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Results for “Institutionalization”

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PubMed2003

Relationship between some biological parameters and plasma testosterone in institutionalized aging men.

BACKGROUND: The decrease in circulating testosterone levels with advancing age has been shown to be related to biological changes in healthy men. OBJECTIVE: We investigated the relationship between total testosterone and several laboratory blood tests (glucose, total cholesterol, total proteins, albumin, RBC) in elderly institutionalized men (mean age: 82.7 years) with chronic illness. RESULTS: There was a dramatically low level of total testosterone in the sample and a strongly significant inverse correlation between testosterone and fasting blood glucose. Hematocrit and albumin were positively correlated to testosterone. CONCLUSION: The negative correlation between testosterone and fasting blood glucose observed in healthy men also exists in institutionalized subjects. The link between testosterone and the related other biological parameters is questioned.

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PubMed1992

Nutritional status of a group of self-sufficient institutionalized elderly people in Perugia (Italy).

The nutritional status of forty-six self sufficient institutionalized elderly people of Perugia was assessed. The diet of this group is slightly better than that of other groups of elderly people previously examined. As observed in other studies, the diet of the elderly from this region of Italy does not seem to be of the Mediterranean type. The location of subcutaneous fat in elderly men is prevalent in the upper trunk and in women in the arms. The clinical signs of nutritional status among this group of self-sufficient institutionalized elderly people are in general not specific and mostly associated with old age. The pathological conditions observed and the administration of drugs do not appear to substantially influence the nutritional status of this group.

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PubMed1992

[The right to treatment of the institutionalized mentally ill in the United States].

In his epochmaking article, Birnbaum proposed that courts should recognize a right to treatment of institutionalized psychiatric patients based on the substantive due process. His proposal was adopted in Rouse v. Cameron as a statutory right. Wyatt v. Stickney decision was the first to hold that there was a constitutionally based right to treatment for involuntarily committed patients. The Supreme Court, though reluctantly, held in Youngberg v. Romeo that the institutionalized mentally retarded were entitled to minimally adequate training, which was drawn in the Fourteenth Amendment.

Commitment of Persons with Psychiatric Disorders↗

PubMed2005

[Addendum to the research on the institutionalization of anatomical studies in modern Japan].

Up to the present, many studies have described the processes of the institutionalization of anatomical studies in modern Japan. But due to the lack of primary sources, especially regarding the situation from the late Meiji period to the Taisho period, there are still some blanks to fill in. This paper reassesses the daily records of a gross anatomy laboratory as historical material and tries to grasp the situations of institutionalization during the said period through analysis. In consequence, several practices of the laboratory not yet open to the public, for example, how and from where cadavers had been collected for anatomical studies in those days, have come to light and some insight into the relationship between medical science and society could be gained.

Anatomy↗

PubMed1991

[The ability of elderly institutionalized pensioners in Reykjavik in maintaining and carrying out oral hygiene procedures in 1984].

In 1984 a random sample of 400 institutionalized old-age pensioners, 67 years and older, was interviewed on oral hygiene habits. Complete denture cleanliness was also studied by using a plaque detector to disclose plaque on the fitting surface of the maxillary denture. Based on the distribution of plaque a grading system using three categories (excellent, fair, poor) was applied to indicate complete denture cleanliness. About 94% of dentulous and 88.7% of edentulous respondents claimed that they were able to take care of their oral hygiene themselves. The proportion of dentulous subjects that cleaned their teeth at least once a day was 66.7%. A great majority (92.4%) of edentulous pensioners reported that they cleaned their complete dentures once a day or more often and women cleaned their dentures more frequently than men. Nevertheless cleanliness was graded excellent in only 14.4% of the complete dentures. This seems to indicate a need for increased education on the importance of a good oral hygiene and that institutionalized pensioners should receive more help with their daily oral hygiene.

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PubMed1990

On the nosology of moderate mental retardation with special attention to X-linked mental retardation. A diagnostic genetic survey of 274 institutionalized moderately mentally retarded men.

In this paper we report the results of a genetic-diagnostic survey of 274 institutionalized moderately mentally retarded adult males and compare these data with those from our previous studies in the severely mentally retarded and from a comparable population of 262 institutionalized moderately mentally retarded males and females (The Borgenstein experience). Special attention is paid to the nosology of X-linked mental retardation and familial mental retardation in general.

Belgium↗

PubMed1989

Diagnosis and treatment of incontinence in the institutionalized elderly.

A selective, stepped strategy will diagnose the cause of incontinence in most institutionalized elderly patients. It consists of rectifying the transient causes of incontinence, searching for serious and treatable underlying conditions, and then formulating a differential diagnosis. If the benefit of empiric therapy exceeds the risk it can be initiated, recalling that incontinence in these patients is multifaceted, and that small improvements in many areas unrelated to the urinary tract will often be sufficient to restore continence. If the risk of empiric therapy exceeds the benefit, further urodynamic testing is warranted since it is safe, feasible, and reproducible. Such an approach will minimize the use of invasive testing, indwelling catheters, and toxic medications. Coupled with optimism, creativity, and persistence, it can lead to substantial improvements in the lives of many incontinent institutionalized patients. Ultimately, the optimal care of incontinence in the nursing home will require an increased number of motivated and well-paid nursing assistants, less invasive diagnostic testing, and improved, better targeted therapy. Still, even in 1989, much can be done to "cure sometimes, relieve often, and comfort always."

Age Factors↗

PubMed1985

Hepatitis A and B in non-institutionalized mentally retarded patients.

The high incidence of hepatitis A and B in institutionalized patients with Down's syndrome is not fully understood. Under poor hygienic conditions immunological alterations might predispose to these infections. To minimize environmental influences, 125 patients with Down's syndrome (mean age 11.9 years) living at home with their families were studied for the occurrence of serological markers of Hepatitis A and B. 106 outpatients with mental retardation of other genesis (mean age 12.4 years), and 114 consecutive voluntary blood donors (mean age 18.0 years) from the same area served as controls. Evidence of previous hepatitis A virus infection was found in 5.6% of Down's patients, in 9.4% of other mentally retarded patients, and in 16.7% of healthy controls. Evidence of previous or ongoing hepatitis B virus infection was a common finding in both groups of mental retardation (Down's syndrome 20.0%, other mentally retarded patients 11.3%) in sharp contrast to healthy blood donors (0.9%, p less than 0.05). Patients with Down's syndrome, however, revealed a much higher incidence of HBs-antigenemia as compared with other mentally retarded patients (12.8% vs. 2.8%, p less than 0.01). All HBs antigen-positive cases had normal transaminase levels and no overt clinical signs of liver disease, suggesting an asymptomatic carrier state. These data indicate that hepatitis A is not a special risk for mentally retarded outpatients, while hepatitis B virus infection is hyperendemic even in not-institutionalized patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

Autopsy study of the elderly institutionalized patient. Review of 234 autopsies.

Autopsies are performed much less frequently in the elderly than in younger patients. Little information exists as to causes of death in the institutionalized elderly. The clinical diagnostic error rate documented by autopsy studies ranges from 6% to 68%. We analyzed the clinical and autopsy records of 234 patients who died during a 14 1/2-year period at our chronic care institution to determine the accuracy of clinical cause of death in addition to the pathologic cause of death. The most common causes of death included bronchopneumonia (33%), congestive heart failure (15%), metastatic carcinoma (14%), pulmonary embolism (8%), myocardial infarction (7%), cerebrovascular accident (6%), unknown cause of death (8%), and a miscellaneous group (9%). The highest diagnostic error rate was in the underdiagnosis of pulmonary embolism (39% antemortem accuracy rate). The most accurately diagnosed condition was cerebrovascular accident (92% antemortem accuracy rate). Pneumonia was correctly diagnosed antemortem in 73% of the patients studied. These data suggest that serious and potentially treatable illnesses are underdiagnosed in the elderly institutionalized patient and that there is valuable information to be learned by performing autopsies in the elderly population.

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PubMed1979

Institutionalized rule violation and control in organized minor league hockey.

In minor league hockey, rule violation including the illegitimate use of force is institutionalized behaviour. Illegitimate tactics are among the minimal general criteria for the assessment and selection of players. No formal mechanism operates to socialize players to obey normative rules. The "official" control system is ineffective in preventing normative rule violation. However, it regulates the game according to constitutive rules preventing its disorganization, and creates the impression that players actually govern their conduct according to normative rules. An informal control system (combative and aggressive in orientation) legitimizes and regulates the amount and kinds of rule violation occurring, and highlights collective meanings of the occupation. A scheme is presented for reducing institutionalized rule violation. Team success (victory) and rule conformity are considered desirable and are rewarded. What value to assign these two "things" remains problematic. To avoid undermining motivation to win the contest, more value must be assigned team success than rule conformity. The question is how much more.

Aggression↗

PubMed1982

Coding, strategic behavior, and language performance of institutionalized mentally retarded young adults.

An information-processing model was used to examine the coding and language functions of institutionalized, moderately and severely retarded persons. Contextual grammatical structures were found to relate to sequential processing whereas comprehension and expression of relational thought was related to both sequential processing and simultaneous processing. The sample was divided into four subgroups based upon etiology. Down's syndrome residents, in general, performed more poorly on most measures than did brain-damaged subjects and subjects of unknown etiology. Down syndrome subjects were significantly less capable than others on sequential-processing tasks and in expressive language. The utility of the model was discussed in terms of remedial programming for institutionalized retarded persons.

Adolescent↗

PubMed1982

Imitation by institutionalized and noninstitutionalized mentally retarded and nonretarded children.

Institutionalized and noninstitutionalized mentally retarded children and noninstitutionalized nonretarded children matched for MA performed on two imitation tasks. The institutionalized retarded group was found to be more imitative on the first task. For all groups, peers as opposed to adults were found to be the more salient model on the second task. Performance across the two imitation tasks was not correlated; however, within each of the tasks, amount of imitation of peers was related to amount of imitation of adults. These findings were interpreted within the framework of Zigler's outerdirectedness formulation.

Adolescent↗

PubMed1982

Developmental changes of institutionalized mentally retarded children: a semilongitudinal study.

Developmental Record ratings were obtained for 200 institutionalized mentally retarded children over a 3-year period. Following a principal components analysis to determine the most appropriate form of inputting data, we obtained semilongitudinal developmental curves for children at each of four levels of retardation and for boys and girls separately. Results indicated that differences in measured intelligence are associated with differences in various kinds of developmental behavior and that between the ages of 7 and 20 years the relationship is primarily a linear one. When subjects were divided according to sex instead of level of retardation, differences appeared to be minimal. These results should be helpful in predicting later attainments of institutionalized retarded children since ratings on the Developmental Record can be translated into specific types of developmental behavior.

Adolescent↗

PubMed1995

Evaluation of a new solid formulation of calcium and vitamin D in institutionalized elderly subjects. A randomized comparative trial versus separate administration of both constituents.

Supplementation with 800 IU of vitamin D and 1 g of calcium each day is recommended in institutionalized elderly subjects to prevent secondary hyperparathyroidism and its adverse skeletal effects. An original formulation (IDEOS) combining vitamin D and calcium has been developed for use in this end. The aim of this study was to determine whether administration of this association, of which each tablet contains 500 mg calcium and 400 IU vitamin D3, produces the same beneficial effects on laboratory parameters as separate administration of both active agents. A multicenter randomized study was conducted in 91 elderly institutionalized subjects (mean age 83.1 years) who had vitamin D deficiency [25-(OH)D < 6 ng/ml] without severe renal failure. Subjects were randomly assigned to one of the two treatment groups. Treatment duration was six months. One group (G1, n = 46) received one tablet of the new formulation twice daily. The other (G2, n = 45) received 8 drops of vitamin D3 (800 IU/day) and one calcium carbonate 500 mg tablet twice daily. Blood tests were carried out at inclusion and after three and six months of treatment. In group G1, plasma 25-(OH)D levels increased from 2.6 ng/ml at inclusion to 14.6 ng/ml at month 6 (p < 0.001), and iPTH fell from 63.2 pg/ml at inclusion to 33.8 pg/ml at month 6 (p < 0.001). In group G2, 25-(OH)D rose from 2.8 ng/ml at inclusion to 13.5 ng/ml at month 6 (p < 0.001), and iPTH fell from 55.4 pg/ml at inclusion to 32.5 pg/ml at month 6 (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1995

Effectiveness of a topical antifungal regimen for the treatment of oral candidiasis in older, chronically ill, institutionalized, adults.

Because of predisposing systemic disease, the frequent administration of medication, and the use of a complete denture, oral candidiasis is a common problem among older, chronically ill, institutionalized adults. This randomized clinical trial was designed to evaluate the effectiveness of an antifungal denture soaking solution (48 mL nystatin liquid, 100,000 IU/mL, dissolved in 432 mL of distilled water producing 10,000 IU nystatin mL solution), used as an adjunct to a nystatin vaginal lozenge (100,000 IU/g, dissolved in the mouth three times daily for seven days) in a group of older, chronically ill, institutionalized adults. Although the clinical signs and symptoms of oral candidiasis were resolved in all subjects following therapy, the presence of invasive Candida hyphae was detected in approximately 80 per cent of tissue and/or dentures. When compared to tap water, the use of an antifungal denture soaking solution produced no detectable difference in the presence of Candida albicans hyphae over a three-month period (M-H chi-square = 0.021, p = 0.886), but it did reduce the rate of recurrence of clinical signs and symptoms. The appropriateness of this regimen for the treatment of oral candidiasis in this type of patient is challenged.

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PubMed1994

[Prevalence estimation of urinary incontinence among non-institutionalized persons aged 60 and over in Japan].

In order to estimate the total number and the prevalence rate of persons experiencing urinary incontinence among the non-instutionalized, aged 60 and over in Japan, a questionnaire survey was conducted in 16 prefectures in December 1991. The questionnaires were distributed and collected by public health nurses in Health Centers. A total of 12,180 questionnaires were administered. There were 11,528 responses (response rate of 94.6%), of which 11,142 were analysed. The main results were follows; 1) Daily urinary incontinence occurred in approximately 4.1% of the men and 5.3% of the women living at home. 2) 6.2% of the men and 8.9% of the women living at home had regular urinary incontinence with at least one episode of leakage per month in the preceding 12 months. 3) The prevalence of urinary incontinence increased with age for both sexes. 4) The 95% confidence interval estimate for the number of non-institutionalized persons over 60 years old suffering from urinary incontinent incidents nearly daily was estimated to be from 305,000 to 351,000 in men and from 554,000 to 675,000 in woman. 5) The 95% confidence interval estimate for the number of non-institutionalized persons over 60 years old with urinary incontinence of at least one episode of leakage per 5 months was from 3,507,000 to 3,889,000 for both sexes. 6) In order to determine age-specific prevalence for urinary incontinence for all age groups, a sampling survey is needed. 7) Research emphasizing the assessment of preventive interventions necessary since incontinence is preventable and medical and surgical treatment options are available.

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PubMed1995

Vitamin A status in the institutionalized elderly. Critical analysis of four evaluation criteria: dietary vitamin A intake, serum retinol, relative dose-response test (RDR) and impression cytology with transfer (ICT).

Infraclinical vitamin A deficiencies may be health-threatening for elderly people, yet they are difficult to assess unequivocally in this population. In this study, we evaluate the vitamin A status of an elderly institutionalized population (49 subjects, 83.6 +/- 6.1 years of age), by examining four different criteria: the dietary vitamin A intake, the retinol concentration in serum, the relative dose-response test and the impression cytology with transfer. The incidence of infra-clinical deficiencies was estimated to be 55% by examining dietary vitamin A intake, 21% by using the RDR test, 6% by the ICT and 2% from serum retinol values. These variations are not due to the choice of threshold values for each of the methods, yet rather to poor correlations between the results given by these methods. Canonical correlation analyses indicate that some parameters related to retinol secretion from the liver, including Zn, prealbumin and retinol-binding protein, can affect individual patient response towards the different methods. Validation of the RDR test in this elderly population was not successful because of poor reproducibility and moderate correction of RDR-detected vitamin A deficiencies by vitamin A supplementation. The method chosen for the determination of vitamin A status in elderly people must be carefully evaluated to account for possible age-related changes in the patient response to the method employed. In the institutionalized elderly population examined in this study, we observed a low vitamin A intake, whereas serum retinol and ICT are within normal ranges and while RDR test's responses appear too variable to draw any conclusion.

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PubMed1997

Patterns of caregiving following the institutionalization of elderly husbands.

The purpose of this study was to examine the caregiving career of older women following the institutionalization of their husbands. Informed by the interpretive perspective in sociology and Hughes's (1971) concept of career, the study employed a longitudinal, prospective, and descriptive design and combined the quantitative and qualitative approaches. The data used in the analysis were drawn from a larger study designed to explore the transition to quasi-widowhood and wives' responses to their husbands' institutionalization. The caregiving career of wives was seen as a pattern of frequent visiting and increasing involvement in the provision of care. Over the nine-month period of the study, two caregiving patterns emerged that were distinguished by a variety of circumstances and interactions. Wives who relinquished aspects of caregiving were more likely to be caring for husbands who were, in large measure, cognitively impaired. These wives reported good morale, few symptoms of depression, change in marital closeness, and satisfaction with aspects of institutional care. Wives who continued to be heavily involved in caregiving were more likely to have husbands who were physically impaired. They had depression scores indicative of moderate to severe depression, reported no change in marital closeness, and were dissatisfied with aspects of institutional care.

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