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…

Early Adverse Experiences and the Neurobiology of Facial Emotion Processing

ERIC Educational Resources Information Center

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

2009-01-01

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

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…

43 CFR 17.252 - Education of institutionalized persons.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

45 CFR 605.54 - Education of institutionalized persons.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

45 CFR 84.54 - Education of institutionalized persons.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

45 CFR 84.54 - Education of institutionalized persons.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

43 CFR 17.252 - Education of institutionalized persons.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

43 CFR 17.252 - Education of institutionalized persons.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

45 CFR 84.54 - Education of institutionalized persons.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

43 CFR 17.252 - Education of institutionalized persons.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

45 CFR 84.54 - Education of institutionalized persons.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

42 CFR 435.1009 - Institutionalized individuals.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

45 CFR 84.54 - Education of institutionalized persons.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

45 CFR 605.54 - Education of institutionalized persons.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

43 CFR 17.252 - Education of institutionalized persons.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

PubMed

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

2006-01-01

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

Predictors of institutionalization in patients with dementia in Korea.

PubMed

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

2002-02-01

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

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.

[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.

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

PubMed

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

2015-05-01

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

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

Code of Federal Regulations, 2011 CFR

2011-01-01

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

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…

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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

ERIC Educational Resources Information Center

Emory, Ruth

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

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…

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,…

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.

Predicting institutionalization after traumatic brain injury inpatient rehabilitation.

PubMed

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

2015-02-15

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

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

PubMed

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

2016-02-01

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

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

PubMed

Li, Yushi; Buechel, Annie

2007-01-01

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

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

PubMed

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

2014-02-01

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

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

PubMed

Holder, H D; Moore, R S

2000-01-01

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

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

ERIC Educational Resources Information Center

Bértoa, Fernando Casal

2017-01-01

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

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?…

Early adverse experiences and the neurobiology of facial emotion processing.

PubMed

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

2009-01-01

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

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

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

ERIC Educational Resources Information Center

Cuban, Sondra; Anderson, Jeffrey B.

2007-01-01

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

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…

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

PubMed

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

1992-01-01

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

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

PubMed

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

2014-01-01

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

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.

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.

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

PubMed

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

2017-11-13

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

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

PubMed Central

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

2017-01-01

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

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

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

PubMed

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

2017-01-01

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

[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.

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

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

PubMed

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

2015-12-01

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

Institutionalization of Older Adults After the Death of a Spouse

PubMed Central

Nihtilä, Elina; Martikainen, Pekka

2008-01-01

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

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

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

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

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

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.

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

PubMed

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

2012-08-06

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

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

PubMed

Hage, Jerald; Valadez, Joseph J

2017-11-01

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

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

PubMed Central

Hage, Jerald; Valadez, Joseph J

2017-01-01

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

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

PubMed

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

2016-10-22

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

Family functionality: a study of Brazilian institutionalized elderly individuals.

PubMed

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

2014-01-01

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

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

PubMed

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

2007-10-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

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

Risk Factors for Institutionalization After Traumatic Brain Injury Inpatient Rehabilitation.

PubMed

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

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

[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.

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.

Durability of Effects of Group Counseling with Institutionalized Delinquent Females

ERIC Educational Resources Information Center

Redfering, David L.

1973-01-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2015-01-01

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

Services to Status Offenders and Delinquents under Title XX.

ERIC Educational Resources Information Center

Nelson, Gary M.

1982-01-01

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

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

ERIC Educational Resources Information Center

Lee, Dong Yul; And Others

1977-01-01

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

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

PubMed

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

2017-08-01

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

Relation between functional mobility and dynapenia in institutionalized frail elderly.

PubMed

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

2017-01-01

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

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

PubMed

Cobo, Carmen María Sarabia

2014-12-01

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

A framework for institutionalizing quality assurance.

PubMed

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

2002-12-01

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

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

PubMed

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

2011-01-01

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

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.

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)

Institutional Placement: Phases of the Transition.

ERIC Educational Resources Information Center

Zarit, Steven H.; Whitlatch, Carol J.

1992-01-01

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

42 CFR 436.1005 - Institutionalized individuals.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

42 CFR 436.1005 - Institutionalized individuals.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Career Salience of Institutionalized Adolescent Offenders.

ERIC Educational Resources Information Center

Munson, Wayne W.; Strauss, Christine F.

1993-01-01

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

People in Institutions in Europe.

ERIC Educational Resources Information Center

Hatton, Chris; And Others

1995-01-01

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

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)

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

PubMed

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

2012-03-01

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

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

PubMed

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

2017-04-01

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

Neuropsychological Differences Among Subtypes of Schizophrenia

ERIC Educational Resources Information Center

Goldstein, Gerald; Halperin, Keith M.

1977-01-01

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

Reshaping Institutional Boundaries to Accommodate an Engagement Agenda

ERIC Educational Resources Information Center

Sandmann, Lorilee R.; Weerts, David J.

2008-01-01

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

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…

Institutionalizing Educational Productivity.

ERIC Educational Resources Information Center

Kean, Michael H.

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

Piagetian Object Permanence in Severely Mentally Retarded Adults.

ERIC Educational Resources Information Center

Brekke, Beverly; And Others

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

Relation between functional mobility and dynapenia in institutionalized frail elderly

PubMed Central

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

2017-01-01

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

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

PubMed

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

2009-03-01

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

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

PubMed Central

2009-01-01

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

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

PubMed

Chen, Lin

2015-01-01

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

Institutionalization of 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…

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…

Institutionalizing Diversity: Transforming Higher Education

ERIC Educational Resources Information Center

McRae-Yates, Velda

2009-01-01

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

34 CFR 104.54 - Education of institutionalized persons.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

The International Institutionalization of Education.

ERIC Educational Resources Information Center

Goodman, Norman G.

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

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

PubMed

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

2013-06-01

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

38 CFR 18.454 - Education of institutionalized persons.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

ERIC Educational Resources Information Center

Maiden, Robert J.

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

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

ERIC Educational Resources Information Center

Howes, Nancy J.

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

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…

38 CFR 18.454 - Education of institutionalized persons.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

38 CFR 18.454 - Education of institutionalized persons.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

38 CFR 18.454 - Education of institutionalized persons.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Factors Influencing Title VII Bilingual Program Institutionalization.

ERIC Educational Resources Information Center

Lewis, Gerald R.; And Others

1985-01-01

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

38 CFR 18.454 - Education of institutionalized persons.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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…

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

ERIC Educational Resources Information Center

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

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

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…

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…

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…

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…

Institutionalized Racism and the Education of Blacks

ERIC Educational Resources Information Center

Spears, Arthur K.

1978-01-01

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

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…

Ethical Considerations for People Who Are Homeless and Mentally Ill

ERIC Educational Resources Information Center

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

2004-01-01

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

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

DTIC Science & Technology

1980-05-01

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

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

ERIC Educational Resources Information Center

Ladner, Judith L.

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

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

ERIC Educational Resources Information Center

Perego, Gaia; Caputi, Marcella; Ogliari, Anna

2016-01-01

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

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

ERIC Educational Resources Information Center

Keller, Roy Heath

2011-01-01

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

The Research Paper and Postmodernist Pedagogy.

ERIC Educational Resources Information Center

McDonald, James C.

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

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…

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…

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

ERIC Educational Resources Information Center

Ramirez, Francisco O.; Boli, John

1987-01-01

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

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…

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)

Towards a Novel Conceptual Framework for Understanding Mergers in Higher Education

ERIC Educational Resources Information Center

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

2016-01-01

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

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…

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

ERIC Educational Resources Information Center

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

2006-01-01

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

Filipino Arts among Elders in Institutionalized Care Settings

ERIC Educational Resources Information Center

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

2011-01-01

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

The Effects of Duration of Caregiving on Institutionalization

ERIC Educational Resources Information Center

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

2005-01-01

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

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

ERIC Educational Resources Information Center

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

2006-01-01

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

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…

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

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…

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

PubMed

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

1985-01-01

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

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

PubMed

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

2017-01-01

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

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

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

PubMed

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

2016-01-01

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

Institutionalization of evidence-informed practices in healthcare settings

PubMed Central

2012-01-01

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

Institutionalization of evidence-informed practices in healthcare settings.

PubMed

Novotná, Gabriela; Dobbins, Maureen; Henderson, Joanna

2012-11-21

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

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

PubMed

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

2009-01-01

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

Adverse Outcomes After Hospitalization and Delirium in Persons With Alzheimer Disease

PubMed Central

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

2012-01-01

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

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

PubMed

Tanikake, Chisato

2005-03-01

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

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

PubMed

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

2016-06-15

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

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…

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…

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

ERIC Educational Resources Information Center

Driva, A.; And Others

1985-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

ERIC Educational Resources Information Center

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

2009-01-01

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

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…

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…

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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…

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

ERIC Educational Resources Information Center

Han, SoongHee

2017-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2015-11-01

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

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

PubMed Central

Weissert, W G; Cready, C M

1989-01-01

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

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.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Political Party System Institutionalization and Democracy: The Case of Panama

DTIC Science & Technology

1998-03-01

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

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

ERIC Educational Resources Information Center

Emory, Ruth

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

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…

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

PubMed

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

2018-02-01

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

[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.

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.

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

PubMed

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

2018-07-15

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

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

PubMed

Barone, Lavinia; Lionetti, Francesca; Green, Jonathan

2017-08-01

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

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

PubMed

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

2018-06-14

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

[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.

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

PubMed

Yasumura, Seiji

2014-01-01

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

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

ERIC Educational Resources Information Center

Boyd, Joe K.; Hensley, J. Higgins

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

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

ERIC Educational Resources Information Center

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

2018-01-01

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

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

ERIC Educational Resources Information Center

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

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

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

ERIC Educational Resources Information Center

Linaker, Olav

1991-01-01

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

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

ERIC Educational Resources Information Center

Brekke, Beverly W.; And Others

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

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

ERIC Educational Resources Information Center

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

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

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-08-01

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

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

PubMed

Fortunato, Laura; Drusini, Andrea G

2005-06-01

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

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

ERIC Educational Resources Information Center

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

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

Quality circles: Organizational adaptations, improvements and results

NASA Technical Reports Server (NTRS)

Tortorich, R.

1985-01-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

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

2013-01-01

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

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.

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

PubMed

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

2013-01-01

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

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

ERIC Educational Resources Information Center

Kavulic, Michael A.

2017-01-01

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

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

ERIC Educational Resources Information Center

Klausmeier, Herbert J.; Fruth, Marvin J.

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

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

DTIC Science & Technology

2017-04-06

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

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

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.

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

PubMed

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

2008-01-01

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

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

PubMed

Katsurada, Emiko; Tanimukai, Mitsue; Akazawa, Junko

2017-08-01

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

[Institutionalized elderly: functional capacity and physical fitness].

PubMed

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

2010-09-01

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

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

PubMed

Chen, Lin

2017-04-01

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

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

PubMed

Hartz, Z M

1999-01-01

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

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

PubMed

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

2018-04-24

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

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

DTIC Science & Technology

1980-11-07

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

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

PubMed

Bychkova, Olga

2016-08-01

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

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.

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

PubMed

Tataw, David

2012-01-01

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

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

PubMed

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

2017-06-26

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2006-07-01

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

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

PubMed

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

2006-04-01

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

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

PubMed

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

2014-11-26

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

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

PubMed

Henn, Matt; Oldfield, Ben; Hart, James

2017-08-30

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

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.

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

PubMed Central

Delbroek, Tom; Vermeylen, Wietse; Spildooren, Joke

2017-01-01

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

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

An Even Distribution of Protein Intake Daily Promotes Protein Adequacy but Does Not Influence Nutritional Status in Institutionalized Elderly.

PubMed

Tieland, Michael; Beelen, Janne; Laan, Anna C M; Poon, Shirley; de Groot, Lisette C P G M; Seeman, Ego; Wang, Xiaofang; Iuliano, Sandra

2018-01-01

Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of malnutrition. Therefore, we aim to determine the association between protein intake distribution and nutritional status in institutionalized elderly people. Cross-sectional study among 481 institutionalized older adults. Dietary data from 481 ambulant elderly people (68.8% female, mean age 87.5 ± 6.3 years) residing in 52 aged-care facilities in Victoria, Australia, were assessed over 2 days using plate waste analysis. Nutritional status was determined using the Mini-Nutritional Assessment tool and serum (n = 208) analyzed for albumin, hemoglobin, and IGF-1. Protein intake distribution was classified as: spread (even distribution across 3 meals, n = 65), pulse (most protein consumed in one meal, n = 72) or intermediate (n = 344). Regression analysis was used to investigate associations. Mean protein intakes were higher in the spread (60.5 ± 2.0 g/d) than intermediate group (56.0 ± 0.8 g/d, P = .037), and tended to be higher than those in the pulse group (55.9 ± 1.9 g/d, P = .097). Residents with an even distribution of protein intake achieved a higher level of the recommended daily intake for protein (96.2 ± 30.0%) than the intermediate (86.3 ± 26.2%, P = .008) and pulse (87.4 ± 30.5%, P = .06) groups, and also achieved a greater level of their estimated energy requirements (intermediate; P = .039, pulse; P = .001). Nutritional status (Mini-Nutritional Assessment score) did not differ between groups (pulse; 20.5 ± 4.5, intermediate; 21.0 ± 2.5, spread; 20.5 ± 3.5), nor did any other indices of nutritional status. Meeting protein requirements is required before protein distribution may influence nutritional status in institutionalized elderly. Achieving adequate protein and energy intakes is more likely when protein is distributed evenly throughout the day. Provision of high protein foods especially at breakfast, and in the evening, may support protein adequacy and healthy aging, especially for institutionalized elderly. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Nursing Home Admission: When, Why, Where?

PubMed Central

Bergman, H.; Clarfield, A. M.

1985-01-01

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

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

PubMed

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

2012-01-01

Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17, p = .006). The intervention had no effect on internalizing disorders in boys (OR = 0.47, p = .150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR = 12.5, p < .001), but no difference was observed in boys (OR = 2.0, p = .205). Greater attachment security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

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

NASA Astrophysics Data System (ADS)

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

2017-06-01

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

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

PubMed

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

2018-05-01

Self-concept is seen as both an outcome of sociocognitive and emotional development, and a factor in social and mental health outcomes. Although the contribution of attachment experiences to self-concept has been limited to quality of primary attachment relationships, little is known of the effects of disturbed attachment on self-concept in institutionalized children. Thus, the current study examined associations between disturbed attachment behaviours in institutionalized children and self-concept, testing limited exploration as an explanatory factor. Thirty-three institutionalized children, aged 4-12, participated in a multimethod and multi-informant assessment of disturbed attachment behaviours (i.e., Disturbances of Attachment Interview and Behavioral Signs of Disturbed Attachment in Young Children), self-concept (i.e., Pictorial Scale of Perceived Competence and Social Acceptance for Young Children), and exploratory behaviours (i.e., Student Exploratory Behaviours Observation Scale). Analyses were conducted using bootstrapping techniques. Global self-concept converged with teacher-rated children's self-concept, except for physical competence domain. Disturbed attachment behaviours were identified in 62.5% of the children, and this was associated with lower levels of exploration and lower scores on self-concept, compared with children without disturbed attachment behaviours. Furthermore, exploratory behaviours mediated the effects of disturbed attachment behaviours on self-concept. Institution-reared children with disturbed attachment behaviours were likely to have a negative perception of self and one's own competences. Limited exploratory behaviours explained this linkage. Targeting disordered attachment in children reared in institutions and their caregivers should become a high priority as a means for preventing socioemotional development issues. © 2017 John Wiley & Sons Ltd.

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.

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.

[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.

A patient mobility framework that travels: European and United States-Mexican comparisons.

PubMed

Laugesen, Miriam J; Vargas-Bustamante, Arturo

2010-10-01

To develop a framework that parsimoniously explains divergent patient mobility in the United States and Europe. Review of studies of patient mobility; data from the 2007 Flash Eurobarometer and the 2001 California Health Interview Survey was analyzed; and we reviewed government policies and documents in the United States and Europe. Four types of patient mobility are defined: primary, complementary, duplicative, and institutionalized. Primary exit occurs when people without comprehensive insurance travel because they cannot afford to pay for health insurance or directly finance care, as in the United States and Mexico. Second, people will exit to buy complementary services not covered, or partially covered by domestic health insurance, in both the United States and Europe. Third, in Europe, patient mobility for duplicative services provides faster or better quality treatment. Finally, governments and insurers can encourage institutionalized exit through expanded delivery options and financing. Institutionalized exit is developing in Europe, but uncoordinated and geographically limited in the United States. This parsimonious framework explains patient mobility by considering domestic health system characteristics relating to cost and quality. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

The Ciência & Saúde Coletiva journal and the process of institutionalization of a field of knowledge and practices.

PubMed

Nunes, Everardo Duarte

2015-07-01

This paper takes as its starting point the concepts that make up the process of institutionalization of a field of knowledge in the following phases: 1. Differentiation of subjects, methods and techniques of knowledge or existing disciplines, 2. The subject previously considered as peripheral is now seem as part of a particular field of knowledge, 3. The new field becomes significant in the set of an area and starts the standardization of recruitment of human resources, selection of experts and financial resources, and 4. Consolidation of the new field, building its culture within the scientific community, with its social networks of communication, scientific associations and its own publications. Our central objective is to analyze the role of the Ciência e Saúde Coletiva Journal in the process of institutionalization of the Collective Health; we situate the Collective Health and its stages, make a brief report on the history of scientific publications by emphasizing the Brazilian studies on the public health field, and work the early stages of the Journal.

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

Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution

PubMed Central

Marcos-Tejedor, Félix; Iglesias-Sánchez, María José

2018-01-01

Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal pathologies of the foot of institutionalized people with psychiatric disorders compared to people without these disorders. A transversal and observational study was conducted on 107 participants, divided into two groups who have used different types of shoes throughout their lives. The control group comprised 63 autonomous people who mainly use leather footwear and a study group of 44 institutionalized people with intellectual disabilities and psychiatric disorders who mainly use textile footwear. There were significant differences between populations. The group with psychiatric disorders presented more xerosis and hyperkeratosis. Footwear with inappropriate characteristics is a possible causal agent of skin alterations. Wearing footwear with quality textile uppers, e.g., fabric or felt, could influence the appearance of these alterations. Leather footwear is recommended for institutionalized people to reduce symptoms of xerosis and improve their quality of life. PMID:29587357

Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution.

PubMed

Pérez-Pico, Ana María; Marcos-Tejedor, Félix; Iglesias-Sánchez, María José; Acevedo, Raquel Mayordomo

2018-03-24

Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal pathologies of the foot of institutionalized people with psychiatric disorders compared to people without these disorders. A transversal and observational study was conducted on 107 participants, divided into two groups who have used different types of shoes throughout their lives. The control group comprised 63 autonomous people who mainly use leather footwear and a study group of 44 institutionalized people with intellectual disabilities and psychiatric disorders who mainly use textile footwear. There were significant differences between populations. The group with psychiatric disorders presented more xerosis and hyperkeratosis. Footwear with inappropriate characteristics is a possible causal agent of skin alterations. Wearing footwear with quality textile uppers, e.g., fabric or felt, could influence the appearance of these alterations. Leather footwear is recommended for institutionalized people to reduce symptoms of xerosis and improve their quality of life.

Developing proper mealtime behaviors of the institutionalized retarded.

PubMed

O'brien, F; Azrin, N H

1972-01-01

The institutionalized mentally retarded display a variety of unsanitary, disruptive, and improper table manners. A program was developed that included (1) acquisition-training of a high standard of proper table manners and (2) maintenance procedures to provide continued motivation to maintain proper mealtime behaviors and decrease improper skills. Twelve retardates received acquisition training, individually, by a combination of verbal instruction, imitation, and manual guidance. The students then ate in their group dining arrangement where the staff supervisor provided continuing approval for proper manners and verbal correction and timeout for improper manners. The results were: (1) the trained retardates showed significant improvement, whereas those untrained did not; (2) the trained retardates ate as well in the institution as non-retarded customers did in a public restaurant; (3) proper eating was maintained in the group dining setting; (4) timeout was rarely needed; (5) the program was easily administered by regular staff in a regular dining setting. The rapidity, feasibility, and effectiveness of the program suggests the program as a solution to improper mealtime behaviors by the institutionalized mentally retarded.

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

PubMed

Quah, Stella R

2017-07-01

This study discusses the main barriers to partnership between family and health services in the context of schizophrenia and de-institutionalization (reduction of the length of hospitalization whenever possible and returning the patient to the community) addressed to deal with the increasing costs and demand for health care services. Thus, in de-institutionalization the burden of care is not resolved but shared with the family, under the assumption that the patient has someone-a family caregiver-who can take up the responsibility of care at home. Despite the high burden of care faced by the family caregiver in mental illness, the necessary systematic partnership between the medical team and the family caregiver is missing. Subjects were 47 family caregivers of persons living with schizophrenia. Data were collected using in-depth interviews, structured questionnaires and attitudinal scales. Data analysis included factor analysis and odds ratios. Two types of barriers to partnership are identified in the literature: health services barriers and barriers attributed to the family. The findings confirm the health services barriers but reject the assumed family barriers.

Socio-demographics, spirituality, and quality of life among community-dwelling and institutionalized older adults: A structural equation model.

PubMed

Soriano, Christian Albert F; Sarmiento, Winona D; Songco, Francis Justin G; Macindo, John Rey B; Conde, Alita R

2016-01-01

The increasing life expectancy of the population prompts an array of health conditions that impair an older adults' quality of life (QoL). Although demographics and spirituality have been associated with QoL, limited literature elucidated the exact mechanisms of their interactions, especially in a culturally-diverse country like Philippines. Hence, this study determined the relationship among socio-demographics, spirituality, and QoL of Filipino older adults in a community and institutional setting. A predictive-correlational study among 200 randomly-selected community-dwelling and institutionalized older adults was conducted, with a 99% power and a medium effect size. Data were collected using a three-part questionnaire from September to November 2015. The questionnaire was composed of the robotfoto, Spirituality Assessment Scale, and modified Older People's Quality of Life which assessed socio-demographics, spirituality, and QoL. Analysis showed that institutionalization in a nursing home positively and negatively affected spirituality and QoL, generating an acceptable model (χ(2)/df=2.12, RMSEA=0.08, and CFI=0.95). The negative direct effect of institutionalization on social relationship, leisure, & social activities QoL (β=-0.42, p<0.01) also initiates a cascade of indirect negative effects on both spirituality and QoL dimensions. The development of a structural model illustrating the interrelationship of socio-demographics, spirituality, and QoL helps healthcare professionals in predicting facets of spirituality and QoL that can be compromised by living in a nursing home. This understanding provides impetus in evaluating and refining geriatric healthcare programs, policies, and protocols to render individualized, holistic care in a socially-cohesive environment among older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

Delayed Maturation in Brain Electrical Activity Partially Explains the Association Between Early Environmental Deprivation and Symptoms of Attention-Deficit/Hyperactivity Disorder

PubMed Central

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

2010-01-01

Background Children raised in institutional settings are exposed to social and environmental circumstances that may deprive them of expected environmental inputs during sensitive periods of brain development that are necessary to foster healthy development. This deprivation is thought to underlie the abnormalities in neurodevelopment that have been found in previously institutionalized children. It is unknown whether deviations in neurodevelopment explain the high rates of developmental problems evident in previously institutionalized children, including psychiatric disorders. Methods We present data from a sample of children raised in institutions in Bucharest, Romania (n = 117) and an age- and sex-matched sample of community control subjects (n = 49). Electroencephalogram data were acquired following entry into the study at age 6 to 30 months, and a structured diagnostic interview of psychiatric disorders was completed at age 54 months. Results Children reared in institutions evidenced greater symptoms of attention-deficit/hyperactivity disorder, anxiety, depression, and disruptive behavior disorders than community controls. Electroencephalogram revealed significant reductions in alpha relative power and increases in theta relative power among children reared in institutions in frontal, temporal, and occipital regions, suggesting a delay in cortical maturation. This pattern of brain activity predicted symptoms of hyperactivity and impulsivity at age 54 months, and significantly mediated the association between institutionalization and attention-deficit/hyperactivity disorder symptoms. Electroencephalogram power was unrelated to depression, anxiety, or disruptive behaviors. Conclusions These findings document a potential neurodevelopmental mechanism underlying the association between institutionalization and psychiatric morbidity. Deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life. PMID:20497899

Effects of a multicomponent exercise program in institutionalized elders with Alzheimer's disease.

PubMed

Sampaio, Arnaldina; Marques, Elisa A; Mota, Jorge; Carvalho, Joana

2016-10-18

This study examined the effect of a Multicomponent Training (MT) intervention on cognitive function, functional fitness and anthropometric variables in institutionalized patients with Alzheimer's disease (AD). Thirty-seven institutionalized elders (84.05 ± 5.58 years) clinically diagnosed with AD (mild and moderate stages) were divided into two groups: Experimental Group (EG, n = 19) and Control Group (CG, n = 18). The EG participated in a six-month supervised MT program (aerobic, muscular resistance, flexibility and postural exercises) of 45-55 minutes/session, twice/week. Cognitive function (MMSE), physical fitness (Senior Fitness Test) and anthropometric variables (Body Mass Index and Waist Circumference), were assessed before (M1), after three months (M2) and after six months (M3) of the experimental protocol. A two-way ANOVA, with repeated measures, revealed significant group and time interactions on cognitive function, chair stand, arm curl, 2-min step, 8-foot up-and-go (UG), chair sit-and-reach (CSR) and back scratch tests as well as waist circumference. Accordingly, for those variables a different response in each group was evident over the time, supported by a significantly better EG performance in chair stand, arm curl, 2-min step, UG, CSR and back scratch tests from M1 to M3, and a significant increase in MMSE from M1 to M2. The CG's performance decreased over time (M1 to M3) in chair stand, arm curl, 2-min step, UG, CSR, back scratch and MMSE. Results suggest that MT programs may be an important non-pharmacological strategy to improve physical and cognitive functions in institutionalized AD patients. © The Author(s) 2016.

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

PubMed

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

2011-08-01

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

Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level.

PubMed

Gálvez-Barrón, César; Narvaiza, Leire; Dapena, María D; Macho, Oscar; Rodríguez-Molinero, Alejandro

2016-04-01

In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population. To explore prevalence and considered pharmacological treatments for pain in this population. Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews. Pain's prevalence was 52.5 % (CI 95 % 48.28-56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93-1.02) in females and 0.99 (CI 95 % 0.92-1.06) in males]. The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline's recommendations are probably not being considered to select the analgesic therapy.

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

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.

The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people.

PubMed

Manders, M; De Groot, L C P G M; Hoefnagels, W H L; Dhonukshe-Rutten, R A M; Wouters-Wesseling, W; Mulders, A J M J; Van Staveren, W A

2009-11-01

To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Homes for the elderly and nursing homes in the Netherlands. Institutionalized elderly people older than 60 years, with a BMI < or = 30 kg/m2, and a Mini-Mental State Examination score of at least 10 points. In addition to their usual diet the participants (n=176) received either a nutrient dense drink or a placebo drink twice a day during 24 weeks. The functionality measures included cognitive function, mood, physical performance and the ability to perform activities of daily living. In the supplement group a favorable effect of the intervention drink on body weight (1.6 kg difference in change; P = .035), calf circumference (0.9 cm difference in change; P = .048), and blood values (e.g. Hcy decreased from 16.8 to 11.2 mumol/L in the supplement group) was found. In the total group no significant effect was found on functionality outcomes. However, a subgroup of participants with BMI at baseline below 24.4 kg/m2 performed better on the cognitive subscale of Alzheimer's Disease Assessment Scale (P = .09), and its language sub score (P = .01) after 24 weeks of intervention. The results in the total group of this trial suggest that the nutritional supplement used in this study improves nutritional status. Furthermore, the results of this trial suggest that it is effective as treatment for decreasing function in a subgroup of institutionalized elderly people with low BMI.

Can Doll therapy preserve or promote attachment in people with cognitive, behavioral, and emotional problems? A pilot study in institutionalized patients with dementia

PubMed Central

Pezzati, Rita; Molteni, Valentina; Bani, Marco; Settanta, Carmen; Di Maggio, Maria Grazia; Villa, Ivan; Poletti, Barbara; Ardito, Rita B.

2014-01-01

Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the Bowlby’s theory of attachment to investigate the effectiveness of Doll therapy. The hypothesis that we here propose is that the emotional experience of the person with dementia during Doll therapy activates caregiving and exploration systems together with the attachment one. To test this hypothesis we compared institutionalized patients with dementia undergoing Doll therapy with a control group and assessed measures of the relational dimension with the environment, such as gaze direction, behaviors of exploration, and behaviors of caregiving. We used an experimental protocol consisting of 10 non-consecutive sessions structured with the goal of recreating a situation of (1) separation from a known figure and (2) interaction with the environment in order to partially recreate the prototypical phases of the “Strange situation.” All sessions were videotaped and analyzed through an observational grid. Results support the effectiveness of Doll therapy in promoting and maintaining the affective-relational dimension of attachment-caregiving and the attentive dimension of exploration in patients with advanced stage of dementia. Thus, our results suggest that the use of Doll therapy promotes clinically significant improvements in the ability to relate with the surrounding world. This may be important for managing and caring for patients with dementia in institutionalized context. PMID:24795682

Association of nutritional status as measured by the Mini-Nutritional Assessment Short Form with changes in mobility, institutionalization and death after hip fracture.

PubMed

Nuotio, M; Tuominen, P; Luukkaala, T

2016-03-01

We examined the association of nutritional status as measured by the Mini-Nutritional Assessment Short Form (MNA-SF) with changes in mobility, institutionalization and death after hip fracture. Population-based prospective data were collected on 472 out of 693 consecutive hip fracture patients aged 65 years and over between January 2010 and December 2012. Declined vs same or improved mobility level, institutionalization and death during the 4-month follow-up were the outcomes. Age, gender, American Society of Anesthesiologists scores, pre-fracture diagnosis of a memory disorder, mobility level, living arrangements and MNA-SF scores at baseline were the independent variables. Age-adjusted and multivariate logistic regression and Cox proportional hazards models were conducted. At baseline, 41 (9%) patients were malnourished and 200 (42%) patients at risk of malnutrition according to the MNA-SF. During the follow-up, 90 (19%) had died. In the multivariate Cox proportional hazards model, malnutrition (hazard ratio 2.16; 95% confidence interval (CI) 1.07-4.34) was associated with mortality. In the multivariate binary logistic regression analyses, risk of malnutrition (odds ratios (OR) 2.42; 95% CI 1.25-4.66) and malnutrition (OR 6.10;95% CI 2.01-18.5) predicted institutionalization. Risk of malnutrition (OR 2.03; 95% CI 1.24-3.31) was associated with decline in the mobility level. Malnutrition or risk of malnutrition as measured by the MNA-SF were independent predictors of negative outcomes after hip fracture. Patients classified as being at risk of malnutrition by the MNA-SF may constitute a patient population with mild-to-moderate malnutrition and may require specific attention when nutritional interventions are designed after hip fracture.

Can Doll therapy preserve or promote attachment in people with cognitive, behavioral, and emotional problems? A pilot study in institutionalized patients with dementia.

PubMed

Pezzati, Rita; Molteni, Valentina; Bani, Marco; Settanta, Carmen; Di Maggio, Maria Grazia; Villa, Ivan; Poletti, Barbara; Ardito, Rita B

2014-01-01

Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the Bowlby's theory of attachment to investigate the effectiveness of Doll therapy. The hypothesis that we here propose is that the emotional experience of the person with dementia during Doll therapy activates caregiving and exploration systems together with the attachment one. To test this hypothesis we compared institutionalized patients with dementia undergoing Doll therapy with a control group and assessed measures of the relational dimension with the environment, such as gaze direction, behaviors of exploration, and behaviors of caregiving. We used an experimental protocol consisting of 10 non-consecutive sessions structured with the goal of recreating a situation of (1) separation from a known figure and (2) interaction with the environment in order to partially recreate the prototypical phases of the "Strange situation." All sessions were videotaped and analyzed through an observational grid. Results support the effectiveness of Doll therapy in promoting and maintaining the affective-relational dimension of attachment-caregiving and the attentive dimension of exploration in patients with advanced stage of dementia. Thus, our results suggest that the use of Doll therapy promotes clinically significant improvements in the ability to relate with the surrounding world. This may be important for managing and caring for patients with dementia in institutionalized context.

Current update on portable dental equipment.

PubMed

Charlton, David G; Ehrlich, A D; Miniotis, Nicholas J

2007-02-01

The dental care needs of the elderly are increasing as their population grows. For some of the elderly (eg, the nonambulatory, homebound, institutionalized), accessing dental care is a problem because they are unable to visit a traditional dental clinic. In the past, dental care has been taken to the homebound or institutionalized elderly by dentists using portable dental equipment. However, the perception that such equipment is difficult or impossible to obtain has limited the availability of on-site care. The purpose of this article is to describe various types of portable dental equipment and their features so that dentists interested in providing care to this group of patients are aware of them.

Patterns of family caregiving and support provided to older psychiatric patients in long-term care.

PubMed

Beeler, J; Rosenthal, A; Cohler, B

1999-09-01

Data on patterns of relationships and caregiving between older, institutionalized chronically mentally ill patients and their families were gathered in brief face-to-face interviews with 109 patients randomly selected from residents age 45 or older in a large intermediate care facility in Chicago. Three-fourths of the sample maintained some form of family contact. One-third had been married or had children. Siblings were the most frequently identified family contact and support. The results suggests that older, institutionalized psychiatric patients continue to have family contact and that siblings and offspring become increasingly important as patients age.

Interface between intellectual disability and mental health: hermeneutic review.

PubMed

Surjus, Luciana Togni de Lima e Silva; Campos, Rosana Teresa Onocko

2014-06-01

A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population. 

Validation of the Italian version of the Apathy Evaluation Scale (AES-I) in institutionalized geriatric patients.

PubMed

Borgi, Marta; Caccamo, Floriana; Giuliani, Alessandro; Piergentili, Alessandro; Sessa, Sonia; Reda, Emilia; Alleva, Enrico; Cirulli, Francesca; Miraglia, Fabio

2016-01-01

Apathy is a very common symptom in the institutionalized elderly and represents a condition of both clinical and public health importance. The Apathy Evaluation Scale (AES) has been shown to be a valid and reliable tool for characterizing, quantifying and differentiating apathy in various health conditions. The aims of this study were to establish the validity and reliability of the Italian version of the AES, and to assess the severity of apathy in a sample of Italian institutionalized geriatric patients. Data were collected from clinical interviews using the AES informant version (AES-I). Associations between measures of apathy and depression, cognitive functioning and perceived quality of life were evaluated, as well as the effects of the living environment on apathetic symptoms. Multiple forms of reliability and validity (i.e. test-retest, internal consistency, discriminability of apathy rating from a standard measure of depression) were satisfied. Our results also show that the characteristics of the care setting may affect the severity of apathetic symptoms. The AES-I Italian version is a reliable and valid instrument for measuring apathy in Italian patients, also allowing a direct comparison with data gathered in other countries.

[The Impact of Sunlight Exposure on the Health of Older Adults].

PubMed

Lin, Tzu-Chia; Liao, Yen-Chi

2016-08-01

Appropriate exposure to sunlight not only contributes to the production of vitamin D, which has been associated with enhanced bone health, mood, and cognitive functions, but also regulates the secretion of melatonin, which has been associated with the mediation of circadian rhythms, improved sleep quality, and optimized physical and social activity in the elderly. However, damage to the skin, eyes, and immune system has also been widely associated with long-term exposure to sunlight. Several studies have shown that many elderly, especially those that reside in institutions, do not receive sufficient sunlight exposure. Institutionalized elderly tend to participate in indoor activities and spend significant periods of time alone and asleep in front of the television. Furthermore, factors such as poor health, environmental design, indoor/outdoor preference, and activity design may impact the access of institutionalized elderly to sunlight more than their non-institutionalized peers. Therefore, we suggest that in addition to obtaining sufficient levels of vitamin D from their diet and from supplements, the elderly should perform outdoor activities for 20-30 minutes a day for five days each week. Furthermore, we suggest that the environment of the care facility should be made be more accessible and that some activities should be held outdoors.

Factors associated with sarcopenia in institutionalized elderly.

PubMed

Mesquita, Alice Ferreira; Silva, Emanuelle Cruz da; Eickemberg, Michaela; Roriz, Anna Karla Carneiro; Barreto-Medeiros, Jairza Maria; Ramos, Lílian Barbosa

2017-03-30

The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.

Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data

PubMed Central

2013-01-01

Background Dementia patients are often cared for in institutional arrangements, which are associated with substantial spending on professional long-term care services. Nevertheless, there is little evidence on the exact cost differences between community-based and institutional dementia care, especially when it comes to the distinct health care services. Adopting the perspective of the German social security system, which combines Statutory Health Insurance and Compulsory Long-Term Care Insurance (payer perspective), our study aimed to compare community-living and institutionalized dementia patients regarding their health care service utilization profiles and to contrast the respective expenditures. Methods We analysed 2006 claims data for 2,934 institutionalized and 5,484 community-living individuals stratified by so-called care levels, which reflect different needs for support in activities of daily living. Concordant general linear models adjusting for clinical and demographic differences were run for each stratum separately to estimate mean per capita utilization and expenditures in both settings. Subsequently, spending for the community-living and the institutionalized population as a whole was compared within an extended overall model. Results Regarding both settings, health and long-term care expenditures rose the higher the care level. Thus, long-term care spending was always increased in nursing homes, but health care spending was comparable. However, the underlying service utilization profiles differed, with nursing home residents receiving more frequent visits from medical specialists but fewer in-hospital services and anti-dementia drug prescriptions. Altogether, institutional care required additional yearly per capita expenses of ca. €200 on health and ca. €11,200 on long-term care. Conclusion Community-based dementia care is cost saving from the payer perspective due to substantially lower long-term care expenditures. Health care spending is comparable but community-living and institutionalized individuals present characteristic service utilization patterns. This apparently reflects the existence of setting-specific care strategies. However, the bare economic figures do not indicate whether these different concepts affect the quality of care provision and disregard patient preferences and caregiver-related aspects. Hence, additional research combining primary and secondary data seems to be required to foster both, sound allocation of scarce resources and the development of patient-centred dementia care in each setting. PMID:23286826

Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data.

PubMed

Schwarzkopf, Larissa; Menn, Petra; Leidl, Reiner; Graessel, Elmar; Holle, Rolf

2013-01-03

Dementia patients are often cared for in institutional arrangements, which are associated with substantial spending on professional long-term care services. Nevertheless, there is little evidence on the exact cost differences between community-based and institutional dementia care, especially when it comes to the distinct health care services. Adopting the perspective of the German social security system, which combines Statutory Health Insurance and Compulsory Long-Term Care Insurance (payer perspective), our study aimed to compare community-living and institutionalized dementia patients regarding their health care service utilization profiles and to contrast the respective expenditures. We analysed 2006 claims data for 2,934 institutionalized and 5,484 community-living individuals stratified by so-called care levels, which reflect different needs for support in activities of daily living. Concordant general linear models adjusting for clinical and demographic differences were run for each stratum separately to estimate mean per capita utilization and expenditures in both settings. Subsequently, spending for the community-living and the institutionalized population as a whole was compared within an extended overall model. Regarding both settings, health and long-term care expenditures rose the higher the care level. Thus, long-term care spending was always increased in nursing homes, but health care spending was comparable. However, the underlying service utilization profiles differed, with nursing home residents receiving more frequent visits from medical specialists but fewer in-hospital services and anti-dementia drug prescriptions. Altogether, institutional care required additional yearly per capita expenses of ca. €200 on health and ca. €11,200 on long-term care. Community-based dementia care is cost saving from the payer perspective due to substantially lower long-term care expenditures. Health care spending is comparable but community-living and institutionalized individuals present characteristic service utilization patterns. This apparently reflects the existence of setting-specific care strategies. However, the bare economic figures do not indicate whether these different concepts affect the quality of care provision and disregard patient preferences and caregiver-related aspects. Hence, additional research combining primary and secondary data seems to be required to foster both, sound allocation of scarce resources and the development of patient-centred dementia care in each setting.

[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.

Interface between Intellectual Disability and Mental Health: hermeneutic review

PubMed Central

Surjus, Luciana Togni de Lima e Silva; Campos, Rosana Teresa Onocko

2014-01-01

A literature review was conducted aiming to understand the interface between the Intellectual Disability and Mental Health fields and to contribute to mitigating the path of institutionalizing individuals with intellectual deficiencies. The so-called dual diagnosis phenomenon remains underestimated in Brazil but is the object of research and specific public policy internationally. This phenomenon alerts us to the prevalence of mental health problems in those with intellectual disabilities, limiting their social inclusion. The findings reinforce the importance of this theme and indicate possible diagnostic invisibility of the development of mental illness in those with intellectual disabilities in Brazil, which may contribute to sustaining psychiatric institutionalization of this population.  PMID:25119948

Validity, efficacy and reliability of 3 nutritional screening tools regarding the nutritional assessment in different social and health areas.

PubMed

Castro-Vega, Iciar; Veses Martín, Silvia; Cantero Llorca, Juana; Barrios Marta, Cristina; Bañuls, Celia; Hernández-Mijares, Antonio

2018-03-09

Nutritional screening allows for the detection of nutritional risk. Validated tools should be implemented, and their usefulness should be contrasted with a gold standard. The aim of this study is to discover the validity, efficacy and reliability of 3 nutritional screening tools in relation to complete nutritional assessment. A sub-analysis of a cross-sectional and descriptive study on the prevalence of disease-related malnutrition. The sample was selected from outpatients, hospitalized and institutionalized patients. MUST, MNAsf and MST screening were employed. A nutritional assessment of all the patients was undertaken. The SENPE-SEDOM consensus was used for the diagnosis. In the outpatients, both MUST and MNAsf have a similar validity in relation to the nutritional assessment (AUC 0.871 and 0.883, respectively). In the institutionalized patients, the MUST screening method is the one that shows the greatest validity (AUC 0.815), whereas in the hospitalized patients, the most valid methods are both MUST and MST (AUC 0.868 and 0.853, respectively). It is essential to use nutritional screening to invest the available resources wisely. Based on our results, MUST is the most suitable screening method in hospitalized and institutionalized patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Institutionalizing Telemedicine Applications: The Challenge of Legitimizing Decision-Making

PubMed Central

Lettieri, Emanuele

2011-01-01

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements— rationality, fairness, and efficiency—that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications—benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators’ perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed. PMID:21955510

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.

Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

PubMed Central

Wright, John; Parry, Jayne; Scully, Edward

2005-01-01

European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device. PMID:15976899

Institutionalizing 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.

Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

PubMed

Wright, John; Parry, Jayne; Scully, Edward

2005-06-01

European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device.

Atypical EEG Power Correlates With Indiscriminately Friendly Behavior in Internationally Adopted Children

PubMed Central

Tarullo, Amanda R.; Garvin, Melissa C.; Gunnar, Megan R.

2012-01-01

While effects of institutional care on behavioral development have been studied extensively, effects on neural systems underlying these socioemotional and attention deficits are only beginning to be examined. The current study assessed electroencephalogram (EEG) power in 18-month-old internationally adopted, post-institutionalized children (n = 37) and comparison groups of non-adopted children (n = 47) and children internationally adopted from foster care (n = 39). For their age, post-institutionalized children had an atypical EEG power distribution, with relative power concentrated in lower frequency bands compared to non-adopted children. Both internationally adopted groups had lower absolute alpha power than non-adopted children. EEG power was not related to growth at adoption or to global cognitive ability. Atypical EEG power distribution at 18 months predicted indiscriminate friendliness and poorer inhibitory control at 36 months. Both post-institutionalized and foster care children were more likely than non-adopted children to exhibit indiscriminate friendliness. Results are consistent with a cortical hypoactivation model of the effects of early deprivation on neural development and provide initial evidence associating this atypical EEG pattern with indiscriminate friendliness. Outcomes observed in the foster care children raise questions about the specificity of institutional rearing as a risk factor and emphasize the need for broader consideration of the effects of early deprivation and disruptions in care. PMID:21171750

The socioeconomic health gradient across the life cycle: what role for selective mortality and institutionalization?

PubMed Central

Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

2013-01-01

Several studies have documented the now fairly stylized fact that health inequalities by income differ across the age distribution: in cross-sections the health gap between rich and poor tends to widen until about age 50 and then declines at higher ages. It has been suggested that selective mortality and institutionalization could be important factors driving the convergence at higher ages. We use eight waves of a health survey linked to four registries (on mortality, hospitalizations, (municipal) residence status and taxable incomes) to test this hypothesis. We construct life cycle profiles of health for birth year/gender/income groups from the health surveys (based on 128,689 observations) and exploit the registries to obtain precise estimates of individual probabilities of mortality and institutionalization using a seven year observation period for 2,521,122 individuals. We generate selection corrected health profiles using an inverse probability weighting procedure and find that attrition is indeed not random: older, poorer and unhealthier individuals are significantly more likely not to survive the next year and to be admitted to an institution. While these selection effects are very significant, they are not very large. We therefore reject the hypothesis that selective dropout is an important determinant of the differential health trajectories by income over the life course in the Netherlands. PMID:24161090

The national science agenda as a ritual of modern nation-statehood: The consequences of national "Science for National Development" projects

NASA Astrophysics Data System (ADS)

Drori, Gili S.

This study is a comparative investigation of the ways by which the globalization of modern science affects the characteristics of different nation-states. Whereas much research and policy discussion focuses on science as an instrumental, or technical, system with immediate consequences for national conditions, such as economic development, science should also be regarded as a general cultural framework, which is highly institutionalized at the global level. As such, the institutionalization of science at both the global and national levels affects a wide variety of national properties. Following this line of reasoning, this dissertation study employs cross-national and longitudinal data and multiple-indicator methods to show national-level consequences of scientific expansion on the processes of rationalization and modernization of social and political life. It appears that the cross-national expansion of science practice results in, or is associated with, a variety of measures of (a) the standardization of civil and governmental procedures and (b) the expansion of the political rights and political engagement. I conclude from these empirical findings that scientization encourages (a) greater general societal rationalization and (b) expanded notions of social actorhood and agency. This evidence demonstrates how the globalization of science alters local conditions, both civil and political, by supporting the institutionalization of bureaucratic practices and participatory politics. Thus, the expansion of science--clearly affected by global processes--carries a general secularized faith in a rationalized world and in human agency. In this sense, the practice of science is a national ritual, whose social role is as a legitimacy-providing institution, rather then a technically functional institution. On a broader level, the study emphasizes the relations between globalization processes and the sovereignty of the nation-state. I conclude that science carries modernist and global notions of rational governance, identity politics, self-determination, and democratization. Science globalization processes, therefore, encourage the worldwide institutionalization of the liberal mode of governmentality.

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.

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

PubMed

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

2006-01-01

A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to identify those at high-risk of recurrent falls. Copyright (c) 2006 S. Karger AG, Basel.

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

PubMed

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

2015-08-01

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

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

PubMed

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

2000-08-08

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

Effectiveness of multi-component non-pharmacologic delirium interventions: A Meta-analysis

PubMed Central

Hshieh, Tammy T.; Yue, Jirong; Oh, Esther; Puelle, Margaret; Dowal, Sarah; Travison, Thomas; Inouye, Sharon K.

2015-01-01

Importance Delirium, an acute disorder with high morbidity and mortality, is often preventable through multi-component non-pharmacologic strategies. The efficacy of these strategies for preventing subsequent adverse outcomes has been limited to small studies. Objective Evaluate available evidence on multi-component non-pharmacologic delirium interventions in reducing incident delirium and preventing poor outcomes associated with delirium. Data Sources PubMed, Google Scholar, ScienceDirect and Cochrane Database of Systematic Reviews from January 1, 1999–December 31, 2013. Study Selection Studies examining the following outcomes were included: delirium incidence, falls, length of stay, rate of discharge to a long-term care institution, change in functional or cognitive status. Data Extraction and Synthesis Two experienced physician reviewers independently and blindly abstracted data on outcome measures using a standardized approach. The reviewers conducted quality ratings based on the Cochrane Risk of Bias criteria for each study. Main Outcomes and Measures We identified 14 interventional studies. Results for outcomes of delirium, falls, length of stay and institutionalization data were pooled for meta-analysis but heterogeneity limited meta-analysis of results for outcomes of functional and cognitive decline. Overall, eleven studies demonstrated significant reductions in delirium incidence (Odds Ratio 0.47, 95% Confidence Interval 0.38–0.58). The four randomized or matched (RMT) studies reduced delirium incidence by 44% (95% CI 0.42–0.76). Rate of falls decreased significantly among intervention patients in four studies (OR 0.38, 95% CI 0.25–0.60); in the two RMTs, the fall rate was reduced by 64% (95% CI 0.22–0.61). Lengths of stay and institutionalization rates also trended towards decreases in the intervention groups, mean difference −0.16 days shorter (95% CI −0.97–0.64) and odds of institutionalization 5% lower (OR 0.95, 95% CI 0.71–1.26) respectively. Among the higher quality RMTs, length of stay trended −0.33 days shorter (95% CI −1.38–0.72) and odds of institutionalization trended 6% lower (95% CI 0.69–1.30). Conclusions and Relevance Multi-component non-pharmacologic delirium prevention interventions are effective in reducing delirium incidence and preventing falls, with trend towards decreasing length of stay and avoiding institutionalization. Given the current focus on prevention of hospital-based complications and improved cost-effectiveness of care, this meta-analysis supports the use of these interventions to advance acute care for older persons. PMID:25643002

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

PubMed

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

2012-11-14

The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202) versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100). 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Primary: Independence, assessed by Sunnaas ADL Index(SI). Secondary: Hospital and short-term nursing home length of stay (LOS); institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson's χ2, ANCOVA, Regression and Kaplan-Meier analyses. Overall SI scores were 26.1 (SD 7.2) compared to 27.0 (SD 5.7) at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5)). The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7)). Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6), p=0.05). The institutionalization increased in PCNHR (from 12%-28%, p=0.001), but not in PCDIR (from 16.9%-19.3%, p= 0.45). The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient was 3528€ for rehabilitation (p<0.001, 95%CI(2455-4756)), and 10134€ for the at-home care (p=0.002, 95%CI(4066-16202)). The total costs of rehabilitation and care were 18702€ (=1.6 times) higher for PCNHR than for PCDIR. At 18 months follow-up the PCDIR-patients maintained higher levels of independence, spent fewer days in short-term nursing homes, and did not increase the institutionalization compared to PCNHR. The costs of rehabilitation and care were substantially lower for PCDIR. More communities should consider adopting the PCDIR model. Clinicaltrials.gov ID NCT01457300.

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

PubMed

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

2018-04-01

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

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.

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

PubMed

Hasler, Véronique

2013-01-01

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

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

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

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

[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.

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

PubMed Central

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

2015-01-01

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

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.

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

PubMed

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

2012-09-01

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

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

PubMed

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

2012-01-01

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

Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

PubMed

Herrmann, Nathan; Eryavec, Goran

1994-01-01

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

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

PubMed

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

2016-01-01

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

The Prevalence of Traumatic Brain Injury Among People With Co-Occurring Mental Health and Substance Use Disorders.

PubMed

McHugo, Gregory J; Krassenbaum, Sarah; Donley, Sachiko; Corrigan, John D; Bogner, Jennifer; Drake, Robert E

To estimate the rate and severity of traumatic brain injury (TBI) among people with co-occurring mental health and substance use disorders and to compare demographic, diagnostic, and institutionalization differences between those who screen positive or negative. Outpatient community mental health center in Washington, District of Columbia. A total of 295 people with co-occurring mental health and substance use disorders enrolled in a prospective study of integrated treatment of substance abuse. Cross-sectional baseline assessment. The Ohio State University TBI Identification Method. Standardized measures assessed psychiatric diagnoses, symptom severity, current and lifetime substance use, and history of institutionalization. Eighty percent screened positive for TBI, and 25% reported at least 1 moderate or severe TBI. TBI was associated with current alcohol use and psychiatric symptom severity and with lifetime institutionalization and homelessness. It was more common among participants with posttraumatic stress disorder, borderline personality disorder, and antisocial personality disorder. Men (vs women) and participants with psychotic disorders (vs those with mood disorders) had an earlier age of first TBI with loss of consciousness. TBI is common among people with co-occurring mental health and substance use disorders. Repeated and serious TBIs are common in this population. Failure to detect TBI in people with co-occurring disorders who are seeking integrated treatment could lead to misdiagnosis and inappropriately targeted treatment and rehabilitation.

42 CFR 436.403 - State residence.

Code of Federal Regulations, 2010 CFR

2010-10-01

... individual and the individual's family would constitute arranging or making a State placement. However, the... adoptive parent(s) move into another State. (k) Continued Medicaid for institutionalized recipients. An...

42 CFR 447.53 - Applicability; specification; multiple charges.

Code of Federal Regulations, 2013 CFR

2013-10-01

... sharing. (2) Pregnant women. Services furnished to pregnant women if such services related to the... sharing all services furnished to pregnant women if they desire. (3) Institutionalized individuals...

Bio-ontologies: current trends and future directions

PubMed Central

Bodenreider, Olivier; Stevens, Robert

2006-01-01

In recent years, as a knowledge-based discipline, bioinformatics has been made more computationally amenable. After its beginnings as a technology advocated by computer scientists to overcome problems of heterogeneity, ontology has been taken up by biologists themselves as a means to consistently annotate features from genotype to phenotype. In medical informatics, artifacts called ontologies have been used for a longer period of time to produce controlled lexicons for coding schemes. In this article, we review the current position in ontologies and how they have become institutionalized within biomedicine. As the field has matured, the much older philosophical aspects of ontology have come into play. With this and the institutionalization of ontology has come greater formality. We review this trend and what benefits it might bring to ontologies and their use within biomedicine. PMID:16899495

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

PubMed

Krais, W A

1989-01-01

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

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

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

PubMed Central

2012-01-01

Background The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Methods Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202) versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100). Participants: 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Outcome measures: Primary: Independence, assessed by Sunnaas ADL Index(SI). Secondary: Hospital and short-term nursing home length of stay (LOS); institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson’s χ2, ANCOVA, Regression and Kaplan-Meier analyses. Results Overall SI scores were 26.1 (SD 7.2) compared to 27.0 (SD 5.7) at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5)). The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7)). Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6), p=0.05). The institutionalization increased in PCNHR (from 12%-28%, p=0.001), but not in PCDIR (from 16.9%-19.3%, p= 0.45). The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient was 3528€ for rehabilitation (p<0.001, 95%CI(2455–4756)), and 10134€ for the at-home care (p=0.002, 95%CI(4066–16202)). The total costs of rehabilitation and care were 18702€ (=1.6 times) higher for PCNHR than for PCDIR. Conclusions At 18 months follow-up the PCDIR-patients maintained higher levels of independence, spent fewer days in short-term nursing homes, and did not increase the institutionalization compared to PCNHR. The costs of rehabilitation and care were substantially lower for PCDIR. More communities should consider adopting the PCDIR model. Trial registration Clinicaltrials.gov ID NCT01457300 PMID:23150906

Buffalo complete streets.

DOT National Transportation Integrated Search

2013-01-01

Buffalo, NY formally adopted a local Complete Streets ordinance in 2008; however, implementation has yet : to become institutionalized. Buffalos Complete Streets Coalition, a multi-sector partnership was convened : to implement a Summit and Neighb...

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)

45 CFR 1080.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... institutionalized; or (iii) A public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings. The term homeless or homeless individual does not include any individual...

45 CFR 1080.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... institutionalized; or (iii) A public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings. The term homeless or homeless individual does not include any individual...

45 CFR 1080.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... institutionalized; or (iii) A public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings. The term homeless or homeless individual does not include any individual...

45 CFR 1080.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... institutionalized; or (iii) A public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings. The term homeless or homeless individual does not include any individual...

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, caregivers, oral hygiene, long-term care, oral health. PMID:23524433

Dietary Protein Intake in Dutch Elderly People: A Focus on Protein Sources.

PubMed

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

2015-11-25

Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people. to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people. Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people. Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60%) with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source. Daily protein intake in these older populations is mainly (>80%) provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from animal protein, while during breakfast and lunch a large proportion of protein is derived from plant based protein sources.

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

PubMed Central

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

2014-01-01

Background Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. Methods and Findings Data Sources: Ten databases including CENTRAL and Medline searched through December 2012. Study Selection: Randomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. Data Extraction and Synthesis: Two authors independently extracted data. Outcomes were pooled using random effects. Main Outcomes and Measures: Mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. Results Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [−0.01 to 0.00]). There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18]) or hospitalized (RR = 0.96 [0.91 to 1.01]). There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01]), but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = −0.06 [−0.11 to −0.01]) and physical functioning (SMD = −0.10 [−0.17 to −0.03]) respectively, but these may not be clinically important. Conclusions Home visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programs that are associated with consistent benefits. Due to poor reporting of intervention components and delivery, we cannot exclude the possibility that some programs may be effective. PMID:24622676

[Factors that influence home return from health care facilities for the elderly--related to the attitude of family caregivers].

PubMed

Okuno, Junko; Tomura, Shigeo; Yanagi, Hisako

2006-01-01

The number of users of long-term care insurance has been increasing rapidly since it started in 2000. The number of those who want to enter the long-term care insurance facilities has increased. Although the basic philosophy of long-term care insurance is independence support and self-decision, to enter a facility or home return from facilities is likely to be decided by family caregivers, not by the elderly themselves. Moreover, the number of elderly who return home from welfare facilities is decreasing. We investigated the intension of caregivers who are willing to accept the institutionalized elderly at home and analyzed the factors affecting the acceptance of caregivers. Subjects were elderly who were in long-term care insurance facility in June 2004, and their caregivers. The study was conducted between June 2004 and September 2004 in Ibaraki Prefecture in Japan. A face-to-face interview based on a questionnaire was conducted for the institutionalized elderly and by the mail for the caregivers. The caregivers of 34.6% of the elderly who hoped to return home intended to accept them home. There were differences between the plans of the elderly and caregivers. The risk factors (OR, 95% CI) to make the intention of the caregivers to accept the institutionalized elderly home difficult were level of cooperation with other family members to take care of elderly (OR 15.37, 2.05-115.24), dementia behavior disturbance category with more than one (OR 8.34, 1.02-68.05), time spending in bed of a day (OR 1.31, 1.01-1.71), few knowledge of long-term care insurance system of caregivers (OR 3.65,0.81-16.38). It has been suggested that more physical activities in the facility, establishment of a care-system for the demented elderly living in the community and an educational campaign by the long-term care insurance system are necessary to increase the willingness of caregivers to accept home return of institutionalized elderly.

Nutritional situation of elderly nursing home residents.

PubMed

Pauly, L; Stehle, P; Volkert, D

2007-02-01

Malnutrition in institutionalized elderly is of individual and public concern since it negatively affects health outcome and quality of life and is often preventable. Over the past years several studies have examined the prevalence of malnutrition in institutionalized elderly and reported greatly diverse results. The purpose of the present literature review is to give an overview of the current knowledge about the nutritional situation of institutionalized elderly having specific regard to the prevalence of protein-energy malnutrition and nutrition-related problems. Based on a literature search and additional articles from the files of the authors, observational studies with relatively unselected populations reporting figures for the prevalence of malnutrition and/or the prevalence of nutrition-related problems (e. g. poor appetite, chewing or swallowing problems, eating dependency or poor intake) and published between 1990 and 2006 were considered. Relevant information was extracted and compiled. A total of 42 eligible studies with 41 to 6832 participants were found. BMI was the most frequently used parameter for nutritional assessment with mean values mostly between 21 and 24 kg/m(2). Eight studies applied a cut-off value of 20 kg/m(2) and reported between 10% and 50% low values. Weight loss was reported in 7 studies with prevalence rates between 5 and 41%, reduced serum albumin (< 35 g/L) in 10 studies with prevalence rates between 0 and 50%. According to the MNA (12 studies) malnutrition was observed in 2 to 38% and a risk of malnutrition in 37 to 62%. Nutritional problems were reported in 17 studies, again with great variability between the studies. In physically and mentally capable study populations malnutrition was relatively unfrequent. Prevalence rates were highest in studies with great proportions of disabled and severely impaired residents. It can be concluded that malnutrition is generally widespread in institutionalized elderly. Prevalence rates vary according to the parameters and cut-off values used for nutritional assessment and according to the population under study. Future studies should carefully characterize their participants and use standardized nutritional assessment tools in order to achieve better comparability of study results as up to now.

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

NASA Astrophysics Data System (ADS)

Watcharadamrongkun, Suntaree

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

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

PubMed

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

2013-07-01

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

The Greatest Opportunity

ERIC Educational Resources Information Center

Mawby, Russell G.

1977-01-01

The day is past when colleges can be youth-centered. Creativity now needs to be applied to institutionalizing continuing education, to organizing problem-oriented programs, to identifying target audiences, and to employing new technology. (Editor/LBH)

Deaf not Daft: The Deaf in Mental Subnormality Hospitals.

ERIC Educational Resources Information Center

Williams, Chris

1982-01-01

Case studies of deaf or hearing impaired persons in institutions for the mentally retarded illustrate the ways in which the "invisible handicap" can mask cognitive ability, causing unnecessary institutionalization. (CL)

Fire Safety Training with Adults Who Are Profoundly Mentally Retarded.

ERIC Educational Resources Information Center

Rae, Rosamond; Roll, David

1985-01-01

An intensive fire safety training program for profoundly mentally retarded institutionalized persons resulted in a significant decrease in mean evacuation time and gradual substitution of verbal for physical prompts. (CL)

Undergraduate Research and Its Impact on Student Success for Underrepresented Students

ERIC Educational Resources Information Center

O'Donnell, Ken; Botelho, Judy; Brown, Jessica; González, Gerardo M.; Head, William

2015-01-01

This chapter captures the mission and spirit of the California State University in its efforts to institutionalize undergraduate research and support the success of students traditionally underrepresented in higher education.

Institutionalizing Conflict Response: The Case of Schoolboards

ERIC Educational Resources Information Center

Stelzer, Leigh

1974-01-01

The author examines how although school board governments lack formal mechanisms for channeling conflict, they compensate with an informal mechanism known as receptivity. Competitive elections are an institutional mechanism that support this receptivity. (DE)

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

Code of Federal Regulations, 2010 CFR

2010-07-01

... education, basis skills instruction, and abnormal psychology; (5) Guidance and counseling programs; (6... programs with educational institutions, community-based organizations of demonstrated effectiveness, and...

42 CFR 441.102 - Plan of care for institutionalized recipients.

Code of Federal Regulations, 2010 CFR

2010-10-01

... include— (1) An initial review of the recipient's medical, psychiatric, and social needs— (i) Within 90... recipient. (2) Periodic review of the recipient's medical, psychiatric, and social needs; (3) A...

34 CFR 607.22 - What are the selection criteria for development grants?

Code of Federal Regulations, 2011 CFR

2011-07-01

... growth and self-sufficiency of the institution; and (4) The plan clearly and comprehensively describes the methods and resources the institution will use to institutionalize practice and improvements...

Facility uses Six Sigma to improve quality.

PubMed

2006-09-01

Initiative demonstrates a 23% improvement in first bed assignment to a private isolation room. Keys to improvement found in enhanced communication and staff training. Staff develop reporting mechanism to sustain and institutionalize project results.

Epidemiology of human toxocariasis in northern Italy.

PubMed

Genchi, C; Di Sacco, B; Gatti, S; Sangalli, G; Scaglia, M

1990-12-01

Sera from both clinically healthy adults (2112) and adult patients (471) were tested to assess the main risk factors for Toxocara infection in humans in Northern Italy. The patient group included 257 adult epileptics, 76 Strongyloides stercoralis-infected adult patients and 142 institutionalized mentally retarded adult patients. The overall seroprevalence in healthy population was 3.98%. No significant differences in seroprevalence were observed for sex, residence (urban or rural) or dog ownership, while seroprevalence significantly increased with age (18- greater than 51 years). Highest seroprevalence values were found in outdoor or soil-related workers. The seroprevalence was 4.35% in adult epileptics, 9.21% in Strongyloides stercoralis-infected patients and 14.47%-10.61% among institutionalized mentally retarded patients. These findings suggest that the prevalent source of human toxocariasis is the environmental contamination by infectious eggs of the parasite.

A rapid method of toilet training the institutionalized retarded1

PubMed Central

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

1971-01-01

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

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

PubMed

Lee, D Y; Syrnyk, R

1977-01-01

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

Management of lower urinary tract symptoms in Parkinson's disease in the neurology clinic.

PubMed

Madan, Arina; Ray, Sudeshna; Burdick, Daniel; Agarwal, Pinky

2017-12-01

This clinical review aims to evaluate lower urinary tract symptoms (LUTS) in Parkinson's disease (PD) patients and the current treatment options available for these symptoms in a neurology setting. The review also addresses when referral to urology is appropriate. A literature search was conducted using the keywords 'LUTS', 'non-motor symptoms', 'overactive bladder', 'Parkinson's disease' and 'urinary symptoms' using the Medline/Pubmed search engine. Data collected ranged from 2000 to present with emphasis on recent publications. This review was conducted because LUTS in PD has a major impact on quality of life and is associated with early institutionalization. Emphasis is placed on treating overactive bladder with conservative strategies and medical management in the neurology setting. Quality of life can be improved and institutionalization can be delayed with a multimodal approach to bladder care.

Cognitive recovery in socially deprived young children: the Bucharest Early Intervention Project.

PubMed

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

2007-12-21

In a randomized controlled trial, we compared abandoned children reared in institutions to abandoned children placed in institutions but then moved to foster care. Young children living in institutions were randomly assigned to continued institutional care or to placement in foster care, and their cognitive development was tracked through 54 months of age. The cognitive outcome of children who remained in the institution was markedly below that of never-institutionalized children and children taken out of the institution and placed into foster care. The improved cognitive outcomes we observed at 42 and 54 months were most marked for the youngest children placed in foster care. These results point to the negative sequelae of early institutionalization, suggest a possible sensitive period in cognitive development, and underscore the advantages of family placements for young abandoned children.

Long-term care in international perspective.

PubMed

Doty, P

1988-12-01

The findings of a study of long-term care policies in 18 countries are reported in this article. Initial data were collected by a questionnaire survey under the auspices of the International Social Security Association. These data were supplemented by published documents and government statistics obtained while researching long-term care for the International Social Security Association and, subsequently, for the Organization for Economic Cooperation and Development. The principal focus is a cross-national comparison of institutionalization rates for the elderly. Differences in use rates for medically oriented facilities are less than those for nonmedical residential long-term care facilities. Only a small amount of variation is related to demographic differences, such as older or more female elderly populations in those countries with higher institutionalization rates. Included also is a description of the modes of financing long-term care.

Mergers and acquisitions in professional organizations: a complex adaptive systems approach.

PubMed

Walls, M E; McDaniel, R R

1999-09-01

Nurse managers face unique challenges as they cope with mergers and acquisitions among health care organizations. These challenges can be better understood if it is recognized that health care institutions are professional organizations and that the transformations required are extremely difficult. These difficulties are caused, in part, by the institutionalized nature of professional organizations, and this nature is explicated. Professional organizations are stubborn. They are repositories of expertise and values that are societal in origin and difficult to change. When professional organizations are understood as complex adaptive systems, complexity theory offers insight that provide strategies for managing mergers and acquisitions that may not be apparent when more traditional conceptualizations of professional organizations are used. Specific managerial techniques consistent with both the institutionalized characteristics and the complex adaptive systems characteristics of professional organizations are offered to nurse managers.

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

PubMed

Biddle, Justin

2013-12-01

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

Medical and agricultural entomology in Brazil: a historical approach.

PubMed

Benchimol, J L

2008-12-01

Medical Entomology emerged in Brazil in the late nineteenth century, through the initiative of a group of physicians dedicated to researching microorganisms related to diseases of public health importance, especially yellow fever and malaria. They led the institutionalization of Bacteriology and Tropical Medicine in southeast Brazil and the sanitation of coastal cities and, subsequently, rural areas. Medical Entomology provided the professionals who would undertake campaigns against agricultural plagues, as well as the institutionalization of Agronomy and Veterinary Medicine. In the present article, I intend to show how relations between the professionals who gave life to Medical Entomology in Brazil were interwoven and to illustrate their relations with entomologists in other countries. I will also present an overview of the research problems faced by Brazilian entomologists at the turn of the nineteenth century and early decades of the twentieth.

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

PubMed

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

2010-09-01

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

Dental Survey of Institutionalized Children with Autistic Disorder

PubMed Central

Kakodkar, Pradnya; Chaugule, Vishwas; Nimbalkar, Vidya

2012-01-01

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

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

PubMed

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

2016-05-01

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

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

PubMed

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

2011-01-01

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

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

PubMed

Mahieu, Lieslot; Gastmans, Chris

2012-03-01

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

Effects of Combining Methylphenidate and a Classroom Token System in Modifying Hyperactive Behavior

ERIC Educational Resources Information Center

Christensen, Donald E.

1975-01-01

The combined effects of methylphenidate (Ritalin) and a token reinforcement program in controlling the classroom behavior of 16 hyperactive, institutionalized retarded youngsters (9- to 15-years-old) was investigated. (Author)

Special Issue on Labor in the Americas.

ERIC Educational Resources Information Center

Cornfield, Daniel B.; And Others

1997-01-01

Includes "Labor Transnationalism?" (Cornfield); "Globalization and International Labor Organizing" (Boswell, Stevis); "Trade Unions and European Integration" (Hyman); "Trade Policy and Southern Economy" (Margo, Griffin); "Institutionalization of the Sociology of Work in Latin America" (Abramo et…

Education and Professionalization: An Historical Example

ERIC Educational Resources Information Center

Bullough, Vern L.

1970-01-01

Institutionalization of training within the university seems to have been the key to professionalization, and those areas which first were regarded as graduate" subjects -- medicine, divinity, and law -- early came to be looked upon as professions. (Author)

Balancing Act: How to Capture Knowledge without Killing It.

ERIC Educational Resources Information Center

Brown, John Seely; Duguid, Paul

2000-01-01

Top-down processes for institutionalizing ideas can stifle creativity. Xerox researchers learned how to combine process-based and practice-based methods in order to disseminate best practices from a community of repair technicians. (JOW)

Suppression of Repetitive Self-Injurious Behavior by Contingent Inhalation of Aromatic Ammonia

ERIC Educational Resources Information Center

Baumeister, Alan A.; Baumeister, Alfred A.

1978-01-01

Two severely retarded institutionalized children (4 and 7 years old) who exhibited high rates of severely self-injurious behaviors were punished with aromatic ammonia inhalation on a response-contingent basis. (Author/SBH)

MEDICARE CURRENT BENEFICIARY SURVEY (MCBS) DATA

EPA Science Inventory

The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. MCBS, which is sponsored by the Centers for Medicare & Medicaid Services (CMS), is a comprehe...

Lymphocyte Surface Markers and Serum Immunoglobulins in Persons with Down's Syndrome.

ERIC Educational Resources Information Center

And Others; Hann, Hie-Won L.

1979-01-01

Distributions of the serum immunoglobulins (IgM), of T and B lymphocytes, and subpopulations of B lymphocytes were studied in children and institutionalized adults with Down's syndrome and appropriate mentally retarded controls. (Author)

Distance Learning for Special Populations

ERIC Educational Resources Information Center

Bates, Rodger A.

2012-01-01

Distance education strategies for remotely deployed, highly mobile, or institutionalized populations are reviewed and critiqued. Specifically, asynchronous, offline responses for special military units, Native Americans on remote reservations, prison populations and other geographically, temporally or technologically isolated niche populations are…

[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.

Nature Cure and Non-Communicable Diseases: Ecological Therapy as Health Care in India.

PubMed

Alter, Joseph S; Nair, R M; Nair, Rukmani

2017-12-07

With rapidly increasing rates of non-communicable diseases, India is experiencing a dramatic public health crisis that is closely linked to changing lifestyles and the growth of the middle-class. In this essay we discuss how the practice of Nature Cure provides a way of understanding the scale and scope of the crisis, as it is embodied, and a way to understand key elements of a solution to problems that the crisis presents for institutionalized health care. As institutionalized in contemporary India, Nature Cure involves treatment and managed care using earth, air, sunlight, and water as well as a strict dietary regimen. In this regard, the essay shows how Nature Cure's bio-ecological orientation toward public health, which is grounded in the history of its modern incorporation into India, provides an expansionist, ecological model for holistic care that counters the reductionist logic of bio-medical pharmaceuticalization.

Non university sources of science in Chile

NASA Astrophysics Data System (ADS)

Soto, Leopoldo

2016-05-01

The following ideas are widely accepted in Chile with respect to scientific activity: is carried out mainly in universities and science is considered a naturally university activity, that was developed in a period of more than 150 years by isolated individual efforts, c) it was transformed into an institutionalized activity at the universities after the university reform movement at the end of the 1960 decade, d) the activity is finally institutionalized in the country with the creation of the “Comisión Nacional de Investigatión Científica y Tecnológica, CONICYT (National Commission for Scientific and Technological Research) in 1967. This work presents preliminary findings showing that there are other institutional initiatives, different to the efforts from universities and directly dependent of the Chilean Government, in order to produce science and technology in Chile. This governmental initiatives start at the beginning of the Republic of Chile circa of 1810.

Creating a national culture of quality: the Tanzania experience.

PubMed

Mwidunda, Patrick E; Eliakimu, Eliudi

2015-07-01

Although quality improvement has been a priority for Tanzania's health sector since the 1970s, few effective quality improvement initiatives were implemented, due to limited expertise, political commitment and resources. More recently, as the HIV epidemic gained momentum within the country, an influx of funding and of international organizations with quality improvement expertise accelerated the implementation of quality improvement projects, as well as efforts to institutionalize quality improvement at the national level. The support of US President's Emergency Plan for AIDS Relief (PEPFAR) and other donors, and the increasing numbers of HIV-implementing partners focused on quality management, and quality improvement strategies catalysed the development of HIV-specific quality improvement initiatives first, and then of national quality improvement frameworks. The diversity of quality improvement approaches championed by various donors and partners also presented important challenges to harmonization and institutionalization of quality improvement programmes.

[Reintegration of victimized children and adolescents in their parents' view].

PubMed

Martins, Camilla Soccio; Ferriani, Maria das Graças Carvalho

2003-01-01

This study aims at learning, from some aggressor families' point of view, the way reintegration of child and adolescent victims into their own families happen, in the city of Ribeirão Preto-SP in 2002. The methodology used is descriptive and qualitative; data were collected through interviews and observation of participants. Nine families whose children were institutionalized were surveyed. Results showed that the institutionalization of children is a way for some families to rethink the kind of education parents are providing their childrenwith/their own education. For the other ones, it was perceived as a support for behavioral problems. As noticed, some parents stressed a negative influence falling upon their children, which made them more disobedient on their return home, and causing disciplinary procedures harder to be established. The conclusion is that reintegration of the target children/adolescents is harnessed by violence happening inside families.

[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.

Nature Cure and Non-Communicable Diseases: Ecological Therapy as Health Care in India

PubMed Central

Alter, Joseph S.; Nair, R. M.; Nair, Rukmani

2017-01-01

With rapidly increasing rates of non-communicable diseases, India is experiencing a dramatic public health crisis that is closely linked to changing lifestyles and the growth of the middle-class. In this essay we discuss how the practice of Nature Cure provides a way of understanding the scale and scope of the crisis, as it is embodied, and a way to understand key elements of a solution to problems that the crisis presents for institutionalized health care. As institutionalized in contemporary India, Nature Cure involves treatment and managed care using earth, air, sunlight, and water as well as a strict dietary regimen. In this regard, the essay shows how Nature Cure’s bio-ecological orientation toward public health, which is grounded in the history of its modern incorporation into India, provides an expansionist, ecological model for holistic care that counters the reductionist logic of bio-medical pharmaceuticalization. PMID:29215549

Race, Racism, and Access to Renal Transplantation among African Americans.

PubMed

Arriola, Kimberly Jacob

2017-01-01

There are clear and compelling racial disparities in access to renal transplant, which is the therapy of choice for many patients with end stage renal disease. This paper conceptualizes the role of racism (i.e., internalized, personally-mediated, and institutionalized) in creating and perpetuating these disparities at multiple levels of the social ecology by integrating two often-cited theories in the literature. Internalized racism is manifested at the intrapersonal level when, for example, African American patients devalue their self-worth, thereby not pursuing the most aggressive treatment available. Personally-mediated racism is manifested at the interpersonal level when, for example, physicians exhibit unconscious race bias that impacts their treatment decisions. One example of institutionalized racism being manifested at the institutional, community, and public policy levels is the longstanding existence of racial residential segregation and empirically established links between neighborhood racial composition and dialysis facility-level transplantation rates. This paper concludes with clinical, research, and policy recommendations.

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

PubMed Central

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

2017-01-01

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

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.

Factors associated with functional incapacity in elders living in long stay institutions in Brazil: a cross-sectional study.

PubMed

Mattos, Inês Echenique; do Carmo, Cleber Nascimento; Santiago, Lívia Maria; Luz, Laércio Lima

2014-04-15

The increase of the elderly population and the high prevalence of chronic diseases have contributed to the increasing importance of functional ability as a global public health problem. This study aimed to assess functional capacity in institutionalized elders, as well as undertake an exploratory analysis of its associated factors. This is a cross-sectional study with institutionalized Brazilian elders. Functional capacity was assessed using the Katz Index for Activities of Daily Living (ADL) and the Lawton Scale for Instrumental Activities of Daily Living (IADL). The characteristics of dependent individuals were described and logistic regression models were developed for both scales. Multiple models that included all selected variables were developed using a hierarchical approach. We considered the results from the Wald test (p <0.05) as a rule for progressing to the next level. A population of 760 elders was considered. The prevalence of dependence was 50.3% for ADL and 81.2% for IADL. We observed associations between ADL dependence and the following factors: self-report of stroke, difficulty of walking 400 meters, lower total scores in questions related to the temporal orientation section of the cognition test, and self-reports of frequently feeling upset. IADL dependence was associated with educational level, self-report of cancer, difficulty of walking 400 meters, use of glasses, and self-reported memory problems. Sociodemographic and health conditions were associated with functional incapacity in institutionalized elders. Based on these findings, we emphasize the importance of both prevention and treatment of chronic conditions as well as social support in the maintenance of individuals' autonomy.

Thyroid status in a large cohort of patients with mental retardation: the TOP-R (Thyroid Origin of Psychomotor Retardation) study.

PubMed

Visser, Willem Edward; de Rijke, Yolanda B; van Toor, Hans; Visser, Theo J

2011-09-01

Abnormalities in thyroid state may affect development and function of the brain and result in mental retardation (MR). Thyroid parameters have not been systematically investigated in institutionalized MR subjects. The objective is to measure thyroid parameters in a novel cohort of 946 institutionalized subjects. The TOP-R (Thyroid Origin of Psychomotor Retardation) study is a cross-sectional nation-wide multicentre study. Subjects with unexplained MR. The majority of the MR subjects had thyroid parameters within the reference range used in our laboratory. Antiepileptic drugs (AEDs) use affected thyroid hormones (T4: 102·1 ± 1·2 vs 83·9 ± 1·2 nmol/l, P < 1 × 10(-24) ; FT4: 18·0 ± 0·2 vs 16·1 ± 0·2 pmol/l, P < 1 × 10(-9) ; T3: 1·72 ± 0·02 vs 1·57 ± 0·02 nmol/l, P < 1 × 10(-9) ; and rT3: 0·37 ± 0·01 vs 0·27 ± 0·01 nmol/l, P < 1 × 10(-28) in subjects without vs with AEDs). The prevalence of unrecognized primary hypothyroidism and hyperthyroidism was 5·2% and 2·8%, respectively. We report thyroid parameters in a cohort of institutionalized subjects with MR. Our findings substantiate the fact that AEDs affect thyroid hormone levels. Future studies will be employed to investigate genetic causes of MR related to abnormalities in thyroid hormone homeostasis. © 2011 Blackwell Publishing Ltd.

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

PubMed

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

2017-01-01

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

Reactive attachment disorder following early maltreatment: systematic evidence beyond the institution.

PubMed

Kay, Catherine; Green, Jonathan

2013-05-01

Reactive Attachment Disorder (RAD) remains one of the least evidence-based areas of DSM and ICD nosology. Recent evidence from severely deprived institutional samples has informed review of RAD criteria for DSM-V; however, this data is not necessarily generalizable to expectable child environments in the developed world. We provide the first systematic study of this important syndrome in maltreated non-institutionalized adolescents from a high-income country. 153 high-risk adolescents in English out-of-home Looked After Care (LAC: mean age 174 months, SD 23, 52 % male) and 42 low-risk (LR) community controls (mean age 168 months, SD 18, 38 % male) were assessed for RAD behaviors. Data on maltreatment and care history were collected from social work reports and concurrent psychopathology from caregiver report. Triangulated data sources informed independent researcher ratings of adaptive functioning. LAC adolescents showed high prevalence of RAD behaviors. Factor analysis showed four symptom groups; Disinhibited Indiscriminate, Attention Seeking, Superficial Relationships and Unpredictability. RAD was associated with multiple maltreatment experience, earlier entry to care and increased rates of psychopathology. Superficial Relationships and Attention Seeking factors showed strong independent association with particularly pervasive functional impairment. Disinhibited RAD behaviors are identifiable with high prevalence in non-institutionalized high-risk adolescents. They are strongly associated with psychopathology and functional impairment. Retention of this subtype in DSM-V is supported. Findings on the inhibited subtype in adolescence are less persuasive. RAD behavior is a relevant marker of developmental impairment, has significant clinical implications and is deserving of further study within non-institutionalized risk populations.

Video Games to Augment Leisure Programming in a State Hospital Residence for Developmentally Disabled Clients.

ERIC Educational Resources Information Center

Powers, Janet; Ball, Thomas S.

1983-01-01

Three mildly and moderately retarded, physically handicapped institutionalized men (17-30 years old) successfully participated in a recreation program involving adapted videogames. Doubles play fostered cooperative social interaction between players. (CL)

Behavioral Therapy of Phobias: A Case with Gynecomastia and Mental Retardation

ERIC Educational Resources Information Center

Revenq, Bernard

1974-01-01

A 13-year-old boy, institutionalized for severe mental retardation, who was found to have obsessive tendencies and an IQ of 71 to 78, was systematically desensitized for phobias associated with ambigous sexual identity. (MC)

Facing Fear, Releasing Resistance, Enabling Education

ERIC Educational Resources Information Center

Stengel, Barbara

2008-01-01

This essay is a response to Barbara Applebaum's essay, "Engaging Student Disengagement: Resistance or Disagreement?" in which Applebaum explores privileged university students' "disengagement" when asked to confront institutionalized oppression. Applebaum analyzes and recommends Lynn Weber Cannon's rules for classroom discourse…

The Multicultural Movement and Its Euphemisms.

ERIC Educational Resources Information Center

Fitzgerald, Thomas K.

2000-01-01

Discusses educational implications of the multicultural movement, highlighting: relativism versus anti-relativism; consequences of institutionalizing differences; implications of confusing culture with identity; tensions involved in cultural identification; African Americans as an example of race, class, and education; the neglected variable of…

34 CFR 606.24 - How does the Secretary use an applicant's performance under a previous development grant when...

Code of Federal Regulations, 2011 CFR

2011-07-01

... awarding a development grant? (a)(1) In addition to evaluating an application under the selection criteria..., including, but not limited to, the applicant's success in institutionalizing practices developed and...

Institutionalizing Information Literacy

ERIC Educational Resources Information Center

Weiner, Sharon A.

2012-01-01

There is increasing recognition that information literacy is essential for individual and community empowerment, workforce readiness, and global competitiveness. However, there is a history of difficulty in integrating information literacy with the postsecondary educational process. This paper posits that a greater understanding of the…

Institutionalizing Security Force Assistance

DTIC Science & Technology

2008-05-19

long before current conflicts developed. An Australian Armoured [sic] Corps Officer with experience in both the Solomon Islands and Iraq noted...and the national level policy. Despite some turnover and changes among the senior military and civilian leadership, the underlying tone has not

3 CFR 8608 - Proclamation 8608 of November 30, 2010. Helsinki Human Rights Day, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... institutionalized in the Organization for Security and Cooperation in Europe (OSCE), still serve as a beacon to all... states to reexamine their compliance with their OSCE commitments. The Helsinki Final Act, with its...

20 CFR 416.212 - Continuation of full benefits in certain cases of medical confinement.

Code of Federal Regulations, 2011 CFR

2011-04-01

...., personal hygiene items, snacks, candy); and (3) The month of your institutionalization is one of the first...., personal hygiene items, snacks, candy). If the institution is the representative payee, it will not be...

Focusing or Narrowing: Trade-Offs in the Development of Adult Basic Education, 1991-2015

ERIC Educational Resources Information Center

Belzer, Alisa

2017-01-01

This chapter reviews the implications of policy as it has affected adult basic education over the last 25 years and problematizes the increasing institutionalization and stability that it has brought to the field.

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

PubMed

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

2015-05-01

The objective of this study was to assess the effects of a hyperproteic, hypercaloric oral nutritional supplement with prebiotic fiber, vitamin D, and calcium, plus a standardized physical intervention, in the functional status, strength, nutritional status, and quality of life of frail institutionalized older adults. Multicentric prospective observational study under usual clinical practice conditions. Four nursing homes from Burgos (2), Albacete, and Madrid, Spain. Participants included 91 institutionalized older adults (age ≥70), able to walk 50 m, and meeting at least 3 of the Fried frailty phenotype criteria. Daily intake of two 200-mL bottles of an oral nutritional supplement, each bottle containing 300 kcal, 20 g protein, 3 g fiber, 500 IU vitamin D, and 480 mg calcium, plus a standardized physical exercise training consisting of flexibility, balance, and strengthening exercises for arms and legs, 5 days per week. Short Physical Performance Battery (SPPB), Short-Form-Late-Life Function and Disability Instrument (SF-LLFDI) function subscale, handgrip strength, EuroQoL-5 Dimensions visual analogic scale (EQ5DVAS), weight, body mass index (BMI), and Short-Form Mini Nutritional Assessment (MNA-SF) at baseline and 6 and 12 weeks. Forty-eight participants (52.7%) improved at least 1 point in the SPPB at week 6, and 44 (48.4%) did so at week 12; 39 participants (42.9%) improved at least 2 points in the SF-LLFDI at week 6, and 46 (50.5%) at week 12. Participants improved their quality of life measured with the EQ5DVAS by 6% (95% confidence interval [CI] 3%-10%) at week 6, and by 5% (95% CI 0%-10%) at week 12. They also improved their nutritional status (weight gain, BMI increase, and higher MNA-SF scores at 6- and 12-week follow-up). This improvement was higher in participants with more frailty criteria, lower functional level, lower vitamin D levels, and poorer nutritional status. A 12-week intervention with oral nutritional supplementation plus physical exercise improves function, nutritional status, and quality of life in frail institutionalized older adults. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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 emotional discomfort brought on by witnessing this behavior. Relatively little work has been published on older residents' perspectives regarding aged sexuality in institutionalized elderly care. If, however, we wish to devote ourselves to individualized or person-centered nursing care, we will have to gain more insight into the patient's perspective and take notice of the needs, expectations, attitudes, experiences and behaviors of residents with regard to (aged) sexuality. Hence more research is needed that depicts the issue of aged sexuality in institutionalized elderly care from a patient's and thus resident oriented perspective. Copyright © 2015 Elsevier Ltd. All rights reserved.

All That Glitters Isn't Gold--Four Steps to School Improvement.

ERIC Educational Resources Information Center

Huddle, Eugene

1987-01-01

Outlines findings from a study by the United States Department of Education's Office of Educational Research and Improvement of successful school improvement programs. The findings are categorized under four stages: initiation, initial implementation, full implementation, and institutionalization. (MD)

The Exercise Capacity of Blind Children.

ERIC Educational Resources Information Center

Jankowski, L. W.; Evans, J. K.

1981-01-01

To determine whether blind children in a well-equipped modern institution are receiving enough physical education activities to maintain good physical condition, the physiological characteristics of 20 institutionalized blind children were measured according to body composition, pulmonary function, and tolerance for exercise. (Author)

[Habilitation of Mentally Retarded Persons: Wyatt vs. Hardin and Related Cases--Collected Comments.

ERIC Educational Resources Information Center

Mental Retardation, 1981

1981-01-01

Four articles address the 1978 Wyatt v. Hardin proceedings which debated the issues of the training/habilitation potential of institutionalized mentally retarded persons and the feasibility of placing these persons in community-based living facilities. (SB)

The Future of Instructional Teacher Leader Roles

ERIC Educational Resources Information Center

Mangin, Melinda M.; Stoelinga, Sara Ray

2010-01-01

In response to increased performance expectations, schools and districts are turning to nonsupervisory, school-based, instructional teacher leader roles to help improve teachers' instruction and enhance student learning. Increased opportunities to learn about teacher leadership may facilitate the implementation and institutionalization of…

Response to K. Anderson-Levitt's Rejoinder.

ERIC Educational Resources Information Center

LeTendre, Gerald; Baker, David; Akiba, Motoko; Goesling, Brian; Wiseman, Alex

2002-01-01

Responds to a commentary on "Teachers' Work: Institutional Isomorphism and Cultural Variation in the U.S., Germany and Japan," suggesting that the article raises several useful issues about global versus national cultures, institutionalization, and comparative analysis of teaching in three nations. Clarifies argument and illustrates…

Conditions That Facilitate the Implementation of Educational Technology Innovations.

ERIC Educational Resources Information Center

Ely, Donald P.

1990-01-01

Describes eight conditions that facilitate the adoption, implementation, and institutionalization of educational technology innovations and suggests applications to the transfer of portable software. Applications of these conditions involving educational technology in Indonesia, Chile, and Peru are evaluated, and guidelines for successful…

Winning the Peace: Institutionalizing Provincial Reconstruction Teams in the United States Military

DTIC Science & Technology

2012-06-15

dental and veterinary care; the construction of rudimentary surface transportation systems and public facilities; and...rather than at the tactical unit level. Provided that this change occurs, the entire calculus of the PRT could correspondingly change. Assuming that

A First Course in Intercultural Communication.

ERIC Educational Resources Information Center

Goodyear, F. H.; Williams, Patrick L.

The Texas Christian University course description, outline, and supporting bibliography deal with the problems of intercultural, interracial communication. The course plan begins with the thesis that racism is institutionalized and that the eradication of racism requires changes in individuals' awareness of their own hidden discriminatory…

"Don't Tread On Me": Ethological Perspectives on Institutionalization.

ERIC Educational Resources Information Center

Senn, Bruce J.; Steiner, Joseph R.

1978-01-01

The concept of dignity is developed from an ethological perspective. Special attention is given to innate, phylogentically programed behavior, the role of releasers, the importance of rituals, and the fact that "management problems" in institutions are often cries for dignity. (Author)

The Human-Animal Bond and the Elementary School Counselor.

ERIC Educational Resources Information Center

Nebbe, Linda Lloyd

1991-01-01

Discusses research on the significance of the human-animal relationship among various populations (elderly, children, business executives, displaced children, institutionalized children, juvenile offenders, and emotionally disturbed children). Describes experiences of incorporating the human-animal bond into an elementary school guidance and…

Effects of Peanut Butter on Ruminating.

ERIC Educational Resources Information Center

Greene, Katherine S.; And Others

1991-01-01

Effects of supplementary peanut butter on rumination behavior among five institutionalized mentally retarded adults were studied, by independently manipulating caloric density versus consistency of the peanut butter. Results showed an inverse relationship between rates of rumination and amount of peanut butter consumed, an effect primarily…

The Way of Sweat.

ERIC Educational Resources Information Center

Leonhardy, Galen

2001-01-01

Presents a narrative description of experiences shared by the author, his father, and a Nez Perce man named Larry Greene. Explores those experiences in relation to institutionalized education in order to provide insight into not only subjugated ways of knowing but also alternative places of learning. (SG)

Institutional Commitment to Fairness in College Teaching.

ERIC Educational Resources Information Center

Rodabaugh, Rita Cobb

1996-01-01

The role of college faculty in creating a climate of fairness is examined, distinguishing three kinds of fairness--interactional, procedural, and outcome. The roles of departments, administrators, and others in institutionalizing fairness and making explicit the institution's commitment to fairness are also considered. (MSE)

Children without Permanent Parents: Research, Practice, and Policy

ERIC Educational Resources Information Center

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

2011-01-01

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

Organizational Ethics Development and the Human Resource Professional.

ERIC Educational Resources Information Center

Petrick, Joseph A.

1992-01-01

Surveys literature on organizational moral development and describes research methodology employed, summarizes research findings, and examines career implications for human resource professionals. Contends that institutionalizing an ethics program can impact favorably on both the organization and the career of the implementing human resource…

42 CFR 441.13 - Prohibitions on FFP: Institutionalized individuals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... institution for mental diseases, except an individual who is under age 22 and receiving inpatient psychiatric... receiving inpatient psychiatric services), payments to institutions for the mentally retarded or persons with related conditions and to psychiatric facilities or programs providing inpatient psychiatric...

A New System for Improving the Care of Neglected and Abused Children

ERIC Educational Resources Information Center

Burt, Marvin R.; Balyeat, Ralph

1974-01-01

A demonstration program of a system coordinating the wide variety of services provided for neglected and abused children in a metropolitan area has produced many gains in the handling of such cases: notably, avoidance of institutionalization. (Author/CS)

Whither Sex Education? Excellence in Comprehensive Program Development.

ERIC Educational Resources Information Center

Southern, Stephen

A review of recent sex education literature is presented in an attempt to integrate observations and recommendations related to both program development and innovation acceptance. A Developmental Research and Utilization Model is employed to systematically guide planning, implementation, evaluation, advocacy, and institutionalization. Curriculum…

Marketing Information Literacy

ERIC Educational Resources Information Center

Seale, Maura

2013-01-01

In 2012, more than a decade after the original Association of College and Research Libraries (ACRL) Information Literacy Competency Standards for Higher Education (hereafter the Standards) were institutionalized as the goal of academic library instruction, the Information Literacy Competency Standards Review Task Force convened by ACRL recommended…

Systems Models for Transportation Problems : Volume 2. An Introduction to Urban Center Modeling.

DOT National Transportation Integrated Search

1976-03-01

Our thermodynamic theory considers the problem of attempting to formalize in a modeling sense what might be done in an urban economy, wherein transportation planning and other institutionalized requirements of the domain are also to be satisfied, and...

42 CFR 436.407 - Types of acceptable documentary evidence of citizenship.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (including general education and high school equivalency diplomas), marriage certificates, divorce decrees... perjury by a residential care facility director or administrator on behalf of an institutionalized... State database subsequent changes in eligibility should not require repeating the documentation of...

42 CFR 436.407 - Types of acceptable documentary evidence of citizenship.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (including general education and high school equivalency diplomas), marriage certificates, divorce decrees... perjury by a residential care facility director or administrator on behalf of an institutionalized... State database subsequent changes in eligibility should not require repeating the documentation of...

Libraries in Wisconsin Institutions: Status Report.

ERIC Educational Resources Information Center

Merriam, Elizabeth B.

The Wisconsin Library Association Round Table of Hospitals and Institutional Librarians became concerned about adequate funding of institutional libraries; the right of institutionalized persons to read and to have educational, legal, and recreational materials; and the development of staff libraries for treatment, rehabilitation, and research…

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

PubMed

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

2017-01-01

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

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

PubMed

Ongan, Dilek; Rakıcıoğlu, Neslişah

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

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.

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

PubMed

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

2005-08-01

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

Hearing Impairment Affects Dementia Incidence. An Analysis Based on Longitudinal Health Claims Data in Germany

PubMed Central

Teipel, Stefan; Óvári, Attila; Kilimann, Ingo; Witt, Gabriele; Doblhammer, Gabriele

2016-01-01

Recent research has revealed an association between hearing impairment and dementia. The objective of this study is to determine the effect of hearing impairment on dementia incidence in a longitudinal study, and whether ear, nose, and throat (ENT) specialist care, care level, institutionalization, or depression mediates or moderates this pathway. The present study used a longitudinal sample of 154,783 persons aged 65 and older from claims data of the largest German health insurer; containing 14,602 incident dementia diagnoses between 2006 and 2010. Dementia and hearing impairment diagnoses were defined according to International Classification of Diseases, Tenth Revision, codes. We used a Kaplan Meier estimator and performed Cox proportional hazard models to explore the effect of hearing impairment on dementia incidence, controlling for ENT specialist care, care level, institutionalization, and depression. Gender, age, and comorbidities were controlled for as potential confounders. Patients with bilateral (HR = 1.43, p<0.001) and side-unspecified (HR = 1.20, p<0.001) hearing impairment had higher risks of dementia incidence than patients without hearing impairment. We found no significant effect for unilateral hearing impairment and other diseases of the ear. The effect of hearing impairment was only partly mediated through ENT specialist utilization. Significant interaction between hearing impairment and specialist care, care level, and institutionalization, respectively, indicated moderating effects. We discuss possible explanations for these effects. This study underlines the importance of the association between hearing impairment and dementia. Preserving hearing ability may maintain social participation and may reduce the burden associated with dementia. The particular impact of hearing aid use should be the subject of further investigations, as it offers potential intervention on the pathway to dementia. PMID:27391486

A framework and a measurement instrument for sustainability of work practices in long-term care

PubMed Central

2011-01-01

Background In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices after implementation. The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization. Methods The exploratory methodological design consisted of three phases: a) framework development; b) instrument development; and c) field testing in former improvement teams in a quality improvement program for health care (N teams = 63, N individual = 112). Data were collected not until at least one year had passed after implementation. Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach's alpha coefficient. A long and a short version of the instrument are proposed. Results The χ2- difference test of the -2 Log Likelihood estimates demonstrated that the hierarchical two factor model with routinization and institutionalization as separate constructs showed a better fit than the one factor model (p < .01). Secondly, construct validity of the instrument was strong as indicated by the high factor loadings of the items. Finally, the internal consistency of the subscales was good. Conclusions The theoretical framework offers a valuable starting point for the analysis of sustainability on the level of actual changed work practices. Even though the two dimensions routinization and institutionalization are related, they are clearly distinguishable and each has distinct value in the discussion of sustainability. Finally, the subscales conformed to psychometric properties defined in literature. The instrument can be used in the evaluation of improvement projects. PMID:22087884

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

PubMed

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

2017-05-01

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

High-Quality Foster Care Mitigates Callous-Unemotional Traits Following Early Deprivation in Boys: A Randomized Controlled Trial.

PubMed

Humphreys, Kathryn L; McGoron, Lucy; Sheridan, Margaret A; McLaughlin, Katie A; Fox, Nathan A; Nelson, Charles A; Zeanah, Charles H

2015-12-01

Callous-unemotional (CU) traits in childhood are a developmental precursor to psychopathy, yet the origins and etiology of CU traits are not known. We examined CU traits among 12-year-old children exposed to severe early deprivation and evaluated whether a high-quality foster care intervention mitigated the development of high levels of CU traits. Participants were from the Bucharest Early Intervention Project, a randomized controlled trial of foster care for children in institutions. Children were recruited from institutions in Bucharest, Romania, along with age- and sex-matched children who were never institutionalized. Children raised in institutional settings were randomized (mean age = 22 months) to either a foster care group (n = 68) or a care-as-usual group (n = 68). CU traits were assessed at age 12.75 years in available participants from the randomized trial (n = 95) and children who were never institutionalized (n = 50). Children who experienced institutional rearing as young children had significantly higher levels of CU traits in early adolescence compared to children who were never institutionalized. Intent-to-treat analysis indicated that, among boys, CU traits were significantly lower among those who received the foster care intervention compared to those randomized to care as usual. Caregiver responsiveness to distress, but not caregiver warmth, mediated the intervention effect on CU traits in boys. These findings provide the first evidence to date that psychosocial intervention can prevent the onset of CU traits. Although severe early deprivation predicted higher levels of CU traits, high-quality foster care that emphasized responsive caregiving reduced the impact of deprivation on CU trait development for boys. The Bucharest Early Intervention Project; http://clinicaltrials.gov; NCT00747396. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.

PubMed

Bogaerts, An; Delecluse, Christophe; Boonen, Steven; Claessens, Albrecht L; Milisen, Koen; Verschueren, Sabine M P

2011-03-01

Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity. Copyright © 2010 Elsevier B.V. All rights reserved.

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

PubMed

Heather, Nick

2012-08-01

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

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

PubMed Central

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

2008-01-01

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

2008 Disability Status Report: The United States

ERIC Educational Resources Information Center

Erickson, W. Lee C.; von Schrader, S.

2010-01-01

The Annual Disability Status Reports provide policy makers, disability advocates, reporters, and the public with a summary of the most recent demographic and economic statistics on the non-institutionalized population with disabilities. They contain information on the population size and disability prevalence for various demographic…

Building a Training and Development Program.

ERIC Educational Resources Information Center

Bare, Alan C.

An approach to building an effective training and development (T&D) process within postsecondary institutions is described. The process involves three distinct phases: developing an inservice skills training program, institutionalizing an on-the-job career development process, and conducting organizational development activities. The focus of the…

Training Procedure Manual for the Mentally Retarded.

ERIC Educational Resources Information Center

Dustin, Josephine; And Others

Presented is a training procedure manual for institutionalized moderately, severely, and profoundly retarded persons. Teaching activities are suggested for the following skill areas: motor development and awareness (including sensory stimulation, mat skills, and music and basic rhythm); toileting; eating skills (such as straw sipping and table…

'All I Can Remember Were Tablets': Pat's Story.

ERIC Educational Resources Information Center

McClimens, Alex

2002-01-01

This article discusses the use of personal narrative in social science research and in helping individuals with learning difficulties renegotiate their sense of identity. One woman's story of her life is used to illustrate the corrosive effects of institutionalization in identity formation. (Contains references.) (DB)

Restructuring: A School-Based Plan of Action.

ERIC Educational Resources Information Center

Rothberg, Robert A.; Bozeman, William C.

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

2 Courts Put Limits on Research Involving the Mentally Ill.

ERIC Educational Resources Information Center

Burd, Stephen

1995-01-01

Courts in New York and Texas have imposed limits on psychiatric research involving involuntarily institutionalized patients as subjects, citing state and constitutional protection of privacy, due process, and equal protection. Some are concerned that mental health research and treatment will suffer. (MSE)

Mate-Selection Systems and Criteria: Variation according to Family Structure.

ERIC Educational Resources Information Center

Lee, Gary R.; Stone, Lorene Hemphill

1980-01-01

Autonomous mate selection based on romantic attraction is more likely to be institutionalized in societies with nuclear family systems. Neolocal residence customs increase the probability that mate selection is autonomous but decrease the probability that it is based on romantic attraction. (Author)

Health Behaviors among Baby Boomer Informal Caregivers

ERIC Educational Resources Information Center

Hoffman, Geoffrey J.; Lee, Jihey; Mendez-Luck, Carolyn A.

2012-01-01

Purpose of the Study: This study examines health-risk behaviors among "Baby Boomer" caregivers and non-caregivers. Design and Methods: Data from the 2009 California Health Interview Survey of the state's non-institutionalized population provided individual-level, caregiving, and health behavior characteristics for 5,688 informal…

Sustained Change: Institutionalizing Interdisciplinary Graduate Education

ERIC Educational Resources Information Center

Borrego, Maura; Boden, Daniel; Newswander, Lynita K.

2014-01-01

We employ Scott's three pillars of institutions (regulative, normative, and cultural-cognitive) to investigate how higher education organizations change to support interdisciplinary graduate education. Using document analysis and case study approaches, we illustrate how strategies which address both policies and cultural norms are most…

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Overview of the Girls' Education Activity.

ERIC Educational Resources Information Center

Brush, Lorelei; Heyman, Cory; Provasnik, Stephen; Fanning, Marina; Lent, Drew; De Wilde, Johan; Leal, Angela; Saher, Najat Yamouri; Robles, Ana Maria; Mendoza, Johanna

In 1996, the United States Agency for International Development (USAID) began the Girls' Education Activity (GEA). GEA's goal has been to assist host country governments and private sector and nongovernmental entities in formulating, institutionalizing, and implementing country initiatives for girls' education. These initiatives have been designed…

Medical Ethics Education: Coming of Age.

ERIC Educational Resources Information Center

Miles, Steven H.; And Others

1989-01-01

A discussion of medical ethics in the medical curriculum reviews its recent history, examines areas of consensus, and describes teaching objectives and methods, course content, and program evaluation at preclinical and clinical levels. Prerequisites for successful institutionalization of medical ethics education are defined, and its future is…

From Scholarisation to Social Capital.

ERIC Educational Resources Information Center

Schuller, Tom

The arguments for deschooling expressed by Ivan Illich a quarter of a century ago have relevance today. We are in danger of losing their most salient insights; perhaps because the critique was phrased in this oversimplified binary form, excessive institutionalization should be countered by deinstitutionalization, professionalism by…

Comparing Faculty Perceptions of Sustainability Teaching at Two US Universities

ERIC Educational Resources Information Center

Tziganuk, Ashlee; Gliedt, Travis

2017-01-01

Purpose: This study aims to examine and compare faculty perceptions of the process of institutionalizing sustainability, developing sustainability pedagogy and activating key sustainability competencies between the University of Oklahoma (OU) and Arizona State University (ASU). Design/methodology/approach: Semi-structured interviews were conducted…

The Change of South Korean Adult Education in Globalization.

ERIC Educational Resources Information Center

Park, Sung-Jung

2002-01-01

Describes the development of adult education in South Korea from postwar modernization to the current globalized environment. Notes that adult higher education is increasingly formalized and institutionalized, with expanded credentialism, inequality, and government intervention and a weakening connection between adult education and social…

Medicaid--It's Not Just about Income!

ERIC Educational Resources Information Center

Mercado, Denise

2007-01-01

Medicaid Waivers are crucial to the community life of individuals with significant disabilities and their families. In a nutshell, Medicaid Waivers prevent institutionalization by providing the support individuals with significant disabilities need to live in the communities of their choice. These supports include Personal Care services and…

Expeditionary Economics: A Force Multiplier in the Counterinsurgency Fight

DTIC Science & Technology

2012-05-17

the Army is the Money as a Weapon System (MAA WS) Standard Operating Procedure. This SOP is infrequently updated and has remained essentially ...Research Series: Expeditionary Economics, 2011 June. Schramm, Carl J. "Institutionalizing Ecnomics Analysis in the U.S. Military: The Basis for

BEST (Better Educational Skills Training). Final Report.

ERIC Educational Resources Information Center

Vermont Adult Learning, Rutland.

This document contains a final report, evaluation report, and materials from the Better Educational Skills Training (BEST) workplace literacy program in Vermont. The seven-page final report describes program components: (1) expanding and institutionalizing the workplace literacy program developed through two previous national workplace literacy…

Institutionalized Hypocrisy: The Myth of Intercollegiate Athletics

ERIC Educational Resources Information Center

Flowers, Ronald D.

2009-01-01

America is unique in that participation in sports has historically been linked to colleges and universities under the premise that participation serves an educational function and supplements the mission of higher education. Yet, intercollegiate athletics is seldom discussed in institutional accreditation self-studies, mission statements, or…

In Defense of Teacher Professionalism as a Policy Choice.

ERIC Educational Resources Information Center

Sykes, Gary

1991-01-01

Whereas democracy institutionalizes distrust, professionalism relies on trust. Responding to Berbules and Densmore, this article identifies strong normative reasons, grounded in the interests of children, for promoting teacher professionalism. Exorcising the evils of classic professionalism will eliminate neither equity nor quality problems.…

BIOELECTRICAL IMPEDANCE VECTOR ANALYSIS IDENTIFIES SARCOPENIA IN NURSING HOME RESIDENTS

USDA-ARS?s Scientific Manuscript database

Loss of muscle mass and water shifts between body compartments are contributing factors to frailty in the elderly. The body composition changes are especially pronounced in institutionalized elderly. We investigated the ability of single-frequency bioelectrical impedance analysis (BIA) to identify b...

Library Community Services.

ERIC Educational Resources Information Center

Correy, Therese; And Others

Services to the elderly, institutionalized, and physically and mentally exceptional, who are unable to use the public library in its traditional form, are described in this guide to programs at the Inglewood (California) Public Library. Topics include: (1) overall library goals and activities; (2) functional and organizational structure of…

Counseling Juvenile Offenders in Institutional Settings.

ERIC Educational Resources Information Center

Chaneles, Sol, Ed.

1982-01-01

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

Internationalizing the Community College: Examples of Success. ERIC Digest.

ERIC Educational Resources Information Center

Quimbita, Grace

With the growing technological, economic and political interdependence between nations, the word "community" has come to have international implications. In order to alleviate American ignorance about other nations and global issues, community colleges must institutionalize international perspectives into their curricula. More than 50%…

Social Studies: The Electoral Process.

ERIC Educational Resources Information Center

Schrager, Donald M.

This quinmester course of study for grades seven through nine provides a framework for analyzing election processes in a democracy by investigating democratic societies of the past, and contrasting democracies with totalitarian types of government. Major emphasis is upon analyzing the system of institutionalized political parties, the…

A neurogenetics approach to defining differential susceptibility to institutional care

PubMed Central

Brett, Zoe H.; Sheridan, Margaret; Humphreys, Kate; Smyke, Anna; Gleason, Mary Margaret; Fox, Nathan; Zeanah, Charles; Nelson, Charles; Drury, Stacy

2014-01-01

An individual's neurodevelopmental and cognitive sequelae to negative early experiences may, in part, be explained by genetic susceptibility. We examined whether extreme differences in the early caregiving environment, defined as exposure to severe psychosocial deprivation associated with institutional care compared to normative rearing, interacted with a biologically informed genoset comprising BDNF (rs6265), COMT (rs4680), and SIRT1 (rs3758391) to predict distinct outcomes of neurodevelopment at age 8 (N = 193, 97 males and 96 females). Ethnicity was categorized as Romanian (71%), Roma (21%), unknown (7%), or other (1%). We identified a significant interaction between early caregiving environment (i.e., institutionalized versus never institutionalized children) and the a priori defined genoset for full-scale IQ, two spatial working memory tasks, and prefrontal cortex gray matter volume. Model validation was performed using a bootstrap resampling procedure. Although we hypothesized that the effect of this genoset would operate in a manner consistent with differential susceptibility, our results demonstrate a complex interaction where vantage susceptibility, diathesis stress, and differential susceptibility are implicated. PMID:25663728

Effects of a 10-week multimodal exercise program on physical and cognitive function of nursing home residents: a psychomotor intervention pilot study.

PubMed

Pereira, Catarina; Rosado, Hugo; Cruz-Ferreira, Ana; Marmeleira, José

2018-05-01

Nursing home institutionalization tends to exacerbate loss of functioning. Examine the feasibility and the effect of a psychomotor intervention-a multimodal exercise program promoting simultaneous cognitive and motor stimulation-on the executive (planning ability and selective attention) and physical function of nursing home residents. Seventeen participants engaged in a 10-week multimodal exercise program and 17 maintained usual activities. Exercise group improved planning ability (25-32%), selective attention (19-67%), and physical function [aerobic endurance, lower body strength, agility, balance, gait, and mobility (19-41%)], corresponding to an effect size ranging from 0.29 (small) to 1.11 (high), p < 0.05. The multimodal exercise program was feasible and well tolerated. The program improved executive and physical functions of the nursing home residents, reverting the usual loss of both cognitive and motor functioning in older adult institutionalized. Multimodal exercise programs may help to maintain or improve nursing home residents' functioning.

How social-class stereotypes maintain inequality.

PubMed

Durante, Federica; Fiske, Susan T

2017-12-01

Social class stereotypes support inequality through various routes: ambivalent content, early appearance in children, achievement consequences, institutionalization in education, appearance in cross-class social encounters, and prevalence in the most unequal societies. Class-stereotype content is ambivalent, describing lower-SES people both negatively (less competent, less human, more objectified), and sometimes positively, perhaps warmer than upper-SES people. Children acquire the wealth aspects of class stereotypes early, which become more nuanced with development. In school, class stereotypes advantage higher-SES students, and educational contexts institutionalize social-class distinctions. Beyond school, well-intentioned face-to-face encounters ironically draw on stereotypes to reinforce the alleged competence of higher-status people and sometimes the alleged warmth of lower-status people. Countries with more inequality show more of these ambivalent stereotypes of both lower-SES and higher-SES people. At a variety of levels and life stages, social-class stereotypes reinforce inequality, but constructive contact can undermine them; future efforts need to address high-status privilege and to query more heterogeneous samples. Copyright © 2017 Elsevier Ltd. All rights reserved.

Community-based telemonitoring for hypertension management: practical challenges and potential solutions.

PubMed

Hovey, Lauren; Kaylor, Mary Beth; Alwan, Majd; Resnick, Helaine E

2011-10-01

Older adults residing in rural areas often lack convenient, patient-centered, community-based approaches to facilitate receipt of routine care to manage common chronic conditions. Without adequate access to appropriate disease management resources, the risk of seniors' experiencing acute events related to these common conditions increases substantially. Further, poorly managed chronic conditions are costly and place seniors at increased risk of institutionalization and permanent loss of independence. Novel, telehealth-based approaches to management of common chronic conditions like hypertension may not only improve the health of older adults, but may also lead to substantial cost savings associated with acute care episodes and institutionalization. The aim of this report is to summarize practical considerations related to operations and logistics of a unique community-based telemonitoring pilot study targeting rural seniors who utilize community-based senior centers. This article reviews the technological challenges encountered during the study and proposes solutions relevant to future research and implementation of telehealth in community-based, congregate settings.

Validity of the International Fitness Scale "IFIS" in older adults.

PubMed

Merellano-Navarro, Eugenio; Collado-Mateo, Daniel; García-Rubio, Javier; Gusi, Narcís; Olivares, Pedro R

2017-09-01

To validate the "International Fitness Scale" (IFIS) in older adults. Firstly, cognitive interviews were performed to ensure that the questionnaire was comprehensive for older Chilean adults. After that, a transversal study of 401 institutionalized and non-institutionalized older adults from Maule region in Chile was conducted. A battery of validated fitness tests for this population was used in order to compare the responses obtained in the IFIS with the objectively measured fitness performance (back scratch, chair sit-and-reach, handgrip, 30-s chair stand, timed up-and-go and 6-min walking). Indicated that IFIS presented a high compliance in the comprehension of the items which defined it, and it was able of categorizing older adults according to their measured physical fitness levels. The analysis of covariance ANCOVA adjusted by sex and age showed a concordance between IFIS and the score in physical fitness tests. Based on the results of this study, IFIS questionnaire is a good alternative to assess physical fitness in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

A neurogenetics approach to defining differential susceptibility to institutional care.

PubMed

Brett, Zoe H; Sheridan, Margaret; Humphreys, Kate; Smyke, Anna; Gleason, Mary Margaret; Fox, Nathan; Zeanah, Charles; Nelson, Charles; Drury, Stacy

2015-03-01

An individual's neurodevelopmental and cognitive sequelae to negative early experiences may, in part, be explained by genetic susceptibility. We examined whether extreme differences in the early caregiving environment, defined as exposure to severe psychosocial deprivation associated with institutional care compared to normative rearing, interacted with a biologically informed genoset comprising BDNF (rs6265), COMT (rs4680), and SIRT1 (rs3758391) to predict distinct outcomes of neurodevelopment at age 8 ( N = 193, 97 males and 96 females). Ethnicity was categorized as Romanian (71%), Roma (21%), unknown (7%), or other (1%). We identified a significant interaction between early caregiving environment (i.e., institutionalized versus never institutionalized children) and the a priori defined genoset for full-scale IQ, two spatial working memory tasks, and prefrontal cortex gray matter volume. Model validation was performed using a bootstrap resampling procedure. Although we hypothesized that the effect of this genoset would operate in a manner consistent with differential susceptibility, our results demonstrate a complex interaction where vantage susceptibility, diathesis stress, and differential susceptibility are implicated.

The Youth Psychopathic Traits Inventory: Measurement Invariance and Psychometric Properties among Portuguese Youths

PubMed Central

Pechorro, Pedro; Ribeiro da Silva, Diana; Andershed, Henrik; Rijo, Daniel; Abrunhosa Gonçalves, Rui

2016-01-01

The aim of the present study was to examine the psychometric properties of the Youth Psychopathic Traits Inventory (YPI) among a mixed-gender sample of 782 Portuguese youth (M = 15.87 years; SD = 1.72), in a school context. Confirmatory factor analysis revealed the expected three-factor first-order structure. Cross-gender measurement invariance and cross-sample measurement invariance using a forensic sample of institutionalized males were also confirmed. The Portuguese version of the YPI demonstrated generally adequate psychometric properties of internal consistency, mean inter-item correlation, convergent validity, discriminant validity, and criterion-related validity of statistically significant associations with conduct disorder symptoms, alcohol abuse, drug use, and unprotected sex. In terms of known-groups validity, males scored higher than females, and males from the school sample scored lower than institutionalized males. The use of the YPI among the Portuguese male and female youth population is psychometrically justified, and it can be a useful measure to identify adolescents with high levels of psychopathic traits. PMID:27571095

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

PubMed

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

2018-01-01

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

Physical activity and functional fitness in institutionalized vs. independently living elderly: a comparison of 70-80-year-old city-dwellers.

PubMed

Król-Zielińska, Magdalena; Kusy, Krzysztof; Zieliński, Jacek; Osiński, Wiesław

2011-01-01

The purpose of the study was to compare the level of energy expenditure due to physical activity (EEPA) and functional fitness (FF) in 59 women and 82 men aged 70-80 years, divided into three groups: permanent residents in assisted-living facilities (ALFs), participants in adult day care centers (DCCs) and older people living independently, members in community senior centers (CSCs). EEPA and FF were analyzed taking into consideration sex differences. The energy expenditure tended to be lower in DCCs and ALFs subjects than in CSCs members, but significant differences were obtained only in women. Women in different living settings differed only in endurance. In men, the differences were clear in most tests (endurance, strength, agility/dynamic balance) except for flexibility. Institutionalization was connected with a significantly lower level of FF and equalization of sex differences. Education seemed to be an important factor influencing the level of FF in men. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Predictors of female worker attitudes towards menstruation and the provision of help to institutionalized women with intellectual disabilities in Taiwan.

PubMed

Chou, Yueh-Ching; Lu, Zxy-yann J; Pu, Cheng-yun; Lan, Chung-Fu

2008-08-01

No previous research has examined the importance of both individual and environmental factors for predicting caregivers' menstrual attitudes. To explore the predictors of female caregivers' attitudes towards menstruation and the help they give to women with intellectual disabilities, we conducted a cross-sectional questionnaire survey which was completed by 725 female workers from 12 institutions in Taiwan. The Menstrual Attitudes Questionnaire (MAQ) and a structured questionnaire were used. Logistic regression analysis revealed that individual characteristics such as age and education were significantly associated with menstrual attitudes of female caregivers working with institutionalized women with intellectual disabilities. Furthermore, the environmental context, such as the frequency of discussions with colleagues, training in menstrual management care and the level of difficulty when giving help in menstruation management, was important for improving caregivers' menstrual attitudes. This study contributes to the existing literature by determining both individual and environmental predictors of caregivers' menstrual attitudes.

Fears of institutionalized mentally retarded adults.

PubMed

Sternlicht, M

1979-01-01

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

Sustainability Science and Education in the Neoliberal Ecoprison

ERIC Educational Resources Information Center

Little, Peter C.

2015-01-01

As part of the general "greening" of prisons in the last decade of neoliberalization and the formation of institutionalized programs to provide science and environmental education opportunities for the incarcerated, the Sustainability in Prisons Project (SPP), a partnership between Evergreen State College and the Washington State…

Predictors of Sustainability of Social Programs

ERIC Educational Resources Information Center

Savaya, Riki; Spiro, Shimon E.

2012-01-01

This article presents the findings of a large scale study that tested a comprehensive model of predictors of three manifestations of sustainability: continuation, institutionalization, and duration. Based on the literature the predictors were arrayed in four groups: variables pertaining to the project, the auspice organization, the community, and…

Institutionalizing Political and Civic Engagement on Campus

ERIC Educational Resources Information Center

Hoffman, Adam H.

2015-01-01

In this quasi-experimental design, I examine the impact of a political engagement program on students, looking at traditional measures of internal efficacy, as well as other areas of political engagement including levels of political knowledge, the development of political skills, and interest in media coverage of politics.

Outdoor Programming for Older Adults Who Are Frail.

ERIC Educational Resources Information Center

Buettner, Linda; Kennison, Judith

1993-01-01

Discusses the benefits of outdoor nature-oriented activities for very old, frail elderly, and institutionalized elderly persons with regard to exercising to increase mobility, spiritual development, sensory stimulation, and social interaction. A study of elderly participants in a "back to nature" experience suggests that modified camping…

Teaching Art to High Risk Groups.

ERIC Educational Resources Information Center

Rossol, Monona

The role of art therapy is considered in working with such high risk groups as the institutionalized, mentally retarded, elderly, visually impaired, physically handicapped, asthmatic, hyper- and hypo-active children, hearing impaired, and patients on mind altering drugs. The special risks of infectious diseases (such as serum hepatitis), and…

38 CFR 13.102 - Accountability of legal custodians.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Accountability of legal... VETERANS BENEFITS ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.102 Accountability of legal custodians. (a) Institutionalized veterans without spouse or child. The legal custodian of VA benefits of an incompetent veteran who...

38 CFR 13.102 - Accountability of legal custodians.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Accountability of legal... VETERANS BENEFITS ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.102 Accountability of legal custodians. (a) Institutionalized veterans without spouse or child. The legal custodian of VA benefits of an incompetent veteran who...

Confronting Tensions in Collaborative Postsecondary Indigenous Education Programs: A Reader's Theatre Presentation.

ERIC Educational Resources Information Center

White, Carolyne; Martin, Joe; Hays, Pat; Senese, Guy; Foley, Jean Ann; Nuvayouma, Diane; Riley-Taylor, Elaine

This conference "performance session" addresses the tensions encountered by indigenous educators in colleges and universities as they collaborate with tribal offices of education to create culturally responsive educational practices. Colonial schooling has left a legacy of institutionalized racism and sexism, sustained by postsecondary…

Interrogating Institutionalized Establishments: Urban-Rural Inequalities in China's Higher Education

ERIC Educational Resources Information Center

Li, Mei; Yang, Rui

2013-01-01

China's urban-rural disparities are a fundamental source of China's overall educational inequalities. This article addresses the issue with data collected through interviews with members at various Chinese higher education institutions. It interrogates China's current policies together with the socio-political institutional arrangements that…

Tribal-federal collaboration in resource management

Treesearch

Ellen M. Donoghue; Sara A. Thompson; John C. Bliss

2010-01-01

The increase in collaborative projects involving American Indian tribes and natural resource management agencies in the United States reflects two emergent trends: 1) the use of collaborative approaches between agencies and groups in managing natural resources; and 2) the concurrent increased recognition of American Indian rights, institutionalization of consultation...

Listening to Families' Views Regarding Institutionalization & Deinstitutionalization.

ERIC Educational Resources Information Center

Tabatabainia, Mohammad Mehdi

2003-01-01

A study of 22 Australian families whose relatives were living in an institution found families expressed their opposition to deinstitutionalization for the following reasons: adverse effects on themselves and on their relatives with intellectual disabilities; inadequate community-based residential settings; and provision of good services by the…

The Victimization of the Homeless Mentally Ill.

ERIC Educational Resources Information Center

French, Laurence

An indication of the failure of the mental health system in this country is reflected in the increasingly visible homeless population, many of whom suffer from some form of untreated mental illness. Public policy priorities have shifted from proactive, treatment-oriented policies to reactive, punitive institutionalization. The…

Issues in Benchmarking and Assessing Institutional Engagement

ERIC Educational Resources Information Center

Furco, Andrew; Miller, William

2009-01-01

The process of assessing and benchmarking community engagement can take many forms. To date, more than two dozen assessment tools for measuring community engagement institutionalization have been published. These tools vary substantially in purpose, level of complexity, scope, process, structure, and focus. While some instruments are designed to…

Perspective on Intelligence Testing.

ERIC Educational Resources Information Center

Lennon, Roger T.

1978-01-01

We should seek an updated perspective on intelligence testing because it is useful to reevaluate any practice that has long become institutionalized, especially one that is subject to severe criticism. Cultural bias is the most prominent criticism. Testing proponents contend that intelligence tests reflect skills and knowledge emphasized in school…

Disciplinary Politics and the Institutionalization of the Generic Triad in Classical Rhetoric.

ERIC Educational Resources Information Center

Liu, Yameng

1995-01-01

Discusses the concepts of rhetoric in general and specifically the generic triad in classical rhetoric. Outlines contemporary versions of the function and realm of rhetoric. Discusses the clash between Aristotle and Quintilian regarding the triad and its relationship to contemporary debates. (HB)

Beyond Compartmentalization: A Relational Approach towards Agency and Vulnerability of Young Migrants

ERIC Educational Resources Information Center

Huijsmans, Roy

2012-01-01

Based on fieldwork material from Lao People's Democratic Republic, this paper introduces an analytical framework that transcends compartmentalized approaches towards migration involving young people. The notions of fluid and institutionalized forms of migration illuminate key differences and commonalities in the relational fabric underpinning…

Practice Architectures and Sustainable Curriculum Renewal

ERIC Educational Resources Information Center

Goodyear, Victoria A.; Casey, Ashley; Kirk, David

2017-01-01

While there are numerous pedagogical innovations and varying forms of professional learning to support change, teachers rarely move beyond the initial implementation of new ideas and policies and few innovations reach the institutionalized stage. Building on both site ontologies and situated learning in communities of practice perspectives, this…

Opening Windows of Understanding for Learners in a Global Community

ERIC Educational Resources Information Center

Ashmore, Pamela; Murphy, Carole

2007-01-01

This article presents an innovative approach to diversity education. The approach is multidisciplinary, and it was developed by blending the expertise of anthropological research with the pedagogical skills developed by education specialists. To institutionalize this approach, a unique university-level collaboration occurred between students and…

Professional Development in Action: Improving Teaching for English Learners

ERIC Educational Resources Information Center

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

2010-01-01

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

The World Educational Revolution, 1950-1970.

ERIC Educational Resources Information Center

Meyer, John W.; And Others

An analysis of worldwide educational expansion between 1950 and 1970 is presented along with explanations for the expansion. The paper particularly addresses the socialization process and the institutionalization of schooling along national lines. Section I reviews available theories which seek to explain the expansion of education in the modern…

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

DTIC Science & Technology

1997-01-01

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

Francis Bacon and the Historiography of Scientific Rhetoric.

ERIC Educational Resources Information Center

Zappen, James P.

1989-01-01

Reviews three twentieth-century interpretations of Francis Bacon's science and rhetoric: positivistic science and the plain style; institutionalized science and its more highly figured style; and democratic science. Presents the author's own interpretation, and concludes that each interpretation reflects different perceptions of the good of the…

Compulsory Schooling as Preventative Defense

ERIC Educational Resources Information Center

Rocha, Samuel D.

2013-01-01

The question whether compulsory schooling is justifiable or not has been treated at considerable length by critics, defenders, and positions in-between. What these treatments--about paternalism and autonomy and institutionalization and more--have not directly analyzed is a question that precedes the issue of overall justification: the preliminary…

Assistance Programs: A Timely Solution for the Adult Education Setting.

ERIC Educational Resources Information Center

Burns, Shannon M.

1998-01-01

Discusses the use of formal employee assistance programs (EAPs) with adult students who have personal problems that could affect their school performance. Looks at the differences between EAPs and traditional counseling services: EAPs have a written assistance policy; they institutionalize consistency; they are confidential. (JOW)

Enrollment Logics and Discourses: Toward Developing an Enrollment Knowledge Framework

ERIC Educational Resources Information Center

Snowden, Monique L.

2013-01-01

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

Restoring the Health of Scholarly Publishing

ERIC Educational Resources Information Center

Eisenberg, Barry; Romero, Lisa

2010-01-01

Librarians and scholars who seek to counter the rampant commercialism and consolidation that endanger equal and affordable access to knowledge can learn from the recent successful effort to pass health-care reform. Organizations with a commanding presence in an industry naturally seek to institutionalize their indispensability. They finance…

Language, Violence, and Indian Mis-education.

ERIC Educational Resources Information Center

Russell, Caskey

2002-01-01

Traces the history of institutionalized violence--both physical and symbolic--within American Indian education; the legacy of shame and guilt from the boarding school era, when oppression was internalized; and the relationship of such "mis-education" to the decline of Tlingit language and culture in southwestern Alaska. Discusses…

Differentiating Language Arts in Belize

ERIC Educational Resources Information Center

Cook, Pamela R.

2009-01-01

Purpose: There is limited amount of research that constitutes non-traditional curricula implemented within an institutionalized context of developing countries. An attempt is made in this project to gain a clearer understanding of a non-traditional early learning program within an orphanage campus setting of Ladyville, Belize, Central America.…

Peru: Institutionalizing Quechua

ERIC Educational Resources Information Center

Lagoria, Consuelo Alfaro; Ballon, Lourdes Zegarra

1976-01-01

Discusses the 1975 decision of the Peruvian government to designate Quechua as an official language. Specific programs carried out as a result of this law are analyzed and assessed with respect to their effects and implications. The problems encountered in producing instructional materials for languages which are fragmented into dialects are…

Independent Living Services for Youths in Foster Care.

ERIC Educational Resources Information Center

Sims, Anne R.

1988-01-01

Claims successful institutionalization of emancipation programs for youths in foster care will depend on a variety of factors, including astute political opposition to the current administration, production of accurate outcome data from the programs, community acceptance, and agency change. Contends independent living is a healthy goal for…

Frankfurt Medical Department Activity (FMEDDAC) OB/GYN Clinic Study

DTIC Science & Technology

1993-08-01

ideas took hold and flourished in post-World War II Japan ( Arikan , 1990). The Japanese institutionalized the following chain FMEDDAC OB-GYN 8 reaction...be required for most organizations. FMEDDAC OB-GYN 69 References Arikan , V.L. (1991). Total quality management - Applications to nursing service

Reconceptualizing Faculty Mentoring within a Community of Practice Model

ERIC Educational Resources Information Center

Smith, Emily R.; Calderwood, Patricia E.; Dohm, Faith A.; Gill Lopez, Paula

2013-01-01

Despite the growing knowledge base on mentoring in academia, providing effective mentoring for faculty presents several complex dilemmas for academic units charged with facilitating mentoring. How do we institutionalize voluntary and spontaneous mentoring interaction? How do we support a collaborative climate in an inherently individual and…

Use of Multi-Sensory Reinforcement in Toilet Training Retardates.

ERIC Educational Resources Information Center

Bates, Karla K.; Armenti, Simma

A behavior modification program in toilet training, utilizing reinforcing properties of music, candy, cold drinks, and television was instigated with institutionalized (nontoilet trained) males, ages 15-20 , who were profoundly, severely and moderately mentally handicapped. Eleven experimental and 11 control subjects were involved. A Toileting…

Collective Bargaining: Explaining California's System. Report.

ERIC Educational Resources Information Center

Howell, Penny

Collective bargaining to establish salaries, benefits, and working conditions for public school employees is now an institutionalized fact of life in California. Virtually all public school districts participate in collective bargaining. School districts can implement most new laws--from class-size reduction to teacher evaluation--only after they…

42 CFR 436.407 - Types of acceptable documentary evidence of citizenship.

Code of Federal Regulations, 2011 CFR

2011-10-01

... perjury by a residential care facility director or administrator on behalf of an institutionalized... State database subsequent changes in eligibility should not require repeating the documentation of... databases to verify that the individual already established citizenship. (6) CMS requires that as a check...

Institutionalizing Professional Development Schools: Supporting the Principal.

ERIC Educational Resources Information Center

Bowen, Gail; Adkison, Judith

Professional-development schools are collaborations between universities and public schools to improve the nation's teaching force. Prospective teachers are assigned to K-12 schools for formal instruction, planned experiences in classrooms, and mentoring from master teachers. This paper presents findings of a qualitative study that described the…

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

PubMed

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

2015-05-01

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

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

PubMed

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

2005-09-01

Phenytoin (PH) is indicated primarily for the control of grand mal and psychomotor seizures. However, topical PH has been used for the treatment of various types of ulcers, including pressure ulcers. The aim of this study was to investigate the possibility of a relationship between the use of oral PH and the prevalence of pressure ulcers among bedridden institutionalized elderly patients. This retrospective chart review was conducted in a state-run urban geriatric medical center in Israel and involved long-term bedridden institutionalized patients who were receiving chronic antiepileptic medication during the 7-year period between January 1996 and December 2003. The prevalence of pressure ulcers in patients who received treatment with PH alone or in combination with other antiepileptic drugs was compared with that in patients who received antiepileptic agents other than PH. The study analyzed data from the medical charts of 153 patients, 72 of whom received PH alone or in combination with other antiepileptic drugs, and 81 of whom received antiepileptic agents other than PH. Patients' mean (SD) age was 78.5 (7.2) years; 106 (69.3%) were women. All patients were totally dependent with respect to activities of daily living (mean Katz score, 2.0 [2.0]) and had severe cognitive decline (mean Mini-Mental State Examination score, 3.5 [3.3]). Pressure ulcers occurred in 9.7% of PH recipients and 27.2% of non-PH recipients (P = 0.006; chi2 = 7.55). In PH recipients, 85.7% of pressure ulcers were of mild to moderate severity (stage I or II), compared with 59.1% of ulcers in non-PH recipients; the difference between groups was not statistically significant. Four (18.2%) non-PH recipients and no PH recipients had stage IV pressure ulcers. In the PH group, 71.4% of patients had a pressure ulcer in only 1 anatomic location, compared with 22.7% of the non-PH group (P = 0.023; chi2 = 5.13); 28.6% of PH recipients and 63.6% of non-PH recipients had pressure ulcers in 2 or 3 anatomic locations; and 3 (13.6%) non-PH recipients and no PH recipients had pressure ulcers in > or = 4 areas. In the long-term bedridden institutionalized patients studied, those who received PH had lower rates of pressure ulcers, as well as less severe ulcers. PH may be a useful anticonvulsive agent in frail elderly patients, who are at risk for the development of pressure ulcers.

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

PubMed

Dugenia, M E

1982-12-01

The goal of the Philippine Population Education Program (PEP) since its inception in 1972 is to institutionalize population education in the formal educational system. The PEP Training Section views institutionalization of population education in the inservice education program for elementary school teachers as part of the process of making it an integral part of that program. In practice elementary school teachers periodically attend training programs organized by division or district supervisors and school principals. This is the usual modality through which teachers are updated on or informed about new thrusts and recent developments in teaching content, strategies, and methodologies. In this context, the PEP Training Section convened a seminar workshop in December 1981 for 10 subject area supervisors from the 3 large geographic island groups of Luzon, Visayas, and Mindanao. They represented 10 school divisions and subject areas where population education is integrated. The specific objectives of the 5 day activity were to: discuss existing inservice training programs in the school divisions; prepare a training model incorporating population education in the overall division inservice training program; and develop a content chart or a listing of topical areas on population education for the training model. 1 of the outputs of the seminar workshop was a training model incorporating population education in the regular inservice training programs using 3 delivery schemes, i.e., seminar workship on the teaching of specific subject areas; district staff meeting and/or echo seminars organized by district supervisors following division seminars; and regular teachers' meeting at the school level organized by school principals. Another output was a content chart listing suggested topics in population education classified according to subject areas into which they will be incorporated. The semninar workshop concluded with a plan to try out the model using the identified modalities in respective school divisions during the year 1982 and an agreement to reconvene for a feedback conference after the tryout. During the feedback conference held in August 1982, certain factors that are critical for the institutionalization of population education in the inservice training programs for teachers were identified: need for support of the top officials of the school division; need for diffusion of the training to other subject areas; and need for involvement of the supervisory hierarchy. The pilot experience showed that involvement of the supervisory hierarchy in charge of training of teachers in planning and organization of inservice training programs facilitates training and articulates and corrdinates training management.

Interaction with Mass Media: The Importance of Rhythm and Tempo.

ERIC Educational Resources Information Center

Snow, Robert P.

1987-01-01

Stresses that understanding the impact of interaction with mass media requires conceptualizing media as an institutionalized social form. A critical feature of this process is the grammatical character of media interaction in the form of rhythm and tempo, because these rhythms and tempos become established in everyday routine. (SKC)

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

ERIC Educational Resources Information Center

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

2014-01-01

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

Effects of Helicobacter Pylori Eradication Among Adults with Intellectual Disability

ERIC Educational Resources Information Center

Wallace, R. A.; Schluter, P. J.; Webb, P. M.

2004-01-01

Compared to the general population, Helicobacter pylori infection is more common among adults with intellectual disability (ID) and is associated with greater levels of disability, maladaptive behaviour, and institutionalization. Little information exists about the effects of eradication therapy in this group, so we aimed to evaluate: (1) success…

Elevated Amygdala Response to Faces following Early Deprivation

ERIC Educational Resources Information Center

Tottenham, N.; Hare, T. A.; Millner, A.; Gilhooly, T.; Zevin, J. D.; Casey, B. J.

2011-01-01

A functional neuroimaging study examined the long-term neural correlates of early adverse rearing conditions in humans as they relate to socio-emotional development. Previously institutionalized (PI) children and a same-aged comparison group were scanned using functional magnetic resonance imaging (fMRI) while performing an Emotional Face Go/Nogo…

Community Living Skills: Nutrition I.

ERIC Educational Resources Information Center

Kreps, Alice Roelofs; Dreith, Rita Vallero

One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Nutrition I. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized persons to…

Religion, Modernity and Social Rights in European Education

ERIC Educational Resources Information Center

Zambeta, Evie

2008-01-01

Religion, as social construct and institutional reality, has played a pivotal role in shaping European societies. In spite of the impact of Enlightenment theories in the formation of European modernity, institutionalized religions and established churches have managed to maintain their influence in the public domain. Educational systems, the par…

Strategic directions and mechanisms in technology transfer

NASA Technical Reports Server (NTRS)

Mackin, Robert

1992-01-01

An outline summarizing the Working Panel discussion related to strategic directions for technology transfer is presented. Specific topics addressed include measuring success, management of technology, innovation and experimentation in the tech transfer process, integration of tech transfer into R&D planning, institutionalization of tech transfer, and policy/legislative resources.

From Science Studies to Scientific Literacy: A View from the Classroom

ERIC Educational Resources Information Center

Allchin, Douglas

2014-01-01

The prospective virtues of using history and philosophy of science in science teaching have been pronounced for decades. Recently, a role for nature of science in supporting scientific literacy has become widely institutionalized in curriculum standards internationally. This short review addresses these current needs, highlighting the concrete…

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

ERIC Educational Resources Information Center

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

2011-01-01

Background: Experience in institutional/orphanage care has been linked to increased mental health problems. Research suggests that 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…