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Biomedical subjects

L Alverno

Publications and source records attributed to L Alverno.

8 recordsLinked to original sources
PubMed1993

Comparison of clinical indicators in two nursing homes.

OBJECTIVE: Pressure ulcer prevalences in 30 VA nursing homes in 1986 ranged from 0% to 15%. The institutions with lowest ("A") and highest ("B") prevalence were selected for further examination. DESIGN: Analysis of nursing home files for five study periods, each lasting 6 months. SETTING: A and B were 60-bed rural and 280-bed urban facilities, respectively. MEASUREMENTS: Eleven outcome indicators were calculated for each study period: prevalences and incidences of pressure ulcer, aggressive behavior and disruptive behavior, 6-month declines in each of the four activities of daily living (ADLs), and prevalence of underweight. RESULTS: Populations in A and B were similar with regard to age, sex, length of stay, degree of dependency, and level of nursing care. All indicators for the first study period were more favorable in A than in B. In addition, underweight (body mass index < 22 kg/M2) was significantly less prevalent in A than in B. The differences between the two institutions in the indicators were persistent over the five study periods from 1988 to 1991. CONCLUSIONS: The populations of A and B were similar in the available measures of severity of illness. Nevertheless, the residents in nursing home A were significantly less likely to experience adverse outcomes than were the residents in nursing home B. The virtual absence of pressure ulcers, physical aggression, and verbal disruption in nursing home A, despite the presence of many immobile and demented residents, suggested that these complications can mostly be prevented.

Activities of Daily Living↗
PubMed1993

A comparison of physically aggressive behavior in two VA nursing homes.

OBJECTIVE: To investigate an apparent difference in the prevalence of physically aggressive behavior in two Veterans Affairs (VA) nursing homes, the authors compared ratings by nurses of residents' assaultive behaviors at the beginning and end of two six-month periods in 1987 and 1991. METHODS: The prevalence of assaultive behavior in each of three diagnostic subgroups (neurologic, psychiatric, and medical) at nursing homes A and B was determined using standardized biannual ratings of patients' behavior. Chi square analysis was used to compare prevalence rates and to compare the proportions of nonaggressive patients who were rated as aggressive at the end of each six-month period. RESULTS: Nursing homes A and B were significantly different in the proportions of patients in the three subgroups; facility A had a greater percentage of neurologic and psychiatric patients, and facility B had a greater percentage of medical patients. Both in 1987 and in 1991, the prevalence of assaultive behavior in nursing home A in all three diagnostic subgroups was higher than that in nursing home B, usually by a statistically significant margin. A significantly higher proportion of nursing home A residents in each subgroup who were rated as nonaggressive at the beginning of the two periods were rated as aggressive at the end of each period. CONCLUSIONS: Further studies are needed to learn whether the substantial difference in assaultive behavior resulted from intrinsic characteristics of the facilities' populations or from the qualities of their environments.

Activities of Daily Living↗
PubMed1992

Indicators of adverse somatic outcome in three Veterans Affairs nursing homes.

Frequencies of undernutrition, bedsores, and deterioration in activities of daily living were compared in three Veterans Affairs nursing homes serving both chronic psychiatric patients and medical or neurological patients. The three facilities varied in the proportions of patients with adverse outcomes, with one home having noticeably higher rates for both subgroups of patients. In each home, the two subgroups were equally likely to show evidence of adverse outcome, suggesting that differences in the frequency of adverse outcomes among the facilities were accounted for by extrinsic factors related to quality of care rather than intrinsic factors related to patient characteristics.

Activities of Daily Living↗
PubMed1981

Reserpine and alpha-methyldopa in the treatment of tardive dyskinesia.

Thirty inpatients with evidence of tardive dyskinesia secondary to antipsychotic medications participated in this double-blind, controlled, randomized study comparing reserpine, alpha-methyldopa and placebo. Reserpine at doses of 0.75--1.5 mg daily, or alpha-methyldopa at doses of 750--1,500 mg daily, produced a statistically significant improvement in tardive dyskinesia symptomatology compared to the results obtained with placebo.

Adult↗
PubMedDate not supplied

A brief self-assessing depression scale.

The Wang-Self-Assessing Depression Scale (SADS) was devised to provide a brief self-rating form for measuring depressive symptomatology. The present study compares the SADS with the Zung Self-Rating Depression Scale (SDS) to assess reliability and relative ease of completion. Ninety-three ratings on each scale were obtained from a subject group that included normal volunteers and patients with differing degrees of depression. The paired t-test showed no significant difference between mean SDS scores and mean SADS scores for normal volunteers or subjects rated at any of the four depression levels. Positive correlation was demonstrated between tsds scores and SADS scores for depressed and normal subjects. The period of time required to complete the Wang SADS was found to be significantly shorter than for the Zung SDS, while the number of errors and requests for additional assistance were significantly lower. It was felt that these differences would constitute an advantage in the clinical use of the Wang SADS for diagnosing, evaluating, and monitoring the progress of depressed inpatients and outpatients.

Depression↗