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At least 109 records · Page 6Linked to original sources
PubMed1976

Shigellosis transmitted by nurses.

Twelve cases of Shigella sonnei infection, with two deaths, occurred at a custodial institution in Donelson, Tennessee, in April and May 1973. Nine of the cases and both deaths were in patients hospitalized at the institution's infirmary. The patients with nosocomial shigellosis were significantly younger and had been hospitalized significantly longer than controls. Epidemiologic investigation implicated staff members in the transmission of illness from one patient to another and identified the previous use of broad-spectrum antibiotics as a significant factor in placing patients at risk of acquiring shigellosis.

Adult↗
PubMed1998

Survival rates among children with severe neurologic disabilities.

BACKGROUND: This study was done to determine survival rates in subpopulations of severely neurologically disabled children who reside in pediatric skilled nursing facilities and to compare these survival rates with those in previously published studies. METHODS: Data were collected at three pediatric skilled nursing facilities over the 1986 to 1996 decade. The total study population numbered 447. We studied in detail six groups of the most severely disabled children and correlated their survival rates with clinical parameters and the presence of other significant diseases. RESULTS: The survival rates in our six groups of severely disabled children were significantly better than those previously reported. In group 1, our 8-year survival rate was 66%, as compared with 5% in the previous study. In group 2, our 8-year survival rate was 89%, versus 22% in the previous study. We obtained better survival rates in all six groups studied, irrespective of the analysis including children less than 1 year old, between 1 year and 15 years old, or more than 15 years old. The most significant determinant for reduced survival was the presence of other significant diseases. Those with other significant diseases had a 10-year survival rate of 45%, whereas those who were relatively healthy had a survival rate of 90%. Patients who received gastrostomy tube feedings had a better 10-year survival rate than those fed by nasogastric tube (78% vs 41%). This difference was independent of the presence of other significant medical diseases. CONCLUSIONS: Our results show substantially better survival rates than those previously reported. These improved results are most likely related to much more intense medical management of severely disabled children in skilled nursing facilities than at home or in other residential settings. Our study also showed a significantly better survival rate for those fed by gastrostomy tube as compared with nasogastric tube.

Adolescent↗
PubMedDate not supplied

Loreto House: a pattern of care.

This short article is primarily concerned with, what the authors consider to be, two important considerations in any form of residential child care, particularly long-term: 1 The great need for a coherent overall philosophy, which is clearly understood by all members of staff. It is felt that, all too often, assumptions are made about general agreement, which are not necessarily borne out by observed practice. 2 The need for the meticulous selection of primary caring staff, followed by relevant in-service training rather than an overreliance upon, what are sometimes, quite arbitrary qualifications. The article attempts to present a broad profile of a unit which, although it does not claim to represent the ideal, is nonetheless beginning to assume a purposive and identifiable character. The point is made that clinicism, professionalism and academic discussion are important but they are not the only considerations. The children must remain the raison d'etre for such a unit, not the justification. The authors hope to have conveyed their conviction that cooperation and communication between the members of a multidisciplinary team presents the most practical and the most productive approach to the care of profoundly and multiply handicapped children.

Adolescent↗
PubMed2005

Not by bread alone project: a 2-year follow-up report.

BACKGROUND: We have previously reported the developmental gains achieved, after introducing a simple programme of structured play to stimulate children in an orphanage. It was envisaged that the caregivers could continue the programme. However, the enthusiasm of the caregivers waned over the year the programme was entrusted to them. After 1 year, a full time play therapist was recruited to rejuvenate the play programme. METHODS: Children's development was assessed using the Indian adaptation of the Bayley Scales of Infant Development. The first assessment was done when the play therapist joined. Subsequently, three-monthly assessments were done and the scores achieved were recorded. RESULTS: The initial mean motor and mental scores, when the play therapist joined, were 66.14 and 56.95, respectively (similar to the pre-intervention scores of the pilot study reported in an earlier paper). The scores improved to 81.84 and 78.25 within 3 months of restarting the play programme. CONCLUSION: The schedule of the 'Not by Bread Alone' project can accelerate the motor and mental development of children in orphanages. However, it requires a highly motivated and dedicated person to sustain this programme over long periods.

Attitude to Health↗
PubMed2006

Comparative analysis of the frequency of lower urinary tract dysfunction among institutionalised and non-institutionalised children.

OBJECTIVES: To evaluate the level of symptoms of lower urinary tract dysfunction (LUTD) in orphans in institutions, and compare these data with schoolchildren of the same age group who were not institutionalised, as LUTD in children is related to factors such as social isolation and low self-esteem, with other psychological changes also being cited, although it is unknown whether these problems are primary or secondary to the symptoms of LUTD. PATIENTS AND METHODS: Children institutionalised in orphanages with no parental presence and who are isolated from a family environment are probably more sensitive to psychological disturbances. Psychological changes have been associated with symptoms of urgency and urinary incontinence. Thus 89 orphans were compared with 143 schoolchildren not in institutions. A questionnaire was devised and completed by the care-taking staff in the orphanage, while for the schoolchildren the parents completed the questionnaire. The mean age in the institutionalised children was 7.9 years and that of the control group 7.8 years (P = 0.32). Thirty-nine (44%) of the orphans were boys, vs 74 (54%) of the control group (P = 0.17). RESULTS: The incidence of urgency, diurnal urinary incontinence, nocturnal enuresis and constipation in the orphans and in the control group were: 45 (51%) and 57 (40) (P = 0.17), 36 (40%) and 19 (13%) (P < 0.001), 39 (47%) and 38 (27%) (P = 0.002), and 27 (30%) and 43 (30%) (P = 0.76), respectively. CONCLUSION: Children living in orphanages have a significantly higher level of diurnal urinary incontinence and nocturnal enuresis than those not in an institution.

Child↗
PubMedDate not supplied

Do the effects of early severe deprivation on cognition persist into early adolescence? Findings from the English and Romanian adoptees study.

Cognitive outcomes at age 11 of 131 Romanian adoptees from institutions were compared with 50 U.K. adopted children. Key findings were of both continuity and change: (1) marked adverse effects persisted at age 11 for many of the children who were over 6 months on arrival; (2) there was some catch-up between ages 6 and 11 for the bottom 15%; (3) there was a decrease of 15 points for those over 6 months on arrival, but no differentiation within the 6-42-month range; (4) there was marked heterogeneity of outcome but this was not associated with the educational background of the adoptive families. The findings draw attention to the psychological as well as physical risks of institutional deprivation.

Adolescent↗
PubMed2004

High seroprevalence of Helicobacter pylori infection in non-institutionalised children with mental retardation.

Eighty-four children with mental retardation (34 boys, 50 girls; age range 2-18 years, median 6 years) and 84 age- and gender-matched outpatient controls were studied. All children were living at home, had never stayed in an institution, and came from the same urban area. Seropositivity for Helicobacter pylori was found in 42 (50%) of 84 mentally retarded children and 16 (19%) of 84 controls (p < 0.01). Socio-economic factors did not differ between the two groups. The findings indicated that a higher prevalence of H. pylori infection occurs in children with mental retardation, regardless of whether they are institutionalised.

Adolescent↗