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PubMed1997

The relationship between premorbid life-style and wandering behaviors in institutionalized people with dementia.

Forty-nine ambulatory residents participated in a study conducted to determine the relationship between premorbid life-style, work, and ways of handling stress, and wandering in dementia units. The sample consisted of 23 males and 26 females with a mean age of 79. Family members responded to open-ended questionnaires that asked about premorbid leisure activities, hobbies, exercise, stress management, type of employment and social interactions. Activities were ranked according to energy expended on the Metabolic Cost of Activities (MET) Scale. No activity equaled Inactive (0); 1.5-2 METS equaled Mildly Active (1), 2-3 METS equaled Moderately Active (2), and 3-4 METS equaled Very Active (3). Subjects were observed three times for one-hour intervals on each of three shifts (day, evening, night) at randomly selected times to assess wandering behavior. Behavior was logged every five minutes. The subjects' most frequent conditions were awake (21%), alone (20%), and in their own rooms (17%). Twenty-four (50%) of the subjects were observed pacing, and 16 (33%) were agitated/restless at some point in time. Statistical analyses showed no significant correlations between premorbid life-style variable rankings and the amount of time spent standing, walking and pacing. The findings suggest that wandering behavior is not influenced by premorbid life-styles.

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PubMed2000

Beyond Experimentation: Emerging Issues in the Institutionalization of Joint Forest Management in India.

/ During the last decade, a major initiative for community involvement in the management of state forest lands was started in India in the form of Joint Forest Management (JFM) programs. Despite the progress and positive impacts, the JFM program is still in the experimental phase. Latent conflicts related to caste, class, and gender issues are threatening JFM institutions at the village level. The Forest Department is also facing a number of internal conflicts as it tries to adjust to its new role under JFM. Some thoughtful and creative attempts have been made to resolve these conflicts. However, a much more concerted effort is required along with creation of suitable mechanisms at local, state, and national levels to discuss and resolve present and future conflicts.

Journal Article↗
PubMed2005

Could the ethics of institutionalized health care be anything but Kantian? Collecting building blocks for a unifying metaethics.

Is a Health Care Ethics possible? Against sceptical and relativist doubts Kantian deontology may advance a challenging alternative affirming the possibility of such an ethics on the condition that deontology be adopted as a total programme or complete vision. Kantian deontology is enlisted to move us from an ethics of two-person informal care to one of institutions. It justifies this affirmative answer by occupying a commanding meta-ethical stand. Such a total programme comprises, on the one hand, a dual-aspect strategy incorporating the macro- (institutional) and micro- (person-to-person) levels while, on the other, it integrates consistently within moral epistemology a meta-ethics with lower-ground moral theories. The article describes the issues to be dealt with and the problems which have to be solved on the way to a unifying theory of that kind (Sections I-III) and indicates elements of Kantian moral philosophy which may serve as building blocks (Section IV). Among these are not only Kant's ideas concerning the moral acting of persons and his ideas concerning civil society and state but also his ideas concerning morality, schematism and religion.

Delivery of Health Care↗
PubMed1983

Effects of an experimental diet on parotid saliva and dental plaque pH in institutionalized children.

Sixty-six children aged 6-12, permanent residents of a children's home, were placed on a diet during a 45-day experimental period to measure salivary flow-rate, pH of saliva and dental plaque, total concentrations of salivary proteins, inorganic phosphate, bicarbonate, calcium and amylase. The total caloric content, as well as the proportional nutrient and calorie distribution of the foods, were determined and compared with those of the previous habitual diet. After the experimental period, stimulated parotid salivary flow, increased by 40 per cent over the pre-experimental values. Total proteins of saliva and pH of both saliva and dental plaque increased significantly, whereas inorganic phosphate concentration decreased. Concentrations of bicarbonate, calcium and amylase did not differ from those found pre-experimentally. The findings appear to derive from lesser retention and increased hardness of the foods in the experimental diet.

Child↗
PubMed1987

The clinical nurse researcher: institutionalizing the role.

The role of the clinical nurse researcher is central to the conduct of clinically relevant research and the integration of research findings into nursing practice, particularly within inpatient settings. Interviews with clinical nurse researchers revealed that implementation of the role occured under four major models: nursing research unit, dual roles, collaborative roles, and functional role division. Organizational and colleague support were critical to the visibility and viability of the clinical nurse researcher role.

Health Facilities↗
PubMed1992

Prevalence of predisposing factors for endocarditis among an elderly institutionalized population.

The charts of 100 nursing home patients in a Veterans Affairs skilled nursing facility were reviewed to identify the need for endocarditis prevention prior to dental procedures. Forty-two (42%) had identifiable needs. Systolic murmurs, documented in 38% of the residents, were the most prevalent abnormality. Five patients had other indications for antibiotic coverage (history of rheumatic heart disease, previous endocarditis, artificial heart valve), which added four unique patients (those not already identified by murmurs) to the total. The dental implications of these findings are discussed.

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