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At least 1,603 records · Page 89Linked to original sources
PubMed1986

Falls in the institutionalized elderly in Japan.

Falls can be considered a vital factor in impeding successful aging in the elderly. The purpose of the study is to know rates of falls per year among the elderly, to observe the situations when falls occurred, and to clarify the association of falls with physical deterioration. The survey was carried out in 1406 residents aged 65 and over of the Tokyo Metropolitan Home for the Elderly in 1982. The rate of subjects who fell more than once during a one-year period was 14.5%. Females had a higher rate than males. Sixty per cent of all the falls occurred indoors. As for the cause of the falls, extrinsic factors were accounted three times as much as intrinsic factors. Among injuries sustained by the falls, fracture was more frequent in females than in males. Length of time of standing on one leg was shorter for fallers than for non-fallers in both sexes. However, the differences were not significant when age was controlled. Fall is attributed not only to physical factors but also to environmental factors. Therefore, it should be encouraged to design an environment with devices.

Accidents↗
PubMed1989

Duration of immunity to hepatitis B vaccination in institutionalized mentally retarded patients.

Susceptible individuals of an institution for the mentally retarded (20 residents and six staff members) were vaccinated with Hevac B Pasteur (5 micrograms, months 0, 1, 2, 14). There were protective levels of anti-HBs in 75% of residents and 100% of staff members after 15 months from the first dose of the vaccine. After a 4-year follow-up period, there were persistent and protective levels of anti-HBs in 80% of residents, compared with 66% in staff members. In addition, no clinical hepatitis B infections were observed during this period.

Adolescent↗
PubMed1990

Immunogenicity of a recombinant DNA hepatitis B vaccine in institutionalized patients with Down's syndrome.

Residents of institutions for the mentally handicapped, especially Down's syndrome (DS) patients, are at increased risk for exposure to hepatitis B virus (HBV). Indeed, during a serological survey of 770 mentally retarded residents in institutions in Antwerp in 1985, 32.6% of the 92 DS patients screened were HBsAg positive, compared with 7.2% of the 678 other mentally retarded (OMR) patients (p less than 0.001). Seronegative mentally handicapped individuals (275 in number including 18 DS patients) from three institutions were vaccinated with 20 micrograms of a recombinant yeast-derived hepatitis B vaccine (YDV) according to a 0, 1, 6 month schedule. Serum samples were tested at months 1, 2, 7, 12 and 24 for HBV markers by radioimmunoassay. One month after the third vaccine dose, 81.3 and 97.7% of DS and OMR patients had seroconverted, respectively, with GMTs of 516.3 and 1078.7 mIU ml-1. Two years after the start of the vaccination course, 66.7 and 96% of subjects in the two groups still had protective antibody levels (greater than or equal to 10 mIU ml-1), although GMTs had decreased to 40.1 and 166.3 mIU ml-1 in the two groups, respectively. Only one of the 18 DS patients had transient asymptomatic anti-HBc infection at month 2, no subject followed up being infected after the full vaccination course. Thus, the institutionally mentally handicapped, including DS patients are capable of responding adequately to YDV.

Adolescent↗
PubMed1983

Social skills training with institutionalized severely and profoundly mentally retarded persons.

This paper examines the literature on training severely and profoundly retarded individuals in social skills. Experimental studies have focused mainly on three areas: (1) cooperative responding during play, (2) non-verbal physical or close-proximity interactions, and (3) conversational skills. Training procedures varied but usually involved combinations of physical and verbal prompting, modeling, shaping, and social and edible reinforcement. These studies provide strong evidence that severely and profoundly retarded individuals can be taught useful interpersonal skills and can sometimes even assist the development of these skills in their peers. In general, the studies were methodologically sound in terms of basic design and interobserver reliabilities but weak with respect to maintenance and follow-up procedures. Only some studies tested for generalization of treatment effects and only a few specifically trained for such generalization.

Behavior Therapy↗
PubMed2005

Policies to increase influenza and pneumococcal immunizations in chronically ill and institutionalized settings.

BACKGROUND: The objective of this study was to understand better the status of and ways to improve dissemination of influenza and pneumococcal standing-order vaccination policies to at-risk adults in health care institutions. METHODS: A statewide sample of 5 different types of institutions serving at-risk elderly persons in North Carolina was surveyed. A 45-question telephone survey was administered to infection control nurses or facility directors at 267 (86% response rate) health care facilities involved in direct patient care. RESULTS: A majority of respondents reported that influenza (81%) and pneumococcal (59%) diseases were important to their facility, and 63% stated that the influenza vaccine was very effective versus 47% for pneumococcal. Except nursing homes, few facilities reported adoption of standing-order policies to vaccinate routinely the at-risk adults. Over 70% of respondents stated that their facilities might consider adopting standing-order policies for influenza and pneumococcal disease. A majority of respondents also supported a state law that requires such vaccines for high-risk patients unless contraindicated or the patient refuses. CONCLUSIONS: Respondents across diverse health care institutions appear interested in adopting standing-order policies to increase influenza and pneumococcal vaccination rates and are more likely to do so if provided with appropriate administrative and/or financial support for implementation.

Ambulatory Care Facilities↗
PubMed2005

Positive effects of aerobic physical activity in institutionalized older subjects complaining of dyspnea.

Dyspnea is a common complaint in older subjects, but in some patients a disease responsible for this symptom is not found. We aimed to evaluate the effects of a short program of regular aerobic physical activity on dyspnea and ability to walk in a sample of older nursing home residents without evidence of cardiac and pulmonary disease. Limitation from dyspnea in daily activities was reported by 82% of residents; 34% of these individuals did not show any evidence of cardiac or pulmonary disease. In these subjects a 4-week period of daily exercise training compared with no intervention resulted in a significant improvement of dyspnea and endurance to walking. Dyspnea is an extremely common complaint in elderly residents in long-term facilities. About one-third of these subjects do not show evidence of cardiac or pulmonary disease. In these individuals a short period of exercise training has favorable effects on dyspnea and ability to walk.

Aged↗
PubMed2004

Folate and cobalamin synergistically decrease the risk of high plasma homocysteine in a nonsupplemented elderly institutionalized population.

OBJECTIVE: Total plasma homocysteine (tHcy) has been associated with an increased risk of cardiovascular disease in the general population and elderly subjects are at high risk of elevated homocysteine because of an impaired vitamin status. The aim of the present study was to determine the independent and interactive association of adequate folate and cobalamin (intake and serum levels) with tHcy in elderly subjects who were not taking vitamin supplementation. DESIGN AND METHODS: Cross-sectional analysis of a sample of 140 elderly recruited from seven nursing homes in Asturias (Northern Spain). Dietary intake was assessed by a food frequency questionnaire, and serum folate, cobalamin, and tHcy were determined in fasting blood samples. RESULTS: Mean tHcy concentration was 13.3 micromol/L (upper quartile of tHcy >16.0 micromol/L) and was inversely correlated with serum folate. Subjects with an adequate intake or serum levels of both folate and B12 were at a reduced risk of being in the highest quartile of tHcy. In both cases, the reduction of high tHcy (upper quartile) risk was found to be greater than expected when subjects with high levels of both vitamins were considered together. CONCLUSIONS: Adequate folate and cobalamin (both intake and serum levels) act synergistically to decrease the risk of high total plasma homocysteine levels in this elderly population.

Aged↗
PubMedDate not supplied

Oral health protocol for the dependent institutionalized elderly.

Establishing an oral hygiene protocol for the frail and functionally dependent elderly should be of special concern to health care providers. The previous assessment of a care center, including patients or residents and staff, allows an effective strategy to be designed. Oral health protocols are mainly based on the daily removal of bacterial plaque from teeth or prostheses (or both), cleaning of oral mucosa, and continual oral hydration. These practices are facilitated by the use of electric toothbrushes and products such as chlorhexidine, fluoride toothpastes, and rinses or gels for dry mouth. This type of protocol should include regular collaboration with dental professionals and provide a program of continuous training for nursing staff on oral health issues.

Activities of Daily Living↗
PubMed2006

Institutionalizing effective pain management practices: practice change programs to improve the quality of pain management in small health care organizations.

The Resource Center of the American Alliance of Cancer Pain Initiatives provided templates, faculty, and ongoing consultation to assist seven state pain initiatives to implement programs to improve pain management practices. A total of 113 health care organizations participated. Each organization committed to support a team of two to three staff through a 10-month pain quality improvement process, which included a site visit, two educational conferences, pre- and postprogram analyses of the organizational structures in place to support pain assessment and management, quality improvement work plan development, and patient survey data collection. Postprogram results showed statistically significant increases in the presence of structural elements that are critical to effective pain management, as well as statistically significant, though modest, decreases in the percentage of patients who reported pain of any severity, and specifically moderate to severe pain, in the previous 24 hours. The largest changes occurred in long-term care facilities. Nevertheless, the percentage of patients in moderate to severe pain remained unacceptably high.

Delivery of Health Care↗
PubMed2005

Retrospective assessment of influenza vaccine effectiveness among the non-institutionalized elderly population in Japan.

To construct a framework for monitoring the effectiveness of influenza vaccine, we retrospectively surveyed elderly (> or = 65 years old) people living in rural areas of Kyoto prefecture, Japan, using a self-administered questionnaire, for their influenza-related symptoms during the peak influenza season of 2003-2004. A total of 2301 elderly individuals responded, of whom 1533 (66.6%) had been vaccinated. The odds ratio (OR) of vaccination for fever of > or = 38 degrees C, adjusted for sex, age and underlying conditions, was 0.77 (95% confidence interval (CI), 0.40-1.47), and the OR for a diagnosis of influenza in clinics was 0.81 (95% CI, 0.41-1.57). These findings suggested that the vaccine was 20% effective, although this effectiveness was not statistically significant.

Adult↗