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PubMed1989

Secondary enuresis in institutionalized conduct-disordered children.

The incidence of secondary enuresis in 16 institutionalized conduct-disordered children was examined. In contrast to a control group of 16 noninstitutionalized conduct-disordered children, the former showed significantly more enuretic behaviour. Also, enuresis began within 6 mo. of the children's separation from their families, suggesting this problem is very likely related to the emotional trauma surrounding the change in living conditions. However, the small number of subjects limits further interpretation of the findings.

Adolescent↗

PubMed1985

Collaborative WHO xylitol field studies in Hungary. I. Three-year caries activity in institutionalized children.

The aim of this 3-year field study was to assess the value of partial substitution of sucrose with peroral xylitol (14-20 g/day) as a caries-preventive measure (X group) in comparison with systemic administration of fluoride (F group) and restorative treatment procedures solely (C group). An F dentifrice was used unsupervised in the X and F groups, the former containing 10% xylitol. The C group used customary, predominantly F-free dentifrices distributed by the local health authorities. The final material consisted of 689 institutionalized children (6-11 years). Caries was scored yearly in duplicate by two continuously calibrated teams. At base line the X group had a significantly higher caries prevalence than the F and C groups. The 3-year DMFS increment was 4.2 in the X group, 6.5 in the F group, and 7.7 in the C group. The corresponding ratio (RS) between caries incidence and the tooth surface population at risk was RSx, 4.9; RSF, 6.6; and RSC, 8.6. It is concluded that dietary xylitol in solid sweets resulted in a lower increment of caries than obtained in the F and C groups (p less than 0.001, covariance analysis, with base-line prevalence, number of permanent teeth, and visible plaque index as covariants).

Animals↗

PubMed1987

Development of phenytoin-induced gingival overgrowth in non-institutionalized epileptic children subjected to different plaque control programs.

The periodontal condition was studied in phenytoin (PHT)-treated non-institutionalized epileptic children (n = 59) subjected to different preventive programs. One group followed an intensive preventive program during a 2-year period initiated before the start of PHT medication. The second group was given a moderate preventive program initiated after various periods of PHT medication. Patients not subjected to any additional preventive program during their PHT medication were used as controls. None of the individuals following the intensive preventive program developed pseudopockets. About 46% of the children in the moderate preventive group and 40% of the individuals not subjected to any preventive program developed pseudopockets. The amount of time the children were without plaque control was significantly and positively correlated to the development of gingival overgrowth. To minimize this occurrence, PHT-treated children should be subjected to a preventive program initiated before the start of PHT medication.

Adolescent↗

PubMed1998

Body composition in institutionalized elderly people in Granada (Spain). Relation with other nutritional parameters.

Anthropometric characteristics and body composition were assessed in a group of 93 institutionalized elderly people, mean age 80.9 +/- 7.6 years, in Granada (Spain). The body composition was measured by the bioelectrical impedance technique. The influence of dietary energy intake, lifestyle, physical activity and health data were studied. Forty-five per cent of the women and 17% of the men were obese (BMI > 30 kg/m2) and 78% of the women and 54% of the men were overweight (BMI > 25 kg/m2). Only 12% of men and 4% of women suffered from undernutrition (BMI < 20 kg/m2). No significant correlations (P > 0.05) were found between BMI or body fat percentage and energy intake. Lifestyle and health data do not affect the BMI or body composition, but a significant negative correlation (P < 0.05) was found between the physical handicap level and the energy intake in all the sample (r = -0.26) and in the women (r = -0.16).

Aged↗

PubMed1996

Nutritional status of vitamin A and E in institutionalized elderly people in Granada (Spain).

A study has been carried out on the nutritional status of vitamin A and E in 93 institutionalized elderly people in Granada (Spain) by studying their vitamin intake and the serum values of retinol and alpha-tocopherol. The influence of lipid intake and lipids in plasma has been also discussed. The vitamin A intake is higher than the recommended amount and represent 209% DR in men and 217% DR in women. The vitamin E intake is deficient in 33% of the men and 27% of the women. The serum values of retinol indicate that 11% of the women have a deficiency (< 0.7 microM), and that 39% of the men and 32% of the women have low values (0.7-1.22 microM). As for the serum values of alpha-tocopherol, 6% of the women have deficient values, and 82% of the men and 37% of the women have low values (11.6-23.2 microM).

Aged↗

PubMed2000

Physical activities and energy expenditures of institutionalized Japanese elderly women.

The daily energy expenditure and physical activity index of institutionalized Japanese elderly women were measured. One hundred and thirteen Japanese elderly women (aged 79.5 -/+ 7.0 y) who live in institutions for the elderly and receive meal services participated voluntarily. A dietary survey, energy metabolic study, and time study were carried out over three consecutive days, and the basal metabolic rate (BMR) and energy expenditure by physical activity were measured. The intensity of daily physical activity was based on the physical activity index (PAI: total/basal energy expenditure). The mean BMR was 881 +/- 145 kcal/d (20.9 +/- 3.8 kcal/kg BW). The PAI in individuals ranged from 1.01 to 1.57, the mean value was 1.26 +/- 0.14, and 64% of the subjects examined showed a lower value than 1.3 of PAI. From these values, the mean total energy expenditure was calculated as 1,112 +/- 231 kcal/d (26.2 +/- 5.2 kcal/kg BW).

Aged↗

PubMed2002

Community-acquired methicillin-resistant Staphylococcus aureus in institutionalized adults with developmental disabilities.

Methicillin-resistant Staphylococcus aureus (MRSA) has recently been reported to emerge in the community setting. We describe the investigation and control of a community-acquired outbreak of MRSA skin infections in a closed community of institutionalized adults with developmental disabilities. In a 9-month period in 1997, 20 (71%) of 28 residents had 73 infectious episodes. Of the cultures, 60% and 32% obtained from residents and personnel, respectively, grew S. aureus; 96% and 27% were MRSA. All isolates were genetically related by pulsed-field gel electrophoresis and belonged to a phage type not previously described in the region. No known risk factors for MRSA acquisition were found. However, 58 antibiotic courses had been administered to 16 residents during the preceding 9 months. Infection control measures, antibiotic restriction, and appropriate therapy resulted in successful termination of this outbreak. Selective antibiotic pressure may result in the emergence, persistence, and dissemination of MRSA strains, causing prolonged disease.

Adolescent↗

PubMed1990

A need for social support. The chronically mentally ill institutionalized elderly.

Now that nursing homes are playing a major role in community care of psychiatric patients, they must be evaluated for the extent to which they offer and provide opportunities for social reintegration. Reality orientation and therapeutic milieu are the interventions used most often with elderly institutionalized chronically mentally ill patients. Attention that the elderly chronically mentally ill patients receive in reality orientation or in therapeutic milieu is probably more beneficial than the treatment itself.

Aged↗

PubMed2001

The effect of physical restraints on fall rates in older adults who are institutionalized.

Since the Omnibus Budget Reconciliation Act (OBRA) of 1987, there has been a significant reduction in the use of physical restraints to prevent falls in older adults who are institutionalized because of the developing awareness of the physical and psychological problems associated with them. The purpose of this ex post facto descriptive study was to determine if there is a difference in falls when physical restraints are allowed or prohibited in one older adult population. Data from incident reports from a purposive sample of 97 older adults in one long-term care facility were analyzed before and after the implementation of a restraint-free policy. The results indicated no significant difference in the number of falls before and after the policy change. However, there was a significantly lower number of falls with injuries and a significantly higher number of falls without injuries. These findings suggest older adults will continue to fall with or without the use of physical restraints because of changes associated with the aging process and risk factors. Removing physical barriers from older adults and allowing freedom of movement may decrease the severity of injury sustained in a fall.

Accidental Falls↗

PubMedDate not supplied

Oral health status and treatment needs in institutionalized psychiatric patients: one year descriptive cross sectional study.

BACKGROUND AND OBJECTIVES: Psychiatric patients are one of the special groups requiring attention as they are often neglected. Oral health is an major determinant of general health for psychiatric patients and may have a low priority in the context of mental illness. The present study was conducted to assess the oral health status and treatment needs of institutionalized psychiatric patients of Davangere. METHODS: 220 psychiatric patients admitted in two general hospitals of Davangere during the period of one year were included in the study. The oral health status was evaluated with respect to caries, oral hygiene, and periodontal status. RESULTS: Of the 180 examined with the response rate of 81.8%. 58.3% were males, mean age was 36.7 years, 57.8% had < 1 year of mental illness with a mean of 2.2 years, and 90% were self-sufficient. The multiple logistic regression analysis showed that the mean DMFT (0.92) increased with age, duration of mental illness, and irregularity of oral hygiene habits (P<0.001). Mean OHI-S score was 3.3 and multiple logistic regression analysis showed that the mean OHI-S score increased with age (P<0.001). The multiple logistic regression analysis showed that the CPI score increased with age, duration of mental illness, and degree of helplessness (P<0.001). INTERPRETATION AND CONCLUSION: The findings of this study demonstrates low caries prevalence, poor oral hygiene, and extensive unmet needs for dental treatment.

Activities of Daily Living↗

PubMed2006

[Prevalence of osteoporosis assessed by quantitative ultrasound calcaneus measurements in institutionalized elderly population].

OBJECTIVES: To analyze using quantitative ultrasound of calcaneus (QUS) the prevalence of osteoporosis in institutionalized elderly people, in order to contribute to state reliable criteria (T-score units) for the diagnosis of osteoporosis which allow advances in bone fracture prevention. MATERIAL AND METHODS: Elderly people (n=171) were divided into separate groups according to sex and age criteria (three decades, from 70 to 90 years) and analyzed using QUS. RESULTS: Both globally and in the younger groups, women showed significantly lower values than men in all densitometry variables (p < 0.001). In the oldest group only T-score and BUA showed statistical differences (p = 0.039 y p = 0.025, respectively). The prevalence of osteoporosis in women was higher than in men whichever criteria were applied in all age groups. Applying the WHO criteria with QUS, the prevalence of osteoporosis in global population is close to that stated by DEXA using the same criteria. CONCLUSIONS: QUS could be useful to assess the bone mass evolution with age and for the diagnosis and monitoring of osteoporosis. In our elderly population, the WHO criteria for DEXA, are also the most suitable ones for QUS utilization.

Aged↗

PubMed1999

[Risk factors associated with falls in institutionalized elderly population. A prospective cohort study].

BACKGROUND: Falls in elderly subjects are a frequent cause of morbidity and mortality. The present study investigated risk factors associated with falls in institutionalized elderly subjects. PATIENTS AND METHODS: The subjects of this prospective cohort study were 190 persons aged 65 years or older, who were able to walk unassisted. We recorded sociodemographic variables, morbidity, drugs, functional capacity, cognitive status, gait and balance. Crude and adjusted density ratios (DR) were calculated and Cox proportional risk analysis was performed. RESULTS: A total of 121 falls occurred in 7 persons, for a fall rate of 0.75 per person per year. Independent risk factors identified with multivariate analysis were diabetes mellitus (DR = 3.6), slow gait (DR = 1.7), failed Romberg test (DR = 3.2) and fall(s) during the previous 12 months (DR = 1.9). Drugs that were associated with significant risk were digitalis, antiarrhythmics, neuroleptics, antidepressants and oral bronchodilators. A higher number of chronic diseases acted as a protective factor. CONCLUSIONS: The main risk factors associated with falls in elderly were easy to identify. Analysis of these factors can help to identify elderly persons with a high risk of falls, and thus focus appropriate preventive measures on these subjects.

Accidental Falls↗

PubMed1982

Medicaid program; state residency for institutionalized individuals--Health Care Financing Administration. Interim final rule with comment period.

These regulations extend the time period in which a State is required to furnish Medicaid to a beneficiary who is institutionalized in That State and who, under other provisions of the regulations, would be considered a resident of another State. As originally published, the regulations specified a time period of two years during which the requirements applied. That period ended on October 15, 1981. This document extends that period to June 23, 1983, in order to allow HCFA time to review all of the Medicaid policies on residency to determine if any changes are needed and to give States more time to transfer patients if desired.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed2000

Predictions of violent and total infractions among institutionalized male juvenile offenders.

Forensic practitioners in settings with institutionalized adolescent offenders are frequently responsible for the accurate classification of problematic and potentially violent youths. Methods of assessment often include traditional tests, such as the MMPI and MMPI-A, and interview-based determinations of psychopathy. In a study of residential male adolescent offenders, the MMPI-A and the Screening Version of the Psychopathy Checklist (PCL:SV) were used to predict total, violent, self-injurious, and nonviolent infractions in a treatment-oriented facility for delinquents. In predicting the overall number of infractions, the MMPI-A was superior to the PCL:SV. Psychopaths manifested a significantly higher rate of violent infractions than nonpsychopaths. Finally, ethnic differences raise serious concerns about the generalizability of the PCL:SV; differences were found in the relationship between psychopathy and infractions based on ethnicity.

Adolescent↗

PubMed1999

Periodontal status and treatment needs of 12-15 year old institutionalized mentally handicapped school children in Ibadan, Nigeria.

Mentally handicapped children are known, to have poor periodontal health. But previous studies lack conformity due to the use of different indices by the different authors. Twenty-five institutionalized mentally handicapped school children in Ibadan, Nigeria were studied with the aim of assessing their periodontal health and per treatment needs using the CPITN which is known to be simple and has international uniformity. The result showed that none of the children had healthy periodontium and all the children will need oral hygiene care with a significant percentage (8%) requiring complex periodontal care. The need for comprehensive preventive dental program is discussed since the hallmark of management of the children is prevention.

Adolescent↗

PubMed1975

Effects of directive vs. nondirective play therapy with institutionalized mentally retarded children.

Institutionalized retarded children were randomly assigned to 11 sessions of directive play therapy (N = 5), nondirective play therapy (N = 5), or no treatment (N = 4). Student nurses were therapists. The Denver Developmental Screening Test was administered before and after treatment. For the Fine Motor and Personal-Social scales, a significant interaction effect (p smaller than .05) was found between treatment group and measurement period (pre vs. post). The interactions tended to support the hypothesis that play therapy was effective in increasing developmental level but not the hypothesis that directive therapy was more effective than nondirective therapy.

Child↗

PubMed2001

A focus on the institutionalized aged and special care patient for today's practice.

Dentists must understand the growing institutionalized-aged and special-needs population, the places wherein they reside, and the unique challenges of access that confront both the patient and dentist. This article discusses governmental regulation and legislation of long-term-care facilities and outlines professional duties and requirements of dentists who care for residents of such facilities. It will also cover the treatment needs of this population and the venues available to the hospital-trained dentist.

Aged↗

PubMed2002

Reliability of the mini nutritional assessment (MNA) in institutionalized elderly people.

OBJECTIVES: To measure the reliability of the Mini Nutritional Assessment (MNA) in institutionalized elderly people. DESIGN: 12 day interobserver reliability study. PARTICIPANTS AND SETTING: All subjects admitted to two long term geriatric units in Mataró (Barcelona, Spain) over 4 months during 1996 (n=67). MEASUREMENTS: in each center, different trained nurses independently administered the MNA on two separate occasions. RESULTS: Mean (standard deviation) scores for the two assessments of the MNA were 20.8 (5.4) and 21.3 (4.6) respectively. Internal consistency, estimated by the Cronbach's Alpha, were 0.83 and 0.74 for the first and second assessment respectively. Test-retest reliability, according to the intraclass correlation coefficient (ICC), was 0.89 for the total MNA score and higher than 0.89 for its continuous items. According to the Kappa index, test-retest reliability for the stratified total MNA was substantial (0.78); for the 18 ordinal or nominal items of the MNA it was 'almost perfect' or 'substantial' in 12 items, 5 were 'moderate' to 'fair' and in I item it was 'slight'. Subjective health evaluation, the number of glasses of liquids per day, and brachial circumference (this former with an ICC=0.91) were the items with the lowest Kappa indices. CONCLUSION: The MNA test has good levels of reliability, according to its internal consistency and its test-retest reproducibility. Some improvements can still be introduced by refining the categorization and content of some items with low reliability.

Aged↗