to adopt a new strategy was described in this study. We use the transtheoretical model of change to frame the five phases through which the organization transitioned from a best-of-breed system to an enterprise system. We explore the five phases of change from the perspective of a maturing approach to new technology adoption. Data collection included archival retrieval and review as well as interviews with key stakeholders. Although there was always a focus on some enterprise capabilities such as computerized physician order entry, the emphasis on EMR selection tended to be driven by specialty requirements. Focusing on the patient across the continuum of care, as opposed to focusing on excessive requirements by clinical specialties, was essential in forming and deploying a vision for the new EMR. This research outlines a successful pathway used by an organization that had invested heavily in EMR technology and was faced with evaluating whether to continue that investment or start with a new platform. Rather than focusing on the technology alone, efforts to reframe the discussion to one that focused on the patient resulted in less resistance to change.

Perpetual transitions in Romanian healthcare.

PubMed

Spiru, Luiza; Traşcu, Răzvan Ioan; Turcu, Ileana; Mărzan, Mircea

2011-12-01

Although Romania has a long-lasting tradition in organized medical healthcare, in the last two decades the Romanian healthcare system has been undergoing a perpetual transition with negative effects on all parties involved. The lack of long-term strategic vision, the implementation of initiatives without any impact studies, hence the constant short-term approach from the policy makers, combined with the "inherited" low allocation from GDP to the healthcare system have contributed significantly to its current evolution. Currently, most measures taken are of the "fire-fighting" type, rather than looking to the broader, long time perspective. There should be no wonder then, that predictive and preventive services do not get the proper attention and support. Patient and physicians should step in and take action in regulating a system that was originally designed for them. But until this happens, the organizations with leadership skills and vision need to take action-and this has already started.

[The institutionalization of health care in Russia: actual trends].

PubMed

Erugina, M V; Krom, I L

2016-01-01

Since XX century, health care is a first-rate social institution. The analysis of tendencies of functioning of institution of health care in modern Russia is presented by the article in methodological plane of the system of social structural functions (AGIL) proposed by T. Parsons. The patient is the main participant of medical organizational process. The activity of other participants of process of organization of medical care is to be focused primarily on satisfaction of needs of patient during medical care rendering. The society implements training of subjects for executing their professional roles that determines professionalization of executed functions. The most important purpose of modern training programs in medical education is determined by leading level of cognition, forecasting and achievement of socially significant aftermaths of future during structuring of educational process. In the context of integrative function the coordination of activities of participants of interaction is implemented. In conditions of actual tendencies of market economy the interaction of participants of the process of medical care rendering and the process of quality control of medical care is developed on the basis of implementation of standards of medical care. In Russia, the institutionalization of health care presupposes cooperation and interaction of subjects of system differing by degree and amount of collaborative work. The latent function (maintenance of value pattern) determines regularity, predictability, stability of functioning of social relationships. The social control supports expedient behavior of participants of process of medical care rendering. The dysfunctional practices of modern Russian health care are considered in the context of concept of effective interaction of participants of medical organizational process targeted to maintenance of rights of patients for accessible and qualitative medical care. As a result of applied analysis, the problems were

Institutionalizing integrated treatment for concurrent disorders: creating new organizational discourse.

PubMed

Novotná, Gabriela

2013-01-01

The high overlap of mental health and substance use problems in the Canadian health care system and the subsequent demand for more effective services for clients with these high-risk issues have stimulated the debate on their integrated treatment. Although the idea of integration has been endorsed by decision makers at both programs and system levels, little attention has been paid to factors that have facilitated this process. In this article, the processes by which organizational texts, language, metaphors, and symbols have facilitated institutionalization of integrated treatment are identified and discussed. Findings from a qualitative case study of 2 treatment programs that were part of a large, urban hospital in Ontario providing services for populations with concurrent disorders are presented. Data were collected using semistructured interviews with professionals and clients, analysis of policy and organizational documents, and nonparticipant observations. Research evidence on comorbidity, government reports, and other organizational texts that were created and disseminated across the province has contributed to the dissemination of the concept of integration. Certain ideas might be successfully implemented when environments are conducive to change; such environmental catalysts include the status of professionals who support new discourse, the characteristics and importance of the problem being addressed, and the timing of implementation. The findings clearly demonstrate that the conditions of the wider institutional environment-the emergence of research evidence on comorbidity and the provincial health care reform, with its focus on rationalizing the existing health care system-supported the idea of integration. The ability to understand how discursive activities of program planners, clinicians, and policy makers contribute to making new ideas deeply embedded in organizational structures can become an important mechanism of effective decision

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.

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…

5 CFR 315.705 - Employees serving under transitional or veterans recruitment appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... veterans recruitment appointments. 315.705 Section 315.705 Administrative Personnel OFFICE OF PERSONNEL... veterans recruitment appointments. (a) Agency action. (1) An agency shall convert the employment of an... substantially continuous service under a veterans recruitment appointment or under a combination of transitional...

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…

Factors associated with negative self-perception of oral health among institutionalized elderly.

PubMed

Melo, Laércio Almeida de; Sousa, Meily de Mello; Medeiros, Annie Karoline Bezerra de; Carreiro, Adriana da Fonte Porto; Lima, Kenio Costa de

2016-11-01

The aim of this study was to determine self-perception of oral-health in institutionalized elderly, and look into the sociodemographic and clinical aspects associated with negative self-perception. One hundred and sixty-six elderly were assessed by answering a self-perception question that predicts the GOHAI (Geriatric Oral Health Assessment Index). Sociodemographic data was obtained from a previously validated questionnaire and clinical data taken from the WHO file and QST-TMD used to check the existence of TMD (temporomandibular disturbance). The data gathered was submitted to Mann-Whitney, Fisher's Exact and Chi-squared tests with a 5% significance level. The average age of the study population was 80.5, and 75.9% were women. The mean DMFT (decayed, missing, and filled teeth in permanent teeth) was 28.9, the majority of the sample subject (65%) reported good to excellent teeth, gums and prostheses (dentures and bridges). Three questions in the TMD questionnaire (QST-DTM) were associated with negative self-perception. Those claiming that their jaws "lock" when they open or close their mouth, who always have pain at the front or side of their jaw, or whose jaws get tired during the course of the day are less satisfied with their oral health. We conclude that clinical and sociodemographic conditions have little influence on self-perception of oral health, possibly because pain is the main factor associated with negative self-perception in these individuals.

Academic Institutionalization of Community Health Services: Way Ahead in Medical Education Reforms

PubMed Central

Kumar, Raman

2012-01-01

Policy on medical education has a major bearing on the outcome of health care delivery system. Countries plan and execute development of human resource in health, based on the realistic assessments of health system needs. A closer observation of medical education and its impact on the delivery system in India reveals disturbing trends. Primary care forms backbone of any system for health care delivery. One of the major challenges in India has been chronic deficiency of trained human resource eager to work in primary care setting. Attracting talent and employing skilled workforce seems a distant dream. Talking specifically of the medical education, there are large regional variations, urban - rural divide and issues with financing of the infrastructure. The existing design of medical education is not compatible with the health care delivery system of India. Impact is visible at both qualitative as well as quantitative levels. Medical education and the delivery system are working independent of each other, leading outcomes which are inequitable and unjust. Decades of negligence of medical education regulatory mechanism has allowed cropping of multiple monopolies governed by complex set of conflict of interest. Primary care physicians, supposed to be the community based team leaders stand disfranchised academically and professionally. To undo the distorted trajectory, a paradigm shift is required. In this paper, we propose expansion of ownership in medical education with academic institutionalization of community health services. PMID:24478994

A modified PATH algorithm rapidly generates transition states comparable to those found by other well established algorithms

PubMed Central

Chandrasekaran, Srinivas Niranj; Das, Jhuma; Dokholyan, Nikolay V.; Carter, Charles W.

2016-01-01

PATH rapidly computes a path and a transition state between crystal structures by minimizing the Onsager-Machlup action. It requires input parameters whose range of values can generate different transition-state structures that cannot be uniquely compared with those generated by other methods. We outline modifications to estimate these input parameters to circumvent these difficulties and validate the PATH transition states by showing consistency between transition-states derived by different algorithms for unrelated protein systems. Although functional protein conformational change trajectories are to a degree stochastic, they nonetheless pass through a well-defined transition state whose detailed structural properties can rapidly be identified using PATH. PMID:26958584

Contextual Predictors of Self-Determined Actions in Students with and without Intellectual Disability

ERIC Educational Resources Information Center

Mumbardó-Adam, Cristina; Shogren, Karrie A.; Guàrdia-olmos, Joan; Giné, Climent

2017-01-01

Research in the field of intellectual disability suggests that promotion of self-determination triggers positive transition outcomes for youth with intellectual disability. This article examines the contributions of personal and environmental variables in predicting self-determined action in students with and without intellectual disability. The…

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

Changing Horses in Midstream: The Dangers of Unplanned Head Transitions

ERIC Educational Resources Information Center

Quinby, Lee

2015-01-01

Quick leadership transitions may succeed in other industries, but they don't usually work in the "business of relationships" we call school. Boards that respond to a solvable problem by firing the head may believe that action is necessary and good for the school. In truth, these abrupt changes almost always hurt schools, with devastating…

Tackling health inequalities: moving theory to action

PubMed Central

Signal, Louise; Martin, Jennifer; Reid, Papaarangi; Carroll, Christopher; Howden-Chapman, Philippa; Ormsby, Vera Keefe; Richards, Ruth; Robson, Bridget; Wall, Teresa

2007-01-01

Background This paper reports on health inequalities awareness-raising workshops conducted with senior New Zealand health sector staff as part of the Government's goal of reducing inequalities in health, education, employment and housing. Methods The workshops were based on a multi-method needs assessment with senior staff in key health institutions. The workshops aimed to increase the knowledge and skills of health sector staff to act on, and advocate for, eliminating inequalities in health. They were practical, evidence-based, and action oriented and took a social approach to the causes of inequalities in health. The workshops used ethnicity as a case study and explored racism as a driver of inequalities. They focused on the role of institutionalized racism, or racism that is built into health sector institutions. Institutional theory provided a framework for participants to analyse how their institutions create and maintain inequalities and how they can act to change this. Results Participants identified a range of institutional mechanisms that promote inequalities and a range of ways to address them including: undertaking further training, using Māori (the indigenous people) models of health in policy-making, increasing Māori participation and partnership in decision making, strengthening sector relationships with iwi (tribes), funding and supporting services provided 'by Māori for Māori', ensuring a strategic approach to intersectoral work, encouraging stronger community involvement in the work of the institution, requiring all evaluations to assess impact on inequalities, and requiring the sector to report on progress in addressing health inequalities. The workshops were rated highly by participants, who indicated increased commitment to tackle inequalities as a result of the training. Discussion Government and sector leadership were critical to the success of the workshops and subsequent changes in policy and practice. The use of locally adapted equity

Tackling health inequalities: moving theory to action.

PubMed

Signal, Louise; Martin, Jennifer; Reid, Papaarangi; Carroll, Christopher; Howden-Chapman, Philippa; Ormsby, Vera Keefe; Richards, Ruth; Robson, Bridget; Wall, Teresa

2007-10-03

This paper reports on health inequalities awareness-raising workshops conducted with senior New Zealand health sector staff as part of the Government's goal of reducing inequalities in health, education, employment and housing. The workshops were based on a multi-method needs assessment with senior staff in key health institutions. The workshops aimed to increase the knowledge and skills of health sector staff to act on, and advocate for, eliminating inequalities in health. They were practical, evidence-based, and action oriented and took a social approach to the causes of inequalities in health. The workshops used ethnicity as a case study and explored racism as a driver of inequalities. They focused on the role of institutionalized racism, or racism that is built into health sector institutions. Institutional theory provided a framework for participants to analyse how their institutions create and maintain inequalities and how they can act to change this. Participants identified a range of institutional mechanisms that promote inequalities and a range of ways to address them including: undertaking further training, using Māori (the indigenous people) models of health in policy-making, increasing Māori participation and partnership in decision making, strengthening sector relationships with iwi (tribes), funding and supporting services provided 'by Māori for Māori', ensuring a strategic approach to intersectoral work, encouraging stronger community involvement in the work of the institution, requiring all evaluations to assess impact on inequalities, and requiring the sector to report on progress in addressing health inequalities. The workshops were rated highly by participants, who indicated increased commitment to tackle inequalities as a result of the training. Government and sector leadership were critical to the success of the workshops and subsequent changes in policy and practice. The use of locally adapted equity tools, requiring participants to

An Institutional Approach to Understanding Energy Transitions

NASA Astrophysics Data System (ADS)

Koster, Auriane Magdalena

Energy is a central concern of sustainability because how we produce and consume energy affects society, economy, and the environment. Sustainability scientists are interested in energy transitions away from fossil fuels because they are nonrenewable, increasingly expensive, have adverse health effects, and may be the main driver of climate change. They see an opportunity for developing countries to avoid the negative consequences fossil-fuel-based energy systems, and also to increase resilience, by leap-frogging-over the centralized energy grid systems that dominate the developed world. Energy transitions pose both challenges and opportunities. Obstacles to transitions include 1) an existing, centralized, complex energy-grid system, whose function is invisible to most users, 2) coordination and collective-action problems that are path dependent, and 3) difficulty in scaling up RE technologies. Because energy transitions rely on technological and social innovations, I am interested in how institutional factors can be leveraged to surmount these obstacles. The overarching question that underlies my research is: What constellation of institutional, biophysical, and social factors are essential for an energy transition? My objective is to derive a set of "design principles," that I term institutional drivers, for energy transitions analogous to Ostrom's institutional design principles. My dissertation research will analyze energy transitions using two approaches: applying the Institutional Analysis and Development Framework and a comparative case study analysis comprised of both primary and secondary sources. This dissertation includes: 1) an analysis of the world's energy portfolio; 2) a case study analysis of five countries; 3) a description of the institutional factors likely to promote a transition to renewable-energy use; and 4) an in-depth case study of Thailand's progress in replacing nonrenewable energy sources with renewable energy sources. My research will

Power effects on cognitive control: Turning conflict into action.

PubMed

Schmid, Petra C; Kleiman, Tali; Amodio, David M

2015-06-01

Power is known to promote effective goal pursuit, especially when it requires one to overcome distractions or bias. We proposed that this effect involves the ability to engage and implement cognitive control. In Study 1, we demonstrated that power enhances behavioral performance on a response conflict task and that it does so by enhancing controlled processing rather than by reducing automatic processing. In Study 2, we used an event-related potential index of anterior cingulate activity to test whether power effects on control were due to enhanced conflict sensitivity or action implementation. Power did not significantly affect neural sensitivity to conflict; rather, high power was associated with a stronger link between conflict processing and intended action, relative to low power. These findings suggest a new perspective on how social factors can affect controlled processing and offer new evidence regarding the transition between conflict detection and the implementation of action control. (c) 2015 APA, all rights reserved).

Effects of an Oral Nutritional Supplementation Plus Physical Exercise Intervention on the Physical Function, Nutritional Status, and Quality of Life in Frail Institutionalized Older Adults: The ACTIVNES Study.

PubMed

Abizanda, Pedro; López, Mateo Díez; García, Victoria Pérez; Estrella, Juan de Dios; da Silva González, Álvaro; Vilardell, Núria Barcons; Torres, Krysmarú Araujo

2015-05-01

The objective of this study was to assess the effects of a hyperproteic, hypercaloric oral nutritional supplement with prebiotic fiber, vitamin D, and calcium, plus a standardized physical intervention, in the functional status, strength, nutritional status, and quality of life of frail institutionalized older adults. Multicentric prospective observational study under usual clinical practice conditions. Four nursing homes from Burgos (2), Albacete, and Madrid, Spain. Participants included 91 institutionalized older adults (age ≥70), able to walk 50 m, and meeting at least 3 of the Fried frailty phenotype criteria. Daily intake of two 200-mL bottles of an oral nutritional supplement, each bottle containing 300 kcal, 20 g protein, 3 g fiber, 500 IU vitamin D, and 480 mg calcium, plus a standardized physical exercise training consisting of flexibility, balance, and strengthening exercises for arms and legs, 5 days per week. Short Physical Performance Battery (SPPB), Short-Form-Late-Life Function and Disability Instrument (SF-LLFDI) function subscale, handgrip strength, EuroQoL-5 Dimensions visual analogic scale (EQ5DVAS), weight, body mass index (BMI), and Short-Form Mini Nutritional Assessment (MNA-SF) at baseline and 6 and 12 weeks. Forty-eight participants (52.7%) improved at least 1 point in the SPPB at week 6, and 44 (48.4%) did so at week 12; 39 participants (42.9%) improved at least 2 points in the SF-LLFDI at week 6, and 46 (50.5%) at week 12. Participants improved their quality of life measured with the EQ5DVAS by 6% (95% confidence interval [CI] 3%-10%) at week 6, and by 5% (95% CI 0%-10%) at week 12. They also improved their nutritional status (weight gain, BMI increase, and higher MNA-SF scores at 6- and 12-week follow-up). This improvement was higher in participants with more frailty criteria, lower functional level, lower vitamin D levels, and poorer nutritional status. A 12-week intervention with oral nutritional supplementation plus physical

Integrating big data and actionable health coaching to optimize wellness.

PubMed

Hood, Leroy; Lovejoy, Jennifer C; Price, Nathan D

2015-01-09

The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory.

Emergence, institutionalization and renewal: Rhythms of adaptive governance in complex social-ecological systems.

PubMed

Chaffin, Brian C; Gunderson, Lance H

2016-01-01

Adaptive governance provides the capacity for environmental managers and decision makers to confront variable degrees of uncertainty inherent to complex social-ecological systems. Current theoretical conceptualizations of adaptive governance represent a series of structures and processes best suited for either adapting or transforming existing environmental governance regimes towards forms flexible enough to confront rapid ecological change. As the number of empirical examples of adaptive governance described in the literature grows, the conceptual basis of adaptive governance remains largely under theorized. We argue that reconnecting adaptive governance with foundational concepts of ecological resilience-specifically Panarchy and the adaptive cycle of complex systems-highlights the importance of episodic disturbances and cross-scale interactions in triggering reorganizations in governance. By envisioning the processes of adaptive governance through the lens of Panarchy, scholars and practitioners alike will be better able to identify the emergence of adaptive governance, as well as take advantage of opportunities to institutionalize this type of governance in pursuit of sustainability outcomes. The synergistic analysis of adaptive governance and Panarchy can provide critical insight for analyzing the role of social dynamics during oscillating periods of stability and instability in social-ecological systems. A deeper understanding of the potential for cross-scale interactions to shape adaptive governance regimes may be useful as society faces the challenge of mitigating the impacts of global environmental change. Copyright © 2015 Elsevier Ltd. All rights reserved.

Identification of different nutritional status groups in institutionalized elderly people by cluster analysis.

PubMed

López-Contreras, María José; López, Maria Ángeles; Canteras, Manuel; Candela, María Emilia; Zamora, Salvador; Pérez-Llamas, Francisca

2014-03-01

To apply a cluster analysis to groups of individuals of similar characteristics in an attempt to identify undernutrition or the risk of undernutrition in this population. A cross-sectional study. Seven public nursing homes in the province of Murcia, on the Mediterranean coast of Spain. 205 subjects aged 65 and older (131 women and 74 men). Dietary intake (energy and nutrients), anthropometric (body mass index, skinfold thickness, mid-arm muscle circumference, mid-arm muscle area, corrected arm muscle area, waist to hip ratio) and biochemical and haematological (serum albumin, transferrin, total cholesterol, total lymphocyte count). Variables were analyzed by cluster analysis. The results of the cluster analysis, including intake, anthropometric and analytical data showed that, of the 205 elderly subjects, 66 (32.2%) were over - weight/obese, 72 (35.1%) had an adequate nutritional status and 67 (32.7%) were undernourished or at risk of undernutrition. The undernourished or at risk of undernutrition group showed the lowest values for dietary intake and the anthropometric and analytical parameters measured. Our study shows that cluster analysis is a useful statistical method for assessing the nutritional status of institutionalized elderly populations. In contrast, use of the specific reference values frequently described in the literature might fail to detect real cases of undernourishment or those at risk of undernutrition. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Evidence that displacement activities facilitate behavioural transitions in ring-tailed lemurs.

PubMed

Buckley, Victoria; Semple, Stuart

2012-07-01

Displacement activities are behavioural patterns defined by their apparent irrelevance to an animal's ongoing actions. Despite being identified in diverse taxa, their function remains poorly understood. One hypothesis posits that displacement activities facilitate transitions between different behaviours by mediating changes in animals' motivational state. Under this hypothesis, it is predicted that displacement activities will occur more frequently around changes in behaviour than at other times, and also that rates of displacement activities will be higher before than after such behavioural transitions. We tested these two predictions in wild ring-tailed lemurs (Lemur catta). During focal observations, animals' behavioural state was continuously recorded, as were all occurrences of self-scratching, a common displacement activity in this species. Self-scratching rates were found to be significantly elevated both before and after behavioural transitions. Furthermore, self-scratching rates were significantly higher before behavioural transitions occurred than after. These results, therefore, provide support for the hypothesis that displacement activities facilitate behavioural transitions in L. catta. Copyright © 2012 Elsevier B.V. All rights reserved.

DEVELOPMENT AND INSTITUTIONALIZATION OF THE FIRST ONLINE CERTIFICATE AND MASTER PROGRAM OF BIOMEDICAL INFORMATICS IN GLOBAL HEALTH IN PERU

PubMed Central

García, Patricia J.; Egoavil, Miguel S.; Blas, Magaly M.; Alvarado-Vásquez, Eduardo; Curioso, Walter H.; Zimic, Mirko; Castagnetto, Jesus M.; Lescano, Andrés G.; Lopez, Diego M.; Cárcamo, Cesar P.

2017-01-01

Training in Biomedical Informatics is essential to meet the challenges of a globalized world. However, the development of postgraduate training and research programs in this area are scarce in Latin America. Through QUIPU: Andean Center for Training and research in Iformatics for Global Health, has developed the first Certificate and Master’s Program on Biomedical Informatics in the Andean Region. The aim of this article is to describe the experience of the program. To date, 51 students from Peru, Chile, Ecuador, Colombia and Venezuela have participated; they come from health ministries, hospitals, universities, research centers, professional associations and private companies. Seventeen courses were offered with the participation of faculty from Argentina, Chile, Colombia, USA, Mexico and Peru. This program is already institutionalized at the School of Public Health and Administration from the Universidad Peruana Cayetano Heredia. PMID:26338399

DNA methylation at stress-related genes is associated with exposure to early life institutionalization

PubMed Central

Non, Amy L.; Hollister, Brittany M.; Humphreys, Kathryn L.; Childebayeva, Ainash; Esteves, Kyle; Zeanah, Charles H.; Fox, Nathan A.; Nelson, Charles A.; Drury, Stacy S.

2017-01-01

Objectives Differences in DNA methylation have been associated with early life adversity, suggesting that alterations in methylation function as one pathway through which adverse early environments are biologically embedded. This study examined associations between exposure to institutional care, quantified as the percent time in institutional care at specified follow-up assessment ages, and DNA methylation status in two stress-related genes: FKBP5 and SLC6A4. Materials and Methods We analyzed data from the Bucharest Early Intervention Project, which is a prospective study in which children reared in institutional settings were randomly assigned (mean age 22 months) to either newly created foster care or care as usual (to remain in their current placement) and prospectively followed. A group of children from the same geographic area, with no history of institutionalized caregiving, were also recruited. DNA methylation status was determined in DNA extracted from buccal epithelial cells of children at age 12. Results An inverse association was identified such that more time spent in institutional care was associated with lower DNA methylation at specific CpG sites within both genes. Discussion These results suggest a lasting impact of early severe social deprivation on methylation patterns in these genes, and contribute to a growing literature linking early adversity and epigenetic variation in children. PMID:27218411

Our women must return home: institutionalized patriarchy in colonial central Nyanza district, 1945-1963.

PubMed

Okuro, Samwel Ong'wen

2010-01-01

Colonial policies and practices were very instrumental in the creation of the Luo Diaspora. This Diaspora extended far beyond the physical and cultural boundaries of Central Nyanza as was constituted by the colonial administration. To colonial officials, this Diaspora represented "detribalized natives" responsible for social decay and immorality in the colonial townships. Similarly, to the male elders in the rural areas, this Diaspora was an affront towards destabilizing tribal authority and sanctions, which governed Luo moral order, Luo marriage, and Luo identity as it existed prior to colonialism. This article uses patriarchy as an analytical framework to understand how male elders and colonial officials collaborated to assert control over young women under suspicion of prostitution. The article argues that the Ramogi African Welfare Association (RAWA) was a post-war patriarchal institution which was used by male elders, with the encouragement of the colonial officials, to intimidate, harass and repatriate young women seeking wage employment within the emerging colonial townships. In this article, I use archival and field data gathered from Central Nyanza between 1999 and 2002 to illustrate how institutionalized patriarchy threatened many women and young girls seeking to migrate to colonial towns in order to exploit the limited economic and social opportunities that colonialism provided.

Control and instanton trajectories for random transitions in turbulent flows

NASA Astrophysics Data System (ADS)

Bouchet, Freddy; Laurie, Jason; Zaboronski, Oleg

2011-12-01

Many turbulent systems exhibit random switches between qualitatively different attractors. The transition between these bistable states is often an extremely rare event, that can not be computed through DNS, due to complexity limitations. We present results for the calculation of instanton trajectories (a control problem) between non-equilibrium stationary states (attractors) in the 2D stochastic Navier-Stokes equations. By representing the transition probability between two states using a path integral formulation, we can compute the most probable trajectory (instanton) joining two non-equilibrium stationary states. Technically, this is equivalent to the minimization of an action, which can be related to a fluid mechanics control problem.

Adapting The Joint Commission's Seven Foundations of Safe and Effective Transitions of Care to Home

PubMed Central

Labson, Margherita C.

2015-01-01

The purpose of this article is to describe The Joint Commission's 7 foundations of safe and effective transitions of care to home: (a) leadership support; (b) multidisciplinary collaboration; (c) early identification of patients/clients at risk; (d) transitional planning; (e) medication management; (f) patient and family action/engagement; and (g) transfer of information. These foundations were identified by The Joint Commission after a review of published research; focus groups with healthcare professionals involved in transitions of care; and visits to diverse healthcare organizations. The author, who is the executive director of The Joint Commission's Home Care Accreditation Program, illustrates how healthcare organizations are adapting the 7 foundations of safe and effective transitions of care to home. PMID:25742092

Transition and closeout of the Fernald Closure Project

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

Bilson, H.E.; Terry, T.; Reising, J.

The U.S. Department of Energy (DOE) and Fluor Fernald have completed the majority of the cleanup of the Fernald Site. The over 1,000 acre complex for processing uranium has been demolished and soil contamination has been remediated. With acres of wetlands and prairies replacing the buildings and waste pits. At the end of the project the focus shifted to developing demonstrating the completion of the project and the contract, as well as ensuring a smooth transition of the facility from the DOE's Environmental Management (EM) Program to the DOE's Legacy Management (LM) Program. Working with the DOE, each portion ofmore » the closure contract was examined for specific closure definition. From this negotiation effort the Comprehensive Exit and Transition Plan (CE/T Plan) was written. The CE/T Plan is intended to assist DOE in the analysis that the site is ready for transfer into long-term stewardship (LTS) (also referred to as legacy management) and that Fluor Fernald, Inc. has satisfactorily completed the closure contract statement of work elements. Following the Lessons Learned from the closure of the Rocky Flats Site, the DOE's Legacy Management Program created a matrix of Transition Elements required to ensure adequate information was in place to allow the new prime contractor to perform the Legacy Management scope of work. The transition plan included over 1,000 elements broken down into functional areas and relied on specific Fernald Responsibility Transition Packages (RTPs) for detailed transition actions. The template for Closure and Transition Planning used at the Fernald Site was developed using the best Lessons Learned from across the DOE Complex. The template could be used for other sites, and lessons learned from this closure and transition will be appropriate for all closure projects. (authors)« less

ShakeAlert Users Transition to the Production Prototype System

NASA Astrophysics Data System (ADS)

Strauss, J. A.; Vinci, M.; Steele, W. P.; Hellweg, M.; Allen, R. M.; DeGroot, R. M.

2016-12-01

The ShakeAlert Earthquake Early Warning system transitioned from the demonstration system into the fully-fledged production prototype system this year. Users were migrated over to the new system concurrent with the release of the ShakeAlert UserDisplay Version 2.5.0. The production prototype system provides robust connectivity, fail-over mechanisms to ensure that alarms are deliverd even if one connection fails, and provides a framework to connect future stations, participants, and other sources as the project expands to the full public system. We will present an overview of key user sectors that are either testing or launching pilot projects for the system within their organizations. We will outline the implementation of certain actions, and highlight accomplishments and challenges the Beta Users encounter in fully implementing ShakeAlert within their organizations. By better studying these issues, project partners can better assist the users in incorporating early warning in their operations. Opening up the system to allow for pilot projects enables ShakeAlert users to develop hardware, software, and policy solutions for actions in response to early warning alerts in a controlled environment. This is the first step on the path toward limited rollouts. The pilot groups leverage the expertise of our stakeholders to develop the `last mile' alert distribution and responses. The transition went smoothly in February 2015, for users in California, and we expect to connect with more beta users and pilot groups in this next phase. User transition is planned for Fall 2016 for users in the Pacific Northwest. Beta Users, such as municipalities, emergency response groups, and county officials, lifelines, schools, and private industry continue to meet with ShakeAlert partners to 1) further education and training on both benefits and limitations 2) strategize on implementation actions, such as opening fire house bay doors in response to an alarm, and 3) coordinate continued

77 FR 71287 - CNMI-Only Transitional Worker Numerical Limitation for Fiscal Year 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-30

...-ZB15 CNMI-Only Transitional Worker Numerical Limitation for Fiscal Year 2013 AGENCY: U.S. Citizenship and Immigration Services, DHS. ACTION: Notification of numerical limitation. SUMMARY: The Secretary of Homeland Security announces that the numerical limitation for the annual fiscal year numerical limitation...

Finite-density transition line for QCD with 695 MeV dynamical fermions

NASA Astrophysics Data System (ADS)

Greensite, Jeff; Höllwieser, Roman

2018-06-01

We apply the relative weights method to SU(3) gauge theory with staggered fermions of mass 695 MeV at a set of temperatures in the range 151 ≤T ≤267 MeV , to obtain an effective Polyakov line action at each temperature. We then apply a mean field method to search for phase transitions in the effective theory at finite densities. The result is a transition line in the plane of temperature and chemical potential, with an end point at high temperature, as expected, but also a second end point at a lower temperature. We cannot rule out the possibilities that a transition line reappears at temperatures lower than the range investigated, or that the second end point is absent for light quarks.

Neural Correlates of Human Action Observation in Hearing and Deaf Subjects

PubMed Central

Corina, David; Chiu, Yi-Shiuan; Knapp, Heather; Greenwald, Ralf; Jose-Robertson, Lucia San; Braun, Allen

2007-01-01

Accumulating evidence has suggested the existence of a human action recognition system involving inferior frontal, parietal, and superior temporal regions that may participate in both the perception and execution of actions. However, little is known about the specificity of this system in response to different forms of human action. Here we present data from PET neuroimaging studies from passive viewing of three distinct action types, intransitive self-oriented actions (e.g., stretching, rubbing one’s eyes, etc.), transitive object-oriented actions (e.g., opening a door, lifting a cup to the lips to drink), and the abstract, symbolic actions–signs used in American Sign Language. Our results show that these different classes of human actions engage a frontal/parietal/STS human action recognition system in a highly similar fashion. However, the results indicate that this neural consistency across motion classes is true primarily for hearing subjects. Data from deaf signers shows a non-uniform response to different classes of human actions. As expected, deaf signers engaged left-hemisphere perisylvian language areas during the perception of signed language signs. Surprisingly, these subjects did not engage the expected frontal/parietal/STS circuitry during passive viewing of non-linguistic actions, but rather reliably activated middle-occipital temporal-ventral regions which are known to participate in the detection of human bodies, faces, and movements. Comparisons with data from hearing subjects establish statistically significant contributions of middle-occipital temporal-ventral during the processing of non-linguistic actions in deaf signers. These results suggest that during human motion processing, deaf individuals may engage specialized neural systems that allow for rapid, online differentiation of meaningful linguistic actions from non-linguistic human movements. PMID:17459349