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Relationships between Minnesota Multiphasic Personality Inventory (MMPI) scales and criteria were evaluated to determine if the MMPI is gender biased when considering a juvenile delinquent population. The MMPI was administered to 549 juvenile delinquents: 105 Black men, 37 Black women, 331 White men, and 76 White women. In addition, behavioral and rating measures were collected; they served as adjustment criteria. Except for the criterion assessing neurotic symptomatology, equations that regressed criteria on MMPI scales neither underpredicted nor overpredicted for a gender. The MMPI tended to underpredict ratings of neurotic symptomatology for women. Significant differences in correlation coefficients for Black men and women occurred for the behavioral, nonrating criteria. Scale 4 was the best predictor for Black men, whereas Scales, 8, F, 1, and 2 tended to be the best predictors for Black women. Some possible explanations for these results are offered.
We conducted a questionnaire survey on life styles and health status for 293 patients with Hansen's disease. They were admitted to the wards for disabled and physically able patients of Ohshima Seishoen, in Kagawa prefecture, in 1991. This institution is one of Japan's national leprosy sanitarians. We measured patients' life satisfaction with the Delighted-Terrible Scale. In this report, the distribution of life satisfaction and its associated factors were examined for 210(71.7%) respondents. Factors examined were length of treatment, physical health, and social aspects of life at the sanatorium. The major findings were as follows; 1. The patients aged under 60 had lower proportions of being satisfied with life than those aged 60 or older. The proportions of life satisfaction of the 40-59 age group were 17% for men and 22% for women, while for the 60 or older age groups were 33-44% for men and 41-45% for women. The proportions of life satisfaction in the 60 or older age groups were lower than those of community dwelling elderly persons. 2. We examined factors associated with life satisfaction for the respondents aged 60 or older. Dependence on activities of daily living (ADL) was associated with life satisfaction in some ADL items. Care and aid provided by the staff of the sanatorium may modify the relationship between ADL impairment and life satisfaction. For social aspects of life at the sanatorium, both having networks with family members and having resources other than family were associated with life satisfaction. Going out and positively spending their daily lives were associated with life satisfaction, too. These associations were significant for men. Similar patterns of association were observed for women, but were insignificant. This finding suggests that it is important for the health and medical care staff to pay attention to the social aspects of the life of elderly patients with Hansen's disease.
We set out to determine the prevalence of bacteriuria in elderly patients institutionalised in 10 homes in Northumberland. Single mid-stream urine (MSU) specimens were collected from 161 asymptomatic patients aged 64-101 years. Thirty-four (21%) samples had > 100 white blood cells (WBC/microliter) on microscopy as well as a significant bacteriuria of > 10(8) bacteria/l, being suggestive of a true urinary tract infection. A total of 115(71%) samples had < 100 WBC. Seventy-five (46%) samples could be described as 'contaminated' or 'infection unlikely' but of these only 31 (19.2% of all samples) were reported as 'contaminated' by the laboratory. This study confirms previous work in America to indicate the high level of bacteriuria in institutionalised elderly patients as well as the very high number (46%) who may show bacteriuria but no rise in the number of WBC suggesting contamination only. Nurses and GPs must be very cautious in interpreting MSU results from such patients.
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This study determined the effectiveness of a 6-month program of regular exercises for the improvement of functional performance of the elderly living in a nursing home. The 40 subjects aged 60 to 99 who took part in this trial were assigned either to a comparative group or an exercise group. The following variables were measured: functional performance with the use of an obstacle course, a lower-limb function test, and a 6-minute walk test (gait velocity); isometric strength of the knee extensors; proprioception of the lower limbs; mental status through the Mini-Mental State Examination (MMSE); and depression symptoms with the use of the Geriatric Depression Scale (GDS). In the exercise group, 19 subjects completed the program and attended an average of 32 (68%) sessions. At the end of the trial, the exercise subjects showed significant performance improvement in quantitative and qualitative obstacle course scores, lower-limb function test, gait velocity test, knee extensors strength, and the GDS, while the nonexercise subjects showed significant decrease in qualitative obstacle course score, lower-limb function, gait velocity, MMSE, and the GDS.
In this study, we developed time-and-need-based community case management guidelines by tracking case management activity for 234 elderly clients over their first 6 months of care. Clients were interviewed at the time services began and again 6 months later to determine physical, emotional, and cognitive status. We found that the Regina Risk Indicator Tool (RRIT), a brief measure of risk for requiring institutional care, differentiated clients needing varying amounts of case management. Using these results, an expert panel devised guidelines for ranges of case management time for clients at different levels of need: low risk, some risk, and high risk. Quality measures, response times for initial contact and assessment, and service review parameters were also incorporated into the guidelines. Tools for workload measurement, quality review, client satisfaction, and service provider communication were developed. Focus group analysis of the guidelines with various stakeholders and a pilot implementation guided further revision. Future directions are outlined in the article, including the need to focus on outcomes of the guidelines and study of guideline implementation processes.
About 5% of the nation's elderly reside in nursing homes; many of these individuals experience varying levels of cognitive impairment. Although physical and nonphysical intimacy are important to their well-being, numerous structural and nonstructural barriers exist to their enjoyment of intimate relationships. Additionally, significant legal and ethical issues must be considered in the formulation of institutional policy and procedures to address the intimacy needs of cognitively impaired elderly residents. This article explores the barriers that exist and the models that have been suggested to guide institutional administrators and staff in evaluating residents' needs, and concludes with recommendations.
Aggressive and self-injurious behaviors of four retarded children were reduced by combining various techniques with the differential reinforcement of other behaviors (DRO). In one study, aggressive responses of a severely retarded child were reduced when DRO was combined with a 30-sec timeout. In a second study, various aggressive classroom behaviors were reduced when the child was told "no" for an inappropriate response but earned puzzle pieces for periods of time when inappropriate responses resulted did not occur. Exchangeable tokens were given to a third subject for every 15 min in which aggressive responding did not occur, while each inappropriate response resulted in the loss of all tokens accrued. Responding was decreased to a level far below baseline. For a fourth child, self-injurious responses were followed by "no", and intervals of time in which no self-injurious responding occurred earned candy. The rate of this behavior reduced significantly. In each case, the DRO procedure combined with the other techniques proved to be manageable for the teacher and successful in reducing the inappropriate behavior.
In the last several years, various organizations have produced strikingly similar documents by which institutions for retarded persons are judged for licensure. The purpose of the present study was to determine whether residential units that were licensed differed from residential units that were not licensed in terms of the active programming behaviors of their staff and residents. Data were collected through a time-sampling procedure that yielded about 160,000 observations on eight staff and six resident behaviors. Results showed that the licensed units were just as derelict as unlicensed units in providing habilitative programming for their retarded residents. Maladaptive responding by residents occurred at least as much as task-related residents. Maladaptive responding by residents occurred at least as much as task-related behaviors: residents spent as much time self-stimulating as they did in programming; they also engaged in self-abusive behavior about as much time as they engaged in on-task responding. Results were discussed in terms of the failure of governmental regulations that are not based on observation to adequately assess habilitative programming.