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PubMed1979

Hand Test indices of violent and destructive behavior for institutionalized mental retardates.

The Hand Test (Wagner, 1962) and the maladaptive behavior scale of the AAMD Adaptive Behavior Scale (ABS) were administered to 78 institutionalized retardates (46 males and 32 females) in order to investigate the relationship between violent and destructive behavior and two purported indicants of violent and destructive acting-out behavior on the Hand Test, the acting-out-score (AOS and movement-content response (ACT-MOV). Significant correlations between the two Hand Test indices and the number of types of violent and destructive behavior evinced during a three-month period were obtained.

Acting Out↗

PubMed1995

Dementia in Parkinson's disease: a population-based study in ambulatory and institutionalized individuals.

We examined the frequency of dementia and depressive symptomatology in 60 Parkinson's disease (PD) patients, identified in a large representative sample of the population, aged 65 years and older, living at home or in institutions in Gironde, France. Dementia, diagnosed according to DSM-III-R criteria, was present in 17.6%, and depressive symptomatology, assessed by the Center for Epidemiologic Studies-Depression Scale, was present in 32.7%. The frequency of dementia in PD increased strongly with age and was higher in institutionalized PD patients than in those living at home. PD was significantly associated with dementia for individuals living at home (odds ratio = 8.2, adjusted for age and symptoms of depression.

Aged↗

PubMedDate not supplied

Using television to improve the social behavior of institutionalized children.

This field experiment assessed the effects of a "TV diet" composed of ten prosocial programs on the social behavior of eight-to-eighteen year old behaviorally disordered youngsters who were institutionalized in a state psychiatric facility. The influence of a post-viewing group discussion which highlighted the televised positive messages was also examined. The prosocial diet resulted in the youngsters behaving more altruistically, less verbally aggressive, and less destructively relative to those exposed to the control diet containing programs the youngsters typically viewed. The post-viewing discussion reduced the effectiveness of the prosocial programming but mitigated some of the negative effects of the control diet.

Adolescent↗

PubMed2003

Appendicular fractures: a significant problem among institutionalized adults with developmental disabilities.

A high incidence of nontraumatic fracture in adults with developmental disabilities living in a state-run facility was described. Risk factors for fracture, including bone mineral density (BMD), were investigated to determine whether people at highest risk for fracture could be prospectively identified. There was a 7.3% incidence of fracture among 391 adults. Risk factors were examined for 23 residents with fracture and 23 age-, race-, and gender-matched controls. There was a trend for antiepileptic medication usage to be associated with fractures. Estimated BMD by heel ultrasound did not predict fracture; however, values were much lower than those for the general population. Fractures and low BMD are significant problems among institutionalized adults with severe developmental disabilities. Further studies to identify therapies to prevent fractures are warranted.

Adolescent↗

PubMed1992

The ventilator-assisted individual. Cost analysis of institutionalization vs rehabilitation and in-home management.

The purpose of this article is to present a cost analysis of in-home vs institutionalization for severely physically disabled ventilator-assisted individuals (VAIs). Following rehabilitation and adaptation to noninvasive methods of ventilatory support, 30 VAIs were maintained in the community for 12.9 +/- 1.1 years with personal care attendants organized by a home care vendor reimbursed by New York City Medicaid. The program permitted self-directed severely disabled clients, including these 30 exclusively nontracheostomized VAIs, to live in the community and direct their attendant care and personal affairs. Prior to discharge home, the 30 patients resided in the respiratory unit of a long-term care facility for a mean of 8.9 +/- 10.1 years. The unit is currently reimbursed at a mean rate of $718.80 per patient per day. The current mean total cost of maintaining these VAIs in the community is $235.13 +/- 56.73 per patient per day. The conversion to and/or maintenance on 24-h nontracheostomy ventilatory support permitted discharge to the community by allowing the VAI to be attended by trained but uncredentialed home care attendants, thus avoiding prohibitively expensive in-home nursing for tracheostomy care. This created a savings to the public of 77 percent or $176,137 per year per client. We conclude that conversion to and/or use of noninvasive methods of ventilatory aid can be a reasonable and cost-saving goal. More respiratory rehabilitation centers are needed to free up hospital beds and facilitate discharge of VAIs to the community. There is also evidence that trained attendants should be permitted to suction tracheostomized VAIs in the home.

Costs and Cost Analysis↗

PubMed2003

Prevalence of low bone density in institutionalized men with developmental disabilities.

This study investigates the prevalence and degree of low bone mineral density (BMD) in a group of 108 institutionalized men with developmental disabilities. Speed of sound (SOS) and broadband attenuation (BUA) of the calcaneus were measured to determine a quantitative ultrasound index (QUI). Comparison was made to the values for this index in a reference population of age-matched and young adult controls. Thirty-four percent of the study participants had QUI values more than 2 standard deviations (SDs) below those of age-matched controls. Fifty-one percent of this population showed QUI values more than 2 SDs below those of the young adult reference group, suggesting a high prevalence of significantly decreased BMD.

Adult↗

PubMed1995

[Nutritional and disease diagnosis in institutionalized children. Day care center Elisio Teixeira Leite, Perus, SP 1993].

As a part of one survey about health conditions in institutionalized children, the nutritional status were evaluated. Data were obtained through antropometric assessment in a sample of 111 pre-school children matriculated in a small official day-care center in Perus-SP. According to Gomez, 50.0% of all that children were classified as malnourished, 23.4% of them in the I degree; 22.4% in II degree and only 4.3% in III degree. Taking into account the Waterlow's classification there was a highest frequency of cronic-actual malnutrition (30.8%) concentrated in children between 12-48 months of age. Additionally, these children presented highest incidence of infective-respiratory and intestinal diseases. These evidences lead on to the improvement of the follow-up of children growth and food consumption, specially that under 24 meses, to attempt for an early identification of malnutrition, thus increasing the chance of nutritional recuperation.

Brazil↗

PubMedDate not supplied

[Reflecting on the institutionalized elderly].

Qualitative and descriptive research that aimed at identifying how the elderly-family relationship has been taking place by identifying the reasons that led family members to opt for the institutionalization of their elderly, obtaining also the view of the family about home caring. Data collection was performed by using an open questioning instrument. Data collection was performed from August 2002 to July 2003. The subjects of the research were relatives of elderly people living at a home in a town in the northwestern region of Rio Grande do Sul. Through content analysis, it was seen that the greatest difficulty found by the family in spending time with their elderly relative is the "lack of time to care" for him, because most of them require full-time caring.

Age Factors↗

PubMedDate not supplied

Circulation flow of enteropathogenic bacteria in institutionalized children. I. An epidemiologic study.

The circulation flow and maintenance of enteropathogenic bacteria were studied from May 1982 to April 1983 in a population of institutionalized children and adult staff contacts in the city of Rio de Janeiro, Brazil. Subjects were assigned to three groups: A and B, included, respectively, 105 and 46 children with diarrhea who were admitted in the institution in different periods, and group C with 82 adult contacts. Faecal cultures were positive in 35.2%, 39.1% and 19.7% of subjects of groups A, B, and C, respectively. It suggests that the transmission was probably fostered by the environment because of as high as 30% of faecal contamination was found in environmental samples. Higher rate of isolation and elevated antibodies levels pointed out that Escherichia coli (EPEC) was the prevalent agent. Shigella predominated in the serological tests. These findings suggest that the institution itself may play an important role in the epidemiology and transmission of enteric infections in the community.

Adult↗

PubMed2006

[Oral health of institutionalized elderly in the eastern zone of São Paulo, Brazil, 1999].

The objective was to verify oral health conditions in institutionalized elderly people in the city of São Paulo, Brazil, through epidemiological analysis. The sample consisted of 293 subjects and was stratified according to age (65-74 years and over 75) and gender. Epidemiological analysis was conducted according to WHO criteria to determine prevalence of oral disease. Chi-square and Mann-Whitney tests were used to check differences between strata. Of the subjects evaluated, 64.8% were women and 65.2% were over 75 years old. DMFT was 30.8 with tooth loss of 96.3%, and this percentage was statistically greater for women (97.0%); 94.7% showed calculus as a major degree of periodontal condition, and only 1.8% presented healthy periodontal conditions and 33.3% presented loss of attachment ranging from 6 to 8 mm. Some 48.1% used total upper and 22.5% total lower prostheses. Edentulism was 68.3%. The data indicate unsatisfactory clinical conditions, as shown by the high CPO-D index and high percentage of edentulism.

Age Distribution↗

PubMedDate not supplied

[Prevalence of root caries and periodontal conditions in an elderly institutionalized population from Piracicaba-SP].

Preventive and invasive dental procedures have improved in the last two decades, leading to a greater longevity of teeth. As a result, teeth are more susceptible to periodontal diseases and, consequently, to root caries. The purpose of this study was to verify the prevalence of both periodontal diseases and root caries in an institutionalized population from Piracicaba-SP, Brazil. In this study, 151 subjects, aging 54 to 93 years, were examined. The sample was divided into two groups: a group of subjects aging 50 to 75 years and a group of subjects over 75 years old. The sextants were examined and classified as to periodontal health, periodontal treatment needs, prevalence of gingival recession and root lesions. In conclusion, a high prevalence of root caries was verified. That indicates an increase in the susceptibility to these lesions, which is associated with the aging process.

Age Factors↗

PubMed1983

The unit play manager as facilitator of purposeful activities among institutionalized profoundly and severely retarded boys.

Child care workers were trained in specified techniques (play manager routines) in an effort to increase purposeful activity among a group of profoundly and severely retarded institutionalized boys. A system of prompts, increasing the availability of toys and regular staff monitoring, were alternated with normal institutional routines in an ABA reversal design. On the average, activity level increased from 10% to a mean of 70% during treatment conditions. Correspondingly, stereotyped or harmful behaviors decreased from an average of 20% to 70% during treatment.

Adolescent↗

PubMed1992

Comparison of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on oral health in institutionalized, mentally handicapped adults: one-year results.

The purpose of this study was to compare the efficacy of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one-year period. Twenty-seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t-test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2-factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Epidemiology of hepatitis B infection in institutionalized mentally retarded clients.

In 1,149 clients of an institution for the mentally retarded, the prevalences of hepatitis B surface antigen (HBsAg) and hepatitis B virus markers were 12 per cent and 66 per cent, respectively. HBsAg prevalence was higher in males, Down syndrome, ambulatory, and older clients, and those with longer institutionalization. Serum alanine aminotransferase levels were abnormal in 31 per cent of HBsAg positive and 10 per cent of HBsAg-negative clients.

Adolescent↗

PubMedDate not supplied

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

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

Adaptation, Psychological↗

PubMed1995

Patterns of drug use among white institutionalized delinquents in Georgia: evidence from a latent class analysis.

Previous research by Kandel [1] and others indicates that adolescent drug use follows a progression from legal drugs, through marijuana, to hard drugs. In this study of drug use patterns, institutionalized delinquents were found to follow a similar progression of drug use. Unlike previous studies which used "rule of thumb" methods of model assessment, this study uses probabilistic assessment of the models. Importantly, the present study supports a modified gate-way sequence, where cocaine use appears as an intermediate step between marijuana use and use of other hard drugs. It is suggested that widespread availability of cocaine in the late 1980's may have resulted in a new "step" in the drug use sequence.

Adolescent↗

PubMed1978

WAIS subtest score characteristics of institutionalized mentally retarded samples.

Scaled scores on WAIS subtests were compared among five samples of institutionalized mentally retarded (aged 16 to 71 yr.) from the East Coast (N = 509), West Coast (N = 436), and three from the Midwest (Ns = 113, 51, and 111). Four of the five samples showed high correlations between the mean profiles suggesting that the performance of the mentally retarded is reliable across geographical locations. Reasons for the discrepancies between these four samples and the fifth sample are discussed.

Adolescent↗

PubMed1983

Hand test personality correlates of aging in institutionalized mentally retarded adults.

To investigate the relation of aging and personality in the institutionalized mentally retarded the projective Hand Test was administered to 103 mentally retarded adults, ranging in age from 18 to 73 yr. (M age = 40.10 yr., SD = 15.80), residing in a midwestern facility for mentally retarded persons. Partial correlation coefficients, with Stanford-Binet IQ as the controlled variable, were computed between age and the 23 Hand Test scoring variables. Results indicated the personality characteristics of aging mentally retarded persons appeared to mirror those for "normal" adults. Implications of results were discussed.

Adolescent↗