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Sample records for child institutionalized

  1. 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.

  2. Child abuse, disruptive behavior disorders, depression, and salivary cortisol levels among institutionalized and community-residing boys in Mongolia.

    PubMed

    Kohrt, Brandon A; Hruschka, Daniel J; Kohrt, Holbrook E; Carrion, Victor G; Waldman, Irwin D; Worthman, Carol M

    2015-03-01

    Hypothalamic-pituitary-adrenal (HPA) axis activity is related to childhood disruptive behavior disorders and to exposure to abuse and neglect. This study explores the relationship of diurnal salivary cortisol levels with oppositional defiant disorder (ODD) and caregiver attitudes toward physical punishment among boys in Mongolia. Salivary cortisol was collected in the home or institution 4 times daily for 4 days from 46 boys, aged 4-10 years, in Ulaanbaatar, Mongolia. Caregivers rated child disruptive behavior symptoms, attitudes toward physical punishment, and community violence exposures. Mixed effects models were used to estimate the association of psychopathology and caregiver attitudes with salivary cortisol levels. Boys meeting criteria for ODD displayed consistently lower diurnal salivary cortisol levels compared to boys without ODD diagnoses. Controlling for ODD diagnosis, boys with depression showed higher cortisol levels throughout the day. No other diagnosis was associated with cortisol levels. Psychiatric diagnosis accounted for 17% of between individual variations in cortisol levels unexplained by the covariates. In a separate model, caregivers' beliefs regarding physical punishment accounted for 11% of between individual differences: boys with caregivers who stated physical punishment was necessary for discipline displayed hypocortisolism. Institutionalization did not associate with cortisol levels. Salivary cortisol data from a non-Western naturalistic setting support an association of reduced basal HPA activity with disruptive behavior disorders and caregiver attitudes toward discipline. These findings suggest HPA functioning may be a reflection of or mediate disruptive behavior disorders in children across ethnic and cultural settings. © 2014 Wiley Publishing Asia Pty Ltd.

  3. Attachment representation in institutionalized children: a preliminary study using the child attachment interview.

    PubMed

    Zaccagnino, Maria; Cussino, Martina; Preziosa, Alessandra; Veglia, Fabio; Carassa, Antonella

    2015-01-01

    The experience of being removed from one's home and the transition to a residential care system pose enormous challenges for a child. Substantial evidence has been found regarding severe developmental effects due to early exposition to extreme psychosocial and affective deprivation. The research on Bowlby's theoretical proposals has highlighted the link between insecure, disorganized and atypical attachment patterns and children both living in foster care facilities and adopted out of those institutions. The goal of this pilot study is to investigate the attachment representation in an Italian sample of children in middle childhood (9-13 years old) who have been removed from their homes. Two compared groups of children participated in this study. The first group was composed of 24 Italian children who had been removed from their homes. The second group, considered as the control group, was composed of 35 Italian children who had never been in foster care placement. The quality of children's attachment to their primary caregivers was assessed by the Child Attachment Interview, an innovative semi-structured interview that seeks to bridge the measurement gap identified in middle childhood The children in foster care placement show a higher percentage of insecure and disorganized attachment representations and lower scores on the Child Reflective Functioning Scale. The clinical implications and enhancements to effective intervention for foster children's caretaking are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Institutionalizing Dance

    ERIC Educational Resources Information Center

    Morrison, Jack

    1976-01-01

    Discusses the problem of institutionalizing dance, its effect and consequences, with Shirley Ririe, Co-Director with Joan Woodbury of the Ririe-Woodbury Dance Company based in Salt Lake City. (Author/RK)

  5. Institutionalized Discontent.

    PubMed

    Gilbert, Neil

    Examining past experiences of student activism at Berkeley this article suggests that the present storm of political correctness sweeping American universities represents more than just another of the periodic crusades that have disrupted academic life over the years. The current wave of activism is different largely because the ever-present minorities of militant faculty and student activists have gained significant reinforcements in their struggle to transform the culture and mission of higher education. Over the last several decades federal regulations and funds have created an alternative bureaucracy within universities that is devoted, not to the core academic mission of teaching and research, but to improving the social climate of university life. The legitimacy and power of the social climate bureaucracy depend on heightening the perception that academic life involves a dangerous environment, from which students need protection - a service provided through creating safe spaces, helping students to recognize micro-aggressions, training them in sexual assault prevention, conducting sensitivity training for faculty and the like. Devoted to heightening this perception of the university campus as a hostile environment, the climate bureaucracy has become a source of institutionalized discontent.

  6. Early Institutionalization: Neurobiological Consequences and Genetic Modifiers

    PubMed Central

    Drury, Stacy; McLaughlin, Kate; Almas, Alisa

    2011-01-01

    Children raised in the profound deprivation associated with institutionalization are at elevated risk for negative outcomes across a host of social and cognitive domains. This risk appears to be mitigated by early foster care or adoption into a family setting. Although pervasive developmental problems have been noted in a substantial proportion of previously institutionalized children, marked variation exists in the nature and severity of these deficits. Increasing evidence suggests that institutional deprivation impacts the developing brain, potentially underlying the wide range of outcomes with which it is associated. In the current review we examine the neural consequences of institutionalization and genetic factors associated with differences in outcome in an effort to characterize the consequences of early deprivation at a neurobiological level. Although the effects of institutional deprivation have been studied for more than 50 years much remains unanswered regarding the pathways through which institutionalization impacts child development. Through a more complete and nuanced assessment of the neural correlates of exposure and recovery as well as a better understanding of the individual factors involved we will be better able to delineate the impact of early adversity in the setting of severe social deprivation. PMID:21042937

  7. Institutionalizing Catholic Identity

    ERIC Educational Resources Information Center

    Heft, James L.

    2012-01-01

    The organizers of the conference on Renewing Mission and Identity in Business Education invited me to offer a description of the efforts made at the University of Dayton to institutionalize its Catholic identity. Until 2006, when I left Dayton to begin leading full-time the Institute for Advanced Catholic Studies at the University of Southern…

  8. Positive Consequences of Institutionalization: Solidarity Between Elderly Parents and Their Middle-Aged Children.

    ERIC Educational Resources Information Center

    Smith, Kristen Falde; Bengtson, Vern L.

    This research questions the frequent observation that elderly persons in long-term care institutions are isolated from their families, and that institutionalization is the final step in the breakdown of family relations. Data consisted of open-ended interviews with institutionalized elderly parents and with the child most involved with the parent…

  9. Positive Consequences of Institutionalization: Solidarity Between Elderly Parents and Their Middle-Aged Children.

    ERIC Educational Resources Information Center

    Smith, Kristen Falde; Bengtson, Vern L.

    This research questions the frequent observation that elderly persons in long-term care institutions are isolated from their families, and that institutionalization is the final step in the breakdown of family relations. Data consisted of open-ended interviews with institutionalized elderly parents and with the child most involved with the parent…

  10. The institutionalization of operations research.

    PubMed

    Phillips, J F; Simmons, R; Simmons, G

    1991-01-01

    When the conceptualization of OR is inappropriate, institutionalization will not take place. For this reason, the discussion here has focused as much on the pitfalls in OR design as on factors that facilitate institutionalization. Research that is inappropriately adapted to the societal or programmatic context will not be institutionalized, nor will OR lead to institutionalized research capabilities if theory is ignored or the research lacks credibility. The institutionalization of credible and scientifically sound OR requires well-trained social scientists who can carry out this task. Career opportunities must persist in OR so that well-trained scientists will find in an attractive and rewarding pursuit. Long-term projects facilitate institutionalization by providing a setting where work teams can be developed and career tracks defined. Academics and universities institutionalize OR by sponsoring training in applied research and developing high-level research leadership. For this reason, institutional linkages and mechanisms that nurture collaboration facilitate the institutionalization of OR. Finally, institutionalization of OR implies that research is being utilized for action by program management and the policy community. There is extensive literature on the determinants of research utilization, much of which is relevant to the question of how OR can be institutionalized.

  11. Unraveling the Mystery of Institutionalization.

    ERIC Educational Resources Information Center

    Miles, Matthew B.

    1983-01-01

    Studies of educational change have not looked at institutionalization of new programs. This study found four approaches to institutionalizing changes: (1) mandated, stable use; (2) skillful, committed use; (3) vulnerability; and (4) indifference. Teacher-administrator harmony is critical to success. (MD)

  12. Institutionalizing solar energy education

    SciTech Connect

    Arwood, J.W.

    1997-12-31

    As America entered the final decade of the 20th century, millions of people turned out to celebrate Earth Day`s 20th anniversary. Environmental awareness was on an upswing, and as a result, environmental education became a priority across the country. Environmental education was making significant headway into the public school system, and recycling emerged as the vanguard of this movement. At first the exclusive province of school children, recycling soon became a household habit. As children collected cans for cash, they also taught their parents to recycle. In its movement from classroom to curbside, recycling rode the school bus to Main Street and, within a few short years, became institutionalized. In this paper, the author demonstrates how the Solar Information and Education Program has evolved to the point where it has become an institutionalized, lasting part of the school experience for thousands of Arizona students. It is hoped that the solar experience for the state`s young people will duplicate the recycling experience of a decade ago, this time taking solar technology from chalkboard to rooftop.

  13. Institutionalization of Planned Organizational Change,

    DTIC Science & Technology

    1978-09-01

    issue of group forces as they bear on institutionalization. The level of interaction among members of the target group seems to determine whether the...group will play a major role in the institutionalization process. The more meetings among target group members, the greater is the number of...interactions and the greater the identity within the target group (Walton, 1975; Goodman, 1979). Identification serves as one force to maintain the new

  14. [Resilience in institutionalized children and adolescents].

    PubMed

    Cordovil, Catarina; Crujo, Margarida; Vilariça, Paula; Caldeira Da Silva, Pedro

    2011-12-01

    The concept of resilience refers to the possibility of individuals to develop positively when exposed to situations of adversity or stress. This is a complex process involving the interaction of vulnerability and protection factors. Researching resilience only makes sense when applied to populations considered at risk which, simultaneously, present adaptive attributes. That is what we find in Child and Adolescent Residential Institutions. There is a rising need of research in the area of institutionalized children. A better knowledge of these populations allows for the creation of more adapted and efficient prevention and promotion health programs. To identify resilience factors and their association with psychopathology in children/ adolescents (C/A) of three residential institutions in Lisbon. Data was collected from a sample of children/ adolescents, aged between 6 and 18, who had been institutionalized for at least a year, whose legal representatives had signed the "informed consent". The three Lisbon institutions were chosen by convenience. Children/ adolescents diagnosed with a Pervasive Developmental Disorder (DSM-IV-TR) were excluded. The instruments used for assessment (Check-list for Characterization of the children/adolescents, Institution and Community, and Child Behavior Checklist) were completed by the care provider that better knows the children/adolescents. There are resilience factors in those children and adolescents who present no psychopathology which are absent in those who have psychopathology. We identified factors that appear to have greater resilience preponderance for the protection of children/adolescents, namely "positive self-esteem," "talents recognized by others" and "cognitive skills". Males have more psychopathology, along with a smaller number of resilience factors than females.

  15. Family Problems concerning the Mentally Retarded Child

    ERIC Educational Resources Information Center

    Klackenberg, Gunnar

    1969-01-01

    A mentally handicapped child causes familial pressures: concerns over future pregnancies, emotional strain, and the necessity for an ultimate decision on whether or not the child should be institutionalized. (JF)

  16. Institutionalizing a Vision for Diversity.

    ERIC Educational Resources Information Center

    Miserandino, Anthony

    1998-01-01

    Institutionalizing a vision for diversity should include (1) commitment to serving students' perceived needs; (2) seeing through the lens of others' experiences; (3) moral leadership from teachers; (4) a sufficient pool of support and goodwill; and (5) focus on students first. (SK)

  17. Hyperactive and Nonhyperactive Institutionalized Retarded Residents

    ERIC Educational Resources Information Center

    Talkington, Larry W.; Hutton, W. Oran

    1973-01-01

    Two hundred twenty-one predominantly adolescent institutionalized retarded residents, classified as hyperactive, were compared on 15 variables to a matched group classified as nonhyperactive. (Author/MC)

  18. The Institutionalized Geriatric Patient Considered in a Framework of Developmental Deprivation.

    ERIC Educational Resources Information Center

    Erber, Joan T.

    1979-01-01

    An overview is presented of several areas of deprivation research (animal, child, young adult) and methods of conceptualizing and measuring deprivation is applied to institutionalized geriatric patients. Suggestions are made for more precise approaches to studying and treating deprivation in this population. (Author/SS)

  19. 42 CFR 441.254 - Mentally incompetent or institutionalized individuals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 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...

  20. 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...

  1. 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.

  2. Longitudinal Predictors of Institutionalization in Old Age

    PubMed Central

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

    2015-01-01

    Objective To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach. Methods In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional fixed-effects logistic regressions (with 201 individuals and 960 observations) were performed to estimate the effects of marital status, depression, dementia, and physical impairments (mobility, hearing and visual impairments) on the risk of admission to old-age home or nursing home. By exploiting the longitudinal data structure using panel econometric models, we were able to control for unobserved heterogeneity such as genetic predisposition and personality traits. Results The probability of institutionalization increased significantly with occurrence of widowhood, depression, dementia, as well as walking and hearing impairments. In particular, the occurrence of widowhood (OR = 78.3), dementia (OR = 154.1) and substantial mobility impairment (OR = 36.7) were strongly associated with institutionalization. Conclusion Findings underline the strong influence of loss of spouse as well as dementia on institutionalization. This is relevant as the number of old people (a) living alone and (b) suffering from dementia is expected to increase rapidly in the next decades. Consequently, it is supposed that the demand for institutionalization among the elderly will increase considerably. Practitioners as well as policy makers should be aware of these upcoming challenges. PMID:26658776

  3. Understanding psychiatric institutionalization: a conceptual review

    PubMed Central

    2013-01-01

    Background Since Goffman’s seminal work on psychiatric institutions, deinstitutionalization has become a leading term in the psychiatric debate. It described the process of closure or downsizing of large psychiatric hospitals and the establishment of alternative services in the community. Yet, there is a lack of clarity on what exactly the concept of institutionalization means in present-day psychiatry. This review aims to identify the meaning of psychiatric institutionalization since the early 1960s to present-day. Method A conceptual review of institutionalization in psychiatry was conducted. Thematic analysis was used to synthesize the findings. Results Four main themes were identified in conceptualizing institutionalization: bricks and mortar of care institutions; policy and legal frameworks regulating care; clinical responsibility and paternalism in clinician-patient relationships; and patients’ adaptive behavior to institutionalized care. Conclusions The concept of institutionalization in psychiatry reflects four distinct themes. All themes have some relevance for the contemporary debate on how psychiatric care should develop and on the role of institutional care in psychiatry. PMID:23773398

  4. Longitudinal Predictors of Institutionalization in Old Age.

    PubMed

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

    2015-01-01

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

  5. 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.

  6. The consequences of early institutionalization: can institutions be improved? – should they?

    PubMed Central

    McCall, Robert B.

    2013-01-01

    Background and scope The focus of this review is on institutionalized children, one of the most inequitably and severely treated groups of children. Although institutions vary, many share some common characteristics, including large groups, high children: caregiver ratios, many and changing caregivers, and caregiver-child interactions that lack warm, sensitive, contingently-responsive, and child-directed behaviors. Resident children develop poorly physically, mentally, and social-emotionally, but those adopted from institutions display substantial catch-up growth in many domains of development. If they are adopted at an early age, there have been no long-term consequences of institutionalization yet measured; but if institutionalization is prolonged, they display higher rates of long-term deficiencies and problems in many domains. Methods This review is based on a database search of the literature, focusing on the development of children while residents, and the development of post-institutionalized children who have been transitioned from institutions to family care. It also draws on the reports and findings of the St. Petersburg–USA Orphanage Intervention. Findings A combination of theories pertaining to attachment (especially caregiver attachment to the infant/toddler), chronic stress, and genetics may explain these outcomes. It appears that caregiver-child interactions are a major contributor to children’s outcomes, and interventions in institutions that improve such interactions produce substantial increases in children’s physical, mental, and social-emotional development, including for children with disabilities. Conclusions Deinstitutionalization and the creation of comprehensive professional child welfare systems emphasizing family care alternatives is a preferred goal, but this is likely to take many low-resource countries decades to develop. If substantial numbers of children remain in institutions despite best efforts to find families for them

  7. School climate and the institutionalization of the CATCH program.

    PubMed

    Parcel, Guy S; Perry, Cheryl L; Kelder, Steven H; Elder, John P; Mitchell, Paul D; Lytle, Leslie A; Johnson, Carolyn C; Stone, Elaine J

    2003-08-01

    School climate refers to various physical and psychosocial structures that shape schools' social and physical environments. The Child and Adolescent Trial for Cardiovascular Health (CATCH) study provided an opportunity to study how aspects of school climate are associated with continued implementation of the CATCH program. Nutrient analysis of menus, observations of physical education (PE) classes, and teacher and staff self-reports were used to measure CATCH program components. Results of this study indicate that aspects of school climate were associated with continued implementation of the CATCH classroom component but not the CATCH food service or PE components. These findings have implications for how we plan for the progression of innovative school health promotion programs from the initial trial stage to institutionalization. Measures of school climate may be useful in determining a school's readiness to adopt and implement an innovative health promotion curriculum.

  8. 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.

  9. Serotonin transporter polymorphism moderates the effects of caregiver intrusiveness on ADHD symptoms among institutionalized preschoolers.

    PubMed

    Baptista, Joana; Belsky, Jay; Mesquita, Ana; Soares, Isabel

    2017-03-01

    Research consistently chronicles a variety of mental health difficulties that plague institutionally reared children, including attention-deficit/hyperactivity disorder (ADHD), even if not all institutionalized children evince such problems. In seeking to extend work in this area, this research on gene × environment (GXE) interplay investigated whether the effect of the quality of institutional care-most notably, caregiver intrusiveness-on ADHD symptoms is moderated by the serotonin transporter (5-HTTLPR) polymorphism. One hundred and twenty-seven institutionalized preschoolers were evaluated using the Child Behavior Checklist. Caregiver-rated attention problems and hyperactivity were unrelated to both 5-HTTLPR polymorphism and caregiver intrusiveness. A significant GXE effect, independent of age at placement or duration of institutionalization, emerged, however, consistent with the differential-susceptibility hypothesis: s/s homozygotes manifest the most and least ADHD symptoms when they experienced, respectively, more and less intrusive caregiving. These results provide new insight into the reasons why some institutionalized children, but not others, exhibit ADHD symptoms.

  10. 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…

  11. On Lasting Innovation in Schools: Beyond Institutionalization.

    ERIC Educational Resources Information Center

    Jansen, Theo; van der Vegt, Rein

    1991-01-01

    Institutionalization is widely recognized as a rounded-off conclusion of the innovation process. This article suggests that innovation means more than achieving stability and should be conceived in more dynamic terms. A specific innovation (open project education in a Dutch secondary school) is used to illustrate the theoretical analysis. (21…

  12. Alternatives to Institutionalization: A Definitive Bibliography.

    ERIC Educational Resources Information Center

    Brantley, James R., Comp.

    This bibliography catalogs all the literature in the National Criminals Justice Reference Service database on the topic of alternatives to institutionalization. The materials represented pertain to such diverse alternatives as juvenile training schools, pre-release centers, halfway houses, work-release programs, weekend sentencing, restitution,…

  13. Family Caregivers' Perspectives on Institutionalization Decisions.

    ERIC Educational Resources Information Center

    Townsend, Aloen L.

    Family caregivers may face ethical dilemmas when deciding whether a parent or spouse should enter a nursing home. There is considerable evidence that decisions about institutionalization are usually stressful and difficult for family members. This study obtained qualitative and quantitative data from two studies conducted at the Margaret Blenkner…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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

  19. A Practical Guide to Institutionalizing Educational Innovations.

    ERIC Educational Resources Information Center

    Lambour, Gary, Ed.; And Others

    The booklet focuses on methods for institutionalizing innovative special education or other educational programs and was developed by the 1980 meeting of the Invisible College on the Institution of Change. An introductory section briefly considers the legal mandate of Public Law 94-142 (the Education for All Handicapped Children Act) to supply all…

  20. [Nutritional characterization by anthropometrics of institutionalized and non-institutionalized elderly Venezuelan].

    PubMed

    Díaz, Nayka; Meertens, Lesbia; Solano, Liseti; Peña, Evelyn

    2005-06-01

    In order to evaluate nutritional status by anthropometry, a group of elderly (60 to 83 years old) was studied: 63 institutionalized and 37 non-institutionalized elderly from Valencia city, Venezuela. Weight, height, triceps skinfold and mid-arm circumference were measured and the body mass index (weight/height2) was calculated. The average age for the institutionalized group was 77.3 +/- 7.5 years old and 69.5 +/- 7.6 years old for the free-living elderly group. Tricipital skinfold (TSF) and mid-arm circumference (MAC) means were within the normal reference range for both groups, without significant differences by sex. Body mass index (BMI) was higher in the institutionalized group. Lower BMI and MAC were found in older elderly (> or =80 y). According to the nutritional classification by BMI, 16% of nutritional deficit, 45% of normal status and 39.7% with of excess weight were found in institutionalized elderly; while in free-living elderly, prevalences were 8%, 62% and 29.7% respectively. Even though normal nutritional status was highly prevalent, institutionalized elderly showed higher prevalences of nutritional alterations (underweight and overweight).

  1. [Predictors of cognitive impairment in population over 64 years institutionalized and non-institutionalized].

    PubMed

    Leiva-Saldaña, Antonio; Sánchez-Ramos, José Luis; León-Jariego, José Carlos; Palacios-Gómez, Leopoldo

    2016-01-01

    Describe the factors which can be associated with cognitive impairment in institutionalized and non-institutionalized elderly. Cross-sectional study of 200 people aged over 64 in Huelva (Spain) in 2014. Of these, 100 people were institutionalized in a residential facility and 100 were not. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE-35), basic activities of daily living by Barthel index, general health through the Goldberg GHQ-28 and social, clinical and behavioural variables were contemplated in the study. The association of cognitive impairment with all the variables was analysed using Chi-square test. Finally, a multivariate analysis was performed using logistic regression to identify possible joint influence of variables to study on the cognitive impairment. The prevalence of cognitive impairment in those institutionalized was 47%, higher than that of non-institutionalized group which was only 8% (p<.001). The dependence for basic activities for daily living and learning activities were the only variables in both groups which were associated with the cognitive impairment. Institutionalization (OR=5.368), age (OR=1.066) and dependence for basic activities (OR=5.036) were negatively associated with CI, while learning activities (OR=.227) were associated in a positive way. Conducting learning activities and the promotion of personal autonomy can delay cognitive impairment in older people. It is important to include cognitive stimulation programs aimed at the old population, especially in residential institutions. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

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

    PubMed

    Kao, Hsueh-Fen Sabrina

    2003-10-01

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

  3. CBCL Behavior Problems of Post-Institutionalized International Adoptees

    PubMed Central

    Hawk, Brandi

    2010-01-01

    With the increase in international adoptions during the last decade, many researchers have investigated the developmental outcomes of these adoptees, including their extreme behaviors. Collectively, these results have not always appeared consistent across studies, perhaps because studies have used children reared in institutions or not, the institutional environments vary in severity, children spend different lengths of time in the institution and are assessed at different ages, and studies use different outcome measures. In an attempt to discern more order in the literature, this review focuses on 18 studies, each of which used the Child Behavior Checklist, and their outcomes are viewed with respect to these parameters. Results suggest that the major factor contributing to extreme behaviors is age at adoption, with those adopted after 6/18 months having more behavior problems, especially Internalizing, Externalizing, and Attention problems. Generally, samples of post-institutional children have more problems than samples of mixed or non-institutional internationally adopted children, and some problems are more likely to be manifest in adolescence, suggesting the effects of deficient early experiences are not simply the persistence of learned behavior but more general dispositions that become more noticeable or severe during adolescence. Findings are discussed in terms of early deficient social–emotional caregiver–child interactions that characterize most institutional environments as a possible major cause of later difficulties in post-institutionalized children. PMID:20514520

  4. 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

    2017-03-06

    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.

  5. Institutionalization and Response Maintenance in Organizational Behavior Management

    ERIC Educational Resources Information Center

    Singurdsson, Sigurdur Oli; Austin, John

    2006-01-01

    A review of the "Journal of Organizational Behavior Management" (1991-2002) was conducted to determine to what extent researchers in OBM programmed for "institutionalization" of applied interventions. Criteria for the term "institutionalization" were derived from McSween and Matthews (2001), and Grindle, Dickinson, and Boettcher (2000). Four…

  6. Factors Influencing the Institutionalization of Distance Education in Higher Education

    ERIC Educational Resources Information Center

    Pina, Anthony A.

    2008-01-01

    The purpose of this study was to determine actions that colleges and universities can take to institutionalize their distance education programs. Thirty factors found to influence the institutionalization of innovations were identified from the literature. These were rated by distance education faculty and leaders as to their importance for…

  7. 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…

  8. 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…

  9. 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…

  10. Institutionalized Crucible Experiences within Intermediate-Level Education

    DTIC Science & Technology

    2015-06-12

    INSTITUTIONALIZED CRUCIBLE EXPERIENCES WITHIN INTERMEDIATE-LEVEL EDUCATION A thesis presented to the Faculty of the U.S...TITLE AND SUBTITLE Institutionalized Crucible Experiences within Intermediate-Level Education 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...effects, both positive and negative, of implementing a crucible experience within Intermediate-Level Education across all military services within the

  11. Relationship between Health and Social Participation among the Institutionalized Elderly.

    ERIC Educational Resources Information Center

    Booth, Dorothy E.

    Although researchers have found a correlation between health and social participation, more data are needed to determine the influence of health on the institutionalized elderly's participation. A study was conducted to explore the relationship between the perceived health status of the institutionalized elderly and their social participation. The…

  12. 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…

  13. 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…

  14. Institutionalization and Response Maintenance in Organizational Behavior Management

    ERIC Educational Resources Information Center

    Singurdsson, Sigurdur Oli; Austin, John

    2006-01-01

    A review of the "Journal of Organizational Behavior Management" (1991-2002) was conducted to determine to what extent researchers in OBM programmed for "institutionalization" of applied interventions. Criteria for the term "institutionalization" were derived from McSween and Matthews (2001), and Grindle, Dickinson, and Boettcher (2000). Four…

  15. 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...

  16. 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... 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...

  17. 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... 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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... 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...

  7. 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 §...

  8. 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...

  9. 45 CFR 605.54 - Education of institutionalized persons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  10. 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 §...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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

  16. 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.

  17. Executive Function in Previously Institutionalized Children

    PubMed Central

    Merz, Emily C.; Harlé, Katia M.; Noble, Kimberly G.; McCall, Robert B.

    2016-01-01

    In studies of children adopted from institutions, being raised in an institution has been associated consistently with an increased risk of persistent cognitive, academic, and social-emotional problems. These findings raise questions about the neurocognitive mechanisms that contribute to these negative outcomes. Theory and models based on studies of animals indicate that development of the prefrontal cortex (PFC) and executive function (EF) may be particularly susceptible to environmental influences during early childhood. In this article, we review recent studies of postinstitutionalized children that examined EF components such as inhibitory control, working memory, shifting, and planning. We then describe emerging research on the structure and function of the PFC. Converging evidence suggests both EF difficulties and alterations in development of the PFC following early institutionalization. We conclude by discussing possible explanations for these findings and implications for prevention and intervention, and by offering suggestions for ongoing research. PMID:27528884

  18. Overcoming Obstacles to Institutionalization of Experiential Learning Programs.

    ERIC Educational Resources Information Center

    Rubin, Sharon G.

    1983-01-01

    Full institutionalization of experiential learning programs remains a major challenge for educators. Their reasons for resistance to change and strategies for overcoming it are discussed. A checklist for change agents is provided. (MLW)

  19. Reality Therapy with Institutionalized Emotionally Disturbed Mentally Retarded Adolescents.

    ERIC Educational Resources Information Center

    Dolly, John P.; Page, D. Patricia

    1981-01-01

    The study evaluated a reality therapy program used with 20 institutionalized mentally retarded (mild to profound) and emotionally disturbed adolescents residing in an institution. Results indicated that 17 of the Ss increased adaptive behaviors and all decreased maladaptive behaviors. (DB)

  20. Institutionalization of gerontological curricular change in schools of social work.

    PubMed

    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 analyze the content of the GeroRich projects' annual reports over the initiative's 3-year period. Diffusion of innovation and institutional theories provided the framework for the finding that mimetic and normative processes, rather than coercive ones, had more direct impact on institutionalization of the curriculum innovations. Provision of resources transformed mimetic to normative isomorphic pressure thereby assisting with the progression of innovation from periphery to core. Programmatic and student-focused factors were the primary aspects associated with sustaining and institutionalizing innovation and changes. Barriers to innovation, such as budget constraints and reaccreditation issues, were also addressed by the projects.

  1. Locus of Control, Perceived Constraint, and Morale among Institutionalized Aged.

    ERIC Educational Resources Information Center

    Fawcett, Gayle; And Others

    1980-01-01

    Contrary to an earlier report, this study showed that life satisfaction of 56 institutionalized elderly women was associated with internality. Satisfaction was inversely related to their perception of institutional constraints, its most powerful determinant. (Author)

  2. Reality Therapy with Institutionalized Emotionally Disturbed Mentally Retarded Adolescents.

    ERIC Educational Resources Information Center

    Dolly, John P.; Page, D. Patricia

    1981-01-01

    The study evaluated a reality therapy program used with 20 institutionalized mentally retarded (mild to profound) and emotionally disturbed adolescents residing in an institution. Results indicated that 17 of the Ss increased adaptive behaviors and all decreased maladaptive behaviors. (DB)

  3. 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

    internalizing disorders in children exposed to institutionalization. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

  4. Forced Conscription of Children during Armed Conflict: Experiences of Former Child Soldiers in Northern Uganda

    ERIC Educational Resources Information Center

    Vindevogel, Sofie; Coppens, Kathleen; Derluyn, Ilse; De Schryver, Maarten; Loots, Gerrit; Broekaert, Eric

    2011-01-01

    Objective: Child soldiering can be considered as one of the worst practices of institutionalized child abuse. However, little is known about the scope and nature of this abuse and the consequent experiences of children enrolled in an armed faction. This research aims at enriching the knowledge on the experiences of child soldiers in the Lord's…

  5. Forced Conscription of Children during Armed Conflict: Experiences of Former Child Soldiers in Northern Uganda

    ERIC Educational Resources Information Center

    Vindevogel, Sofie; Coppens, Kathleen; Derluyn, Ilse; De Schryver, Maarten; Loots, Gerrit; Broekaert, Eric

    2011-01-01

    Objective: Child soldiering can be considered as one of the worst practices of institutionalized child abuse. However, little is known about the scope and nature of this abuse and the consequent experiences of children enrolled in an armed faction. This research aims at enriching the knowledge on the experiences of child soldiers in the Lord's…

  6. Self-perceived health in institutionalized elderly.

    PubMed

    Jerez-Roig, Javier; Souza, Dyego Leandro Bezerra; Andrade, Fabienne Louise Juvêncio Paes de; Lima, Bartolomeu Fagundes de; Medeiros, Rafaela Jordânia de; Oliveira, Nayara Priscila Dantas de; Cabral, Sadote Macêdo; Lima, Kenio Costa

    2016-11-01

    This study aimed to verify health self-perception, its prevalence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted in 10 Long-Term care Institutions for the Elderly (LTIE) in the city of Natal (Northeast Brazil), between October and December 2013. Sociodemographic variables were analyzed, along with institution-related and health state variables. Descriptive and bivariate analyses were carried out (Chi-squared test, Fisher's exact test or linear trend Chi-squared test), as well as multivariate analysis (logistic regression). The final sample consisted of 127 elderly. The prevalence of negative self-perceived health was 63.19% (CI 95%: 55.07-70.63), and was associated with weight loss (PR: 1.54; CI 95%: 1.19-1.99), rheumatic disease (PR: 1.46; CI 95%: 1.05-2.01) and not-for-profit LTIE (PR: 1.37; CI 95%: 1.03-1.83), adjusted by sex. More than half of the elderly reported negative self-perceived health, which was associated with weight loss, rheumatic disease and type of institution. Actions must be developed to promote better health conditions in LTIE, such as nutrition consulting and physical therapy, to improve quality of life.

  7. Trailblazing healthcare: institutionalizing and integrating complementary medicine.

    PubMed

    Sharf, Barbara F; Geist Martin, Patricia; Cosgriff-Hernández, Kevin-Khristián; Moore, Julia

    2012-12-01

    This study examines three integrative health centers to understand their (1) historical development, organizational goals, and modalities, (2) the processes and challenges of integrating complementary and allopathic medicine, while encouraging staff collaboration, and (3) how each center becomes institutionalized within their community. We focus on three organizational case studies that reflect varying forms of integrative health care practices in three U.S. cities. Participant-observation and in-depth interviews with center directors were analyzed qualitatively. Important patterns found within the three cases are (1) the critical role of visionary biomedical practitioners who bridge complementary and allopathic practices, (2) communicating integration internally through team interaction, and (3) communicating integration externally through spatial location, naming, and community outreach. IM centers continue to blaze new trails toward mainstream access and acceptance by gathering evidence for IM, encouraging team collaboration within organizational contexts, constructing organizational identity, and negotiating insurance reimbursements. IM is not the enactment of specific modalities, but rather a philosophy of healing. Though scheduling conflicts, skepticism, and insurance coverage may be obstacles toward IM, collaboration among specialists and with patients should be the ultimate goal. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Potential Selective Responding in a Parent Questionnaire Study of Post-Institutionalized Children

    PubMed Central

    Hawk, Brandi N.; Wright, Amanda; Julian, Megan M.; Rosas, Johana M.; Merz, Emily C.; McCall, Robert B.

    2013-01-01

    Selective responding bias, though under-researched, is of particular concern in the study of post-institutionalized children because many studies rely on mailed questionnaires and response rates are often low. The current study addresses the impact of selective responding in a single wave of data collection and in a multi-wave study. Participants were 121 parents from a larger four-wave study of post-institutionalized children, identified as Never Responders, Previous Responders (but not to the current wave), or Wave 4 Responders. Parents were telephoned and asked about their adopted child's family, school, peer, and behavioral adjustment. The children (47% male) ranged in age from 2 to 20 years (M = 10.79, SD = 4.59) and had been adopted between 5 and 54 months of age (M = 15.49, SD = 9.94). There were no differences in parent ratings of adjustment for a single wave of data collection; however, participants who never responded reported poorer family and peer adjustment than those who had responded to at least one wave of data collection. Within a single wave of data collection, there was no evidence that selective responding contributes much bias. Over a multi-wave study, however, results may under-represent adjustment difficulties, especially with family and friends. PMID:23710124

  9. Indiscriminate Behaviors in Previously Institutionalized Young Children

    PubMed Central

    Fox, Nathan A.; Drury, Stacy S.; Smyke, Anna T.; Nelson, Charles A.; Zeanah, Charles H.

    2014-01-01

    OBJECTIVE: This study included 54-month-old children with a history of institutional care. Our goal was to: (1) examine differences in indiscriminate social behaviors in children with a history of institutional care compared with home-reared children; (2) test whether foster care reduces indiscriminate social behaviors in a randomized controlled trial; and (3) examine early predictors of indiscriminate behaviors. METHODS: Participants were 58 children with a history of institutional care and 31 never-institutionalized control (NIG) subjects enrolled in a randomized controlled trial of foster care for institutional care, assessed from toddlerhood to 54 months. Indiscriminate social behaviors were measured naturalistically by using the Stranger at the Door procedure. RESULTS: In the Stranger at the Door procedure, children with a history of institutional care left with a stranger at higher rates than NIG subjects (33% vs 3.5%; P < .001). Children in the care as usual group left more than NIG subjects (41.9% vs 3.6%; P ≤ .001). The differences between the foster care group (24.1%) and the care as usual group and between foster care group and NIG were not significant. In a logistic regression, early disorganized attachment behaviors, baseline developmental quotient, and caregiving quality after randomization contributed to variance at 54 months. In the same analysis using only children with a history of institutional care, only disorganized attachment contributed significantly to 54-month indiscriminate social behaviors (Exp[B] = 1.6 [95% confidence interval: 1.1–2.5]). CONCLUSIONS: Observed socially indiscriminate behaviors at 54 months were associated with prolonged exposure to institutional care. Young children raised in conditions of deprivation who fail to develop organized attachments as toddlers are at increased risk for subsequent indiscriminate behaviors. PMID:24488743

  10. 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.

  11. Effects of a reminiscence program among institutionalized elderly adults.

    PubMed

    Meléndez-Moral, Juan Carlos; Charco-Ruiz, Laura; Mayordomo-Rodríguez, Teresa; Sales-Galán, Alicia

    2013-01-01

    Institutionalization during old age requires tremendous adaptability. Among the main consequences of the difficulty of adapting to the institutional context are prevalent depressive symptoms and low well-being. Reminiscence therapy has proven to be among the most effective at minimizing these outcomes. This study purpose was to investigate the usefulness of reminiscence intervention in an elderly, institutionalized sample. Following a group format, the intervention lasted eight sessions and compared a treatment group and a control group, using pre-post measures and a single-blind design. We predicted that reminiscence intervention would have a positive impact on depressive symptoms, self-esteem, life satisfaction, and psychological well-being. Significant results were obtained, including a drop in depressive symptoms and improved self-esteem, satisfaction, and psychological well-being. We conclude that reminiscence intervention yielded positive effects in institutionalized, elderly participants.

  12. 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.

  13. Predicting Institutionalization after Traumatic Brain Injury Inpatient Rehabilitation

    PubMed Central

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

    2015-01-01

    Abstract 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

  14. Depressive Symptoms and Associated Factors in Institutionalized Elderly.

    PubMed

    Jerez-Roig, Javier; de Oliveira, Nayara Priscila Dantas; de Lima Filho, Bartolomeu Fagundes; de Farias Bezerra, Maria Amanda; Matias, Monayane Grazielly Leite; Ferreira, Lidiane Macedo; Dos Santos Amaral, Fabienne Louise Juvêncio; Souza, Dyego Leandro Bezerra; Lima, Kenio Costa

    2016-01-01

    Background/Study Context: Depression is a common psychiatric disorder in the elderly that leads to a decrease in quality of life and functional impairment, among other health problems. The study of depressive symptoms in institutionalized elderly is scarce in Latin America and can contribute to plan prevention and treatment actions in order to improve health conditions for the residents as well as quality of life. Therefore, the aim of this study is to determine the prevalence of depressive symptoms and identify its associated factors in institutionalized elderly.

  15. 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…

  16. 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"…

  17. 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"…

  18. 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-...

  19. 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

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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)

  7. Attachment in Institutionalized and Community Children in Romania

    ERIC Educational Resources Information Center

    Zeanah, Charles H.; Smyke, Anna T.; Koga, Sebastian F.; Carlson, Elizabeth

    2005-01-01

    This study examined attachment in institutionalized and community children 12-31 months of age in Bucharest, Romania. Attachment was assessed using ratings of attachment behaviors and ratings of caregiver descriptions in a structured interview. As predicted, children raised in institutions exhibited serious disturbances of attachment as assessed…

  8. 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…

  9. 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…

  10. Pharmacotherapy for Institutionalized Adolescents: Report of a Panel.

    ERIC Educational Resources Information Center

    Kalogerakis, Michael G., Ed.

    Presented are 34 guidelines and related charts developed by a New York panel of experts on psychotherapy with disturbed institutionalized adolescents. The guidelines are organized into general principles, specific indications (acute disturbances subacute, and chronic disturbances), and the patient's rights. Charts include a list of commonly used…

  11. The Role of Public Relations in the Institutionalization of Ethics.

    ERIC Educational Resources Information Center

    Fitzpatrick, Kathy R.

    1996-01-01

    Examines the role and perceived value of public relations in institutional ethics initiatives. Surveys ethics officers in North American institutions. Finds that public relations professionals are not playing key roles in the institutionalization of ethics, and that public relations remains a relatively untapped resource in ethics programs. (PA)

  12. Institutionalizing Innovation in an Organization: A Model and Case Study.

    ERIC Educational Resources Information Center

    Slawski, Carl

    A policy systems theoretical analysis of the problem of institutionalizing innovation in an organization is summarized in a flow diagram. The model is presented in terms of specific hypotheses, and then illustrated with a case of frustrated innovation, the 1968-69 crisis and strike at San Francisco State College. The model is set up (1) to help…

  13. Predictors of Increased Death Following Relocation in Institutionalized Elderly.

    ERIC Educational Resources Information Center

    Mosty, Mark; And Others

    Because research studies on post-relocation mortality in the elderly have come to inconsistent and contradictory conclusions, clinical teams recommending patients for placement are still relying on educated intuition as a basis for clinical decisions in what may be a life-or-death matter for elderly institutionalized patients. This study was…

  14. 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…

  15. Supplementary Auditory and Vestibular Stimulation: Effects on Institutionalized Infants

    ERIC Educational Resources Information Center

    Casler, Lawrence

    1975-01-01

    Supplementary stimulation was supplied for 30 minutes per day for approximately six weeks to 156 normal, full-term institutionalized infants prior to adoption. The Gesell Developmental Schedules were administered regularly (until age 27 months), to determine whether development had been enhanced by the treatment. (JMB)

  16. 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…

  17. 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.…

  18. 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…

  19. 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…

  20. 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…

  1. Long-Term Adaptation to Institutionalization in Dementia Caregivers

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  2. Prader-Willi Syndrome in Two Institutionalized Older Adults.

    ERIC Educational Resources Information Center

    Goldman, Jeri J.

    1988-01-01

    Two case reports are presented of institutionalized women who were diagnosed as having Prader-Willi syndrome at the ages of 54 and 69. Implications are discussed for management of such persons and for program planning/funding for a much longer life expectancy than earlier realized. (Author/JDD)

  3. 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, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING...

  4. 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, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING...

  5. 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, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING...

  6. 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...

  7. 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...

  8. 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...

  9. 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

  10. 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...

  11. 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, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES...

  12. 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...

  13. 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...

  14. The Effects of Duration of Caregiving on Institutionalization

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  15. Long-Term Adaptation to Institutionalization in Dementia Caregivers

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  16. IV. Growth Failure in Institutionalized Children

    PubMed Central

    Johnson, Dana E.; Gunnar, Megan R.

    2013-01-01

    Children within institutional care settings experience significant global growth suppression, which is more profound in children with a higher baseline risk of growth impairment (e.g., low birth weight [LBW] infants and children exposed to alcohol in utero). Nutritional insufficiencies as well as suppression of the growth hormone–insulin-like growth factor axis (GH-IGF-1) caused by social deprivation likely both contribute to the etiology of psychosocial growth failure within these settings. Their relative importance and the consequent clinical presentations probably relate to the age of the child. While catch-up growth in height and weight are rapid when children are placed in a more nurturing environment, many factors, particularly early progression through puberty, compromise final height. Potential for growth recovery is greatest in younger children and within more nurturing environments where catch-up in height and weight is positively correlated with caregiver sensitivity and positive regard. Growth recovery has wider implications for child well-being than size alone, because catch-up in height is a positive predictor of cognitive recovery as well. Even with growth recovery, persistent abnormalities of the hypothalamic-pituitary-adrenal system or the exacerbation of micronutrient deficiencies associated with robust catch-up growth during critical periods of development could potentially influence or be responsible for the cognitive, behavioral, and emotional sequelae of early childhood deprivation. Findings in growth-restricted infants and those children with psychosocial growth are similar, suggesting that children experiencing growth restriction within institutional settings may also share the risk of developing the metabolic syndrome in adulthood (obesity, Type 2 diabetes mellitus, hypertension, heart disease). Psychosocial deprivation within any care-giving environment during early life must be viewed with as much concern as any severely debilitating

  17. Genital human papilloma virus infection in mentally-institutionalized virgins.

    PubMed

    Shimada, Takako; Miyashita, Masako; Miura, Shoko; Nakayama, Daisuke; Miura, Kiyonori; Fukuda, Masafumi; Masuzaki, Hideaki

    2007-09-01

    Human papilloma virus (HPV) can cause cervical cancer. Risk factors for HPV infection are primarily related to sexual behavior. We determined the prevalence of HPV infection and abnormal cervical cytology in institutionalized women with no previous sexual experience. The study subjects were 251 patients who sought screening for cervical cancer (45.9+/-9.4 years, mean+/-S.D., range, 14 to 66). They were institutionalized for psychosomatic disorders since childhood, and had no previous sexual experience. In addition to screening for cervical cancer, specimens for HPV testing were collected. No women who were positive for HPV DNA was detected, though 251 women without sexual experiences were screened by the hybrid capture 2 test including 26 types of HPV-DNA. Transmission through means other than sexual intercourse may not exist because we could not detect HPV DNA in 251 women with no previous sexual experience.

  18. Factors affecting institutionalized older peoples' self-perceived dry mouth.

    PubMed

    Huang, Ying-Chia; Chu, Chiao-Lee; Ho, Ching-Sung; Lan, Shou-Jen; Chen, Wen-Yi; Liang, Yia-Wung; Hsieh, Yen-Ping

    2015-03-01

    The purpose of this study was to determine the factors affecting institutionalized older peoples' self-perceived dry mouth. This cross-sectional study was conducted on elderly residents at 22 long-term care facilities. A total of 165 questionnaires were returned from 13 senior citizen welfare institutions (SCWIs) and nine nursing homes. Multiple logistic regression analysis was used to analyze the data obtained. The results showed that the type of long-term care (LTC) facility, regular oral examinations, wearing dentures, and the ability to chew sticky foods affected self-perceived dry mouth. This study determined an association between the type of LTC facility where the participants lived and self-perceived dry mouth. The results indicated the importance of providing oral care in order to improve and prevent dry mouth among institutionalized older people living in SCWIs who do not undergo regular oral examinations, wear dentures, and have difficulty chewing sticky foods.

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

    DTIC Science & Technology

    1998-03-01

    factor in democratic erosion and corrosive to democratic processes,6 and Guillermo O’Donnell argues that lack of political party institutionalization...Sovereignty: Collectively Defending Democracy in the Americas (John Hopkins University Press, 1996), p. 63. 7 Guillermo O’Donnell, "Delegative...Study of the Transition to Democracy," in Guillermo O’Donnell, et al, eds., Transitions from Authoritarian Rule; Comparative Perspectives (John

  20. "Don't tread on me": ethological perspectives on institutionalization.

    PubMed

    Senn, B J; Steiner, J R

    The concept of dignity is developed from an ethological perspective. Special attention is given to innate, phylogenetically programmed behavior, the role of releasers, the importance of rituals, and the fact that "management problems" in institutions are often cries for dignity. Observations of geriatric patients admitted to a nursing home are given, but it is believed that the generalizations apply equally well to institutionalization in other settings such as residential centers for young people, correctional facilities, or mental hospitals.

  1. Assessment of visual function in institutionalized elderly patients.

    PubMed

    Carcenac, Guillaume; Hérard, Marie-Eve; Kergoat, Marie-Jeanne; Lajeunesse, Yvette; Champoux, Nathalie; Barsauskas, Allan; Kergoat, Hélène

    2009-01-01

    To describe the visual function and ocular health of frail elderly patients institutionalized in a tertiary care university-affiliated geriatric hospital. Retrospective file review. A university-affiliated geriatric hospital. 440 patient files. The archived clinical files of patients from the long-term care beds of the Institut universitaire de gériatrie de Montréal, who had died between April 2000 and 2004 were reviewed. Pertinent medical and visual characteristics were extracted and entered into a database for analysis. The age of the patients ranged from 65 to 104 years. The major ocular conditions observed were cataract, pseudophakia, conjunctivitis-blepharitis, age-related macular degeneration, and glaucoma. Of the 231 patients referred for a partial or full eye examination, visual acuity was available in 178. Visual impairment was considered absent in 87 patients; mild in 52; moderate in 17; and 22 patients were legally blind. Of the 105 patients referred for a full eye examination, an evaluation of the refraction, visual acuity, and ocular health was possible in 89, irrespective of their cognitive status. These data demonstrate that the vast majority of severely disabled elderly patients examined retained good visual acuity into advanced age. The most prevalent ocular conditions observed are treatable, thereby emphasizing the importance of regular eye care for the institutionalized frail elderly. The results clearly demonstrate that it is possible to perform a complete evaluation of visual function and ocular health in the elderly institutionalized patient, independent of age, cognitive status, or communication disorders.

  2. Challenges to institutionalizing strategic environmental assessment: The case of Vietnam

    SciTech Connect

    Slunge, Daniel; Tran, Trang Thi Huyen

    2014-09-15

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

  3. School-based health education programs can be maintained over time: results from the CATCH Institutionalization study.

    PubMed

    Hoelscher, Deanna M; Feldman, Henry A; Johnson, Carolyn C; Lytle, Leslie A; Osganian, Stavroula K; Parcel, Guy S; Kelder, Steven H; Stone, Elaine J; Nader, Philip R

    2004-05-01

    Developing and evaluating interventions to influence students' opportunities for healthful choices has been a focus of school-based health promotion research; however, few studies have examined the sustainability of these programs and viability of continued organizational implementation. The purpose of this study was to determine the maintenance of Child and Adolescent Trial for Cardiovascular Health (CATCH) school-level changes in former intervention (n = 56) and former comparison (n = 20) schools 5 years post-intervention. Twelve schools unexposed to CATCH were measured as controls. Macronutrient content of 5 days of school lunch menus, amount and type of physical education (PE) classes, and health instruction practices in the classroom were assessed. An institutionalization score for schools was developed, using program maintenance variables: % kcal from fat and saturated fat in school lunches, % PE class spent in vigorous and moderate-to-vigorous physical activity, and class time devoted to CATCH topics. Menus from 50% of former intervention cafeterias met the Eat Smart guidelines for fat, compared to 10% of former control cafeterias and 17% of unexposed school cafeterias (P < 0.005). There were no significant differences in implementation of CATCH PE goals between conditions. Although the total time spent teaching CATCH was low in former CATCH schools, the former intervention schools spent significantly more time teaching CATCH and taught more lessons as compared to former comparison schools. Former intervention schools had a higher mean institutionalization score than former comparison schools (P < 0.001). Training had the greatest impact on maintenance of CATCH. Results from this study suggest that changes in the school environment to support healthful behaviors can be maintained over time. Staff training is an important factor in achieving institutionalization of these programs.

  4. [Influence of chronic health problems in dimensions of EQ-5D: study of institutionalized and non-institutionalized elderly].

    PubMed

    Delgado-Sanz, María Concepción; Prieto-Flores, Maria-Eugenia; Forjaz, Maria João; Ayala, Alba; Rojo-Perez, Fermina; Fernandez-Mayoralas, Gloria; Martínez-Martín, Pablo

    2011-12-01

    Chronic medical conditions represent risk factors for health related quality of life (HRQOL). The aim of this study is to analyze the influence of self-reported chronic health conditions in HRQOL, measured through the EQ-5D dimensions, in non-institutionalized and institutionalized older adults. Data were obtained from two studies of quality of life in population aged 60 years or over, in Spain, with a sample of 1,106 community-dwelling adults and 234 residents of care facilities. To analyse the influence of the most prevalent chronic health conditions on HRQOL multiple logistic regression models were adjusted using as dependent variable each EQ-5D dimension, controlling for socio-demographic variables. The chronic health conditions that most influenced the HRQOL of both groups were depression (OR range in the different EQ-5D dimensions: 1.97-6.48), followed by arthrosis/arthritis (OR: 2.81-6.00), sleep problems (OR: 2.81-4.61), diabetes (OR: 1.68-3.44) and hypertension (OR: 1.42-2.45). These problems affected differentially the EQ-5D dimensions and the two groups considered. Pain/discomfort and mobility were the EQ-5D dimensions where more difficulties were reported. The results of this work indicate that the debilitating effect of chronic health conditions on the HRQOL is different for institutionalized and non-institutionalized older adults. They also highlight the importance of promoting healthy ageing to attenuate the negative impact of chronic health conditions on HRQOL in old age.

  5. Nurses' perceptions of sexuality in institutionalized elderly: a literature review.

    PubMed

    Mahieu, Lieslot; Van Elssen, Kim; Gastmans, Chris

    2011-09-01

    Institutionalized elderly continue to have the need for sexual expression and intimacy. Nurses often display negative responses when they are confronted with the sexual behavior of residents. They feel ashamed and do not know how to react. This generates feelings of discomfort, resulting in the denial of resident's needs and desires for sexual fulfillment. The objective of this review is to thoroughly analyze the literature about the knowledge, attitudes, and experiences of nursing staff toward sexuality in institutionalized elderly. We shed light onto the relationship between knowledge and attitudes, and determined whether certain demographic factors relate to the knowledge and attitudes of nursing home caregivers. We conducted an extensive search of the electronic databases Medline, Cinahl, Psychinfo, Web of Science, Philosophers Index, Google Scholar, and Invert for papers published between January 1980 and September 2010. A broad range of search keywords was used. The quantitative studies revealed nursing staff to show rather positive attitudes toward later-life sexuality. However, the extent of the staff's knowledge regarding sexuality in the aged seemed to be very limited. There was no consensus found about the relationship between knowledge and attitudes. As regards the influence of demographic variables, the results were very ambiguous. The qualitative studies showed that caregivers hold rather conservative attitudes toward sexuality in institutionalized elderly. Feelings of discomfort prevailed. The responses to residents' sexual behavior were influenced by the staff's own level of comfort related to sexuality issues and the ethos within the institution where they work. This review gives us a broad outline of the knowledge, attitudes, and experiences of geriatric nurses toward sexuality in institutionalized elderly. If we want the sexual needs of residents to be recognized, more research is needed. Especially needed are more in-depth qualitative studies

  6. Effects of therapeutic touch on anxiety in the institutionalized elderly.

    PubMed

    Simington, J A; Laing, G P

    1993-11-01

    The purpose of this study was to determine the effects of therapeutic touch, a specific healing technique, on state anxiety in 105 institutionalized elderly. A double-blind, three-group experimental design was used. State anxiety was measured using the Spielberger State-Trait Anxiety Inventory. The anxiety level of subjects who received therapeutic touch in the form of a back rub was found to be significantly lower than the anxiety level of subjects who received a back rub without therapeutic touch. Results suggest that this noninvasive intervention has potential for enhancing the quality of life for this population.

  7. How Institutionalized Is Distance Learning? A Study of Institutional Role, Locale and Academic Level

    ERIC Educational Resources Information Center

    Piña, Anthony A.

    2008-01-01

    The purpose of this study was to determine areas of strengths and weaknesses in the institutionalization of distance learning at colleges and universities. To accomplish this goal, 30 factors found to influence the institutionalization of innovations were identified from the literature of several area. These factors were rated by distance learning…

  8. Will It Last? Evidence of Institutionalization at Carnegie Classified Community Engagement Institutions

    ERIC Educational Resources Information Center

    Holland, Barbara A.

    2009-01-01

    The traditional question inferred by attention to institutionalization is, "Will it last?" or "Will it die out when there is a new leader or when the grant ends?" In the case of community engagement, attention to institutionalization reveals a more complex portrait of organizational change that includes a critical reflection on not only the…

  9. Change at Big School and Little School: Institutionalization and Contestation in Participatory Action Research

    ERIC Educational Resources Information Center

    Flores-Kastanis, Eduardo

    2009-01-01

    Participatory action research (PAR) assumes a dialectic model of change where the tension between institutionalization and contestation practices leads to change in schools. This view openly contradicts the three dominating views of institutionalization in the educational change literature. Over the past 11 years, research has been conducted to…

  10. Tools for a Time and Place: Phased Leadership Strategies to Institutionalize a Diversity Agenda

    ERIC Educational Resources Information Center

    Kezar, Adrianna J.

    2007-01-01

    This study examines college presidents who have successfully institutionalized diversity measures on their campuses, focusing on their strategies. The study focus was: Do campuses at different stages of institutionalization in their diversity agendas use different strategies? If so, why? And how do different strategies help move the campus toward…

  11. 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,…

  12. 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,…

  13. The Institutionalization of Sociology in France: Its Social and Political Significance.

    ERIC Educational Resources Information Center

    Burke, Edmund, III

    1984-01-01

    Through an examination of the development of the discipline of sociology in France in the period 1880-1925, this article sheds light on some of the more general processes at work in the institutionalization of the social sciences and on the social and political consequences of that institutionalization. (RM)

  14. 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…

  15. The Effects of Involuntary Residential Relocation on Institutionalized Populations: A Review.

    ERIC Educational Resources Information Center

    Heller, Tamar

    This paper reviews the research of the effects of involuntary residential relocation on the personal adjustment of institutionalized individuals, i.e., the institutionalized elderly, mentally ill, and mentally retarded. Discrepant findings in studies of involuntary relocation are discussed in terms of the transferees' personal characteristics, the…

  16. 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…

  17. 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…

  18. Institutionalize Reciprocity to Overcome the Public Goods Provision Problem.

    PubMed

    Ozono, Hiroki; Kamijo, Yoshio; Shimizu, Kazumi

    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.

  19. 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

  20. 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.

  1. 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.

  2. Factors Associated with Anemia in the Institutionalized Elderly

    PubMed Central

    da Silva, Emanuelle Cruz; Roriz, Anna Karla Carneiro; Eickemberg, Michaela; Mello, Adriana Lima; Côrtes, Elvira Barbosa Quadros; Feitosa, Caroline Alves; Medeiros, Jairza Maria Barreto; Ramos, Lílian Barbosa

    2016-01-01

    As a common problem in long-term care facilities (LTCFs), anemia affects 25–63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR) with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%), as normocytic and normochromic anemia, with no anisocytosis (69.75%). Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04–2.72) and with moderate (PR: 1.98; 95% CI: 1.07–3.63) and total (PR: 2.61; 95% CI: 1.34–5.07) dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00–3.77). The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence. PMID:27607057

  3. Factors Associated with Anemia in the Institutionalized Elderly.

    PubMed

    Silva, Emanuelle Cruz da; Roriz, Anna Karla Carneiro; Eickemberg, Michaela; Mello, Adriana Lima; Côrtes, Elvira Barbosa Quadros; Feitosa, Caroline Alves; Medeiros, Jairza Maria Barreto; Ramos, Lílian Barbosa

    2016-01-01

    As a common problem in long-term care facilities (LTCFs), anemia affects 25-63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR) with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%), as normocytic and normochromic anemia, with no anisocytosis (69.75%). Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04-2.72) and with moderate (PR: 1.98; 95% CI: 1.07-3.63) and total (PR: 2.61; 95% CI: 1.34-5.07) dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00-3.77). The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence.

  4. 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.

  5. [Prevalence of malnutrition in institutionalized intellectually disabled patients].

    PubMed

    Bronberg, Ruben A; Alfaro, Emma L; Bejarano, Ignacio F; Dipierri, Jose E

    2011-01-01

    As patients with intellectual and developmental disability (ID) may be more exposed to unfavorable factors, they are at higher risk of suffering nutritional alterations. Our objective was to determine prevalence of malnutrition in institutionalized patients with ID. An evaluation of the nutritional status through determination of transversal anthropometric parameters of weight (kg) and height (cm) was made on 614 individuals (352 men and 262 women) institutionalized at Colonia Nacional Montes de Oca, Buenos Aires Province, Argentina. Body mass index and prevalence of underweight, overweight and obesity cases by sex and ID type: mild, moderate and severe intellectual disability were determined. Regardless of sex, prevalence of underweight, overweight and obesity were of 2.9%, 30% and 27.7%, respectively. Regardless of degree of ID, greater prevalence of obesity (41.2%) was found amongst women, while overweight (34.7%) was more frequent amongst men. Taking the degree of ID and regardless of sex, greater prevalence of underweight was observed in severe ID, and overweight and obesity amongst mild ID. No any of the patients with mild ID presented underweight. Taking into account sex and ID, higher prevalence of underweight and overweight were observed amongst men with mild ID, (7% and 38.4%, respectively) and of obesity in women with moderate ID (44%). Results obtained would indicate the importance of caloric intake and energy consumption control in adults with ID, paying particular attention to life conditions and alimentary disorders in terms of the degree of ID and their multiple associated disabilities.

  6. [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.

  7. [A survey on urinary incontinence in the institutionalized elderly].

    PubMed

    Homma, Y; Takai, K; Takahashi, S; Higashihara, E; Aso, Y; Urushibara, A

    1992-08-01

    A survey on urinary incontinence in 161 (41 male, 120 female) institutionalized elderly was independently performed by urologists and attending nurses. Urinary incontinence was found in 107 cases (66%), with 76 cases (47%) suffering from severe leakage (more than 5 times a day and needs diaper). The prevalences of incontinence and severe leakage were 63% and 52% at geriatric hospitals, 59% and 29% at intermediate care centers and 78% and 63% at nursing homes, respectively. The risk factors for incontinence were consciousness disturbance, urinary urgency, impaired mobility and dementia, and those for severe leakage were apathy, loss of urinary sensation, dementia and impaired mobility. The type of incontinence was considered functional one in 81% of cases. The agreement of the incontinence type evaluated by urologists and that by nurses was found in 90% of incontinent cases. Incontinence was estimated "incurable" in 54% of cases by attending nurses. These observations indicate a high prevalence of severe and "incurable" incontinence in the institutionalized elderly, urgently warranting an effective remedy for the increasing aged society.

  8. Institutionalized nursing staff: planning and developing a specialized educational framework that enhances psychiatric nurses' roles and promotes de-institutionalization.

    PubMed

    Loukidou, E; Ioannidi, V; Kalokerinou-Anagnostopoulou, A

    2010-11-01

    For centuries psychiatric services were provided by mental health hospitals, which were operating upon bureaucratic principles: strict hierarchies, slow processes and segmentation of duties. Research has shown that psychiatric nursing, as exercised in these traditional settings, has dealt with several problems in relation to: the amount and quality of time spent with patients, the type of duties performed, the lack of autonomy etc. The closure of many psychiatric institutions and their substitution with community-based settings, signified that health professionals should perform a variety of new duties, exhibit new skills and develop new perceptions about their work and the patients. In order for such alterations to occur, education can play a vital role in the re-conceptualization of psychiatric nursing and in the practical preparation of students for their future work. The present paper focuses on the contradiction between nursing as practised in Greek mental health hospitals and the current trends and demands placed upon nurses, to exhibit a new 'face'. The purposes of this paper are: first, to review the research on psychiatric nurses' behaviours in mental health hospitals. Second, to present the outcomes of bureaucracy on employees and finally, to propose an educational scheme that could reinforce the shift from institutionalized work to de-institutionalized.

  9. Potential Consequences of Abandonment in Preschool-Age: Neuropsychological Findings in Institutionalized Children

    PubMed Central

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

    2012-01-01

    Objective: 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. Method: 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. Results: 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. Conclusions: 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. PMID:22713373

  10. [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.

  11. [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.

  12. [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.

  13. Institutionalizing social support through the church and into the community.

    PubMed

    Eng, E; Hatch, J; Callan, A

    1985-01-01

    The positive influence of social support on such health related outcomes as patient adherence to medical regimens and stress reduction at the worksite has captured the attention of public health researchers and practitioners alike. Yet, the broader social outcome of building community competency to undertake and sustain health related solutions without constant intervention from professionals still remains elusive. The difficulty may lie with the need to uncover on each occasion the various roles and functions of social support structures that may or may not exist in a given community. The intent would then be to graft an intervention onto these existing roles and functions in order to mirror the naturally occurring social support structures. A conceptual framework that has been used to institutionalize health related activities through the role and function of the black Church, as a social unit of identity and solution for rural black communities in North Carolina, is put forth for consideration.

  14. 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

  15. Nurses as Antibiotic Brokers: Institutionalized Praxis in the Hospital.

    PubMed

    Broom, Alex; Broom, Jennifer; Kirby, Emma; Scambler, Graham

    2016-11-30

    We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints. We argue that nurses occupy an essential and conscious position as brokers within the hospital; a subject position that is not neutral, facilitates (short-term) cohesion, and involves the pursuit of particular (preferred) nursing outcomes. Illustrating how authority can be diffuse, mediated by institutionalized praxis, and how professionals evade attempts to govern their practice, we challenge the reification of physician prescribing power, arguing that it may work against the utilization of nurses as important stakeholders in the future of antibiotics. © The Author(s) 2016.

  16. Brazilian sanitary reform: dilemmas between the instituing and the institutionalized.

    PubMed

    Fleury, Sonia

    2009-01-01

    The article presents the trajectory of social policies in Brazil and identifies, at each stage, the existing social protection model. It affirms that the Federal Constitution of 1988, when it introduced the concept of Social Security and created the National Health Care System, represented a rupture with what came before. The subordination of the principles of justice and social inclusion, which guided the design of this new social protection model, to a liberal and monetarist policy had important impacts in the phase of implementation of the social policies. However, the dilemma that such policies go through and, in particular, the construction of the National Health Care System must be analyzed from a theoretical perspective that encompasses the agreements and disagreements between the three movements that characterize Brazilian Sanitary Reform, which are: subjectivation, constitutionalization and institutionalization.

  17. [Prevalence and features of falls of institutionalized elders].

    PubMed

    Ferreira, Denise Cristina de Oliveira; Yoshitome, Aparecida Yoshie

    2010-01-01

    This retrospective study seeks to check the prevalence of falls in older people from a long-term care institution for elderly people, in São Paulo, to describe the fallers and the events. We analyzed 121 medical records and 87 fall reports, between August 2006 and August 2007. There were 114 falls suffered by 45 ancians, a prevalence of 37,2%. The majority of fallers are women, average age 83,75 years. We found recurrent falls, various diagnoses and polipharmacy. The majority occurred in own height, in their bedroom, producing mainly hematomas. There is a need of implementation of fall preventive guidelines, due to the importance of this issue and its repercussions to the functional status of the institutionalized elderly.

  18. 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

  19. Quality of life of institutionalized older adults by dementia severity.

    PubMed

    Castro-Monteiro, Emilia; Alhayek-Aí, Mohammed; Diaz-Redondo, Alicia; Ayala, Alba; Rodriguez-Blazquez, Carmen; Rojo-Perez, Fermina; Martinez-Martin, Pablo; Forjaz, Maria João

    2016-01-01

    The goal of the study was to analyze the factors associated with quality of life (QoL) in institutionalized older adults with dementia, based on self and proxy ratings, and if these characteristics differ by dementia severity. Cross-sectional study of 525 people with dementia (PwD) and their caregivers (professional or family caregivers). Two different QoL questionnaires, leading to three measures, were used: QoL in Alzheimer's disease scale (QOL-AD), self and proxy-rated, and QoL in late-stage dementia scale (QUALID), proxy-rated. Multivariate linear regression models were tested for each QoL measure and for mild/moderate and severe stages of dementia. Multiple regression analyses showed a significant association between the three QoL measures and depression. Functional ability was significantly associated with QoL when assessed by proxy. Other factors such as education level, leisure activities and frequency of visits were significantly related with QOL-AD by proxy. The associated factors that differed by dementia severity were education level for moderate dementia, and frequency of visits and who answered the questionnaire (professional vs. family member) for severe dementia. QoL was consistently associated with depressive symptoms independently of the measures as well as functional ability and social leisure activities when the QoL questionnaire was rated by proxy. Treating depressive symptoms, increasing social activities and maintaining the functional ability may decrease the deterioration of QoL in institutionalized older adults with dementia.

  20. [Ophthalmological health care of the institutionalized elderly : The OVIS study].

    PubMed

    Fang, P P; Schnetzer, A; Kupitz, D G; Göbel, A P; Kohnen, T; Reinhard, T; Lorenz, B; Hoerauf, H; Wagenfeld, L; Auffarth, G; Schaub, F; Thieme, H; von Livonius, B; Alten, F; Robering, A; Brandl, C; Ziemssen, F; Krummenauer, F; Holz, F G; Finger, R P

    2017-08-22

    Due to demographic change and societal transformation the number of elderly persons living in retirement homes is growing in Germany. Access to health care is more complicated in the setting of nursing homes. Different regional studies suggest unmet ophthalmological health care needs in institutionalized elderly people. This study assessed the current ophthalmological health care structure and supply status in nursing homes in Germany. This prospective, multicenter cross-sectional study was conducted by 14 study centers in Germany. Elderly people living in 32 nursing homes were included after approval by the local institutional review boards. A standardized examination was performed which included a detailed medical and ocular history, refraction, visual acuity testing, tonometry, biomicroscopy and dilated funduscopy. Unmet ophthalmological health care needs were documented and the data were analyzed descriptively and via logistic regression modelling. A total of 600 participants (434 women and 166 men) aged 50-104 years were examined of which 368 (61%) had ophthalmological conditions requiring treatment. The most prevalent findings were cataracts (315; 53%), disorders of the eyelids (127; 21%), dry eye disease (57; 10%) and posterior capsule opacification (43; 7%). In 63 (11%) of the participants glaucoma was suspected and 55 (9%) of the examined population had a known diagnosis of glaucoma, of whom one third was not on any or on insufficient anti-glaucomatous therapy. 236 (39%) showed signs of age-related macular degeneration (AMD). Only 52% of the examined cohort had been examined by an ophthalmologist within the last 5 years and 39% stated that they would currently not be able to consult an ophthalmologist. Reported barriers were mainly transport and lack of support. This study demonstrates considerable unmet ophthalmological health care needs of the institutionalized elderly in Germany. Novel and reformed models of specialist care provision have to be

  1. 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.

  2. 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)

  3. Caring for our own: the role of institutionalized support structures in Native American nursing student success.

    PubMed

    Cech, Erin A; Metz, Anneke M; Babcock, Tracy; Smith, Jessi L

    2011-09-01

    In this project, the authors asked 19 Native American baccalaureate nursing students to discuss their experiences with a formal institutionalized student support program called "Caring for Our Own: A Reservation/University Partnership Program." The authors investigated the importance of different types of support structures within this program, as viewed by Native American nursing students. They distinguished between four institutionalized support structures: tangible, informational, emotional, and belonging. The authors found that students consider tangible support (such as stipends) to be comparatively less important than other types of support, particularly emotional and belonging support. Responses also revealed the importance of a fifth type of institutionalized support-motivational. The authors further discuss how these institutionalized support structures might lead to successful outcomes for Native American nursing students.

  4. 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)

  5. 42 CFR 50.206 - Sterilization of a mentally incompetent individual or of an institutionalized individual.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Federally Assisted Family Planning Projects § 50.206 Sterilization of a mentally incompetent individual or of an institutionalized individual. Programs or projects to which this subpart applies shall...

  6. 42 CFR 50.206 - Sterilization of a mentally incompetent individual or of an institutionalized individual.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Federally Assisted Family Planning Projects § 50.206 Sterilization of a mentally incompetent individual or of an institutionalized individual. Programs or projects to which this subpart applies shall...

  7. Behavioral and Emotional Symptoms of Post-Institutionalized Children in Middle Childhood

    PubMed Central

    Wiik, Kristen L.; Loman, Michelle M.; Van Ryzin, Mark J.; Armstrong, Jeffrey M.; Essex, Marilyn J.; Pollak, Seth D.; Gunnar, Megan R.

    2010-01-01

    Background Experience in institutional/orphanage care has been linked to increased mental health problems. Research suggests children adopted from institutions experience specific difficulties related to inattention/overactivity. Evidence of internalizing and conduct problems relative to non-adopted peers has been found in early childhood and early adolescence, but problems may not differ from other adopted children. This study clarifies the understanding of behavioral and emotional symptoms of post-institutionalized (PI) children during middle childhood. Methods Eight to eleven-year-old PI children (n=68) and two comparison groups, children internationally adopted from foster care (n=74) and non-adopted children (n=76), and their parents completed the MacArthur Health and Behavior Questionnaire related to ADHD, externalizing, and internalizing symptoms. Group means for symptom level and number of children with symptoms above clinical cutoffs were compared. Results PI children displayed an increased level of ADHD symptoms per parent report. PI child and parent report indicated a higher number of PI children above clinical ADHD cutoff. Both groups of internationally adopted (IA) children had higher levels of externalizing symptoms relative to non-adopted children, with parent report indicating higher numbers of IA children above the externalizing clinical threshold. Informants differed in their report of internalizing symptoms. Parents indicated both IA groups displayed increased internalizing symptom levels and greater numbers above clinical threshold; however, children reported this to be true only for the PI group. Conclusions PI children differ from non-adopted peers across symptom domains in middle childhood. Whether these concerns were more broadly associated with international adoption rather than institutional care depended on symptom domain and informant. An understanding of this variability may be beneficial for treatment and intervention. PMID:20649913

  8. [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.

  9. The unwanted child.

    PubMed

    Trias, M

    1982-12-01

    The problem of the unwanted child is a most grievous aspect of the complex of negative factors associated with underdevelopment. Although the problem of the unwanted child exists in industrialized countries as well, the incidence is much higher in the 3rd world. In industrialized nations modern contraceptives are widely available, public awareness of them is high, and legal abortion may be an option in the event of contraceptive failure or nonuse. In Colombia alone, nearly 1 million women are living in immediate danger of an unwanted pregnancy. In the 3rd world as a whole there are an estimated 150 million who do not want another pregnancy but who lack access to contraceptive information and services. Research from a variety of sources suggests that being unwanted and unloved can have a lasting effect on a child's development. Sociological research confirms the need to preserve the bond between mother and child. Studies of adopted children have established a clear relationship between their physical and psychological development and the age at which they were adopted. If this affective bond is not established in the early months of life, the negative effects which result may prove difficult to overcome. Yet, however late it comes, adoption is always preferable to the relative deprivation a child experiences when institutionalized. Studies conducted in Eastern Europe comparing children whose parents had requested an abortion but had not been granted permission with a control group of children revealed a pattern of inferior physical development and social adjustment in the 1st group. Intelligence, in addition to its important genetic foundation, requires physical nurturing and psychological stimulation from the surrounding environment, provided during the final months of pregnancy or the 1st few years of life. Religious doctrine postulates that universal maternal instinct allows the mother to overcome her problems, but this is often not the case. Infanticide dates

  10. Child Abuse

    MedlinePlus

    ... or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...

  11. Institutionalizing the option of dam removal: the New Hampshire initiative.

    PubMed

    Lindloff, S D

    2003-01-01

    For two years, the State of New Hampshire has worked to institutionalize the option of dam removal. The high gradient streams that flow through the granite hills and mountains of this small northeastern state provided ideal conditions for dam construction, particularly during America's Industrial Revolution of the 1800s when mills were constructed throughout the area. With more than 4,800 dams in the state's database, there are many opportunities for the removal of dams that no longer serve a useful purpose, have become a public safety hazard and impact the river environment. Efforts to facilitate removal of dams in New Hampshire include the formation of a River Restoration Task Force and the creation of a dam removal program within the state agency responsible for regulating dams. This has led to the removal of two dams in the past year, with approximately ten additional projects in various stages of planning. A history of this agency-led initiative, as well as a discussion of the program's strengths, challenges and goals for the future are presented.

  12. 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.

  13. 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.

  14. Classifying eating-related problems among institutionalized people with dementia.

    PubMed

    Shinagawa, Shunichiro; Honda, Kazuki; Kashibayashi, Tetsuo; Shigenobu, Kazue; Nakayama, Kazuhiko; Ikeda, Manabu

    2016-04-01

    Various eating-related problems are commonly observed among people with dementia, and these problems place a huge burden on the caregivers. An appropriate classification of these problems is important in order to understand their underlying mechanisms and to develop a therapeutic approach for managing them. The aim of this study was to develop a possible classification of eating-related problems and to reveal the background factors affecting each of these problems across various conditions causing dementia. The participants were 208 institutionalized patients with a diagnosis of dementia. Care staff were asked to report all kinds of eating-related problems that they observed. After the nurses' responses were analyzed, 24 items relating to eating-related problems were extracted. A factor analysis of these 24 items was conducted, followed by a logistic regression analysis to investigate the independent variables that most affected each of the eating-related factors. Four factors were obtained. Factor 1 was overeating, factor 2 was swallowing problems, factor 3 was decrease in appetite, and factor 4 was obsession with food. Each factor was associated with different background variables, including Mini-Mental State Examination scores, Clinical Dementia Ratings, and neuropsychiatric symptoms. This study suggests that eating-related problems are common across conditions causing dementia and should be separately considered in order to understand their underlying mechanisms. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

  15. The fashioned survivor: institutionalized representations of women with breast cancer.

    PubMed

    Ucok, Ozum

    2007-01-01

    This paper explores some institutionalized visual representations of women with breast cancer and examines the rhetoric of the images in the American Cancer Society product catalogue (2000) and the Look Good ... Feel Better pamphlet. I show that these cultural discourses promote notions of appearance that are 'acceptable', 'desirable', and 'beautiful' even when a person is sick. Suggestions and models offered for women when there is a 'problem' with their bodies through the frame of 'helping' them to cope with the effects of cancer--by managing their appearance--provide models for renewed femininity during/after cancer treatment and function to maintain the existing definitions of beauty, femininity, and gendered appearances even in times of crisis. With an emphasis on the 'normalization' of one's changed 'problematic' appearance, the images function to narrow down women's meanings and choices about their bodies and the ways in which they can manage their bodily appearance. Furthermore, this paper points to possible alternative discourses for further exploration. This study aims to enrich our understandings of cultural meanings of illness by making visual materials a significant part of our research.

  16. 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

  17. 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…

  18. INSTITUTIONALIZATION OF THE MENTALLY RETARDED, A SUMMARY AND ANALYSIS OF STATE LAWS GOVERNING ADMISSION TO RESIDENTIAL FACILITIES, AND LEGAL RIGHTS AND PROTECTIONS OF INSTITUTIONALIZED PATIENTS.

    ERIC Educational Resources Information Center

    NEWMAN, ROGER W., ED.

    SUMMARIZING AND ANALYZING LAWS GOVERNING THE ADMISSION OF THE MENTALLY RETARDED TO RESIDENTIAL FACILITIES AND THE LEGAL RIGHTS AND PROTECTIONS OF INSTITUTIONALIZED PATIENTS, THIS REPORT COVERS THE 50 STATES AND THE DISTRICT OF COLUMBIA AT THE END OF 1966. AFTER A CONSIDERATION OF THE METHOD OF REPORTING, TERMINOLOGY, AND DEFINITIONS, 13 TABLES AND…

  19. Circadian rhythms of agitation in institutionalized patients with Alzheimer's disease.

    PubMed

    Martin, J; Marler, M; Shochat, T; Ancoli-Israel, S

    2000-05-01

    Agitation is a common problem in institutionalized patients with Alzheimer's disease (AD). "Sundowning," or agitation that occurs primarily in the evening, is estimated to occur in 10-25% of nursing home patients. The current study examined circadian patterns of agitation in 85 patients with AD living in nursing homes in the San Diego, California, area. Agitation was assessed using behavioral ratings collected every 15 minutes over 3 days, and activity and light exposure data were collected continuously using Actillume recorders. A five-parameter extension of the traditional cosine function was used to describe the circadian rhythms. The mean acrophase for agitation was 14:38, although there was considerable variability in the agitation rhythms displayed by the patients. Agitation rhythms were more robust than activity rhythms. Surprisingly, only 2 patients (2.4%) were "sundowners." In general, patients were exposed to very low levels of illumination, with higher illumination during the night being associated with less robust agitation rhythms with higher rhythm minima (i.e., some agitation present throughout the day and night). Seasonality was examined; however, there were no consistent seasonal patterns found. This is the largest study to date to examine agitation rhythms using behavioral observations over multiple 24 h periods. The results suggest that, although sundowning is uncommon, agitation appears to have a strong circadian component in most patients that is related to light exposure, sleep, and medication use. Further research into the understanding of agitation rhythms is needed to examine the potential effects of interventions targeting sleep and circadian rhythms.

  20. [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.

  1. 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.

  2. Strength training and light physical activity reduces the apnea-hypopnea index in institutionalized older adults.

    PubMed

    Herrick, Jeffrey E; Bliwise, Donald L; Puri, Shipra; Rogers, Sandy; Richards, Kathy C

    2014-01-01

    To determine the effect of 7 weeks of resistance training and walking on the apnea-hypopnea index (AHI) in institutionalized older adults compared with a usual care control group. Secondary analysis of data from a randomized controlled trial. Ten nursing and 3 assisted living facilities in Arkansas. Institutionalized older adults. Exercise group (EG) performed supervised resistance training to arm and hip extensors on 3 days a week with additional 2 days a week of light walking. Usual care group (UC) participated in the usual activities provided within their living facility. Two nights of polysomnography before and following 7-week intervention. Adjusted means in the EG group showed a decrease in AHI from 20.2 (SD ±1.3) at baseline to 16.7 (SD ±0.9) at 7 weeks. Absolute strength gains were not associated with improved AHI. Supervised resistance training and light walking reduced the severity of obstructive sleep apnea in institutionalized older adults.

  3. Prosthetic status and prosthetic needs among institutionalized geriatric individuals in Nashik City, Maharashtra: a descriptive study.

    PubMed

    Chaware, Sachin; Ghodpage, S L; Sinha, Manish; Chauhan, Vishal; Thakare, Vrushali

    2011-05-01

    A descriptive cross-sectional study was conducted among institutionalized geriatric individuals in Nashik city, Maharashtra, to assess their prosthetic status and needs. The oral examination of the study subjects was carried out using Basic Oral Health Surveys, WHO 1997 criteria. A total of 160 individuals were included in the study of which 40 were females and 120 were males. A total of 55 (34.37%) study participants had some prosthesis at the time of examination, whereas 136 (85%) were in need of prosthesis. A total of 49 subjects (30.62%) needed complete dentures in both jaws. Around 26 (16.25%) of the subjects needed combination prosthesis. The study concludes that the prosthetic status of the institutionalized geriatric individuals in Nashik city is poor with a higher unfulfilled prosthetic needs. A systematic strategy planning is needed to address these needs. There exists a higher unfulfilled prosthodontic need among institutionalized geriatric individuals in Nashik city.

  4. 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?…

  5. 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…

  6. 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

  7. 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

    ... institutionalized individuals in SSI States: Application of patient income to the cost of care. 435.725 Section 435... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA... § 435.725 Post-eligibility treatment of income of institutionalized individuals in SSI States...

  8. Individual correlates of autonomy in activities of daily living of institutionalized elderly individuals: an exploratory study in a holistic perspective.

    PubMed

    Candela, Filippo; Zucchetti, Giulia; Magistro, Daniele

    2013-01-01

    This study aimed at identifying the individual correlates of autonomy in activities of daily living (ADL) of 40 institutionalized elderly individuals. Results showed that balance skill and perception of physical functioning were significantly associated with ADL. Interventions on the physical functioning, both perceived and real, might have positive influence on the autonomy of institutionalized elderly individuals.

  9. An Examination of Factors that Affect the Institutionalization of Service-Learning at American Institutions of Higher Education

    ERIC Educational Resources Information Center

    Vincent, Alisha

    2010-01-01

    Service-Learning as a scholarly, academic activity has been gaining momentum. However, colleges and universities often have difficulty institutionalizing service-learning as a course-based, credit-bearing, form of scholarship that is equal in merit to research or teaching. This study examines how the degree of institutionalization at Campus…

  10. An Examination of Factors that Affect the Institutionalization of Service-Learning at American Institutions of Higher Education

    ERIC Educational Resources Information Center

    Vincent, Alisha

    2010-01-01

    Service-Learning as a scholarly, academic activity has been gaining momentum. However, colleges and universities often have difficulty institutionalizing service-learning as a course-based, credit-bearing, form of scholarship that is equal in merit to research or teaching. This study examines how the degree of institutionalization at Campus…

  11. The Effects of Foster Care Intervention on Socially Deprived Institutionalized Children's Attention and Positive Affect: Results from the BEIP Study

    ERIC Educational Resources Information Center

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

    2009-01-01

    Background: We examined the effects of a foster care intervention on attention and emotion expression in socially deprived children in Romanian institutions. Methods: Institutionalized children were randomized to enter foster care or to remain under institutional care. Subsequently, the institutionalized and foster care groups, along with a…

  12. The Effects of Foster Care Intervention on Socially Deprived Institutionalized Children's Attention and Positive Affect: Results from the BEIP Study

    ERIC Educational Resources Information Center

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

    2009-01-01

    Background: We examined the effects of a foster care intervention on attention and emotion expression in socially deprived children in Romanian institutions. Methods: Institutionalized children were randomized to enter foster care or to remain under institutional care. Subsequently, the institutionalized and foster care groups, along with a…

  13. Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement.

    PubMed

    Tieland, Michael; Borgonjen-Van den Berg, Karin J; van Loon, Luc J C; de Groot, Lisette C P G M

    2012-03-01

    Adequate dietary protein intake is required to postpone and treat sarcopenia in elderly people. Insight into dietary protein intake in this heterogeneous population segment is needed to locate dietary inadequacies and to identify target populations and feeding strategies for dietary interventions. Therefore, we assessed dietary protein intake, distribution of protein intake throughout the day, and the use of protein-containing food sources in community-dwelling, frail, and institutionalized elderly people in the Netherlands. Secondary analyses were carried out using dietary data collected from studies among community-dwelling, frail, and institutionalized elderly people to evaluate protein intake characteristics. Dietary protein intake averaged 1.1 ± 0.3 g/kg-bw/day in community-dwelling, 1.0 ± 0.3 g/kg-bw/day in frail, and 0.8 ± 0.3 g/kg-bw/day in institutionalized elderly men. Similar protein intakes were found in women. Ten percent of the community-dwelling and frail elderly and 35% of the institutionalized elderly people showed a protein intake below the estimated average requirement (0.7 g/kg-bw/day). Protein intake was particularly low at breakfast in community-dwelling (10 ± 10 g), frail (8 ± 5 g), and institutionalized elderly people (12 ± 6 g) with bread and dairy products as predominant protein sources. Whereas daily protein intake is generally well above the recommended dietary allowance in community-dwelling and frail elderly people, a significant proportion of institutionalized elderly showed an intake below the current protein requirement, making them an important target population for dietary interventions. Particularly at breakfast, there is scope for improving protein intake.

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

    PubMed Central

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

    2013-01-01

    Background 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. Literature review 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. Program description 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. Conclusion 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. PMID:23977644

  15. 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.

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

    DTIC Science & Technology

    1980-05-01

    1 0 Several studies and reports cite various rea - sons for rural borrowing and present different levels or percentages for each category of borrowing...AO-AO83 956 ARMY MILITARY PERSONNEL CENTER ALEXANDRIA VA F/G 2/2 INSTITUTIONALIZATION OF RURAL CREDIT IN INDIA: A FOCUS ON THE C--ETC(U) MAY 80 R K...PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS. m INSTITUTIONALIZATION OF RURAL CREDIT IN INDIA: A FOCUS ON THE COOPERATIVE

  17. Falls in institutionalized older adults: risks, consequences and antecedents.

    PubMed

    Araújo, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias Dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

    2017-01-01

    To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey), Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0. A total of 66.7% (30) falls occurred, 20% (9) of them in the external area, with 66.7% (30) of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5). The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05). It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls. Analisar a ocorrência de quedas em idosos institucionalizados quanto aos riscos, consequências e antecedentes. Estudo transversal, realizado com 45 idosos em Instituições de Longa Permanência para Idosos em João Pessoa/PB, Brasil, em junho e julho de 2016. Aplicou-se questionário sociodemográfico e Escala de Equilíbrio de Berg classificando risco de quedas quando escore inferior a 45. Realizou-se estatística descritiva e testes: t independente, Anova (Tukey), Qui-quadrado, Mann Whitney. Considerado significativamente estatístico p < 0,05 e processados no SPSS versão 19.0. As quedas ocorreram em 66,7% (30), sendo 20% (9) na área externa, 66,7% (30) com doença prévia hipertensão e como consequência destacou-se fratura com 11,2% (5). A Escala de Berg avaliou pontuações diferentes (p < 0,05) quando comparadas às quedas sofridas pelos idosos, e as doenças pr

  18. Predictors of Institutionalization of Dementia Patients in Mild and Moderate Stages: A 4-Year Prospective Analysis

    PubMed Central

    Eska, Kathrin; Graessel, Elmar; Donath, Carolin; Schwarzkopf, Larissa; Lauterberg, Joerg; Holle, Rolf

    2013-01-01

    Background Institutionalization is the most important milestone in the care of dementia patients. This study was aimed at identifying relevant predictors of institutionalization in a broad empirical context and interpreting them on the basis of the predictor model proposed by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Methods At the start of this study, 357 patients with mild to moderate dementia were examined by their general practitioners, and a telephone interview was conducted with their caregivers. Four years later, the outcomes ‘institutionalization’ and ‘death’ were determined from health insurance data. Forty-one variables were examined for their predictive influence by univariate and multivariate Cox regression. Results The risk of institutionalization increased significantly (p ≤ 0.05) with older ages of patients [hazard ratio (HR) = 1.05] and caregivers (HR = 1.03), a higher educational level of the caregiver (HR = 1.83), greater use of community health services (HR = 1.59), greater caregiver burden (HR = 1.02), and when the caregiver and patient lived apart (HR = 1.97). Conclusion The results show that there is a multifactorial influence on institutionalization of dementia patients by sociodemographic, health-related, and psychological aspects as well as the care situation, thus validating the predictor model by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Caregiver burden was found to be the strongest predictor accessible to interventions. PMID:24348504

  19. Institutionalizing Support Services for Undocumented Students at Four-Year Colleges and Universities

    ERIC Educational Resources Information Center

    Southern, Kyle G.

    2016-01-01

    This study classifies institutional practices supporting undocumented students' educational success across a three-phase institutionalization model. Data are drawn from interviews with higher education professionals in California. The roles of undocumented student ally educators are also examined as institutional agents supporting this student…

  20. 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…

  1. 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…

  2. 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…

  3. Political Parties and the Institutionalization of Education: A Comparative Analysis of Party Manifestos

    ERIC Educational Resources Information Center

    Jakobi, Anja P.

    2011-01-01

    Education has been featured prominently in recent election campaigns in different countries. This article explains this observation by the idea of a world culture and the global institutionalization of education. It compares party manifestors of 25 OECD countries from 1946 onward, analyzing how education developed in election campaigns over time…

  4. 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…

  5. An exercise program to prevent falls in institutionalized elderly with cognitive deficits: a crossover pilot study.

    PubMed

    DeSure, Ariell R; Peterson, Karen; Gianan, Faith V; Pang, Lorrin

    2013-11-01

    Falls are the leading cause of injury among older adults in the United States, with the institutionalized elderly at elevated risk for injury and death. Physical weakness and mental frailty, prevalent in institutionalized elderly, are major risk factors for falls. The purpose of this study was to evaluate a program that addresses both the physical and mental aspects of exercise to reduce falls in institutionalized elderly. Twenty-seven volunteer subjects residing in an assisted living facility participated in the 24 week randomized crossover study. After demographic, fall history, and mental status examinations, subjects were randomly assigned first to ten weeks of either an exercise class or a control group, followed by a four week "washout period" of no activity, then cross assigned to ten weeks as either a control group or exercise class, respectively. Falls as well as mental status changes were monitored during the study. After adjusting for differences in baseline risk between the control and treatment groups, and for potential residual effects of the treatment during the crossover phase, a statistically significant (P = .025) reduction in falls was found during treatment compared to the control periods. No change in mental status was seen. This small, pilot study shows that exercise programs, which emphasize mental strengthening as well as physical fitness, have the potential to reduce falls among mentally impaired, institutionalized seniors.

  6. 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…

  7. Variation in neural development as a result of exposure to institutionalization early in childhood

    PubMed Central

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

    2012-01-01

    We used structural MRI and EEG to examine brain structure and function in typically developing children in Romania (n = 20), children exposed to institutional rearing (n = 29), and children previously exposed to institutional rearing but then randomized to a high-quality foster care intervention (n = 25). In so doing, we provide a unique evaluation of whether placement in an improved environment mitigates the effects of institutional rearing on neural structure, using data from the only existing randomized controlled trial of foster care for institutionalized children. Children enrolled in the Bucharest Early Intervention Project underwent a T1-weighted MRI protocol. Children with histories of institutional rearing had significantly smaller cortical gray matter volume than never-institutionalized children. Cortical white matter was no different for children placed in foster care than never-institutionalized children but was significantly smaller for children not randomized to foster care. We were also able to explain previously reported reductions in EEG α-power among institutionally reared children compared with children raised in families using these MRI data. As hypothesized, the association between institutionalization and EEG α-power was partially mediated by cortical white matter volume for children not randomized to foster care. The increase in white matter among children randomized to an improved rearing environment relative to children who remained in institutional care suggests the potential for developmental “catch up” in white matter growth, even following extreme environmental deprivation. PMID:22826224

  8. The Institutionalization of Scientific Information: A Scientometric Model (ISI-S Model).

    ERIC Educational Resources Information Center

    Vinkler, Peter

    2002-01-01

    Introduces a scientometric model (ISI-S model) for describing the institutionalization process of scientific information. ISI-S describes the information and knowledge systems of scientific publications as a global network of interdependent information and knowledge clusters that are dynamically changing by their content and size. (Author/LRW)

  9. 42 CFR 441.102 - Plan of care for institutionalized recipients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Plan of care for institutionalized recipients. 441.102 Section 441.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... SPECIFIC SERVICES Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases §...

  10. Quality of Life, Family Support, and Comorbidities in Institutionalized Elders With and Without Symptoms of Depression.

    PubMed

    de Araújo, Aurigena Antunes; Rebouças Barbosa, Rosa Angélica Silveira; de Menezes, Marília Stefani Souza; de Medeiros, Ingrid Iana Fernandes; de Araújo, Raimundo Fernandes; de Medeiros, Caroline Addison Carvalho Xavier

    2016-06-01

    The institutionalization of elders can decrease the health status and quality of life in this population. The aim of this study was to analyze the socio-demographic, quality of life, family support, and comorbidities variables in institutionalized elders with and without symptoms of depression. This was a cross-sectional study in institutions for long permanence for the elderly in the State of Rio Grande do Norte, Brazil. Two institutionalized elderly groups were compared (138 elders: 69 with and 69 without depressive symptoms). The instruments used were: mini-mental state examination, geriatric depression scale in the reduced version, socio-demographic questionnaire, quality of life (World Health Organization Quality of Life abbreviated-WHOQOL-bref), and inventory of perception of family support. Elders with depressive symptoms had inferior quality of life than those without depressive symptoms. Other factors that negatively influenced the quality of life in this population include: low economic conditions, occurrence of comorbidities, and deficient family assistance. These results have important implications in the decision making process with regard to strategies for improving the health status of institutionalized elders.

  11. Activity Level, Organization, and Social-Emotional Behaviors in Post-Institutionalized Children.

    ERIC Educational Resources Information Center

    Kadlec, Mary Beth; Cermak, Sharon A.

    2002-01-01

    Compared activity and behaviors of 36- to 82-month-olds adopted from Romanian orphanages and with varying lengths of institutionalization (more than 6 months or less than 2 months) with those of age- and gender-matched American-born control groups. Found that each Romanian group exhibited more problems in activity level, organization, and…

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

    PubMed

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

    2010-03-01

    The current study examined the effects of institutionalization on the discrimination of facial expressions of emotion in 3 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 abandoned at birth who were randomly assigned to high-quality foster care following a baseline assessment. A third group consisted of never-institutionalized children who were reared by their biological parents. All children were familiarized to happy, sad, fearful, and neutral facial expressions and tested on their ability to discriminate familiar versus novel facial expressions. Contrary to our prediction, all three groups of children were equally able to discriminate among the different expressions. Furthermore, in contrast to findings at 13-30 months of age, these same children showed familiarity rather than novelty preferences toward different expressions. There were also asymmetries in children's discrimination of facial expressions depending on which facial expression served as the familiar versus the novel stimulus. Collectively, early institutionalization appears not to impact the development of the ability to discriminate facial expressions of emotion, at least when preferential looking serves as the dependent measure. These findings are discussed in the context of the myriad domains that are affected by early institutionalization.

  13. 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…

  14. Rett Syndrome Symptomatology of Institutionalized Adults with Mental Retardation: Comparison of Males and Females.

    ERIC Educational Resources Information Center

    Burd, Larry; And Others

    1991-01-01

    The study of 297 institutionalized adults with mental retardation found no symptom of Rett syndrome occurred more frequently in males than in females and no single cluster of symptoms appeared to differentiate males from females. Only females were found to meet the necessary criteria for diagnosis of Rett syndrome. (Author/DB)

  15. 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…

  16. Activities of oral antibiotics on Providencia strains isolated from institutionalized elderly patients with urinary tract infections.

    PubMed

    Cornaglia, G; Frugoni, S; Mazzariol, A; Piacentini, E; Berlusconi, A; Fontana, R

    1995-12-01

    More than 250 Providencia strains isolated from the urine of institutionalized elderly patients were tested against cefaclor, cefuroxime, cefetamet, cefpodoxime, ciprofloxacin, and amoxicillin-clavulanic acid. Our results confirm the strong activities of expanded-spectrum oral cephalosporins against Providencia isolates, f1p4ell as the marked differences in susceptibilities among accurately identified Providencia species.

  17. Activities of oral antibiotics on Providencia strains isolated from institutionalized elderly patients with urinary tract infections.

    PubMed Central

    Cornaglia, G; Frugoni, S; Mazzariol, A; Piacentini, E; Berlusconi, A; Fontana, R

    1995-01-01

    More than 250 Providencia strains isolated from the urine of institutionalized elderly patients were tested against cefaclor, cefuroxime, cefetamet, cefpodoxime, ciprofloxacin, and amoxicillin-clavulanic acid. Our results confirm the strong activities of expanded-spectrum oral cephalosporins against Providencia isolates, f1p4ell as the marked differences in susceptibilities among accurately identified Providencia species. PMID:8593030

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

    PubMed

    Kwon, Suhye; Tae, Young Sook

    2014-02-01

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

  19. 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…

  20. Political Parties and the Institutionalization of Education: A Comparative Analysis of Party Manifestos

    ERIC Educational Resources Information Center

    Jakobi, Anja P.

    2011-01-01

    Education has been featured prominently in recent election campaigns in different countries. This article explains this observation by the idea of a world culture and the global institutionalization of education. It compares party manifestors of 25 OECD countries from 1946 onward, analyzing how education developed in election campaigns over time…

  1. 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…

  2. Institutionalizing Support Services for Undocumented Students at Four-Year Colleges and Universities

    ERIC Educational Resources Information Center

    Southern, Kyle G.

    2016-01-01

    This study classifies institutional practices supporting undocumented students' educational success across a three-phase institutionalization model. Data are drawn from interviews with higher education professionals in California. The roles of undocumented student ally educators are also examined as institutional agents supporting this student…

  3. 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…

  4. An Exercise Program to Prevent Falls in Institutionalized Elderly with Cognitive Deficits: A Crossover Pilot Study

    PubMed Central

    Peterson, Karen; Gianan, Faith V; Pang, Lorrin

    2013-01-01

    Falls are the leading cause of injury among older adults in the United States, with the institutionalized elderly at elevated risk for injury and death. Physical weakness and mental frailty, prevalent in institutionalized elderly, are major risk factors for falls. The purpose of this study was to evaluate a program that addresses both the physical and mental aspects of exercise to reduce falls in institutionalized elderly. Twenty-seven volunteer subjects residing in an assisted living facility participated in the 24 week randomized crossover study. After demographic, fall history, and mental status examinations, subjects were randomly assigned first to ten weeks of either an exercise class or a control group, followed by a four week “washout period” of no activity, then cross assigned to ten weeks as either a control group or exercise class, respectively. Falls as well as mental status changes were monitored during the study. After adjusting for differences in baseline risk between the control and treatment groups, and for potential residual effects of the treatment during the crossover phase, a statistically significant (P = .025) reduction in falls was found during treatment compared to the control periods. No change in mental status was seen. This small, pilot study shows that exercise programs, which emphasize mental strengthening as well as physical fitness, have the potential to reduce falls among mentally impaired, institutionalized seniors. PMID:24251085

  5. 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…

  6. Prospective Study of the Prevalence of Alzheimer-Type Dementia in Institutionalized Individuals with Down Syndrome.

    ERIC Educational Resources Information Center

    Visser, F. E.; And Others

    1997-01-01

    Institutionalized patients with Down syndrome (N=307) were monitored for 5 to 10 years to determine prevalence of Alzheimer-type dementia. Prevalence increased from 11% between ages 40 and 49 to 77% between 60 and 69. All patients 70 and over had dementia. Mean age of onset of dementia was 56 years. Neuropathological findings were consistent with…

  7. Inequality in the characteristics of the institutionalized elderly in the city of Natal, Brazil.

    PubMed

    Pinheiro, Natália Cristina Garcia; Holanda, Vinicius Carlos Duarte; Melo, Laércio Almeida de; Medeiros, Annie Karoline Bezerra de; Lima, Kenio Costa de

    2016-11-01

    The aim of this study was to describe the differences in the profile of elderly residents in non-profit and for-profit Long-Term Residential Institutions for the Elderly (ILPI). We visited 12 ILPIs in the city of Natal, Rio Grande do Norte. Six of them were non-profits housing 260 elderly, and six were for-profit institutions, housing 127 elderly. The unequal characteristics of the elderly in these facilities are based on socioeconomic data and the reason for institutionalization. The data was submitted to Chi-squared or Student's t, with a significance level of 5%. Illiterate, single, black or brown, individuals with no retirement/pension or healthcare plan, no children and no visitors who purchase something outside the institution with their own money are associated with non-profit ILPIs. When analyzing the reasons for institutionalization, family conflict, abandonment and being homeless were associated with the elderly institutionalized in non-profit ILPIs. The main reason for the elderly institutionalized in for-profit ILPIs was "being ill". The conditions of the elderly in non-profit ILPIs were poorer, reflecting the social inequality these subjects experienced throughout their lifetime.

  8. 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…

  9. Factors Related to the Self-Concept of Institutionalized, White, Male, Adolescent Drug Abusers.

    ERIC Educational Resources Information Center

    Reardon, Barbara; Griffing, Penelope

    1983-01-01

    Examined factors related to the self-concept of institutionalized male drug abusers (N=140). The Tennessee Self Concept Scale, a family questionnaire, and an interview were administered. Results yielded several predictors of self-concept, including parent-adolescent relationship, number of prior status offenses, and preference for nondepressant…

  10. Institutionalizing the School-to-Work Transition. [Final Report, Part II].

    ERIC Educational Resources Information Center

    Smith, R. C.

    This study argues that school-to-work programs should be institutionalized in the schools to provide assistance to students without vocational education, who are not headed for college. Such students, it is asserted, are often disadvantaged, minority, and otherwise underserved youth. The report examines the issue of "school-to-work"…

  11. 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…

  12. 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…

  13. An innovative strategy for institutionalizing a community-based tobacco program.

    PubMed

    Freestone, J; Linzer, J; McKetney, C; Basnett, D; Prendergast, E

    2001-01-01

    When Proposition 99 tobacco control program funding to state health departments was reduced in 1993, Contra Costa County developed a strategy to institutionalize its tobacco control programs in other organizations. This effort identified seven funding priorities and three stable, experienced community organizations "adopted" these priorities.

  14. The Institutionalization of Scientific Information: A Scientometric Model (ISI-S Model).

    ERIC Educational Resources Information Center

    Vinkler, Peter

    2002-01-01

    Introduces a scientometric model (ISI-S model) for describing the institutionalization process of scientific information. ISI-S describes the information and knowledge systems of scientific publications as a global network of interdependent information and knowledge clusters that are dynamically changing by their content and size. (Author/LRW)

  15. A Diffusion of Innovations Approach to Gerontological Curriculum Enrichment: Institutionalizing and Sustaining Curricular Change

    ERIC Educational Resources Information Center

    Dorfman, Lorraine T.; Murty, Susan A.

    2005-01-01

    This article describes a gerontological enrichment model for institutionalizing and sustaining curricular change utilizing Rogers' (1995, 2003) diffusion of innovations approach to organizational change. The goal of the project, funded by the John A. Hartford Foundation, is to transform the social work curriculum at a major state university so…

  16. 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)

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  18. 42 CFR 50.206 - Sterilization of a mentally incompetent individual or of an institutionalized individual.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Sterilization of a mentally incompetent individual or of an institutionalized individual. 50.206 Section 50.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in...

  19. 42 CFR 50.206 - Sterilization of a mentally incompetent individual or of an institutionalized individual.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Sterilization of a mentally incompetent individual or of an institutionalized individual. 50.206 Section 50.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in...

  20. 42 CFR 50.206 - Sterilization of a mentally incompetent individual or of an institutionalized individual.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Sterilization of a mentally incompetent individual or of an institutionalized individual. 50.206 Section 50.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in...

  1. 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…

  2. Development and Evaluation of a Social Skills Training Program for Physically Aggressive Institutionalized Elderly.

    ERIC Educational Resources Information Center

    Vaccaro, Frank J.

    This study replicated a social skills training program previously designed to eliminate verbally aggressive behavior in six institutionalized elderly, by substituting physical acts of aggression for verbal ones. The treatment package consisted of instructions, modeling, role playing, and feedback. Dependent measures included confirmed incidents of…

  3. 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…

  4. 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.

  5. De-Institutionalizing for the Blind: Life Learning Center for the Blind Retarded, Boston

    ERIC Educational Resources Information Center

    Stephens, Suzanne

    1978-01-01

    A projected learning center in an urban area will be a transitional home, part of an evolving effort to "de-institutionalize" the living environment of the blind and train them to become self-sufficient enough to lead normal lives. (Author/MLF)

  6. Waves of Educational Model Production: The Case of Higher Education Institutionalization in Malawi, 1964-2004

    ERIC Educational Resources Information Center

    Holland, Dana G.

    2010-01-01

    The domain of national education systems has been identified as one of the richest areas for exploring questions about globalization, particularly the degree of worldwide convergence in educational institutions. This article addresses questions about the transnational production and institutionalization of educational models through a historical…

  7. Development of Level of Institutionalization Scales for Health Promotion Programs [and] Commentary.

    ERIC Educational Resources Information Center

    Goodman, Robert M.; And Others

    1993-01-01

    Responses from 322 (71%) health promotion program administrators tested a level of institutionalization scale. Results support four factors for routinization of program in each subsystem (production, maintenance, support, management) and four on degree of program saturation in subsystems. Routinization correlated more highly with program…

  8. 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…

  9. INSTITUTIONALIZING SAFEGUARDS-BY-DESIGN: HIGH-LEVEL FRAMEWORK

    SciTech Connect

    Trond Bjornard PhD; Joseph Alexander; Robert Bean; Brian Castle; Scott DeMuth, Ph.D.; Phillip Durst; Michael Ehinger; Prof. Michael Golay, Ph.D.; Kevin Hase, Ph.D.; David J. Hebditch, DPhil; John Hockert, Ph.D.; Bruce Meppen; James Morgan; Jerry Phillips, Ph.D., PE

    2009-02-01

    participation in facility design options analysis in the conceptual design phase to enhance intrinsic features, among others. The SBD process is unlikely to be broadly applied in the absence of formal requirements to do so, or compelling evidence of its value. Neither exists today. A formal instrument to require the application of SBD is needed and would vary according to both the national and regulatory environment. Several possible approaches to implementation of the requirements within the DOE framework are explored in this report. Finally, there are numerous barriers to the implementation of SBD, including the lack of a strong safeguards culture, intellectual property concerns, the sensitive nature of safeguards information, and the potentially divergent or conflicting interests of participants in the process. In terms of SBD implementation in the United States, there are no commercial nuclear facilities that are under IAEA safeguards. Efforts to institutionalize SBD must address these issues. Specific work in FY09 could focus on the following: finalizing the proposed SBD process for use by DOE and performing a pilot application on a DOE project in the planning phase; developing regulatory options for mandating SBD; further development of safeguards-related design guidance, principles and requirements; development of a specific SBD process tailored to the NRC environment; and development of an engagement strategy for the IAEA and other international partners.

  10. Resistance training does not alter same-day sleep architecture in institutionalized older adults.

    PubMed

    Herrick, Jeffrey E; Puri, Shipra; Richards, Kathy C

    2017-08-10

    Sleep disturbance is a common symptom in institutionalized older adults that reduces their quality of life and may contribute to progression of cognitive impairment. While we found that a 7-week combination of resistance training, walking and social activity significantly improved sleep in institutionalized older adults compared with a usual care control group, no one to our knowledge has determined the acute effects of resistance training on same-day sleep in this population. Given the effort required to promote exercise adherence in institutionalized older adults and to obtain a positive training effect, understanding of the acute effects of resistance training on same-day sleep architecture should be elucidated, especially with respect to unintended consequences. This secondary data analysis assessed if resistance training altered the same-day sleep architecture in institutionalized older adults. Forty-three participants (age 81.5 ± 8.1 years, male = 17, female = 26) had two attended overnight polysomnography tests in their rooms for sleep architecture analysis; one polysomnography with same-day resistance training, one without any resistance training. Resistance training consisted of chest and leg press exercises (three sets, eight repetitions, 80% predicted one-repetition maximum). There were no significant changes in sleep architecture between either polysomnography nights; sleep efficiency (P = 0.71), time in non-rapid eye movement stages (P = 0.50), time in rapid eye movement stages (P = 0.14), time awake (P = 0.56), time until sleep onset (P = 0.47), total sleep stage shifts (P = 0.65) or rapid eye movement sleep stage latency (P = 0.57). Our results show no acute same-day effects of resistance training on sleep architecture in institutionalized older adults. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT00888706. © 2017 European Sleep Research Society.

  11. [Child and juvenile delinquency and legal system in the province of Buenos Aires, Argentina].

    PubMed

    Folino, Jorge O; Domenech, Ernesto; Gutiérrez, María A; Lescano, María J

    2009-01-01

    Taking into account the social relevance of child and juvenile delinquency, the little availability of local scientific evidence concerning the subject and the moment of change in the system, this article is intended to describe the criminal system of responsibility in the Province of Buenos Aires, Argentina. Psychiatric and psychological aspects of youth involved in crimes and of those who are institutionalized in the Legal Department of La Plata shall be explored.

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

    PubMed Central

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

    2016-01-01

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

  13. 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

  14. Quality improvement practices to institutionalize supply chain best practices for iCCM: Evidence from Rwanda and Malawi.

    PubMed

    Chandani, Yasmin; Duffy, Malia; Lamphere, Barbara; Noel, Megan; Heaton, Alexis; Andersson, Sarah

    2016-07-28

    Supply chain bottlenecks that prevent community health workers (CHWs) from accessing essential medicines significantly increase under-5 child mortality, particularly in poor and rural areas. Using implementation research, interventions aimed at improving supply chain practices and access to medicines were tested in Malawi and Rwanda. These interventions included simple demand-based resupply procedures, using mobile technology and traditional methods for communication, and multilevel, performance-driven quality improvement (QI) teams. Mixed-method evaluations were conducted at baseline (2010), midline (2013), and endline (2014). Baseline assessments identified common bottlenecks and established performance levels. Midline assessments identified which intervention package had the greatest impact. Endline surveys measured the progress of scale-up and institutionalization of each innovation. In both Rwanda and Malawi CHWs, health center staff, and district managers all cited many benefits of the establishment of resupply procedures and QI teams: such as providing structure and processes, a means to analyze and discuss problems and enhance collaboration between staff. Implementing simple, streamlined, demand-based resupply procedures formed the basis for informed and regular resupply, and increased the visibility of appropriate and timely community logistics data. QI teams played a critical role in reinforcing resupply procedures and routinely unlocking the bottlenecks that prevent the continuous flow of critical health products. While simple, streamlined, demand-based resupply procedures provide the basis for regular, functional, and efficient resupply of CHWs, the procedures alone are not sufficient to create consistent change in product availability. Supporting these procedures with multilevel QI teams reinforces the correct and consistent use of resupply procedures. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. [Factors associated with institutionalization: perspectives for children who suffered domestic violence].

    PubMed

    Gabatz, Ruth Irmgard Bärtschi; Padoin, Stela Maris de Mello; Neves, Eliane Tatsch; Terra, Marlene Gomes

    2010-12-01

    This is a qualitative study aimed to understand the factors associated with institutionalization of children who suffered domestic violence. It was carried out in two institutions for shelter in Southern Brazil in June and July, 2008. The creative sensitive method was chosen for data production and involved two dynamics of creativity and sensibility: playing on stage and body knowledge with four school-age children. The data were submitted to French discourse analysis. The results pointed out as factors associated to institutionalization: mother's mental disorders and alcohol abuse and aggression. We believe that the reconnaissance of the factors associated with domestic violence enables a preventive work, minimizing its deleterious effects to family as a whole. In this way, caring must be directed not only to the children whom suffered domestic violence but also to their families involving victims and aggressors.

  16. The Lived Environment Life Quality Model for institutionalized people with dementia.

    PubMed

    Wood, Wendy; Lampe, Jenna L; Logan, Christina A; Metcalfe, Amy R; Hoesly, Beth E

    2017-02-01

    There is a need for a conceptual practice model that explicates ecological complexities involved in using occupation to optimize the quality of life of institutionalized people with dementia. This study aimed to prepare the Lived Environment Life Quality Model, a dementia-specific conceptual practice model of occupational therapy in institutional facilities, for publication and application to practice. Interviews and focus groups with six expert occupational therapists were subjected to qualitative content analysis to confirm, disconfirm, and further develop the model. The model's lived-environment domain as the focus of assessment and intervention was extensively confirmed, and its quality-of-life domain as the focus of intervention goals and outcomes was both confirmed and further developed. As confirmed in this study, the Lived Environment Life Quality Model is a client-centred, ecologically valid, and occupation-focused guide to optimizing quality of life of institutionalized adults with dementia in present moments and progressively over time.

  17. 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.

  18. Religiosity and Subjective Well-Being amongst Institutionalized Elderly in Pakistan.

    PubMed

    Gull, Fouzia; Dawood, Saima

    2013-01-01

    In Pakistan, the issue of institutionalized elderly is a neglected area and little is known about their subjective conditions. The present study was conducted in 2012 which examined the relationship between religiosity and subjective well being amongst institutionalized elderly people. Data was collected from 100 adults above the age of 60 years in Lahore,Pakistan, through purposive sampling strategy. Religiosity was measured through Religiosity Index, while Trait Well Being Inventory was used to assess subjective well being. Pearson product moment correlation coefficient and regression analysis were used for the analysis of the data, which revealed that religiosity has a significant positive relationship with life satisfaction. However, no association was found between religiosity and mood level. Moreover, regression analysis indicated that religiosity positively predicted life satisfaction among elderly. The current research would create awareness and urge the policy makers to look into this social issue and provide better long term care to the residents of old homes.

  19. Health-related quality of life in Brazilian community-dwelling and institutionalized elderly: Comparison between genders.

    PubMed

    Cucato, Gabriel Grizzo; Ritti-Dias, Raphael Mendes; Cendoroglo, Maysa Seabra; Carvalho, José Maria Maluf DE; Nasri, Fábio; Costa, Maria Luiza Monteiro; Matos, Luciana Diniz Nagem Janot DE; Franco, Fábio Gazelato DE Mello

    2016-12-01

    To compare the health-related quality of life (HRQL) indicators between institutionalized and community-dwelling elderly men and women. This was a cross-sectional study with a sample of 496 elderly men and women, surveyed by researchers at a private hospital that attends institutionalized and community-dwelling elderly. HRQL (World Health Organization Quality of Life), daily living activities (Katz questionnaire), and instrumental daily living activities (Lawton questionnaire), mini-mental state examination, handgrip strength test, and function capacity (timed up and go test) were obtained. Institutionalized men presented higher scores in physical and psychological domains of HRQL compared to elderly men living alone (p<0.05). Among women, the scores in all domains (physical, psychological, relationship, and environment) were similar between institutionalized and community-dwelling individuals. Institutionalized elderly men reported better scores in physical and psychological domains of HRQL compared to their community-dwelling pairs, while both institutionalized and community-dwelling elderly women presented similar HRQL.

  20. Older Asian Americans and Pacific Islanders with Activities of Daily Living (ADL) limitations: immigration and other factors associated with institutionalization.

    PubMed

    Fuller-Thomson, Esme; Chi, Monica

    2012-09-07

    This study determined the national prevalence and profile of Asian Americans with Activities of Daily Living (ADL) limitations and identified factors associated with institutionalization. Data were obtained from 2006 American Community Survey, which replaced the long-form of the US Census. The data are nationally representative of both institutionalized and community-dwelling older adults. Respondents were Vietnamese (n = 203), Korean (n = 131), Japanese (n = 193), Filipino (n = 309), Asian Indian (n = 169), Chinese (n = 404), Hawaiian/Pacific Islander (n = 54), and non-Hispanic whites (n = 55,040) aged 55 and over who all had ADL limitations. The prevalence of institutionalized among those with ADL limitations varies substantially from 4.7% of Asian Indians to 18.8% of Korean Americans with ADL limitations. Every AAPI group had a lower prevalence of institutionalization than disabled Non-Hispanic whites older adults (23.8%) (p < 0.001). After adjustment for socio-demographic characteristics, Asian Indians, Vietnamese, Japanese, Filipino, and Chinese had significantly lower odds of institutionalization than non-Hispanic whites (OR = 0.29, 0.31, 0.58, 0.51, 0.70, respectively). When the sample was restricted to AAPIs, the odds of institutionalization were higher among those who were older, unmarried, cognitively impaired and those who spoke English at home. This variation suggests that aggregating data across the AAPI groups obscures meaningful differences among these subpopulations and substantial inter-group differences may have important implications in the long-term care setting.

  1. Digestive symptoms in older adults: prevalence and associations with institutionalization and mortality.

    PubMed

    Alameel, Turki; Basheikh, Mohammed; Andrew, Melissa K

    2012-12-01

    Digestive symptoms are common in adults. However, little is known about their prevalence in older adults and the association of digestive symptoms with institutionalization and mortality in community-dwelling older adults. To determine the prevalence of digestive symptoms among older adults in Canada and whether they are associated with increased risk of institutionalization and mortality, independent of the effect of potential confounders. The present study was a secondary analysis of data collected from community-dwelling participants 65 years of age and older in the Canadian Study of Health and Aging. Measures incuded age, sex, presence of digestive symptoms, cognition, impairment in activities of daily living (ADL) and self-reported health. Outcome measures included death or institutionalization over the 10 years of follow-up. Digestive symptoms were found in 2288 (25.6%) of the 8949 subjects. Those with digestive symptoms were older, with a mean difference in age of six months (P=0.007). Digestive symptoms were more common among women (28.4%) than men (20.3%), among individuals with poor self-reported health and those with an increased number of impairments in their ADLs (P<0.001). The presence of digestive symptoms was associated with higher mortality (HR 1.15 [95% CI 1.05 to 1.25] adjusted for age, sex, cognitive function and ADL impairment); however, this association was not statistically significant after adjusting for self-reported health. Although digestive symptoms were associated with increased mortality independent of age and sex, cognition and function, this association was largely explained by poor self-assessed health. Digestive symptoms were not associated with institutionalization.

  2. Cognitive and affective assessment in day care versus institutionalized elderly patients: a 1-year longitudinal study

    PubMed Central

    Maseda, Ana; Balo, Aránzazu; Lorenzo–López, Laura; Lodeiro–Fernández, Leire; Rodríguez–Villamil, José Luis; Millán–Calenti, José Carlos

    2014-01-01

    Purpose Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. Patients and methods Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). Results Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild–moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. Conclusion Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and

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

    PubMed

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

    2014-08-01

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

  4. Costs of Malnutrition in Institutionalized and Community-Dwelling Older Adults: A Systematic Review.

    PubMed

    Abizanda, Pedro; Sinclair, Alan; Barcons, Núria; Lizán, Luis; Rodríguez-Mañas, Leocadio

    2016-01-01

    The aim of this study was to assess health economics evidence published to date on malnutrition costs in institutionalized or community-dwelling older adults. A systematic search of the literature published until December 2013 was performed using standard literature, international and national electronic databases, including MedLine/PubMed, Cochrane Library, ISI WOK, SCOPUS, MEDES, IBECS, and Google Scholar. Publications identified referred to the economic burden and use of medical resources associated with malnutrition (or risk of malnutrition) in institutionalized or community-dwelling older adults, written in either English or Spanish. Costs were updated to 2014 (€). A total of 9 studies of 46 initially retrieved met the preestablished criteria and were submitted to thorough scrutiny. All publications reviewed involved studies conducted in Europe, and the results regarding the contents of all the studies showed that total costs associated with malnutrition in institutionalized and community-dwelling older adults were considerably higher than those of well-nourished ones, mainly due to a higher use of health care resources (GP consultations, hospitalizations, health care monitoring, and treatments). Interventions to reduce the prevalence of malnutrition, such as the use of oral nutritional supplements, showed an important decrease in-hospital admissions and medical visits. Malnutrition is associated with higher health care costs in institutionalized or community-dwelling older adults. The adoption of nutritional interventions, such as oral nutritional supplements, may have an important impact in reducing annual health care costs per patient. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  5. Institutionalizing the Tri-Focal View: Continuing a Performance Evaluation Concept

    DTIC Science & Technology

    2006-02-07

    360 Degree Feedback and Perfomance Appraisal.”Training, Vol. 34, (1997): 62-68. Newman, Richard J, “ Job Reviews go Full Circle.” U.S. News...Institutionalizing the Tri-Focal View: Continuing a Performance Evaluation Concept Subject Area Leadership EWS 2006...and how he (the candidate) views his own performance. This methodology has proved to be an effective litmus test for leadership potential since

  6. Differences in breakfast habits between institutionalized and independent elderly Spanish people.

    PubMed

    Redondo, M R; Ortega, R M; López-Sobaler, A M; Quintas, M E; Zamora, M J; Andrés, P; Encinas-Sotillos, A

    1996-01-01

    An investigation was made into the breakfast habits of 150 elderly people between 65 and 95 years of age. The food intake of 58 institutionalized subjects was followed by means of "precise individual weighing of food". The food intake of 92 subjects living independently was followed using a prospective method involving the keeping of a "weighed food record". For all subjects the study lasted 5 consecutive days including a Sunday. Institutionalized subjects spent more time at breakfast (p < 0.01 in women) and the food they consumed was more varied, both in terms of number of foods (p < 0.001) and food groups (p < 0.001). Their breakfasts included more fruit (P < 0.001), fibre (P < 0.05 in women) and vitamin A (P < 0.01) than those of independent subjects, 7% of whom took no breakfast at all with a further 8% consuming only a glass of milk or fruit juice. 62.7% of independent and 43.1% of institutionalized subjects consumed an inadequate breakfast (i.e. their breakfasts provided less than 20% of their energy expenditure). The breakfasts of institutionalized subjects contained a greater percentage of their total daily intake of carbohydrates (P < 0.001 in women), fibre (P < 0.01 in women), thiamine (p < 0.05 in women), vitamin B12 (p < 0.05 in women, p < 0.001 in men), vitamin D (p < 0.01 in women) and magnesium (p < 0.05 in women). Given the importance of breakfast in the maintenance of a satisfactory nutritive condition, these results suggest that both qualitative and quantitative improvements of elderly people's breakfasts are required. Residing at an old people's home seems to improve the quality of breakfast consumed, especially for elderly women.

  7. Child Care and Child Nutrition

    ERIC Educational Resources Information Center

    Karolak, Eric

    2009-01-01

    The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…

  8. Child Care and Child Nutrition

    ERIC Educational Resources Information Center

    Karolak, Eric

    2009-01-01

    The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…

  9. [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.

  10. 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.

  11. Strength training and light physical activity reduces the apnea-hypopnea index in institutionalized older adults

    PubMed Central

    Herrick, Jeffrey E.; Bliwise, Donald L.; Puri, Shipra; Rogers, Sandy; Richards, Kathy C.

    2014-01-01

    Objectives To determine the effect of 7-weeks of resistance training and walking on the apneahypopnea index (AHI) in institutionalized older adults compared to a usual care control group. Design Secondary analysis of data from a randomized controlled-trial. Setting Ten nursing and three assisted living facilities in Arkansas. Participants Institutionalized older adults. Interventions Exercise group (EG) performed supervised resistance training to arm and hip extensors on 3 days a week with additional 2 days a week of light walking. Usual care group (UC) participated in the usual activities provided within their living facility. Measurements 2 nights of polysomnography before and following 7-week intervention. Results Adjusted means in the EG group showed a decrease in AHI from 20.2 (SD±1.3) at baseline to 16.7 (SD±0.9) at 7 weeks. Absolute strength gains were not associated with improved AHI. Conclusion Supervised resistance training and light walking reduced the severity of OSA in institutionalized older adults. PMID:25294621

  12. Placement in Foster Care Enhances Quality of Attachment Among Young Institutionalized Children

    PubMed Central

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

    2014-01-01

    This study examined classifications of attachment in three groups of children in Bucharest, Romania at age 42 months. The first two groups had been placed in institutions soon after birth, assessed comprehensively and then randomly assigned to either care as usual, including institutionalization (care as usual/institutional group) or to foster care (intervention group). These groups were compared to a group of family-reared children recruited from pediatric clinics (never institutionalized group). Attachment was assessed using ratings of attachment behavior in the Strange Situation Procedure at 42 months of age. Attachment classifications for children randomly assigned to foster care were markedly different from those of children who received care as usual, particularly at the extremes of the classifications (Secure and Insecure-other). Importantly, children placed in foster care before 24 months were more likely to have secure attachments with their caregivers. In addition, children placed into foster care earlier showed more likelihood of being organized in their relationships with their caregivers. Further, cognitive status predicted greater likelihood of organized attachment for children in the Care as Usual/Institution group and greater likelihood of secure attachment in the foster care group and the never institutionalized group. These findings demonstrate that foster care is an important intervention to address the effects of early adverse rearing conditions. PMID:20331663

  13. [Institutionalization of community programs: review of theoretical models and proposal of a model-].

    PubMed

    Renaud, L; Chevalier, S; O'Loughlin, J

    1997-01-01

    Community-based health promotion programs to change lifestyle habits must remain in their host organizations for extended periods of time in order to have impact. Their effectiveness can be closely linked to their long term viability or institutionalization. To remain viable, these programs must survive beyond initial investment and support by external organizations. However, some programs disappear when external investment is withdrawn. This can be costly and in addition can generate resistance to the implementation of other health promotion programs in the future. Recently, interest in the processes involved in the institutionalization of these programs has increased. Based on 28 publications, this article reviews selected conceptual models that highlight environmental, organizational, community and marketing-related, variables possibly related to the institutionalization process. A new model is proposed to link these diverse models according to: characteristics of the program, characteristics of the host organization, characteristics related to the adoption, implementation and incorporation of the program, and finally characteristics related to the fit (mutual adjustment) between the host and the program.

  14. [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.

  15. Relationship between Inflammation and Oxidative Stress and Cognitive Decline in the Institutionalized Elderly

    PubMed Central

    Baierle, Marília; Nascimento, Sabrina N.; Moro, Angela M.; Brucker, Natália; Freitas, Fernando; Gauer, Bruna; Durgante, Juliano; Bordignon, Suelen; Zibetti, Murilo; Trentini, Clarissa M.; Duarte, Marta M. M. F.; Grune, Tilman; Breusing, Nicolle; Garcia, Solange C.

    2015-01-01

    Objective. Cognitive impairment reduces quality of life and is related to vascular and neurodegenerative disorders. However, there is also a close relationship between these diseases and oxidative stress. Thus, the purpose of this study was to assess whether inflammation and oxidative damage are associated with low cognitive performance in the elderly with different housing conditions. Methods. The study groups consisted of 32 institutionalized and 25 noninstitutionalized Brazilian elderly subjects. Oxidative damage, inflammation markers, and cognitive function were evaluated. Results. The results demonstrated pronounced oxidative stress in the institutionalized elderly group, which also had a lower antioxidant status compared to noninstitutionalized subjects. High levels of proinflammatory cytokines were also observed in the institutionalized elderly. Furthermore, the raised levels of inflammatory markers were correlated with increased oxidative stress, and both were associated with low cognitive performance. However, based on multiple linear regression analysis, oxidative stress appears to be the main factor responsible for the cognitive decline. Conclusions. The findings suggest that individuals with lower antioxidant status are more vulnerable to oxidative stress, which is associated with cognitive function, leading to reduced life quality and expectancy. PMID:25874023

  16. [EPIDEMIOLOGY OF FALLS IN THE NON-INSTITUTIONALIZED SPANISH ELDERLY POPULATION, SYSTEMATIC REVIEW 2014].

    PubMed

    Pellicer García, Begoña; Juarez Vela, Raúl; Gracia Carrasco, Elías; Guerrero Portillo, Sandra; García Moyano, Loreto María; Azón Belarre, José Carlos

    2015-11-01

    OBJECTIVE To identify scientific publications about falls among non-institutionalized Spanish elderly population and to summarize the study findings which analysed the incidence, the risk factors and the consequences of the falls in the geriatric spanish population aged 65 years and over who lives institutionalized in our country. Systematic review of the epidemiological observational studies in Spain, with recording of falls, with temporary retrospective and published as scientific articles between the years 2003 and 2014 included. The articles search took place in July 2014, with the limit of language and publication year, in the electronic databases PubMed, Dialnet, RedALyC, SciELO, Enfispo and Google Scholar. The percentage of people who suffered falls depending on the publication year. The frequency of falls recorded varied from 14.9 % to 66.2 %. The mean intake of daily drugs was between 2.7 to 4.5 drugs per day. The fear of falling that had the elderly population non-institutionalized was between 44.7 % and 49.4 %. The vast majority of falls occurred at home, with percentages between 55.1 % and 61 %. Between 30 % and 55.1 % of people who suffered falls maintained health care contact immediately and the fractures prevalence was between 0 % and 26.1 %. CONCLUSTON: It can be confirmed that the falls prevalence in the spanish elderly population is high, so the need ofnew researches are appreciated.

  17. Institutionalizing a Comprehensive Tobacco-Cessation Protocol in an Indigenous Health System: Lessons Learned

    PubMed Central

    Santos, LorrieAnn; Braun, Kathryn; Aea, Kamuela; Shearer, Leimomi

    2008-01-01

    Background Native Hawaiians have high smoking prevalence and high lung cancer mortality rates. Objectives To describe a comprehensive tobacco cessation protocol and share lessons learned in institutionalizing it across the five Native Hawaiian Health Care Systems (NHHCS). Methods NHHCS representatives worked together to culturally tailor the Agency for Healthcare Research and Quality protocol for smoking cessation. Process objectives included number of staff trained in tobacco cessation, inclusion of the Tobacco User Guide Sheet (TUGS) in the intake process and medical record, and expansion of programs for smokers who want to quit. Outcome objectives included percent of individuals asked about smoking status and percent of identified smokers that received brief intervention, set a quit date, were linked to services, and remained smoke-free for 90 days. Results After 18 months, the NHHCS were at different stages of protocol adoption. More successful NHHCS were more likely to have several champions for the program and administrative support for staff training, new programs, and integrating the TUGS into client charts. They also showed greater success in getting smokers to set a quit date and remain smoke-free for 90 days. Conclusion Although the five NHHCS helped design the protocol, each operates independently. More effort and time are needed to help each system overcome internal barriers to institutionalizing a new protocol and to facilitate support for tobacco-cessation champions among medical records and data management supervisors. These lessons may be useful to other organizations that want to institutionalize a comprehensive tobacco-cessation protocol. PMID:20208308

  18. Vitamin B12 deficiency in the institutionalized elderly: A regional study.

    PubMed

    Wong, C W; Ip, C Y; Leung, C P; Leung, C S; Cheng, J N; Siu, C Y

    2015-09-01

    The prevalence of vitamin B12 deficiency increases with age and is suggested to be even higher in the elderly living in institutions. This retrospective study evaluated the vitamin B12 and folate status of 1996 institutionalized elderly residents aged over 65years. Among them, 34.9% had vitamin B12 deficiency (serum vitamin B12 <150pmol/L), 11.8% had folate deficiency (serum folate <6.8nmol/L), and 4.9% had both. The majority of vitamin B12 deficient residents (68%) had serum vitamin B12 between 100pmol/L and 149pmol/L. Macrocytosis was found in 24.2% of vitamin B12 deficient residents. A significant increase in macrocytosis was associated with a decrease in serum vitamin B12 below 100pmol/L. Macrocytosis was most common in those with vitamin B12 ≦69pmol/L (50.9%). Overall, vitamin B12 deficiency is common in the institutionalized elderly, however macrocytosis cannot predict deficiency. More liberal testing for vitamin B12 status in the institutionalized elderly may be warranted. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. 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.

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

    PubMed

    Barone, Lavinia; Lionetti, Francesca; Green, Jonathan

    2017-03-22

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

  1. Child Development & Behavior Topics

    MedlinePlus

    ... Your Child Topics Commentaries Featured Links Contact Us Child Development & Behavior Topics A B C D E F ... Seat Safety Carbon Monoxide Chewing Tobacco Child Care Child Development Milestones Child Development, What Do Grown-Ups Know ...

  2. [Child abuse].

    PubMed

    V Essen, H; Schlickewei, W; Dietz, H-G

    2005-02-01

    Child abuse is most often diagnosed by an emergency doctor on call who sometimes "feels" more than knows what he is confronted with. He should nevertheless always take a medical history and make a physical and radiological examination. X-ray imaging and an ophthalmologic retinal examination are the most important diagnostic steps. Typical findings are multiple and/or dorsal rib fractures, complex skull fractures, physeal fractures, all fractures within the first 12 months, multiple fractures in different localisations and stages of healing, all injuries with uncommon distributions, all patterned bruises, immersion burns, intramural hematoma and every unexplained loss of consciousness. The first step towards victim protection is always the removal of the abused child from its caregivers by admitting it to hospital, as 95% of all cases of reported child abuse take place within the child's family.

  3. Disobedient Child

    MedlinePlus

    ... of growing up and testing adult guidelines and expectations. It is one way for children to learn ... At times, it is due to unreasonable parental expectations. Or it might be related to the child's ...

  4. [Child labour].

    PubMed

    Marsella, L T; Savastano, L; Saracino, V; Del Vecchio, R

    2005-01-01

    The authors emphasize the violation of children's and adolescents' rights as a result of the exploitation of child labour. Besides the legal aspect, they pointed out the medical features related to the delicate growing process of the child in the phases of development and adaptation of the main organs to hard work. Currently the problem is being supervised by those states that recognize the right for minors to be protected against any kind of physical, mental, spiritual and moral risk.

  5. From institutional care to family support: development of an effective early intervention network in the Nizhny Novgorod Region, Russian Federation, to support family care for children at risk for institutionalization.

    PubMed

    Johnson, Dana E; Dovbnya, Svyatoslav V; Morozova, Tatiana U; Richards, Melinda A; Bogdanova, Julia G

    2014-01-01

    Despite efforts of the government to reform child protection, Russia continues to rely on institutional care due to the lack of support services for families in crisis, children with disabilities, and foster and adoptive parents.The project goal was to establish a replicable professional model that would direct the child welfare system in the Nizhny Novgorod Region away from institutional care and toward services for young children and their families that reduce the risk of institutionalization. The program was carried out over a 3-year period through a public-private partnership, which included the Ministries of Social Policy and Health of the Nizhny Novgorod Region, Firefly, and KPMG with partial funding by the United States Agency for International Development (USAID). Participation of professionals was excellent, attitudinal changes were extensive, and there were significant improvements in the understanding and utilization of early intervention concepts. The number of visits to program sites increased from essentially none to almost 1,000/month during the course of the project. Difficulties employing standardized child-based measures of success and developing ministry data-collection systems were encountered. Changes within the child welfare system in Russia are possible, but require a knowledgeable and adequately funded and supported program within regions receptive to change. © 2014 Michigan Association for Infant Mental Health.

  6. 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

  7. Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia.

    PubMed

    Reinbott, Anika; Jordan, Irmgard

    2016-01-01

    nutrition education programme carried out by government and community health volunteers as well as local NGOs addressing caregivers with a child between 5 and 18 months of age has great potential to improve IYCF practices. Since no impact on average height-for-age Z-scores could be demonstrated in this RCT, we suggest for Cambodia that (1) more emphasis be put on animal-source food and other protein sources in nutrition education, (2) nutrition education be implemented in the community through trained government and community members including peers as trainers, (3) sessions on family nutrition be included in the curriculum and the continuation of breastfeeding be emphasized, and (4) nutrition education be institutionalized, including continuous in-service training for sustainability. © 2016 S. Karger AG, Basel.

  8. 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.

  9. Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up.

    PubMed

    de Macedo, Liliane Dias E Dias; 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.

  10. EQ-5D rated by proxy in institutionalized older adults with dementia: psychometric pros and cons.

    PubMed

    Diaz-Redondo, Alicia; Rodriguez-Blazquez, Carmen; Ayala, Alba; Martinez-Martin, Pablo; Forjaz, Maria João

    2014-04-01

    Measurement of health-related quality of life in people with dementia is a challenge, because of their special characteristics and the difficulties that this term entails itself. The present study aimed at assessing the psychometric properties of the EQ-5D rated by a familiar or a professional caregiver of institutionalized older adults with dementia. We analyzed the EQ-5D psychometric properties from 525 questionnaires rated by proxy, in a sample of institutionalized older adults with dementia. The mean EQ-5D index score was 0.11 ± 0.38, and 51.54 ± 21.47 for the visual analog scale. The intraclass correlation coefficient was 0.72. Regarding internal consistency, Cronbach's alpha was 0.64, and the item-total correlation ranged from 0.33 to 0.53. Exploratory factor analysis identified a functional and a subjective factor, accounting for 67.35% of the variance. Convergent validity of EQ-5D with Quality of Life Alzheimer's Disease by proxy and Quality of Life in Late-stage Dementia scales was satisfactory (r = 0.36-0.58). The EQ-5D showed appropriate discriminative validity among patients grouped into several categories. Multiple linear regression models, using EQ-index and visual analog scale as dependent variables, identified dependence level, proxy characteristics, leisure and comorbidity as determinants of quality of life. Despite some limitations in the more subjective dimensions, the proxy-rated EQ-5D showed satisfactory psychometric properties in the present study, suggesting that it is a valid and alternative instrument to assess quality of life in institutionalized older people with dementia. © 2013 Japan Geriatrics Society.

  11. Self-perceived oral health status in institutionalized elderly in Brazil.

    PubMed

    Piuvezam, Grasiela; de Lima, Kenio Costa

    2012-01-01

    This study aims to identify self-perceived oral health status in institutionalized elderly in Brazil, using the Geriatric Oral Health Assessment Index (GOHAI) and to seek associations with objective and subjective conditions and behavior related to oral health, individual traits, and environmental factors. A cross-sectional study using census with institutionalized elderly in Brazil. A total of 1192 individuals were evaluated, and 587 (49.2%) responded to the GOHAI. A questionnaire and an epidemiological survey were applied. The Mann-Whitney, Kruskal-Wallis, Fisher's exact, chi-square, and multiple logistic regression tests were performed. Mean age was 74.98 ± 9.5 years, 51.4% (302) were male. The mean DMFT-index (DMFT=decayed, missing, filled teeth) was 28.8 ± 5.5 and 54.5% (320) of the elderly were toothless. Categorized GOHAI showed that 75% (440) of the individuals had positive self-perception of oral health status. Multiple logistic regression demonstrated that the last visit to the dentist (adjusted prevalence ratio=PR=4.058; confidence interval=CI=1.526-10.789), presence of gingival problems (adjusted PR=5.703; CI=1.754-18.544), and self-rating of teeth, gums, or prosthesis (adjusted PR=19.514; CI=5.075-75.041) remained significant in the model. Predominance of positive self-perception of oral health status was observed despite poor oral conditions. Thus, for the institutionalized population, the present study recommends epidemiological and self-perception surveys to ensure adequate planning of oral health strategies.

  12. Self-concept in institutionalized children with disturbed attachment: The mediating role of exploratory behaviours.

    PubMed

    Vacaru, V S; Sterkenburg, P S; Schuengel, C

    2017-09-11

    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.

  13. 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

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

    PubMed Central

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

    2014-01-01

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

  15. Sensor technologies aiming at fall prevention in institutionalized old adults: a synthesis of current knowledge.

    PubMed

    Kosse, N M; Brands, K; Bauer, J M; Hortobagyi, T; Lamoth, C J C

    2013-09-01

    Falls are a serious health problem in old adults especially in nursing home residents and hospitalized patients. To prevent elderly from falling, sensors have been increasingly used in intramural care settings. However, there is no clear overview of the current used technologies and their results in fall prevention. The present study reviews sensor systems that prevent falls in geriatric patients living in an intramural setting and describe fall rates, fall-related injuries, false alarms, and user experience associated with such systems. We conducted a systematic search for studies that used sensor technologies with the aim to prevent falls in institutionalized geriatric patients. A total of 12 studies met the search criteria. Three randomized clinical trials reported no reductions in fall rate but three before-after studies reported significant reductions of 2.4-37 falls per 1000 patient days. Although there was up to 77% reduction in fall-related injuries and there was relatively low, 16%, rate of false alarms, the current data are inconsistent whether current sensor technologies are effective in reducing the number of falls in institutionalized geriatric patients. The occurrence of false alarms (16%) was too high to maintain full attention of the nursing staff. Additionally including the users opinion and demands in developing and introducing sensor systems into intramural care settings seems to be required to make an intervention successful. The evidence is inconsistent whether the current sensor systems can prevent falls and fall-related injuries in institutionalized elderly. Further research should focus more comprehensively on user requirements and effective ways using intelligent alarms. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Exergames: neuroplastic hypothesis about cognitive improvement and biological effects on physical function of institutionalized older persons

    PubMed Central

    Monteiro-Junior, Renato Sobral; Vaghetti, César Augusto Otero; Nascimento, Osvaldo José M.; Laks, Jerson; Deslandes, Andrea Camaz

    2016-01-01

    Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were (1) to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and (2) to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed. PMID:27073355

  17. [Institutionalized and Individual Crisis Intervention Between Youth Welfare and Adolescent Psychiatry, Specified for Unaccompanied Minor Refugees].

    PubMed

    Schepker, Renate

    2017-01-01

    Institutionalized and Individual Crisis Intervention Between Youth Welfare and Adolescent Psychiatry, Specified for Unaccompanied Minor Refugees Minor refugees put a challenge to the intercultural openness, including an abdication from diagnostic schemes. They need creativity, modification of treatment manuals and the therapist's ability to engage himself as a person. They need another notion of abstinence and the ability to cooperate with interpreters of language and culture. In cooperation with youth welfare institutions for unaccompanied minor refugees, principles that have been developed for institutional cooperation and individual crisis intervention plans have been modified: high threshold inpatient admission, multi-step-approach and reliability of cooperation.

  18. Frailty Index and Incident Mortality, Hospitalization, and Institutionalization in Alzheimer's Disease: Data From the ICTUS Study.

    PubMed

    Kelaiditi, Eirini; Andrieu, Sandrine; Cantet, Christelle; Vellas, Bruno; Cesari, Matteo

    2016-04-01

    The identification of an objective evaluation of frailty capable of predicting adverse outcomes in Alzheimer's disease is increasingly discussed. The purpose of this study was to investigate whether the Frailty Index (FI) predicts hospitalization, institutionalization, and mortality in Alzheimer's disease patients. A prospective multicenter cohort study (follow-up = 2 years) that included 1,191 participants with Alzheimer's disease was carried out. The outcomes of interest were incident hospitalization, institutionalization, and mortality. The FI was calculated as the ratio of actual to thirty potential deficits, that is, deficits presented by the participant divided by 30. Severity of dementia was assessed using the Clinical Dementia Rating score. Cox proportional hazard models were performed. Mean age of the study sample was 76.2 (SD = 7.6) years. A quadratic relationship of the FI with age was reported at baseline (R (2) = .045, p < .001). The FI showed a statistically significant association with mortality (age- and gender-adjusted hazard ratio [HR] = 1.019, 95% confidence interval [CI] = 1.002-1.037, p = .031) and hospitalization (age- and gender-adjusted HR = 1.017, 95% CI = 1.006-1.029, p = .004) and a borderline significance with institutionalization. When the Clinical Dementia Rating score was simultaneously included in the age- and gender-adjusted models, the FI confirmed its predictive capacity for hospitalization (HR = 1.019, 95% CI = 1.006-1.032, p = .004), whereas the Clinical Dementia Rating score was the strongest predictor for mortality (HR = 1.922, 95% CI = 1.256-2.941, p = .003) and institutionalization (HR = 1.955, 95%CI = 1.427-2.679, p < .001). The FI is a robust predictor of adverse outcomes even after the stage of the underlying dementia is considered. Future work should evaluate the clinical implementation of the FI in the assessment of demented individuals in order to improve the personalization of care. © The Author 2015. Published by

  19. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2017-06-01

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

  1. Your Child's Development: Newborn

    MedlinePlus

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child's Development: Newborn KidsHealth > For Parents > Your Child's Development: Newborn ...

  2. Child Sexual Abuse

    MedlinePlus

    ... Enter ZIP code here Enter ZIP code here Child Sexual Abuse Public This section is for Veterans, General Public, Family, & Friends Child Sexual Abuse What is child sexual abuse? Child sexual abuse ...

  3. Office of Child Care

    MedlinePlus

    ... Early Head Start-Child Care Partnerships. Review the profiles. > What is the Office of Child Care (OCC)? The Office of Child Care supports low-income working families through child care financial assistance and ...

  4. Predictors of the time to institutionalization in young- versus late-onset dementia: results from the Needs in Young Onset Dementia (NeedYD) study.

    PubMed

    Bakker, Christian; de Vugt, Marjolein E; van Vliet, Deliane; Verhey, Frans R J; Pijnenburg, Yolande A; Vernooij-Dassen, Myrra J F J; Koopmans, Raymond T C M

    2013-04-01

    To investigate the time from symptom onset to institutionalization in persons with young-onset dementia (YOD) and compare these findings with late-onset dementia (LOD), and to determine which factors predict institutionalization in persons with YOD compared with LOD. Longitudinal study of community-dwelling patients with YOD and LOD and their caregivers. A total of 226 patients with YOD and 102 with LOD and their informal caregivers were recruited through memory clinics and health care facilities. Cox proportional hazard models were used to relate covariates with time to institutionalization. The main outcome was time from symptom onset to institutionalization. Key predictors were cohort (YOD or LOD), neuropsychiatric symptoms, caregiver distress caused by neuropsychiatric symptoms, and caregivers' sense of competence (Short Sense of Competence Questionnaire total score). The time from symptom onset to institutionalization was nearly 9 years for patients with YOD compared with approximately 4 years for patients with LOD. In the YOD group, apathy significantly predicted time of institutionalization. Furthermore, the caregiver's competence in caring for the person with dementia significantly predicted institutionalization in both groups. Patients with YOD are cared for at home for a longer period than patients with LOD. The results of this study underline the importance of a timely diagnosis for these patients and their families to facilitate the initiation of appropriate care and support. Support programs aimed at enhancing the caregivers' sense of competence and ability to deal with neuropsychiatric symptoms, especially apathy, may postpone the institutionalization of the patient. Copyright © 2013. Published by Elsevier Inc.

  5. Predictive factors for hospitalized and institutionalized care-giving of the aged patients with diabetes mellitus in Japan.

    PubMed

    Matsuzawa, Toshioki; Sakurai, Takashi; Kuranaga, Masako; Endo, Hidetoshi; Yokono, Koichi

    2011-01-21

    To identify predictive factors for hospitalized and institutionalized care-giving among a group of aged patients with diabetes mellitus in Japan, retrospective chart review was performed in 288 diabetic subjects aged 65 years or older. Independent variables, based on the chart review, were age, sex, diagnosis, diabetic control and complications. Comprehensive geriatric assessment was performed to obtain information on the functional capacity and demographic variables, including physical and mental function, and socioeconomic status. 131 diabetic patients were considered as frail elderly and characterized for their higher age, longer duration of diabetes, higher frequency of insulin use, lower cognitive function, and lower QOL, in comparison with those of non-frail patients. All non-frail diabetic patients were independently treated at their homes, while 38 subjects out of 131 frail diabetic patients were hospitalized or institutionalized. Apparent clinical features of hospitalized/institutionalized patients were higher age, higher serum creatinine, and higher prevalence of stroke episodes, advanced cognitive decline and absence of key caregiver in the family members, in comparison with those of in-home frail diabetic patients. The predicted probabilities from the multivariate logistic regression analysis in predicting hospitalized and institutionalized care-giving were as follows: Log p/(1 - p) = -19.801x1 - 54.269x2 + 721.405; where x1 = cognitive function (score), x2 = social support (score). Receiver operating characteristic curve analysis revealed a satisfactory discrimination for hospitalized and institutionalized care-giving in frail diabetic elderly with 92.9% of sensitivity and 91.4% of specificity, when the cutoff point of the model was set at 0.992. We concluded that cognitive decline and low social support are the predictive for hospital and institutional care-giving, and that demographic and mental information as well as diagnostic data should be

  6. Project CHILD.

    ERIC Educational Resources Information Center

    Robison, Helen F.; And Others

    This document described Project CHILD, a program of educational change and curriculum development for disadvantaged prekindergarten and kindergarten children. The historical part of this report indicates that the project began in 1966 with a small-scale study of teacher behavior and children's responses in a few classrooms in a Harlem school…

  7. Child Development

    MedlinePlus

    ... same sex. Peer approval becomes very important. Your child may try new behaviors to be part of "the group." This can also be the time that parents or teachers recognize learning disabilities or ... can get worse as time goes on, so it is important to get help early.

  8. Child's Play

    ERIC Educational Resources Information Center

    Woolsey, Kristina; Woolsey, Matthew

    2008-01-01

    Emerging digital technologies enable teachers and students to access and manipulate sights and sounds in their school environments. The challenge is to systematically include these new media in academic environments, and to include adults who are ill prepared in technical issues as primary guides in this effort. This article suggests that child's…

  9. 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.

  10. Training food service supervisors using hand-held computers to conduct nutritional screening of institutionalized elderly patients.

    PubMed

    Orta, J

    1995-01-01

    Six food service supervisors (FSSs) working in skilled nursing facilities were trained to use a hand-held computer, COMPU-CAL/PRO 5.1, to screen institutionalized elderly patients for selected nutritional variables and to record results in the medical record. The study demonstrates that hand-held computer-assisted nutritional screenings: (1) are readily adaptable to on-going efforts, (2) are useful in identifying potential indicators of poor nutritional status in institutionalized elderly patients, (3) can be taught to FSS in a relatively short time, (4) increase nutritionally relevant variables that can be assessed, and (5) improve the quality of documentation in the medical record.

  11. Religious women's groups help promote child survival and development.

    PubMed

    Munir, L Z

    1989-07-01

    Indonesia faces the 2 major problems of high infant mortality and high child mortality at present. To improve the situation, the government urges the participation of all community members, especially those already organized in the nongovernmental organizations (NGOs). Because religion has a strong influence on people's daily lives in Indonesia, a special project called the Child Survival Project was established in 1986 as a joint undertaking of the government and UNICEF. Initially 12 religious NGOs (8 Islamic, 1 Hindu, 1 Protestant, and 2 Catholic) were involved as implementing agencies. The majority of members of these NGOs are women. The strategy used has been to establish, in cooperation with the 12 NGOs, a communication network through which child survival messages would be disseminated to help generate increased use of Posyandu services, especially immunization, oral rehydration therapy, and growth monitoring. Messages are incorporated into the normal activities of these religious groups, such as Al-Quran reading classes, Sunday schools, and Bible classes. In addition, guidelines for a reporting and feedback system have been prepared for use at village, subdistrict, district, and provincial levels for project monitoring. Religious women's NGOs can serve with their specific characteristics can serve as motivators, facilitators, and catalysts of child survival and development programs for their community target groups. NGOs should be considered as partners of the government in mobilizing the community to achieve a common goal. All endeavors undertaken so far in relation to child survival and development are expected to be institutionalized.

  12. 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.

  13. Partnership: The Missing Link in the Process of De-Institutionalization of Mental Health Care.

    PubMed

    Quah, Stella R

    2015-11-19

    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.

  14. Duration of early adversity and structural brain development in post-institutionalized adolescents.

    PubMed

    Hodel, Amanda S; Hunt, Ruskin H; Cowell, Raquel A; Van Den Heuvel, Sara E; Gunnar, Megan R; Thomas, Kathleen M

    2015-01-15

    For children reared in institutions for orphaned or abandoned children, multiple aspects of the early environment deviate from species-typical experiences, which may lead to alterations in neurobehavioral development. Although the effects of early deprivation and early life stress have been studied extensively in animal models, less is known about implications for human brain development. This structural neuroimaging study examined the long-term neural correlates of early adverse rearing environments in a large sample of 12-14 year old children (N = 110) who were internationally adopted from institutional care as young children (median age at adoption = 12 months) relative to a same age, comparison group reared with their biological families in the United States. History of institutional rearing was associated with broad changes in cortical volume even after controlling for variability in head size. Results suggested that prefrontal cortex was especially susceptible to early adversity, with significant reductions in volume (driven primarily by differences in surface area rather than cortical thickness) in post-institutionalized youth. Hippocampal volumes showed an association with duration of institutional care, with later-adopted children showing the smallest volumes relative to non-adopted controls. Larger amygdala volumes were not detected in this sample of post-institutionalized children. These data suggest that this temporally discrete period of early deprivation is associated with persisting alterations in brain morphology even years after exposure. Furthermore, these alterations are not completely ameliorated by subsequent environmental enrichment by early adolescence. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Sociodemographic and health factors associated with chronic pain in institutionalized elderly

    PubMed Central

    Barbosa, Maria Helena; Bolina, Alison Fernandes; Tavares, Jordânia Lumênia; Cordeiro, Aldenora Laísa Paiva de Carvalho; Luiz, Raíssa Bianca; de Oliveira, Karoline Faria

    2014-01-01

    OBJECTIVES: to characterize chronic pain in institutionalized elderly and verify the associated factors. METHOD: observational, cross-sectional and non-experimental study with a quantitative approach. The study participants were 124 elderly living in Long-Term Care Institutions for the Elderly (LTCIs) in a city in Minas Gerais (Brazil). Approval for the project was obtained from the Research Ethics Committee. The elderly's clinical and sociodemographic variables and pain-related aspects were assessed. The data were analyzed through descriptive statistics and bivariate analysis (chi-squared). RESULTS: the prevalence of chronic pain corresponded to 58.1%; for more than 10 years (26.4%); in lower limbs (31.9%); characterized as "twinges" (33.3%); 33.3% adopted medication treatment; the pain did not improve (41.7 %); or worsen (34.7 %). It was evidenced that elderly aged 60├ 70 old had 70% less chances of chronic pain than those aged 80 years and older (p=0.018). CONCLUSION: institutionalized elderly have a high prevalence of chronic pain, mainly in the lower limbs. No factors of pain improvement or worsening were identified and medication was evidenced as the preferred treatment. Age showed to be associated with the presence of pain. It is considered important to accomplish multiprofessional actions at the LTCIs to guide prevention and rehabilitation actions of the pain episodes in these elderly. PMID:25591097

  16. Efficacy of a 28-day oral cyanocobalamin supplementation on vitamin B status in Spanish institutionalized elderly.

    PubMed

    Albers, Ulrike; Pedrero-Chamizo, Raquel; Meléndez, Agustin; Pietrzik, Klaus; Castillo, Manuel J; González-Gross, Marcela

    2012-04-01

    Cobalamin deficiency is a common problem in the elderly. There is no consensus about adequate doses for supplementation. We performed an intervention study in order to establish the efficacy of a supplement providing 500 µg cyanocobalamin for four weeks in sixty-four institutionalized elderly residents, over 60 years of age, in Madrid (Spain). Before and after treatment, concentrations of serum cobalamin, serum holotranscobalamin, serum total homocysteine, and serum and red blood cell folate were analyzed. Clusters were built according to the initial cobalamin status and differences in the effect of supplementation were checked using a general linear model for repeated measures. Cobalamin and holotranscobalamin increased highly significantly from 308 to 558 pmol/L and from 54 to 96 pmol/L (p < 0.001) in the whole study group as well as in each subgroup (clustered by initial cobalamin levels, all p < 0.01), with the highest relative change in the subgroup with the lowest initial cobalamin values. Total homocysteine decreased from 15 to 13 µmol/l, p < 0.001). Only the change of cobalamin (F = 4.61, p < 0.01), but not of holotranscobalamin nor total homocysteine, depended on the initial serum cobalamin status. A supplementation with an oral supplement solution of 500 µg cyanocobalamin daily for only four weeks, a shorter period than that found in former studies, may be considered suitable in institutionalized elderly.

  17. Childhood Abuse and Delinquency: A Descriptive Study of Institutionalized Female Youth in Singapore.

    PubMed

    Chu, Chi Meng; Thomas, Stuart D M; Ng, Vivienne P Y

    2009-03-01

    Childhood abuse experiences appear prevalent in institutionalized children and youth, but research to date has been limited. Moreover, there is no published study that has examined the issue of childhood abuse and delinquency within institutionalized children and youth in Singapore. This study was cross-sectional in design with follow-up criminal record checks. Data were collected from multiple data sources including official records, structured clinical interviews, and self-report questionnaires on 79 adolescent female residential youth. Two thirds reported having experienced childhood abuse and a higher proportion reported having previously engaged in self-harming behaviours. Participants with multiple types of abuse reported being abused at a younger age, were more likely to be subjected to repeated physical abuse, to have overdosed on medication, and to have reported more health and sexual concerns and trauma symptomatology than those who reported either experiencing one or no previous types of abuse. Fourteen (18%) of the sample had been convicted of further criminal offences over a 6½-year follow-up. The adolescents with histories of multiple types of abuse in childhood presented with more health concerns and traumatic symptomatology, self-reported delinquency, as well as past self-harming behaviour during their institutional stay. Identification of these additionally vulnerable adolescents has important clinical implications for identification, assessment and intervention planning.

  18. Poor Dental Status and Oral Hygiene Practices in Institutionalized Older People in Northeast Brazil

    PubMed Central

    Ribeiro Gaião, Luciene; Leitão de Almeida, Maria Eneide; Bezerra Filho, José Gomes; Leggat, Peter; Heukelbach, Jorg

    2009-01-01

    In this study we describe the dental status and oral hygiene practices in institutionalized older people and identify factors associated with poor dental status. A cross-sectional study was performed in a nursing home in Fortaleza, the capital of Ceará State (northeast Brazil). The number of decayed, missing, and filled teeth (DMFT) was assessed in the residents of the nursing home (n = 167; mean age = 76.6 years). The mean DMFT value was 29.7; the mean number of missing teeth was 28.4. Ninety-three (58.1%) were edentulous. Almost 90% practiced oral hygiene, but only about half used a toothbrush. Only 8% had visited a dentist in the preceding three months. Most of the variables regarding oral hygiene habits (such as the use of toothbrush, frequency of oral hygiene per day, regular tooth brushing after meals) did not show any significant association with the DMFT. In multivariate regression analysis, age, general literacy level, and practice of oral hygiene were independently associated with the DMFT (R2 = 0.13). Institutionalized older people in northeast Brazil have poor dental status, and oral hygiene practices are insufficient. Dental health education is needed focusing on the special needs of this neglected and socioeconomically deprived population to improve their quality of life. PMID:20339459

  19. Prevalence of fecal incontinence (FI) and associated factors in institutionalized older adults.

    PubMed

    Jerez-Roig, Javier; Souza, Dyego L B; Amaral, Fabienne L J S; Lima, Kenio C

    2015-01-01

    The objective of this work is to determine the prevalence of FI and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December 2013, in 10 nursing homes (NHs) of the city of Natal (Northeast Brazil). Individuals over the age of 60 were included in the study, while those hospitalized or in terminal phase were excluded. Data collection included sociodemographic information, FI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). FI was verified through the Minimum Data Set (MDS) 3.0, which was also used to assess toileting programs. The Chi-square test and the linear Chi-square test were performed for bivariate analysis, as well as logistic regression for multivariate analysis. The final sample consisted of 321 elderly, mostly females, with mean age of 81.5 years. The prevalence of FI was 42.68% (CI 95%, 37.39-48.15). Most residents presenting FI were always incontinent (83.9%) and the most frequent incontinence type was total FI (solid and liquid stools). Incontinence control measures were applied only to 9.7% of the residents. The final model revealed a statistically significant association between FI and functional and cognitive impairments. It is concluded that FI is a health issue that affects almost half of the institutionalized elderly, and is associated with functional and cognitive disability.

  20. Validation analysis of a geriatric dehydration screening tool in community-dwelling and institutionalized elderly people.

    PubMed

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

    2015-03-02

    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.

  1. Duration of Early Adversity and Structural Brain Development in Post-Institutionalized Adolescents

    PubMed Central

    Hodel, Amanda S.; Hunt, Ruskin H.; Cowell, Raquel A.; Van Den Heuvel, Sara E.; Gunnar, Megan R.; Thomas, Kathleen M.

    2014-01-01

    For children reared in institutions for orphaned or abandoned children, multiple aspects of the early environment deviate from species-typical experiences, which may lead to alterations in neurobehavioral development. Although the effects of early deprivation and early life stress have been studied extensively in animal models, less is known about implications for human brain development. This structural neuroimaging study examined the long-term neural correlates of early adverse rearing environments in a large sample of 12–14 year old children (N = 110) who were internationally adopted from institutional care as young children (median age at adoption = 12 months) relative to a same age, comparison group reared with their biological families in the United States. History of institutional rearing was associated with broad changes in cortical volume even after controlling for variability in head size. Results suggested that prefrontal cortex was especially susceptible to early adversity, with significant reductions in volume (driven primarily by differences in surface area rather than cortical thickness) in post-institutionalized youth. Hippocampal volumes showed an association with duration of institutional care, with later-adopted children showing the smallest volumes relative to non-adopted controls. Larger amygdala volumes were not detected in this sample of post-institutionalized children. These data suggest that this temporally discrete period of early deprivation is associated with persisting alterations in brain morphology even years after exposure. Furthermore, these alterations are not completely ameliorated by subsequent environmental enrichment by early adolescence. PMID:25451478

  2. Association between serum calcium and periodontal disease progression in non-institutionalized elderly.

    PubMed

    Amarasena, Najith; Yoshihara, Akihiro; Hirotomi, Toshinobu; Takano, Naoko; Miyazaki, Hideo

    2008-12-01

    To assess the effect of baseline serum calcium on the progression of periodontal disease in non-institutionalized elderly. Although a few studies have found some evidence of the role played by dietary calcium in periodontal disease process, there is a paucity of information pertinent to longitudinal assessment of serum calcium-periodontal relationships. Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for six consecutive years. Progression of periodontal disease (PPD) was defined as the number of teeth that showed additional attachment loss of > or =3 mm during the 6 years. The number of PPD was calculated for each subject and categorised into four levels, namely, PPD(0), PPD(1), PPD(2) and PPD(3) where the number of teeth with additional attachment loss ranged from 0, 1-10, 11-20 and >20 respectively. The levels of serum calcium, albumin, random blood sugar, immunoglobulin (IgG, IgA and IgM), gender, smoking habits, education, gingival bleeding and the number of teeth present were obtained at baseline. Serum calcium, IgA, smoking, gingival bleeding and teeth present were associated with PPD at p < or = 0.10 and were included in a multinomial logistic regression analysis. Serum calcium was the only variable that was significantly associated with PPD with relative risks of 100 at PPD(1) and PPD(2), respectively, and 1000 at PPD(3). Serum calcium may be considered a risk factor for periodontal disease progression in non-institutionalized elderly.

  3. 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.

  4. [Functional impairment, fear of falling and body composition in institutionalized elderly].

    PubMed

    São Romão Preto, Leonel; Nogueiro Santos, Ana Luisa; Mendes, Maria Eugénia; Pinto Novo, André; Pimentel, Maria Helena

    2015-01-01

    To analyze changes in the aging process of institutionalized elderly over a 24 months period, including physical condition, fear of falling, and body composition. A longitudinal, analytic and prospective study was implemented in 3 residential care homes for seniors. Data were collected using a socio-demographic and clinical questionnaire, the Rikli and Jones Senior Fitness Test, handgrip dynamometry and bioelectric impedance. The Portuguese version of the Falls Efficacy Scale was used for measure fear of falling. Fifty-one institutionalized elderly (82.5 ± 7.4 years) were included. In the 24 months analysis period, functional decline was observed (P<.05) in tests: sit to stand, harm curl, sit and reach and Up and Go. In average falls occurred 1.7 times. Were observed a decrease of self-efficacy to prevent falling, and falls prevalence was 42.1%. Results suggest a functional decrease, mainly in variables related with strength and muscular control of arms and legs, agility/dynamic balance and flexibility. Data don't highlight significant changes in body composition, however, tend to a muscle mass and bone mineral mass reduction. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  5. [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.

  6. Federal Assistance to States to Prevent the Abuse of Children in Child Care Facilities. Hearings before the Subcommittee on Juvenile Justice of the Committee on the Judiciary. United States Senate, Ninety-Eighth Congress, Second Session (April 11 and September 18, 1984).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

    These Congressional hearings provide the text of and materials related to proposed Senate Bill S. 521, intended to promote the public welfare by protecting institutionalized children from abuse, and Senate Bill S.1924, which would create a central federal file of sexual assault and child molesting arrests and convictions. This federal file would…

  7. 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.

  8. 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

    ... institutionalized individuals in States using more restrictive requirements than SSI: Application of patient income..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES... individuals in States using more restrictive requirements than SSI: Application of patient income to the cost...

  9. 42 CFR 435.832 - Post-eligibility treatment of income of institutionalized individuals: Application of patient...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS... institutionalized individuals: Application of patient income to the cost of care. (a) Basic rules. (1) The agency... determine eligibility for an optional State supplement for an individual in his own home, if the agency...

  10. Influence of Multiple Models on the Behavior of Institutionalized Retarded Children: Increased Generalization to Other Models and Other Behaviors

    ERIC Educational Resources Information Center

    Marburg, Carol C.; And Others

    1976-01-01

    Institutionalized retarded children were reinforced for imitating the same model or three different models. A posttest to assess levels of imitation was then conducted by a new model. Pretest-posttest comparisons indicated that imitation with new models was greater for children trained with multiple as opposed to single models. (Author)

  11. 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…

  12. Towards an Innovative University in the South? Institutionalizing Euro-Mediterranean Co-operation in Research, Technology, and Higher Education.

    ERIC Educational Resources Information Center

    Kuitunen, Jorma

    1999-01-01

    Discusses strategies for institutionalizing research, technological, and educational (RTE) cooperation in the context of recent Euro- Mediterranean relations. Examines social contexts that determine the process of creating a new Euro-Mediterranean cooperation policy. Describes the 1995 ministerial conference which examined RTE policies,…

  13. INDISCRIMINATE BEHAVIOR OBSERVED IN THE STRANGE SITUATION AMONG INSTITUTIONALIZED TODDLERS: RELATIONS TO CAREGIVER REPORT AND TO EARLY FAMILY RISK

    PubMed Central

    Oliveira, Paula S.; Soares, Isabel; Martins, Carla; Silva, Joana R.; Marques, Sofia; Baptista, Joana; Lyons-Ruth, Karlen

    2014-01-01

    Socially disinhibited or indiscriminate behavior (IB) has traditionally been investigated using caregiver reports. More recently, an observational measure based on the Strange Situation Procedure (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978), the Rating of Infant and Stranger Engagement (RISE; C. Riley, A. Atlas-Corbett, & K. Lyons-Ruth, 2005), was validated in home-reared at-risk children. The present study aimed to validate the RISE in an institutionally reared sample using the caregiver report, to assess whether IB assessed with the RISE was elevated among the institutionalized children, and to explore potential risk factors associated with IB. The study was conducted among 74 institutionalized toddlers aged 11 to 30 months. Sociodemographic questionnaires were used to assess pre-admission experiences, and aspects of institutional placement were coded from the children’s files in the institution and staff’s report. Institutionalized children displayed high frequencies of IB as assessed on the RISE, and this instrument was validated against caregiver report. Pre-admission experiences of the institutionalized children in their biological families—namely, prenatal risk and maternal emotional neglect risk—predicted IB. Results suggest that the RISE is adequate to use among institutionally reared toddlers and point to aspects of the early familial environment that may be implicated in IB. PMID:25552781

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

    PubMed Central

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

    2012-01-01

    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. PMID:23045660

  15. 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...

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  17. 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...

  18. 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...

  19. Exploring the Current Theoretical Background about Adoption until Institutionalization of Online Education in Universities: Needs for Further Research

    ERIC Educational Resources Information Center

    Casanovas, Ines

    2010-01-01

    Online education in institutional contexts means new organizational problems. The fact that universities need to change to accommodate the impact of technology on learning is already known and accepted. Coping with changes from adoption until institutionalization of online education represents a formidable management challenge for universities.…

  20. Institutionalized Facilities Program, 1983-84. E.C.I.A. Chapter 1, Part B. Final Evaluation Report.

    ERIC Educational Resources Information Center

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

    In 1983-84, the Education Consolidation Improvement Act (E.C.I.A.), Chapter 1, Part B Institutionalized Facilities Program was sponsored jointly by the Division of Special Education and, for the first time, the Division of the High Schools of the New York City Public Schools. The program provided supplementary career education and daily living…

  1. E.C.I.A. Chapter 1, Part B. Institutionalized Facilities Program, Summer 1983. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Tobias, Robert; And Others

    The 1983 summer E.C.I.A. Chapter 1, Part B Institutionalized Facilities Program provided supplementary career education and daily living skills instruction to 780 students residing in facilities for neglected and delinquent children and youth. Analyses of the pupil achievement data indicated that the program was highly effective: nearly all…

  2. 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…

  3. Institutionalized Facilities Program, 1986-87. E.C.I.A. Chapter 1, Part B. OEA Evaluation Report.

    ERIC Educational Resources Information Center

    Miller, Ronald C.; And Others

    The New York City Public Schools' Institutionalized Facilities Program, which provides after-school supplementary instruction in pre-vocational skills and activities of daily living for students residing for short or long terms in institutions for the neglected and delinquent, was evaluated for the 1986-87 school year. The purpose of this program…

  4. Institutionalized Facilities Program Summer, 1985. E.C.I.A. Chapter 1, Part B. OEA Evaluation Report.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn. Office of Educational Assessment.

    This document is an evaluation report on a program in which 288 students aged 6 to 20 received supplementary career education and daily living skills instruction under the ECIA, Chapter 1, Part B Institutionalized Facilities Program. The students resided in 10 institutions for the neglected and delinquent. The evaluation summary states that: (1)…

  5. Aquatic physical therapy as a treatment modality in healthcare for non-institutionalized elderly persons: a systematic review.

    PubMed

    Sarmento, Gisele da Silveira; Pegoraro, Andréa Sanchez Navarro; Cordeiro, Renata Cereda

    2011-03-01

    To review scientific literature pertaining to aquatic physical therapy in the elderly and institutionalized population. A qualitative systematic review of electronic databases MEDLINE and LILACS, with the topic index terms: "hydrotherapy," "homes for the aged or residential facilities," and "aged. In light of the lack of studies carried out on the institutionalized population, we opted for reviewing literature on the effectiveness of this modality of physical therapy treatment on the non-institutionalized elderly population in order to produce knowledge that can be critically analyzed according to its potential applicability for the institutionalized population. The methodological quality of the studies was assessed using the Delphi listing. Of the 27 studies analyzed by their abstracts, 10 studies were excluded since they did not correspond to the eligibility criteria. We analyzed the subject characteristics of each study, as well as the quality of the methods (good methodological quality in 47% of the studies), the result measurements considered, the intervention strategies, the sites where they took place, and the professionals involved (76% by physical therapists). Although a large part of the studies demonstrated good results with aquatic physical therapy practice, none of them had been applied on long-stay institution for the elderly. Therefore, more studies are needed in this area for a model of assistance to long-stay institution for the elderly to be proposed.

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

    PubMed Central

    2012-01-01

    Background 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. Methods/design 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. Discussion This research will provide knowledge on the functional status of frail older persons who are still living at home. This is important

  7. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    PubMed

    Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

    2012-01-01

    Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

  8. Institutionalizing Provider-Initiated HIV Testing and Counselling for Children: An Observational Case Study from Zambia

    PubMed Central

    Mutanga, Jane N.; Raymond, Juliette; Towle, Megan S.; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

    2012-01-01

    Background Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia’s Southern Province, and serving a catchment area of 1.2 million people. Methods and Principal Findings Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital’s inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant

  9. 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

  10. 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

  11. Pathways to collaboration: exploring values and collaborative practice between child welfare and substance abuse treatment fields.

    PubMed

    Drabble, Laurie

    2007-02-01

    Although recent research has highlighted the importance of "bridging the gap" between child welfare and substance abuse treatment delivery systems, few studies examine specific factors that may facilitate such collaboration. This study examined similarities and differences in values and perceived capacity for collaboration between substance abuse and child welfare fields based on survey data from more than 350 respondents in 12 California counties. Although respondents across disciplines held similar values in some areas, such as priorities for services, significant differences between respondents from child welfare and substance abuse fields were found in other areas, including values and beliefs about drug use and drug-using parents, funding, and planning and measurement of outcomes. Respondents from counties with a strong history of collaboration were more likely to report institutionalized collaborative practices in several areas, from use of multidisciplinary teams for case planning to use of multiyear budgeting to plan for integrated services.

  12. Foundations of Child Psychiatry.

    ERIC Educational Resources Information Center

    Miller, Emanuel, Ed.; And Others

    Twenty-eight papers examine basic theories and clinical methods in child psychiatry. Theories and methods discussed concern child psychiatry and the World Health Organization, pediatrics, child disturbances, observation, the psychodiagnostic approach, longitudinal research in child development, the comparative approach to early child development,…

  13. An analysis of a partial task training strategy for profoundly retarded institutionalized clients.

    PubMed

    Cipani, E

    1985-03-01

    This study investigated the effects of a partial task training strategy on productivity and on-task behavior in three profoundly retarded institutionalized clients in a pre-skills workshop classroom. Partial task training consisted of the presentation of "mini-tasks," with reinforcement for completion of those tasks. Additionally, behavior monitors were used to provide the clients with further positive comments and prompts. The results indicated that this strategy was effective in decreasing high rates of off-task behavior and in substantially increasing the number of pieces completed during the session. However, the effect on other inappropriate behaviors was minimal. This strategy demonstrated that profoundly retarded clients could be taught to increase on-task behavior and productivity in pre-skills workshop classes.

  14. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders

    PubMed Central

    Ancuelle, Victor; Zamudio, Rodrigo; Mendiola, Andrea; Guillen, Daniel; Ortiz, Pedro J; Tello, Tania; Vizcarra, Darwin

    2015-01-01

    We aimed to evaluate the impact in sleep quality and musculoskeletal pain of a Medium-Firm Mattress (MFM), and their relationship with objective sleep parameters in a group of institutionalized elders. The sample size included forty older adults with musculoskeletal pain. We did a clinical assessment at baseline and weekly trough the study period of four weeks. We employed the Pittsburgh Sleep Quality Index (PSQI) and Pain Visual Analog Scale (P-VAS). Additionally a sub-group of good sleepers, selected from PSQI baseline evaluation, were studied with actigraphy and randomized to MFM or High Firm Mattress (HFM), in two consecutive nights. We found a significant reduction of cervical, dorsal and lumbar pain. PSQI results did not change. The actigraphy evaluation found a significant shorter sleep onset latency with MFM, and a slightly better, but not statistically significant, sleep efficiency. The medium firmness mattress improved musculoskeletal pain and modified the sleep latency. PMID:26779317

  15. Frequency of Fra X syndrome among institutionalized mentally retarded males in Poland

    SciTech Connect

    Mazurczak, T.; Bocian, E.; Milewski, M.

    1996-07-12

    Results of cytogenetic studies, performed in a group of 201 institutionalized mentally retarded males, are presented. At least two cytogenetic methods for eliciting the Xq27.3 fragile site, recommended by the Fourth International Workshop on the Fra X Syndrome were used. A subgroup of 67 out of 201 studied males was also examined using molecular methods. In 6 (2.9%) males fra X syndrome was diagnosed. All cytogenetic positive results were confirmed by molecular analysis. Five patients had full expansion CGG repeats and one had both premutation and full mutation. Postulated frequency of fra X syndrome in Polish population being 0.2-0.4 / 1,000 males seems to be lower than it could be expected on the basis of previous literature data. 19 refs., 4 tabs.

  16. [The emergence and institutionalization of sexology in Portugal: processes, actors, and specificities].

    PubMed

    Alarcão, Violeta; Machado, Fernando Luís; Giami, Alain

    2016-09-05

    Based on Bourdieu's field theory, this article analyzes the emergence and institutionalization of sexology as a science and profession in Portugal, identifying relevant institutions, actors, and professional practices and discussing its relations and specificities. The analysis begins by contextualizing the emergence of modern Western sexology in order to comprehend the Portuguese case in the international sexology context. The second section describes the social, cultural, and institutional factors that have driven the professionalization of sexology. The third section describes the emergence of Portuguese sexology and its principal historical milestones, institutions, and actors. Finally, the article discusses some implications of this process for the role of sexology as a science and profession. The study reveals the dynamics of national and international processes in the field, in the transition from a holistic perspective of sexology to the hegemony of sexual medicine, and sheds light on its mechanisms of legitimation as a transdisciplinary science of sexuality, suggesting future perspectives.

  17. On the failed institutionalization of German comparative psychology prior to 1940.

    PubMed

    Kressley-Mba, Regina A

    2006-02-01

    Despite an illustrious history marked by the work of Wolfgang Köhler and Mathilde Hertz, among others-the significance of which still resonates in different fields of animal behavior research-and the fact that interesting work in the field continues, comparative psychology has no official status within German psychology. A partial explanation for this lack of official representation might derive from unsuccessful attempts historically to secure institutional status. "Gifted" animals served as much of the impetus for the beginning of a scientific animal psychology in Germany and contributed to its institutionalization by providing the incentive for the establishment of organizations dealing with animal psychology. Although initially serving as a catalyst for an interdisciplinary exchange on animal psychology, the case of Clever Hans was also exploited to help psychology gain institutional status in the field, albeit without lasting success.

  18. Community-Acquired Methicillin-Resistant Staphylococcus aureus in Institutionalized Adults with Developmental Disabilities1

    PubMed Central

    Borer, Abraham; Gilad, Jacob; Yagupsky, Pablo; Peled, Nechama; Porat, Nurith; Trefler, Ronit; Shprecher-Levy, Hannah; Riesenberg, Klaris; Shipman, Miriam

    2002-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has recently been reported to emerge in the community setting. We describe the investigation and control of a community-acquired outbreak of MRSA skin infections in a closed community of institutionalized adults with developmental disabilities. In a 9-month period in 1997, 20 (71%) of 28 residents had 73 infectious episodes. Of the cultures, 60% and 32% obtained from residents and personnel, respectively, grew S. aureus; 96% and 27% were MRSA. All isolates were genetically related by pulsed-field gel electrophoresis and belonged to a phage type not previously described in the region. No known risk factors for MRSA acquisition were found. However, 58 antibiotic courses had been administered to 16 residents during the preceding 9 months. Infection control measures, antibiotic restriction, and appropriate therapy resulted in successful termination of this outbreak. Selective antibiotic pressure may result in the emergence, persistence, and dissemination of MRSA strains, causing prolonged disease. PMID:12194775

  19. Rehabilitation of the institutionalized patient: description of a programme and follow-up of 60 patients.

    PubMed

    Baker, G H; Woods, T J; Anderson, J A

    1977-05-01

    The programme in an intensive rehabilitation unit in a large psychiatric hospital is described. Features include the use of non-medical staff as primary therapists, the use of a mini-bus to facilitate regular visits by patients to their home areas, the inclusion of the mini-bus driver on weekly staff conferences, the use of sociodrama, the re-organization of hospital money payments to patients, the promotion of relations with community-based facilities through occasional "teach-in" days, and a special liaison social worker providing intensive follow-up after discharge. Rehabilitation was prolonged (average stay about one year) and about half of those selected for rehabilitation from the long-stay wards were discharged. Follow-up showed that these patients benefited from discharge, in spite of a relatively high incidence of psychopathology and of social problems. Those transferred back to long-stay wards showed increased institutionalization.

  20. Spiritual Religious Coping is Associated with Quality of Life in Institutionalized Older Adults.

    PubMed

    Vitorino, Luciano Magalhães; Lucchetti, Giancarlo; Santos, Ana Eliza Oliveira; Lucchetti, Alessandra L G; Ferreira, Eric Batista; Adami, Nilce Piva; Vianna, Lucila Amaral Carneiro

    2016-04-01

    The purpose of this study was to investigate the relationship between spiritual/religious coping (SRCOPE) strategies and quality of life (QoL) in institutionalized older adults. This is a cross-sectional, correlational study, with a sample of 77 older adults in Brazil. The present study found long-term care patients use religious and spiritual coping strategies to deal with their chronic health conditions. Positive SRCOPE and Total SRCOPE have positive correlations with most QoL domains from the WHOQOL-OLD and WHOQOL-BREF. On the other hand, Negative SRCOPE strategies correlated negatively with the facets of "death and dying" from the WHOQOL-OLD. These results suggest the need for an integrative approach for long-term care patients, considering the positive and negative aspects of coping.

  1. 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.

  2. Effects of socialization games on proximity and prosocial behavior of aggressive mentally retarded institutionalized women.

    PubMed

    Edmonson, B; Han, S S

    1983-01-01

    Socialization games, designed to reinforce prosocial behavior between moderately and severely mentally retarded aggressive institutionalized women, were presented to two groups on 12 occasions over 8 weeks, randomly interspersed with 12 sessions of arts and crafts or filmstrip stories. Half of the sessions were presented in the morning and half in the afternoon. Video-taped observations of interpersonal behavior for 10 minutes after each session were analyzed in terms of friendly, unfriendly, and inactive behavior, and the distance of each subject from each other subject was measured. The rate of friendly behavior was significantly greater after the games and was higher in morning than afternoon sessions. The games also significantly decreased interpersonal distance. Both unfriendly behavior and inactivity were higher after the "placebo" sessions. The relevance of these results to institutional programming was discussed.

  3. Anticholinergic drug exposure is associated with delirium and postdischarge institutionalization in acutely ill hospitalized older patients.

    PubMed

    Egberts, Angelique; van der Craats, Saskia T; van Wijk, Melissa D; Alkilabe, Shams; van den Bemt, Patricia M L A; Mattace-Raso, Francesco U S

    2017-06-01

    Several studies investigated the possible association between anticholinergic drugs and diverse clinical outcomes in older persons, but the results are inconsistent. The aim of this study was to investigate whether anticholinergic drug exposure is associated with delirium on admission, length of hospital stay, postdischarge institutionalization and in-hospital mortality in acutely ill hospitalized older patients. In this observational chart review study, we included acutely ill patients aged 65 and older who were admitted to the geriatric ward of the Erasmus University Medical Center, Rotterdam, The Netherlands, between 2012 and 2015 (n = 905). Anticholinergic drug exposure on admission was defined as the use of anticholinergic drugs, total number of anticholinergic drugs and anticholinergic drug burden score (ADB), quantified with the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden scale (ACB) and the list of Chew et al. (Chew). Logistic regression analyses were performed to investigate possible associations between anticholinergic drug exposure and the aforementioned outcomes. Analyses were adjusted for age, sex, comorbidities, non-anticholinergic drugs and delirium, where appropriate. Moderate and high ADB measured with the ARS were associated with delirium on admission with odds ratios (OR) of 1.70 (95% confidence interval (CI) = 1.16-2.49) and 1.83 (95% CI = 1.06-3.15), respectively. High ADB measured with the ARS was also associated with postdischarge institutionalization (OR = 2.43, 95% CI = 1.24-4.75). No associations were found using the ACB and Chew. Future studies are warranted to investigate the clinical usefulness of the ARS in reducing complications in older persons.

  4. Acceptance and commitment therapy for clients institutionalized for severe substance-use disorder: a pilot study.

    PubMed

    Svanberg, Gabriella; Munck, Ingrid; Levander, Maria

    2017-01-01

    Individuals with substance-use disorder (SUD) often have co-occurring mental health disorders and decreased executive function, both of which are barriers to sustained rehabilitation. Clients with severe SUD can be institutionalized in The Swedish National Board of Institutional Care but are difficult to engage and dropout rates remain high. Recent studies suggest that acceptance and commitment therapy (ACT) is an effective treatment for mental health and SUD. The overall aims of the present pilot study were to explore a manual-based ACT intervention for clients institutionalized for severe SUD and to describe the effects on mental health, psychological flexibility, and executive function. This pilot study is the first to use a manual-based ACT intervention within an inpatient context. Eighteen participants received a seven-session ACT intervention tailored for SUD. Statistical analyses were performed for the complete data (n=18) and on an individual level of follow-up data for each participant. In order to follow and describe changes, the strategy was to assess the change in 13 clinical scales from pre-intervention to post-intervention. Results suggested that there was no change in mental health and a trend implying positive changes for psychological flexibility and for 9 of 10 executive functions (e.g., inhibitory control, task monitoring, and emotional control). The pilot study suggests clinical gains in psychological flexibility and executive functions both at the Institution regulated by the Care of Alcoholics and Drugabuser Act (also known as LVM home) and at the individual level. Since the sample size does not provide adequate statistical power to generalize and to draw firm conclusions concerning intervention effects, findings are descriptive and preliminary in nature. Further development and implementation of ACT on a larger scale study, including the maintenance phase and a follow-up, is needed.

  5. A 6-month follow-up of nutritional status in institutionalized patients with Alzheimer's disease.

    PubMed

    Van Wymelbeke, V; Guédon, A; Maniere, D; Manckoundia, P; Pfitzenmeyer, P

    2004-01-01

    A follow up of nutritional status in institutionalized patients with Alzheimer's disease. Observational study. Specialized unit for patients with Alzheimer's disease in Dijon hospital, France. Fourteen women, aged 72-92 years. On admission of patients to the specialized unit for dementia, body weight, body mass index, arm muscle circumference (AMC) and triceps skin fold (TSF) were measured. Serum concentrations of albumin, prealbumin, homocysteine, orosomucoide, calcium, folates, vitamins B12 and B6 and C-reactive protein were recorded. The same clinical and biological measurements were repeated at day 30, 90 and 180. Both mean weight and mean BMI increased throughout the study with significant differences between day 0 and day 90, and day 180 (p<0.01). The weight gain was associated with a significant increase in AMC and TSF (p<0.01 and p<0.001, respectively). There was no significant difference for values of both mean serum levels of albumin and prealbumin between day 0 and day 180. Whatever the period, serum concentrations of folates and vitamin B12 were in the normal range, while mean levels of vitamin B6 were lower than the normal range; For all these values, there was no significant difference between day 0, 30, 90, 180. Mean levels of C-reactive protein and orosomucoide and lymphocyte counts were in the normal range both at admission and day 180. No significant difference was noted between value of homocysteine at admission and at day 180. In this special care unit, the patients with Alzheimer's disease who take part in daily activities and particularly preparation of the meal don't lose weight. It is certain that future studies recording food intake and energy expenditure are necessary to explain the benefits in the nutritional status observed in patients showing dementia when they are institutionalized in a special unit.

  6. Dementia and Nutrition. Intervention study in institutionalized patients with Alzheimer disease.

    PubMed

    Gil Gregorio, P; Ramirez Diaz, S P; Ribera Casado, J M

    2003-01-01

    To know nutritional status of a group of institutionalized patients with moderate Alzheimer's Disease (AD), and to ascertain the effects of an intervention with nutritional supplements on morbidity and mortality after one year follow-up. 99 patients (mean age: 86.5 years), 80 women, with a diagnosis of AD according with NINCDS/ADRDA criteria, were recruited from 8 nursing-homes. 25 were included in an intervention group and received a nutritional supplements along 12 months. Evolution was evaluated according to the Functional Assessment Staging Test (FAST). Patients with FAST levels 5-6 were included. General clinical variables as well as variables reflecting cognitive state and nutritional status: anthropometric, biochemical data and Mini Nutritional Assessment (MNA) were analysed. Statistical analysis was carry out with the SPSS 10.0 package. Mean time since diagnosis was 49 months, with a 20.2 months duration of institutionalization. Mean value of MNA was 20.1 3.5. 16.5% of patients had a BMI equal o lower than 21. After one year the intervention group showed higher levels of albumin (P=05), pre-albumin (P=05), iron (P=01), zinc (P=05), and beta-carotene (P=05) than the control group. The same response in BMI (P=05), MNA (P=05), and triceps skinfold (P=01). Mortality was lower (16% vs. 22.7%), without statistical significance, in the intervention group, as it was the number of infectious events (47% vs. 66% P=05), and the days in bed (7.5 2.1 vs. 17.3 5.6 P=05). Nutritional supplements applied to a group of patients with AD living in nursing-homes can reduce morbidity and mortality after one year follow-up.

  7. Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt.

    PubMed

    El Kady, Heba M; Ibrahim, Hala K; Mohamed, Sherine G

    2012-12-01

    Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia. The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt. This study was done through two phases. A cross-sectional design was used in the first phase to detect the prevalence of sleep problems and their correlates among the elderly, then pretest-posttest design was used to apply an intervention program to the elders who suffered from insomnia. A pre-designed structured interview questionnaire was presented to the participants. The main outcome measure was sleep quality, as measured by the Pittsburgh Sleep Quality Index. The study included a total of 210 elders (97 males and 113 females), with a mean age of 72.2 ± 5.3 years, about two thirds of them were poor sleepers (63.3%). The results show that after carrying out the behavioral therapy for the elders, the percentage of poor sleepers decreased from 63.3% to 46.2%. Two variables (educational level and female sex) proved to be statistically significantly related to the improvement in sleep quality. A goal of this intervention program was considerably achieved. Importantly, the intervention appears to improve sleep quality among the elders. Data from this study re-enforce the continuing need for more sleep educational programs that are intended to attract the attention of elders especially those institutionalized.

  8. ADHD Symptoms in Post-Institutionalized Children Are Partially Mediated by Altered Frontal EEG Asymmetry.

    PubMed

    Frenkel, Tahl I; Koss, Kalsea J; Donzella, Bonny; Frenn, Kristin A; Lamm, Connie; Fox, Nathan A; Gunnar, Megan R

    2016-09-29

    Individual differences in the propensity for left versus right frontal electroencephalogram (EEG) asymmetry may underlie differences in approach/withdrawal tendencies and mental health deficits. Growing evidence suggests that early life adversity may shape brain development and contribute to the emergence of mental health problems. The present study examined frontal EEG asymmetry (FEA) following the transition to family care in children adopted internationally from institutional care settings between 15 and 36 months of age (N = 82; 46 female, 36 male). Two comparison groups were included: an international adoption control consisting of children adopted from foster care with little to no institutional deprivation (N = 45; 17 female, 28 male) and a post-adoption condition control consisting of children reared in birth families of the same education and income as the adoptive families (N = 48; 23 female, 25 male). Consistent with evidence of greater approach and impulsivity-related behavior problems in post-institutionalized (PI) children, PI status was associated with greater left FEA than found in the other two groups. In addition, left FEA served as a mediator between institutionalization and age 5 ADHD symptoms for girls. Age at adoption and other preadoption factors were examined with results suggesting that earlier adoption into a supportive family resulted in a more typical pattern of brain functioning. Findings support the idea that the capacity of brain activity to evidence typical functioning following perturbation may differ in relation to the timing of intervention and suggest that the earlier the intervention of adoption, the better.

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

    PubMed

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

    2017-05-22

    There is 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, independents 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.

  10. 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.

  11. Child Sexual Abuse

    MedlinePlus

    Sexual abuse is one form of child abuse. It includes a wide range of actions between a child ... to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual ...

  12. Child Sexual Abuse

    MedlinePlus

    ... Vietnamese Sexual Abuse No. 9; Updated November 2014 Child sexual abuse has been reported up to 80,000 times ... sexual abuse can be devastating to the child. Child sexual abuse can take place within the family, by a ...

  13. Ileostomy and your child

    MedlinePlus

    ... embarrassment. You may see some changes in your child's behavior at first. Sometimes teenagers have a harder time ... You being open and natural will help your child's behavior stay positive. Help your child learn how to ...

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

    PubMed Central

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

    2016-01-01

    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. SIGNIFICANCE STATEMENT 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

  15. [Variables associated with functional recovery and post-discharge institutionalization of elderly cared in an average stay geriatric unit].

    PubMed

    Baztán, J J; González, M; Morales, C; Vázquez, E; Morón, N; Forcano, S; Ruipérez, I

    2004-11-01

    To describe the evolution and results of the rehabilitation of elderly disabled cared in an average stay geriatric unit, and to define the factors associated with functional improvement and post-discharge institutionalization. Observational longitudinal study in 459 patients with functional disability consecutively hospitalized between May 2000 and December 2001. Basal variables collected included the clinical, functional, mental, and sociodemographic manifestations previous to the admission. The favorable functional response (defined as a functional gain during the admission of > or = 20 points in the Barthel index) and the post-discharge institutionalization were regarded the main result variables. The average age of patients was 80.56 (SD: +/- 7.45) years, 64.9% were women and 81% came from acute hospital units; the main cause of disability was stroke (48.5%) followed by orthopedic pathology (26.2%) and immobility for different causes (23.5%). 72.5% of patients get functional improvement and 16.4% were institutionalized after the discharge. The main independent risk factors for poor functional response found in the multivariate analysis were a scoring in Pfeiffer's cognitive test of 5-7 points (OR: 0.42; 95% CI: 0,22-0.78) and > or = 8 (OR: 0.29; 95% CI: 0.12-0.71), and a scoring in Barthel's index < 60 prior to the deterioration (OR: 0.36; 95% CI: 0.14-0.93). Independent risk factors for institutionalization after the discharge were age (OR: 1.06; 95% CI: 1.01-1.12), and a scoring in the Gijon's sociofamiliar scale > or = 9 (OR: 6.83; 95% CI: 1.91-24.47). A functional disability after the discharge in the Barthel's index < 40 also was independently associated to post-discharge institutionalization (OR: 3,07; 95% CI: 1.04-10.06). Most of elderly with recent disability benefit functionally from care in specific hospital geriatric units. Moderate or severe cognitive deterioration after hospitalization is associated to lower recovery probability. Very advanced age

  16. 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

  17. Anticandidal efficacy of denture cleansing tablet, Triphala, Aloe vera, and Cashew leaf on complete dentures of institutionalized elderly.

    PubMed

    Shetty, Pooja J; Hegde, Vijaya; Gomes, Leslie

    2014-01-01

    With an increase in the number of dependent elderly, there is a need to introduce few natural products for denture cleansing, which are easily and economically available. Hence the aim of this study was to compare the anticandidal efficacy of denture cleansing tablet (sodium bicarbonate and sodium perborate monohydrate), Triphala (Phyllanthus emblica, Terminalia chebula and Terminalia belerica fruits powders in equal proportion), cashew leaf, Aloe vera and water (control) on complete dentures of institutionalized elderly. Study population consisted of 50 institutionalized elderly of Mangalore, Karnataka, with 10 in each group. Swabs were collected from the dentures before and after the use of denture cleansing tablet, Triphala, cashew leaf, Aloe vera, and water (control). Thereafter, the swabs were cultured on Sabouraud dextrose agar and the total candida counts were determined. Denture cleansing tablet and Triphala Churna showed a statistically significant reduction in Candida counts (P < 0.05). Denture cleansing tablet and Triphala Churna were found to be more effective.

  18. Effect of sublingual administration of interferon-alpha on the immune response to influenza vaccination in institutionalized elderly individuals.

    PubMed

    Launay, Odile; Grabar, Sophie; Bloch, Frédéric; Desaint, Corinne; Jegou, David; Lallemand, Christophe; Erickson, Robert; Lebon, Pierre; Tovey, Michael G

    2008-07-29

    A randomized double-blind placebo-controlled study was conducted to determine the effect of sublingual administration of IFNalpha on the immune response to influenza vaccination in elderly institutionalized individuals. Sublingual administration of 10 million IU of IFNalpha immediately prior to vaccination, reduced the geometric mean haemagglutination inhibitory (HAI) and IgG2 circulating antibody titers, and the secretory IgA (sIgA) response in saliva, to the New York strain of influenza A virus, 21 days post-vaccination, without detectable drug-related local or systemic toxicity. IFN treatment did not inhibit the immune response to the other components of the vaccine; the New Caledonia strain of influenza A virus, or the Jiangsu strain of influenza B virus. At the dose tested sublingual administration of IFNalpha reduces the immune response to influenza vaccination in elderly institutionalized individuals.

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

    PubMed

    Ridde, Valéry

    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.

  20. Anticandidal efficacy of denture cleansing tablet, Triphala, Aloe vera, and Cashew leaf on complete dentures of institutionalized elderly

    PubMed Central

    Shetty, Pooja J.; Hegde, Vijaya; Gomes, Leslie

    2014-01-01

    With an increase in the number of dependent elderly, there is a need to introduce few natural products for denture cleansing, which are easily and economically available. Hence the aim of this study was to compare the anticandidal efficacy of denture cleansing tablet (sodium bicarbonate and sodium perborate monohydrate), Triphala (Phyllanthus emblica, Terminalia chebula and Terminalia belerica fruits powders in equal proportion), cashew leaf, Aloe vera and water (control) on complete dentures of institutionalized elderly. Study population consisted of 50 institutionalized elderly of Mangalore, Karnataka, with 10 in each group. Swabs were collected from the dentures before and after the use of denture cleansing tablet, Triphala, cashew leaf, Aloe vera, and water (control). Thereafter, the swabs were cultured on Sabouraud dextrose agar and the total candida counts were determined. Denture cleansing tablet and Triphala Churna showed a statistically significant reduction in Candida counts (P < 0.05). Denture cleansing tablet and Triphala Churna were found to be more effective. PMID:24812470

  1. The child dream and the child transference.

    PubMed

    De Francisco, D

    1986-01-01

    This paper explores the symbolic meaning of dreams in which children appear with special attention to the way children in dreams symbolize the self, particularly the dependent and developing self. It is suggested that patients' growth in analysis can be monitored by observing what happens to the children in their dreams. This paper also explores the vicissitudes of the child transference, in which the patient treats the analyst as a child. An analysis is described in which the child dream and the child transference played an important role in elucidating the patient's neurotic behaviors. The author contends that the child dream and the child transference are common and clinically useful phenomena, especially important in the analysis of dependency conflicts. An additional thesis of this paper is that the child transference is most likely to be found in instances where a patient played a parental role with one of their parents during childhood.

  2. Female Engagement Teams: Making the Case for Institutionalization Based on U.S. Security Objectives in Africa

    DTIC Science & Technology

    2013-05-23

    FEMALE ENGAGEMENT TEAMS: MAKING THE CASE FOR INSTITUTIONALIZATION BASED ON U.S. SECURITY OBJECTIVES IN AFRICA A Monograph... Africa 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jones, Gina Maria O. 5d. PROJECT NUMBER...which FETs could (and should) be used to help accomplish U.S. security objectives in Africa . However, to ensure that future FET employments are as

  3. Institutionalizing State-Sponsored Terrorism: A Decade of Violence in Argentine Terrorism; Revolution and Military Reaction, 1970-1979.

    DTIC Science & Technology

    1998-10-27

    This thesis examines the institutionalization of violence in the history of the Republic of Argentina, and pays special attention to the...institutional terrorism of the decade of the 1970’s. The history of Argentina clearly shows that legalized violence has always been a method of gaining and...of violence and military elitism, then takes a closer look at the terrorist threat of the early 1970’s and the military response from 1975 to 1979

  4. 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

  5. Effectiveness of group reminiscence for improving wellbeing of institutionalized elderly adults: study protocol for a randomized controlled trial.

    PubMed

    Gaggioli, Andrea; Scaratti, Chiara; Morganti, Luca; Stramba-Badiale, Marco; Agostoni, Monica; Spatola, Chiara A M; Molinari, Enrico; Cipresso, Pietro; Riva, Giuseppe

    2014-10-25

    Group reminiscence therapy is a brief and structured intervention in which participants share personal past events with peers. This approach has been shown to be promising for improving wellbeing and reducing depressive symptoms among institutionalized older adults. However, despite the considerable interest in reminiscence group therapy, controlled studies to determine its specific benefits as compared to generic social interactions with peers (group conversations about everyday subjects) are still lacking. We have designed a randomized controlled trial aimed at comparing the effects of group reminiscence therapy with those of group recreational activity on the psychological wellbeing of an institutionalized sample of older adults. The study includes two groups of 20 hospitalized elderly participants: the experimental group and the control group. Participants included in the experimental group will receive six sessions of group reminiscence therapy, while the control group will participate in a recreational group discussion. A repeated-measures design will be used post-intervention and three months post-intervention to evaluate changes in self-reported outcome measures of depressive symptoms, self-esteem, life satisfaction, and quality of life from baseline. The protocol of a study aimed at examining the specific effects of group reminiscence therapy on psychological wellbeing, depression, and quality of life among institutionalized elderly people is described. It is expected that the outcomes of this trial will contribute to our knowledge about the process of group reminiscence, evaluate its effectiveness in improving psychological wellbeing of institutionalized individuals, and identify the best conditions for optimizing this approach. This trial was registered with ClinicalTrials.gov (registration number: NCT02077153) on 31 January 2014.

  6. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

    The purpose of this paper was to elaborate on the definitions of child abuse in order to improve the understanding of child abuse. The definitions given by the U.S. House Joint Committee on Child Abuse in the Child Abuse Prevention and Treatment Act, and in research by Holden (1984), are cited. These definitions refer to the nature of abusive acts…

  7. Child Support Report, 2002.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    2002-01-01

    This document comprises the 12 issues for 2002 of the Child Support Report, which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Featured regularly are editorials and information on events of interest and…

  8. Child Support Report, 1997.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    1997-01-01

    This document consists of the twelve issues of "Child Support Report" newsletter published during 1997. Monthly issues typically explore problems related to child support enforcement, report on federal and state government child support enforcement initiatives, and summarize research related to child support. Editorials and information…

  9. Child Support Report, 2000.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    2000-01-01

    This document comprises the 12 issues for 2000 of the "Child Support Report," which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Featured regularly are editorials and information on events of…

  10. Child Support Report, 1999.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    1999-01-01

    This document comprises the 12 issues for 1999 of the "Child Support Report," which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Editorials and information on events and conferences of interest and…

  11. Child Support Report, 2001.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    2001-01-01

    This document comprises the 12 issues for 2001 of the "Child Support Report," which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Featured regularly are editorials and information on events of…

  12. Cortisol, DHEAS and aging: resistance to cortisol suppression in frail institutionalized elderly.

    PubMed

    Carvalhaes-Neto, N; Huayllas, M K; Ramos, L R; Cendoroglo, M S; Kater, C E

    2003-01-01

    Convincing evidences has linked the hypothalamus-pituitary-adrenal (HPA) axis to aging patterns. F excess is implicated in the development of frailty characteristics whereas DHEAS is positively correlated to successful aging. We compared serum F and DHEAS levels of independent community-living (successful group, 19 M and 28 F, 69 to 87 yr) with those of institutionalized elderly (frail group, 20 M and 30 F, 65 to 95 yr). Serum F was determined at 1) baseline (08:00 h, 16:00 h and 23:00 h), 2) after 2 overnight dexamethasone (DEX) suppression tests (DST, using 0.25 and 1.0 mg doses), and 3) 60 min after ACTH stimulation (250 microg i.v. bolus); serum DHEAS was determined at 08:00 h. Basal serum F at 08:00 h, 16:00 h and 23:00 h and serum DHEAS levels were similar in both groups; however F: DHEAS ratio at 08:00 h was higher in the frail, compared to the successful group (mean +/- SD: 0.55 +/- 0.53 and 0.35 +/- 0.41, respectively; p = 0.04). In response to DST, F suppression was less effective in frail elderly after either 0.25 or 1.0 mg doses (9.0 +/- 6.0 and 2.0 +/- 0.9 microg/dl), as compared to the successful group (5.8 +/- 4.4 and 1.5 +/- 0.5 microg/dl) (p = 0.01). In addition, a significant correlation was observed between post-DEX F levels (both doses) and parameters of cognitive and physical frailty. Normal and similar F levels were observed after ACTH stimulation in both groups. Our data suggest a deficient feedback regulation of the HPA axis in frail institutionalized elderly, as demonstrated by a higher set point for F suppression. This augmented HPA tonus enforces the hypothesis that even milder F excess may be related to characteristics of frailty in the elderly.

  13. Evidence for a Prognostic Role of Orthostatic Hypertension on Survival in a Very Old Institutionalized Population.

    PubMed

    Agnoletti, Davide; Valbusa, Filippo; Labat, Carlos; Gautier, Sylvie; Mourad, Jean-Jacques; Benetos, Athanase

    2016-01-01

    In old individuals, regulation of blood pressure during postural changes is impaired. Several studies have assessed the clinical impact of orthostatic hypotension (OHypoT) during the aging process. By contrast, the prevalence and prognostic role of the increase in blood pressure in upright position (orthostatic hypertension, OHyperT) in old adults remain unknown. We investigated the association of OHyperT with cardiovascular morbidity and mortality in a population of old institutionalized subjects. A 2-year follow-up longitudinal study was conducted on 972 subjects (mean age [SD] 88 [5]) from the PARTAGE (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population) study, able to maintain a standing position. OHyperT was defined as an increase in systolic blood pressure ≥20 mm Hg during the first and third minute of standing. Three groups of subjects were compared: orthostatic normotension (n=540), OHypoT (n=157), and OHyperT (n=275). OHyperT prevalence (28%) was higher than OHypoT (16%). Sitting systolic blood pressure was higher in OHypoT compared with orthostatic normotension and OHyperT groups (146 [23] versus 136 [21] and 136 [20] mm Hg, respectively, P<0.001). The OHyperT group was associated with a greater risk of cardiovascular morbidity and mortality than orthostatic normotension (hazard ratio 1.51 [1.09-2.08], P<0.01) and remained unchanged after adjustment for age, sex, sitting systolic blood pressure, and comorbidities. No difference in cardiovascular morbidity and mortality was observed between OHyperT and OHypoT groups. In conclusion, in a old frail population, the increase in systolic blood pressure during upright position occurs frequently and is associated with higher cardiovascular morbidity and mortality independently of sitting blood pressure levels and major comorbidities. Health professional should take into account not only the decrease but also the increase in blood pressure when standing up. URL

  14. Dental Caries Status of Institutionalized Orphan Children from Jammu and Kashmir, India

    PubMed Central

    Tangade, Pradeep; Ravishankar, TL; Tirth, Amit; Pal, Sumit; Batra, Manu

    2016-01-01

    Introduction It has been well documented that the absence of family support influences the general and oral health of the children. Factors that lead to the development of disease at a given point in time are likely to have their roots in a complex chain of environmental events that may have begun years before. A number of studies have examined the relationship between dental caries and material deprivation and found a positive association between them. Though orphans contribute to 2% of world’s population, literature regarding their oral health status is very scarce. This study was carried out with the aim to assess the dental caries status of institutionalized orphan children from Jammu and Kashmir. Materials and methods A total of 1,664 children that included 1,201 boys and 463 girls from registered orphanages in the state of Jammu and Kashmir were included in the study. Written informed consent was obtained prior to the start of the study; decayed, extracted, filled teeth (deft)/ decayed, extracted, filled surface (defs) and decayed, missing, and filled teeth (DMFT)/decayed, missing, and filled surface (DMFS) indices were used to assess the caries status of primary and permanent dentition. Multiple choice, close-ended questionnaires were administered to assess the oral hygiene habits, knowledge, and dietary behavior of orphan children prior to examination. The study subjects were divided into three groups according to the age of ≤ 6, 7 to 11, and ≥12 years. Results Results showed that caries prevalence in primary dentition was higher in subjects’ ≤6 years of age where the prevalence was 50.9%; in subjects 7 to 11 years of age, the prevalence was 25.2%. Caries prevalence in permanent dentition within the age group 7 to 11 was 69.1%, while in subjects’ ≥12 years, the prevalence was 66.2%. Use of toothbrush was the most prevalent method of cleaning the teeth in both the genders, while toothpaste was reported to be the most prevalent material to be

  15. Erosive tooth wear status of institutionalized alcoholic patients under rehabilitation therapy in the north of Portugal.

    PubMed

    Teixeira, Liliana; Manso, Maria-Conceição; Manarte-Monteiro, Patrícia

    2017-04-01

    The objective of the study was to determine the erosive tooth wear (ETW) status of institutionalized patients for alcohol misuse rehabilitation therapy in the north of Portugal. Descriptive, analytical, and cross-sectional study, conducted on 277 individuals (83.4 % men) with an average age of 43.6 ± 8.4 years, institutionalized at Instituto da Droga e Toxicodependência-Delegação Regional Norte (IDT-Norte). ETW prevalence and severity were assessed by Eccles and Jenkins index. Multivariate logistic regression was used to identify ETW risk factors. Subjects with ETW risk identification according to biological and behavioral exposure were determined in the study. ETW prevalence was 98.6 %. In the cohort, 51.3 % showed localized ETW lesions, 40.1 % generalized ETW lesions, and 7.2 % enamel ETW lesions, more frequently localized in maxilla. From the examined dental surfaces (n = 15,598), 11,493 had erosive wear lesions: 92.4 % (95 % CI 91.7-93.1 %) of all occlusal surfaces, 71.9 % (95 % CI 70.7-73.1 %) of all palatal/lingual, and 56.7 % (95 % CI 55.4-58.1 %) of all buccal surfaces. Buccal and lingual surfaces showed 43.2 and 41.8 % enamel erosive wear lesions; occlusal surfaces had 43.4 % localized erosive wear lesions in dentin. The main ETW risk factors were as follows: age, gastroesophageal reflux disease over 1 year, daily intake of alcohol ≥240 g (grams), and intra-oral location in anterior region; 46.2 % of the participants had erosive risk by exposure to biological and behavioral factors. The ETW status showed high values for disease prevalence and severity, mainly located in the maxilla, and high frequency of erosive wear lesions at occlusal, buccal, and lingual surfaces, resulting from simultaneous exposure to several risk factors. For ETW differential diagnosis, the association of both clinical and biological/nutritional/behavioral risk factors should be done for each studied population.

  16. 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

  17. Physical fitness levels among independent non-institutionalized Spanish elderly: the elderly EXERNET multi-center study.

    PubMed

    Pedrero-Chamizo, R; Gómez-Cabello, A; Delgado, S; Rodríguez-Llarena, S; Rodríguez-Marroyo, J A; Cabanillas, E; Meléndez, A; Vicente-Rodríguez, G; Aznar, S; Villa, G; Espino, L; Gusi, N; Casajus, J A; Ara, I; González-Gross, M

    2012-01-01

    Physical fitness is gaining in importance in all population groups, including elderly, but data are still scarce. The aim of this study was to report gender and age specific physical fitness levels in non-institutionalized Spanish elderly. A representative sample of 3136 elderly (≥ 65 y), 724 men and 2412 women, from 6 Regions of Spain: Madrid, Aragón, Castilla y León, Castilla-La Mancha, Extremadura and Canarias were assessed in the elderly EXERNET multi-center study between 2008 and 2009. The authors assessed static balance, muscular strength, flexibility, agility, walking speed and cardiorespiratory fitness using eight different fitness tests: one leg balance, chair stand, arm curl, chair sit-and-reach, back scratch, 8-foot up-and-go, 30-m walk, and 6 min walk tests. The authors derived gender and age-specific normative values for physical fitness in the non-institutionalized Spanish elderly. The figures showed greater physical fitness in the elderly men than in women, except for the flexibility test, and a trend toward decreased physical fitness in both genders as their age increased. The normative values hereby provided will enable evaluation and correct interpretation of independent non-institutionalized Spanish elderly fitness status. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

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

    2014-01-01

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

  19. Child labor: a forgotten focus for child welfare.

    PubMed

    Otis, J; Pasztor, E M; McFadden, E J

    2001-01-01

    Child labor is driven by child and family impoverishment, market forces, and political apathy concerning the rights of the child. Although a fundamental concern of the early 20th century child welfare system, today child labor is often seen as outside the scope of child welfare and child protective services. Making child labor a focus of child advocacy activity once again could do much to better the lives of children.

  20. Forced conscription of children during armed conflict: experiences of former child soldiers in northern Uganda.

    PubMed

    Vindevogel, Sofie; Coppens, Kathleen; Derluyn, Ilse; De Schryver, Maarten; Loots, Gerrit; Broekaert, Eric

    2011-07-01

    Child soldiering can be considered as one of the worst practices of institutionalized child abuse. However, little is known about the scope and nature of this abuse and the consequent experiences of children enrolled in an armed faction. This research aims at enriching the knowledge on the experiences of child soldiers in the Lord's Resistance Army (LRA) in northern Uganda. The databases of 4 former Interim Care Centres for returned child soldiers in northern Uganda, comprising socio-demographic information of 8,790 returnees, and additional data from the Rachele Rehabilitation Centre on war-related experiences of 1,995 former child soldiers, are analyzed using descriptive statistics, analysis of covariance and regression analysis. During on average 1.5 years in captivity, nearly all participants had various war-related experiences, whereby 88% witnessed and 76% forcibly participated in atrocities. Variations in exposure to warfare appear to be mainly associated with age of abduction, duration of captivity, location of captivity, being military trained, and being a rebel's wife. These findings testify to the vastness of abuse lived through by the child soldiers in this study. They fulfilled a multifaceted position in the LRA, which delivers a range of potential direct and indirect consequences. The variables decisive in differential experiences unveil trends in the strategic abduction by the LRA and in differential exposure to warfare among child soldiers. The variation in exposure to warfare urges for an individualized approach and monitoring of returning child soldiers. In order to address the potential indirect impact of child soldiering, support also needs to be oriented towards the child's network, based on a socio-ecological approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. 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

  2. [Prevalence of osteoporosis assessed by quantitative ultrasound calcaneus measurements in institutionalized elderly population].

    PubMed

    Navas Cámara, F J; Fernández de Santiago, F J; Bayona Marzo, I; Mingo Gómez, T; de la Fuente Sanz, M M; Cacho del Amo, A

    2006-08-01

    To analyze using quantitative ultrasound of calcaneus (QUS) the prevalence of osteoporosis in institutionalized elderly people, in order to contribute to state reliable criteria (T-score units) for the diagnosis of osteoporosis which allow advances in bone fracture prevention. Elderly people (n=171) were divided into separate groups according to sex and age criteria (three decades, from 70 to 90 years) and analyzed using QUS. Both globally and in the younger groups, women showed significantly lower values than men in all densitometry variables (p < 0.001). In the oldest group only T-score and BUA showed statistical differences (p = 0.039 y p = 0.025, respectively). The prevalence of osteoporosis in women was higher than in men whichever criteria were applied in all age groups. Applying the WHO criteria with QUS, the prevalence of osteoporosis in global population is close to that stated by DEXA using the same criteria. QUS could be useful to assess the bone mass evolution with age and for the diagnosis and monitoring of osteoporosis. In our elderly population, the WHO criteria for DEXA, are also the most suitable ones for QUS utilization.

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

    PubMed

    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

    2016-09-01

    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 proportion of time in institutional care at specified follow-up assessment ages, and DNA methylation status in two stress-related genes: FKBP5 and SLC6A4. 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. 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. 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. Am J Phys Anthropol 161:84-93, 2016.. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. 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

  5. Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system.

    PubMed

    Salmerón-Castro, J; Kazcano Ponce, E C; Pérez Cuevas, R; del Río Gómez, I; Torres Torija, I; Hernández Avila, M

    1998-01-01

    The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP) is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionalizing CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1) improving coverage; 2) implementing smear-taking quality control; 3) improving quality in interpretation of Pap test; 4) guaranteeing treatment for women for whom abnormalities are detected; 5) improving follow-up; 6) development of quality control measures and 7) development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

  6. A cognitive intervention to enhance institutionalized older adults' social support networks and decrease loneliness.

    PubMed

    Winningham, R G; Pike, N L

    2007-11-01

    Nearly all older adults experience social losses, which can disrupt their social support networks and impair their quality of life. Events such as retirement, an inability to drive, death of a spouse and/or close life-long friends, or moving to an elder care facility may negatively affect the quality of older adults' social support networks. Low levels of perceived social support are associated with increased depression, impaired immune functioning and reduced life expectancy. Moreover, social interactions can be cognitively stimulating and may help older adults preserve their cognitive abilities. In the present study, institutionalized older adults were exposed to either a cognitive enhancement programme designed to enhance social networks or a control group. Measures of perceived social support and loneliness were administered before and after a 3-month, group-based intervention. There was a significant interaction between group and time. Those who did not participate in the intervention experienced a decrease in perceived social support and an increase in perceived loneliness. Participants in the intervention group stayed the same on the above measures. Helping older adults increase or maintain the quality of their social networks may lead to enhanced cognitive functioning, decreased depression and improved quality of life. Recommendations to help assisted living facilities, nursing homes, retirement communities and senior centres develop social and cognitive interventions are provided.

  7. Defining oral neglect in institutionalized elderly: a consensus definition for the protection of vulnerable elderly people.

    PubMed

    Katz, Ralph V; Smith, Barbara J; Berkey, Douglas B; Guset, Adela; O'Connor, Michael P

    2010-04-01

    The authors administered surveys to develop an operational definition of oral neglect in institutionalized elderly (ONiIE) in the United States. The authors administered a Delphi technique survey involving three rounds to a panel of 19 geriatric dental experts in 1995 to arrive at a definition of ONiIE. The authors validated the 1995 ONiIE definition by administering a Delphi technique survey involving four rounds to a subset of eight experts from the 1995 panel. The panelists in the 2009 survey validated the 28 oral diseases or conditions that were part of the 1995 ONiIE definition and added one new oral condition-bleeding. They also reached consensus agreement for each of the 29 listed oral diseases and conditions regarding both the diagnostic stage at which those diseases and conditions should be included in a definition (mild, moderate, or severe) and the specified time period required to constitute neglect (that is, total "time to qualify as neglect" was eight days for acute conditions and 35 days for chronic conditions). An expert-driven consensus ONiIE definition was established. It consists of 29 oral diseases and conditions, each of which has been associated with a diagnostic stage and a specified time period required to constitute neglect. Since federal legislation that funds payments to nursing homes for the care and housing of their residents requires that there shall be no oral neglect, this validated consensus ONiIE definition provides a utilitarian means to enforce that legislative expectation.

  8. Association between complaints of dizziness and hypertension in non-institutionalized elders

    PubMed Central

    Lopes, Anália Rosário; Moreira, Michelle Damasceno; Trelha, Celita Salmaso; Marchiori, Luciana Lozza de Moraes

    2013-01-01

    Summary Introduction: Advancing age increases the risk for a number of chronic diseases. Hypertension and dizziness are highly prevalent in the elderly population and represent major health problems. Objective: To verify the association between complaints of dizziness and the presence of hypertension in non-institutionalized elders. Method: This was a prospective cross-sectional cohort study of the elderly population of Londrina, Paraná in terms of aging and longevity. The required sample size was calculated, and subjects e” 60 years of age of both genders were selected at random. Data were collected using a questionnaire covering socio-demographic information and self-reported cases of hypertension and dizziness. Statistical analysis was performed using the chi-square test with p d” 0.05 as the level of significance. Results: The study included 493 elderly subjects, of whom 257 (52.1%) complained of dizziness and 308 (62.5%) reported a diagnosis of arterial systemic hypertension. Dizziness was significantly associated with hypertension (χ2 = 6.26, p = 0.01) and female sex. Conclusions: Hypertension and dizziness were both highly prevalent and were significantly associated, showing the great need for investments in preventive measures. PMID:25992007

  9. Screening depression among institutionalized older Chinese men by minimum data set: we need a new instrument.

    PubMed

    Liang, Chih-Kuang; Chen, Liang-Kung; Tsai, Chia-Fen; Su, Tung-Ping; Lo, Yuk-Keung; Lan, Chung-Fu; Hwang, Shinn-Jang

    2011-12-01

    To compare the effectiveness of the Minimum Data Set-based Depression Rating Scale (MDS-DRS) and Geriatric Depression Scale (GDS) in screening depression among older institutionalized Chinese men living in Taiwan. MDS Nursing Home 2.1 Chinese version, Mini-Mental State Examination (MMSE), and short form Geriatric Depression Scale (GDS-15) were used among elderly residents in Banciao Veterans Home. Screening results of MDS-DRS and GDS-15, and relationship between 16 MDS Mood and Anxiety symptoms and depression were evaluated. The prevalence of depression defined by MDS-DRS and GDS were 0.2% and 8.7%, respectively. Multiple logistic regression disclosed that E1a (OR: 12.9, 95% CI: 2.8-58.8, p = 0.001), E1k (OR: 15.6, 95% CI: 5.6-43.5, p < 0.001), and E1l (OR: 22.2, 95% CI: 6.1-83.3, p < 0.001) were all independent associative factors for GDS-defined depression but only explained 51.9% of all depressive subjects. The effectiveness of MDS-DRS is limited, and a new MDS-based depression screening instrument is needed.

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

    PubMed Central

    Perc, Matjaž

    2012-01-01

    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. PMID:22468228

  11. Televisits: sustaining long distance family relationships among institutionalized elders through technology.

    PubMed

    Mickus, M A; Luz, C C

    2002-11-01

    The role of social support in the health of older persons is well documented. This support is particularly important for isolated nursing home residents. The purpose of this study was to test the feasibility of using low-cost videophones to enhance communication between nursing home residents and their families. Ten pairs of residents and family members received videophones and engaged in regular televisits for six months. All participants completed brief survey instruments prior to and after the study period to determine the effects of the televisits on the frequency and quality of contacts. A post-study survey assessed ease and satisfaction with using videophones. Findings include identification of technical and design problems, possible solutions, factors affecting actual use of equipment, and conditions under which benefits of use may be optimal. Categories for estimating potential actual users are suggested. Importantly, the study demonstrates that videophones can be used successfully by a wide range of frail nursing home residents and can enhance social interactions, regardless of distance. Affordable videophone technology offers the potential for reduced isolation among institutionalized elders and others with distance and mobility barriers.

  12. The effect of a modified meat product on nutritional status in institutionalized elderly people.

    PubMed

    Beriain, M J; Ibáñez, F C; Baleztena, J; Oria, E

    2011-01-01

    To determine whether the inclusion of a new modified meat product as a dietary supplement has a positive influence on the nutritional status and blood lipid profile of institutionalized elderly subjects. A sample population of elderly people living in institutions (9 men and 29 women aged 68-97 years) completed a crossover study with two dietary supplements. Nutritionally complete diets differed only in food supplementation, first, with a standard meat product and, subsequently, with a modified meat product. Venous blood samples were taken prior to each of the three phases of the study: the basal phase, during which participants followed their normal, controlled diet; a control phase (3 days per week for 3 weeks), during which the subjects' normal diet was supplemented with 50 g of the standard product; and an experimental phase (3 days per week for 3 weeks), when the normal diet was supplemented with 50 g of the modified product. Nutritional intervention did not influence hematological parameters or serum lipids. The modified meat product altered blood concentrations of urea, creatinine, GOT, transferrin, iron, and retinol-binding protein. Consumption of both the standard and the modified products contributes to maintaining the individuals' nutritional status and equalizes nutritional status across the study population with no effect on blood lipid profiles. Despite the limitations of the experiment, the introduction of dietary supplements in meat products significantly increased plasma iron levels in this elderly sample.

  13. [Vitamin B12 and folate in non-institutionalized urban older people].

    PubMed

    Ramírez Pereda, Abraham; Pacheco, Bertha I; Astiazarán-García, Humberto; Esparza-Romero, Julián; Alemán-Mateo, Heliodoro

    2006-06-01

    Vitamin B12 and folate deficiencies are the main nutritional determinants of hyperhomocysteinemia, which is an independent risk factor for cardiovascular diseases. There is scarce information about nutritional status on vitamin B12 and serum levels of folate in Mexican older people. The objective was to evaluate the nutritional status of vitamin B12 and folic acid concentration in non-institutionalized, urban elderly men and women subjects. One hundred volunteers over 60 years were included in this cross-sectional study. Serum levels of vitamin B12 and folate were measured. In addition some biochemical and anthropometric indicators were also evaluated. Considering serum values of vitamin, 30% had vitamin B12 deficiency, 52% normal status and 18% with high levels. None subjects had folic acid deficiency, by the contrary, a high proportion (62%) showed elevated levels in serum. There was an effect of sex on vitamin B12 status. Elderly men showed significantly lower levels of vitamin B12, and it was according with significant higher prevalence of vitamin B12 deficiency in this group as compared with the women group. The high proportion of vitamin B12 deficiency found in this study underline a possible public health problem and guarantee further survey-studies about vitamin B12 status and to explore causes and consequences of the deficiency. Finally, due the sample size and the design of the study, the results must be seen with caution and not try to generalize.

  14. Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders.

    PubMed

    Cruz Gonzalez, Alberto Carlos; Marín Zuluaga, Dairo Javier

    2016-05-31

    The aim of this study was to compare the clinical performance of root caries restorations after a six-month period using two methods, a conventional technique with rotary instruments and an atraumatic restorative technique (ART), in an institutionalized elderly population in the city of Bogotá, Colombia. Root caries represents a multifactorial, progressive, chronic lesion with softened, irregular and darkened tissue involving the radicular surface; it is highly prevalent in the elderly, especially in those who are physically or cognitively impaired. A quasi-experimental, double-blind, longitudinal study was carried out after cluster randomization of the sample. Two different experienced dentists, previously trained, performed the restorations using each technique. After six months, two new investigators performed a blind evaluation of the condition of the restorations. The results showed a significantly higher rate of success (92.9%) using the conventional technique (p < 0.03). However, we concluded that ART may have been the preferred technique in the study population because 81% of those restorations survived or were successful during the observation period.

  15. Sclerostin in institutionalized elderly women: associations with quantitative bone ultrasound, bone turnover, fractures, and mortality.

    PubMed

    Amrein, Karin; Dobnig, Harald; Wagner, Doris; Piswanger-Sölkner, Claudia; Pieber, Thomas R; Pilz, Stefan; Tomaschitz, Andreas; Dimai, Hans Peter; Fahrleitner-Pammer, Astrid

    2014-06-01

    To evaluate the association between levels of circulating sclerostin (an emerging biomarker and important regulator of bone formation) and laboratory parameters of bone and mineral metabolism, bone mineral density and quality measured using quantitative ultrasound (QUS), fracture risk, and mortality. Prospective cohort study. Austrian nursing homes (N = 95). Female nursing home residents aged 70 and older (mean 84 ± 6; N = 539). Serum sclerostin, bone turnover markers, and bone mineral density and quality were measured at baseline. Participants were followed for clinical fractures and all-cause mortality. Partial correlation analysis adjusted for age, weight, and renal function revealed a significant positive correlation between sclerostin levels and calcaneal stiffness and radial and phalangeal speed of sound (all P < .01) and a significant negative correlation between sclerostin levels and osteocalcin, serum C-terminal telopeptide of type I collagen, and parathyroid hormone (PTH; P < .05). After a mean follow-up of 27 ± 8 months, 139 participants (26%) had died and 64 had a hip or other nonvertebral fracture (12%). Sclerostin was not predictive of mortality. In women with a negative fracture history, it was significantly but not linearly associated with fracture risk. In institutionalized elderly women, there is a significant relationship between serum sclerostin levels and QUS indices, bone turnover, and PTH, but sclerostin was not strongly associated with important clinical outcomes. Thus, it remains unclear whether sclerostin is a clinically useful predictor of fractures or mortality, at least in this setting. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  16. Infections and antimicrobial use among institutionalized residents in Hungary: increasing need of microbiological surveillance.

    PubMed

    Szabó, Rita; Böröcz, Karolina

    2015-03-01

    As a result of the age-related changes, more elders live in long-term care facilities (LTCFs). Due to their susceptibility, infections and excess use of antimicrobials are common. The aim was to estimate the burden of infections and antimicrobial use in Hungarian LTCFs in order to increase the attention given to the prevention. European-wide point prevalence survey was conducted between April and May 2013. For each resident who had a signs and symptoms of an infection and/or treated with an antibacterial for systemic use a resident questionnaire was completed. Descriptive statistics were used to present the data. In total, 91 LTCFs with 11,823 residents were selected in this survey. The 252 residents had a sign/symptom of an infection (2.1%) and 156 received antimicrobial (1.3%). Skin and soft tissues (36.5%) was the most frequent infection. However, antimicrobials were mostly prescribed for respiratory tract infections (40.4%). The most common therapeutic antimicrobial agent (97.5%) belonged to the quinolone antibacterials (34.2%). Our results emphasise the need for targeted improvement of antimicrobial use including: reducing the use of quinolone antibacterials in order to prevent the spread of Clostridium difficile and other antimicrobial resistant microorganisms among institutionalized residents.

  17. 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.

  18. [The Norton Scale as predictor of health-related quality of life in institutionalized elderly].

    PubMed

    González-Expósito, Josefina; García-Román, Juan Carlos; Prado-Amores, María; Pardo-Fernández, Laura; Pariente-Rodrigo, Emilio

    2015-01-01

    A low Norton Scale (NS) score predicts pressure ulcer risk and several adverse outcomes in the elderly. On the other hand, health-related quality of life (HRQOL) is an indicator with clinical and predictive utilities. The aim was to assess the relationship between NS and HRQOL, in a gender analysis. Fifty-one women and 39 men, institutionalized and aged≥65 years, were evaluated through personal interview and medical records. The NS, HRQOL -with EuroQol-5D-, age, body mass index, falls, use of psychoactive drugs, cognitive function and Charlson, Barthel and Tinetti indexes, were assessed. Two regression models were developed, with EuroQol-5D as dependent variable. The NS showed the same score in both sexes, with a median (interquartile range) value of 19 (2). Women presented a worse HRQOL, with an EuroQol-5D=0.78, whereas it was 0.87 in men (P=.02). The NS score was correlated with HRQOL in women (r=0.57; P<.001) but not in men (r=0.15; P=.36). After adjusting for confounders, the NS showed a β value of 0.54 (P=.02) in women and β=0.35 (P=.14) in men. The NS has shown to be the strongest factor on HRQOL in women, regardless of age, comorbidity and the rest of covariates. Conversely, the relationship was weaker and non-significant in men. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  19. [Factors associated with the danger of accidental falls among institutionalized elderly individuals: an integrative review].

    PubMed

    Gomes, Erika Carla Cavalcanti; Marques, Ana Paula de Oliveira; Leal, Márcia Carréra Campos; Barros, Benvinda Pereira de

    2014-08-01

    The scope of this research is to identify the major risk factors associated with accidental falls among the elderly. It involves an integrative review of the literature between 2002 and 2012 in English and Portuguese. The selection of articles was based on the following key words in the Lilacs, Medline and BDENF databases: accidental falls, homes for the elderly and health services. In the final sample 19 articles were selected, of which 11 were national and 8 were international. They indicate that the major factors related to the risk of accidental falls in Homes for the Elderly are: being female, being diagnosed with chronic disease, treatment with benzodiazepine, earlier cases of accident falls, and mobility restriction. The research reveals that architectonic and furniture inadequacies in Homes for the Elderly may be predisposing factors for accidental falls. Analysis of the articles reveals the need for further longitudinal studies and, consequently, enhanced monitoring of the conditions of the functional capacity of the elderly, especially the risks related to falls, considered one of the leading causes of death among institutionalized elderly individuals.

  20. 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.

  1. Nutritional status of institutionalized elderly Brazilians: a study with the Mini Nutritional Assessment.

    PubMed

    Amorim Sena Pereira, Maria Luiza; de Almeida Moreira, Pricilla; Cunha de Oliveira, Carolina; Carneiro Roriz, Anna Karla; Teresópolis Reis Amaral, Magali; Lima Mello, Adriana; Barbosa Ramos, Lílian

    2014-10-04

    To assess the nutritional status of elderly living in nursing homes in the city of Salvador, Brazil and associated factors. Cross-sectional study performed with 359 individuals of both sexes, ages equal or over 60 years old, located in Nursing Homes in the urban area of the city of Salvador, Bahia, Brazil. Regarding nutritional status according to Mini Nutritional Assessment (MNA), 66.3% of the evaluated elderly were malnourished and at risk of malnutrition. When comparing sexes, it has been observed that among men the prevalence of this condition (76.6%) was higher than in women (62.4%). It has been observed, as a result of the multivariate analysis, that only the variable functional capacity for Activities of Daily Living (ADL) was statistically significant. There was moderate correlation between MNA and Mini-Mental State Examination (r=0.454; p<0.0001), as well as between MNA and the ADL scale (r=0.569; p<0.0001). There was weak negative correlation between MNA total score and age (r=0.159; p=0.002). Malnutrition and malnutrition risk were conditions of remarkable importance, with almost two-thirds of the elderly in this situation. ADL functional capacity must be monitored given their close relationship with the nutritional status of the elderly. An interdisciplinary approach in the context of institutionalization is needed due to the association between nutritional status and variables of different dimensions. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  2. 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.

  3. 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

  4. Child Study and Observation: Child Development 101.

    ERIC Educational Resources Information Center

    Jones, Joanna

    This syllabus outlines the structure, objectives, and lesson plans for Child Development 101, a twelve-week course on child study and observation offered at Chaffey Community College. A statement of the educational philosophy upon which the course was developed precedes a list of course objectives, competencies, and the grading system. The bulk of…

  5. Child Guidance for Child Caregivers: Instructor's Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This instructor guide is designed for use by postsecondary child development instructors in courses that have both lecture and laboratory sections. The guide is organized into five units covering the following subject matter: foundations and assumptions about child caregiving, development of young children, indirect guidance of children's…

  6. Child Care Subsidies and Child Development

    ERIC Educational Resources Information Center

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  7. Child Care Subsidies and Child Development

    ERIC Educational Resources Information Center

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  8. Child poverty and changes in child poverty.

    PubMed

    Chen, Wen-Hao; Corak, Miles

    2008-08-01

    This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.

  9. Child-to-Child programme in Malaysia.

    PubMed

    Kasim, M S; Abraham, S

    1982-09-01

    Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.

  10. Holocaust Child Survivors and Child Sexual Abuse

    ERIC Educational Resources Information Center

    Lev-Wiesel, Rachel; Amir, Marianne

    2005-01-01

    This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the…

  11. Correlation between movement complexity during static standing and balance function in institutionalized older adults

    PubMed Central

    Yamagata, Momoko; Ikezoe, Tome; Kamiya, Midori; Masaki, Mitsuhiro; Ichihashi, Noriaki

    2017-01-01

    Purpose Sample entropy (SampEn) is an analysis to evaluate movement complexity of the center of pressure (COP). A lower value of SampEn indicates lower complexity of COP variability, that is, rigidity, and lower degrees of freedom. Previous studies reported the association of increased SampEn with improved standing balance ability in young subjects. However, no studies have examined these relationships among older adults. Thus, we aimed to investigate the relationship between SampEn and standing balance ability in older adults. Subjects and methods The subjects were 33 institutionalized older adults (aged 82.2±6.5 years). COP during static standing was measured. The standard deviation (SD) values of COP and SampEn in the sagittal and frontal planes were calculated using time series data. One-leg standing test (OLST), functional reach (FR) test, and lateral reach (LR) test were also measured to evaluate standing balance ability. Results OLST, FR, and LR were 6.5±8.3 s, 19.8±5.9 cm, and 18.2±6.4 cm, respectively. Pearson correlation analysis revealed that SampEn in the sagittal plane significantly correlated with OLST (r=−0.35) and FR (r=−0.36). However, SampEn in the frontal plane and SD of COP in both sagittal and frontal planes had no relationship with any of the clinical balance tests. Conclusion Lower SampEn implies rigidity for postural control. In the present study, it was found that lower SampEn in the sagittal plane was related to a higher balance function, which suggests that older adults utilized body rigidity to maintain postural stability as a compensative strategy. PMID:28331301

  12. 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.

  13. The effect of group exercise frequency on health related quality of life in institutionalized elderly

    PubMed Central

    Rugbeer, Nivash; Ramklass, Serela; Mckune, Andrew; van Heerden, Johan

    2017-01-01

    Introduction The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. Methods One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. Results A significant difference was noted in social function post training 2X/week (MD = -13.85, 95% CI [-24.66, -3.38], p = 0.017, d = 0.674) and 3X/week (MD = -13.30, 95% CI [-21.81, -5.59], p = 0.003, d = 0.712) a week. Training 3X/week a week provided an additional benefit in vitality (MD = -7.55, 95% CI [-13.16, -1.91], p = 0.018, d =0. 379). Improvements in mental component summary scale post training 2X/week (MD = -4.08, 95% CI [-7.67, -0.42], p = 0.033, d = 0.425) and 3X/week (MD = -6.67, 95% CI [-10.92, -2.33], p = 0.005, d = 0.567) a week was further noted. Conclusion Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence. PMID:28451013

  14. Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans

    PubMed Central

    Chassé, Kathleen

    2017-01-01

    Physical function performance tests, including sit to stand tests and Timed Up and Go, assess the functional capacity of older adults. Their ability to predict falls warrants further investigation. The objective was to determine if a modified 30-second Sit to Stand test that allowed upper extremity use and Timed Up and Go test predicted falls in institutionalized Veterans. Fifty-three older adult Veterans (mean age = 91 years, 49 men) residing in a long-term care hospital completed modified 30-second Sit to Stand and Timed Up and Go tests. The number of falls over one year was collected. The ability of modified 30-second Sit to Stand or Timed Up and Go to predict if participants had fallen was examined using logistic regression. The ability of these tests to predict the number of falls was examined using negative binomial regression. Both analyses controlled for age, history of falls, cognition, and comorbidities. The modified 30-second Sit to Stand was significantly (p < 0.05) related to if participants fell (odds ratio = 0.75, 95% confidence interval = 0.58, 0.97) and the number of falls (incidence rate ratio = 0.82, 95% confidence interval = 0.68, 0.98); decreased repetitions were associated with increased number of falls. Timed Up and Go was not significantly (p > 0.05) related to if participants fell (odds ratio = 1.03, 95% confidence interval = 0.96, 1.10) or the number of falls (incidence rate ratio = 1.01, 95% confidence interval = 0.98, 1.05). The modified 30-second Sit to Stand that allowed upper extremity use offers an alternative method to screen for fall risk in older adults in long-term care. PMID:28464024

  15. Co-occurrence of neuropsychiatric syndromes in demented and psychotic institutionalized elderly.

    PubMed

    Dechamps, Arnaud; Jutand, Marthe Aline; Onifade, Chérifa; Richard-Harston, Sandrine; Bourdel-Marchasson, Isabelle

    2008-11-01

    To explore and determine the clinical figures of behavioral syndromes from the factor structure of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) in demented and psychotic patients. Two nursing homes and two long-term care homes. Observational, cross-sectional. One hundred and sixty-three institutionalized elderly with dementia or psychosis (66.9% female), mean age 80.9 +/- 9.1 years. The NPI-NH includes 12 neuropsychiatric symptoms and a distress scale. The product score of frequency (F) and severity (S) ratings provides an overall score for each of the 12 items. An exploratory principal component analysis with Varimax rotation was performed on the F x S scores according to patients' diagnosis. High internal consistency of the NPI-NH was found (alpha = 0.8). In demented patients a 4-factor solution was found that explained 63.9% of the variance, with the syndromes: (a) 'hyperactivity'; (b) 'affective'; (c) 'psychosis'; and (d) 'Hallucinations'. A four-factor solution was also found in psychotic patients, explaining 61.3% of variance, with syndromes: (a) 'affective'; (b) 'frontal lobe symptoms'; (c) 'sundowning'; and (d) 'psychomotor agitation'. A syndrome was unlikely to appear alone but was most likely to occur with other syndromes. A specific pattern of syndrome co-occurrence were found in demented (a + b + c in 30.5% of cases) and psychotic patients (a + b + c + d in 35.2% of cases). The syndrome taxonomies are consistent with the diagnostic criteria. The clinical use of syndrome co-occurrence could help to further understand and evaluate behavioral changes in pharmacological and non-pharmacological treatments. Copyright (c) 2008 John Wiley & Sons, Ltd.

  16. Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans.

    PubMed

    Applebaum, Eva V; Breton, Dominic; Feng, Zhuo Wei; Ta, An-Tchi; Walsh, Kayley; Chassé, Kathleen; Robbins, Shawn M

    2017-01-01

    Physical function performance tests, including sit to stand tests and Timed Up and Go, assess the functional capacity of older adults. Their ability to predict falls warrants further investigation. The objective was to determine if a modified 30-second Sit to Stand test that allowed upper extremity use and Timed Up and Go test predicted falls in institutionalized Veterans. Fifty-three older adult Veterans (mean age = 91 years, 49 men) residing in a long-term care hospital completed modified 30-second Sit to Stand and Timed Up and Go tests. The number of falls over one year was collected. The ability of modified 30-second Sit to Stand or Timed Up and Go to predict if participants had fallen was examined using logistic regression. The ability of these tests to predict the number of falls was examined using negative binomial regression. Both analyses controlled for age, history of falls, cognition, and comorbidities. The modified 30-second Sit to Stand was significantly (p < 0.05) related to if participants fell (odds ratio = 0.75, 95% confidence interval = 0.58, 0.97) and the number of falls (incidence rate ratio = 0.82, 95% confidence interval = 0.68, 0.98); decreased repetitions were associated with increased number of falls. Timed Up and Go was not significantly (p > 0.05) related to if participants fell (odds ratio = 1.03, 95% confidence interval = 0.96, 1.10) or the number of falls (incidence rate ratio = 1.01, 95% confidence interval = 0.98, 1.05). The modified 30-second Sit to Stand that allowed upper extremity use offers an alternative method to screen for fall risk in older adults in long-term care.

  17. The Clinical Presentation and Outcome of the Institutionalized Wandering Mentally Ill in India

    PubMed Central

    Shah, Nilima; Mehta, Ritambhara

    2016-01-01

    Introduction There are estimated 400,000 wandering mentally ill persons in India, found in poor physical state wandering on streets and railway stations; mainly treated either by government run Hospitals for Mental Health (HMH) or Psychiatry units of a Government Medical College (GMC). They require psychosocial rehabilitation along with treatment. Aim To study the presentation, clinical profile and rehabilitative outcome of wandering mentally ill admitted in government psychiatric care facilities. The objective was to establish them as a distinct psychiatric inpatient population requiring special attention. Materials and Methods The study was a chart review of all wandering mentally ill patients institutionalized during a period of two years in two distinct government facilities. Additionally, clinical staff was interviewed for cross checking the data and for eliciting problems faced in management. The discharged patients were contacted to assess the present status. Results Forty seven patients in HMH and 35 patients in GMC were studied. Wandering mentally ill patients were brought to mental health facility by helping person (30) and police (23). Majority of them (61) were picked up from streets and railway station. Most of them (56) belonged to <40 years age group and communication with them was difficult due to language barrier in 51. Diagnosed as Psychosis NOS (45) initially, they presented with poor physical condition, with positive viral markers (25) and pregnancy in females (4). Most common final diagnosis was schizophrenia (45) along with prominent negative symptoms and poor cognitive abilities. Forty three of them showed good improvement on treatment. Forty five gave their address; Relatives were found in 39 through police, post cards and social workers and were rehabilitated back to family. Conclusion Wandering mentally ill constitutes a unique patient population with specific challenges different from other inpatients in management and rehabilitation

  18. Dental health status among sensory impaired and blind institutionalized children aged 6 to 20 years.

    PubMed

    Sanjay, Venkataraam; Shetty, Sumanth M; Shetty, Rashmi G; Managoli, Noopur A; Gugawad, Sachin C; Hitesh, D

    2014-02-01

    This study was planned to assess the dental caries status among disabled children as dental health is an integral part of general body health and this group is deprived of health care needs. A sample of 310 disabled children was gathered including 195- Hearing impaired, 115 - blind. Of which 226 were males and 84 were females. A study questionnaire was prepared to include demographic information and WHO oral health assessment form (1997) to record dental caries status.Data was analysed using student's test and ANOVA test was used at p≤0.05. The overall mean for DMFT scores for males and females was 2.11 (1.753) and 1.75 (1.275) respectively. Similarly overall mean for dft was 0.31 (0.254) for males and 0.27 (0.143) for females. Mean DMFT of blind students was more as compared to hearing impaired ones as 2.16 (2.005) and 1.80 (1.264) respectively. Age factor showed a significant increase in the mean DMFT scores with advancing age at p ≤ 0.001. Overall mean scores of caries was very high and it increased with increasing age. Blind children experienced more caries then hearing impaired children in permanent, whereas it was opposite in primary dentition. So there is urgent need of both comprehensive and incremental dental care for this subgroup of population. How to cite the article: Sanjay V, Shetty SM, Shetty RG, Managoli NA, Gugawad SC, Hitesh D. Dental health status among sensory impaired and blind institutionalized children aged 6 to 20 years. J Int Oral Health 2014;6(1):55-8.

  19. 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

  20. Knee flexion contractures in institutionalized elderly: prevalence, severity, stability, and related variables.

    PubMed

    Mollinger, L A; Steffen, T M

    1993-07-01

    The purpose of this study was to document the prevalence, severity, and progression of knee flexion contractures (KFCs) in a population of institutionalized elderly and to identify relationships between knee extension and other variables. The subjects were 112 nursing home residents who exhibited a broad range of ambulation and cognitive function abilities. Data were collected initially (T1) and after a 10-month period (T2). Only 25% of the population had extension in the 0- to 5-degree (lacking full extension) range bilaterally at T1 and T2, leaving the majority of subjects with some degree of unilateral KFC. Most of the subjects with a KFC greater than 20 degrees were nonambulatory and had a significantly higher occurrence of resistance to motion than did nonambulators with a KFC of less than 20 degrees. Knee extension measurements did not change in most subjects between T1 and T2. The knees that did show a change in KFC (either an increase or a decrease) had a significantly higher occurrence of resistance to passive motion than did other knees. Compared with the subjects who gained extension, the subjects who lost extension over the study period more frequently had minimal KFC at T1, were ambulatory at T1, showed a regression in ambulation at T2, and developed resistance to motion at T2. The data confirmed significant positive correlations between degree of KFC and presence of resistance to passive knee motion, cognitive impairment, impaired ambulation, and presence of knee pain. Physical therapy assessment and intervention may be appropriate in nonambulatory nursing home residents with resistance to passive motion, residents with KFC approaching 20 degrees, and ambulatory residents with minimal KFC who develop resistance and begin to regress in ambulation. Several areas for future study are suggested.

  1. The effects of early foster care intervention on attention biases in previously institutionalized children in Romania.

    PubMed

    Troller-Renfree, Sonya; McDermott, Jennifer Martin; Nelson, Charles A; Zeanah, Charles H; Fox, Nathan A

    2015-09-01

    Children raised in institutions experience psychosocial deprivation that can negatively impact attention skills and emotion regulation, which subsequently may influence behavioral regulation and social relationships. The current study examined visual attention biases in 8-year-old children who were part of the Bucharest Early Intervention Project (BEIP). Relations among attention biases and concurrent social outcomes were also investigated. In early childhood, 136 children abandoned at birth or shortly thereafter into institutional care were randomized to receive a high-quality foster care intervention or care-as-usual within the context of the Bucharest Early Intervention Project (BEIP). At 8 years of age, 50 care-as-usual, 55 foster care, and 52 community controls performed a behavioral dot-probe task, and indices of attention biases to threat and positive stimuli were calculated. Concurrent data on social behavior were collected. Children placed into the foster care intervention had a significant attention bias toward positive stimuli, while children who received care-as-usual had a significant bias toward threat. Children in the foster care intervention had a significantly larger positive bias when compared to the care-as-usual group. A positive bias was related to more social engagement, more prosocial behavior, less externalizing disorders, and less emotionally withdrawn behavior. The magnitude of positive bias was predicted by age of placement into foster care among children with a history of institutionalization. An attention bias towards positive stimuli was associated with reduced risk for behavioral problems amongst children who experienced early psychosocial deprivation. Research assessing attention biases in children experiencing early environmental stress may refine our understanding of the mechanisms underlying risk for later psychiatric and social disorders and inform prevention efforts. © 2014 John Wiley & Sons Ltd.

  2. The effect of group exercise frequency on health related quality of life in institutionalized elderly.

    PubMed

    Rugbeer, Nivash; Ramklass, Serela; Mckune, Andrew; van Heerden, Johan

    2017-01-01

    The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. A significant difference was noted in social function post training 2X/week (MD = -13.85, 95% CI [-24.66, -3.38], p = 0.017, d = 0.674) and 3X/week (MD = -13.30, 95% CI [-21.81, -5.59], p = 0.003, d = 0.712) a week. Training 3X/week a week provided an additional benefit in vitality (MD = -7.55, 95% CI [-13.16, -1.91], p = 0.018, d =0. 379). Improvements in mental component summary scale post training 2X/week (MD = -4.08, 95% CI [-7.67, -0.42], p = 0.033, d = 0.425) and 3X/week (MD = -6.67, 95% CI [-10.92, -2.33], p = 0.005, d = 0.567) a week was further noted. Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence.

  3. Risk-Taking and Sensation Seeking Propensity in Post-Institutionalized Early Adolescents

    PubMed Central

    Loman, Michelle M.; Johnson, Anna E.; Quevedo, Karina; Lafavor, Theresa L.; Gunnar, Megan R.

    2014-01-01

    Background Youth with histories of institutional/orphanage care are at increased risk for externalizing and internalizing problems during childhood and adolescence. Although these problems have been well described, the related adolescent behaviors of risk-taking and sensation seeking have not yet been explored in this population. This study examined risk-taking and sensation seeking propensity, and associations with conduct problems and depressive symptoms, in early adolescents who were adopted as young children from institutional care. Methods Risk-taking and sensation seeking propensities of 12- and 13-year-old post-institutionalized (PI; n=54) adolescents were compared to two groups: youth internationally adopted early from foster care (PFC; n=44) and non-adopted youth (NA; n=58). Participants were recruited to equally represent pre/early- and mid/late-pubertal stages within each group. Participants completed the youth version of the Balloon Analogue Risk Task (Lejuez et al., 2007) and the Sensation Seeking Scale for Children (Russo et al., 1991). Parents completed clinical ratings of participants’ conduct problems and depressive symptoms. Results PI adolescents demonstrated lower risk-taking than PFC and NA peers. Pre/early-pubertal PI youth showed lower sensation seeking, while mid/late pubertal PI youth did not differ in from other groups. PI adolescents had higher levels of conduct problems but did not differ from the other youth in depressive symptoms. In PI youth only, conduct problems were negatively correlated with risk-taking and positively correlated with sensation seeking, while depressive symptoms were negatively correlated with both risk-taking and sensation seeking. Conclusions Early institutional care is associated with less risk-taking and sensation seeking during adolescence. The deprived environment of an institution likely contributes to PI youth having a preference for safe choices, which may only be partially reversed with puberty. Whether

  4. Comfort-Supporting Nursing Activities for End-of-Life Patients in an Institutionalized Environment.

    PubMed

    Kisvetrová, Helena; Vévodová, Šárka; Školoudík, David

    2017-09-04

    Comfort promotion plays a significant role in end-of-life patient care. The objective of this study was to determine the utilization rate of comfort supporting nursing activities in end-of-life patients in an institutionalized environment in the Czech Republic in relation to the age of the registered nurses (RNs), length of work experience, education level, and type of workplace. A cross-sectional, descriptive study was designed. A questionnaire with Likert scales included 31 activities of dying care and spiritual support interventions. The sample comprised 907 RNs working in 49 institutions in nine regions of the Czech Republic. The Kruskal-Wallis test, Mann-Whitney U post-hoc test with Bonferroni correction of significance, Spearman's correlation analysis, and logical regression model were used for statistical evaluation. The least frequently implemented activity by RNs was "Show the patient's willingness to discuss death" and the most frequent activity was "Threat to the patient's dignity and respect." The highest utilization rate of nursing activities was reported in the physical dimension, while the lowest utilization rate of nursing activities was in the social dimension set. Significant predictors for the high utilization rate of physical dimension set activities were hospice care departments, long-term care facilities (LTCFs), and the age of RNs. Hospice departments were also a predictor of high utilization rate of activities in the psychological, spiritual, and social dimension set activities. With the exception of hospice departments, RNs used activities encouraging psychological, spiritual, and social comfort for end-of-life patients less frequently than the physical dimension. RNs in hospitals and LTCFs focus insufficiently on the spiritual and psychosocial comfort of end-of-life patients. This study is of particular significance to educators who prepare the next generation of nurses. © 2017 Sigma Theta Tau International.

  5. Impact of Nutritional Status on Cognition in Institutionalized Orphans: A Pilot Study.

    PubMed

    Kamath, Sanjana M; Venkatappa, Kavana G; Sparshadeep, Ergod Manjunath

    2017-03-01

    Proper nutrition is critical for maximizing brain function and enhancing learning. There is accumulating evidence that early malnutrition, marked by stunting, is associated with long-term deficits in cognitive and academic performance, even when social and psychological differences are controlled. All over the world, children living without permanent parental care are at a heightened risk for under-nutrition, putting their health and development in great jeopardy. To assess the nutritional and cognitive status in institutionalized orphans which might help to formulate effective interventions for improving the nutritional status of vulnerable children in future. This cross-sectional, study included 70 children (35 orphans and 35 non-orphans). Their anthropometric measurements (height, weight, and BMI) were measured and cognition was assessed using subsets of Wechsler Intelligence Scale for Children-Revised (WISC-R): Block design and Digit span. The data obtained was subjected to descriptive statistical analysis. 18.57% (13) of children had stunting, 15.71% (11) had wasting, 22.86% (16) were underweight, and 17.14% (12) showed thinness. Mean±SD of Block design in non-orphans was significantly higher compared to orphans (p-value 0·05). Mean±SD of Digit span in non-orphans was significantly higher compared to orphans (p-value 0·000). For Block design, there was moderate positive correlation with nutritional status based on Z-scores (p-value <0·05). Digit span also showed moderate positive correlation (p-value <0·05). The results of our study indicate that children in orphanages have high rates of both malnutrition and cognitive delay compared to the non-orphans and there was a direct correlation between both the variables. If orphanages are here to stay as a last resort for children deprived of a family there is an urgent need to improve the institutional environment in order to foster the development of millions of children in orphanages around the world.

  6. Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people.

    PubMed

    Curcio, Francesco; Basile, Claudia; Liguori, Ilaria; Della-Morte, David; Gargiulo, Gaetano; Galizia, Gianluigi; Testa, Gianluca; Langellotto, Assunta; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

    2016-12-01

    Elderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m(2); p for trend <0.001). Similarly, muscle strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg; p for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (y = 4.5x + 0.4, r = 0.61; p < 0.01) and strength (y = 14.0x + 0.8, r = 0.53; p < 0.01). Multivariate analysis confirms the strong relationship between the TMT score and muscle mass (r = 0.48, p = 0.024) and strength (r = 0.39, p = 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls.

  7. Prevalence of diabetes mellitus among non institutionalized elderly in Monastir City

    PubMed Central

    2012-01-01

    Background Diabetes is a major public health problem worldwide. This problem is particularly relevant to the elderly. The prevalence of each condition increase with age. The present study aimed to determine the prevalence of Diabetes Mellitus (DM) among elderly; we also examined socio-economic factors and life style that are likely to be associated with DM. Methods A cross-sectional study was conducted in 2008–2009, and used a multistage cluster sampling method to select a representative sample among non institutionalized elderly in Monastir City. A total of 598 elderly aged 65 to 95 years were included. Results The prevalence of DM was 27.4% (29.2% in males’ vs 26.5% in females). Elderly with DM showed higher prevalence of hypertension, obesity and abdominal obesity. DM prevalence decreased with advancing ages in both men and women. Urban residents had a higher prevalence than did their rural counterparts. In multivariate analysis, DM was associated with abdominal obesity (OR [95% CI], 2.6 [1.1-6]; p <0.01), co-existing diseases (3.8 [2.4-6]; p <0.01), and hypertension (2.7 [1.6-4.5] ; p <0.01). Conclusion The study highlights the DM problem in Tunisia. An ageing population together with social, economic and lifestyle changes have led to a dramatic increase in DM. These data emphasize the urgent need for a comprehensive integrated population-based intervention program to ameliorate the growing problem of DM. PMID:22898260

  8. Dental health status among sensory impaired and blind institutionalized children aged 6 to 20 years

    PubMed Central

    Sanjay, Venkataraam; Shetty, Sumanth M; Shetty, Rashmi G; Managoli, Noopur A; Gugawad, Sachin C; Hitesh, D

    2014-01-01

    Background: This study was planned to assess the dental caries status among disabled children as dental health is an integral part of general body health and this group is deprived of health care needs. Materials & Methods: A sample of 310 disabled children was gathered including 195- Hearing impaired, 115 – blind. Of which 226 were males and 84 were females. A study questionnaire was prepared to include demographic information and WHO oral health assessment form (1997) to record dental caries status.Data was analysed using student’s test and ANOVA test was used at p≤0.05. Results: The overall mean for DMFT scores for males and females was 2.11 (1.753) and 1.75 (1.275) respectively. Similarly overall mean for dft was 0.31 (0.254) for males and 0.27 (0.143) for females. Mean DMFT of blind students was more as compared to hearing impaired ones as 2.16 (2.005) and 1.80 (1.264) respectively. Age factor showed a significant increase in the mean DMFT scores with advancing age at p ≤ 0.001. Conclusion: Overall mean scores of caries was very high and it increased with increasing age. Blind children experienced more caries then hearing impaired children in permanent, whereas it was opposite in primary dentition. So there is urgent need of both comprehensive and incremental dental care for this subgroup of population. How to cite the article: Sanjay V, Shetty SM, Shetty RG, Managoli NA, Gugawad SC, Hitesh D. Dental health status among sensory impaired and blind institutionalized children aged 6 to 20 years. J Int Oral Health 2014;6(1):55-8. PMID:24653604

  9. Decreased plasma brain-derived neurotrophic factor levels in institutionalized elderly with depressive disorder.

    PubMed

    Chu, Chin-Liang; Liang, Chih-Kuang; Chou, Ming-Yueh; Lin, Yu-Te; Pan, Chih-Chuan; Lu, Ti; Chen, Liang-Kung; Chow, Philip C

    2012-06-01

    To compare the differences in plasma brain-derived neurotrophic factor (BDNF) levels among institutionalized ethnic Chinese elderly participants with major depression, those with subclinical depression, and a nondepressed control group. A cross-sectional study. The veterans' home in southern Taiwan. One hundred sixty-seven residents. Questionnaires including the Minimum Data Set Nursing Home 2.1, Chinese-language version, and the short-form Geriatric Depression Scale, Chinese-language version. Depressive disorder was diagnosed by a well-trained psychiatrist using DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision) criteria. We measured plasma BDNF levels in the following 3 groups: nondepressive subjects (n = 122), subclinically depressive subjects (n = 33), and subjects with major depression (n = 12). Plasma BDNF was assayed using the sandwich ELISA method. We noted a significantly negative association between age and plasma BDNF in the regression model. There was no significant correlation between BDNF plasma levels and body weight or platelet counts. We found that plasma BDNF was significantly lower in the major depressive group (mean, 115.1 pg/mL; SD, 57.2) than in the nondepressive group (mean, 548.8 pg/mL; SD, 370.6; P < .001). The BDNF plasma concentrations in the subclinically depressive group (mean, 231.8 pg/mL; SD, 92.4; P < .001) and control group were also significantly different. Our findings revealed that plasma BDNF levels were reduced not only in ethnic Chinese elderly patients with major depressive disorder but also in those with subclinical depression. This makes the plasma BDNF level a potential biological marker for clinical or subclinical depression. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  10. Evaluation design for a complex intervention program targeting loneliness in non-institutionalized elderly Dutch people

    PubMed Central

    2010-01-01

    Background The aim of this paper is to provide the rationale for an evaluation design for a complex intervention program targeting loneliness among non-institutionalized elderly people in a Dutch community. Complex public health interventions characteristically use the combined approach of intervening on the individual and on the environmental level. It is assumed that the components of a complex intervention interact with and reinforce each other. Furthermore, implementation is highly context-specific and its impact is influenced by external factors. Although the entire community is exposed to the intervention components, each individual is exposed to different components with a different intensity. Methods/Design A logic model of change is used to develop the evaluation design. The model describes what outcomes may logically be expected at different points in time at the individual level. In order to address the complexity of a real-life setting, the evaluation design of the loneliness intervention comprises two types of evaluation studies. The first uses a quasi-experimental pre-test post-test design to evaluate the effectiveness of the overall intervention. A control community comparable to the intervention community was selected, with baseline measurements in 2008 and follow-up measurements scheduled for 2010. This study focuses on changes in the prevalence of loneliness and in the determinants of loneliness within individuals in the general elderly population. Complementarily, the second study is designed to evaluate the individual intervention components and focuses on delivery, reach, acceptance, and short-term outcomes. Different means of project records and surveys among participants are used to collect these data. Discussion Combining these two evaluation strategies has the potential to assess the effectiveness of the overall complex intervention and the contribution of the individual intervention components thereto. PMID:20836840

  11. [Survey of activities of daily living in non-institutionalized elderly residents].

    PubMed

    Yamakawa, M; Ueshima, H; Okayama, A; Kita, Y; Tsujihashi, M; Mikami, F; Satoh, M; Nishida, A; Hatano, A; Miyata, K

    1994-10-01

    To investigate the states of activities of daily living (ADLs) in the elderly, non-institutionalized residents-aged 65 and over living in Azuchi (population of approximately 12,000) were interviewed. Data was collected from 1,287 subjects (509 men and 778 women; 92.1%) for the 3 years, 1990 to 1992. Differences in difficulties with the 6 basic ADLs (BADLs) and the 7 instrumental ADLs (IADLs) were analyzed according to gender and age. For the BADLs (eating, dressing, bathing, using the toilet, mobility, and incontinence), only the percentage of incontinence was significantly higher in women than in men (p < 0.01). The percentage of those fully independent in the 6 BADLs in men was 87%, which was higher than that in women (77%), but except for incontinence there were no significant differences between the sexes. The percentages of disability in the BADLs for women and for both sexes combined were higher according to age (p < 0.01), but for men, only those of dressing (p < 0.05) and of incontinence (p < 0.01) were related with age. The disability percentage for cooking was the only activity among the IADLs (cooking, using the telephone, cleaning house, walking, shopping, going up and down steps, and using transportation) which was significantly higher in men (p < 0.01), but those for walking, going up and down steps, and using transportation were higher in women (p < 0.01). The percentage of those who were fully independent was 74% in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Child Dental Health

    MedlinePlus

    Healthy teeth are important to your child's overall health. From the time your child is born, there are things you can do to promote healthy teeth and prevent cavities. For babies, you should clean ...

  13. Child abuse - physical

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/001552.htm Child abuse - physical To use the sharing features on this page, please enable JavaScript. Physical child abuse is a serious problem. Here are some facts: ...

  14. Your Child's Development: Newborn

    MedlinePlus

    ... Your 1- to 2-Year-Old Your Child's Development: Newborn KidsHealth > For Parents > Your Child's Development: Newborn ... changed; or goes to sleep ) Movement and Physical Development moves in response to sights and sounds rooting ...

  15. FAQ: Child Sexual Exploitation

    MedlinePlus

    ... the age of 18. Is child pornography a crime? It is a federal crime to knowingly possess, manufacture, distribute or access with ... lasting harms from the permanent memorialization of the crimes committed against them. Studies indicate that child victims ...

  16. Cholesterol and Your Child

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Cholesterol and Your Child KidsHealth > For Parents > Cholesterol and ... child's risk of developing heart disease later. About Cholesterol Cholesterol is a waxy substance produced by the ...

  17. Spleen removal - child - discharge

    MedlinePlus

    ... activity restrictions will depend on: The type of surgery (open or laparoscopic) Your child's age The reason for the operation Ask your doctor about specific activity instructions and ... other pain medicines to use at home if your child needs them.

  18. National Child Traumatic Stress Network

    MedlinePlus

    ... Public Awareness Month of the Military Family / Child Child Abuse Prevention Month National Alcohol Awareness Month National Day ... Month of the Military Child (April, 2017) National Child Abuse Prevention Month (April 2017) National Alcohol Awareness Month ( ...

  19. Your Child's Development: 15 Months

    MedlinePlus

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child's Development: 15 Months KidsHealth > For Parents > Your Child's Development: ...

  20. Your Child's Development: 6 Months

    MedlinePlus

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child's Development: 6 Months KidsHealth > For Parents > Your Child's Development: ...

  1. The Limping Child

    PubMed Central

    Tredwell, Stephen J.

    1979-01-01

    The challenge of the limping child demands that the primary care physician identify those problems which are urgent, when neglect can harm the child, and to provide appropriate supportive care for those which are not. The approach to the limping child should consider the child's age, whether or not the limp is painful, and certain key physical findings. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7aFig. 7b PMID:21297725

  2. Your Child's Checkups

    MedlinePlus

    ... Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Your Child's Development (Birth to 3 Years) Feeding Your 1- to 3- ... 2-Year-Old Your Child's Checkups KidsHealth > ... en español Las revisiones médicas de su hijo From your child's birth to young adulthood, you'll be visiting the ...

  3. Child Nutrition. Beginnings Workshop.

    ERIC Educational Resources Information Center

    Hayden, Jacqueline; Eastman, Wayne; Aird, Laura Dutil; McCrea, Nadine L.

    2002-01-01

    Four workshops focus on nutrition for infants and children in child care settings. Articles are: (1) "Nutrition and Child Development: Global Perspectives" (Jacqueline Hayden); (2) "Working with Families around Nutritional Issues" (Wayne Eastman); (3) "Breastfeeding Promotion in Child Care" (Laura Dutil Aird); and (4) "Food as Shared…

  4. Mother-Child Bonding.

    ERIC Educational Resources Information Center

    Pearce, Joseph Chilton

    1994-01-01

    Examines the nature of mother-child bonding from the prenatal stage through early infancy, discussing how the mother's actions, even before birth, stimulate her child's senses. Explains the crucial role that physical contact, breastfeeding, and visual stimuli have on mother-child bonding in human and animal newborns. (MDM)

  5. Child Care Services Handbook.

    ERIC Educational Resources Information Center

    Duval County School Board, Jacksonville, FL.

    A companion document to the curriculum guide for a secondary level child care services curriculum, this handbook contains a variety of administrative and program resources for the teacher: The vocational curriculum outline for child care services; a calendar of suggested public relations activities; procedures for building child care services…

  6. Child Care Update: 1987.

    ERIC Educational Resources Information Center

    Levy, Vic; And Others

    This paper provides information on child care needs, existing services, and special topics related to child care in Dane County, Wisconsin. Section I describes and compares needs and services; indicates locations of current full-day services; and offers specific recommendations for expanding child care. Section II concerns cost and affordability…

  7. Managing the Difficult Child.

    ERIC Educational Resources Information Center

    Murphy, Linda; Della Corte, Suzanne

    1990-01-01

    This newsletter issue focuses on ways parents can manage the difficult child with special needs. Characteristics of the difficult child are listed including poor listening skills, irritableness, impulsivity, and tendency to have tantrums. Typical reactions to the difficult child by parents, siblings, other relatives, neighbors, the school, and…

  8. Child Care Design Guide.

    ERIC Educational Resources Information Center

    Olds, Anita Rui

    This book provides architects, interior designers, developers, and child-care professionals with detailed information on the planning and design of child care centers. Part 1 examines the current state of child care in the United States and offers an overall philosophical concert--the spirit of place--as the framework for all center design. Part 2…

  9. Child Care Bulletin, 1997.

    ERIC Educational Resources Information Center

    McGhee, Marilyn, Ed.

    1997-01-01

    This document is comprised of six issues of the Child Care Bulletin, a bimonthly publication of the National Child Care Information Center. The January-February issue focuses on involving communities in child care planning. Topics discussed in this issue include: community mobilization strategies, assessing needs and establishing goals, and…

  10. 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.

  11. Body mass index as discriminator of the lean mass deficit and excess body fat in institutionalized elderly people.

    PubMed

    Barbosa, Maria Helena; Bolina, Alisson F; Luiz, Raíssa B; de Oliveira, Karoline F; Virtuoso, Jair S; Rodrigues, Rosalina A P; Silva, Larissa C; da Cunha, Daniel F; De Mattia, Ana Lúcia; Barichello, Elizabeth

    2015-01-01

    The objective of this study was to identify the discriminating criterion for body mass index (BMI) in the prediction of low fat free mass and high body fat percentage according to sex among older people. Observational analytical study with cross-sectional design was used for this study. All institutionalized older people from the city of Uberaba (Minas Gerais, Brazil) who fit within the inclusion and exclusion criteria were approached. Sixty-five institutionalized older people were evaluated after signing a Free and Informed Consent Form. Descriptive and inferential statistical procedures were employed for the analysis, using Student's t-test and multiple linear regression. Receiver Operating Characteristic (ROC) curves were constructed to determine the BMI (kg/m(2)) cut-off points. The study complied with all the ethical norms for research involving human beings. In comparing the anthropometric measurements obtained via bioimpedance, elder male had higher mean height and body water volume than females. However, women had higher mean triceps skinfold and fat free mass than men. The BMI cut-off points, as discriminators of low fat free mass percentage and high body fat percentage in women, were ≤22.4 kg/m(2) and >26.6 kg/m(2), respectively; while for men they were ≤19.2 kg/m(2) and >23.8 kg/m(2). The results of this study indicate the need for multicenter studies aimed at suggesting BMI cut-off points for institutionalized older people, taking into account specific sex characteristics. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. 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.

  13. A Randomized Placebo-Controlled Discontinuation Study of Cholinesterase Inhibitors in Institutionalized Patients With Moderate to Severe Alzheimer Disease.

    PubMed

    Herrmann, Nathan; O'Regan, Jordana; Ruthirakuhan, Myuri; Kiss, Alexander; Eryavec, Goran; Williams, Evelyn; Lanctôt, Krista L

    2016-02-01

    Cholinesterase inhibitors (ChEIs) offer modest benefits in Alzheimer disease (AD), which must be balanced against risks. Relatively few data delineate the benefits and risks of long-term ChEI administration in institutionalized patients with advanced AD. This study investigated the effects of ChEI discontinuation in institutionalized patients with AD. Institutionalized patients with moderate to severe AD (standardized Mini- Mental Status Examination ≤15) and treated with a ChEI for ≥2 years were randomized, double-blind, to ChEI continuation or placebo, with a 2-week tapering phase, for 8-weeks. The primary outcome of this pilot study was change on the Clinician's Global Impression of Change (CGI-C) scale. Secondary outcomes included safety, efficacy, and tolerability. Baseline (BL) predictors of clinical deterioration were also determined. Forty patients (mean ± standard deviation age = 89.3 ± 3.5 years, standardized Mini-Mental Status Examination = 8.1 ± 5.2, Neuropsychiatric Inventory-Nursing Home version total score = 21.1 ± 15.9, 80% male) were randomized to ChEI continuation (n = 21) or placebo (n = 19). There was no significant difference in clinical worsening in the ChEI continuation (28.6%) and placebo groups (36.8%) on CGI-C (odds ratio for worsening 1.58, 95% confidence interval .38-6.55, P = .53). The occurrence of adverse events was similar in both groups. There were no significant differences in any of the secondary outcome measures. In the placebo group, BL hallucinations predicted CGI-C worsening [F(1,17) = 6.4, P = .02], and there was a trend for BL delusions to predict CGI-C worsening [F(1,15) = 3.5, P = .08]. These results suggest that ChEI discontinuation is safe and well tolerated in the majority of institutionalized patients with moderate to severe AD. When discontinuing ChEI, the presence of hallucinations and delusions may predict clinical deterioration, suggesting the need for increased caution

  14. [Proximal humeral fractures in the elderly : Quality of life, clinical results and institutionalization following primary reverse fracture arthroplasty].

    PubMed

    Merschin, D; Stangl, R

    2016-12-01

    Treatment of humeral head fractures in the elderly remains a challenge. Within the framework of demographic change the incidence as well as the direct and indirect consequences of injuries will rise. The analysis of an optimal treatment should include functional parameters as well as global health parameters, e.g. quality of life. The aim of this study was the evaluation of functional outcome, institutionalization (necessity of placement in a residential care home for the elderly, even if temporary), the influence of cognitive deficits, quality of life and the pattern of complications after primary reverse shoulder arthroplasty. The study included a total of 34 patients (mean age 79.8 ± 6.7 years, 29 female) after implantation of a reversed modular fracture arthroplasty. The mean follow-up was 23 ± 10.6 months). The functional Constant-Murley score (CS), radiology results as well as the extent of institutionalization and quality of life as measured by the EQ-5D questionnaire were collated. The clinical examination showed good results in the CS (54 points, SD ± 9). In comparison to the age and gender-related CS according to Gerber the patient scores amounted to 78.9 %. The comparison of patients with and without cognitive deficits did not show any differences (53 vs. 54 points, p = 0.6525). The rate of institutionalization after treatment of humeral head fractures by reversed fracture arthroplasty was 2.94 %. The quality of life measured with EQ-5D showed a health-related quality of life (HRQoL) of 0.801. The rate of complications was 2.94 % involving an incomplete lesion of the radial nerve which was in regression. The results of this study showed good to moderate functional results, very low rates of complications and institutionalization and very good results according to the HRQoL. In comparison to conservative treatment or plate osteosynthesis, better results were achieved in this study with respect to HRQoL.

  15. From child to child: children as communicators.

    PubMed

    Phinney, R; Evans, J

    1993-01-01

    Older children commonly care for their younger siblings while parents work to provide for the household. Through play, dance, and talk, children tend to interact with each other more intensely than do adults. In so doing, messages and awareness are exchanged more effectively. Child-to-Child is an active, child-centered learning approach which aims to capitalize on this phenomenon by training older siblings to be effective communicators. This approach has been formally practiced in over 70 countries since 1979. Child-to-Child encourages children to learn the meaning and importance of health messages on their own. Children will then be most likely to retain and communicate information throughout the family, to neighbors, and to the general community. No blueprint exists, however, on which program planners may base the design of new programs. Programs should instead be adapted by those living within the community and culture to fit local needs and circumstances. Nonetheless, the Aga Khan Foundation supported the study of 7 highly different Child-to-Child projects over 3 years in India to obtain some sense of which program elements are successful and potentially useful in other settings. The study revealed that all of the programs helped increase the health knowledge of children and teachers. Little information was obtained on the extent to which information was diffused by children within the community. Overall, the study produced the following results: planners should consider using Child-to-Child projects in schools; teacher training should be made a priority; administrative support should be provided; entire staffs should be made to feel involved in the decision making process; obstacles to changing teaching methods should not be underestimated; teaching materials should be locally made; projects should be integrated into official curricula; program topics should be relevant to local realities; respected authorities should be called upon to reinforce the validity

  16. How Nigeria built child survival themes into national television.

    PubMed

    Gleason, G

    1990-01-01

    As part of the Government of Nigeria's goal of providing universal child immunization, a strategy was developed to strengthen the production capacity of the Nigerian Television Authority (NTA) and to award higher priority to health issues in NTA programming. At the national level, a child survival-oriented training, coordination, and production unit was established to produce "spot messages" on primary health care. In 1985-86, radio and television staff from all Nigerian states attended workshops at which Ministry of Health officials outlined Nigeria's maternal-child health problems and emphasized the potential of the broadcast media in health education. Each station was linked with an officer in the local Ministry of Health to ensure ongoing collaboration on technical problems and health programs in need of promotion. Another set of state-level workshops brought together media producers and radio and television writers to encourage them to integrate primary health care themes into their programs. In addition, a Nigerian nongovernmental organization has organized workshops for electronic media writers and producers aimed at incorporating family planning themes into several popular television programs. In 1986, both NTA and the Federal Radio Corporation of Nigeria signed agreements further committing their networks to the child survival campaign. The Nigerian experience exemplifies the potential for creating and institutionalizing long-term efforts to use the mass media to bring new information to the general population on health-related issues. Needed at this point is more knowledge about specific communication strategies that are most effective in promoting sustainable behavioral change on the family and community levels in a country with much social and cultural diversity.

  17. Different patterns in use of antibiotics for lower urinary tract infection in institutionalized and home-dwelling elderly: a register-based study.

    PubMed

    Haasum, Ylva; Fastbom, Johan; Johnell, Kristina

    2013-03-01

    We compared the quality and pattern of use of antibiotics to treat urinary tract infection (UTI) between institutionalized and home-dwelling elderly. We analyzed the quality of use of UTI antibiotics in Swedish people aged ≥ 65 years at 30 September 2008 (1,260,843 home-dwelling and 86,721 institutionalized elderly). Data regarding drug use, age and sex were retrieved from the Swedish Prescribed Drug Register and information about type of housing from the Social Services Register. In women, we assessed: (1) the proportion who use quinolones (should be as low as possible); (2) the proportion treated with the recommended drugs (pivmecillinam, nitrofurantoin, or trimethoprim) (proportions should be about 40 %, 40 % and 15-20 %, respectively); In men, we assessed: (1) the proportion who used quinolones or trimethoprim (should be as high as possible). The 1-day point prevalence for antibiotic use for UTI was 1.6 % among institutionalized and 0.9 % among home-dwelling elderly. Of these, about 15 % of institutionalized and 19 % of home-dwelling women used quinolones. The proportion of women treated with the recommended drugs pivmecillinam, nitrofurantoin or trimethoprim was 29 %, 27 % and 45 % in institutions and 40 %, 28 % and 34 % for home-dwellers. In men treated with antibiotics for UTI, quinolones or trimethoprim were used by about 76 % in institutions and 85 % in home-dwellers. Our results indicate that recommendations for UTI treatment with antibiotics are not adequately followed. The high use of trimethoprim amongst institutionalized women and the low use of quinolones or trimethoprim among institutionalized men need further investigation.

  18. Seasonal Variation in Mortality, Medical Care Expenditure and Institutionalization in Older People: Evidence from a Dutch Cohort of Older Health Insurance Clients

    PubMed Central

    Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David; Westendorp, Rudi Gerardus Johannes

    2015-01-01

    Background The mortality rates of older people changes with the seasons. However, it has not been properly investigated whether the seasons affect medical care expenditure (MCE) and institutionalization. Seasonal variation in MCE is plausible, as MCE rises exponentially before death. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality. Methods Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer and were linked with data from the Netherlands Institute for Social Research, and Statistics Netherlands (n = 61,495). The Seasonal and Trend decomposition using Loess (STL) method was used to divide mortality rates, MCE, and institutionalization rates into a long-term trend, seasonal variation, and remaining variation. For every season we calculated the 95% confidence interval compared to the long-term trend using Welch’s t-test. Results The mortality rates of older people differ significantly between the seasons, and are 21% higher in the winter compared to the summer. MCE rises with 13% from the summer to the winter; this seasonal difference is higher for the non-deceased than for the deceased group (14% vs. 6%). Seasonal variation in mortality is more pronounced in men and people in residential care. Seasonal variation in MCE is more pronounced in women. Institutionalization rates are significantly higher in the winter, but the other seasons show no significant impact. Conclusions Seasonal changes affect mortality and the level of MCE of older people; institutionalization rates peak in the winter. Seasonal variation in MCE exists independently from patterns in mortality. Seasonal variation in mortality is similar for both institutionalized and community-dwelling elderly. Policy-makers, epidemiologists and health economists are urged to acknowledge and include the impact of

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

    PubMed

    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

    2015-11-01

    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.

  20. 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