SEARCH · PubMed Health

Results for “Institutionalization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources

PubMed1979

Platelet monoamine oxidase activity in schizophrenia. Relationship to disease, treatment, institutionalization and outcome.

A study was made of platelet monoamine oxidase (MAO) activity in non-medicated, newly-admitted schizophrenics and institutionalized chronic schizophrenics both on and off medication. These patients were compared to two control groups: normal subjects and brain-damaged institutionalized patients. No relationship was found between platelet MAO activity and the severity or duration of illness, duration of psychotropic medication, presence of auditory hallucinations or institutionalization. Mean platelet MAO activity did not differ significantly between the schizophrenic subgroups and control groups. Thirty-one patients studied before and after treatment with phenothiazines showed no significant change in platelet MAO activity. The findings did not indicate a relationship between schizophrenia, its treatment or outcome and platelet MAO activity.

Antipsychotic Agents↗

PubMed1996

[Urogenital symptoms and their resulting discomfort in non-institutionalized 50-to-75-year-old Dutch women].

OBJECTIVE: To determine the prevalence of urogenital symptoms in non-institutionalized Dutch women, aged 50 to 75 years, and the degree of discomfort. DESIGN: Cross-sectional study. SETTING: Nationwide investigation. METHOD: A questionnaire was sent to 2157 non-institutionalized Dutch women aged 50 to 75 years. The survey sample was representative of the female population aged 50 to 75 years with respect to age, marital status, level of education and menopausal age. RESULTS: The usable response was 81.6% (n = 1761). The overall prevalence of vaginal dryness, soreness and dyspareunia was 27%. The prevalence of micturition symptoms, urinary incontinence and recurrent urinary tract infections was 36%. The prevalence estimates for vaginal dryness and urinary incontinence showed a linear decrease with increasing age. Almost half of the symptomatic women reported moderate to severe discomfort. One-third of those affected received medical care. Previous hysterectomy had no effect on the reported prevalence estimates. Hysterectomized women reported moderate to severe complaints more often than non-hysterectomized ones. CONCLUSION: The prevalence of urogenital symptoms in non-institutionalized Dutch women aged 50 to 75 years, was high: 47%. Of these women, 40% to 60% experienced discomfort, but only one-third had sought medical advice. These urogenital problems will probably increase in the coming decades.

Aged↗

PubMedDate not supplied

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

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

Community Health Planning↗

PubMed1999

Impact of trace elements and vitamin supplementation on immunity and infections in institutionalized elderly patients: a randomized controlled trial. MIN. VIT. AOX. geriatric network.

BACKGROUND: Antioxidant supplementation is thought to improve immunity and thereby reduce infectious morbidity. However, few large trials in elderly people have been conducted that include end points for clinical variables. OBJECTIVE: To determine the effects of long-term daily supplementation with trace elements (zinc sulfate and selenium sulfide) or vitamins (beta carotene, ascorbic acid, and vitamin E) on immunity and the incidence of infections in institutionalized elderly people. METHODS: This randomized, double-blind, placebo-controlled intervention study included 725 institutionalized elderly patients (>65 years) from 25 geriatric centers in France. Patients received an oral daily supplement of nutritional doses of trace elements (zinc and selenium sulfide) or vitamins (beta carotene, ascorbic acid, and vitamin E) or a placebo within a 2 x 2 factorial design for 2 years. MAIN OUTCOME MEASURES: Delayed-type hypersensitivity skin response, humoral response to influenza vaccine, and infectious morbidity and mortality. RESULTS: Correction of specific nutrient deficiencies was observed after 6 months of supplementation and was maintained for the first year, during which there was no effect of any treatment on delayed-type hypersensitivity skin response. Antibody titers after influenza vaccine were higher in groups that received trace elements alone or associated with vitamins, whereas the vitamin group had significantly lower antibody titers (P<.05). The number of patients without respiratory tract infections during the study was higher in groups that received trace elements (P = .06). Supplementation with neither trace elements nor vitamins significantly reduced the incidence of urogenital infections. Survival analysis for the 2 years did not show any differences between the 4 groups. CONCLUSIONS: Low-dose supplementation of zinc and selenium provides significant improvement in elderly patients by increasing the humoral response after vaccination and could have considerable public health importance by reducing morbidity from respiratory tract infections.

Aged↗

PubMed1984

Prediction of recidivism in young offenders after brief institutionalization.

Administered 100 delinquent adolescent boys a battery of tests that measured intelligence, mental control, self-concept and physical fitness. The battery of tests was administered at the beginning and at the end of short-term institutional placement (M = 6 months) and again 1 to 2 years after release from the institution. Significant prediction of prosocial behavior in the year after institutionalization was achieved by using tests that reflected mental control and academic achievement. Background variables such as race, socioeconomic status, family status, and previous criminal charges were not related significantly to presence or absence of antisocial behavior during the year after institutionalization. Implications for management and treatment are discussed.

Achievement↗

PubMed1996

Quantitative ultrasound of bone in institutionalized elderly women: a cross-sectional and longitudinal study.

Quantitative ultrasound of bone is a promising method for bone assessment: radiation-free, portable and predictive of hip fracture. Its portability allowed us to study the relationships between ultrasonic parameters of bone with age and with non-vertebral fractures in elderly women living in 19 nursing homes. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the calcaneus were measured (and the stiffness index calculated) in a sample of 270 institutionalized women, aged 85 +/- 7 years, using an Achilles bone densitometer (Lunar). The effects of age, history of non-vertebral and non-traumatic fractures, body mass index, triceps skinfold and arm circumference were assessed on BUA, SOS and stiffness index. Furthermore, to evaluate longitudinally the influence of aging on the ultrasound parameters of bone, 60 subjects from the same group had a second ultrasound measurement after 1 year. The cross-sectional analysis of the data on all 270 women showed a significant decrease (p < 0.001) with age in BUA, SOS and stiffness index (-0.47%, -0.06%, and -1.01% respectively per year). In the 94 women, (35%) with a history of previous non-vertebral fractures, ultrasound parameters were significantly lower (p < 0.0001) than in the 176 women with no history of fracture (-8.3% for BUA, -1.3% for SOS, -18.9% for stiffness index). In contrast, there was no significant difference in anthropometric measurements between the groups with and without previous non-vertebral fractures, although the measurements decreased significantly with age. In the longitudinal study, repeated quantitative ultrasound after 11.4 +/- 0.8 months showed no significant decrease in BUA (-1%) but a significant decrease in SOS (-0.3%, p < 0.0001) and in stiffness index (-3.6%, p < 0.0002). In conclusion, quantitative ultrasound of the calcaneus measures properties of bone which continue to decline in institutionalized elderly women, and is able to discriminate women with previous non-vertebral fractures.

Aged↗

PubMed2003

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

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

Activities of Daily Living↗

PubMed2004

Cost-effectiveness of hip protectors in frail institutionalized elderly.

A randomized controlled trial was performed to examine the cost-effectiveness of external hip protectors in the prevention of hip fractures. Since the hip protectors were not effective in preventing hip fractures in our study, the main objective became to examine whether the use of hip protectors results in lower average costs per participant in the hip protector group as compared with the control group. In addition, the average costs of a hip fracture and subsequent rehabilitation in frail, institutionalized elderly were calculated. Residents from apartment houses for the elderly, homes for the elderly and nursing homes with a high risk for hip fractures were randomized to the hip protector group (n=276) or control group (n=285). Costs were calculated for the hip fracture and subsequent rehabilitation until 1 year after the fracture. Six months after each hip fracture, a nurse was interviewed and after 12 months, a questionnaire was sent to the general practitioner or nursing home physician to determine the utilization of health care resources. Differences in costs between the groups were analyzed using non-parametric bootstrapping. Eighteen hip fractures occurred in the intervention group and 20 hip fractures (in 19 persons) in the control group (log rank P-value=0.86). The average costs per participant, including the costs of the intervention, were Euro 913 in the intervention group and Euro 502 in the control group (cost difference of Euro -411; 95% confidence interval: -723; 57). The average costs of a hip fracture and subsequent rehabilitation were Euro 8100 (95% CI: 6716-10,010). The use of hip protectors was not associated with lower costs. In addition, the average costs of a hip fracture and subsequent rehabilitation in the first year after the fracture were estimated at Euro 8100 in institutionalized elderly.

Aged↗

PubMed1998

[Successful coping with declining objective life style by institutionalized long-term patients. Results of a follow-up analysis of quality of life in long-term care institutions with the Zurich Quality of Life Inventory].

Measurement of quality of life in institutionalized frail patients is difficult considering the high prevalence of dementia. The Zurich quality of life inventory was developed specifically for this purpose and applied to describe longitudinally 103 institutionalized long-term care patients 3-12 months after entry: 11 slow-stream-rehabilitation patients (SSR), 16 severely dependent patients (ASL), 61 moderately dependent patients (ALL), and 15 young severely dependent patients, all of whom were assessed at least twice. The objective conditions of life deteriorated in all 4 groups, significantly in the SSR and ASL, and with high significance in the whole population from 121 +/- 54 to 139 +/- 58 (P < 0.001). Well-being did not change significantly in any of the groups or overall (from 122 +/- 59 to 117 +/- 54, p = 0.90). Deteriorating life conditions were due to a decline in clinical dementia rating, (p < 0.01) and living space diameter (p < 0.001), whereas the remaining subscores of life condition, i.e., number of falls, days of sickness, life style rating, and all subscores of well-being, i.e., number of medicines, valuation of handicap and of suffering, visual self-rating of well-being and caregivers' stress did not change significantly.

Activities of Daily Living↗

PubMed2005

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

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.

Aged↗

PubMed1983

Salivary phenytoin levels in institutionalized epileptics.

Measurement of phenytoin (PHT) levels in saliva has been advocated as a monitor of plasma levels, and therefore of effective dosage. All studies to date have been performed on outpatients. We have now analyzed whole saliva from 62 mentally retarded, institutionalized, PHT-treated persons with epilepsy. Both PHT and its major human metabolite, 5-(para-hydroxyphenyl)-5-phenylhydantoin (pHPPH) were measured using gas-liquid chromatography. We detected large inter-individual variations in saliva PHT and pHPPH levels. Data were ranked and subjected to statistical analysis according to Spearman. Significant positive correlations were detected between daily PHT dose and plasma total PHT concentration, plasma PHT and salivary PHT, and daily dose and salivary PHT level. When data were categorized and analyzed according to the type of medication being administered in addition to PHT, different results were obtained. Polypharmacy can influence drug and metabolite levels and relationships in institutionalized persons with epilepsy.

Adolescent↗

PubMed1986

Syncope in institutionalized elderly: the impact of multiple pathological conditions and situational stress.

We conducted a prospective study to identify clinical factors which predispose institutionalized elderly to syncope. Over 3 years, 97 patients (mean age = 87 +/- 6 y) developed syncope. On clinical evaluation, diagnoses fell into two categories: specific diseases including myocardial infarction (6%) and aortic stenosis (5%); and situational stresses including drug-induced hypotension (11%), postprandial syncope (8%), defecation syncope (7%) and postural hypotension (6%). Clinical variables derived from the history, physical examination, and laboratory evaluation of these patients were compared to those of 118 non-syncopal age-matched subjects evaluated in similar fashion. Multivariate analysis identified five independent statistically significant correlates of syncope: coronary artery disease (p = 0.0003), functional impairment (p = 0.006), postural blood pressure reduction (p = 0.003), aortic stenosis (p = 0.008), and insulin therapy (p = 0.03). Syncope patients were more likely than controls to have two or more coexistent factors (p = 0.0001). Syncope in institutionalized elderly is often due to the interaction of multiple coexistent clinical abnormalities which impair cardiovascular compensation for common situational stresses.

Age Factors↗

PubMed1985

Characteristic patterns of word association responses in institutionalized elderly with and without senile dementia.

This study examined the responses of 91 institutionalized elderly persons to the Goldfarb-Halpern Word Association Test (1981), Journal of Speech and Hearing Research, 24, 233-246. Subjects with senile dementia evidenced a characteristic pattern of responses which included marked reduction of paradigmatic responses, no decrease in syntagmatic responses, and a marked increase in unclassifiable and multiword responses not previously reported in the literature. The declines and increases appeared linear and progressive with severity of dementia. The pattern was distinct from that of any other adult group previously tested with this tool. Institutionalized elderly subjects without senile dementia performed similarly to previously tested noninstitutionalized elderly. Theoretical and clinical implications are discussed.

Aged↗

PubMed1982

Institutional structures: catalysts of or barriers to quality care for the institutionalized aged in Scotland and the U.S.

The care of the elderly in two long-term care institutions, one in Scotland and one in the United States, is described, compared, and analyzed. In Scotland three institutional structures, the National Health Service, the Geriatric Service, and the specialty of geriatrics are identified as catalysts of quality care. In the U.S. Medicare and Medicaid, the absence of geriatrics as a specialty, and the nursing home are identified as barriers to quality care for the institutionalized aged. The findings suggest that three components, an adequate government insurance program, professionals who specialize in the care of the aged, and a structure to provide continuing comprehensive care, are essential for a successful program of care for the institutionalized elderly.

Aged↗

PubMed1985

Who are those most likely to be institutionalized, the elderly who receive comprehensive home care services or those who do not?

Three samples of clients aged 65 and over from three different home care and homemaker programs are compared to elderly persons with a risk of institutionalization chosen from three random samples of people aged 65 and over living in the catchment areas of the three programs. The most important differences between the clienteles and the populations with a risk of institutionalization appear when examining the availability of help. The populations at risk generally have access to a source of help living with the elderly person while the clienteles of comprehensive home care programs depend on outside help. Home care and homemaker programs therefore replace in-home services with out-of-home services. These services will be effective insofar as they succeed in reproducing some of the essential characteristics of in-home care.

Aged↗

PubMed1991

Dental care of institutionalized elderly in Singapore.

Previous studies have identified considerable barriers to dental care and unmet dental needs among institutionalized elderly. This study examined physical and financial arrangements for dental care of institutionalized elderly in Singapore. Chief administrators of the 68 homes for the elderly in Singapore were interviewed. Results showed that 48 homes (70.7%) assumed responsibility for arranging dental care and providing access to treatment facilities for its ambulant residents while only 33 homes (48.5%) had similar arrangements for semi- and non-ambulant residents. Four of the homes (5.9%) reported having in-house dental facilities while the rest arranged for its residents to be treated either in public dental facilities (44.2%) or in private dental offices (20.6%). Type of sponsorship of the homes and ambulatory status were closely associated with the type of arrangement for dental care. Over 64.6% of homes (44) required residents to be fully responsible for the costs of their dental care. The availability of subsidies for residents' dental costs was found to be associated with the type of sponsorship and type of arrangement for care. Lack of physical access and financial constraints were found to be potential problems in the utilization of dental services in this population group.

Aged↗

PubMed1994

Hardiness and death attitudes: predictors of depression in the institutionalized elderly.

There are varied and high estimated prevalence rates of depression in the institutionalized elderly. Personality characteristics and attitudes are two attributes in the uniqueness of humans that have been overlooked in explaining depression. This study examined the relationships of hardiness and death attitudes to depression. The sample consisted of 90 consenting participants; 46 women and 44 men. The mean age of the sample was 73.3 years. This study produced the following three major findings: hardiness and depression are correlated; healthy death attitudes are related to low depression scores; and the combination of nonhardiness and health-limiting death attitudes are reliable predictors of depression in the institutionalized elderly.

Aged↗

PubMedDate not supplied

Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study.

Reduction in muscle mass and physical function depends on a variety of interacting factors: age, physical activity level, nutritional state and the type and impact of disease. The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength, balance, mobility, ambulation and activities of daily living (ADL) in institutionalized elderly people aged 65 and over with multiple diagnoses. Baseline assessments consisted of strength, balance, mobility/ambulation, and ADL. Twenty-one subjects were included in the intervention program. A control group (21 subjects) was first matched in pairs according to gender, age, ADL and mobility, and then by balance, ambulation and strength. The intervention program was individualized and included strength, mobility, balance and endurance training. Follow-up measures were conducted directly after the intervention and 10 weeks later. After drop-out, 20 subjects in the intervention group and 15 subjects in the control group remained for analyses. Balance and mobility improved significantly in the intervention group while declining in the control group. This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses.

Activities of Daily Living↗