María Claudia Carcelén Velarde
Full Text Available The study describes the future goals and concerns of institutionalized adolescents, and also identifies their attitudes towards the past, the present and the future, comparing them with a group of non-institutionalized adolescents with similar characteristics. It is a descriptive study with a transversal design, of 34 institutionalized and 41 non-institutionalized adolescents between 15 to 17 years old. The instruments were the Motivational Induction Method (MIM and the Time Attitude Scale (TAS (Nuttin, 1985. Goals are related to interpersonal contacts, the self-realization and the self. Institutionalized adolescents show more goals related to the development of aptitudes and a major necessity of interpersonal contacts associated with the fear of the damage caused by settling these relationships.
Lee, Dong Yul; And Others
The self-perception theory which predicts that the introduction of extrinsic rewards for behavior that was intrinsically rewarding may decrease overall motivation was tested on 44 mildly retarded institutionalized adolescents. (Author/CL)
Tainá Ribas Mélo
Full Text Available Abstract Aim: To assess motor abilities and functioning of institutionalized children and adolescents with cerebral palsy (CP within a contextual model of development. Methods: Eleven institutionalized Brazilian children and adolescents aged 2-19 (14 ± 5 years, 5 males and 6 females, were evaluated through the Gross Motor Function Measure (GMFM-88 and 66 and the Functional Independence Measure (FIM, and classified according to the ICF core set. Results: The evaluated individuals have severe impairments as indicated by their GMFM scores and confirmed by their need for full assistance in basic activities of daily living according to the FIM assessment. The difficulties manifested reflected on the ICF body functions and activities and participation domains. Conclusion: Most institutionalized children and adolescents with CP had GMFM-66 scores comparable to those indicated in literature. The ICF-based assessment identified environmental barriers that might be considered for improvement in order to facilitate activities and participation.
Mota, Catarina Pinheiro; Matos, Paula Mena
This study analyzes the contribution of peer attachment in predicting active coping and self-esteem in a sample of 109 institutionalized adolescents. It also explores the mediating role of social skills in the association between peer attachment, coping, and self-esteem. Structural equation modeling identified a model able to predict a positive…
War, Firdous Ahmad; Ved, Rifat Saroosh; Paul, Mohammad Altaf
The primary purpose of this paper was to compare the epidemiology of mental health problems and self-esteem of conflict hit adolescents living in charitable seminaries with their counterparts brought up in natural homes. Substantive body of the literature illustrates the emotional and behavioral issues experienced by these adolescents. In this study, 27 adolescents from a charitable Muslim seminary and 30 adolescents from a regular school were recruited. Self-report measures and clinical interview were used to measure mental health and self-esteem. The findings indicate that adolescents in institution setting may not be having mental health and self-esteem-related issues when compared to adolescents living in intact by parent homes. While the authors acknowledge the limitations of the study, these findings need further research to examine the causes for these differences.
Catarina Pinheiro Mota
Full Text Available O presente artigo procura problematizar as implicações da institucionalização de jovens em Portugal, dando relevância à qualidade das relações e laços afectivos na reorganização interna da esfera emocional. A vinculação é entendida enquanto processo contínuo, em que as relações com figuras afectivamente significativas permitem reestruturar bases seguras nos jovens. A institucionalização em casas de abrigo ou orfanatos é geradora de sentimentos de perda e abandono, podendo a integração ser ainda mais dificultada pela desconfiança e pelo medo do desconhecido. Sublinha-se o carácter transformador das relações afectivamente estáveis dentro e fora das instituições que poderão promover a adaptação psicossocial e a construção de representações mais favoráveis acerca de si e do mundo ao longo do ciclo vital.The present paper aims to discuss the implications of the adolescent's institutionalization in Portugal, giving relevance to the quality of affective relations and bonds for the internal reorganization of the emotional sphere. Attachment is understood as a continuous process, where the relationships with significant emotional figures allow reorganization of secure bases in adolescents and young adults. The institutionalization in shelter houses or orphanages generates feelings of loss and abandonment in the adolescents, and the process of integration is accompanied by mistrust and the fear of the unknown. An emphasis is put on the reconstructive character of stable affective relations developed with members of the institutions and outer contexts, promoting psychosocial adaptation and the construction of more favourable representations of self and the world along the life cycle.
Scheifes, Arlette; de Jong, Daniël; Stolker, Joost Jan; Nijman, Henk L I; Egberts, Toine C G; Heerdink, Eibert R
Psychotropic drugs are a cornerstone in the treatment of psychopathology and/or behavioral problems in children with intellectual disability (ID), despite concerns about efficacy and safety. Studies on the prevalence of psychotropic drug use have mainly been focused on adults with ID or children without ID. Therefore the aim of this cross sectional study was to assess the prevalence and characteristics of psychotropic drug use in children with mild ID who were institutionalized in specialized inpatient treatment facilities in The Netherlands. Demographic data, psychiatric diagnoses, the nature of the behavioral problems, level of intellectual functioning, and medication data were extracted from medical records using a standardized data collection form. Adjusted relative risks (ARR) for the association between patient characteristics and psychotropic drug use were estimated with Cox regression analysis. Of the 472 included children, 29.4% (n=139) used any psychotropic drug, of which 15.3% (n=72) used antipsychotics (mainly risperidone), and 14.8% (n=70) used psychostimulants (mainly methylphenidate). Age, sex, and behavioral problems were associated with psychotropic drug use. Boys had a 1.7 (95%CI 1.1-2.4) higher probability of using psychotropic drugs, compared to girls adjusted for age and behavioral problems. Having any behavioral problem was associated with psychotropic drug use with an ARR of 2.1 (95%CI 1.3-3.3), adjusted for sex and age. The high prevalence of psychotropic drug use in children with ID is worrisome because of the lack of evidence of effectiveness (especially for behavioral problems) at this young age, and the potential of adverse drug reactions. Copyright © 2013 Elsevier Ltd. All rights reserved.
Jacobsen, Brian Arly
Introduktion til Tidsskrift for Islamforskning temanummer Islam & institutioner Udgivelsesdato: 18-02......Introduktion til Tidsskrift for Islamforskning temanummer Islam & institutioner Udgivelsesdato: 18-02...
Kjeldsen, Anna Karina
of institutionalization when strategic communication is not yet visible as organizational practice, and how can such detections provide explanation for the later outcome of the process? (2) How can studies of strategic communication benefit from an institutional perspective? How can the virus metaphor generate a deeper...... understanding of the mechanisms that interact from the time an organization is exposed to a new organizational idea such as strategic communication until it surfaces in the form of symptoms such as mission and vision statements, communication manuals and communication positions? The first part of the article...... focuses on a discussion of the virus metaphor as an alternative to the widespread fashion metaphor for processes of institutionalization. The second part of the article provides empirical examples of the virus metaphor employed, examples that are drawn from a study of the institutionalization of strategic...
Perfil funcional de comunicação e desempenho sócio-cognitivo de adolescentes autistas institucionalizados Functional communicative profile and social-cognitive performance of institutionalized autistic adolescents
Danielle Azarias Defense
Full Text Available OBJETIVO: o objetivo dessa pesquisa foi descrever as características funcionais da comunicação de adolescentes autistas institucionalizados, ao longo de um período de aproximadamente seis meses, nos aspectos de: número de atos comunicativos por minuto, proporção de interpessoalidade da comunicação e proporção de utilização dos meios comunicativos gestual, vocal e verbal assim como descrever as características do desempenho sócio-cognitivo dos sujeitos ao longo desse período. MÉTODOS: foram sujeitos dessa pesquisa oito adolescentes autistas institucionalizados que foram avaliados durante seis meses quanto ao perfil funcional de comunicação e ao desempenho sócio-cognitivo. Os dados obtidos foram submetidos à análise estatística não paramétrica. RESULTADOS: foi observada evolução quanto ao número de atos comunicativos por minuto e à proporção de funções comunicativas interpessoais, mas não foi observada evolução significativa quanto aos aspectos sócio-cognitivos. CONCLUSÃO: foi possível observar evolução na linguagem em adolescentes autistas institucionalizados num período de tempo de seis meses, mas não foi possível identificar correlações com o desempenho sócio-cognitivo.PURPOSE: this study aims at describing the functional communication characteristics of institutionalized autistic adolescents for a period of six months approximately as for: number of communicative acts per minute, interpersonal proportion and means of proportion communication use (gestural, vocal, verbal as well as to describe the subjects' characteristics as for social cognitive performance in this period. METHODS: the subjects were eight institutionalized adolescents with autism. Their functional communicative profile and social-cognitive performance were assessed during a six-month period and resulting data were analyzed with non-parametric statistic methods. RESULTS: it was possible to observe that there was an improvement in
Normann, Leo; Agger Nielsen, Jeppe
of how it was legitimized as a “ready-to-use” management model. Further, our account reveals how cluster management translated into considerably different local variants as it travelled into specific organizations. However, these processes have not occurred sequentially with cluster management first...... legitimized at the field level, then spread, and finally translated into action in the adopting organizations. Instead, we observed entangled field and organizational-level processes. Accordingly, we argue that cluster management institutionalization is most readily understood by simultaneously investigating...
Fayolle, Alain; Landström, Hans; Gartner, Bill
In this article, we briefly identify three main challenges/issues that should be taken into consideration in the institutionalization of entrepreneurship research: (1) recognizing the complexity of the phenomenon under study; (2) producing interesting, relevant and useful research results for all...... stakeholders; and (3) developing a critical posture in research. Following the discussion of these challenges/issues we introduce the five contributions to the Special Issue that, in different ways, problematize and challenge mainstream research and approaches. These articles use ‘dissensus discourses’, apply...
-institutional theory points out, however, the considerable regulatory impact of ‘soft’ forms of institutionalization such as incentives structures, sedimented normative codes, logics of appropriateness and routinized practices. The article explores the role that soft forms of institutionalization might play...
Koch, Christian; Hansen, Hans Henrik; Stissing Jensen, Jens
, and they become dependent of national and other institutional foresights. Since 2000 the Danish ministry of Science, Technology and Innovation has tendered nine technology foresights. These could be used by SMEs as supplementary to internal decision making. One also expects to see these foresights placed firmly...... in the national strategy of coordinating and strengthening policy on research, technology and innovation in one superministry. The paper evaluates the methods, impact and role in policy making of these technological foresights. The particular role of institutionalized public foresight in relation to enterprise......Technology and knowledge monitoring is a continual challenge especially for small and medium size enterprises. Technological foresight seemingly offers important parts of this crucial monitoring. The SMEs rarely possess sufficient resources to do systematic foresights, or forecasts however...
Levin, April R; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A
To determine the risk of difficulties with social communication and restricted/repetitive behaviors as well as the rate of autism in children institutionalized in early infancy and to assess the impact of a foster care intervention on ameliorating this risk. Children abandoned at birth and raised in institutions in Bucharest, Romania were randomly assigned to a care-as-usual group (institutional care, CAUG), or placed in family-centered foster care (FCG) as part of the Bucharest Early Intervention Project (BEIP). At approximately 10 years of age, the Social Communication Questionnaire (SCQ) was administered to caregivers of children in both groups as well as to parents of a typically developing community sample (Never-Institutionalized group [NIG]) residing in Bucharest, Romania. Children scoring ≥12 on the SCQ underwent clinical evaluation for autism spectrum disorder (ASD). Caregivers of children with a history of institutionalization reported that these children had significantly more deviant behavior than never-institutionalized children on all subdomains of the SCQ (all p communication. Three of 60 CAUG children, 2 of 57 FCG children, and none of the NIG children received a formal ASD diagnosis. Early institutional rearing was associated with an increased risk of social communication difficulties and ASD. A family-centered foster care intervention improved social communication skills. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Meyer, Renate; Jancsary, Dennis; Höllerer, Markus A.
How do visualization and visual forms of communication influence the process of transforming a novel idea into established organizational practice? In this paper, we build theory with regard to the role of visuals in manifesting and giving form to an innovative idea as it proceeds through various...... stages of institutionalization. Ideas become institutionalized not merely through widespread diffusion in a cognitive-discursive form but eventually through their translation into concrete activities and transformation into specific patterns of organizational practice. We argue that visualization plays...... a pivotal and unique role in this process. Visualization bridges the ideational with the practical realm by providing representations of ideas, connecting them to existing knowledge, and illustrating the specific actions that instantiate them. Similar to verbal discourse, and often in tandem, visual...
Petrovski, Mihajlo; Minovska, Ana; Ivanovski, Kiro; Forna, Doriana Agop; Forna, Consuela Norna
Subjective presence of dry mouth is most common oral problem among the institutionalized elderly. To assess the subjective presence of xerostomia among institutionalized elderly. Total numbers of 70 subjects older than 65 years institutionalized in one nursing home were evaluated. The subjective presence of xerstomia was determinated. To determine the level of expressiveness of xerostomia is used questionnaire recommended by Carda et al. 62.8% from the subjects believed that they ...
. Basel-komiteen har endnu ikke udformet konkrete krav til systemisk vigtige finansielle institutioner, men rammerne for de samlede regulative Basel III-kapitalkrav er i dag så langt fremme, at de schweiziske myndigheders forslag til kapitalkrav for systemiske institutioner i det følgende sammenlignes med...... Basel III....
Boligstandarden i plejehjem og institutioner for handicappede diskuteres meget for tiden. Denne rapport er den første landsdækkende undersøgelse af boligstandarden i plejehjem, beskyttede boliger og institutioner for voksne med handicap. Den indeholder blandt andet oplysninger om, hvor store være...
Full Text Available Aim: The aim of this study was to assess and compare images and stereotypes of aging in institutionalized and non-institutionalized elderly people. This is a descriptive study using a survey. Method: The instruments used were a sociodemographic questionnaire and the ImAges scale. A total of 120 elderly people, aged between 65 and 99 years, participated in this study. Results: Statistically significant differences were found, for the scale’s three factors, between institutionalized and non-institutionalized older adults. In the factor “dependence, sadness and old-fashioned”, the institutionalized participants presented a higher number of negative images and stereotypes (M = 51.8; DP = 6.01 than the non-institutionalized participants (M = 49.0; DP = 7.85, these differences were significant (t(118 = -2.16; p < 0.05. In the “maturity, activity and affectivity” factor, there were also significant differences (t(118 = 2.04; p < 0.05, the non-institutionalized participants present higher rates of positive images and stereotypes (M = 20.2; DP = 3.28, when compared to institutionalized participants (M = 19.0; DP = 3.310. Conclusion: The results suggested that institutionalized older adults presented more negative aging images than non-institutionalized.
Agger Nielsen, Jeppe; Mathiassen, Lars; Newell, Sue
Although institutional theory has become a more dominant perspective in information systems research, studies have only paid scant attention to how field dynamics and organizational processes coevolve during information technology institutionalization. Against this backdrop, we present a new...
Denise L. Fleck
Full Text Available Institutionalization processes have an ambivalent effect on organizational long-term success. Even though they foster organizational stability and permanence, they also bring about rigidity and resistance to change. As a result, successful organizations are likely to lose their competitive advantage over time. The paper addresses this issue through the investigation of the institutionalization processes of two long-lived companies: General Electric, a firm that has been a long-term success and its rival, Westinghouse, which was broken up after eleven decades of existence. The longitudinal, multilevel analysis of firms and industry has identified two different modes of organizational institutionalization. The reactive mode gives rise to rigidity and change resistance, much like institutional theory predicts; the proactive mode, on the other hand, neutralizes those negative effects of institutionalization processes. In the reactive mode, structure predominates. In the proactive mode, agency plays a major role in organizational institutionalization, and in managing the organization’s relations with the environment, clearly contributing to environmental institutionalization.
Yamada, Yukari; Siersma, Volkert; Avlund, Kirsten
The effect of home help services has been inconsistent. Raising the hypothesis that receiving small amounts of home help may postpone or prevent institutionalization, the aim of the present study is to analyze how light and heavy use of home help services was related to the risk...... for institutionalization. The study was a secondary analysis of a Danish intervention study on preventive home visits in 34 municipalities from 1999 to 2003, including 2642 home-dwelling older people who were nondisabled and did not receive public home help services at baseline in 1999 and who lived at home 18 months...... after baseline. Cox regression analysis showed that those who received home help services during the first 18 months after baseline were at higher risk of being institutionalized during the subsequent three years than those who did not receive such services. However, receiving home help for less than 1h...
Full Text Available The article aims to provide some ethical orientation on how sustainability might be actualized by institutions. Since institutionalization is about rules and organization, it presupposes ideas and concepts by which institutions can be substantiated. After outlining terminology, the article deals with underlying ethical and conceptual problems which are highly relevant for any suggestions concerning institutionalization. These problems are: (a the ethical scope of the sustainability perspective (natural capital, poverty, sentient animals, (b the theory of justice on which ideas about sustainability are built (capability approach, Rawlsianism, and (c the favored concept of sustainability (weak, intermediate, and strong sustainability. These problems are analyzed in turn. As a result, a Rawlsian concept of rule-based strong sustainability is proposed. The specific problems of institutionalization are addressed by applying Rawls’s concept of branches. The article concludes with arguments in favor of three transnational duties which hold for states that have adopted Rawlsian strong sustainability.
Objectives: The objective of the study was to determine the oral health status and diet habits of institutionalized elders in Lagos, Nigeria Materials and Methods: This cross-sectional study was conducted among institutionalized elders in Lagos State, Nigeria. Age and sex matched non-institutionalized elderly were also ...
Lewis, Gerald R.; And Others
This study of the primary restraining and driving forces that influence Title VII bilingual education programs found the external environment, the local community, to be the main factor influencing institutionalization and self-renewal. The internal environment--the local school, and the local school's organization or central office, school board,…
Navarro, Jose I.; Menacho, Inmaculada; Alcalde, Concepcion; Marchena, Esperanza; Ruiz, Gonzalo; Aguilar, Manuel
The efficiency of different cognitive training procedures in elderly people was studied. Two types of methods to train cognitive and memory functions were compared. One method was based on new technologies and the other one on pencil-and-paper activities. Thirty-six elderly institutionalized people aged 68-94 were trained. Quantitative and memory…
Popoola, Ifeoluwa; Garner, Bart; Ammeter, Anthony; Krey, Nina; Beu Ammeter, Danielle; Schafer, Stuart
Extant research on academic cheating primarily focuses on the impact of honor codes on academic cheating. However, the influence of ethics institutionalization is curiously missing in past research. The authors developed and validated a structural equations model in the R programming language to examine the impact of formal (explicit) and informal…
Lívia Maria Santiago
Full Text Available OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals.
Haack, Patrick; Schoeneborn, Dennis
by drawing on the prominent management practice of corporate responsibility. Our paper contributes to the development of a general theory of decoupling and institutionalization by examining the boundary conditions under which organizations adopt ceremonially or implement substantively a policy. We discuss...
Leiva-Saldaña, Antonio; Sánchez-Ramos, José Luis; León-Jariego, José Carlos; Palacios-Gómez, Leopoldo
Describe the factors which can be associated with cognitive impairment in institutionalized and non-institutionalized elderly. Cross-sectional study of 200 people aged over 64 in Huelva (Spain) in 2014. Of these, 100 people were institutionalized in a residential facility and 100 were not. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE-35), basic activities of daily living by Barthel index, general health through the Goldberg GHQ-28 and social, clinical and behavioural variables were contemplated in the study. The association of cognitive impairment with all the variables was analysed using Chi-square test. Finally, a multivariate analysis was performed using logistic regression to identify possible joint influence of variables to study on the cognitive impairment. The prevalence of cognitive impairment in those institutionalized was 47%, higher than that of non-institutionalized group which was only 8% (p<.001). The dependence for basic activities for daily living and learning activities were the only variables in both groups which were associated with the cognitive impairment. Institutionalization (OR=5.368), age (OR=1.066) and dependence for basic activities (OR=5.036) were negatively associated with CI, while learning activities (OR=.227) were associated in a positive way. Conducting learning activities and the promotion of personal autonomy can delay cognitive impairment in older people. It is important to include cognitive stimulation programs aimed at the old population, especially in residential institutions. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Silimperi, Diana R; Franco, Lynne Miller; Veldhuyzen van Zanten, Tisna; MacAulay, Catherine
To develop a framework to support the institutionalization of quality assurance (QA). The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.
Agoguè, Marine; Boxenbaum, Eva
innovation. An important question facing innovation research is thus how actors can generate ideas that break with the field frame in highly institutionalized fields? To answer this question, we draw on insights into dual process modeling from cognitive sciences. Dual process modeling emphasizes...... the different nature of the conscious (deliberate) and subconscious (implicit) systems involved in ideation. We further elaborate on how these two systems relate to four streams of research that management scholars evoke to model microprocesses of generating new ideas, namely metaphors, conceptual blending......The early phase of innovation processes in highly institutionalized fields relies on the capabilities of actors to generate new ideas that break with the field frame. Informed by a dominant logic, a field frame shapes collective cognition and can thus prevent the generation of new ideas and block...
Alfonso Lopez Lira Arjona
Full Text Available The informal sector has been growing throughout the last century in emerging economies. Particularly in Latin America, both a long-term instability in economic and political environments, and a continuous migration from rural to urban areas; have triggered the appearance of unregulated businesses and employments. Small and Medium-sized Enterprises (SMEs operate informally in one or more business processes, in order to reduce costs and maximize profits. Leaving aside tax evasion and illegal labor, such SMEs often have low technology and an unskilled work force; which threatens its survival in highly competitive environments. The purpose of this paper is to highlight the impact of the Multi National Corporation (MNC and the Academia in the formalization of SMEs. This is aimed through a collaborative model for the institutionalization of operational and managerial knowledge within SMEs. Qualitative results indicate that improvements are triggered by a self-conscious awareness of the value derived from institutionalizing best business practices.
Anastácio, Zélia; Bezerra, Milena Oliveira; Zamith-Cruz, Judite; Antão, Celeste; Veiga-Branco, Augusta
Several reasons like unfavorable socio-economic conditions, negligence and maltreatment has led to institutionalization of adolescents. Our research question is: What are the level of satisfaction and socioemotional competencies of adolescents living in host institutions? Research aimed to characterize satisfaction, self-esteem, assertiveness and resilience of institutionalized adolescents and to establish associations with personal factors. It was a transversal study following a predominantl...
Suzuki, Hanako; Tomoda, Akemi
Background Although exposure to early life stress is known to affect mental health, the underlying mechanisms of its impacts on depressive symptoms among institutionalized children and adolescents have been little studied. Methods To investigate the role of attachment and self-esteem in association with adverse childhood experiences (ACEs) and depressive symptoms, 342 children (149 boys, 193 girls; age range 9-18 years old, mean age?=?13.5???2.4) living in residential foster care facilities i...
Wernet, Stephen P.; Singleton, Judy L.
This study addresses factors associated with sustainability and institutionalization of change in the 67 Geriatric Enrichment in Social Work Education (GeroRich) projects, and the ways innovations introduced became institutionalized at the respective colleges and universities. An unobtrusive qualitative-descriptive research design was used to…
Mesquita, Alice Ferreira; Silva, Emanuelle Cruz da; Eickemberg, Michaela; Roriz, Anna Karla Carneiro; Barreto-Medeiros, Jairza Maria; Ramos, Lílian Barbosa
The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.
Ebberts, Blaine D. [Portland District, U.S. Army Corps of Engineers, 333 SW 1st Avenue, Portland OR 97204 U.S.A.; Zelinsky, Ben D. [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Karnezis, Jason P. [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Studebaker, Cynthia A. [Portland District, U.S. Army Corps of Engineers, 333 SW 1st Avenue, Portland OR 97204 U.S.A.; Lopez-Johnston, Siena [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Creason, Anne M. [Fish and Wildlife Division, Bonneville Power Administration, 905 NE 11th Avenue, Portland OR 97208 U.S.A.; Krasnow, Lynne [Columbia Hydropower Branch, National Marine Fisheries Service, 1201 NE Lloyd Boulevard Suite 1100, Portland OR 97232 U.S.A.; Johnson, Gary E. [Pacific Northwest National Laboratory, 620 SW 5th Avenue, Suite 810, Portland OR 97204 U.S.A.; Thom, Ronald M. [Pacific Northwest National Laboratory, Marine Science Laboratory, 1286 Washington Harbor Road, Sequim WA 98382 U.S.A.
We successfully implemented and institutionalized an adaptive management (AM) process for the Columbia Estuary Ecosystem Restoration Program, which is a large-scale restoration program focused on improving ecosystem conditions in the 234-km lower Columbia River and estuary. For our purpose, “institutionalized” means the AM process and restoration program are embedded in the work flow of the implementing agencies and affected parties. While plans outlining frameworks, processes, or approaches to AM of ecosystem restoration programs are commonplace, establishment for the long term is not. This paper presents the basic AM framework and explains how AM was implemented and institutionalized. Starting with a common goal, we pursued included a well-understood governance and decision-making structure, routine coordination and communication activities, data and information sharing, commitment from partners and upper agency management to the AM process, and meaningful cooperation among program managers and partners. The overall approach and steps to implement and institutionalize AM for ecosystem restoration explained here are applicable to situations where it has been less than successful or, as in our case, the restoration program is just getting started.
Clara Fróes de Oliveira Sanfelice
Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.
Redfering, David L.
The current study is a one-year follow-up of an earlier report that group counseling with institutionalized delinquent females resulted in significant gains in the connotative meanings of several concepts. (Author)
from the mouth and gingiva of 138 institutionalized mentally retarded patients of Sari to culture in specific media to ... Key words: Oral and gingival microbial flora, Mental retardation, D%, Sari ... staphylococcus aureus and, in case of negative.
Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes
ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (sho...
Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges Junior, Noé Gomes
ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups ...
Kim, Jae-Min; Shin, Il-Seon; Jeong, Seong-Joo; Gormley, Niall; Yoon, Jin-Sang
Many studies have sought to determine the predictors of institutionalization of patients with dementia. Such studies, performed in developed western societies, have come to various conclusions which may not be supported in an East Asian culture such as that found in Korea. This study aimed to determine the factors that predict institutionalization of patients in Korea diagnosed with dementia. Seventy-nine cases (37 institutionalized, 42 community-dwelling) in the Kwangju area were evaluated for patient characteristics, severity of dementia symptoms, caregiver characteristics, burden and distress. Logistic regression was performed to determine predictors of actual institutionalization. Six predictors of institutionalization were identified. Of these, three were patient-related factors: higher score on the Clinical Dementia Rating, higher score on the Brief Psychiatric Rating Scale, and shorter duration of dementia. The other three were caregiver-related factors: younger age, higher education (formal schooling), and higher cost of home care. As seen in previous western studies, institutionalization of dementia sufferers was influenced by both patient and caregiver factors. But, the specific predictors and their relative influences might be explained best by the particular social, cultural and economic situation in Korea. This study was the first of its kind in Korea and, as such, could serve as a reference for future intra-cultural and cross-cultural comparisons. Copyright 2002 John Wiley & Sons, Ltd.
Morgan, James B.; Kovacic, Donald N.; Whitaker, J. Michael
Safeguards for nuclear facilities can be significantly improved by developing and implementing methodologies for integrating proliferation resistance into the design of new facilities. This paper proposes a method to systematically analyze a facility's processes, systems, equipment, structures and management controls to ensure that all relevant proliferation scenarios that could potentially result in unacceptable consequences have been identified, evaluated and mitigated. This approach could be institutionalized into a country's regulatory structure similar to the way facilities are licensed to operate safely and are monitored through inspections and incident reporting to ensure compliance with domestic and international safeguards. Furthermore, taking credit for existing systems and equipment that have been analyzed and approved to assure a facility's reliable and safe operations will reduce the overall cost of implementing intrinsic and extrinsic proliferation-resistant features. The ultimate goal is to integrate safety, reliability, security and safeguards operations into the design of new facilities to effectively and efficiently prevent diversion, theft and misuse of nuclear material and sensitive technologies at both the facility and state level. To facilitate this approach at the facility level, this paper discusses an integrated proliferation resistance analysis (IPRA) process. If effectively implemented, this integrated approach will also facilitate the application of International Atomic Energy Agency (IAEA) safeguards
The patterns of fears of institutionalized mentally retarded adults were studied in a sample of i2 moderately retarded men and women between the ages of 21-49. The direct questioning method was employed. Two interviews were held, two weeks apart; the first interview elicited the Ss' fears, while the second concerned the fears of their friends. A total of 146 responses were obtained, and these were categorized according to the types of fears: supernatural-natural events, animals, physical injury, psychological stress, egocentric responses, and no fears. The Ss displayed a higher percentage of fears in the preoperational stage than in the concrete operational stage. In a comparison of male to female fears, only one category, that of fears of animals, reached significance. The study suggested that the same developmental trend of fears that appears in normal children appears in the retarded as well, and these fears follow Piaget's level of cognitive development, proceeding from egocentric perceptions of causality to realistic cause and effect thinking.
van Delft, Ivanka; Finkenauer, Catrin; Verbruggen, Janna
This study aimed to examine the effects of child maltreatment subtypes (physical abuse, sexual abuse, neglect, and exposure to domestic violence) and cumulative child maltreatment on depressive symptoms in adulthood, and examine the protective effects of social connectedness in a sample of formerly institutionalized females. The sample consisted of 124 females who were institutionalized in a Dutch juvenile justice institution during adolescence and were followed-up when they were on average 32 years old. Information about child maltreatment was extracted from treatment files. Retrospective data on social connectedness in young adulthood were established during interviews using a Life History Calendar. Relationship quality at follow-up was assessed with items derived from the Rochester Youth Development Study. The Center for Epidemiological Studies Scale for Depression (CES-D) was used to measure depressive symptoms in adulthood. Results showed that 85.5% of the females experienced child maltreatment, and co-occurrence of subtypes was high. Cumulative child maltreatment increased the risk of depression in adulthood. Furthermore, social connectedness, that is, more employment over time and the quality of the romantic relationship at follow-up, protected against the development of depression. However, social connectedness did not buffer the effect of maltreatment on depression. Our findings indicate that treatment of these girls should focus on improving the social-emotional development to promote positive interpersonal relationships and include educational and vocational components to guide these girls toward increased opportunities on the labor market. © The Author(s) 2015.
Meléndez-Moral, Juan Carlos; Charco-Ruiz, Laura; Mayordomo-Rodríguez, Teresa; Sales-Galán, Alicia
Institutionalization during old age requires tremendous adaptability. Among the main consequences of the difficulty of adapting to the institutional context are prevalent depressive symptoms and low well-being. Reminiscence therapy has proven to be among the most effective at minimizing these outcomes. This study purpose was to investigate the usefulness of reminiscence intervention in an elderly, institutionalized sample. Following a group format, the intervention lasted eight sessions and compared a treatment group and a control group, using pre-post measures and a single-blind design. We predicted that reminiscence intervention would have a positive impact on depressive symptoms, self-esteem, life satisfaction, and psychological well-being. Significant results were obtained, including a drop in depressive symptoms and improved self-esteem, satisfaction, and psychological well-being. We conclude that reminiscence intervention yielded positive effects in institutionalized, elderly participants.
Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes
To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test.
Rasmussen, Grane Mikael Gregaard; Gottlieb, Stefan Christoffer
, the chapter accounts for the data collection methods used to conduct the empirical data collection and the appertaining choices that are made, based on the account for analyzing institutionalization processes. The analysis unfolds over seven chapters, starting with an exposition of the political foundation...... and disseminated to the construction industry. The fourth chapter demonstrates how benchmarking was concretized into a benchmarking system and articulated to address several political focus areas for the construction industry. BEC accordingly became a political arena where many local perspectives and strategic...... emerged as actors expressed diverse political interests in the institutionalization of benchmarking. The political struggles accounted for in chapter five constituted a powerful political pressure and called for transformations of the institutionalization in order for benchmarking to attain institutional...
McLaughlin, Katie A; Zeanah, Charles H; Fox, Nathan A; Nelson, Charles A
Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17, p = .006). The intervention had no effect on internalizing disorders in boys (OR = 0.47, p = .150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR = 12.5, p security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization. © 2011 The Authors
Haahr, Lars; Svejvig, Per
of the first stages of institutionalization as well as it points to critical issues related to the progression of this process. The paper adds to the emerging literature on social media by an industry level longitudinal study of how organizational use of social media can be understood as a process......Although social media research has accelerated dramatically in the last few years, few studies have addressed organizational use of social media as a process of institutionalization at industry level and over a longer time period. Against this backdrop, we present the findings from an industry...
Cassandra Moseley; Susan Charnley
This paper examines micro-processes of institutionalization, using the case of stewardship contracting within the US Forest Service. Our basic premise is that, until a new policy becomes an everyday practice among local actors, it will not become institutionalized at the macro-scale. We find that micro-processes of institutionalization are driven by a mixture of large-...
Institutionalizing Gender and Women's Rights and Citizenship at Cheikh Anta Diop ... The results will provide an information base for other teaching and research ... aux problèmes auxquels l'Inde est confrontée, comme le stress thermique, ...
Jacy Aurelia Vieira de Sousa
Full Text Available Objective: to identify the factors associated with the risk of falls in institutionalized elderly. Methods: analytical study carried out in two long-stay institutions for the elderly, with 61 residents of both sexes. Data collection was performed by means of a socio-demographic and clinical form and Downton’s Fall Risk Index. Results: 31 (50.8% old people at high risk of falling were identified. There was an association of risk for falls in institutionalized elderly with gender (p=0.007, age (p=0.004, time of institutionalization (p=0.028, adverse events (p=0.000, use (p=0.035 and number of drugs (p=0.038, use of auxiliary equipment (p=0.022, type of walking (p=0.044 and history of falls in the last 12 months (p=0.000 Conclusion: it is recognized as essential to identify factors associated with the occurrence of falls for the prioritization of specific interventions aimed at institutionalized elderly.
Jacy Aurelia Vieira de Sousa
Full Text Available Objective: to identify the factors associated with the risk of falls in institutionalized elderly. Methods: analytical study carried out in two long-stay institutions for the elderly, with 61 residents of both sexes. Data collection was performed by means of a socio-demographic and clinical form and Downton’s Fall Risk Index. Results: 31 (50.8% old people at high risk of falling were identified. There was an association of risk for falls in institutionalized elderly with gender (p=0.007, age (p=0.004, time of institutionalization (p=0.028, adverse events (p=0.000, use (p=0.035 and number of drugs (p=0.038, use of auxiliary equipment (p=0.022, type of walking (p=0.044 and history of falls in the last 12 months (p=0.000. Conclusion: it is recognized as essential to identify factors associated with the occurrence of falls for the prioritization of specific interventions aimed at institutionalized elderly.
Gaugler, Joseph E.; Pot, Anne Margriet; Zarit, Steven H.
Purpose: Longitudinal research in dementia has acknowledged the importance of transitions during the course of family caregiving. However, long-term adaptation to institutionalization has received little attention. This study attempts to describe caregivers' adaptation (changes in stress, well-being, and psychosocial resources) to placement up to…
Nasution, Muhamad Faisal Fariduddin Attar
This study focuses on the institutionalization of information security in the banking sector. This study is important to pursue since it explicates the internalization of information security governance and practices and how such internalization develops an organizational resistance towards security breach. The study argues that information…
Tietgenskolen i Odense dannede den 24. oktober 2008 rammen om den workshop Nye Institutioner afholdt som led i udviklingen af en kommunikationsstrategi. Dagens tema var: Tidens udfordringer–nye roller og relationer for bibliotek og uddannelse, og formålet var at kaste lys over følgende spørgsmål...
Cai, Yuzhuo; Zhang, Han; Pinheiro, Rómulo
There is a lack of in-depth studies on how technology transfer organizations (TTOs) are organized and developed. This paper examines the evolution/institutionalization of TTOs in Tsinghua University (TU), as a microcosm of the development of TTOs in Chinese universities. It explores two issues in particular: what kinds of TTOs have been developed…
Novotná, Gabriela; Dobbins, Maureen; Henderson, Joanna
The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs.
As a result, Ethiopia is not gifted with workable, modernized and institutionalized commercial arbitration. It stands to the rear of commercial arbitration which is underpinned in diverse legal systems, used widely by many participants and acknowledged as relevant dispute resolution, particularly on commercial matters in ...
de Guzman, Allan B.; Satuito, James Cyril B.; Satumba, Miko Anne E.; Segui, Diego Rey A.; Serquina, Faith Evelyn C.; Serrano, Lawrence Jan P.; Sevilla, Madelyn D.
The use of traditional art in recreational therapies is unexplored. This paper, thus, attempts to surface the unique power of traditional Filipino arts (TFA) as synergizing lens in capturing the individual and the collective experiences of a select group of Filipino elderly in an institutionalized care setting relative to their feelings of…
Goldman, Jeri J.
Two case reports are presented of institutionalized women who were diagnosed as having Prader-Willi syndrome at the ages of 54 and 69. Implications are discussed for management of such persons and for program planning/funding for a much longer life expectancy than earlier realized. (Author/JDD)
Meyer, Renate; Jancsary, Dennis; Boxenbaum, Eva
How does visual communication contribute to the emergence and consolidation of new institutions? Previous research on institutionalization has primarily focused on verbal text and neglected its interaction with visual forms of communication. We propose that a more thorough and systematic engagement...... of unique affordances (i.e., particular opportunities for meaning construction) of visual communication. First, we argue that the visual mode has certain ‘constitutive features’ that enable affordances different from those of verbal text. Second, we systematically discuss a set of affordances of visual...... communication and how it may extend, speed up, or strengthen the effect of verbal communication. Essentially, we argue that visual communication plays a crucial role in shaping the trajectory of institutionalization....
Full Text Available This study emphasizes the connection between the sites of memory and thenational identity, having as main objective to highlight the institutionalization ofthe cultural memory. Two main sites of memory are analysed: the archive and thelibrary, as representative for the cultural memory.The ideological and politicalinfluences are also revealed. The final part of this paper points out new challengesin the global digital age.
Compte Nunes, Guillem
[EN] In order to advance toward an understanding of the mechanisms of social transformation, overcoming the rhetoric about the importance of children’s participation and the marginalization of the knowledge on children’s issues, this paper identifies facilitating factors for and barriers against the institutionalization of children’s participation in a public child protective service. The results are interpreted through the 4I model of organizational learning. They highlight th...
Ulrich, Frank; Mengiste, Shegaw Anagaw; Müller, Sune Dueholm
in existing institutionalized technologies within the organization and that emerging technologies introduce neoteric ideas to the organization. Furthermore, we argue that when attempting to introduce technology-based ideas, human actors will focus their attention on ideas embedded in existing...... theories of creativity, Scandinavian institutionalism, and empirical data from two Danish organizations, this article investigates the interplay between creativity, technology, and human sensemaking in the process of translating and transforming technology ideas into full-fledged technological innovations....
E A Yakimova
Full Text Available The article dwells upon the process of formation and work peculiarities of the key structures of the Azerbaijani-Israeli cooperation. The author pinpoints achievements in the institutionalization of economic contacts, the main of which is the creation of a bilateral chamber of commerce. However the interaction potential is not fully exploited due to the absence of the Azerbaijani embassy in Israel.
Araújo Neto, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da
ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova ...
Slunge, Daniel, E-mail: email@example.com [Department of Economics, University of Gothenburg, Box 640, S-405 30 Gothenburg (Sweden); Tran, Trang Thi Huyen, E-mail: firstname.lastname@example.org [University of Gothenburg, Box 640, S-405 30 Gothenburg (Sweden)
Building on new institutional theory, this paper develops an analytical framework for analyzing constraints to the institutionalization of strategic environmental assessment (SEA) at four different institutional levels. The framework is tested in an empirical analysis of the environmental assessment system in Vietnam, which is a frontrunner among developing countries regarding the introduction and use of SEA. Building on interviews with Vietnamese and international experts, as well as an extensive literature review, we identify institutional constraints which challenge the effective use of SEA in Vietnam. We conclude that commonly identified constraints, such as inadequate training, technical guidelines, baseline data and financial resources, are strongly linked to constraints at higher institutional levels, such as incentives to not share information between ministries and severe restrictions on access to information and public participation. Without a thorough understanding of these institutional constraints, there is a risk that attempts to improve the use of SEA are misdirected. Thus, a careful institutional analysis should guide efforts to introduce and improve the use of SEA in Vietnam and other developing countries. The analytical framework for analyzing constraints to institutionalization of SEA presented in this paper represents a systematic effort in this direction. - Highlights: • A framework for analyzing constraints to institutionalizing SEA is developed • Empirical analysis of the strategic environmental assessment system in Vietnam • Constraints in the action arena linked to deeper institutional constraints • Institutional analysis needed prior to introducing SEA in developing countries.
Slunge, Daniel; Tran, Trang Thi Huyen
Building on new institutional theory, this paper develops an analytical framework for analyzing constraints to the institutionalization of strategic environmental assessment (SEA) at four different institutional levels. The framework is tested in an empirical analysis of the environmental assessment system in Vietnam, which is a frontrunner among developing countries regarding the introduction and use of SEA. Building on interviews with Vietnamese and international experts, as well as an extensive literature review, we identify institutional constraints which challenge the effective use of SEA in Vietnam. We conclude that commonly identified constraints, such as inadequate training, technical guidelines, baseline data and financial resources, are strongly linked to constraints at higher institutional levels, such as incentives to not share information between ministries and severe restrictions on access to information and public participation. Without a thorough understanding of these institutional constraints, there is a risk that attempts to improve the use of SEA are misdirected. Thus, a careful institutional analysis should guide efforts to introduce and improve the use of SEA in Vietnam and other developing countries. The analytical framework for analyzing constraints to institutionalization of SEA presented in this paper represents a systematic effort in this direction. - Highlights: • A framework for analyzing constraints to institutionalizing SEA is developed • Empirical analysis of the strategic environmental assessment system in Vietnam • Constraints in the action arena linked to deeper institutional constraints • Institutional analysis needed prior to introducing SEA in developing countries
Suzuki, Hanako; Tomoda, Akemi
Although exposure to early life stress is known to affect mental health, the underlying mechanisms of its impacts on depressive symptoms among institutionalized children and adolescents have been little studied. To investigate the role of attachment and self-esteem in association with adverse childhood experiences (ACEs) and depressive symptoms, 342 children (149 boys, 193 girls; age range 9-18 years old, mean age = 13.5 ± 2.4) living in residential foster care facilities in Japan completed questionnaires related to internal working models, self-esteem, and depressive symptoms. Their care workers completed questionnaires on ACEs. Structural equation modeling (SEM) was created and the goodness of fit was examined (CMIN = 129.223, df = 1.360, GFI = .959, AGFI = .936, CFI = .939, RMSEA = .033). Maltreatment negatively predicted scores on secure attachment, but positively predicted scores on avoidant and ambivalent attachment. The secure attachment score negatively predicted depressive symptoms. The ambivalent attachment score positively predicted depressive symptoms both directly and through self-esteem, whereas the avoidant attachment score positively predicted depressive symptoms only directly. Maltreatment neither directly predicts self-esteem nor depressive symptoms, and parental illness/death and parental sociopathic behaviors did not predict any variables. Results show that the adversity of child maltreatment affects depression through attachment styles and low self-esteem among institutionalized children. Implications of child maltreatment and recommendations for child welfare services and clinical interventions for institutionalized children are discussed.
Petrovski, Mihajlo; Minovska, Ana; Ivanovski, Kiro
Introduction: The presence of subjective feelings of dry mouth is the most common oral problem in the institutionalized elderly. Purpose: to assess the subjective presence of xerostomia in the institutionalized elderly. Materials and method: Seventy individuals, older than 65 years and institutionalized in a particular nursing home, were evaluated. The subjective presence of xerstomia was determined. To determine the level of expressiveness of xerostomia, a questionnaire recommended b...
King-Sears, Margaret E.
This article provides guidelines for knowing when to institutionalize peer-mediated instruction and interventions (PMII), and generalization techniques familiar to special educators are linked specifically to institutionalization of PMII. Barriers and promoters of sustained PMII in schools are identified, with implications for how stakeholders…
Herrmann, Nathan; Eryavec, Goran
Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Castillo-Riquelme, Marianela; Santelices C, Emilio
The Chilean health system has not been completely oblivious to health technology assessment (HTA). In fact, significant advances in the areas of health prioritization using criteria of disease burden, effectiveness and cost-effectiveness among others, can be acknowledged. The introduction of the reform of Explicit Health Guarantees (GES) has been an important milestone in this arena, allowing the consideration of other dimensions such as social preferences in health. However, the application of HTA encompasses the entire health system and in that sense the institutionalization of a process properly defined and extensively validated in our country, is imminent. This paper discusses the foundations on which progress must be made in institutionalizing HTA, starting from the architecture of our health care system and in light of the economic and social reality. We review some background information first, and then discuss some important considerations in our context, including information on the institutional and legal framework. It concludes with the authors' view on some key elements to consider in HTA in Chile, which does not necessarily represent the vision of the Ministry of Health.
Full Text Available In the present study it is intended to characterize the history of falls and to evaluate the fear to fall in aged institutionalized. The sample is composed for 113 institutionalized aged people, 32 men and 81 women with a average 82,96 ± 7,03 age of years. The data had been collected by means of a questionnaire and statistical analyzed (descriptive statistics, parametric tests - Test T and Anova - Test U-Mann Whitney, and Test of Kruskal-Wallis – and the Test of Tukey. The results point in the direction of that the women present a bigger number of falls (24.8% and greater fear to fall (Med=55. The falls had occurred in its majority in the context of the room of the institutions. It was verified that people who had at least a fall experience present greater fear to fall comparatively (Med=55 with that they had not the same had no incident of fall in period of time (Med=77. Our results come to strengthen the hypothesis of the changeable sex to be able to be considered a factor of fall risk. Aged that they present a history of falls seems to be more vulnerable to develop the fear to fall.
Full Text Available The objective is to determine the risk factorspredictors of falls in institutionalized elderlypeople. Methodology: Analysis of data from alongitudinal cohort study. Subjects: Institutionalizedelderly volunteers residents of a nursinghome in Arbelaez, Colombia enrolled andfollowed for six months (N= 116; mean age: 78years. Main outcome measures: Falls detected via nurses reports and medical records. Independentvariables: Baseline measures of demographics,medical history, drug intake, depression, mentalstate, visual acuity, orthostatic hypotension,body mass index, cardiovascular state, limbdeformities, limb strength, tone, trophism, rageof motion, Romberg, one leg balance test, GetUp and Go test and timed Get Up and Go test.Evaluation of home facilities by the TESS-NHand SCUEQS scales. Results: Over the six monthfollow-up 36% experienced a fall. All noneinjurious falls. The independent significantpredictors of all falls using logistic regression were female gender, history of dizziness and anabnormal one leg balance test. With coefficientB values of 1.029, 2.024 and 1.712, respectively.Conclusion: The female gender, the history ofdizziness and abnormal one-leg balance testappear to be the main and significant predictorsof falls in institutionalized elderly persons.However, no single factor seems to be accurateenough to be relied on as a sole predictor of fallrisk because so many diverse factors are involvedin falling
Justine, Maria; Hamid, Tengku Aizan
This study examined the effects of a multicomponent exercise program on depression and quality of life in institutionalized older adults. A quasi-experimental pretest-posttest design was used. Participants were recruited from a publicly funded shelter home in Seremban, Negeri Sembilan Malaysia. The experimental group consisted of 23 volunteers 60 or older who performed 60 minutes of supervised exercise three times per week for 12 weeks. The control group consisted of 20 volunteers who continued with a sedentary lifestyle. At 12 weeks, the exercise group demonstrated an improvement in quality of life by 10.74% (p > 0.05) but not depression (-1.6%, p > 0.05). The control group demonstrated a decrease in both quality of life by 11.26% (p > 0.05) and level of depression by 17.7% (p > 0.05). This study suggests a multicomponent exercise program is a feasible intervention to improve quality of life in institutionalized older adults. Copyright 2010, SLACK Incorporated.
Elena P. Kostenko
Full Text Available This article touches upon the imperatives of forming HR- management practice in modern Russia. On the basis of the institutional theory and works by D. Nort, R. Scott, R. Coase, G. Buchanan, O. Williamson, P. Tolbert, and L. Zucker, we distinguished three main stages of introduction foreign HR- management models and technologies into the managing of local companies: Preinstitutional stage, characterized by the limited number of companies using this instrument; halfinstitutional stage when all the implanted approaches of HR-management become normative; complete institutionalization when this or that HR- management instrument is standard and legitimate. On the basis of research, conducted in 39 companies in SFD, the article gives the characteristics of HR-management instruments and technologies in terms of their institutionalization. In the article also showed the barriers which prevent fast and effective introduction of foreign management technologies into the HR-management practice in Russia. We pointed out some key instruments of Russian HR-management model and brought out possible directions in transformation of HR-management practice in our country.
Emanuelle Cruz da Silva
Full Text Available As a common problem in long-term care facilities (LTCFs, anemia affects 25-63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%, as normocytic and normochromic anemia, with no anisocytosis (69.75%. Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04-2.72 and with moderate (PR: 1.98; 95% CI: 1.07-3.63 and total (PR: 2.61; 95% CI: 1.34-5.07 dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00-3.77. The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence.
Full Text Available Institutionalization is a dynamic process which is developed as a result of enterprise sensitivity to the environmental transformation and consists of its efforts to conformity to this transformation. Institutional entrepreneurship, however, is the process of building a different constitution inside the enterprise to induce entrepreneurial spirit and to lead the association into transformation and modernism. These two notions can be seen as the activities that will achieve the permanency and the efficiency of family businesses which have a big interest in world economics. In this study, the components of the institutionalization are; social responsibility and professionalization, institutional entrepreneurship components are aimed to be measured on the basis of the risk and proactivity and the modernism in the family businesses which are sampling units. In this study, the deduced survey hypothesis are tested using the statistical analysis data, and the contribution of the study to the association is discussed in the light of derived findings and evaluations, also a set of suggestions which can enlighten the way for next studies are developed and how the business world will profit from this study is emphasized.
Zanaboni, Paolo; Lettieri, Emanuele
During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements--rationality, fairness, and efficiency--that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications--benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators' perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.
Nathan Eric Dickman
Full Text Available For my invited contribution to this special issue of Religions on “Feminisms and the Study of ‘Religions,’” I focus on philosophy of religion and contestations over its relevance to the academic field of Religious Studies. I amplify some feminist philosophers’ voices—especially Pamela Sue Anderson—in corroboration with recent calls from Religious Studies scholars to diversify philosophy of religions in the direction of locating it properly within the current state of Religious Studies. I want to do this by thinking through two proposals in productive tension: first, any philosophy of religions worthy of the name is intrinsically feminist; second, any philosophy of religions worthy of the name is intrinsically traditional. I want to use the productive tension between these two to illuminate ways calls for broadening the field can be enhanced when such calls are seen as both feminist and traditional. I proceed as follows. First, I note three instances of explicitly feminist work in philosophy of religions that do not suffer from the same narrowness as so-called “traditional” philosophy of religion. Religious Studies critics of philosophy of religion overstate the case in claiming feminist philosophy of religion is too narrow. Second, I develop a useful distinction between the concepts of “tradition” and “institution” to locate forces of oppression more precisely in dynamics of institutionalization so that we might rehabilitate tradition as a resource for combating institutionalized oppressiveness. I do this in response to the hegemony of current philosophers of religion who claim to speak about “the traditional god.” And third, I briefly coordinate four topics in religions from diverse feminist perspectives to help refine paths of inquiry for future philosophy of religions that is both feminist and traditional. My hope is that these clarify a philosophy of religions renewed through feminisms—moving from fringe to
Full Text Available In the aim of the study is to determine the institutionalization degree of organized industrial estates and to identify the faced problems and to develop solutions for these problems. By using survey method, information about problems and institutionalization status of organized industrial estates were obtained from managers of the active organized industrial estates. The problems of organized industrial estates are related to the management structure, qualified staff, energy, transportation, regulation and public improvements. Formalization, professionalism, accountability, transparency and social responsibility have been identified as the factors about the institutionalization of organized industrial estates in Turkey according to factor analysis. It could be argued that organized industrial estates in Turkey have an institutional structure and they have institutionalized. However, it could be said that organized industrial estates which operate in 80 cities of Turkey and more than one are in some cities are not at the same level of institutionalization.
Carla P. Lozano
Full Text Available Chile is experiencing a process of demographic aging with an increase in the number of elderly people, a percentage of which resides in Long-term Establishments for the Elderly (LEE. However, there is little information on the reality of the elderly in these long-term care facilities, so this study was conducted to compare the epidemiological profile of the prevalent oral pathologies as well as chronic non-communicable diseases (NCDs, of institutionalized versus noninstitutionalized elderly subjects. Seventy-six institutionalized and forty-three non-institutionalized subjects were examined intraorally, and their clinical health record, gender and age were obtained, according inclusion/exclusion criteria. The results indicate that female gender is the most common, with an average age of 78.5 year, with those 80 years old and above comprising the predominant group. The most prevalent oral lesions within the institutionalized group were denture stomatitis and irritative hyperplasia, while in the noninstitutionalized these two lesions were found less frequently. As for the presence of xerostomia, there was no difference between the groups. The most common condition in both groups was total maxillary and mandibular edentulous, with the latter variable present more frequently in the institutionalized group (p0.05, and depression was the most prevalent NCD in the non-institutionalized group (p<0.05. This study provides valuable information on the epidemiology of elderly´s oral lesions and NCDs to inform the decision-making process of public health policies.
Moulson, Margaret C.; Westerlund, Alissa; Fox, Nathan A.; Zeanah, Charles H.; Nelson, Charles A.
Data are reported from 3 groups of children residing in Bucharest, Romania. Face recognition in currently institutionalized, previously institutionalized, and never-institutionalized children was assessed at 3 time points: preintervention (n = 121), 30 months of age (n = 99), and 42 months of age (n = 77). Children watched photographs of caregiver…
Rafael Damasceno de Barros
Full Text Available ABSTRACT OBJETIVE To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services 2015, a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3; there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1; there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0; those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5; there is computerized system for pharmaceutical services management, OR
Korkmaz, Emine Vasfiye; Çetinkaya, Ali Şükrü
ABSTRACTIncreasing competition and globalization make obligatory businesses to go towarddifferentiation. In competitive environment, that businesses institutionalize and make efforts of the different product and service toward customers enables them to proceed one step further than their competitors. It is considered that expecting the behavior of emotional labor, defined as emotional expression exhibited together with service from the employees,whose institutional...
Full Text Available With this article attempts a comparison of the Greek Constitution of 1975, the constitutions of Germany, USA, Switzerland, Austria, France, UK and Italy on the issue of property relations and general interest, in order to highlight those notified differences relating to these communities and resulted in specific social situations. While the constitutions of the other countries, which are among the most representative democracies of the Western world, are characterized by an increased institutionalization of sociability, the Greek constitution on the issue of general interest takes an antisocial and, at best, neutral attitude. The convergence of the Greek constitution on this issue with the other constitutions is considered a prerequisite for overcoming the crisis and, more generally, for social development. This little effort hopes to contribute to a more social future formulation of the Greek constitution and a corresponding behaviour of Greek society.
Hirnsperger, Hans; Mundschütz, Reinhard; Sonneck, Gernot
Beginning with Freudian psychoanalysis and the Zürich school of psychiatry, which in the early 20th century were the first to call for studies in medical psychology at universities, the article traces the path to the institutionalization of medical psychology in Austria especially in Vienna. Particular attention is devoted to the Academic Society for Medical Psychology (Akademischer Verein für Medizinische Psychologie) which held lectures and courses at the University of Vienna from 1926 to 1938. The Society can thus be viewed as a predecessor of the foundation of the institutes for medical psychology and psychotherapeutic clinics, starting in the late 1960s and continuing into the early 1980s.
Andersen, Lotte Bøgh; Heinesen, Eskil; Pedersen, Lene Holm
theory and the sociology of professions. Empirically, we ask whether different measures of individual performance produce different results. The investigated performance measures vary with regard to risk of common data source bias, standardization of assessment criteria, and external verification...... dimension for the same teachers: the teachers' self-reported contributions to students' academic skills, the students' marks for the year's work given by the teacher, marks in oral exams with one external examiner and the teacher, and marks in written exams with at least one external examiner....... The associations are systematically stronger when the performance measure comes from the same data source as the explanatory variables, but when separate data sources are used and the measurement scale is institutionalized, the level of external verification does not matter much. Based on institutional theory...
Chaves, Caroline Magna Pessoa; Lima, Francisca Elisângela Teixeira; Mendonça, Larissa Bento de Araújo; Custódio, Ires Lopes; Matias, Erica Oliveira
The study aimed to evaluate the growth and development of institutionalized children from 0-6 years old. It had a descriptive, transversal and quantitative approach, and was held in a shelter from the Bureau of Labor and Social Development of the Government of the State of Ceará, in the months of March and April 2011. The sample comprised 44 children. It the sample prevailed male children (59.1%), aged 24 to 72 months (56.8%) and with time of sheltering more than one year (72.7%). It was found that the children were in the normal range of nutrition; however, 65.9% of children did not achieve at least one of the development milestones proposed by the Ministry of Health. The study suggests a reflection on how children living in shelters are being assisted by the health team, making it necessary follow up their growth and development, in order to intervene on the alterations.
Roberta Grangeiro de Oliveira
Full Text Available Objective: To describe the experience of participation in workshops on health education for institutionalized elderly women. Data Synthesis: Actions of health education were performed through the development of educational workshops on lifestyle for 20 elderly women in a philanthropic institution of a municipality, during the month of October 2011. The workshops were divided into three meetings over 2 days. Empathic communication and interaction among the participants were sought through dynamics, aiming to motivate them to talk about the feelings aroused by figures. The healthy lifestyle was then approached, with explanation on diet and physical activity. Conclusion: The implementation of educational measures is effective for the health promotion, the development of critical thinking and the reduction of risk behaviors doi:http://dx.doi.org/10.5020/18061230.2013.p595
Broom, Alex; Broom, Jennifer; Kirby, Emma; Scambler, Graham
We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints. We argue that nurses occupy an essential and conscious position as brokers within the hospital; a subject position that is not neutral, facilitates (short-term) cohesion, and involves the pursuit of particular (preferred) nursing outcomes. Illustrating how authority can be diffuse, mediated by institutionalized praxis, and how professionals evade attempts to govern their practice, we challenge the reification of physician prescribing power, arguing that it may work against the utilization of nurses as important stakeholders in the future of antibiotics.
Full Text Available Abstract Background Senior veterans living in government sponsored, long-term care (LTC facilities, known as veterans' homes (VHs, are a special minority group in Taiwan. These seniors came from different provinces of mainland China during their teenage years at the end of civil wars in 1945. The situation of institutionalized senior veterans shares many characteristics with the concept of "total institution". Very little quality of life (QOL research has involved senior veterans. This study aimed to explore the QOL and related factors of VH-dwelling senior veterans in Taiwan. Methods Chronic conditions and socio-demographic characteristics of 260 male VH residents were recorded. The Brief Form of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF, Taiwanese version; Short-Form 36; Inventory of Socially Supportive Behavior questionnaire; Geriatric Depression Scale-short form; Barthel Index; and instrumental activities of daily living were used. Data analyses including descriptive and inferred statistics were performed using SPSS, version 17. Results WHOQOL-BREF showed acceptable reliability in this study. Compared to Taiwanese male norms, WHOQOL-BREF physical, psychological, and social relationship domain scores were around the 25th percentile, and the environment domain was about the 75th percentile. Our participants scored low in all concepts of SF-36. Although these residents rated the social support of their children, relatives, friends, social and medical staff as low, they gave high satisfaction ratings to their social supports. On multiple stepwise linear regression analysis, depressive symptoms, number of chronic conditions, retired military rank, and relatives' support correlated with QOL in both the physical and psychological domains. Friends' support and depressive symptoms correlated with the social relationships domain. Friends' support and instrumental activities of daily living correlated with the
de Oliveira, Simone Camargo; dos Santos, Ariene Angelini; Pavarini, Sofia Cristina Iost
The present study aimed to investigate the relationship between family functioning and depressive symptoms among institutionalized elderly. This is a descriptive, cross-sectional study of quantitative character. A total of 107 institutionalized elderly were assessed using a sociodemographic questionnaire, the Geriatric Depression Scale (to track depressive symptoms) and the Family APGAR (to assess family functioning). The correlation coefficient of Pearson's, the chi-square test and the crude and adjusted logistic regression were used in the data analysis with a significance level of 5 %. The institutionalized elderly with depressive symptoms were predominantly women and in the age group of 80 years and older. Regarding family functioning, most elderly had high family dysfunctioning (57 %). Family dysfunctioning was higher among the elderly with depressive symptoms. There was a significant correlation between family functioning and depressive symptoms. The conclusion is that institutionalized elderly with dysfunctional families are more likely to have depressive symptoms.
Reitz, Andrew L.
Three formerly institutionalized adults increased their rate of appropriate food serving when cash reinforcement was made contingent on their meeting specified daily criteria. Instructions and self-monitoring and praise had little or no effect on the men's diets. (CL)
Simone Camargo de Oliveira
Full Text Available The present study aimed to investigate the relationship between family functioning and depressive symptoms among institutionalized elderly. This is a descriptive, cross-sectional study of quantitative character. A total of 107 institutionalized elderly were assessed using a sociodemographic questionnaire, the Geriatric Depression Scale (to track depressive symptoms and the Family APGAR (to assess family functioning. The correlation coefficient of Pearson’s, the chi-square test and the crude and adjusted logistic regression were used in the data analysis with a significance level of 5 %. The institutionalized elderly with depressive symptoms were predominantly women and in the age group of 80 years and older. Regarding family functioning, most elderly had high family dysfunctioning (57 %. Family dysfunctioning was higher among the elderly with depressive symptoms. There was a significant correlation between family functioning and depressive symptoms. The conclusion is that institutionalized elderly with dysfunctional families are more likely to have depressive symptoms.
Magalhães, Carlos Pires; Rebelo, Flávia Marisa Ramalho; Anes, Eugénia
Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. This study aims to assess the quality of life of institutionalized elderly undergoing to an active aging program. ...
Magalhães, Carlos; Anes, Eugénia; Rebelo, Flávia
Introduction: Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. Objective: To evaluate the quality of life (QOL) of institutionalized elderly undergoing to an ac...
Kim, M. G.; Hong, S. Y.; Seo, M. R. [Korea Electric Power Research Institute, Taejon (Korea, Republic of)
In this study, for the institutionalization of risk informed and performance based regulation in Korea, the latest technical movements of overseas countries are examined and reviewed. And the issues that was found when license change petition using risk information was submitted in Korean regulatory body are reviewed. Based on these review, the applicable areas to domestic situation will be found and proposed. This study can contribute to setting up the proper direction for the institutionalization of risk informed and performance based regulation.
The main aim of this thesis is to analyze the process of institutionalization and neo-/interdisciplinarization in Women’s/Gender/Feminist Studies (WGFS) in Sweden, and the construction of feminist knowledge within this process. Furthermore, the thesis aims to contribute to the feminist debates on academic feminism as a transformative project. Three questions have guided the research process: 1) How has feminist knowledge been organized and institutionalized into the academy? 2) What are the e...
Hardeman, Rachel R; Murphy, Katy A; Karbeah, J'Mag; Kozhimannil, Katy Backes
Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being.
Caracterização da saúde mental em crianças e adolescentes em acolhimento institucional = Mental health characterization in institutionalized children and adolescents = Caracterización de la salud mental en niños y adolescentes institucionalizados
Full Text Available Este estudo teve como objetivo identificar as experiências de vida traumáticas e a prevalência de problemas de comportamento em crianças e adolescentes em situação de acolhimento institucional. O grupo investigado foi constituído por 41 crianças e adolescentes de ambos os sexos, com idade de 7 a 18 anos, provenientes de cinco casas de acolhimento localizadas na região norte do estado do Rio Grande do Sul. Para a obtenção dos dados, utilizaram-se os instrumentos: Inventário de Eventos Estressores na Infância e Adolescência (IEEIA, Inventário de Depressão Infantil (CDI, e o Child Behavior Checklist (CBCL. Os dados apontaram para a presença de problemas de comportamento em um número significativo de crianças e adolescentes, tendo em vista suas histórias de vida marcadas por eventos traumáticos. Considerando esses dados, destaca-se a importância de instituir políticas públicas que contemplem as necessidades de crianças e adolescentes institucionalizados, a fim de que seus direitos sejam garantidos
O. Ye. Konovalov
Full Text Available The increasing recently interest towards the art house cinema stipulates the relevance in the field of sociological investigations of the cinema proper as a social institution and directly the art cinema, as this area most brightly covers those pressing problems and cardinal social changes that occur nowadays. The article deals with the analysis of the film festival as a structural element when researching the art house cinema as a social institution. At the same time, carrying out the function of the mass media and social institution, the art house cinema represents a great interest for studying in the field of sociology. Acting as mass media, art cinema can originally influence its audience, forming specific models of behavior, social aims, and sometimes political views of its audience. A new judgment of factors of social institutionalization of art cinema is offered for consideration, one of which is the film festival. Basic research on the basis of modern scientific works of foreign researches of the cinema is conducted. This subject offers judgment of processes concerning social interaction in the framework of film festival acting as establishment for performing the function of mass media and a social institution on behalf of the art house cinema.
Full Text Available The task of the paper is to point out the importance of applying regulations of legislative documents in order to achieve an appropriate level of ethical behaviour of participants in tourism. The paper also points up to the existence of the Global Code of Ethics for Tourism UNWTO. It is a basic mechanism which directs an appropriate ethical conduct of all stakeholders in tourism and requires concretization in Serbia as well. The special importance of the work is related to basic principles of ethical codes of conduction of the association of travel agencies in Great Britain (ABTA, Slovenia (ZTAS and Bosnia and Herzegovina (UTA BiH. That kind of document still does not exist in Serbia, nor does indicate its establishment and use. Furthermore, the lack of research works focused to the issue in Serbia requires a discussion about the importance of institutionalizing business ethics in tourism. In order to address a research problem, researchers have applied different methods in each particular phase of the research process. Method used for data collection is desk research. This phase provided data from available references, while data processing was accomplished by description, examination as well as comparison.
Bos, Karen; Zeanah, Charles H.; Fox, Nathan A.; Drury, Stacy S.; McLaughlin, Katie A.; Nelson, Charles A.
Children raised in institutions, considered an extreme example of social deprivation, are one group through which we can better understand the impact of neglect on child health and development. The Bucharest Early Intervention Project (BEIP) is the first randomized, controlled trial of foster care as an intervention for institutionalized children. In this review we describe the mental health outcomes from the BEIP. Specifically, we report findings on attachment styles, attachment disorders, emotional reactivity, and psychiatric symptomatology for children in the BEIP. We describe the impact of the foster care intervention on these outcomes and also describe how outcomes differ by gender and by length of time spent in the institution. In addition, we explore the influence of genetic variation on individual outcomes and recovery from early severe social deprivation, as well as the role of differences in brain development in mediating later psychiatric morbidity. The results from the BEIP confirm and extend the previous findings on the negative sequelae of early institutional care on mental health. The results also underscore the benefit of early family placement for children living in institutions. PMID:21250893
Merz, Emily C.; McCall, Robert B.; Wright, Amanda J.; Luna, Beatriz
Inhibitory control and working memory were examined in post-institutionalized (PI) children adopted into United States families from Russian institutions. The PI sample originated from institutions that were less severely depriving than those represented in previous studies and approximated the level of psychosocial deprivation, which is characterized by adequate physical resources but a lack of consistent and responsive caregiving. PI children (N=75; 29 male) ranged in age from 8–17 years (M=12.97; SD=3.03) and were grouped according to whether they were adopted after 14 months or before 9 months. A non-adopted comparison group (N=133; 65 male) ranged in age from 8–17 years (M=12.26; SD=2.75). PI children adopted after 14 months of age displayed poorer performance on the stop-signal and spatial span tasks relative to PI children adopted before 9 months of age after controlling for age at assessment. The two PI groups did not differ in their performance on a spatial self-ordered search task. Older-adopted PI children also showed poorer spatial span task performance compared to non-adopted children, but younger-adopted PI children did not. Task performance was significantly associated with parent-rated hyperactive-impulsive behavior in everyday contexts. These findings suggest that exposure to prolonged early institutional deprivation may be linked with inhibitory control and working memory difficulties years after adoption. PMID:23519375
Antonio Herculano de Araújo Neto
Full Text Available ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey, Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0. Results: A total of 66.7% (30 falls occurred, 20% (9 of them in the external area, with 66.7% (30 of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5. The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05. Conclusion: It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls.
Alcides Viana de Lima Neto
Full Text Available Background: The population aging in Brazil is characterized by the accumulation of progressive disabilities in their functional activities and daily life. To consider the elderlies in his/her multiple dimensions turns out to be a critical issue to improve their assistance to an institutionalized level, improving their health and quality of life. To perform a mini-overall evaluation of institutionalized elderly person to trace their profile in relation to the socio-demographic, functional capacity, nutritional status and cognition. Methods: descriptive, cross-sectional study of quantitative approach conducted in facilities for the aged people in Natal, RN. Results: 63.3% of the elderly were female, with ages varying from 61 to 103 years. 60.0% were single; 56.7% were literate. 66.7% had no children and 55% lived with their families before the institutionalization. As for the institutionalization time, 63.3% resided in the institution for four years. As what concerns the aspects of health, 73.3 of the elderly presented hearing difficulties, 90% make use of medicines predominantly to diabetes and hypertension. There is clear evidence that the institutionalization has been harmful to the elderly as with regards basic activities of daily living, nutritional status and cognitive aspects. Conclusion: the progressive disability in functional activities of daily life interferes directly in the quality of life, increasing dependency and minimizing the autonomy of these individuals. It is necessary to effective implementation of public policies directed to the institutionalized elderly from the perspective of effective actions for improved attention and assistance. Descriptors: Aged, Institutionalization, Aging, Facilities for the Aged.
Gisélia Santana Souza
Full Text Available ABSTRACT OBJECTIVE To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines, a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%, partial (35.0%-69.0%, and advanced (70.0%-100%, estimated based on the interviewees’ answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05. RESULTS Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the “organization, structure, and financing” dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. CONCLUSION The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional
Lin, Jyy-I; Wang, Jing-Jy; Chiu, Hui-Ju; Lee, Chiung-Ying; Cheng, Su-Fen
The World Health Organization has predicted that arthritis will rise to become the fourth ranked global disability among the elderly. Arthritis is already a main cause of chronic pain, depression, and institutionalization in this group. Chronic pain resulting from arthritis is a serious threat to the elderly population. Study purposes were to: (1) explore chronic pain in elderly residents with arthritis residing at long-term care facilities and to understand the relationship between associated chronic pain and associated factors, and (2) identify the predictive factors of chronic pain. This study used a cross-sectional, descriptive correlational research design. A sample of 114 elderly residents, 65 years of age and older, were recruited from five long-term care facilities in Kaohsiung and Pingtung, Taiwan. Findings showed that the average pain intensity resulting from chronic arthritis during the three months of study was medium (4.51 ± 1.75). There were positive relationships amongst average pain intensity, previous pain intensity, self-perception of arthritis severity and depression status. Negative correlations were found amongst age, self-perception of arthritis severity, number of chronic illnesses experienced, function of daily activity and social support. Previous pain intensity, self-perception of arthritis severity, number of chronic illnesses experienced, function of daily activity and depression status were all found to predict chronic pain. Together, these factors explained 40.4% of total variance. Study results provide information for nurses to consider the physical, psychological, and social aspects of chronic pain when caring for the elderly. Healthcare providers should design individualized health care interventions for elderly people to promote their quality of life.
Full Text Available The genre of the mass song is one of the fundamental phenomena in aesthetics and practice of socialist realism. Mass songs are supposed not only to be accessible to the lay audience, but also to be composed in a way that invites the participation of amateurs. Importantly, the institutions which have been disseminating the mass song under state socialism, such as various institutions of education, culture and art, have also served as mechanisms for the normalization of its ideological content. This article summarizes important aspects of the concept of the mass song in general and offers a multifaceted exemplification, before proceeding to discuss the history of mass songs in socialist Yugoslavia (including, by and large, what is usually referred to as partisan songs, with emphasis on the institutional framework through which they were practiced and disseminated, and on specificities that the genre had accrued within the Yugoslav framework. This historical framework of practicing mass songs in Yugoslavia provides a platform for opening the question of intrinsic incompatibility between the project of a classless society and the institution of art. In regards to this, article discusses contemporary practice of Yugoslav mass songs as practiced by self-organized choirs and their new political potential. Article received: May 6, 2017; Article accepted: May 14, 2017; Published online: September 15, 2017 Original scholarly paper How to cite this article: Atanasovski, Srđan. "Socialism or Art: Yugoslav Mass Song and Its Institutionalizations." AM Journal of Art and Media Studies 13 (2017: 31-42. doi: 10.25038/am.v0i13.185
Marina Ferraz Neves Oliveira
Full Text Available Dependence on drugs is a complex disease, incurable and that its use persists in the face of extremely negative consequences. Objective: was to evaluate the prevalence and severity of caries in users of legal drugs. Methods:It is an epidemiological, cross-sectional, descriptive study, held with adults, users of legal and illegal drugs, institutionalized in rehabilitation centers of municipalities in the southwestern region of the state of Bahia. We used a form with sociodemographic questions about the use of licit and illicit drugs. To assess tooth decay, we used the decayed, missing and filled teeth index (DMFT, and the dental units were assessed with a World Health Organization (WHO Model probe and a dental mirror. Data were tabulated and analyzed in Excel. Results: 73 individuals were evaluated, aged between 18 and 64, mean age 35.5 (SD ± 10.7. It was found that 71.4% are single, 73,7% with low level of education, 74.6% do not use dental floss. Caries prevalence was 98.6%, DMF-T average 15.6. In 18-34 years old individuals, the DMF-T average was 12.1 and from 35 to 64 years old it was 19.8. Regarding dentition, 52.6% of the teeth were affected by the disease. Among the affected teeth, 39.9% were decayed, 44.1% lost and 16% filled. Conclusion: We conclude that there is a high prevalence of caries in this population. Among the dental needs, the restoration of the dental element has to be highlighted.
Souza, Gisélia Santana; Costa, Ediná Alves; Barros, Rafael Damasceno de; Pereira, Marcelo Tavares; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Álvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair
To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees' answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of pautonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services' finalistic activities.
Pinzón-Pulido, Sandra; Garrido Peña, Francisco; Reyes Alcázar, Víctor; Lima-Rodríguez, Joaquín Salvador; Raposo Triano, María Fernanda; Martínez Domene, Manuel; Alonso Trujillo, Federico
Identifying preferences regarding type of care and risk factors for institutionalization of elderly persons in dependency situations in Andalusia. The data on 200,039 persons registered in the System for Autonomy and Dependency Care over the period 2007-2012 were analysed. The study population was described in terms of: age, dependency situation, preferences, support network and clinical factors at the time of inclusion in the study. Separate analysis was made for men and women. A logistic regression model was designed to determine the risk factors for institutionalization for each sex. 87,4% of women and 85,9% of men expressed their wish to receive care in their own home. The risk of institutionalization is three times higher among men than among women. Among women, the risks of institutionalization are: level of dependency, wishing to move into a residential care home, medium consistency and fragility of support network and being diagnosed with dementia. Among men, the risks are: wishing to move into a residential care home and low or medium consistency of support network. Care in the home is the preferred alternative for elderly persons in dependency situations. The risk of institutionalization is conditioned more by the preferences of the person and their family and the characteristics of the support network than by individual's clinical condition. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Putri, Prathiwi Widyatmi; Moulaert, Frank
the city as a multi-scalar socio-ecological system in which different forms of human–water relations and their institutionalization are found. Particular attention is given to informality in this system and how it interacts with ‘regular’ state and corporate market sector practices. Within...... these interactive dynamics, informality is not only understood as a survival strategy but also as a creative practice connecting various social-ecological opportunities, traditional and contemporary technologies and modes of institutionalization to each other. Ongoing institutionalization processes in the formal...... and informal economy, as well as between them, are analysed. Opportunities to integrate and regularize the diverse water sanitation services into community-led closed water–wastewater cycles capable of ensuring public health and sustaining a bio-hydrological balance at the local level are explored....
Sinha, Preeti; Yohannan, Sherin; Thirumoorthy, A; Sivakumar, Palanimuthu Thangaraju
Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn't affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.
Full Text Available Background: Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse. Methods: We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization. Results: In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles. Conclusion: Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care.
Araújo, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias Dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da
To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey), Chi-square, Mann Whitney. Statistically significance was p falls occurred, 20% (9) of them in the external area, with 66.7% (30) of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5). The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p risks of falls. Analisar a ocorrência de quedas em idosos institucionalizados quanto aos riscos, consequências e antecedentes. Estudo transversal, realizado com 45 idosos em Instituições de Longa Permanência para Idosos em João Pessoa/PB, Brasil, em junho e julho de 2016. Aplicou-se questionário sociodemográfico e Escala de Equilíbrio de Berg classificando risco de quedas quando escore inferior a 45. Realizou-se estatística descritiva e testes: t independente, Anova (Tukey), Qui-quadrado, Mann Whitney. Considerado significativamente estatístico p < 0,05 e processados no SPSS versão 19.0. As quedas ocorreram em 66,7% (30), sendo 20% (9) na área externa, 66,7% (30) com doença prévia hipertensão e como consequência destacou-se fratura com 11,2% (5). A Escala de Berg avaliou pontuações diferentes (p < 0,05) quando comparadas às quedas sofridas pelos idosos, e as doenças prévias influenciaram ocorrência de quedas (p < 0,05). Necessita-se implementar políticas públicas de financiamento ou parcerias que possibilitem adaptação dos ambientes visando a redução dos riscos de quedas.
Erugina, M V; Krom, I L
Since XX century, health care is a first-rate social institution. The analysis of tendencies of functioning of institution of health care in modern Russia is presented by the article in methodological plane of the system of social structural functions (AGIL) proposed by T. Parsons. The patient is the main participant of medical organizational process. The activity of other participants of process of organization of medical care is to be focused primarily on satisfaction of needs of patient during medical care rendering. The society implements training of subjects for executing their professional roles that determines professionalization of executed functions. The most important purpose of modern training programs in medical education is determined by leading level of cognition, forecasting and achievement of socially significant aftermaths of future during structuring of educational process. In the context of integrative function the coordination of activities of participants of interaction is implemented. In conditions of actual tendencies of market economy the interaction of participants of the process of medical care rendering and the process of quality control of medical care is developed on the basis of implementation of standards of medical care. In Russia, the institutionalization of health care presupposes cooperation and interaction of subjects of system differing by degree and amount of collaborative work. The latent function (maintenance of value pattern) determines regularity, predictability, stability of functioning of social relationships. The social control supports expedient behavior of participants of process of medical care rendering. The dysfunctional practices of modern Russian health care are considered in the context of concept of effective interaction of participants of medical organizational process targeted to maintenance of rights of patients for accessible and qualitative medical care. As a result of applied analysis, the problems were
Wilcox, Lyndy J; Weber, Brittany C; Cunningham, Tina D; Baldassari, Cristina M
(1) To identify tracheostomy complications in institutionalized children with chronic tracheostomy. (2) To determine factors that predispose to development of tracheostomy complications in institutionalized children with chronic tracheostomy. Case series with chart review over 10 years. Tertiary children's hospital. Children were included if they underwent tracheostomy before 21 years of age and resided at a pediatric nursing facility. Most children were ventilator dependent and had severe comorbid medical conditions, including developmental delay and cerebral palsy. The number of tracheostomy complications and unplanned hospital admissions were recorded. Interventions for tracheostomy complications were also reviewed. Thirty-two institutionalized children with chronic tracheostomy were included. The mean age at time of tracheostomy was 5.4 years, with a mean duration of institutionalization of 9.1 years. Twenty-seven children (84%) experienced tracheostomy complications. The total number of complications was 79. The most common tracheostomy complications identified were peristomal granulation (n = 13) and suprastomal granulation (n = 12). Age at time of tracheostomy, duration of institutionalization, and ventilator dependence did not predict the likelihood of developing a complication. Of 32 patients, 20 were evaluated in the emergency room during the study, and there were 48 unplanned admissions for tracheostomy-related complications during the study. Forty-five urgent direct laryngoscopy and bronchoscopy procedures were performed in a total of 20 children with tracheostomy complications. Tracheostomy complications are common in institutionalized children with chronic tracheostomy and are challenging to manage. Further research is necessary to determine novel ways to reduce tracheostomy complications in this population. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.
Paul J. Anderson
Full Text Available Background . Many nations routinely include health impact assessments (HIA in public policy decisions. Institutionalization of HIA formally integrates health considerations into a governmental decision-making process. We describe an example of institutionalization in the United States through Alaska's early experience with institutionalization of HIA. Literature review . HIA arose from a series of health conferences in the 1970s that affirmed the importance of “health for all.” A number of key milestones eventually defined HIA as a unique field of impact assessment. There are several approaches to institutionalization, and one common approach in the United States is through the National Environmental Policy Act (NEPA. NEPA formed the basis for the earliest HIAs in Alaska. Program description . Early HIAs in Alaska led to conferences, working groups, a state guidance document and the institutionalization of a HIA program within the Department of Health and Social Services in 2010. A medical epidemiologist staffs the program, which utilizes contractors to meet rising demand for HIA. The HIA program has sustainable funding from the state budget and from the state's natural resource permitting process. The HIA document is the main deliverable, but the program performs other tasks, including fieldwork and technical reviews. The HIA program works closely with a host of collaborative partners. Conclusion . Alaska's institutionalized HIA program benefits from sustainable funding that promotes continuous quality improvement and involves the program in the entire life cycle of a development project. The program structure adapts well to variations in workflow and supports a host of quality control activities. Currently, the program focuses on HIAs for natural resource development projects.
Chen, Yigean; Cheng, Jaonan
Chinese society is accustomed to using feelings, reasons, and institutionalizations to determine how to deal with events, which raises a number of questions. How can the directors of early education institutions incorporate feelings, reasons, and institutionalizations into their management? How can they enhance the job performance of teachers?…
Cuban, Sondra; Anderson, Jeffrey B.
We attempt to answer "where" the social justice is in service-learning by probing "what" it is, "how" it looks in the process of being institutionalized at a Jesuit university, and "why" it is important. We develop themes about institutionalizing service-learning from a social justice perspective. Our themes were developed through an analysis of…
Stanton-Nichols, Kathleen; Hatcher, Julie; Cecil, Amanda
Strategies to institutionalize service-learning are well documented (Furco 1996; Holland, 2000). Using Kecskes (2009) Community-Engaged Department Rubric we evaluated service-learning institutionalization within a school at a metropolitan campus. As a result, we propose adding an additional dimension, social return on investment. This added…
María Teresa Gutiérrez
Full Text Available This paper seeks to set out the process by which national elites made major efforts to the hygiene apparatus in Colombia a responsibility of the national state. The motivations behind this were a mix of racial, medical and social reasons. During this period, Colombian doctors, thanks to a racial ideology, built a pro-hygiene narrative in which they argued for the importance of institutionalizing the hygiene apparatus. The paper’s analysis is based upon legislation, reports to the National Congress and medical conferences. The sources have been studied from the perspective of discourse analysis. Key words: hygienism, institutionalization, racial theories. I
Rolden, Herbert Jan Albert; Rohling, Jos Hermanus Theodoor; van Bodegom, David
. It is therefore important to investigate the impact of the seasons on MCE both mediated and unmediated by mortality. METHODS: Data on mortality, MCE and institutionalization from people aged 65 and older in a region in the Netherlands from July 2007 through 2010 were retrieved from a regional health care insurer...... in mortality is similar for both institutionalized and community-dwelling elderly. Policy-makers, epidemiologists and health economists are urged to acknowledge and include the impact of the seasons in future policy and research....
Johnell, Kristina; Fastbom, Johan
Most previous studies about drug use in the elderly population have either investigated drug use in institutions or in the community-dwelling setting. Hence, very few studies have compared drug use in institutionalized and community-dwelling elderly, maybe because of a lack of sufficiently large databases. The aim of the study was to investigate differences in drug use patterns between community-dwelling and institutionalized elderly, after adjustment for age, gender and number of other drugs (used as a proxy for overall co-morbidity). We analysed data from individuals aged ≥65 years who filled at least one drug prescription between July and September 2008 and were consequently registered in the Swedish Prescribed Drug Register (n = 1,347,564; 1,260,843 community-dwelling and 86,721 institutionalized elderly). A list of current prescriptions was constructed for every individual on the arbitrarily chosen date 30 September 2008. Outcome measures were the 20 most common drug classes and the 20 most common individual drugs. Logistic regression analysis was used to investigate whether institutionalization was associated with use of these drugs, after adjustment for age, gender and number of other drugs. Institutionalized elderly were more likely than community-dwelling elderly to use antidepressants, laxatives, minor analgesics, opioids and hypnotics/sedatives, after adjustment for age, gender and number of other drugs. On the contrary, institutionalization was negatively associated with use of lipid modifying agents, angiotensin II antagonists, selective calcium channel blockers, β-blocking agents and ACE inhibitors, after adjustment for age, gender and number of other drugs. Our results indicate that institutionalized elderly are more likely than community-dwelling elderly to use psychotropics, analgesics and laxatives, but less likely to receive recommended cardiovascular drug therapy, which may indicate a need for implementation of evidence-based guidelines for
Trond Bjornard PhD; Joseph Alexander; Robert Bean; Brian Castle; Scott DeMuth, Ph.D.; Phillip Durst; Michael Ehinger; Prof. Michael Golay, Ph.D.; Kevin Hase, Ph.D.; David J. Hebditch, DPhil; John Hockert, Ph.D.; Bruce Meppen; James Morgan; Jerry Phillips, Ph.D., PE
participation in facility design options analysis in the conceptual design phase to enhance intrinsic features, among others. The SBD process is unlikely to be broadly applied in the absence of formal requirements to do so, or compelling evidence of its value. Neither exists today. A formal instrument to require the application of SBD is needed and would vary according to both the national and regulatory environment. Several possible approaches to implementation of the requirements within the DOE framework are explored in this report. Finally, there are numerous barriers to the implementation of SBD, including the lack of a strong safeguards culture, intellectual property concerns, the sensitive nature of safeguards information, and the potentially divergent or conflicting interests of participants in the process. In terms of SBD implementation in the United States, there are no commercial nuclear facilities that are under IAEA safeguards. Efforts to institutionalize SBD must address these issues. Specific work in FY09 could focus on the following: finalizing the proposed SBD process for use by DOE and performing a pilot application on a DOE project in the planning phase; developing regulatory options for mandating SBD; further development of safeguards-related design guidance, principles and requirements; development of a specific SBD process tailored to the NRC environment; and development of an engagement strategy for the IAEA and other international partners.
Bjornard, Trond; Alexander, Joseph; Bean, Robert; Castle, Brian; DeMuth, Scott; Durst, Phillip; Ehinger, Michael; Golay, Michael; Hase, Kevin; Hebditch, David J.; Hockert, John; Meppen, Bruce; Morgan, James; Phillips, Jerry
facility design options analysis in the conceptual design phase to enhance intrinsic features, among others. The SBD process is unlikely to be broadly applied in the absence of formal requirements to do so, or compelling evidence of its value. Neither exists today. A formal instrument to require the application of SBD is needed and would vary according to both the national and regulatory environment. Several possible approaches to implementation of the requirements within the DOE framework are explored in this report. Finally, there are numerous barriers to the implementation of SBD, including the lack of a strong safeguards culture, intellectual property concerns, the sensitive nature of safeguards information, and the potentially divergent or conflicting interests of participants in the process. In terms of SBD implementation in the United States, there are no commercial nuclear facilities that are under IAEA safeguards. Efforts to institutionalize SBD must address these issues. Specific work in FY09 could focus on the following: finalizing the proposed SBD process for use by DOE and performing a pilot application on a DOE project in the planning phase; developing regulatory options for mandating SBD; further development of safeguards-related design guidance, principles and requirements; development of a specific SBD process tailored to the NRC environment; and development of an engagement strategy for the IAEA and other international partners.
Suzele Cristina Coelho Fabrício-Wehbe
Full Text Available ABSTRACT Objective: to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents. Method: the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS, and functional capacity through the Functional Independence Measure. Results: we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years. Conclusion: the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.
Bennett, Jeffrey V.; Thompson, Hugh C.
Background: School district superintendents continue to favor collaborative relationships with their local business communities amid concerns over free-market competition, maintaining public legitimacy, and scarce financial resources. Prior research is inadequate regarding the development, implementation, and institutionalization of school and…
Nekhoda, E.; Kolbysheva, Yu; Makoveeva, V.
The article examines a range of problems related to the process of institutionalization in the corporate social policy, characterizing the social responsibility of business and representing a part of the general strategy of corporate social responsibility. The experience of the social policy implementation in oil and gas companies is analyzed.
Camras, Linda A.; Perlman, Susan B.; Fries, Alison B. Wismer; Pollak, Seth D.
Post-institutionalized Chinese and Eastern European children participated in two emotion understanding tasks. In one task, children selected facial expressions corresponding to four emotion labels (happy, sad, angry, scared). The second task required children to match facial expressions to stories describing situations for these emotions. While…
Batista, Luciana Rodrigues Vieira; Moreira, Emilia Addison Machado; Rauen, Michelle Soares; Corso, Arlete Catarina Tittoni; Fiates, Giovanna Medeiros Rataichesck
Association between oral health status and nutritional status was investigated in 200 semi-institutionalized persons with mental retardation aged 5-53 years, 45.5% female, in the cities of Florianopolis and Sao Jose, province of Santa Catarina, Brazil. In this cross-sectional study, clinical-odontological examination revealed a high percentage of…
van Almenkerk, S.; Depla, M.F.I.A.; Smalbrugge, M.; Eefsting, J.A.; Hertogh, C.M.P.M.
Objectives: In view of the development of an integrated care and treatment program for institutionalized stroke patients tailored to their needs, we aimed to explore their status of functioning in the physical, cognitive, emotional, communicative and social domains. In addition, we explored the
Beelen, J.; Roos, de N.M.; Groot, de C.P.G.M.
To increase the protein intake of older adults, protein enrichment of familiar foods and drinks might be an effective and attractive alternative for oral nutritional supplements (ONS). We performed a pilot study to test whether these products could help institutionalized elderly to
Ramirez, Francisco O.; Boli, John
Examines the origins of state educational systems in Europe in the nineteenth century and the institutionalization of mass education throughout the world in the twentieth century. Shows how construction of mass educational systems became a major and indispensable component of every modern state's nation building activity. Discusses the usefulness…
Jakobi, Anja P.
Education has been featured prominently in recent election campaigns in different countries. This article explains this observation by the idea of a world culture and the global institutionalization of education. It compares party manifestors of 25 OECD countries from 1946 onward, analyzing how education developed in election campaigns over time…
Hsieh, Hsiu-Fang; Wang, Jing-Jy; Yen, Maiofen; Liu, Tzu-Ti
Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver's…
Torres, Nuno; Maia, Joana; Veríssimo, Manuela; Fernandes, Marilia; Silva, Filipa
The present work analyses differences in the attachment representations of institutionalized children as compared with children from low and high educational level living with their natural families. Participants were 91 Portuguese children, 52% girls, aged 48-96 months. There were three different groups: 19 institutionalized children, 16 low educational level families' children and 56 from high educational level families'. Attachment representations were assessed for Security of the narratives of the Attachment Story Completion Task (ASCT). Psychopathological symptoms were assessed using the Child Behaviour Checklist for parents and caretakers. Verbal skills were assessed using the Wechsler Preschool and Primary Scale of Intelligence--Revised. Results show that institutionalized children have significantly lower security of attachment representations, less verbal skills and higher aggressive behaviour than the other two groups. Attachment representations were associated with social/withdrawal and aggression, independently of age, verbal skills and parents' education. The main effect of institutionalization on externalizing aggressive behaviour was completely mediated by the security of attachment representations. Copyright © 2010 John Wiley & Sons, Ltd.
Howes, Nancy J.
This study was undertaken to compare the variables related to the successful institutionalization of changes across divergent organizations, and to design, through cross-validation, an interorganization model of change. Descriptive survey questionnaires and structured interviews were the instruments used. The respondent sample consisted of 1,500…
Kwon, Suhye; Tae, Young Sook
The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.
Gallant, Tricia Bertram; Drinan, Patrick
The strategic choices facing higher education in confronting problems of academic misconduct need to be rethought. Using institutional theory, a model of academic integrity institutionalization is proposed that delineates four stages and a pendulum metaphor. A case study is provided to illustrate how the model can be used by postsecondary…
New institutional theory highlights the importance of language in processes of institutionalization, but Bourdieu argues that institutions are also transmitted by mimesis, i.e., the unconscious imitation of other actors' actions. The aim of this paper is to develop a framework that explains
Jancsary, Dennis; Meyer, Renate; Höllerer, Markus A.
In this article, we develop novel theory on the differentiated impact of verbal and visual texts on the emergence, rise, establishment, and consolidation of institutions. Integrating key insights from social semiotics into a discursive model of institutionalization, we identify distinct affordanc...
Manders, M.; Groot, de C.P.G.M.; Hoefnagels, W.H.L.; Dhonukshe-Rutten, R.A.M.; Wouters-Wesseling, W.; Mulders, A.J.M.J.; Staveren, van W.A.
Objectives To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. Design A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Setting Homes for
Jeon, Hana; Moulson, Margaret C.; Fox, Nathan; Zeanah, Charles; Nelson, Charles A., III
The current study examined the effects of institutionalization on the discrimination of facial expressions of emotion in three groups of 42-month-old children. One group consisted of children abandoned at birth who were randomly assigned to Care-as-Usual (institutional care) following a baseline assessment. Another group consisted of children…
Hongisto, Markus T; Nuotio, Maria; Luukkaala, Tiina; Väistö, Olli; Pihlajamäki, Harri K
Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively. A telephone interview with a structured inquiry was performed at 1, 4, and 12 months after hip fracture. Age-adjusted univariate logistic regression analysis revealed that IADL and MMSE scores measured at the outpatient clinic were significantly associated with living arrangements 1 year after hip fracture. Multivariate logistic regression analysis established that institutionalization 1 year after hip fracture was significantly predicted by institutionalization at 4 months (odds ratio [OR] 16.26, 95 % confidence interval [CI] 7.37-35.86), IADL <5 (OR 12.96, 95 % CI 1.62-103.9), and MMSE <20 (OR 4.19, 95 % CI 1.82-9.66). A cut-off value of 5 was established for IADL with 100 % (95 % CI 96 %-100 %) sensitivity and 38 % (95 % CI 33 %-43 %) specificity and for MMSE, a cut-off value of 20 had 83 % (95 % CI 74 %-91 %) sensitivity and 65 % (95 % CI 60 %-70 %) specificity for institutionalization. During the time period from 4 to 12 months, 66 (11 %) patients changed living arrangements, and 36 (55 %) of these patients required more supportive accommodations. IADL and MMSE scores obtained 4 to 6 months after hospital discharge may be applicable for predicting institutionalization among fragility hip fracture patients ≥65 years of age at 1 year after hip fracture. An IADL score of ≥5 predicted the ability to remain in the community. Changes in living arrangements also often occur after 4 months.
Hage, Jerald; Valadez, Joseph J
The key to high impact health services is institutionalizing and sustaining programme evaluation. Uganda represents a success story in the use of a specific programme evaluation method: Lot Quality Assurance Sampling (LQAS). Institutionalization is defined by two C's: competent programme evaluators and control mechanisms that effectively use evaluation data to improve health services. Sustainability means continued training and funding for the evaluation approach. Social science literature that researches institutionalization has emphasized 'stability', whereas in global health, the issue is determining how to improve the impact of services by 'changing' programmes. In Uganda, we measured the extent of the institutionalization and sustainability of evaluating programmes that produce change in nine districts sampled to represent three largely rural regions and varying levels of effective health programmes. We used the proportion of mothers with children aged 0-11 months who delivered in a health facility as the principal indicator to measure programme effectiveness. Interviews and focus groups were conducted among directors, evaluation supervisors, data collectors in the district health offices, and informant interviews conducted individually at the central government level. Seven of the nine districts demonstrated a high level of institutionalization of evaluation. The two others had only conducted one round of programme evaluation. When we control for the availability of health facilities, we find that the degree of institutionalization is moderately related to the prevalence of the delivery of a baby in a health facility. Evaluation was institutionalized at the central government level. Sustainability existed at both levels. Several measures indicate that lessons from the nine district case studies may be relevant to the 74 districts that had at least two rounds of programme evaluation. We note that there is an association between the evaluation data being used
Full Text Available Prenatal alcohol exposure can have serious and permanent adverse effects. The developing brain is the most vulnerable organ to the insults of prenatal alcohol exposure. A behavioral phenotype of prenatal alcohol exposure including conduct disorders is also described. This study on a sample of Brazilian adolescents convicted for criminal behavior aimed to evaluate possible clinical features of Fetal Alcohol Syndrome (FAS. These were compared to a control group of school adolescents, as well as tested for other environmental risk factors for antisocial behavior. A sample of 262 institutionalized male adolescents due to criminal behavior and 154 male students aged between 13 and 21 years comprised the study population. Maternal use of alcohol was admitted by 48.8% of the mothers of institutionalized adolescents and by 39.9% of the school students. In this sample of adolescents we could not identify -individual cases with a clear diagnosis of FAS, but signs suggestive of FASD were more common in the institutionalized adolescents. Social factors like domestic and family violence were frequent in the risk group, this also being associated to maternal drinking during pregnancy. The inference is that in our sample, criminal behavior is more related to complex interactions between environmental and social issues including prenatal alcohol exposure.
Martins, Camilla Soccio; Ferriani, Maria das Graças Carvalho
This study aims at learning, from some aggressor families' point of view, the way reintegration of child and adolescent victims into their own families happen, in the city of Ribeirão Preto-SP in 2002. The methodology used is descriptive and qualitative; data were collected through interviews and observation of participants. Nine families whose children were institutionalized were surveyed. Results showed that the institutionalization of children is a way for some families to rethink the kind of education parents are providing their childrenwith/their own education. For the other ones, it was perceived as a support for behavioral problems. As noticed, some parents stressed a negative influence falling upon their children, which made them more disobedient on their return home, and causing disciplinary procedures harder to be established. The conclusion is that reintegration of the target children/adolescents is harnessed by violence happening inside families.
Tibu, F; Sheridan, M A; McLaughlin, K A; Nelson, C A; Fox, N A; Zeanah, C H
Young children raised in institutions are exposed to extreme psychosocial deprivation that is associated with elevated risk for psychopathology and other adverse developmental outcomes. The prevalence of attention deficit hyperactivity disorder (ADHD) is particularly high in previously institutionalized children, yet the mechanisms underlying this association are poorly understood. We investigated whether deficits in executive functioning (EF) explain the link between institutionalization and ADHD. A sample of 136 children (aged 6-30 months) was recruited from institutions in Bucharest, Romania, and 72 never institutionalized community children matched for age and gender were recruited through general practitioners' offices. At 8 years of age, children's performance on a number of EF components (working memory, response inhibition and planning) was evaluated. Teachers completed the Health and Behavior Questionnaire, which assesses two core features of ADHD, inattention and impulsivity. Children with history of institutionalization had higher inattention and impulsivity than community controls, and exhibited worse performance on working memory, response inhibition and planning tasks. Lower performances on working memory and response inhibition, but not planning, partially mediated the association between early institutionalization and inattention and impulsivity symptom scales at age 8 years. Institutionalization was associated with decreased EF performance and increased ADHD symptoms. Deficits in working memory and response inhibition were specific mechanisms leading to ADHD in previously institutionalized children. These findings suggest that interventions that foster the development of EF might reduce risk for psychiatric problems in children exposed to early deprivation.
Li, Yushi; Buechel, Annie
The evaluations on institutionalized care facilities from family members, after their loved ones moved into such services, are very different from culture to culture, family to family and person to person. According to a recent survey in the United States and China, it is found that different cultures and the different health conditions of the residents strongly influence family member's viewpoints on institutionalized care services. It is also found that the availability of the institutionalized care facilities plays a significant role, which strongly affects family members' evaluations on nursing home services.
Full Text Available With declines in development assistance for health and growing interest in country ownership, donors are increasingly faced with the task of transitioning health programs to local actors towards a path to sustainability. Yet there is little available guidance on how to measure and evaluate the success of a transition and its subsequent effects. This study assesses the transition of the Avahan HIV/AIDS prevention program in India to investigate how preparations for transition affected continuation of program activities post-transition.Two rounds of two surveys were conducted and supplemented by data from government and Avahan Computerized Management Information Systems (CMIS. Exploratory factor analysis was used to develop two measures: 1 transition readiness pre-transition, and 2 institutionalization (i.e. integration of initial program systems into organizational procedures and behaviors post-transition. A fixed effects model was built to examine changes in key program delivery outcomes over time. An ordinary least square regression was used to assess the relationship between transition readiness and sustainability of service outcomes both directly, and indirectly through institutionalization.Transition readiness data revealed 3 factors (capacity, alignment and communication, on a 15-item scale with adequate internal consistency (alpha 0.73. Institutionalization was modeled as a unidimensional construct, and a 12-item scale demonstrated moderate internal consistency (alpha 0.60. Coverage of key populations and condom distribution were sustained compared to pre-transition levels (p<0.01. Transition readiness, but not institutionalization, predicted sustained outcomes post-transition. Transition readiness did not necessarily lead to institutionalization of key program elements one year after transition.Greater preparedness prior to transition is important to achieve better service delivery outcomes post-transition. This paper illustrates a
Zhang, Q.; Li, T.T.; Gerritsen, A.E.; Witter, D.J.; Bronkhorst, E.M.; Creugers, N.H.J.
PURPOSE: The aim of this study was to investigate missing teeth and prosthodontic replacements in an institutionalized elderly population in China, and to assess dental functionality before and after the prosthodontic replacements based on a hierarchical dental functional classification (HDFC)
Burcharth, Ana Luiza de Araújo; Fosfuri, Andrea
Management literature highlights several potential benefits of institutionalized socialization practices that attempt to increase cohesiveness among employees. This article posits that such practices might also contribute to a biased perception of internally generated knowledge and therefore...
Full Text Available This paper explores the relationship between trust and institutionalized participation. Trust is defined as a subjective expectation about the world that can be disappointed. It is assumed to be related to time, authority, and knowledge. Further, it allows for a retrospective evaluation. In light of this definition, we first analyze the links between participation and trust in established relations between public authorities and citizens in liberal democracies. Next, we examine how institutionalized participation is currently conceived as an efficient tool for overcoming citizens' mistrust of political authorities and institutions. Finally, we argue that participation does not assuage that mistrust, but transforms the nature of the relationship between authorities and citizens, giving rise to what might be characterized as a "government of mistrust".
Wood, Wendy; Lampe, Jenna L; Logan, Christina A; Metcalfe, Amy R; Hoesly, Beth E
There is a need for a conceptual practice model that explicates ecological complexities involved in using occupation to optimize the quality of life of institutionalized people with dementia. This study aimed to prepare the Lived Environment Life Quality Model, a dementia-specific conceptual practice model of occupational therapy in institutional facilities, for publication and application to practice. Interviews and focus groups with six expert occupational therapists were subjected to qualitative content analysis to confirm, disconfirm, and further develop the model. The model's lived-environment domain as the focus of assessment and intervention was extensively confirmed, and its quality-of-life domain as the focus of intervention goals and outcomes was both confirmed and further developed. As confirmed in this study, the Lived Environment Life Quality Model is a client-centred, ecologically valid, and occupation-focused guide to optimizing quality of life of institutionalized adults with dementia in present moments and progressively over time.
Full Text Available This study concerns an investigation of the evolution of the Jesus tradition. Christological titles are studied in terms of the social theory of the institutionalization of charismatic authority. It makes use of Anthony Thiselton's and Bengt Holmberg's application of Max Weber's social theory. It is argued that the followers of Jesus acknowledged and expressed his authority by means of naming. These "names" developed into "titles" when the post-Easter followers of Jesus allocated power to him. The process of the institutionalization of Jesus' charismatic authority relates to the transmission from the oral tradition of Jesus' sayings and deeds to the written evidence. The article emphasizes the work done by the Jesus Seminar. The following "rules of written evidence" are considered: clustering and contexting; revision and commentary; false attribution; difficult sayings and the process of christianising. In Part 2 of the study, Weber,s social theory is applied to the Christological title "Son of Man".
Full Text Available Background: Hepatitis B virus (HBV infection causes chronic infection in human population, with high mortality. One of the high risk communities is mentally retarded children, who are institutionalized. Special conditions in these centers predispose children for HBV infection and transmission to healthy people. In this study our objective was to determine the prevalence of HBV infection among institutionalized mentally retarded children and study its associated risk factors.Materials and Methods: In this study, 250 mentally retarded children (younger than 14 years old were included. They were living in 5 nursing institutions, located in different parts of Tehran. Hepatitis B surface antigen (HBsAg was measured in the sera of these patients by ELISA method.Results: Among 250 children, 20 children (8% were HBsAg positive. HBV infection in girls was more than boys (11% to 5.6%. Among the types of mental retardation, children with cerebral palsy had the highest positive result for HBsAg. The most HBV infection (28.5% was seen in children with longest duration of being institutionalized (10 to 11 years. Vaccinated children were more HBsAg positive (8.7% than non-vaccinated children (5.3%. However, no significant relationship was observed between any of these factors and HBsAg positivity.Conclusion: Despite improvement of people’s health condition and implementation of HBV vaccination, the prevalence of HBV infection is increased in institutionalized mentally retarded children, which highlights the need for active measures to reduce this infection among this high risk population
This dissertation aims to fill a gap in CSR research by adopting a constructivist perspective to investigate how CSR practitioners craft strategies and how this contributes to the institutionalization of CSR in general, and of the ‘business case for CSR’ in particular. It does so by relying on the strategy-as-practice approach and the notions of institutional entrepreneurship and institutional work. This dissertation is based on a single-case study of two CSR practitioners who implemented a C...
Abizanda, Pedro; Sinclair, Alan; Barcons, Núria; Lizán, Luis; Rodríguez-Mañas, Leocadio
The aim of this study was to assess health economics evidence published to date on malnutrition costs in institutionalized or community-dwelling older adults. A systematic search of the literature published until December 2013 was performed using standard literature, international and national electronic databases, including MedLine/PubMed, Cochrane Library, ISI WOK, SCOPUS, MEDES, IBECS, and Google Scholar. Publications identified referred to the economic burden and use of medical resources associated with malnutrition (or risk of malnutrition) in institutionalized or community-dwelling older adults, written in either English or Spanish. Costs were updated to 2014 (€). A total of 9 studies of 46 initially retrieved met the preestablished criteria and were submitted to thorough scrutiny. All publications reviewed involved studies conducted in Europe, and the results regarding the contents of all the studies showed that total costs associated with malnutrition in institutionalized and community-dwelling older adults were considerably higher than those of well-nourished ones, mainly due to a higher use of health care resources (GP consultations, hospitalizations, health care monitoring, and treatments). Interventions to reduce the prevalence of malnutrition, such as the use of oral nutritional supplements, showed an important decrease in-hospital admissions and medical visits. Malnutrition is associated with higher health care costs in institutionalized or community-dwelling older adults. The adoption of nutritional interventions, such as oral nutritional supplements, may have an important impact in reducing annual health care costs per patient. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Luk, James Ka Hay; Chiu, Patrick Ka Chun; Chu, Leung Wing
Older patients with medical illnesses are at risk of institutionalization. The purpose of this study is to investigate the factors leading to institutionalization in older patients after recovery from medical illnesses. We studied 535 older patients in two convalescence hospitals in Hong Kong. Of them, 116 patients (21.7%) needed to move to nursing homes upon discharge. Univariate analysis showed that age, single/divorced/widowed status, longer length of stay, pressure sores, urinary incontinence, urinary catheterization, falls, dementia, diabetes mellitus, Barthel index (100), Elderly Mobility Score (EMS), Chinese version of the mini-mental state examination (C-MMSE) and albumin levels were significant factors associated with institutionalization. Multivariate analysis showed that being single/divorced/widowed (odds ratio=OR=2.74, 95% confidence interval=CI=1.36-5.53, p=0.0048), having urinary incontinence on discharge (OR=5.13, CI=2.66-10.6, p<0.001) and admission due to falls (OR=2.4, CI=1.03-5.57, p=0.04) were independent risk factors for nursing home admission. Higher admission EMS (OR=0.91, CI=0.84-0.97, p=0.009), admission C-MMSE (OR=0.93, CI=0.87-0.98, p=0.019), and discharge albumin levels (OR=0.93, CI=0.88-0.99, p=0.02) were independent protecting factors against nursing home admission. Knowledge of these factors can allow us to predict accommodation outcome and develop intervention strategy to reduce institutionalization in the older patients.
Baunan, Håvard; Berge, Joel
The purpose of this thesis is to understand the concept of risk appetite in terms of what it is, what institutional pressures influence it, and how it is institutionalized in an organization. We try to understand what risk appetite is by examining the most influential enterprise risk management frameworks, reports from practitioners, and scholarly research on the topic. Through a case study of a large and complex Norwegian organization, we seek to explain what influences and in...
Akusu, P.; Ofodile, O.; Agedah, E.
Full text: Nigeria as a newcomer nation is strategically institutionalizing its NKM drive via two facets since it is going into an Inter-governmental Agreement (IGA) to acquire Nuclear Power Plants (NPPs) from foreign technical partners. The NKM implementation strategies include (1) NKM with respect to nuclear research and development activities and (2) NKM with respect to NPP vendor. Some lessons learned in the implementation of the National Nuclear Power Programme (NNPP) are also outlined. (author
Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P
Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Participants' descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel "themes," 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework "Leadership Behaviors Supportive of EBP Institutionalization" (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should "support" EBP. © 2014 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of
This report analyzes recent information about the use and institutionalization of geographic information and related technologies such as geographic information systems (GIS), satellite imagery and the global positioning system (GI/GIS) in the 50 state governments. The devolution of federal responsibilities and activism by state governments are increasing the role of states in GI/GIS, as well as in the nation's governance in general. An organizational chart for each state was prepar...
Nsabimana, Epaphrodite; Martin-Sölch, Chantal
Negative effects of institutionalization and positive effects of deinstitutionalization on children’s wellbeing have been well documented. However, the majority of reports on institutional care rely on adult interviews and there is a wide disparity of results and methodologies in few result-oriented studies of deinstitutionalization outcome. In addition, though all over the world, especially in developed countries, many children in orphanage have parents; little is known about on the effect o...
This article explores the emerging institutionalization of collaborative university-industry networks in Russia. The Russian government has attempted to use a top-down public policy scheme to stimulate and promote network-building in the R&D sector. In order to understand the initial organizational responses that universities and companies select while structuring collaborations, the article utilizes conceptual perspectives from institutional theory, especially drawing on arguments from strategic choice, network-building, and network failure studies.
Abel Merino Orozco; Ana Arraiz Pérez; Fernando Sabirón Sierra
Under 6s football competition is a school sport that has inherent educational implications. Moreover, it is a booming non-formal socio-educational framework where families and children lay training expectations and dreams. The aim is to comprehend the emerging learning processes promoted in this environment for 6 years-old children, when the child starts the institutionalization process in the ruled sport. The research uses a case study design, the ethnographic mode, through participant obser...
Full Text Available This article explores the situation of family farms in the world, highlighted their key role in ensuring food security and preserving natural resources. We consider the activities of the Food and Agriculture Organization (FAO of the United Nations aimed at supporting and developing family farms at the regional, national, international levels. In the process of reforming the agricultural sector of Ukraine is the search for effective forms and methods of management. By introducing international experience progressive institutional approach to a market economy in agricultural production, the country embarked on the creation of family farms. Family farms is the most effective form of economic activity in rural areas, provided their institutionalization, state support, fight against corruption and monopolies in agribusiness. In the article the formation of family farms in Ukraine from institutional positions. Reflects the process of formation of the Institute for Family Business in Ukraine as family farms. Defined intrinsic characteristics and stages of institutionalization of family farms. The analysis measures the state and society on the institutionalization of family farms in Ukraine. Outlined prospects of Ukrainian family farms and proposed institutional arrangements to ensure the balanced functioning of a viable model of family farm management in the context of the family business in Ukraine.
Mauro Cunha Xavier Pinto
Full Text Available In recent decades, the elderly population in Brazil has grown rapidly, as has concern for the health of this population. Institutionalization in nursing homes has appeared as an alternative form of health care for frail elderly that live alone. The present study evaluated the pharmacotherapy and inappropriate drug prescriptions for institutionalized elderly patients living in long-term institutions in southeastern Brazil. This research was conducted at five institutions with a total sample of 151 individuals aged at least 60 years. Databases were used to identify drug interactions, defined daily dose and inappropriate prescriptions. The prevalence of drug intake among the elderly was 95.36%, and there were an average of 3.31 ± 1.80 drug prescriptions per individual. Based on Beers criteria, the prevalence of inappropriate prescriptions was 25.83%. In addition, 70.2% of prescriptions were prescribed at a higher dosage than the defined daily dose (ATC/WHO. Potential drug interactions were identified for 54.11% of prescriptions; 81.42% of these were of moderate severity. The main inappropriate drugs were prescribed for cardiovascular and nervous system problems. Institutionalized elderly individuals presented a high consumption and misuse of medications, requiring professional intervention to monitor prescriptions and improve the quality of service for this population.
Jonsson, P V; Lipsitz, L A; Kelley, M; Koestner, J
Transient hypotension may be one of many factors contributing to the high prevalence of falls among elderly people. To determine the frequency and magnitude of hypotensive responses to common daily activities, and their potential relationship to falls in the elderly, we examined blood pressure (BP) and heart rate during a standardized series of activities in 38 institutionalized recurrent fallers (age, 87 +/- 6 years), 20 institutionalized nonfallers (age, 85 +/- 5 years), and 10 healthy young control subjects (age, 24 +/- 3 years). The coefficient of variation for systolic BP during all activities was higher in elderly subjects (fallers, 14% +/- 5%; nonfallers, 12% +/- 3%) than in young control subjects (8% +/- 1%). In contrast, the coefficient of variation for heart rate during all activities was higher in young subjects than in the elderly subjects. Elderly subjects had marked BP reduction following meals and nitroglycerin, which was significantly greater in fallers than in nonfallers, independent of the cause of the fall. Thus, institutionalized elderly have marked BP variability and hypotensive responses to meals and nitroglycerin. A decline in BP during common preload-reducing stresses may predispose some elderly people to falls.
Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra
The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Sales, Márcia Cristina; de Oliveira, Larissa Praça; de Araújo Cabral, Natalia Louise; de Sousa, Sara Estéfani Soares; das Graças Almeida, Maria; Lemos, Telma Maria Araújo Moura; de Oliveira Lyra, Clélia; de Lima, Kenio Costa; Sena-Evangelista, Karine Cavalcanti Mauricio; de Fatima Campos Pedrosa, Lucia
Changes in zinc metabolism caused by aging and the institutionalization process may contribute to zinc deficiency in elderly individuals. Hypozincemia results in changes in glycemic, lipid, and inflammatory profiles. The aim of this study was to evaluate plasma zinc concentrations and their relationships with sociodemographic, dietary, inflammatory, and cardiometabolic biomarkers in institutionalized elderly individuals. A cross-sectional study was carried out including 255 elderly adults living in nursing homes. The associations between plasma zinc and dietary zinc intake, sociodemographic indicators, and glycemic, lipid, and inflammatory biomarkers were evaluated. Independent variables were analyzed according to quartiles of plasma zinc concentrations (Q1: 93.7 μg/dL). The relationship between plasma zinc concentrations and predictor variables was also tested. In Q1, higher concentrations of the following variables were observed, compared with those in other quartiles: total cholesterol and low-density lipoprotein cholesterol (LDL-c; Q1 > Q2, Q3, Q4; all p Q3, Q4; all p Q3, Q4; p = 0.024 and p = 0.010, respectively); tumor necrosis factor (TNF)-α (Q1 > Q3, p = 0.003). A significant reduction in plasma zinc concentrations was observed with increasing age-adjusted institutionalization time (Δ = - 0.10; 95% confidence interval [CI]: -0.18 to -0.01). The concentrations of total cholesterol (Δ = - 0.19; 95% CI: -0.23 to -0.15), LDL-c (Δ = - 0.19; 95% CI: -0.23 to -0.15), triglycerides (Δ = - 0.11; 95% CI: -0.16 to -0.06), IL-6 (Δ = - 1.41; 95% CI: -2.64 to -0.18), and TNF-α (Δ = - 1.04; 95% CI: -1.71 to -0.36) were also significantly increased. In conclusion, decreased plasma zinc concentrations were associated with longer institutionalization time and worse lipid and inflammatory profiles in elderly institutionalized individuals. Published by Elsevier GmbH.
Wagner Oliveira Batista
Full Text Available OBJECTIVE: to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls.METHOD: to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (α<0.05 were used.RESULTS: there was no significant correlation between the length of institutionalization and the tests for evaluation of risk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups.CONCLUSION: this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged.
Paschoal Tadeu Russo
Full Text Available The Balanced Scorecard (BSC is a methodology that allows managers to define and implement a set of financial or nonfinancial indicators in a balanced way to assess an organization's performance from four viewpoints. Many companies are unsuccessful in their implementation of the BSC. This lack of success may be attributed to different factors, such as strategic problems, planning failures, and poorly defined targets and goals. However, the failed implementation may be attributed in part to the failure to institutionalize habits and routines. In this regard, this objective of this paper is to use institutional theory to determine whether the book Strategy in Action: Balanced Scorecard contains evidence that the BSC model proposed by the authors (Kaplan & Norton includes elements that favor the model's institutionalization. For this purpose, a qualitative bibliographic survey was prepared. The survey revealed 404 clues that were rated according to Tolbert and Zucker's description of the processes inherent to institutionalization and to Scott's proposed framework of legitimation/legitimizing. These findings suggest that the book primarily legitimizes the BSC by examining organizations and describes it as an acknowledged management instrument. The aspects supporting the semi-institutional stage (26% of the findings and the total institutionalization stage (10% of findings suggest that the authors intended to propose a tool without focusing on the institutionalization process, which may partly explain the great difficulty faced by companies attempting to implement this methodology.
Lawan, U M; Yusuf, Nafisa Wali; Musa, Aisha Bala
This study examined the knowledge and practices of adolescent school girls in Kano, Nigeria around menstruation and menstrual hygiene. Data was collected quantitatively and analyzed using Epi info version 3.2.05. The mean age of the students was 14.4 +/- 1.2 years; majority was in their mid adolescence. The students attained menarche at 12.9 +/- 0.8 years. Majority had fair knowledge of menstruation, although deficient in specific knowledge areas. Most of them used sanitary pads as absorbent during their last menses; changed menstrual dressings about 1-5 times per day; and three-quarter increased the frequency of bathing. Institutionalizing sexuality education in Nigerian schools; developing and disseminating sensitive adolescent reproductive health massages targeted at both parents and their adolescent children; and improving access of the adolescents to youth friendly services are veritable means of meeting the adolescent reproductive health needs in Nigeria.
Cancela, José M; Ayán, Carlos; Varela, Silvia; Seijo, Manuel
Long-term interventions aimed at analyzing the impact of physical exercise on important health markers in institutionalized individuals with dementia are relatively scarce. This longitudinal study intends to identify the effects of a physical exercise program on cognitive decline, memory, depression, functional dependence and neuropsychiatric disturbances in institutionalized individuals with dementia. Randomized controlled trial. Homecare residents with dementia were assigned to an exercise (EG) or to a control group (CG). Participants in the EG cycled for at least 15min daily during 15 months, while those in the CG performed alternative sedentary recreational activities. The Mini-Mental State Examination (MEC), the Timed "Up & Go" Test, the Neuropsychiatric Inventory, the Katz Index, the Cornell Scale for Depression in Dementia and the Fuld Object Memory Evaluation were administered before and after the intervention. Sixty-three individuals in the CG and 51 individuals in the EG completed the intervention. A statistically significant decline in cognitive function was observed in individuals included in the CG (p=0.015), while a slight improvement was observed in those included in the EG. Significant improvement was observed in the neuropsychiatric symptoms (p=0.020), memory function (p=0.028) and functional mobility (p=0.043) among those who exercised. Exercise seemed to have a greater effect in those suffering from severe cognitive impairment. This study provides evidence that aerobic physical exercise has a significant impact on improving cognitive functioning, behavior, and functional mobility in institutionalized individuals with dementia. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Full Text Available When life is very unpredictable or uncertain, a routine set of practices may become a very significant element in a person’s daily life, as it may allow a sense of protection from the unknown (Ehn & Löfgren 2010 and encourage feelings of belonging (Rapport & Dawson 1998. In this article I explore how people relate to the immediate future when their presents are filled with unpredictability. More specifically, I explore the everyday practices around café routines of some young people living in Bihać, a town in northwestern Bosnia- Herzegovina (BiH. Popular discourses often link between young people's tendencies to spend time in cafés with apathy and letargy, or alternativley with bad economic conditions. However, these views, whether empathetic or critical, are neither adeqate nor very empowering. Instead, I suggest that we must view café routines within the context of what I call ‘institutionalized unpredictability’. This allows us to distance ourselves from thinking about young people’s practices through dominant paradigms of engagement and disengagement and opens up the possibility to view café routines as ‘radically unpolitical' acts (Farthing 2010. I argue that café routines are both young people’s response to ‘institutionalized unpredictability’, as well as their way to criticize and reproduce it. I further show how institutionalized unpredictability was shaping and shaped by both state and nonstate related practices, relationships, processes and aspirations, suggesting that this is precisely what made it so powerfully pervasive and debilitating.
M. S. Asmolova
Full Text Available Knowledge economy research due to the actualization of the role of knowledge and information. Management, its impact and the institutionalization of management resource provision designed to overcome the problems inherent in the present stage of development. An important research direction is to carry out theoretical analysis of economic resources in the context of their occurrence, development and improvement. This assertion has identified the need to consider the theoretical approach to the institutionalization of forms of resource management software innovation and analysis and typology of approaches by different parameters on the basis of analysis of a large number of sources. The features of the concept of institutionalization as defined phenomenon in a time perspective. In an analysis conducted by scientists used studies from different periods in the development of economic science. The analysis of numerous professional and scientific research led to the conclusion that knowledge and information should be dis-regarded as a new type of economic production factors. Separately, analyzed the impact of globalization processes that have affected the scientific and innovative sphere. Allocated to a separate study by side issues of innovative development of the Russian economy, which prevents the unresolved improve the competitiveness of the national economic and inhibits the formation of regional and national innovation system, restraining the transition to an innovative model of development. Citing as evidence of the deepening of economic globalization, the role of new information technologies and the formation of a single information space. Noting the fact that if the earlier science developed to deepen knowledge on the basis of the social division of Sciences, in the coming century should happen deepening of knowledge on the basis of their socialization.
Kim, H. J.; Cho, J. C.; Min, B. K.; Park, J. S.; Jung, H. D.; Oh, K. M.; Kim, W. K.; Lim, J. H.
In this study, in-depth reviews of the foreign countries' experiences and practices in applications of the periodic safety review (PSR), backfitting and license renewal systems as well as the current status of nuclear power safety assurance programs and activities in Korea have been performed to investigate the necessity and feasibility of the application of the systems for the domestic operating nuclear power plants and to establish effective strategy and methodology for the institutionalization of a periodic safety re-assessment system appropriate to both the domestic and international nuclear power environments by incorporating the PSR with the backfitting and license renewal systems. For these purposes, the regulatory policy, fundamental principles and detailed requirements for the institutionalization of the safety re-assessment system and the effective measures for active implementation of the backfitting program have been developed and then a comparative study of benefits and shortcomings has been conducted for the three different models of the periodic safety re-assessment system incorporated with either the license renewal or life extension process, which have been considered as practicable ones in the domestic situation. The model chosen in this study as the most appropriate safety re-assessment system is the one that the re-assessments are performed at the interval of ten years throughout the service life of nuclear power plant and the ten-year license renewal or life extension after the expiration of design life can be permitted based on the regulatory review of the re-assessment results and follow-up measures. Finally, this paper has discussed on the details of the requirements, approach and procedures established for the institutionalization of the periodic safety re-assessment system chosen as the most appropriate one for domestic applications
Vacaru, V S; Sterkenburg, P S; Schuengel, C
Self-concept is seen as both an outcome of sociocognitive and emotional development, and a factor in social and mental health outcomes. Although the contribution of attachment experiences to self-concept has been limited to quality of primary attachment relationships, little is known of the effects of disturbed attachment on self-concept in institutionalized children. Thus, the current study examined associations between disturbed attachment behaviours in institutionalized children and self-concept, testing limited exploration as an explanatory factor. Thirty-three institutionalized children, aged 4-12, participated in a multimethod and multi-informant assessment of disturbed attachment behaviours (i.e., Disturbances of Attachment Interview and Behavioral Signs of Disturbed Attachment in Young Children), self-concept (i.e., Pictorial Scale of Perceived Competence and Social Acceptance for Young Children), and exploratory behaviours (i.e., Student Exploratory Behaviours Observation Scale). Analyses were conducted using bootstrapping techniques. Global self-concept converged with teacher-rated children's self-concept, except for physical competence domain. Disturbed attachment behaviours were identified in 62.5% of the children, and this was associated with lower levels of exploration and lower scores on self-concept, compared with children without disturbed attachment behaviours. Furthermore, exploratory behaviours mediated the effects of disturbed attachment behaviours on self-concept. Institution-reared children with disturbed attachment behaviours were likely to have a negative perception of self and one's own competences. Limited exploratory behaviours explained this linkage. Targeting disordered attachment in children reared in institutions and their caregivers should become a high priority as a means for preventing socioemotional development issues. © 2017 John Wiley & Sons Ltd.
Ferreira, Ana Rita; Martins, Sonia; Ribeiro, Orquidea; Fernandes, Lia
Neuropsychiatric symptoms are very common in dementia and have been associated with patient and caregiver distress, increased risk of institutionalization and higher costs of care. In this context, the neuropsychiatric inventory (NPI) is the most widely used comprehensive tool designed to measure neuropsychiatric Symptoms in geriatric patients with dementia. The aim of this study was to present the validity and reliability of the European Portuguese version of NPI. A cross-sectional study was carried out with a convenience sample of institutionalized patients (≥ 50 years old) in three nursing homes in Portugal. All patients were also assessed with mini-mental state examination (MMSE) (cognition), geriatric depression scale (GDS) (depression) and adults and older adults functional assessment inventory (IAFAI) (functionality). NPI was administered to a formal caregiver, usually from the clinical staff. Inter-rater and test-retest reliability were assessed in a subsample of 25 randomly selected subjects. The sample included 166 elderly, with a mean age of 80.9 (standard deviation: 10.2) years. Three out of the NPI behavioral items had negative correlations with MMSE: delusions (rs = -0.177, P = 0.024), disinhibition (rs = -0.174, P = 0.026) and aberrant motor activity (rs = -0.182, P = 0.020). The NPI subsection of depression/dysphoria correlated positively with GDS total score (rs = 0.166, P = 0.038). NPI showed good internal consistency (overall α = 0.766; frequency α = 0.737; severity α = 0.734). The inter-rater reliability was excellent (intraclass correlation coefficient (ICC): 1.00, 95% confidence interval (CI) 1.00 - 1.00), as well as test-retest reliability (ICC: 0.91, 95% CI 0.80 - 0.96). The results found for convergent validity, inter-rater and test-retest reliability, showed that this version appears to be a valid and reliable instrument for evaluation of neuropsychiatric symptoms in institutionalized elderly.
Sadeq Ali Al-Maweri
Full Text Available Objectives: The aim of this study was to assess the prevalence of oral mucosal lesions (OMLs and dental caries and to evaluate oral health practices among institutionalized orphan-children in Sana′a city, Yemen. Subjects and Methods: A sample of 202 institutionalized male-orphan-children in the main orphanage in Sana′a city, were matched to 202 non-orphan schoolchildren. Clinical examination included assessment of OMLs based on standard international diagnostic criteria and evaluation of dental status using the Decayed/decayed, Missed/missed and Filled/filled (DMFT/dmft index according to World Health Organization recommendations. Demographic data and oral hygiene practices were obtained by interviewing each subject using special questionnaire form. Results: Majority of children were in the 12-15 year age group. Nine types of lesions were reported among orphans; the most common lesions were fissured tongue (24.3%, herpes labialis (7.9% and traumatic ulcers (2.5%. The occurrence of herpes labialis was found to be significantly higher in orphans than in controls (P < 0.01. The prevalence of dental caries was insignificantly lower among the orphans (84.7% compared with the non-orphans (89.61%; P = 0.136. The mean dmft score was significantly lower in orphans than in controls (2.28 vs. 3.82; P = 0.001. Conclusions: The institutionalized children in this orphanage had a high prevalence of OMLs but low prevalence of dental caries, though they revealed poor oral hygiene practices. Effective oral health promotion strategies need to be implemented to improve the oral health and oral health practices of children living in orphanages.
Manders, M; De Groot, L C P G M; Hoefnagels, W H L; Dhonukshe-Rutten, R A M; Wouters-Wesseling, W; Mulders, A J M J; Van Staveren, W A
To determine whether in the current study the supply of a nutrient dense drink has a positive effect on mental and physical function of institutionalized elderly people. A 24-week, randomized, double-blind, placebo-controlled, parallel-group, intervention trial. Homes for the elderly and nursing homes in the Netherlands. Institutionalized elderly people older than 60 years, with a BMI Mental State Examination score of at least 10 points. In addition to their usual diet the participants (n=176) received either a nutrient dense drink or a placebo drink twice a day during 24 weeks. The functionality measures included cognitive function, mood, physical performance and the ability to perform activities of daily living. In the supplement group a favorable effect of the intervention drink on body weight (1.6 kg difference in change; P = .035), calf circumference (0.9 cm difference in change; P = .048), and blood values (e.g. Hcy decreased from 16.8 to 11.2 mumol/L in the supplement group) was found. In the total group no significant effect was found on functionality outcomes. However, a subgroup of participants with BMI at baseline below 24.4 kg/m2 performed better on the cognitive subscale of Alzheimer's Disease Assessment Scale (P = .09), and its language sub score (P = .01) after 24 weeks of intervention. The results in the total group of this trial suggest that the nutritional supplement used in this study improves nutritional status. Furthermore, the results of this trial suggest that it is effective as treatment for decreasing function in a subgroup of institutionalized elderly people with low BMI.
Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P
Background Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. Aims To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Methods Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Results Participants’ descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel “themes,” 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework “Leadership Behaviors Supportive of EBP Institutionalization” (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Linking Evidence to Action Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should “support” EBP. PMID:24986669
Vescan, M. M.; Soporan, V. F.; Crișan, D. M.; Lehene, T. R.; Pădurețu, S.; Samuila, V.
This paper is motivated by the necessity of introducing the principles of circular economy at the level of different social - economic activities, and from this point of view one of the fields with a special potential is that of the manufacture of castings. Objective: to connect to the organizing and application of the methodology of the circular economy principles. The proposed method is an innovating one, being connected to the use of institutionalization engineering. Formulating the subject: The subject formulated to be solved aims at the introduction of new approaches, defined through institutionalization engineering, which proposes to set the correlation of actions between the specifics of the circular economy and the specific elements of the manufacture of castings. Research method: An institutional structuring operation was imposed for the optimization of the research method, in which different versions interact at the following levels: the level of public policies, the level of the regulatory framework, the level of technical solutions and the level of financing solutions and financial instruments. The determination of the optimal solution established in a dynamic context, favorable for the requirements of the different actors present within the process, appeals to the elements of critical thinking, specific for the engineer’s actions. Achievement of the research activity: The research activity structures a methodology of quantifying the contributions of each stage of the manufacturing process for castings at the fulfilling of the specific conditions of the circular economy, indicating the critical areas of action for more efficient actions of the circular economy, according to the market economy requirements, where there is a potential of implementing the technical solutions by quantizing the financial solutions and the opportunity of using the financial instruments. The major contribution of the research: The proposed methodology, with examples at the
María del Mar Ruperto López
Full Text Available Introduction: Overweight and obesity are recognized mortality risk factors in the general population. The aim of the study was to analyse the phenotypic distribution of body mass index (BMI, and to identify the prevalence of malnutrition and clinical and nutritional factors related to BMI in autonomous institutionalized elders. Material and Methods: Cross-sectional and descriptive study in 104 institutionalized aged people (73% female, mean of age 86.4 [±6.2] years and time on institutionalization 25.7 [±21.7] months. Mini-Nutritional Assessment (MNA, anthropometric measures and laboratory parameters were used for nutritional assessment. Bioimpedance analysis (BIA-101; RJL-System was used for body composition analysis. The sample was classified into BMI tertiles (Tn: T1=<26.2kg/m2; T2=26.3-29.7kg/m2; and T3=≥29.8kg/m2. Results: The phenotypic distribution of BMI was: overweight 51% and, prevalence of obesity 29.8%. Mean of BMI: 28.3 (±4.6 kg/m2. Nutritional risk or malnutrition were 60.6% and 11.5%, respectively in the sample. The tertiles of BMI showed significant differences with: mid-arm muscle circumference, triceps-skinfold thickness, total body water (TBW (all, p<0.001. Subjects into T1 had significantly higher nutritional risk or malnutrition compared with T2 and T3 counterparts (p=0.015. Waist-circumference, calf-circumference (at least, p<0.01, and TBW (p<0.001 were independent predictors of BMI in the linear regression analysis (R2=0.52. Conclusions: Overweight and obesity measured by BMI is not an exclusion criterion of malnutrition in the geriatric population. Nutritional screening by MNA and the conjoint use of clinical-nutritional parameters are useful for identifying at nutritional risk or malnutrition. Further studies are needed to define the potential nutritional risk factors associated with BMI in autonomous institutionalized aged.
Ashourizadeh, Shayegheh; Schøtt, Thomas
are distinct from routine employees and somewhat similar to entrepreneurs. Thereby intrapreneurs are a human resource that by developing new activities for their employer and also by creating new jobs is very valuable. – The rate of intrapreneurship among employees is higher in Denmark than in almost all other......, especially in Denmark, to adopt strategies for institutionalization and management of this human resource....... more frequently than routine employees are self-efficacious, opportunity-perceiving, risk-willing and role-modeling starters, have meaningful and autonomous jobs, and are satisfied with their jobs and salary, but also experience more stress in work; and in these job-characteristics intrapreneurs...
Full Text Available The purpose of this study is to examine the role and effectiveness of rhetorical strategies in the process of institutionalization. Rhetorical strategies present continuity with regard to institutionalization of certain social phenomena in society and are classified as Pathos, Logos and Ethos (Aristotle 1991. When considered from this point of view, institutional actors representing the important sections of the society produce effective texts through the discourse they use and ensuredissemination of the ideas regarding social phenomena they defend. In the study, insurance industry was taken into the scope of research to present in company with which rhetorical strategies institutionalization takes place. In accordance with the idea t hat different strategies might be dominant in different contexts, the findings put forth as a result of Pathos, Ethos and Logos strategies.
Full Text Available This study determined the national prevalence and profile of Asian Americans with Activities of Daily Living (ADL limitations and identified factors associated with institutionalization. Data were obtained from 2006 American Community Survey, which replaced the long-form of the US Census. The data are nationally representative of both institutionalized and community-dwelling older adults. Respondents were Vietnamese (n = 203, Korean (n = 131, Japanese (n = 193, Filipino (n = 309, Asian Indian (n = 169, Chinese (n = 404, Hawaiian/Pacific Islander (n = 54, and non-Hispanic whites (n = 55,040 aged 55 and over who all had ADL limitations. The prevalence of institutionalized among those with ADL limitations varies substantially from 4.7% of Asian Indians to 18.8% of Korean Americans with ADL limitations. Every AAPI group had a lower prevalence of institutionalization than disabled Non-Hispanic whites older adults (23.8% (p < 0.001. After adjustment for socio-demographic characteristics, Asian Indians, Vietnamese, Japanese, Filipino, and Chinese had significantly lower odds of institutionalization than non-Hispanic whites (OR = 0.29, 0.31, 0.58, 0.51, 0.70, respectively. When the sample was restricted to AAPIs, the odds of institutionalization were higher among those who were older, unmarried, cognitively impaired and those who spoke English at home. This variation suggests that aggregating data across the AAPI groups obscures meaningful differences among these subpopulations and substantial inter-group differences may have important implications in the long-term care setting.
This phenomenological study integrated crisis theory, social identity theory, and uncertainty management theory to conceptualize the decision-making process around institutionalization among nursing home residents and their children in Shanghai. I conducted face-to-face, semistructured interviews with 12 dyads of matched elders and their children (N = 24). The findings suggest that caregiving crises triggered intergenerational communication about caregiving alternatives and new arrangements, although each generation had different stances and motivations. Children finalized the decision by helping their parents to manage the uncertainties pertaining to institutionalization. This study sheds light on caregiving decision-making dynamics for the increasing aging population across cultures.
Mohammadi, Fatemeh; Momtaz, Yadollah Abolfathi; Motallebi, Seyedeh Ameneh; Boosepasi, Shahnaz
There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, psocial skills of elderly patients with schizophrenia. Copyright© Bentham Science Publishers; For any queries, please email at email@example.com.
Mahieu, Lieslot; Gastmans, Chris
Admission to a nursing home might challenge the way in which individuals experience their own sexuality, but it does not automatically diminish their need and desire for sexual fulfillment. Despite the fact that sexuality proves to be an intrinsic part of human existence, the sexual expression of geriatric residents remains a sensitive subject for many caregivers and family members. It evokes a variety of ethical issues and concerns, especially when dementia patients are involved. The overall objective of this review was to examine the ethical arguments and concepts about the debate on sexuality within a nursing home environment. We conducted a systematic search for argument-based ethics literature focusing on sexuality in institutionalized elderly people. Twenty-five appropriate studies were identified. A thematic analysis of the included literature led us to distinguish two major groups of ethical arguments: (i) principles and (ii) care. Ethics arguments on sexuality in institutionalized elderly are particularly guided by the principle of respect for autonomy and the concomitant notion of informed consent. Arguments related to care were also apparent within the research literature although they received considerably less attention than the arguments related to the principles of respect for autonomy, beneficence, nonmaleficence and justice. The lack of clarity in the conceptualization of the arguments referred to in the research literature indicates that there is a pressing need for a better defined, more fundamental philosophical-ethical analysis of the values at stake.
December 2013 marked a significant shift in Bolivia with the enactment of a law for the inclusion of indigenous doctors in the National Health System. This article traces the constellation of forces that led to the institutionalization of indigenous medicine in Bolivia. It identifies three factors contributing to this health policy change. The first factor is the crystallization of a strong indigenous movement fighting for the recognition of cultural rights through the foundation of civil society organizations. Second is the rise to power of Evo Morales, the first Latin American president of indigenous origin, who has promoted multicultural policies, formally supported through the promulgation of a new constitution. Lastly is the influence of the global acceptance of alternative medicine. Indigenous doctor organizations in Bolivia have been highly involved throughout the entire process of institutionalization and have played a crucial role in it. An analysis of the relationship between these civil society organizations and the Bolivian government reveals a strong partnership. This dynamic can be described in terms of Interdependence Theory, as each party relied on the other in the promotion and practice of the law to achieve the integration of indigenous medicine as part of the Bolivian Health System. Copyright © 2014 Elsevier Ltd. All rights reserved.
Lindomar Wessler Boneti
Full Text Available This article consists of an epistemological reflection on educational policies in order to contribute to the Red Latinoamerica de Estudios Epistemológicos en Política Educativa (ReLePe debate. It is about to rescue the historical journey of the positivist position as classical epistemological framework of the educational policy institutionalization with regard to the implementation of educational action, with special focus to the set of rules, norms and values that conduct school activity. It is argued that these frameworks are constituted from two interconnected movements: historical construction of the epistemological frameworks of science and the Modern State that with the new mode of production, capitalism, gives rise to the second one: bourgeois movement of class distinction based on lifestyle. Thus, from the “Modern Reason”, it was outlined what may be regarded as a “model of civility”, becoming the epistemological framework and goal of achieving the educational policy institutionalization and school activity in contemporaneity.
Zamazii Oksana V.
Full Text Available The article developes and proves a scientific hypothesis that strengthening the integration processes in the market space causes its institutionalization, and thus leads to the issues of proliferation of the free market players as a result of a division of spheres of influence between the major financial-industrial groups and corporations. It has been proved that a clear hierarchical structure, along with rigid subordination of free economic agents to the chief processor of resources within the growing corporations are those preconditions, which gradually form characteristics of an organization or an institution in terms of markets. An author's own definition of the notion of «institutional market» has been proposed, which is different from the classic formulation. It is emphasized that institutionalization of market space turns the latter into an another economic system, the main characteristics of which are: limited number of buyers and sellers; presence of conglomerates with rigid hierarchical relationships between buyers and sellers; etc. Enlargement and diversification of business as well as growth of its influence not only within its own industry sector, but also in the related sectors, leads to the fact that corporations are trying to control markets (supply and demand which meantime are turning into rigid management structures, acquiring characteristics of institutions (organizations. This hinders the market entry of new market players, increases risks of business and requires on the part of enterprises new marketing techniques for positioning the own ability to create customer value.
Emanuel Dheison dos Santos Penha
Full Text Available This research aims to investigate the process of institutionalization of Junior Enterprises (JEs of the public universities of Ceará, according to the model of institutionalization of Tolbert and Zucker (1999 in its three phases: habituation, objectification and sedimentation. This research is bibliographic, being classified as a descriptive study of qualitative and quantitative nature. The study was conducted in 10 JEs of Ceará. During data collection, questionnaires administered with members, and interviews with the presidents of the JEs were used. The results show that the main reason for the emergence of IOs in public universities of Ceará was the need to combine theory with practice, the main actors in the process of these entities were students. No resistance groups, but there is a threat at the prospect of continuity due to high turnover in JEs. The JEs are among the phases of objectification and sedimentation and isomorphic characteristics, among JEs, are related to the sharing of best management practices.
Abel Merino Orozco
Full Text Available Under 6s football competition is a school sport that has inherent educational implications. Moreover, it is a booming non-formal socio-educational framework where families and children lay training expectations and dreams. The aim is to comprehend the emerging learning processes promoted in this environment for 6 years-old children, when the child starts the institutionalization process in the ruled sport. The research uses a case study design, the ethnographic mode, through participant observation. It uses the narrative and image data to understand the scenario from the perspective of its builder. The results show that the institutionalization process starts from the ingenuity and lack of understanding of the child, who develops training processes in a prescriptive environment, where the competitive performance of the team is pursued. Promoting certain types of learning which the participant himself consciously considers inappropriate undertakes the presence of different kinds of behaviour, which go against the positive values usually attributed to football. The study claims for the necessity of taking advantage of the training opportunities which football offers to children such as the enhancing of creativity, self-efficacy and self-esteem.
Hess, Mailee; Campagna, Elizabeth J.; Jensen, Kristin M.
Background: Adults with intellectual or developmental disability (ID/DD) have multiple risks for low bone mineral density (BMD) without formal guidelines to guide testing. We sought to identify risk factors and patterns of BMD testing among institutionalized adults with ID/DD. Methods: We evaluated risk factors for low BMD (Z-/T-score < -1) and…
Dowling, G.A.; Burr, R.L.; van Someren, E.J.W.; Hubbard, E.M.; Luxenberg, J.S.; Mastick, J.; Cooper, B.A.
OBJECTIVES: To test whether the addition of melatonin to bright-light therapy enhances the efficacy in treating rest-activity (circadian) disruption in institutionalized patients with Alzheimer's disease (AD). DESIGN: Randomized, controlled trial. SETTING: Two nursing homes in San Francisco,
van Bilsen, P.M.A.; Hamers, J.P.H.; Groot, W.; Spreeuwenberg, C.
Objective: To examine the use of community-based social services by elderly people at risk of institutionalization, who prefer to remain at home. Methods: A study with a longitudinal design (measurements at two points in time) was conducted. Results: One hundred and thirty-four elderly people (mean
Tench, R.; Verhoeven, P.; Zerfass, A.
Is strategic communication becoming an established discipline of practice across Europe? Is it in turn becoming institutionalized? And do we mean establishing a renowned practice at the heart of organizational operation? This article aims to address these questions while paying attention to the
Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan
Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.
Batista, Wagner Oliveira; Alves, Edmundo de Drummond; Porto, Flávia; Pereira, Fabio Dutra; Santana, Rosimere Ferreira; Gurgel, Jonas Lírio
OBJECTIVE: to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls. METHOD: to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (αrisk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups. CONCLUSION: this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged. PMID:25296149
Bootsma, A. M. Jikke; Buurman, Bianca M.; Geerlings, Suzanne E.; de Rooij, Sophia E.
To study differences in functional status at admission in acutely hospitalized elderly patients with urinary incontinence, a catheter, or without a catheter or incontinence (controls) and to determine whether incontinence or a catheter are independent risk factors for death, institutionalization, or
Mesquita, A R; Belsky, J; Li, Z; Baptista, J; Carvalho-Correia, E; Maciel, P; Soares, I
Institutionalization adversely impacts children's emotional functioning, proving related to attachment disorders, perhaps most notably that involving indiscriminate behavior, the subject of this report. In seeking to extend work in this area, this research on gene X environment (GXE) interplay investigated whether the serotonin transporter (5-HTTLPR) and val66met Brain-Derived Neurotrophic Factor (BDNF) polymorphisms moderated the effect of institutional care on indiscriminate behavior in preschoolers. Eighty-five institutionalized and 135 home-reared Portuguese children were assessed using Disturbances of Attachment Interview (DAI). GXE results indicated that s/s homozygotes of the 5-HTTLPR gene displayed significantly higher levels of indiscriminate behavior than all other children if institutionalized, something not true of such children when family reared. These findings proved consistent with the diathesis-stress rather than differential-susceptibility model of person×environment interaction. BDNF proved unrelated to indiscriminate behavior. Results are discussed in relation to previous work on this subject of indiscriminate behavior, institutionalization and GXE interaction. Copyright © 2015 Elsevier Inc. All rights reserved.
Gisele da Silveira Sarmento
Full Text Available Objective: To review scientific literature pertaining to aquatic physical therapy in the elderly and institutionalized population. Methods: A qualitative systematic review of electronic databases MEDLINE and LILACS, with the topic index terms: “hydrotherapy”, “homes for the aged or residential facilities”, and “aged. In light of the lack of studies carried out on the institutionalized population, we opted for reviewing literature on the effectiveness of this modality of physical therapy treatment on the non-institutionalized elderly population in order to produce knowledge that can be critically analyzed according to its potential applicability for the institutionalized population. The methodological quality of the studies was assessed using the Delphi listing. Results: Of the 27 studies analyzed by their abstracts, 10 studies were excluded since they did not correspond to the eligibility criteria. We analyzed the subject characteristics of each study, as well as the quality of the methods (good methodological quality in 47% of the studies, the result measurements considered, the intervention strategies, the sites where they took place, and the professionals involved (76% by physical therapists. Conclusion: Although a large part of the studies demonstrated good results with aquatic physical therapy practice, none of them had been applied on long-stay institution for the elderly. Therefore, more studies are needed in this area for a model of assistance to long-stay institution for the elderly to be proposed.
Tieland, Michael; Beelen, Janne; Laan, Anna C.M.; Poon, Shirley; Groot, de Lisette C.P.G.M.; Seeman, Ego; Wang, Xiaofang; Iuliano, Sandra
Objective: Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of
Pimouguet, Clément; Le-Goff, Mélanie; Rizzuto, Debora; Berr, Claudine; Leffondré, Karen; Pérès, Karine; Dartigues, Jean FranÇois; Helmer, Catherine
Although early diagnosis has been hypothesized to benefit both patients and caregivers, until now studies evaluating the effect of early dementia diagnosis are lacking. To investigate the influence of early specialist referral for dementia on the risk of institutionalization and functional decline in Activity of Daily Living (ADL). Incident dementia cases were screened in a prospective population-based cohort, the Three-City Study, and initial specialist consultation for cognitive complaint was assessed at dementia diagnosis. Proportional hazard regression and illness-death models were used to test the association between specialist referral and, respectively, institutionalization and functional decline. Only one third of the incident individuals with dementia had consulted a specialist for cognitive problems early (36%). After adjustment on potential confounders (including cognitive and functional decline) and competing risk of death, participants who had consulted a specialist early in the disease course presented a higher rate of being institutionalized than those who did not (Hazard Ratio = 2.00, 95% Confidence Interval (CI): 1.09- 3.64). But early specialist referral was not associated with further functional decline (HR = 1.09, 95% CI: 0.71- 1.67). Early specialist referral in dementia is associated with increased risk of institutionalization but not with functional decline in ADL. These findings suggest that early care referral in dementia may be a marker of concern for patients and/or caregivers; subsequent medical and social care could be suboptimal or inappropriate to allow patients to stay longer at home.
Buatois, Séverine; Gueguen, René; Gauchard, Gérome C; Benetos, Athanase; Perrin, Philippe P
A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to
Mahieu, Lieslot; Gastmans, Chris
The aim of this systematic literature review is to investigate older residents' thoughts on, experiences of and engagement in sexual behavior and aged sexuality within institutionalized elderly care. Systematic literature review. We conducted an extensive search of the electronic databases Cinahl, Medline, Pubmed, Embase, Web of Science and Invert for papers published between January 1980 and October 2014 when the searches were closed. Additional papers were identified through forward and backward citation chasing. Data from relevant studies were extracted by means of a data extraction form. Relevant data were isolated, summarized, compared, related and categorized according to theme. Quality assessment of the included studies focused on their adequacy of reporting the study's research aim, sampling, collection, and analysis procedures, ethical considerations and results. Twenty-five appropriate studies were identified. These studies varied in research design (using surveys, vignettes, focus groups, interviews, or observation), objectives, quality of reporting, and sample characteristics (i.e. male and/or female long-term care residents with and/or without dementia). Yet, they all point to the relevance of sex and sexuality in old age and emphasize the highly individual character of both sexual interest and expression. Older residents who wish to sexually express themselves, might do this in a wide variety of ways, including, but not limited to, daydreaming, dressing-up, looking for emotional and intellectual intimacy, stroking, caressing, kissing, and engaging in sexual intercourse. Overall, residents appear to have a rather positive attitude toward aged sexuality as such. When it comes to specific sexual behaviors or homosexuality, however, attitudes tend to be more negative. The perceived appropriateness of the displayed behavior is a predominant factor in determining older people's reactions to the sexual behavior of co-residents, rather than the potential
Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu
Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral
Jane N Mutanga
Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early
De Almeida Mello Johanna
Full Text Available Abstract Background Older people usually prefer staying at home rather than going into residential care. The Belgian National Institute for Health and Disability Insurance wishes to invest in home care by financing innovative projects that effectively help older people to stay at home longer. In this study protocol we describe the evaluation of 34 home care projects. These projects are clustered according to the type of their main intervention such as case management, night care, occupational therapy at home and psychological/psychosocial support. The main goal of this study is to identify which types of projects have the most effect in delaying institutionalization of frail older persons. Methods/design This is a longitudinal intervention study based on a quasi-experimental design. Researchers use three comparison strategies to evaluate intervention - comparison among different types of projects, comparisons between older persons in the projects and older persons not benefiting from a project but who are still at home and between older persons in the projects and older persons who are already institutionalized. Projects are asked to include clients who are frail and at risk of institutionalization. In the study we use internationally validated instruments such as the interRAI Home Care instrument, the WHO-QOL-8 and the Zarit Burden Interview-12. These instruments are filled out at baseline, at exit from the project and 6 months after baseline. Additionally, caregivers have to do a follow-up every 6 months until exit from the project. Criteria to exit the cohort will be institutionalization longer than 3 months and death. The main analysis in the study consists of the calculation of incidence rates, cumulative incidence rates and hazard rates of definitive institutionalization through survival analyses for each type of project. Discussion This research will provide knowledge on the functional status of frail older persons who are still living at
De Almeida Mello, Johanna; Van Durme, Therese; Macq, Jean; Declercq, Anja
Older people usually prefer staying at home rather than going into residential care. The Belgian National Institute for Health and Disability Insurance wishes to invest in home care by financing innovative projects that effectively help older people to stay at home longer. In this study protocol we describe the evaluation of 34 home care projects. These projects are clustered according to the type of their main intervention such as case management, night care, occupational therapy at home and psychological/psychosocial support. The main goal of this study is to identify which types of projects have the most effect in delaying institutionalization of frail older persons. This is a longitudinal intervention study based on a quasi-experimental design. Researchers use three comparison strategies to evaluate intervention--comparison among different types of projects, comparisons between older persons in the projects and older persons not benefiting from a project but who are still at home and between older persons in the projects and older persons who are already institutionalized. Projects are asked to include clients who are frail and at risk of institutionalization. In the study we use internationally validated instruments such as the interRAI Home Care instrument, the WHO-QOL-8 and the Zarit Burden Interview-12. These instruments are filled out at baseline, at exit from the project and 6 months after baseline. Additionally, caregivers have to do a follow-up every 6 months until exit from the project. Criteria to exit the cohort will be institutionalization longer than 3 months and death. The main analysis in the study consists of the calculation of incidence rates, cumulative incidence rates and hazard rates of definitive institutionalization through survival analyses for each type of project. This research will provide knowledge on the functional status of frail older persons who are still living at home. This is important information to identify determinants of
Bogner, Hillary R; de Vries McClintock, Heather F; Kurichi, Jibby E; Kwong, Pui L; Xie, Dawei; Hennessy, Sean; Streim, Joel E; Stineman, Margaret G
To examine how patient satisfaction with care coordination and quality and access to medical care influence functional improvement or deterioration (activity limitation stage transitions), institutionalization, or death among older adults. National representative sample with 2-year follow-up. Medicare Current Beneficiary Survey from calendar years 2001 to 2008. Community-dwelling adults (N=23,470) aged ≥65 years followed for 2 years. Not applicable. A multinomial logistic regression model taking into account the complex survey design was used to examine the association between patient satisfaction with care coordination and quality and patient satisfaction with access to medical care and activities of daily living (ADL) stage transitions, institutionalization, or death after 2 years, adjusting for baseline socioeconomics and health-related characteristics. Out of 23,470 Medicare beneficiaries, 14,979 (63.8% weighted) remained stable in ADL stage, 2508 (10.7% weighted) improved, 3210 (13.3% weighted) deteriorated, 582 (2.5% weighted) were institutionalized, and 2281 (9.7% weighted) died. Beneficiaries who were in the top quartile of satisfaction with care coordination and quality were less likely to be institutionalized (adjusted relative risk ratio [RRR], .68; 95% confidence interval [CI], .54-.86). Beneficiaries who were in the top quartile of satisfaction with access to medical care were less likely to functionally deteriorate (adjusted RRR, .87; 95% CI, .79-.97), be institutionalized (adjusted RRR, .72; 95% CI, .56-.92), or die (adjusted RRR, .86; 95% CI, .75-.98). Knowledge of patient satisfaction with medical care and risk of functional deterioration may be helpful for monitoring and addressing disability-related health care disparities and the effect of ongoing policy changes among Medicare beneficiaries. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Consideration of social issues in environmental impact assessment (EIA) of development projects has been an integral part of project cycle since the inception of EIA in Bangladesh in the early 1990s. This paper examines the emergence of social impact assessment (SIA) in Bangladesh environmental management and its institutionalization. It reveals that although SIA does not have a statutory status like EIA, social dimensions are firmly established in donor funded poverty alleviation projects. It is proposed that SIA is given a clear legislative mandate. The Department of Environment (DOE) - the agency that looks after the implementation of EIA on behalf of the government--needs to be strengthened and transparent in order to play a more effective role
Although empirical and theoretical studies affirm that punishment can elevate collaborative efforts, its emergence and stability remain elusive. By peer-punishment the sanctioning is something an individual elects to do depending on the strategies in its neighborhood. The consequences of unsustainable efforts are therefore local. By pool-punishment, on the other hand, where resources for sanctioning are committed in advance and at large, the notion of sustainability has greater significance. In a population with free-riders, punishers must be strong in numbers to keep the ``punishment pool'' from emptying. Failure to do so renders the concept of institutionalized sanctioning futile. We show that pool-punishment in structured populations is sustainable, but only if second-order free-riders are sanctioned as well, and to a such degree that they cannot prevail. A discontinuous phase transition leads to an outbreak of sustainability when punishers subvert second-order free-riders in the competition against defectors.
There are serious problems with the way in which pharmaceutical research is currently practiced, many of which can be traced to the influence of commercial interests on research. One of the most significant is inadequate dissent, or organized skepticism. In order to ameliorate this problem, I develop a proposal that I call the "Adversarial Proceedings for the Evaluation of Pharmaceuticals," to be instituted within a regulatory agency such as the Food and Drug Administration for the evaluation of controversial new drugs and controversial drugs already in the market. This proposal is an organizational one based upon the "science court" proposal by Arthur Kantrowitz in the 1960s and 1970s. The primary benefit of this system is its ability to institutionalize dissent, thereby ensuring that one set of interests does not dominate all others.
Improvement of working environment as a tool to promote sustainable development - from a grass-root strategy to institutionalized professionalism. It is now more than 25 years since substitution of organic solvents started to be considered as a meaningful way in Denmark to reduce harmful effects...... on workers. During that period different groups of actors have been involved, new institutions to improve working environment have emerged, and legislation has been changed. The paper will describe the development from a grass-root strategy to improve working environment to a much more complex situation...... where working environment professionals play an important role, and where the concept of ‘cleaner technology’ is generally accepted as a tool to promote sustainable development in the Danish society. The paper will also discuss the necessity of incorporation of working environment considerations...
Full Text Available This essay reports on the temporary and unpaid forms of labour around which the 2015 World’s Fair (Expo 2015 in Milan is organized and upon which it depends. The collective agreement supporting Expo 2015 is especially significant, the paper contends, in that it has been seized upon by the government of Matteo Renzi as a blueprint for the future of labour relations in Italy. Expo 2015 ushers in the institutionalization of unpaid work in the crisis-stricken Italian economy—a transformation approved by the major Italian trade unions that signed off on the collective agreement, but forcefully opposed by social movements who have decried the expansion of unpaid work permitted by the contract.
Jorge Wilker Bezerra Clares
Full Text Available This is an experience report that aims to describe the application of the nursing process to an institutionalized elderly, based on Virginia Henderson’s theory. The case study was developed in a long-stay institution for the elderly in Fortaleza, Ceará, Brazil, from May to August 2010, by filling out a form, physical examination and observation. Identifying the needs of elimination, communication, recreation and learning allowed to raise the nursing diagnoses, respectively: urge urinary incontinence; impaired social interaction; diversional activity deficit; and impaired memory. The nursing interventions were directed to the health and independence of the elderly. The application of systematic nursing care impacted positively on the health of the elderly, demonstrating the applicability of the nursing systematization based on Henderson’s theory in the scenery in which the study was developed.
Hicham A. Diab
Full Text Available Objectives: To assess the dental status of institutionalized intellectually disabled individuals in Lebanon and the role of background and behavioural determinants. Material and Methods: Oral health was recorded for 652 individuals (6, 12, 15 and 35 - 44 years old using the decayed, missing and filled teeth/decayed and filled teeth (DMFT/dft index. Data collected was statistically analysed with statistical significance set at P = 0.05. Results: Overall, mean DMFT index score was 5.86 (SD 6; composed of 3.64 (SD 4.05 decayed (D teeth; 1.71 (SD 4.38 missing (M teeth; 0.87 (SD 2.51 filled (F teeth. DMFT was highest in adults (12.71 [SD 7.43] and had a large component of missing (6.24 [SD 7.02] and filled (3.31 [SD 4.56] teeth. DMFT scores ranged between 3.5 (SD 4.44 at 6 years and 4.8 (SD 4.52 at 15 years and the decayed component was the main contributor. In multivariate analyses, governorate of residence was statistically significantly (P ≤ 0.040 and P ≤ 0.044 associated with D and DMFT, the degree of disability and caretaker educational level were statistically significantly (P = 0.009 and P = 0.008 associated with D, oral hygiene practices were statistically significantly (P ≤ 0.017; P < 0.001; P ≤ 0.017; P < 0.001 associated with D, M, F and DMFT and sugar consumption was statistically significantly (P ≤ 0.03 and P ≤ 0.019 associated with D and DMFT. Conclusions: In Lebanon, preventive and treatment programs to improve the oral health status of institutionalized intellectually disabled subjects are needed.
Adrian P Mundt
Full Text Available General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that
Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan
General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as
Houdret, Annabelle; Dombrowsky, Ines; Horlemann, Lena
River Basin Management (RBM) as an approach to sustainable water use has become the dominant model of water governance. Its introduction, however, entails a fundamental realignment and rescaling of water-sector institutions along hydrological boundaries. Creating such a new governance scale is inherently political, and is being described as politics of scale. This paper analyzes how the politics of scale play out in the institutionalization of RBM in Mongolia. It furthermore scrutinizes the role of the broader political decentralization process in the introduction of RBM, an issue that has so far received little attention. Finally, it assesses whether the river basin is an adequate water management scale in Mongolia. This article finds that institutionalizing RBM in Mongolia is indeed a highly political negotiation process that does not only concern the choice of the governance scale, but also its detailed institutional design. It furthermore reveals that Mongolia's incomplete political decentralization process has for a long time negatively impacted the decentralization of water-related tasks and the implementation of RBM. However, the 2011 Budget Law and the 2012 Water Law provide for a fiscal strengthening of local governments and clearer sharing of responsibilities among the various different institutions involved in water management. Nevertheless, only if the 2012 Water Law is complemented by adequate by-laws - and if the newly created river basin institutions are adequately equipped - can RBM be effectively put into practice. This article confirms the usefulness of a politics-of-scale approach to understand scalar practices and changes in water management. However, the article also argues for a broadening of the analytical perspective to take the interdependencies between changes in water governance and other political processes, such as decentralization, into account.
Full Text Available Context: In Nepal, Senior citizens are the people who are 60 years and above as defined by the senior citizen act 2063. According to the 2011 census of Nepal, there were 2.1 million elderly inhabitants which constituted 8.1% of total population of Nepal. Aim: To assess the oral health status and treatment needs of institutionalized elderly people. Objectives: To assess the periodontal status, prosthetic status, and prosthetic needs and to compare community periodontal index and the loss of attachment (LOA with age and gender. Setting and Design: A cross-sectional study was conducted in six different old age homes of Kathmandu district. Materials and Methods: The study was conducted among 200 elderly living in six old age homes of Kathmandu district after obtaining consent from the concerned authorities. The clinical findings were recorded using the World Health Organization Oral Health Assessment Form 1997. SPSS version 20 software was used for data analysis and P ≤ 0.05 was considered statistically significant. Results: Among 200 elderly examined, 69 (34.5% were male and 131 (65.5% were female. During probing, calculus was detected among 37.5% of people. The highest prevalence of LOA 4–5 mm was found among 40.5% of people. The prosthetic need was 83%, of which 20% required complete denture, 63% required partial denture. On applying Chi-square test, LOA score was found to be statistically significant between male and female (P = 0.015. Conclusion: The oral health status of the institutionalized elderly was found to be poor.
Mundt, Adrian P.; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan
Background General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. Methodology/Principal Findings General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. Conclusions/Significance After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent
Lee, Myoung Hoon; Park, Chan H.; Yoon, Seok Na.; Hwang, Kyung Hoon
Dementia is one of the clinically recognized indications of regional cerebral blood flow (rCBF) measurement by Tc-99m ECD brain SPET (Single Photon Emission Tomography). There is only limited number of institutions for elderly demented patients who are institutionalized in Korea and SPET is nor available at these institutions. The aim of the study is to evaluate rCBF SPET findings of the patients from such an institution. Thirty-one patients were reffered for rCBF SPET from Yongin Hyoja Hospital, Yongin. They were screened using NINCDS-ADRDA criteria for probable Alzheimers disease (AD) and dementia severity was assumed by the Mini-Mental State examination. In a quite, dim light room, patients were injected with 740 mBq (20mCi) Tc-99m ethyl cysteinate dimmer (ECD), Neurolite R, Dupont Pharmaceuticals, Billerica, MA, USA). SPET was acquired using fanbeam collimators and triple-head gamma camera (MultiSPECT III, Siemens medical systems. Inc. Hoffman Estates, III.USA). SPET was done one hour after the tracer injection and most of the patients needed sedation 30 minutes before the scan. SPET was evaluated visually by 2 nuclear medicine physicians blinded to clinical information. The SPET scans of 31 patients revealed 3 typical AD, 9 atypical AD patterns. Other dementia patterns were 4 cases of frontotemporal lobe dementia, 5 cases of frontal lobe dementia and 2 multifocal infarctions. Only cerebral atrophy is depicted in 8 patients and normal SPECT findings was noted in one patient. Patients who are institutionalized for dementia have varying SPET patterns as expected and SPET findings are useful in the management of these patients with more clearer clinical insight
Ahmad Ali Akbari Kamrani
Full Text Available Aging declines abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly. In order to accomplish this aim, two functional assessment methods, Berg Scale and Tinetti Scale, were used and the validity indices of these methods were calculated. Prospective non-interventional methodological discriminative-validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using/without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use/nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases; independent variable was history of falling; and dependent variables were the results of the two functional assessment methods. Independent t-test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (P=0.0001 and Tinetti Scale (P=0.0001. The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.
Beelen, J; de Roos, N M; de Groot, L C P G M
To increase the protein intake of older adults, protein enrichment of familiar foods and drinks might be an effective and attractive alternative for oral nutritional supplements (ONS). We performed a pilot study to test whether these products could help institutionalized elderly to reach a protein intake of 1.2 gram per kg body weight per day (g/kg/d). Intervention study with one treatment group (no control group). Dietary assessment was done before and at the end of a 10-day intervention. Two care facilities in Gelderland, the Netherlands: a residential care home and a rehabilitation center. 22 elderly subjects (13 women, 9 men; mean age 83.0±9.4 years). We used a variety of newly developed protein enriched regular foods and drinks, including bread, soups, fruit juices, and instant mashed potatoes. Dietary intake was assessed on two consecutive days before and at the end of the intervention, using food records filled out by research assistants. Energy and macronutrient intake was calculated using the 2013 Dutch food composition database. Changes in protein intake were evaluated using paired t-tests. Protein intake increased by 11.8 g/d (P=0.003); from 0.96 to 1.14 g/kg/d (P=0.002). This increase is comparable to protein provided by one standard portion of ONS. The intake of energy and other macronutrients did not change significantly. At the end of the intervention more elderly reached a protein intake level of 1.2 g/kg/d than before (9 vs 4). Protein intake significantly increased during breakfast (+3.7 g) and during the evening (+2.2 g). Including familiar protein enriched foods and drinks in the menu helped to meet protein recommendations in institutionalized elderly.
Ahmad Ali Akbari-Kamrani
Full Text Available Objective: Aging decline abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly people. Materials & Methods: Prospective non–interventional methodological discriminative–validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/ without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using / without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use / nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases independent variable was history of falling and dependent variables were the results of the two functional assessment methods. In order to accomplish the aim of study, two functional assessment methods, Berg scale and Tinetti scale, were used and the validity indices of these methods were calculated. Results: Independent t test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (p=0.00l and Tinetti Scale (p=0.00l. Conclusion: The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.
Maria Albert Rodrigo
Full Text Available In this article, we explore the penetration of different shamanic currents in the new millennium in Spain, with a particular focus on the Region of Valencia. The traditions in this area differ from the shamanic traditions that had been previously adopted in two aspects: they are different shamanic currents and they follow their own settlement dynamics. By using a qualitative methodology based on a combination of thorough interviews and field observations, we have approached diverse neoshamanic manifestations in the years 2015, 2016 and 2017. We have used some of the interviews and observations of our field work. Our unit of analysis has been the Region of Valencia although the theory could be applied to the whole country. Besides, the information that circulates around websites and social media has been taken into account too. From the year 2005 on, new neo-shamanic currents have come to the Region of Valencia. That allows us to speak about a second phase in which the extension, institutionalization and settlement of the phenomenon occur together with a reconfiguration of the traditions that is shown in specific examples. All of this is shown through specific examples: the sakb’e, white way; the followers of Michel Harner and the Ayahuasca intake. The first two are centres/schools where training is given, that is, schools where the shaman’s apprentice is trained in different techniques and trainings for a set period of time that leads to a degree that certificates the training has been completed. They are good examples of the process of institutionalization of the phenomenon. The third example illustrates how the ayahuasca intake is reconfigured through the case that is specifically presented in this article.
Cornejo-Ovalle, Marco; Costa-de-Lima, Kenio; Pérez, Glória; Borrell, Carme; Casals-Peidro, Elías
To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95% 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons.
Cooper, R.; Huisman, M.; Kuh, D; Deeg, D.J.H.
Objectives. To investigate whether 3 positive psychological characteristics, related to sense of control, modify the associations of physical performance levels with subsequent functional decline and institutionalization. Method. One thousand five hundred and thirty-two men and women participating
Pereira, Catarina; Fernandes, Jorge; Raimundo, Armando; Biehl-Printes, Clarissa; Marmeleira, José; Tomas-Carus, Pablo
The objective of this study was to analyze the impact of physical fitness and physical activity on the threat of older adults without cognitive impairment becoming institutionalized. This cross-sectional study involved 195 non-institutionalized (80.1 ± 4.4 years) and 186 institutionalized (83.8 ± 5.2years) participants. Cognitive impairment was assessed using Mini-Mental State Examination, measures of physical fitness were determined by the Senior Fitness Test, and physical activity was assessed using the International Physical Activity Questionnaire. Multivariate binary logistic analysis selected four main determinants of institutionalization in both genders: The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, whereas it decreased by -24.8% by each fewer kg/m(2) in body mass index (BMI), by -0.9% for each additional meter performed in the aerobic endurance test, and by -2.0% for each additional 100 metabolic equivalent of task (MET)-min/week of physical activity expenditure (p physical activity ≤693 MET-min/week) were computed using receiver operating characteristics analysis as cutoffs discriminating institutionalized from non-institutionalized older adults. The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance), may avoid the threat of institutionalization of older adults without cognitive impairment only if they are above the 50(th) percentile. The following parameters are highly recommended: Expending ≥693 MET-min/week on physical activity, having a BMI ≤26.7 kg/m(2), and being able to walk ≥367.6 meters in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cutoffs in old and very old adults.
Batista, Wagner Oliveira; Alves Junior, Edmundo de Drummond; Porto, Flávia; Pereira, Fabio Dutra; Santana, Rosimere Ferreira; Gurgel, Jonas Lírio
to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls. to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (αstudy's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged.
Mila, R; Abellana, R; Padro, L; Basulto, J; Farran, A
The elderly, and especially those attending nursing homes, are at great risk from certain nutritional deficiencies. The aim of this study was to determine which food groups present the highest rates of consumption among the institutionalized elderly and study the energy density of each food group and the number of calories and amount of protein in the total diet of each resident. This was a multicentre observational study of a sample of the institutionalized population over the age of 65. The sample of patients was drawn from four Spanish nursing homes (Santa Coloma Gramanet, Barcelona, Madrid and Bilbao). Our final sample comprised a total of 62 individuals, of whom 22 were men and 40 women, aged between 68 and 96 years. Dietary data were collected using the double weight method for each main meal (breakfast, lunch, afternoon snack and dinner), including food type, the quantity of food served and the amount of plate waste for each of the main meals served during 21 days. The characteristics of the study population were compared by Student's t-test and χ2 test. The results are expressed in terms of their median values and the interquartile range. To analyse the overall differences between sites, gender and food groups we used Kruskall-Wallis test combined with the Mann-Whitney U-test with Bonferroni correction for multiple comparisons. The food group that was served most was milk products (376.25 g/day). A large amount of potatoes were also served (109.64 g/day) as were sweets and pastries (62.14 g/day). The daily serving of fruit (138.34 g/day) and vegetables (239.47 g/day) was equivalent to no more than that of a daily ration in each case. Milk was the food group with the highest consumption (311 g/day). Most of the energy was provided by groups with a higher energy density like as fats and sauces, sweets and pastries and bread. The mean protein consumption was 82,6 g/day (Table 5) and no significant differences were recorded in this consumption between men and
Gaggioli, Andrea; Scaratti, Chiara; Morganti, Luca; Stramba-Badiale, Marco; Agostoni, Monica; Spatola, Chiara A M; Molinari, Enrico; Cipresso, Pietro; Riva, Giuseppe
Group reminiscence therapy is a brief and structured intervention in which participants share personal past events with peers. This approach has been shown to be promising for improving wellbeing and reducing depressive symptoms among institutionalized older adults. However, despite the considerable interest in reminiscence group therapy, controlled studies to determine its specific benefits as compared to generic social interactions with peers (group conversations about everyday subjects) are still lacking. We have designed a randomized controlled trial aimed at comparing the effects of group reminiscence therapy with those of group recreational activity on the psychological wellbeing of an institutionalized sample of older adults. The study includes two groups of 20 hospitalized elderly participants: the experimental group and the control group. Participants included in the experimental group will receive six sessions of group reminiscence therapy, while the control group will participate in a recreational group discussion. A repeated-measures design will be used post-intervention and three months post-intervention to evaluate changes in self-reported outcome measures of depressive symptoms, self-esteem, life satisfaction, and quality of life from baseline. The protocol of a study aimed at examining the specific effects of group reminiscence therapy on psychological wellbeing, depression, and quality of life among institutionalized elderly people is described. It is expected that the outcomes of this trial will contribute to our knowledge about the process of group reminiscence, evaluate its effectiveness in improving psychological wellbeing of institutionalized individuals, and identify the best conditions for optimizing this approach. This trial was registered with ClinicalTrials.gov (registration number: NCT02077153) on 31 January 2014.
Linzalone, Nunzia; Ballarini, Adele; Piccinelli, Cristiano; Viliani, Francesca; Bianchi, Fabrizio
A Health Impact Assessment (HIA) is an evidence-based methodology that includes health promotion and protection goals in decision-making. HIA has been introduced and/or institutionalized to various extents in different countries. In order to promote HIA and preventive health assessments in Italy, a research methodology was followed to identify specific obstacles or facilitators. The experiences of various countries reported in the literature were analyzed in terms of facilitating or hindering the introduction and institutionalization of HIA. A consultation with the proponents of projects and plans in Italy was carried out with a multi-approach methodology in order to characterize the national context. A general implementation plan was drawn up from the international experiences. In Italy this is not yet in place. Specific areas of intervention need to be addressed, including: 1) data availability; 2) tools and methods; 3) engagement of stakeholders; 4) capacity building. The research suggests that the institutionalization of HIA in Italy rests on the government's commitment to providing specific legislation regarding HIA so that skills, intersectoral coordination and dedicated budgets can be built and maintained. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available Background. This work examines the relationship between emotional intelligence (EI and depressive symptomatology in institutionalized older adults, delving into the mechanisms underlying this relationship. Considering that previous evidence of the variation of the EI-depression relationship depending on whether the emotional ability or the perception of that ability is evaluated, a model of multiple mediation was tested in which the dimensions of emotional self-efficacy (ESE act as mediators in the relationship between ability EI and depressive symptomatology. Methods. The sample consisted of 115 institutionalized older adults (47.82% women; 80.3 ± 7.9 years of age from the province of Jaén (Spain who completed a test of ESE, a measure of ability EI, and a self-administered questionnaire of depressive symptoms. Results. The results showed a positive association between older adults’ emotional performance and depressive symptomatology, finding stronger associations with ESE than with EI abilities. In addition, multiple mediation analyses showed that two of the four dimensions of ESE fully mediated the relationship between ability EI and depressive symptoms. Discussion. These findings suggest that older adults’ high levels of emotional competence generate a feeling of ESE which can protect them against depressive symptoms. This work supports the predictive validity of emotional abilities and ESE for the mental health of a group that is particularly vulnerable to depression, institutionalized older adults. The limitations of the work are discussed, and future lines of research were considered.
Full Text Available Agroecology has come a long way. In the past ten years, it has reappeared in France throughout the agricultural sector and is now included in public and private strategies and in supportive policies, with collateral interest effects. Is a new “agro-revolution” taking place? To address this issue, using a methodology mixing hyperlink mapping and textual corpora analysis, we focus here on the trajectory of agroecology in various worlds: that of academia, social movements, non-governmental organizations (NGOs that promote international solidarity, research and training institutions and public policies. This trajectory intertwines actors and time lines, with periods in which certain actors play a specific role, and others in which interactions between actors are dominant in terms of coalition advocacy. Some actors play a major role in circulating agroecology as they belong to several different social worlds (e.g., academia and NGO, present high occupational mobility (from politician to scientist and vice versa, are charismatic or have an irradiating aura in the media, and can articulate and circulate ideas between different social arenas (including between countries. The stabilization of networks of actors is interpreted as the institutionalization of agroecology, both within social movements as well as because of its integration into a policy aimed at an ecological modernization of agriculture. The international positioning of many actors anchors national and regional initiatives more strongly. It is also a prerequisite for the amplification and development of agroecology.
Alvair Silveira Torres Jr.
Full Text Available A multi case research unfolded into a study in a sample of Brazilian manufacturing companies concerning their Continuous Improvement (CI program in manufacturing operations. Stakeholders interviews and performance analyses were conducted. The study aims to analyze the existence or absence of the institutionalization of a CI culture in manufacturing operations, identify barriers and difficulties within the process and propose a model for change. As a result of the research, it was observed that despite the considerable motivation of staff, rapid gains of the company and superior results during the early phases of the CI program, time and again such results were either not upheld or faded out over time, delivering no significant mid-term or long term results, due to poor management of changes. This happened mainly as a result of lack of strategic alignment at all levels of the organization, translated in measureable activities and projects, coached and mentored by the middle and upper management throughout the implementation and maintenance of the program. The selected cases showed a declining in performance after two years of CI program start up. Learning, union and process ownership among participants by means of interactions, are necessary to absorb and incorporate changes, instead of merely "smart words" .
Heredia-Ponce, Erika; Irigoyen-Camacho, A Esther; Sánchez-García, Sergio
To determine the association between oral health and socioeconomic position in institutionalized older women in Mexico City. A cross-sectional study was performed in two groups: high socioeconomic position (HSEP), living in a private retirement home, and low socioeconomic position (LSEP), living in a public assistance center. Oral health was determined by edentulism, oral hygiene, healthy teeth, experience of dental caries, missing and filled teeth, gingival bleeding, dental calculus, and periodontal disease. A latent class analysis (LCA) was used to classify oral health status in dentate. Included were 170 women (HSEP 54.1% and LSEP 45.8%), average age 77.3 (SD = 9.3) years. Oral health status was formed: Edentulous 32.4% HSEP and 67.6% LSEP; Class 1 Unfavorable 0% HSEP and 100% LSEP; Class2 Slightly favorable 41.2% HSEP and58.8% LSEP; and Class3 Favorable 84.6% HSEP and 15.4% LSEP. There was a statistically significant association between socioeconomic position (p < .001) and oral health status. The oral health of women studied was not optimal. Higher socioeconomic position was associated with better oral health status.
Chaffin, Brian C; Gunderson, Lance H
Adaptive governance provides the capacity for environmental managers and decision makers to confront variable degrees of uncertainty inherent to complex social-ecological systems. Current theoretical conceptualizations of adaptive governance represent a series of structures and processes best suited for either adapting or transforming existing environmental governance regimes towards forms flexible enough to confront rapid ecological change. As the number of empirical examples of adaptive governance described in the literature grows, the conceptual basis of adaptive governance remains largely under theorized. We argue that reconnecting adaptive governance with foundational concepts of ecological resilience-specifically Panarchy and the adaptive cycle of complex systems-highlights the importance of episodic disturbances and cross-scale interactions in triggering reorganizations in governance. By envisioning the processes of adaptive governance through the lens of Panarchy, scholars and practitioners alike will be better able to identify the emergence of adaptive governance, as well as take advantage of opportunities to institutionalize this type of governance in pursuit of sustainability outcomes. The synergistic analysis of adaptive governance and Panarchy can provide critical insight for analyzing the role of social dynamics during oscillating periods of stability and instability in social-ecological systems. A deeper understanding of the potential for cross-scale interactions to shape adaptive governance regimes may be useful as society faces the challenge of mitigating the impacts of global environmental change. Copyright © 2015 Elsevier Ltd. All rights reserved.
Waisman, Carlos H.
Full Text Available The purpose of this article is to analyze the varieties of Capitalism that emerged in Latin America and Central-Eastern Europe since 1980 as instances of institutional transfer. The article considers the possibility that Capitalism, as occurs with democracy, is a complex institutional package rather than and elemental institution. Some of its’ components travel faster than others through hybrid forms. These, rather than being instances of imperfect transplantation, or intermediate stages in a process of successful transfer, represent new frameworks, with potential for institutionalization.
El propósito de este artículo es analizar las variedades de Capitalismo que emergieron en Latinoamérica y la Europa Central del Este desde 1980 como ejemplos de transferencia institucional. En el artículo considero la posibilidad de que el capitalismo, al igual que la democracia, es un complejo paquete institucional antes que una institución elemental. Algunos de sus componentes viajan más rápido que otros a través de formas híbridas, constituyendo, por tanto, nuevas perspectivas con potencial suficiente para ser institucionalizadas.
Chen, Wen-Ching; Wang, Jung-Der; Lew-Ting, Chih-Yin; Chiu, Hsien-Jane; Lin, Yi-Ping
It has been noted that workplace violence most frequently occurs in psychiatric settings. The purpose of this study was to explore the workplace violence, including violence situation, victims' feeling, and the prevention strategies, on workers caring for long-term institutionalized schizophrenic patients in Taiwan. We conducted a face-to-face, in-depth, and semi-structured interview with 13 health care workers suffering from physical violence and/or sexual harassment by patients in 2002. First, the interviews were taped and/or paper-notes recorded, then transcribed, organized, and analyzed. Results found that all of the victims alleged they did not receive enough post-incident support, and more than a half of the victims could not call others for help during the violence. To avoid further attack, most victims offered prevention strategies which were considered valuable for establishing guidelines. However, some victims regarded workplace violence as inevitable and part of the job. The most common situations of workplace violence were during routine ward inspections, especially when the victims were alone. The most serious psychological harm was post-traumatic stress disorder (PTSD). In conclusion, we recommended a re-engineering of the organization to a supportive and safe working environment for prevention of workplace violence in the study hospital.
Inma Pastor Gosalbez
Full Text Available The path to eliminating gender gaps moves between advances and promises. Its pace is determined by the combination of policies, legislation and social changes. Despite the measures taken, gender inequality persists in scientific, technological and academic fields. Equality Plans, which must be implemented at Spanish universities since the adoption of the Organic Law 3/2007 of 22 March for the effective equality of women and men, constitute an important, but not sufficient, step to achieve equality in this area. A key factor can be the structures and networks for the implementation of equality policies (intra- and interuniversity ones, as well as those with other agencies and institutions, which are not sufficiently developed at present. This article describes the process of institutionalization of equality policies at Spanish universities and presents an analysis of the legislation applicable to university level. Furthermore, data about equality units and their characteristics are shown. The article concludes with a reflection upon the elements that can increase the impact of university equality structures as well as the remaining challenges.
Full Text Available This article argues that Jesus used the expression "son of man" not in a titular way, but genetically, meaning "humankind". This use of "son of man" developed into a titular usage in which Jesus is identified with "Son of Man". The study shows that Jesus' use of the expression "son of man" should be understood in the context of the "little tradition" which was reinterpreted in terms of the "great tradition" in a titular way. It is argued that this transition from "litle tradition" to "great tradition"can be seen as "false attribution". After Jesus' death when his followers reorganized themselves into a cultic community, they gave Jesus the position "founder of the cult". They did this by making use of honorary titles. The use of the title "Son of Man" for Jesus is interpreted in terms of the social theory of the institutionalization of charismatic authority. The focus is on the title "Son of Man" as it appears in legal sayings or church rules, wisdom sayings and prophetic and apocalyptic sayings.
van Schothorst, Jannine; van den Brand, Crispijn L; Gaakeer, Menno I; Wallenburg, Iris
Emergency medicine is a fast-growing medical profession. Nevertheless, the clinical activities emergency physicians (EPs) carry out and the responsibilities they have differ considerably between hospitals. This article addresses the question how the role of EPs is shaped and institutionalized in the everyday context of acute care in hospitals. A cross-case ethnographic study was conducted, comprising observations, document analysis, and in-depth interviews in three emergency departments in the Netherlands. Drawing on the theoretical concept of institutional work, we show that managers, already established medical specialties, and EPs all conduct institutional work to enhance private interests, which both restricts and enlarges EPs' work domain. These actions are strategic and intentional, as well as unintentional and part of EPs' everyday work in acute care delivery. It is in this very process that tasks and responsibilities are redistributed and the role of the EP is shaped. In contemporary literature it is often argued that the role and status of EPs should be enhanced by strengthening regulation and improving training programs. This article shows that attention should also be paid to the more subtle everyday processes of role development.
In the context of social and intellectual developments and the changing role of German universities in the first half of the nineteenth century, which led to the local institutionalization of the discipline of psychology at German universities, the structure and content of textbooks of psychology are discussed. Textbooks in the first half of the nineteenth century had a pedagogical function in training teachers, in socializing students into the field, and in providing students and readers with knowledge about the subject matter, methodology, and topics of psychology. The textbooks, representative of influence, philosophical-psychological orientations, and different decades in the first half of the nineteenth century, are reconstructed with regard to the definition of psychology, the ways of studying the soul, and how to conceptually organize the field. The textbooks by Herbart, Beneke, and Waitz, which were written within a natural-scientific programmatic vision for psychology, are contrasted with the traditional philosophically intended textbooks of Reinhold, Mussmann, George, and Schilling. Fischhaber's textbook for Gymnasien is summarized. Issues regarding the continuity of psychology are discussed, and discontinuous developments in the history of German psychology are identified.
Full Text Available Background: Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practicability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran. Methods: Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and muscle-strengthening activity was planned for those who had not severe baseline cognitive impairment or were not too frail to undertake the survey. The General Health Questionnaire (GHQ-28 was used to measure mental health status before and after intervention through a face-to-face interview. Descriptive statistics, Wilkcoxon rank-sum, Mann–Whitney U and Chi-Square tests were employed to analyses the data. Results: The applied intervention was significantly improved status of physical health, anxiety and insomnia, social dysfunction and severe depression. Conclusion: Incorporation of physical activity promotion programs into routines of older people residential care homes in Iran is feasible but may need training of physical activity specialists to work with older people based on their physical endurance and limitations.
Petrescu, Cristina; Stoian, Iasmina Rodica; Suciu, Oana; Bredicean, Cristina; Olariu, T R
In the performed study we investigated alcohol consumption--a frequent risk behavior that occurs in teenagers. The institutionalization of children from disturbed family could be a facilitator factor for alcohol consumption. A new group with different habits of the members is created and the information exchange could be useful or noxious. A transversal inquiry, with CORT (Comportamente cu Risc la Tineri--Risk Behaviors in Young People) questionnaire applying in a sample with 64 teenagers, which live in an Investment Center from Lugoj. We selected 16 items referring to alcohol consumption and the social environment. Obtained results showed frequent alcohol consumption in the social environment (group of friends--85% and disorganized family--debut of alcohol consumption under 8 years in boys group). The places of alcohol consumption are bars, restaurants (73% boys), in the Investment Center (59% boys and 29% girls), in the friends' houses, on the street. They consume alcohol in group and alone. The boys became drunk frequent (20% affirmed that became drunk more than 40 times in the last month). Discontent about relation inside the group increases the alcohol consumption outside the group. The alcohol consumption as a learned behavior in the origin disorganized family could be disseminated in the Centers for Children Protection.
Lílian Varanda Pereira
Full Text Available AbstractOBJECTIVECorrelating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales.METHODA study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS of 11 points and a Verbal Descriptor Scale (VDS of five points were compared in three evaluations: overall, at rest and during movement.RESULTSWomen were more representative (61.4% and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales.CONCLUSIONPain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.
Vieira, Cassio Leite; Videira, Antonio A.P.
In this paper, we describe and analyze the introduction and the use of the nuclear emulsions technique in Brazil. Even though consistent researches in cosmic ray physics had been done since the forties of the last century in this country, physicists here only began using this technique after Cesar Lattes' works in Bristol (England) and Berkeley (US). Despite being the implantation of the technique in this country posterior to the origin of the method itself dated from late 1900s, Brazilian scientists were quickly familiarized with it and adopted it not only in cosmic rays, but also in particle physics and nuclear physics, employing it until recently. In our work, we will be concerned with the reasons of this longevity. In other words, why were the nuclear emulsions technique employed for so many years in Brazil, even after its vanishing in physics researches centers in the world? We advance here that the answer to this question involves the institutionalization of science in Brazil mainly physics and economical, social, and geographic reasons. (author)
Alberto Carlos CRUZ GONZALEZ
Full Text Available Abstract The aim of this study was to compare the clinical performance of root caries restorations after a six-month period using two methods, a conventional technique with rotary instruments and an atraumatic restorative technique (ART, in an institutionalized elderly population in the city of Bogotá, Colombia. Root caries represents a multifactorial, progressive, chronic lesion with softened, irregular and darkened tissue involving the radicular surface; it is highly prevalent in the elderly, especially in those who are physically or cognitively impaired. A quasi-experimental, double-blind, longitudinal study was carried out after cluster randomization of the sample. Two different experienced dentists, previously trained, performed the restorations using each technique. After six months, two new investigators performed a blind evaluation of the condition of the restorations. The results showed a significantly higher rate of success (92.9% using the conventional technique (p < 0.03. However, we concluded that ART may have been the preferred technique in the study population because 81% of those restorations survived or were successful during the observation period.
Melo, Laércio Almeida de; Sousa, Meily de Mello; Medeiros, Annie Karoline Bezerra de; Carreiro, Adriana da Fonte Porto; Lima, Kenio Costa de
The aim of this study was to determine self-perception of oral-health in institutionalized elderly, and look into the sociodemographic and clinical aspects associated with negative self-perception. One hundred and sixty-six elderly were assessed by answering a self-perception question that predicts the GOHAI (Geriatric Oral Health Assessment Index). Sociodemographic data was obtained from a previously validated questionnaire and clinical data taken from the WHO file and QST-TMD used to check the existence of TMD (temporomandibular disturbance). The data gathered was submitted to Mann-Whitney, Fisher's Exact and Chi-squared tests with a 5% significance level. The average age of the study population was 80.5, and 75.9% were women. The mean DMFT (decayed, missing, and filled teeth in permanent teeth) was 28.9, the majority of the sample subject (65%) reported good to excellent teeth, gums and prostheses (dentures and bridges). Three questions in the TMD questionnaire (QST-DTM) were associated with negative self-perception. Those claiming that their jaws "lock" when they open or close their mouth, who always have pain at the front or side of their jaw, or whose jaws get tired during the course of the day are less satisfied with their oral health. We conclude that clinical and sociodemographic conditions have little influence on self-perception of oral health, possibly because pain is the main factor associated with negative self-perception in these individuals.
Adolescents are commonly seen as irrational, a position supported to varying degrees by many developmentalists, who often appeal to recent research on adolescent brains. Careful review of relevant evidence, however, shows that (1) adults are less rational than is generally assumed, (2) adolescents (and adults) are categorically different from children with respect to the attainment of advanced levels of rationality and psychological functioning, and (3) adolescents and adults do not differ categorically from each other with respect to any rational competencies, irrational tendencies, brain structures, or neurological functioning. Development often continues in adolescence and beyond but categorical claims about adolescents as distinct from adults cannot be justified. A review of U.S. Supreme Court decisions concerning intellectual freedom, reproductive freedom, and criminal responsibility shows ongoing ambivalence and confusion about the rationality of adolescents. Developmental theory and research suggest that adolescents should be conceptualized as young adults, not immature brains, with important implications for their roles, rights, and responsibilities.
Curcio, Francesco; Basile, Claudia; Liguori, Ilaria; Della-Morte, David; Gargiulo, Gaetano; Galizia, Gianluigi; Testa, Gianluca; Langellotto, Assunta; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale
Elderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m 2 ; p for trend strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg; p for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (y = 4.5x + 0.4, r = 0.61; p strength (y = 14.0x + 0.8, r = 0.53; p strength (r = 0.39, p = 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls.
Béhague, Dominique Pareja
Since the fall of the Brazilian military dictatorship in 1984, a number of structural and ideological changes associated with demilitarization and democracy have changed the face of psychiatric theory and practice. Around the country, pockets of innovative, politically sensitive and Marxist-inspired community-based forms of “psi” practice are developing. This emergent psi movement is making a range of positive contributions to the lives of average citizens, including those of poor disenfranchized youth. This paper, however, explores one particular dimension of the work of psi practitioners that has proven antithetical to the psi community’s current politicized community-based aims. Based on qualitative and quantitative longitudinal ethnographic fieldwork with therapists and young men in Pelotas, this paper analyzes how certain kinds of psi interventions being carried out in schools for a subset of lower-class young men during their early teen years are encouraging some youth to seek military training as a life option. Although these young men initially had quite captivating, engaged and politicized—if also conflicting—interactions with therapists, their eventual disillusionment with their therapeutic and scholastic experiences resulted in high levels of social alienation and depoliticization. In these young men’s search for what can best be described as formulaic solutions to troubling psychological experiences associated with a tumultuous institutionalized transition to adulthood, military training came to represent a form of self-cultivation and self-therapy. Several youth also hoped military training would enable them to actively disengage with local political processes and find shelter from troubling social inequities and injustice. The paper ends by reviewing the implications of these results for the future of psi knowledge and practice in Brazil. PMID:18347961
Savescu Roxana Florenta
Full Text Available As they mature, microcredit organizations in Romania are becoming aware of the importance of marketing in their current activities. Although marketing interventions should be considered important on all types of markets, the reality is that micro-credit companies in Romania have a limited institutional capacity to develop and implement marketing programs. This implies that marketing efforts should be focused and marketing needs should be prioritized, according to the appropriate level of market development (developing markets, growth markets and mature markets. The paper presents the results of an exploratory marketing research study regarding the marketing activity performed by microfinance institutions in Romania. The purpose of the research was to identify courses of action to institutionalize marketing research in the current activity of the subjects analyzed. It has been our intention to give a very practical dimension to the recommendations regarding the marketing information useful for microcredit organizations and categories of marketing research needing to be conducted regularly, making them applicable within the specific Romanian environment. Given the fact that on a national level scientific concerns about microfinance in Romania, in general or about marketing in the field of microfinance in particular are almost nonexistent, this thesis can be regarded as an innovation. This conclusion comes both from the investigation of existing literature and from the author's interviews with managers of microfinance institutions who have argued that this was the first time when Romanian academic institutions got interested in this sector. Potential beneficiaries of the results of this study are: managers of microcredit organizations interested in the development and sustainability of the institutions they manage; various national and international organizations interested in designing technical assistance programs in the areas identified as being
Rugbeer, Nivash; Ramklass, Serela; Mckune, Andrew; van Heerden, Johan
The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures. A significant difference was noted in social function post training 2X/week (MD = -13.85, 95% CI [-24.66, -3.38], p = 0.017, d = 0.674) and 3X/week (MD = -13.30, 95% CI [-21.81, -5.59], p = 0.003, d = 0.712) a week. Training 3X/week a week provided an additional benefit in vitality (MD = -7.55, 95% CI [-13.16, -1.91], p = 0.018, d =0. 379). Improvements in mental component summary scale post training 2X/week (MD = -4.08, 95% CI [-7.67, -0.42], p = 0.033, d = 0.425) and 3X/week (MD = -6.67, 95% CI [-10.92, -2.33], p = 0.005, d = 0.567) a week was further noted. Mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week. The exercise intervention at a frequency 3X/ week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of 2X/week. Additional benefits in vitality were achieved by exercising 3X/week. This may assist the elderly in preserving their independence.
Pedrero-Chamizo, Raquel; Albers, Ulrike; Tobaruela, José L; Meléndez, Agustín; Castillo, Manuel J; González-Gross, Marcela
The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5-100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini-Mental State Examination (MMSE). The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 (MMSE score). All parameters were significantly higher for men (P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age. © 2013 Japan Geriatrics Society.
Seow, Lee Seng Esmond; Chong, Siow Ann; Wang, Peizhi; Shafie, Saleha; Ong, Hui Lin; Subramaniam, Mythily
Metabolic syndrome (MetS) and cardiovascular risk are highly prevalent among individuals with schizophrenia. This study aimed to determine the cardiometabolic profile and the associated risk factors in a group of institutionalized patients with schizophrenia or schizoaffective disorder receiving prolonged hospital care in the only tertiary psychiatric institution in Singapore. Patients residing in long stay wards who were hospitalized for a minimum period of 1year were recruited. Fasting blood sample was collected to obtain levels of blood glucose, total cholesterol, high-density lipoprotein (HDL) and triglycerides. Waist circumference, blood pressure, height and weight were also measured. The prevalence of MetS and the 10-year cardiovascular risk were determined. This inpatient group had a mean age of 56.1years and an average length of hospitalization of 8.8years. The prevalence of MetS in this group was 51.9% and 26.9% based on the AHA/NHLBI and modified NCEP ATP III criteria respectively. Those in the high risk BMI category and those who had pre-existing diabetes had higher odds of MetS. Their 10-year cardiovascular risk was estimated at 12.8%, indicating intermediate risk based on the Framingham risk function. Despite the low smoking rate in this group of inpatients, their cardiovascular risk appeared to be relatively high possibly due to old age and age-related conditions such as hypertension and low HDL. While literature has found the use of atypical antipsychotic medications to increase the risk of MetS, we did not find any significant association. Additionally, the duration of hospitalization did not affect the rate of MetS in our sample. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Mollinger, L A; Steffen, T M
The purpose of this study was to document the prevalence, severity, and progression of knee flexion contractures (KFCs) in a population of institutionalized elderly and to identify relationships between knee extension and other variables. The subjects were 112 nursing home residents who exhibited a broad range of ambulation and cognitive function abilities. Data were collected initially (T1) and after a 10-month period (T2). Only 25% of the population had extension in the 0- to 5-degree (lacking full extension) range bilaterally at T1 and T2, leaving the majority of subjects with some degree of unilateral KFC. Most of the subjects with a KFC greater than 20 degrees were nonambulatory and had a significantly higher occurrence of resistance to motion than did nonambulators with a KFC of less than 20 degrees. Knee extension measurements did not change in most subjects between T1 and T2. The knees that did show a change in KFC (either an increase or a decrease) had a significantly higher occurrence of resistance to passive motion than did other knees. Compared with the subjects who gained extension, the subjects who lost extension over the study period more frequently had minimal KFC at T1, were ambulatory at T1, showed a regression in ambulation at T2, and developed resistance to motion at T2. The data confirmed significant positive correlations between degree of KFC and presence of resistance to passive knee motion, cognitive impairment, impaired ambulation, and presence of knee pain. Physical therapy assessment and intervention may be appropriate in nonambulatory nursing home residents with resistance to passive motion, residents with KFC approaching 20 degrees, and ambulatory residents with minimal KFC who develop resistance and begin to regress in ambulation. Several areas for future study are suggested.
Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A
In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.
Monteiro-Junior, Renato Sobral; da Silva Figueiredo, Luiz Felipe; Maciel-Pinheiro, Paulo de Tarso; Abud, Erick Lohan Rodrigues; Braga, Ana Elisa Mendes Montalvão; Barca, Maria Lage; Engedal, Knut; Nascimento, Osvaldo José M; Deslandes, Andrea Camaz; Laks, Jerson
Improvements on balance, gait and cognition are some of the benefits of exergames. Few studies have investigated the cognitive effects of exergames in institutionalized older persons. To assess the acute effect of a single session of exergames on cognition of institutionalized older persons. Nineteen institutionalized older persons were randomly allocated to Wii (WG, n = 10, 86 ± 7 year, two males) or control groups (CG, n = 9, 86 ± 5 year, one male). The WG performed six exercises with virtual reality, whereas CG performed six exercises without virtual reality. Verbal fluency test (VFT), digit span forward and digit span backward were used to evaluate semantic memory/executive function, short-term memory and work memory, respectively, before and after exergames and Δ post- to pre-session (absolute) and Δ % (relative) were calculated. Parametric (t independent test) and nonparametric (Mann-Whitney test) statistics and effect size were applied to tests for efficacy. VFT was statistically significant within WG (-3.07, df = 9, p = 0.013). We found no statistically significant differences between the two groups (p > 0.05). Effect size between groups of Δ % (median = 21 %) showed moderate effect for WG (0.63). Our data show moderate improvement of semantic memory/executive function due to exergames session. It is possible that cognitive brain areas are activated during exergames, increasing clinical response. A single session of exergames showed no significant improvement in short-term memory, working memory and semantic memory/executive function. The effect size for verbal fluency was promising, and future studies on this issue should be developed. RBR-6rytw2.
Gálvez-Barrón, César; Narvaiza, Leire; Dapena, María D; Macho, Oscar; Rodríguez-Molinero, Alejandro
In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population. To explore prevalence and considered pharmacological treatments for pain in this population. Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews. Pain's prevalence was 52.5 % (CI 95 % 48.28-56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93-1.02) in females and 0.99 (CI 95 % 0.92-1.06) in males]. The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline's recommendations are probably not being considered to select the analgesic therapy.
Jacob Dahl Rendtorff
Full Text Available This paper reconstructs the argument of Axel Honneth's recent book Das Recht der Freiheit as a theory of the institutionalization of freedom in modern society. In particular, it looks at Honneth's argument for the realization of freedom in law and morality that is proposed as a contemporary re-interpretation of Hegel's Philosophy of Right. Then I discuss Honneth's argument for the reality of freedom in the ethical spheres of civil society, in particular in the family, the market and in democracy. Finally, the paper proposes some critical remarks to Honneth's theory.
Rendtorff, Jacob Dahl
This paper reconstructs the argument of Axel Honneth's recent book Das Recht der Freiheit as a theory of the institutionalization of freedom in modern society. In particular, it looks at Honneth's argument for the realization of freedom in law and morality that is proposed as a contemporary re......-interpretation of Hegel's Philosophy of Right. Then I discuss Honneth's argument for the reality of freedom in the ethical spheres of civil society, in particular in the family, the market and in democracy. Finally, the paper proposes some critical remarks to Honneth's theory....
Johansen, Inger; Lindbak, Morten; Stanghelle, Johan K; Brekke, Mette
The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202) versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100). 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Primary: Independence, assessed by Sunnaas ADL Index(SI). Secondary: Hospital and short-term nursing home length of stay (LOS); institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson's χ2, ANCOVA, Regression and Kaplan-Meier analyses. Overall SI scores were 26.1 (SD 7.2) compared to 27.0 (SD 5.7) at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5)). The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7)). Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6), p=0.05). The institutionalization increased in PCNHR (from 12%-28%, p=0.001), but not in PCDIR (from 16.9%-19.3%, p= 0.45). The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient was 3528€ for rehabilitation (prehabilitation and care were 18702€ (=1
Full Text Available Abstract Background The optimal setting and content of primary health care rehabilitation of older people is not known. Our aim was to study independence, institutionalization, death and treatment costs 18 months after primary care rehabilitation of older people in two different settings. Methods Eighteen months follow-up of an open, prospective study comparing the outcome of multi-disciplinary rehabilitation of older people, in a structured and intensive Primary care dedicated inpatient rehabilitation (PCDIR, n=202 versus a less structured and less intensive Primary care nursing home rehabilitation (PCNHR, n=100. Participants: 302 patients, disabled from stroke, hip-fracture, osteoarthritis and other chronic diseases, aged ≥65years, assessed to have a rehabilitation potential and being referred from general hospital or own residence. Outcome measures: Primary: Independence, assessed by Sunnaas ADL Index(SI. Secondary: Hospital and short-term nursing home length of stay (LOS; institutionalization, measured by institutional residence rate; death; and costs of rehabilitation and care. Statistical tests: T-tests, Correlation tests, Pearson’s χ2, ANCOVA, Regression and Kaplan-Meier analyses. Results Overall SI scores were 26.1 (SD 7.2 compared to 27.0 (SD 5.7 at the end of rehabilitation, a statistically, but not clinically significant reduction (p=0.003 95%CI(0.3-1.5. The PCDIR patients scored 2.2points higher in SI than the PCNHR patients, adjusted for age, gender, baseline MMSE and SI scores (p=0.003, 95%CI(0.8-3.7. Out of 49 patients staying >28 days in short-term nursing homes, PCNHR-patients stayed significantly longer than PCDIR-patients (mean difference 104.9 days, 95%CI(0.28-209.6, p=0.05. The institutionalization increased in PCNHR (from 12%-28%, p=0.001, but not in PCDIR (from 16.9%-19.3%, p= 0.45. The overall one year mortality rate was 9.6%. Average costs were substantially higher for PCNHR versus PCDIR. The difference per patient
Full Text Available Stretching has been widely used to increase the range of motion. We assessed the effects of a stretching program on muscle-tendon length, flexibility, torque, and activities of daily living of institutionalized older women. Inclusion/exclusion criteria were according to Mini-Mental State Examination (MMSE (>13, Barthel Index (>13 and Lysholm Scoring Scale (>84. Seventeen 67 ± 9 year-old elderly women from a nursing home were divided into 2 groups at random: the control group (CG, N = 9 participated in enjoyable cultural activities; the stretching group (SG, N = 8 performed active stretching of hamstrings, 4 bouts of 1 min each. Both groups were supervised three times per week over a period of 8 weeks. Peak torque was assessed by an isokinetic method. Both groups were evaluated by a photogrammetric method to assess muscle-tendon length of uni- and biarticular hip flexors and hamstring flexibility. All measurements were analyzed before and after 8 weeks by two-way ANOVA with the level of significance set at 5%. Hamstring flexibility increased by 30% in the SG group compared to pre-training (76.5 ± 13.0° vs 59.5 ± 9.0°, P = 0.0002 and by 9.2% compared to the CG group (76.5 ± 13.0° vs 64.0 ± 12.0°, P = 0.0018. Muscle-tendon lengths of hip biarticular flexor muscles (124 ± 6.8° vs 118.3 ± 7.6°, 5.0 ± 7.0%, P = 0.031 and eccentric knee extensor peak torque were decreased in the CG group compared to pre-test values (-49.4 ± 16.8 vs -60.5 ± 18.9 Nm, -15.7 ± 20%, P = 0.048. The stretching program was sufficient to increase hamstring flexibility and a lack of stretching can cause reduction of muscle performance.
Full Text Available Momoko Yamagata,1 Tome Ikezoe,1 Midori Kamiya,1 Mitsuhiro Masaki,2,3 Noriaki Ichihashi1 1Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, 2Department of Physical Therapy, 3Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan Purpose: Sample entropy (SampEn is an analysis to evaluate movement complexity of the center of pressure (COP. A lower value of SampEn indicates lower complexity of COP variability, that is, rigidity, and lower degrees of freedom. Previous studies reported the association of increased SampEn with improved standing balance ability in young subjects. However, no studies have examined these relationships among older adults. Thus, we aimed to investigate the relationship between SampEn and standing balance ability in older adults.Subjects and methods: The subjects were 33 institutionalized older adults (aged 82.2±6.5 years. COP during static standing was measured. The standard deviation (SD values of COP and SampEn in the sagittal and frontal planes were calculated using time series data. One-leg standing test (OLST, functional reach (FR test, and lateral reach (LR test were also measured to evaluate standing balance ability.Results: OLST, FR, and LR were 6.5±8.3 s, 19.8±5.9 cm, and 18.2±6.4 cm, respectively. Pearson correlation analysis revealed that SampEn in the sagittal plane significantly correlated with OLST (r=-0.35 and FR (r=-0.36. However, SampEn in the frontal plane and SD of COP in both sagittal and frontal planes had no relationship with any of the clinical balance tests.Conclusion: Lower SampEn implies rigidity for postural control. In the present study, it was found that lower SampEn in the sagittal plane was related to a higher balance function, which suggests that older adults utilized body rigidity to maintain postural stability as a compensative strategy. Keywords: older adults, posture, balance, standing, complexity
The third energy package proposes the establishment of an Agency for the Cooperation of Energy Regulators (ACER) and the establishment of a European Network of Transmission System Operators for Electricity (ENTSOE) and a European Network of Transmission System Operators for Gas (ENTSOG). This legislative initiative is a response to the need to further liberalise the energy sector and to create one single energy market. The proposals wish to remedy the lack of regulatory oversight for cross border issues and the existence of a regulatory gap on cross-border issues. This article addresses these proposals and places them in a historical context. The proposals indicate that the European legislator to some degree intends to institutionalize cross border cooperation of regulators and of transmission system operators. So far cross-border cooperation mostly has been brought about on a voluntary basis and not on the basis of European law. Also this cooperation takes place on a voluntary basis and largely outside the scope of the European Commission. If the proposals are excepted they will result in new forms of cooperation in the energy sector. The Agency will be a community body with legal personality that, besides having an advisory role, will in some circumstances be able to take binding decisions. Therefore it will entail more than voluntary cooperation and be a step closer to the establishment of a European regulator. With the creation of ENTSOG and ENTSOE cooperation between transmission system operators will for the first time be obligatory and take place on the basis of European legislation. It will therefore be a new phenomenon. Nevertheless, it is not always clear from the proposals what the result in practice will be nor how the new organizations will relate to each other, to the Commission and to the national regulators and transmission system operators. Currently, the main question is whether the proposals will be adopted by the Council and the European
Full Text Available Protein-energy malnutrition (PEM is a common finding in hospitalized or institutionalized elderly people. In the literature, PEM is not mentioned as being related to individual ability of the patient to feed him or herself correctly. This study analyzed the 56 patients of a nursing home divided into two groups: self-sufficient and non self-sufficient regarding feeding. Levels of serum albumin, transferrin, prealbumin and hemoglobin (Hb were examined and compared to body mass index (BMI calculated with bioelectrical impedance analysis. Fifty-three percent of patients were self-sufficient, while 47% were not self-sufficient for feeding of which 83.3% were women and 16.7% men. Levels below the average range were 49.1% for lymphocyte count, 52.9% for serum albumin, 13.7% for serum transferrin and 52.9% for serum prealbumin. No significant differences were found in terms of patient age, while the mean values of the parameters examined in the two groups, self-sufficient and not, were lower in the patients who were not self-sufficient, even if statistical significance was not reached. Serum albumin was in inverse proportion to age (P<0.05 and 46.1% of individuals with low levels of transferrin also showed low levels of Hb. Anemia was in direct proportion (P<0.05 to age. Measurement of BMI showed values below 22.5 (cut off for risk for malnutrition in 33.4% of the subjects examined. Of the three hematochemical parameters, analysis of a possible relationship with BMI showed only a significant and directly proportional correlation with prealbumin (P<0.05%. These data should be considered in the context of an epidemiological research study carried out in a conditioned and limited environment, where PEM, detected using hematochemical parameters, amounted to 50% of the patients, whereas BMI identified only approximately one-third of patients at risk of malnutrition. There were no statistically significant differences between men and women. Mean values of the
Full Text Available This article explores the phenomenon of foreign policy think tanks in Europe in a comparative perspective and offers a framework of analysis for this topic. Assuming that think tanks were largely imported from the US after World Wars I and II, the article argues that European think tanks have been influenced by the different national political contexts in which they have undergone a process of institutionalization. First, the article hypothesizes that such contexts have contributed to determining different incentives for cooperation between think tanks and national policymakers. Such cooperation is based on the willingness of policymakers to turn to think tanks for expertise, advice or validation of policy decisions. Secondly, different political contexts are expected to influence the strategies of action that think tanks have developed towards policymakers and their audience. In this respect, the article identifies three strategies: the generalist, the advocate and the lobbyist. Empirically, the article is based on a survey of eleven organizations conducted in two countries, Italy and the United Kingdom, in 2013-14. Given that very few data are available on this type of organization, their activities, funding, policy audience and goals are investigated. These indicators are used to investigate the main commonalities and differences between the two cases and to compare them with the hypotheses. The results first show that there is comparatively more funding available for think tanks in the UK system than in the Italian one. Secondly, there is apparently more willingness from policymakers to turn to think tanks for expertise in the former case, considering that the UK think tanks hold a higher number of closed-door events and parliamentary hearings. On the contrary, where policymakers tend, instead, to more scarcely rely on external expertise - as it seems more evident in the Italian case - the core audience of think tanks tends to shift to other
Chen, Shu-Mei; Kuo, Chien-Lin; Chen, Mei-Rong; Lee, Lai-Ling; Lee, Pi-Yueh; Wang, Shu-Fen
Long-term care institutions have become an option for older people who are dependent in daily living. However, insufficient attention has been focused on assessing the life satisfaction of those currently residing in these institutions in Taiwan. Previous research indicates that group reminiscence may improve the life satisfaction of older adults. However, there is currently no consensus regarding the implementation and evaluation of reminiscence interventions. To examine the effect of a structured group reminiscence protocol on the life satisfaction of institutionalized older adults. The study used a quasi-experimental design. A total of 48 older adults were conveniently recruited from two long-term care institutions in southern Taiwan. The experimental group (n = 23) received 8 weeks of structured-group reminiscence for 40 minutes weekly, while the control group (n = 25) received routine care from the institution. Both groups were evaluated using a life-satisfaction questionnaire before and after the intervention and again four weeks later. Life satisfaction scores were statistically similar on the pre-test and significantly different on both post-test questionnaires for the two groups. The scores for the experimental and control groups were pre-test: 24.22 vs 23.36 (p = .063); post-test I: 27.22 vs 23.32 (p < .001); and post-test II: 26.43 vs 23.00 (p < .001). The mean post-test scores for the experimental group were significantly higher than the pre-test score (p < .001). The generalized estimating equation test showed that the overall score of life satisfaction for the experimental group increased by 0.85-points (p = .042) more than the control group, which is a significant difference. The results support that the 8-week structured group reminiscence protocol effectively enhances life satisfaction in older adults. The results of this study may be referenced in the continuing education of nurses working in long-term care institutions in the context of helping
Cruz-Oliver, D M; Malmstrom, T K; Allen, C M; Tumosa, N; Morley, J E
To evaluate predictive validity of cognitive dysfunction of the Saint Louis University mental status (SLUMS) exam or mini-mental state exam (MMSE) for institutionalization and mortality after 7.5-years. Longitudinal study. Geriatric Research, Education and Clinical Center Veterans Affairs Hospital St. Louis, MO. Patients (N=705) were screened for cognitive dysfunction in 2003 using the SLUMS exam and MMSE, and mortality and institutionalization up to 7.5-years later were evaluated as outcome measures. The associations between outcome measures and MMSE and SLUMS exam total scores, and cognitive status were examined using Kaplan-Meier curves and Cox proportional-hazards regression. Five hundred thirty-three charts were reviewed, 176/533(33%) patients had died and 31/526 (6%) were institutionalized during 7.5-year follow-up period. All subjects were male with a mean age of 75 years and most had high school education or greater (71%). MMSE dementia, SLUMS dementia (ps<.001) and MCI (p<.05) groups had significantly lower survival rates than normal cognition group in the Kaplan-Meier curves. Scores classified as dementia on SLUMS (HR=2.4, 95% CI 1.6-3.7; p <.001) or MMSE (HR=2.3, 95% CI 1.5-3.6; p <.001) both predicted mortality and, also, institutionalization (SLUMS: HR=3.5, 95% CI 1.3-9.1; p <.01; MMSE: HR=3.8, 95% CI 1.6-9.0; p <.001) after adjustment for covariates. Unadjusted SLUMS exam MCI predicted morality (HR=1.5, 95% CI 1.1-2.2; p <.019) but not institutionalization. The SLUMS exam and MMSE both predict mortality and institutionalization for male patients screened as positive for dementia.
Labelle, A; Bradford, J M; Bourget, D; Jones, B; Carmichael, M
Clinical, developmental and environmental factors were retrospectively studied in 14 adolescent murderers who had been referred to a forensic psychiatric clinic over an 11 year period. Results of these analyses were compared with findings from previous reports. The majority of subjects came from split families. There was a greater than expected degree of psychiatric illness in the adolescents. Previous psychiatric contact, antisocial behaviour and substance abuse were common among these adolescents. A tentative profile of adolescents who are likely to commit murder can therefore be drawn up, which may suggest direction for preventive action and rehabilitation.
Berry, Alessandra; Borgi, Marta; Terranova, Livia; Chiarotti, Flavia; Alleva, Enrico; Cirulli, Francesca
An ever increasing interest in the therapeutic aspects of the human-animal bond has led to a proliferation of animal-assisted interventions (AAI) involving dogs. However, most of these programs lack a solid methodological structure, and basic evaluative research is needed. The purpose of this study was to test the value of dog-assisted interventions as an innovative tool to increase quality of life in the geriatric population. Nineteen patients (men and women) with a mean age of 85 years participated in the study. Interactions between patients and visiting dogs occurred either in a social situation (socialization sessions) or in a therapeutic context (physical therapy sessions). We derived and characterized a specific ethogram of elderly-dog interactions aimed at evaluating the effectiveness of visiting dogs in improving mood, catalyzing social interactions and reducing their everyday apathetic state. Cortisol levels were also measured in the saliva, and depressive state was evaluated. Overall, results show a time-dependent increase in social behaviour and spontaneous interactions with the dogs. Dog-mediated interactions affected the daily increase in cortisol levels, thus having an 'activational effect', in contrast to the apathetic state of institutionalized elderly. Dog-mediated intervention programs appear to be promising tools to improve the social skills and enrich the daily activities of the institutionalized elderly. © 2012 The Authors. Psychogeriatrics © 2012 Japanese Psychogeriatric Society.
António Palma Seman
Full Text Available OBJETIVO: Analisar a prevalência, causas e evolução da hipotermia acidental em idosos institucionalizados. MÉTODOS: Estudo prospectivo realizado entre janeiro e dezembro de 2004, no Hospital Geriátrico e de Convalescentes D. Pedro II, com 483 internos. Hipotermia foi confirmada por termômetro esofágico, utilizado em todos os pacientes com temperatura axilar menor ou igual a 35ºC (95ºF. Tanto o diagnóstico etiológico quanto as complicações da hipotermia foram observados em exames clínico e subsidiários de urgência como eletrocardiograma, radiografia de tórax, hemograma, gasometria arterial, glicemia, metabólitos, amilase, função hepática e renal, sorologias para HIV, sífilis e hepatite B e urina tipo I. Foram adotadas medidas de reaquecimento entre outras do protocolo de tratamento. RESULTADOS: A prevalência de hipotermia foi de 7,2% especialmente em mulheres (65,7%, e a média de idade do grupo foi 76,4 anos. A maioria dos pacientes (77,1% apresentava elevado grau de dependência (Katz "F" e "G". Hipotermia leve foi identificada na maioria dos idosos (71,4%. A taxa de mortalidade foi de 62,8%, sendo 31,4% em vigência de hipotermia e 31,4% após sua reversão. Em 100,0% dos casos, a etiologia foi infecciosa: pneumonia em 80%, infecção urinária em 60,0%, e úlceras por pressão em 17,1%. Em 60% dos casos havia mais de um foco infeccioso. CONCLUSÃO: A hipotermia em idosos institucionalizados é uma grave condição clínica, com altos índices de mortalidade. A prevenção, o diagnóstico precoce e medidas de reaquecimento central corroboram para um melhor prognóstico.OBJECTIVE: To analyze the prevalence, causes and outcome of hypothermia in institutionalized elderly. METHODS: prospective study held from January to December, 2004 at the Hospital Geriátrico e de Convalescentes Dom Pedro II (Geriatric and Convalescent Hospital Dom Pedro II, with 483 long-term care beds. Hypothermia was diagnosed by esophageal thermometer
Tieland, Michael; Beelen, Janne; Laan, Anna C M; Poon, Shirley; de Groot, Lisette C P G M; Seeman, Ego; Wang, Xiaofang; Iuliano, Sandra
Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of malnutrition. Therefore, we aim to determine the association between protein intake distribution and nutritional status in institutionalized elderly people. Cross-sectional study among 481 institutionalized older adults. Dietary data from 481 ambulant elderly people (68.8% female, mean age 87.5 ± 6.3 years) residing in 52 aged-care facilities in Victoria, Australia, were assessed over 2 days using plate waste analysis. Nutritional status was determined using the Mini-Nutritional Assessment tool and serum (n = 208) analyzed for albumin, hemoglobin, and IGF-1. Protein intake distribution was classified as: spread (even distribution across 3 meals, n = 65), pulse (most protein consumed in one meal, n = 72) or intermediate (n = 344). Regression analysis was used to investigate associations. Mean protein intakes were higher in the spread (60.5 ± 2.0 g/d) than intermediate group (56.0 ± 0.8 g/d, P = .037), and tended to be higher than those in the pulse group (55.9 ± 1.9 g/d, P = .097). Residents with an even distribution of protein intake achieved a higher level of the recommended daily intake for protein (96.2 ± 30.0%) than the intermediate (86.3 ± 26.2%, P = .008) and pulse (87.4 ± 30.5%, P = .06) groups, and also achieved a greater level of their estimated energy requirements (intermediate; P = .039, pulse; P = .001). Nutritional status (Mini-Nutritional Assessment score) did not differ between groups (pulse; 20.5 ± 4.5, intermediate; 21.0 ± 2.5, spread; 20.5 ± 3.5), nor did any other indices of nutritional status. Meeting protein requirements is required before protein distribution may influence nutritional status in institutionalized
Foreman, Susan; Seligman, Linda
Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)
proportion of women on the entire scientific staff, senior and junior (excluding postdoctoral scholars) has risen from 19% in 2005 to 27% in 2011. With the revised search processes, diversity in the applicant pool (defined as the number of women and/or racial minorities as a percent of the total number of applicants) increased dramatically, with 8 out of 10 searches over the period 2009-2010 showing a diversity of at least 70% in the applicant pool compared to an average diversity of less than 50% over the period 2007-2009. Of the new scientific hires in 2009-2010 almost half were either female or a racial minority. Postdoctoral scholars at LDEO have seen the greatest increase in racial diversity, from approximately 91% white in 2005 to 67% white in 2011. This group also has the most gender diversity at LDEO - approximately 47% female in 2011 up from 41% in 2005. Overall, the LDEO experience of institutionalizing ADVANCE has the potential to serve as a model for other scientific research institutions.
Janaina Francisca de Souza Campos Vinha
Full Text Available This paper presents reflections on the still poorly treated and discussed theme. The formation of research groups is a "new" form of organization of academic and scientific work that has recently been institutionalized by the major institutions of higher education, research and development agencies in Brazil. The research groups in Geography were treated mainly on two aspects: as important spaces for socialization of knowledge that has been growing steadily and that subsidize the training of future teachers, foster critical and reflective stance, highlighting the collective work in the study of common themes; and as important socialization spaces of knowledge that has been growing steadily, and as part of the restructuring process initiated in the 1990s, a period that the Groups Directory Research of Brazil (DGPB formalizes the groups with CNPq. By analyzing the role of postgraduate research and its relation to the formation of research groups have demonstrated that besides the expressiveness achieved with the increase of the groups in all regions of the country, this form of organization also brought repercussions to the fields of education and research segments that incorporated resets the world of work and readjusted neoliberal policies. Este artigo apresenta reflexões sobre uma temática ainda pouco tratada e discutida. A formação de grupos de pesquisa é uma “nova” forma de organização do trabalho acadêmico e científico que recentemente foi institucionalizado pelos principais centros de Ensino Superior, pesquisas e agências de fomento no Brasil. Os grupos de pesquisa em Geografia foram tratados, sobretudo, diante de dois aspectos: como espaços importantes de socialização do conhecimento que vem crescendo progressivamente e que subsidiam a formação do futuro docente e fomentam a postura crítica e reflexiva, com destaque ao trabalho coletivo no estudo de temas em comum; e como parte do processo de reestruturação produtiva
Weening-Dijksterhuis, Elizabeth; de Greef, Mathieu H. G.; Scherder, Erik J. A.; Slaets, Joris P. J.; van der Schans, Cees P.
Weening-Dijksterhuis E, de Greef MHG, Scherder EJA, Slaets JPJ, van der Schans CP: Frail institutionalized older persons: A comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Phys Med Rehabil 2011;90:156Y168. The objective of this study
Klerkx, L.W.A.; Leeuwis, C.
The purpose of this paper is to critically examine the institutionalization of demand-driven modes of working in the R&D planning process and reveal possible weaknesses, through an analysis of a system of collective R&D funding by farmers. The findings indicate that, although end-users have
Brekke, Beverly W.; And Others
A 40-item behavior analysis task, the Menstrual Care Scale, was developed and tested with 75 randomly selected institutionalized severely retarded women (13-59 years old). The need for developing personal care skills in menstruation habits had been identified as a priority area for sexuality instruction by staff and confirmed by analysis of…
Bossers, Willem J R; Scherder, Erik J A; Boersma, Froukje; Hortobágyi, Tibor; van der Woude, Lucas H V; van Heuvelen, Marieke J G
Objectives: We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Methods: Thirty-three patients with dementia, recruited from one nursing home, participated in this
Bossers, W.J.R; Scherder, E.J.A.; Boersma, F.; Hortobágyi, T.; van der Woude, L.H.V.; van Heuvelen, M.J.G.
Objectives: We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Methods: Thirty-three patients with dementia, recruited from one nursing home, participated in this
Full Text Available Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services.Ten databases including CENTRAL and Medline searched through December 2012.Randomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge.Two authors independently extracted data. Outcomes were pooled using random effects.Mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness.Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [-0.01 to 0.00]. There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18] or hospitalized (RR = 0.96 [0.91 to 1.01]. There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01], but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = -0.06 [-0.11 to -0.01] and physical functioning (SMD = -0.10 [-0.17 to -0.03] respectively, but these may not be clinically important.Home visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programs that are associated with consistent benefits. Due to poor reporting
Arinzon, Zeev; Zeilig, Gabriel; Berner, Yitshal N; Adunsky, Abraham
Phenytoin (PH) is indicated primarily for the control of grand mal and psychomotor seizures. However, topical PH has been used for the treatment of various types of ulcers, including pressure ulcers. The aim of this study was to investigate the possibility of a relationship between the use of oral PH and the prevalence of pressure ulcers among bedridden institutionalized elderly patients. This retrospective chart review was conducted in a state-run urban geriatric medical center in Israel and involved long-term bedridden institutionalized patients who were receiving chronic antiepileptic medication during the 7-year period between January 1996 and December 2003. The prevalence of pressure ulcers in patients who received treatment with PH alone or in combination with other antiepileptic drugs was compared with that in patients who received antiepileptic agents other than PH. The study analyzed data from the medical charts of 153 patients, 72 of whom received PH alone or in combination with other antiepileptic drugs, and 81 of whom received antiepileptic agents other than PH. Patients' mean (SD) age was 78.5 (7.2) years; 106 (69.3%) were women. All patients were totally dependent with respect to activities of daily living (mean Katz score, 2.0 [2.0]) and had severe cognitive decline (mean Mini-Mental State Examination score, 3.5 [3.3]). Pressure ulcers occurred in 9.7% of PH recipients and 27.2% of non-PH recipients (P = 0.006; chi2 = 7.55). In PH recipients, 85.7% of pressure ulcers were of mild to moderate severity (stage I or II), compared with 59.1% of ulcers in non-PH recipients; the difference between groups was not statistically significant. Four (18.2%) non-PH recipients and no PH recipients had stage IV pressure ulcers. In the PH group, 71.4% of patients had a pressure ulcer in only 1 anatomic location, compared with 22.7% of the non-PH group (P = 0.023; chi2 = 5.13); 28.6% of PH recipients and 63.6% of non-PH recipients had pressure ulcers in 2 or 3
Dugenia, M E
The goal of the Philippine Population Education Program (PEP) since its inception in 1972 is to institutionalize population education in the formal educational system. The PEP Training Section views institutionalization of population education in the inservice education program for elementary school teachers as part of the process of making it an integral part of that program. In practice elementary school teachers periodically attend training programs organized by division or district supervisors and school principals. This is the usual modality through which teachers are updated on or informed about new thrusts and recent developments in teaching content, strategies, and methodologies. In this context, the PEP Training Section convened a seminar workshop in December 1981 for 10 subject area supervisors from the 3 large geographic island groups of Luzon, Visayas, and Mindanao. They represented 10 school divisions and subject areas where population education is integrated. The specific objectives of the 5 day activity were to: discuss existing inservice training programs in the school divisions; prepare a training model incorporating population education in the overall division inservice training program; and develop a content chart or a listing of topical areas on population education for the training model. 1 of the outputs of the seminar workshop was a training model incorporating population education in the regular inservice training programs using 3 delivery schemes, i.e., seminar workship on the teaching of specific subject areas; district staff meeting and/or echo seminars organized by district supervisors following division seminars; and regular teachers' meeting at the school level organized by school principals. Another output was a content chart listing suggested topics in population education classified according to subject areas into which they will be incorporated. The semninar workshop concluded with a plan to try out the model using the identified
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García, Patricia J; Egoavil, Miguel S; Blas, Magaly M; Alvarado-Vásquez, Eduardo; Curioso, Walter H; Zimic, Mirko; Castagnetto, Jesus M; Lescano, Andrés G; Lopez, Diego M; Cárcamo, Cesar P
Training in Biomedical Informatics is essential to meet the challenges of a globalized world. However, the development of postgraduate training and research programs in this area are scarce in Latin America. Through QUIPU: Andean Center for Training and research in Iformatics for Global Health, has developed the first Certificate and Masters Program on Biomedical Informatics in the Andean Region. The aim of this article is to describe the experience of the program. To date, 51 students from Peru, Chile, Ecuador, Colombia and Venezuela have participated; they come from health ministries, hospitals, universities, research centers, professional associations and private companies. Seventeen courses were offered with the participation of faculty from Argentina, Chile, Colombia, USA, Mexico and Peru. This program is already institutionalized at the School of Public Health and Administration from the Universidad Peruana Cayetano Heredia.
Chou, Yueh-Ching; Lu, Zxy-yann J; Pu, Cheng-yun; Lan, Chung-Fu
No previous research has examined the importance of both individual and environmental factors for predicting caregivers' menstrual attitudes. To explore the predictors of female caregivers' attitudes towards menstruation and the help they give to women with intellectual disabilities, we conducted a cross-sectional questionnaire survey which was completed by 725 female workers from 12 institutions in Taiwan. The Menstrual Attitudes Questionnaire (MAQ) and a structured questionnaire were used. Logistic regression analysis revealed that individual characteristics such as age and education were significantly associated with menstrual attitudes of female caregivers working with institutionalized women with intellectual disabilities. Furthermore, the environmental context, such as the frequency of discussions with colleagues, training in menstrual management care and the level of difficulty when giving help in menstruation management, was important for improving caregivers' menstrual attitudes. This study contributes to the existing literature by determining both individual and environmental predictors of caregivers' menstrual attitudes.
García, Patricia J.; Egoavil, Miguel S.; Blas, Magaly M.; Alvarado-Vásquez, Eduardo; Curioso, Walter H.; Zimic, Mirko; Castagnetto, Jesus M.; Lescano, Andrés G.; Lopez, Diego M.; Cárcamo, Cesar P.
Training in Biomedical Informatics is essential to meet the challenges of a globalized world. However, the development of postgraduate training and research programs in this area are scarce in Latin America. Through QUIPU: Andean Center for Training and research in Iformatics for Global Health, has developed the first Certificate and Master’s Program on Biomedical Informatics in the Andean Region. The aim of this article is to describe the experience of the program. To date, 51 students from Peru, Chile, Ecuador, Colombia and Venezuela have participated; they come from health ministries, hospitals, universities, research centers, professional associations and private companies. Seventeen courses were offered with the participation of faculty from Argentina, Chile, Colombia, USA, Mexico and Peru. This program is already institutionalized at the School of Public Health and Administration from the Universidad Peruana Cayetano Heredia. PMID:26338399
Full Text Available Denne artikel indeholder præsentation og analyse af data indsamlet på 5 psykiatriske institutioner i Danmark, der har musikterapi i behandlingen. Formålet med undersøgelsen er dels at beskrive den patientgruppe der modtager musikterapi i psykiatrien, og dels undersøge om enkelte variable kan prædiktere drop-out fra behandlingen. Både demografiske, psykiatriske og terapeutiske data indsamles fra 91 patienter, der har modtaget musikterapi i perioden august 2003 til juli 2004. Undersøgelsen viser, at i denne gruppe rekrutteres patienterne overvejende fra hospitalerne, de har ofte enten skizofreni lidelser eller personlighedsforstyrrelser. 16 % dropper i gennemsnit ud af behandlingen. Der var ingen enkelte variable, der prædikterede drop-out fra behandlingen.
Pitula, Clio E; Wenner, Jennifer A; Gunnar, Megan R; Thomas, Kathleen M
Chronic parental maltreatment has been associated with lower levels of interpersonal trust, and depriving environments have been shown to predict short-sighted, risk-averse decision-making. The present study examined whether a circumscribed period of adverse care occurring only early in life was associated with biases in trust behavior. Fifty-three post-institutionalized (PI) youth, adopted internationally on average by 1 year of age, and 33 never-institutionalized, non-adopted youth (M age = 12.9 years) played a trust game. Participants decided whether or not to share coins with a different anonymous peer in each trial with the potential to receive a larger number of coins in return. Trials were presented in blocks that varied in the degree to which the peers behaved in a trustworthy (reciprocal) or untrustworthy (non-reciprocal) manner. A comparison condition consisted of a computerized lottery with the same choices and probabilistic risk as the peer trials. Non-adopted comparison youth showed a tendency to share more with peers than to invest in the lottery and tended to maintain their level of sharing across trials despite experiencing trials in which peers failed to reciprocate. In contrast, PI children, particularly those who were adopted over 1 year of age, shared less with peers than they invested in the lottery and quickly adapted their sharing behavior to peers' responses. These results suggest that PI youth were more mistrusting, more sensitive to both defection and reciprocation, and potentially more accurate in their trusting decisions than comparison youth. Results support the presence of a sensitive period for the development of trust in others, whereby conditions early in life may set long-term biases in decision-making. © 2016 John Wiley & Sons Ltd.
Guss, Carly E; Divasta, Amy D
Gynecomastia, defined as the presence of glandular breast tissue in men, is a common, typically benign physical exam finding during adolescence. Although the exact pathogenesis of gynecomastia is unknown, it is likely due to a hormonal imbalance between estrogens and androgens. Most cases are idiopathic and do not require further evaluation if the history and physical examination are reassuring. Although the majority of cases will resolve spontaneously, surgical correction may be an option for adolescents with persistent and problematic gynecomastia. Gynecomastia can have significant negative impact on one's self-esteem, and it is crucial that primary care providers screen adolescents with gynecomastia for mental health concerns. Future studies are necessary to elucidate the true incidence and prevalence of gynecomastia in adolescent males, and to further investigate the short-term and long-term physical and emotional effects of gynecomastia. Copyright© of YS Medical Media ltd.
Impacto da saúde bucal no cotidiano de idosos institucionalizados e não institucionalizados da cidade do Recife (PE, Brasil Impact of oral health in the daily life of institutionalized and non institutionalized elder in the city of Recife (PE, Brazil
Eliane Helena Alvim de Souza
Full Text Available Este artigo tem como objetivo avaliar a influência da saúde bucal no cotidiano de idosos institucionalizados e não institucionalizados da cidade do Recife (PE, bem como verificar se a saúde bucal tem a mesma relevância para os dois grupos estudados. Para avaliar a percepção de saúde bucal, utilizou-se o índice Geriatric Oral Health Assessment Index (GOHAI. As faixas do GOHAI foram categorizadas em baixa percepção (The objective of the study is to assess the influence of oral health in the daily routine of both institutionalized and non-institutionalized elders living in the city of Recife-PE, as well as to come to conclusions concerning the relevance level of oral health in both groups. In order to assess the perception of oral health, it was used the Geriatric Oral Health Assessment Index (GOHAI. The GOHAI levels, concerning the perception, were categorized in: low (<= 50, average (51 to 60 and high (57 to 60. Oral health conditions were represented by the DMFT index (with cavity, lost and repaired teeth. It was observed that the percentage of elderly with a GOHAI not higher than 50 (low perception of oral health was rather higher in the non-institutionalized group than in the institutionalized (92,2% x 64,9%. The average DMFT and the number of lost teeth were higher in the institutionalized group (96,01% x 87,87%. The perception of oral health was lower for more than half of the examined elderly population, but there being a meaningful difference between the two groups concerning the GOHAI, with lower levels for the non-institutionalized group. The result of the perception of oral health was compatible with the high number of decayed and lost teeth.
Carla Maria Ariano Destro
/ or written language disturbances in a group of institutionalized juvenile offenders, checking how possible language and communication difficulties impact on these subjects' social life. METHOD: exploratory and descriptive study, with 40 interns of Fundação Casa / IU 25 unit - Rio Negro/ Franco da Rocha city complex - SP, between 15 and 18 year old. For collecting the data we applied the Mini-Mental State Examination - MMSE test, to detect individuals who may have cognitive impairment; the Montreal test, to examine simple oral and written language abilities and a semi-structured an interview, whose script was related to General Health, School Path, Vocational Path and perceptions of criminal behavior. RESULTS: the results showed that the majority of the population was literate and there was no occurrence of cognitive impairment. There was a high rate of school dropouts due from difficulties in following school curriculum and adapting to school rules and dynamics, indicating the impacts referring to language difficulties, especially written language, on condition that, in combination with other factors favored the conduct infractions. CONCLUSION: the young offenders had problems to develop and to engage in socio-cultural patterns and values, including school rules, which impose limits on their discursive access and movement, by restricting the uses of language, as a path to the development of personal social practice and citizenship. The findings provide evidence, among other factors, on the social impact that poor schooling and socialization of young people may come to cause. The study demonstrates that language should be designed as a social practice, mostly in the expression and communication forms of these subjects.
Jesús Manuel Vallejo Sánchez
become institutionalized with absence of neurological pathology or severe cognitive impairment of the home care nursing Jose Matía Calvo of Cádiz. It was sifted to the subjects by the mini cognitive test in the version of Wolf during January, 2008, there being obtained a sample of which were studied social, demography and of control variables. Results: it is clear that DCL's prevalencia in the elders become institutionalized in our center is 27 %, number higher than the contributed one like average for some authors for the general population (15-20 %, but minor that the established one in other home care nursing, that range between 38,7 and 44 %. Conclusions: the increase stated of the prevalencia of the cognitive impairment in the older population and his repercussion in the level of independence and quality of life of major become institutionalized, justifies the need to identify prematurely such alteration to initiate, as soon as possible, you programme of intervention directed to delaying the dependence, promoting the residual capacities and improving the quality of life of these elders.
Fortunato, Laura; Drusini, Andrea G
Socio-demographic, behavioral, functional and anthropometric data for groups of elderly Quechua Indians of Peru were used to investigate the effects of gender and lifestyle patterns on nutritional status. Two community-dwelling samples were selected for study, representative of divergent lifestyles in terms of their combination of socio-economic, demographic and cultural contexts, plus an ad-hoc sample of institutionalized individuals with controlled food intake and reduced physical activity. Results suggest that differences in socio-demographic, behavioral and functional characteristics exist between the sexes and across settings (low- vs. highland) and lifestyles (institutionalized vs. community-dwelling; semi-urban vs. rural). These factors are likely to be related to diverging dietary and physical activity patterns, and have considerable effects on the nutritional status of the respondents.
Hartz Zulmira M. A.
Full Text Available The purpose of this article is to describe several chronological milestones in institutionalizing the evaluation of public programs and policies in France from a governmental perspective and in the health sector, situating such references in the international context. The institutional nature of evaluation implies integrating it into an action-oriented model, linking analytical activities to management, thus constituting the formulation of an evaluation policy for policy evaluation. The study focuses on issues related to the structure, practice, and utilization of evaluation results as well as other characteristics providing the French model with a certain resistance to traditional "fast-food" or "ready-made" methodological approaches. The institutionalization of sectorial evaluation appears more promising than that of the government's centralized channel, despite the work developed by a Scientific Evaluation Council, and suggests avenues for reflection and debate pertaining to the Brazilian Unified Health System.
Zulmira M. A. Hartz
Full Text Available The purpose of this article is to describe several chronological milestones in institutionalizing the evaluation of public programs and policies in France from a governmental perspective and in the health sector, situating such references in the international context. The institutional nature of evaluation implies integrating it into an action-oriented model, linking analytical activities to management, thus constituting the formulation of an evaluation policy for policy evaluation. The study focuses on issues related to the structure, practice, and utilization of evaluation results as well as other characteristics providing the French model with a certain resistance to traditional "fast-food" or "ready-made" methodological approaches. The institutionalization of sectorial evaluation appears more promising than that of the government's centralized channel, despite the work developed by a Scientific Evaluation Council, and suggests avenues for reflection and debate pertaining to the Brazilian Unified Health System.
Hartz, Z M
The purpose of this article is to describe several chronological milestones in institutionalizing the evaluation of public programs and policies in France from a governmental perspective and in the health sector, situating such references in the international context. The institutional nature of evaluation implies integrating it into an action-oriented model, linking analytical activities to management, thus constituting the formulation of an evaluation policy for policy evaluation. The study focuses on issues related to the structure, practice, and utilization of evaluation results as well as other characteristics providing the French model with a certain resistance to traditional "fast-food" or "ready-made" methodological approaches. The institutionalization of sectorial evaluation appears more promising than that of the government's centralized channel, despite the work developed by a Scientific Evaluation Council, and suggests avenues for reflection and debate pertaining to the Brazilian Unified Health System.
Francisco Apolo Carvajal
Full Text Available Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention. Moreover, health professionals received a training course. Results: Medication was being crushed for 33% (618/1875 of residents (mean: 5 drugs susceptible of crushing. 220 pharmaceutical interventions were performed, mostly in extended release or gastro-resistant drugs (48% were accepted. Switch was the type of intervention more frequent (79%, mainly to Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention. Moreover, health professionals received a training course. Results
Lam, Freddy Mh; Chan, Philip Fl; Liao, L R; Woo, Jean; Hui, Elsie; Lai, Charles Wk; Kwok, Timothy Cy; Pang, Marco Yc
To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits. A single-blinded randomized controlled trial was conducted. This study was carried out in residential care units. In total, 73 older adults (40 women, mean age: 82.3 ± 7.3 years) were enrolled into this study. Participants were randomly allocated to one of the three groups: strength and balance program combined with whole-body vibration, strength and balance program without whole-body vibration, and social and recreational activities consisting of upper limb exercises only. All participants completed three training sessions per week for eight weeks. Assessment of mobility, balance, lower limb strength, walking endurance, and self-perceived balance confidence were conducted at baseline and immediately after the eight-week intervention. Incidences of falls requiring medical attention were recorded for one year after the end of the training period. A significant time × group interaction was found for lower limb strength (five-times-sit-to-stand test; P = 0.048), with the exercise-only group showing improvement (pretest: 35.8 ± 16.1 seconds; posttest: 29.0 ± 9.8 seconds), compared with a decline in strength among controls (pretest: 27.1 ± 10.4 seconds; posttest: 28.7 ± 12.3 seconds; P = 0.030). The exercise with whole-body vibration group had a significantly better outcome in balance confidence (pretest: 39.2 ± 29.0; posttest: 48.4 ± 30.6) than the exercise-only group (pretest: 35.9 ± 24.8; posttest: 38.2 ± 26.5; P = 0.033). The exercise program was effective in improving lower limb strength among institutionalized older adults but adding whole-body vibration did not enhance its effect. Whole-body vibration may improve balance confidence without enhancing actual balance performance.
Wright, John; Parry, Jayne; Scully, Edward
European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into o...
Pezzati, Rita; Molteni, Valentina; Bani, Marco; Settanta, Carmen; Di Maggio, Maria Grazia; Villa, Ivan; Poletti, Barbara; Ardito, Rita B.
Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the...
Rita ePezzati; Rita ePezzati; Valentina eMolteni; Valentina eMolteni; Marco eBani; Carmen eSettanta; Maria Grazia eDi Maggio; Ivan eVilla; Barbara ePoletti; Barbara ePoletti; Rita B. Ardito
Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the...
Abdullah K. Shehabat
This paper explains how the two protagonists, Firdaus and Sara, successfully paved their own ways in search of self-liberation despite the authoritarian patriarchy and institutionalized religions that plagued them. El Saadawi's Woman at Point Zero and Yezierska’s Bread Givers represent the fruitful struggle these protagonists experienced as they come to forge an identity and be themselves. The paper argues that the protagonists manage to free themselves, establish their own spiritual homes at...
Should an adolescent offender be punished more leniently than an adult offender? Many theorists believe the answer to be in the affirmative. According to the diminished culpability model, adolescents are less mature than adults and, therefore, less responsible for their wrongdoings and should...... consequently be punished less harshly. This article concerns the first part of the model: the relation between immaturity and diminished responsibility. It is argued that this relation faces three normative challenges which do not allow for easy answers and which are still widely ignored in the comprehensive...
Potter, Julia; Santelli, John S
The majority of adolescents become sexually active during their teenage years, making contraceptive counseling an important aspect of routine adolescent healthcare. However, many healthcare providers express discomfort when it comes to counseling adolescents about contraceptive options. This Special Report highlights the evidence supporting age-appropriate contraceptive counseling for adolescents and focuses on best practices for addressing adolescents' questions and concerns about contraceptive methods.
Fernández-Mayoralas, Gloria; Rojo-Pérez, Fermina; Martínez-Martín, Pablo; Prieto-Flores, Maria-Eugenia; Rodríguez-Blázquez, Carmen; Martín-García, Salomé; Rojo-Abuín, José-Manuel; Forjaz, Maria-Joao
Active ageing, considered from the perspective of participation in leisure activities, promotes life satisfaction and personal well-being. The aims of this work are to define and explain leisure activity profiles among institutionalized older adults, considering their sociodemographic characteristics and objective and subjective conditions in relation to their quality of life. Two samples of institutionalized people aged 60 and over were analysed together: 234 older adults without dementia and 525 with dementia. Sociodemographic, economic, family and social network, and health and functioning variables were selected. Cluster analysis was applied to obtain activity profiles according to the leisure activities, and ordinal regression models were performed to analyse factors associated to activity level. The sample was clustered into three groups of people: active (27%), moderately active (35%) and inactive people (38%). In the final regression model (Nagelkerke pseudo R(2) = 0.500), a higher level of activity was associated with better cognitive function (Pfeiffer scale), self-perceived health status and functional ability, as well as with a higher frequency of gathering with family and friends, and higher educational level. The decline in physical and mental health, the loss of functional capabilities and the weakening of family and social ties represent a significant barrier to active ageing in a context of institutionalization.
Rakhlin, Natalia; Hein, Sascha; Doyle, Niamh; Hart, Lesley; Koposov, Roman; Macomber, Donna; Ruchkin, Vladislav; Strelina, Anastasia; Tan, Mei; Grigorenko, Elena L
The present study sought to compare 4 groups of age- and gender-matched children-(a) those reared in institutions for children without parental care in Russia; (b) those raised by their biological parents in Russia; (c) those adopted to the United States from Russian institutions; and (d) those born in the United States and raised by their biological parents-on indicators of cognition, language, and early learning. In addition, we aimed to compare the effects of the length of time spent in an institution, the age of initial placement in an institution, the age at adoption, and pre-institutional risk factors (i.e., prenatal substance exposure and prematurity and low birth weight) on the above-mentioned outcomes in the 2 groups of children with institutionalization experiences. Our results confirm previous reports demonstrating negative consequences of institutionalization and substantial ameliorating effects of adoption. They also underscore the complexity of the effects of institutionalization and adoption, showing that they are intertwined with the effects of pre-institutional risk factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Hernández-Galiot, Ana; Goñi, Isabel
Scientific evidence indicates that adherence to the Mediterranean diet protects against the deterioration of cognitive status and depressive symptoms during aging. However, few studies have been conducted in elderly non-institutionalized subjects. This study evaluated the relation between the adherence to the Mediterranean dietary pattern and cognitive status and depressive symptoms in an elderly population over 75 years. A cross-sectional study was conducted in a Mediterranean city (Garrucha, Spain) in 79 elderly people over 75 (36 men and 41 women). Adherence to the Mediterranean dietary pattern was determined using the Mediterranean Diet Adherence Screener (MEDAS). Cognitive function was determined by the Mini Mental State Examination (MMSE), and depressive symptoms were assessed by the Geriatric Depression Scale (GDS). Most of population showed a very high adherence to the Mediterranean diet pattern and optimal cognitive and affective status. They consumed olive oil as their main source of fat, high levels of fish and fruit, low levels of foods with added sugars, and a low consumption of red meat. A significant relation between the MEDAS and MMSE scores was found. However, no relationship was observed between the MEDAS and GDS. The Mediterranean diet pattern was positively related with the cognitive function, although the infl uence of a healthy dietary pattern on the symptomatology of depression was unclear. However, an effective strategy against cognitive function and depression would be to improve physical activity rates, establish lifelong healthy eating habits, and consume a nutritionally-rich diet in order to enhance quality of life of the elderly.
Giacomello, Karina Jorgino; Melo, Luciana de Lione
This qualitative research is based on the reference framework of Phenomenology--analysis of the structure of the situated phenomenon, and aims to understand institutionalized children victims of violence through therapeutic play sessions. Participants were three sheltered children of preschool age, one boy and two goals. The therapeutic play sessions of the drama type were held in a reserved place and ranged from 30 to 50 minutes, using the following guiding proposal: "Let us play that we are children who live at the shelter?" Two broad theme categories could be captured: playing and pretending and playing and reality. When they are pretending while playing, sometimes calmly, sometimes violently, the children brought contents that evidenced situations in their daily family reality. When they expose their reality, the children addressed questions about the shelter institution and the bond with these professionals and with the relatives. It can be affirmed that therapeutic play allowed for the children's effective communication by expressing their feelings, desires, experiences, criticism against the environment they live in and family relations, besides permitting a moment of pleasure and relaxation.
Jnaneswar, Avinash; Subramaniya, Goutham Bala; Pathi, Jayashree; Jha, Kunal; Suresan, Vinay; Kumar, Gunjan
Over 5% of the world's population has disabling hearing loss. The oral health of the disabled may be disused for the reason of the disabling condition, a challenging disease or the limited access to oral health care. The objectives of the study were to assess the prevalence of dental caries and periodontal status of institutionalized hearing impaired (HI) children in Khordha district of Odisha. A descriptive cross-sectional study on the HI children was conducted in Khordha district, Odisha. Type III examination procedure was conducted to assess the oral health status of the children. Statistical analysis was performed by Chi-square test and Student's t-test, and the significance level was fixed at P caries prevalence was 19.3%. Statistically highly significant difference was found for mean decayed teeth (DT), missing teeth decayed, missing filled teeth (FT) (P dental services as well as dental health education is necessary to ensure the optimum dental health within the reach of these less fortunate children.
Fuadiah, N. F.; Suryadi, D.; Turmudi
This study focuses on the design of a didactical situation in addition and subtraction involving negative integers at the pilot experiment phase. As we know, negative numbers become an obstacle for students in solving problems related to them. This study aims to create a didactical design that can assist students in understanding the addition and subtraction. Another expected result in this way is that students are introduced to the characteristics of addition and subtraction of integers. The design was implemented on 32 seventh grade students in one of the classes in a junior secondary school as the pilot experiment. Learning activities were observed thoroughly including the students’ responses that emerged during the learning activities. The written documentation of the students was also used to support the analysis in the learning activities. The results of the analysis showed that this method could help the students perform a large number of integer operations that could not be done with a number line. The teacher’s support as a didactical potential contract was still needed to encourage institutionalization processes. The results of the design analysis used as the basis of the revision are expected to be implemented by the teacher in the teaching experiment.
Sergi, Giuseppe; Coin, Alessandra; Mulone, Silvana; Castegnaro, Eugenio; Giantin, Valter; Manzato, Enzo; Busetto, Luca; Inelmen, Emine Meral; Marin, Sara; Enzi, Giuliano
Our study investigated nutritional status, body composition, and resting energy expenditure (REE) in elderly patients with advanced-stage pressure sores (PS), in addition to researching any hypermetabolic condition and its relationship with PS size. The study involved 52 institutionalized bedridden elderly women (aged 83.7 +/- 6.3 years), divided into two groups: 23 with advanced-stage (stage 3 and 4) PS and 29 without PS. Albumin, prealbumin, and retinol-binding protein were measured in all patients, and fat-free mass (FFM) and fat mass (FM) were obtained by dual-energy x-ray absorptiometry (DEXA). REE was measured by indirect calorimetry and predicted with the Harris-Benedict formula. PS area and volume were also measured. The elderly women with and without PS were comparable in age, FFM, and FM. Mean albumin, prealbumin, and retinol-binding protein values were lower in cases with PS. Unadjusted mean REE was significantly higher in patients with PS (1212.3 +/- 236.7 vs 1085.5 +/- 161.3 kcal/d; p 110% of the predicted REE, was seen in 74% of patients with PS and 38% of controls. The difference between measured and predicted REE (DeltaREE) correlated with PS volume (r = 0.58; p elderly women are associated with a hypermetabolic state that is influenced by the volume of the PS.
Stronski Huwiler, S M; Remafedi, G
Homosexuality has existed in all civilizations, but societal disapproval and cultural taboos have negatively influenced its recognition. A significant percentage of youths identify themselves as homosexual, and even more experience sex with the same sex or are confused about sexual feelings. A unifying etiological theory attributes the expression of sexual orientation to genes that shape the central nervous system's development, organization, and structure via prenatal sex steroids. Environmental factors may influence the expression of genetic potential. Several models of psychosocial development describe initial stages of awareness and confusion about same-sex attractions, followed by acknowledgement of homosexuality, disclosure to others, and eventual integration of sexual identity into a comprehensive sense of self. Stressors related to isolation, stigma, and violence may predispose homosexual adolescents to impaired social, emotional, and physical health, resulting in depression and suicide, school problems, substance abuse, running away eating disorders, risky sexual behavior, and illegal conduct. As with all adolescents, the overall goals in the care of homosexual youth are to promote normal adolescent development, social and emotional well-being, and physical health. A comprehensive, multidisciplinary approach is required to address medical, mental health, and psychosocial issues within the context of the adolescents' community and culture.
Calero, Juan del Rey
The social Adolescent features are insecurity, narcissism, eroticism, more impetuosity than reason. 1/3 of adolescents have risk behaviour for health. The pregnancy rate in adolescent are 9/1,000 (11,720, the abort about 50 %). The total abort (2009) were 114,480. Increase the rate of 8,4 (1990) to 14,6/ 1,000 (2009). The sexual education fails. The consulting about contraceptives get pregnancy of the OR 3,2, condom OR 2,7. The adolescent are influenced in his matter: oeer have 70-75 % of influence, mother 30-40 %, father 15 %, for yhe environment and education Cyberspace access to information: 33 % exposed to unwanted sexual materials, 1 in 7 solicited sexual online. The argument have 4 central topic: Morality and Responsibility, Desire (responsibility vs gratification), Danger (fear related to pregnancy and STD/VIH), and Victimization. The prevention of STD: so called safe sex, delayed, and abstinence, Prevention HPV vaccine. The information is not enough, are necessary personal integral formation in values as self control, abstinence, mutual respect, responsibility, reasonable decisions.
Full Text Available The aim is to analyse the parenting styles effects (acceptance, negative control and negligence on prosociality and aggressive behavior in adolescents through the mediator variables empathy and emotional instability, and also, if this model fits to the same extent when we study adolescents institutionalized due to problems with the law and adolescents from the general population, and at the same time, if the values of the different analyzed variables are similar in both groups of adolescents. We carried out a cross-sectional study. 220 participants from schools in the metropolitan area of Valencia took part in the study. Also, 220 young offenders took part recruited from four Youth Detention Centres of Valencia, in which they were carrying out court sentences. The age of the subjects range from 15-18 years. The results indicate that the emotional variables act as mediators in general, in the non-offender adolescents, but it has been observed, in the offender adolescents, a direct effect of support on aggressive behavior in a negative way and on prosociality in a positive way; and of negligence on aggressive behavior and of permissiveness on prosociality in a negative way.
Rubén A. Bronberg
Full Text Available Los pacientes con discapacidad intelectual (DI pueden presentar un riesgo elevado de padecer alteraciones nutricionales. Nuestro objetivo fue determinar la prevalencia de malnutrición en pacientes institucionalizados con DI, en la Colonia Nacional Montes de Oca, provincia de Buenos Aires, Argentina. Se realizó valoración antropométrica transversal mediante peso (kg y talla (cm en 614 individuos (352 varones y 262 mujeres. Se determinó IMC y la prevalencia de bajo peso, sobrepeso y obesidad por sexo y tipo de DI: leve, moderada y grave. Independientemente del sexo, las prevalencias de bajo peso, sobrepeso y obesidad fueron del 2.9%, 30% y 27.7% respectivamente. Sin considerar el grupo de DI, en mujeres se observó mayor prevalencia de obesidad (41.2% y en varones de sobrepeso (34.7%. Teniendo en cuenta el grado de DI e independientemente del sexo se observó mayor prevalencia de bajo peso en DI grave y de sobrepeso y obesidad en DI leve. Ninguno de los pacientes con DI leve presentó bajo peso. Teniendo en cuenta el sexo y el grupo de DI las mayores prevalencias de bajo peso y sobrepeso se hallaron en varones con DI leve, (7% y 38.4% respectivamente y de obesidad en mujeres con DI moderada (44%. Los resultados obtenidos indicarían la importancia del control del ingreso calórico y gasto energético de adultos con DI, prestando especial atención a las condiciones de vida y a los desordenes alimentarios en relación al grado de DI y a sus múltiples discapacidades asociadas.As patients with intellectual and developmental disability (ID may be more exposed to unfavorable factors, they are at higher risk of suffering nutritional alterations. Our objective was to determine prevalence of malnutrition in institutionalized patients with ID. An evaluation of the nutritional status through determination of transversal anthropometric parameters of weight (kg and height (cm was made on 614 individuals (352 men and 262 women institutionalized at
Barbosa, Nair Palhano
The purpose of this research is to study the trajectory of the environmental question in the planning of government policies. For this, the historic process of the emergence and institutionalization of the debate over the environment in the electric sector was redeemed, mainly observing the changes that occurred in the organizational and planning structure of projects. The electric sector is understood to be comprised of the network of interests and social relationships that sustain the set of policies whose principle axis is the generation, transmission and distribution of energy; this network may or may not be extrapolated beyond the design of its institutional structure. During the course of the studies carried out to prepare this thesis, the environmental question was understood, at least in a preliminary fashion, to consist of a general set of problems, diagnoses, situations, plans, programs and actions, as are institutional forms that explicitly refer to the environment as their subject, cause or objective for being or their justification. The research that the work presented here was based upon was oriented by methodological procedures that are characteristic of institutional analyses and representation studies, and used documentation available about and produced by the Electric Sector as a source of information as well as interviews and questionnaires with people directly or indirectly involved with the topic. This procedure allowed for the observation that the treatment of the environmental question in the electric sector underwent moments that varied according to the level of internalization during the different stages of the sector's projects, as well as during the formulation of its institutional policy. (author)
Full Text Available Introduction: Over 5% of the world's population has disabling hearing loss. The oral health of the disabled may be disused for the reason of the disabling condition, a challenging disease or the limited access to oral health care. Objectives: The objectives of the study were to assess the prevalence of dental caries and periodontal status of institutionalized hearing impaired (HI children in Khordha district of Odisha. Materials and Methods: A descriptive cross-sectional study on the HI children was conducted in Khordha district, Odisha. Type III examination procedure was conducted to assess the oral health status of the children. Statistical analysis was performed by Chi-square test and Student's t-test, and the significance level was fixed at P < 0.05. Results: The final population consisted of 540 HI children out of which 262 (48.5% were male and 278 (51.5% were female, 285 (52.8% children had severe hearing loss and 227 (42.0% had profound hearing loss. Bleeding on probing was found in 72 (13.3% female children as compared to 57 (10.6% male children. While 131 (24.3% female children had calculus, 124 (23.0% male children had the same condition. Total caries prevalence was 19.3%. Statistically highly significant difference was found for mean decayed teeth (DT, missing teeth decayed, missing filled teeth (FT (P < 0.001, while for mean FT there was no statistically significant difference according to age groups. Statistically highly significant difference was found for mean DT, extracted teeth and decayed, extracted, filled teeth (P < 0.001. Conclusion: An improved accessibility to dental services as well as dental health education is necessary to ensure the optimum dental health within the reach of these less fortunate children.
Barbosa, Nair Palhano
The purpose of this research is to study the trajectory of the environmental question in the planning of government policies. For this, the historic process of the emergence and institutionalization of the debate over the environment in the electric sector was redeemed, mainly observing the changes that occurred in the organizational and planning structure of projects. The electric sector is understood to be comprised of the network of interests and social relationships that sustain the set of policies whose principle axis is the generation, transmission and distribution of energy; this network may or may not be extrapolated beyond the design of its institutional structure. During the course of the studies carried out to prepare this thesis, the environmental question was understood, at least in a preliminary fashion, to consist of a general set of problems, diagnoses, situations, plans, programs and actions, as are institutional forms that explicitly refer to the environment as their subject, cause or objective for being or their justification. The research that the work presented here was based upon was oriented by methodological procedures that are characteristic of institutional analyses and representation studies, and used documentation available about and produced by the Electric Sector as a source of information as well as interviews and questionnaires with people directly or indirectly involved with the topic. This procedure allowed for the observation that the treatment of the environmental question in the electric sector underwent moments that varied according to the level of internalization during the different stages of the sector's projects, as well as during the formulation of its institutional policy. (author)
Motalebi, Seyedeh Ameneh; Cheong, Loke Seng; Iranagh, Jamileh Amirzadeh; Mohammadi, Fatemeh
Background/Study Context: Given the rapid increase in the aging population worldwide, fall prevention is of utmost importance. It is essential to establish an efficient, simple, safe, and low-cost intervention method for reducing the risk of falls. This study examined the effect of 12 weeks of progressive elastic resistance training on lower-limb muscle strength and balance in seniors living in the Rumah Seri Kenangan, social welfare home in Cheras, Malaysia. A total of 51 subjects qualified to take part in this quasi-experimental study. They were assigned to either the resistance exercise group (n = 26) or control group (n = 25). The mean age of the 45 participants who completed the program was 70.7 (SD = 6.6). The exercise group met twice per week and performing one to three sets of 8 to 10 repetitions for each of nine lower-limb elastic resistance exercises. All exercises were conducted at low to moderate intensities in sitting or standing positions. The subjects were tested at baseline and 6 and 12 weeks into the program. The results showed statistically significant improvements in lower-limb muscle strength as measured by five times sit-to-stand test (%Δ = 22.6) and dynamic balance quantified by the timed up-and-go test (%Δ = 18.7), four-square step test (%Δ = 14.67), and step test for the right (%Δ = 18.36) and left (%Δ = 18.80) legs. No significant changes were observed in static balance as measured using the tandem stand test (%Δ = 3.25), and one-leg stand test with eyes opened (%Δ = 9.58) and eyes closed (%Δ = -0.61) after completion of the program. The findings support the feasibility and efficacy of a simple and inexpensive resistance training program to improve lower-limb muscle strength and dynamic balance among the institutionalized older adults.
Cheng, Sheung-Tak; Yip, Leona C Y; Jim, Olivia T T; Hui, Anna N N
To examine the relationship between self-perceptions of aging and acute medical events in chronically institutionalized middle-aged and older persons with schizophrenia. Participants were 83 persons with schizophrenia (30% women; mean age = 58.48, SD = 8.14) residing in a long-stay care home, who were without organic mental disorders, mental retardation, serious audiovisual impairment, and serious cognitive and physical impairment. They received assessments in body mass index, functional health, and global mental status, and responded to measures of self-perception of aging at baseline. Acute events that required medical attention were recorded for the next 3 months. 8% of the participants had acute medical events. Bivariate analysis suggested that number of comorbid medical conditions, mobility, Mini-Mental State Examination, and negative self-perception of aging were predictive of acute medical events. However, multivariate analysis (logistic regression) showed that only mobility (OR = 0.78, p = 0.04) and negative self-perception of aging (OR = 3.38, p = 0.02) had independent effects on acute medical events, with the latter being the stronger predictor. Positive aging self-perception, body mass index, and smoking were unrelated to medical events. Physical vulnerabilities may not be sufficient to explain the development of acute medical events in late-life schizophrenia. How individuals perceive their aging process, which is expected to regulate health behavior and help-seeking, may be an even more important factor. Further research should investigate whether such self-perceptions, which are probably rooted in stereotypes about aging socialized early in life, are modifiable in this population. Copyright © 2011 John Wiley & Sons, Ltd.
Chandani, Yasmin; Duffy, Malia; Lamphere, Barbara; Noel, Megan; Heaton, Alexis; Andersson, Sarah
Supply chain bottlenecks that prevent community health workers (CHWs) from accessing essential medicines significantly increase under-5 child mortality, particularly in poor and rural areas. Using implementation research, interventions aimed at improving supply chain practices and access to medicines were tested in Malawi and Rwanda. These interventions included simple demand-based resupply procedures, using mobile technology and traditional methods for communication, and multilevel, performance-driven quality improvement (QI) teams. Mixed-method evaluations were conducted at baseline (2010), midline (2013), and endline (2014). Baseline assessments identified common bottlenecks and established performance levels. Midline assessments identified which intervention package had the greatest impact. Endline surveys measured the progress of scale-up and institutionalization of each innovation. In both Rwanda and Malawi CHWs, health center staff, and district managers all cited many benefits of the establishment of resupply procedures and QI teams: such as providing structure and processes, a means to analyze and discuss problems and enhance collaboration between staff. Implementing simple, streamlined, demand-based resupply procedures formed the basis for informed and regular resupply, and increased the visibility of appropriate and timely community logistics data. QI teams played a critical role in reinforcing resupply procedures and routinely unlocking the bottlenecks that prevent the continuous flow of critical health products. While simple, streamlined, demand-based resupply procedures provide the basis for regular, functional, and efficient resupply of CHWs, the procedures alone are not sufficient to create consistent change in product availability. Supporting these procedures with multilevel QI teams reinforces the correct and consistent use of resupply procedures. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Mael, Fred A.; Morath, Ray A.; McLellan, Jeffrey A.
Examines positive and negative correlates of adolescent work as a function of work dimensions. Results indicate that concurrent costs and benefits of adolescent employment may depend on dimensions of work as well as adolescent characteristics. Adolescent employment was generally related to subsequent work motivation and nonacademic performance.…
Ahorlu, Collins K; Pfeiffer, Constanze; Obrist, Brigit
Adolescent pregnancy exposes female adolescents to medical, social and economic risks. In Ghana, adolescent mothers are more likely to experience complications during pregnancy and delivery as compared to older mothers. This study examined the competencies of adolescent girls to either proactively prevent teenage pregnancy or reactively cope effectively with it. A cross-sectional survey approach was used to interview 820 adolescent girls aged 15-19 years in Accra, Ghana. The main focus of the study was to examine how social capital (various kinds of valued relations with significant others), economic capital (command over economic resources, mainly cash and assets), cultural capital (personal dispositions and habits; knowledge and tradition stored in material forms and institutionalized) and symbolic capital (honour, recognition and prestige) contribute to the development of competencies of adolescents to deal with the threat of teenage pregnancy and childbirth. Out of 820 adolescents interviewed, 128 (16%) were pregnant or mothers. Adolescents in both groups (62% never pregnant girls and 68% pregnant/young mothers) have access to social support, especially from their parents. Parents are taking the place of aunts and grandmothers in providing sexual education to their adolescent girls due to changing social structures where extended families no longer reside together in most cases. More (79%) pregnant girls and young mothers compared to never pregnant girls (38%) have access to economic support (P = pregnancy among adolescent girls. Findings showed that adolescent girls, especially those that get pregnant should not be viewed as weak and vulnerable because many of them have developed competencies to cope with pregnancy and childbirth effectively. Thus, focusing on developing the competencies of girls to access social, economic and cultural capitals may be an effective way of tackling the threat of teenage pregnancy than focusing only on their vulnerability and
Pate, Russell R; Flynn, Jennifer I; Dowda, Marsha
Obesity rates among children and adolescents in developed countries have increased dramatically since the 1970s. During that same period, numerous secular changes have combined to reduce the demand for physical activity in day-to-day life, and many barriers to physical activity are now evident. As a consequence, most children and adolescents do not meet the accepted public health guidelines for physical activity. Accordingly, public health interventions are needed to increase physical activity in adolescence. Such interventions, if successfully implemented, can be expected to improve fitness and health as well as reduce the prevalence of overweight and obesity in young people. Promotion of physical activity in populations of children and adolescents will require comprehensive strategic planning and adoption of new policies in multiple societal sectors. This paper highlights nine initiatives that can address the problem of physical activity in children. The initiatives are to: establish comprehensive school physical activity programming; demand high quality physical education; require physical activity in early child care and education; require physical activity in afterschool programs; create equity in community resources; activate youth sports programs; re-normalize active transport to school; institutionalize clinic-based physical activity assessment and counseling; and build activity-friendly homes. A case will be made for comprehensive national and international strategic planning aimed at effective and large-scale implementation of these initiatives and tactics.
Weaver, Meaghann S; Wratchford, Dale
Adolescence, the transition between childhood and adulthood, represents a time of rapid biological, neurocognitive, and psychosocial changes. These changes have important implications for the development and evolution of adolescent spirituality, particularly for adolescents with chronic or life-limiting illnesses. To contribute positively to adolescent spiritual formation, palliative care teams benefit from understanding the normative changes expected to occur during adolescence. This paper provides a narrative review of adolescent spirituality while recognizing the role of religious, familial, and cultural influences on spiritual development during the teenage years. By giving explicit attention to the contextual norms surrounding adolescence and still recognizing each adolescent-aged patient as unique, palliative care teams can help adolescents transition toward meaningful and sustainable spiritual growth. This paper reviews the clinical and research implications relevant to integrating adolescent spiritual health as part of comprehensive palliative care.
Full Text Available Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the Bowlby’s theory of attachment to investigate the effectiveness of Doll therapy. The hypothesis that we here propose is that the emotional experience of the person with dementia during Doll therapy activates caregiving and exploration systems together with the attachment one. To test this hypothesis we compared institutionalized patients with dementia undergoing Doll therapy with a control group and assessed measures of the relational dimension with the environment, such as gaze direction, behaviors of exploration, and behaviors of caregiving. We used an experimental protocol consisting of 10 non-consecutive sessions structured with the goal of recreating a situation of (1 separation from a known figure and (2 interaction with the environment in order to partially recreate the prototypical phases of the ‘Strange situation’. All sessions were videotaped and analyzed through an observational grid. Results support the effectiveness of Doll therapy in promoting and maintaining the affective-relational dimension of attachment-caregiving and the attentive dimension of exploration in patients with advanced stage of dementia. Thus, our results suggest that the use of Doll therapy promotes clinically significant improvements in the ability to relate with the surrounding world. This may be important for managing and caring for patients with dementia in institutionalized context.
Pezzati, Rita; Molteni, Valentina; Bani, Marco; Settanta, Carmen; Di Maggio, Maria Grazia; Villa, Ivan; Poletti, Barbara; Ardito, Rita B
Doll therapy is a non-pharmacological intervention aimed at reducing behavioral and psychological disorders in institutionalized patients with dementia. This therapy as a care tool has been integrated into the context of long-term care institutions, in which the need to find solutions to cognitive, behavioral and emotional problems showed by people with dementia meets the primary objective of developing good care practices focusing on patients and their needs. In the present work we adopt the Bowlby's theory of attachment to investigate the effectiveness of Doll therapy. The hypothesis that we here propose is that the emotional experience of the person with dementia during Doll therapy activates caregiving and exploration systems together with the attachment one. To test this hypothesis we compared institutionalized patients with dementia undergoing Doll therapy with a control group and assessed measures of the relational dimension with the environment, such as gaze direction, behaviors of exploration, and behaviors of caregiving. We used an experimental protocol consisting of 10 non-consecutive sessions structured with the goal of recreating a situation of (1) separation from a known figure and (2) interaction with the environment in order to partially recreate the prototypical phases of the "Strange situation." All sessions were videotaped and analyzed through an observational grid. Results support the effectiveness of Doll therapy in promoting and maintaining the affective-relational dimension of attachment-caregiving and the attentive dimension of exploration in patients with advanced stage of dementia. Thus, our results suggest that the use of Doll therapy promotes clinically significant improvements in the ability to relate with the surrounding world. This may be important for managing and caring for patients with dementia in institutionalized context.
Nuotio, M; Tuominen, P; Luukkaala, T
We examined the association of nutritional status as measured by the Mini-Nutritional Assessment Short Form (MNA-SF) with changes in mobility, institutionalization and death after hip fracture. Population-based prospective data were collected on 472 out of 693 consecutive hip fracture patients aged 65 years and over between January 2010 and December 2012. Declined vs same or improved mobility level, institutionalization and death during the 4-month follow-up were the outcomes. Age, gender, American Society of Anesthesiologists scores, pre-fracture diagnosis of a memory disorder, mobility level, living arrangements and MNA-SF scores at baseline were the independent variables. Age-adjusted and multivariate logistic regression and Cox proportional hazards models were conducted. At baseline, 41 (9%) patients were malnourished and 200 (42%) patients at risk of malnutrition according to the MNA-SF. During the follow-up, 90 (19%) had died. In the multivariate Cox proportional hazards model, malnutrition (hazard ratio 2.16; 95% confidence interval (CI) 1.07-4.34) was associated with mortality. In the multivariate binary logistic regression analyses, risk of malnutrition (odds ratios (OR) 2.42; 95% CI 1.25-4.66) and malnutrition (OR 6.10;95% CI 2.01-18.5) predicted institutionalization. Risk of malnutrition (OR 2.03; 95% CI 1.24-3.31) was associated with decline in the mobility level. Malnutrition or risk of malnutrition as measured by the MNA-SF were independent predictors of negative outcomes after hip fracture. Patients classified as being at risk of malnutrition by the MNA-SF may constitute a patient population with mild-to-moderate malnutrition and may require specific attention when nutritional interventions are designed after hip fracture.
de Goede, I.H.A.
This dissertation on “Development of Adolescent Relationships” addresses relationships with parents, friends, and romantic partners in adolescence from a developmental perspective. By studying both parent-adolescent relationships and peer relationships at the same time, as well as interrelations between these types of relationships, this dissertation provides more information on the processes taking place in relationships during adolescence. Findings indicate that parent-adolescent relationsh...
Full Text Available This paper assesses the practices developed in France, Italy, Greece, and Germany in order to accommodate rock’n’roll music and bring it closer to their own music styles and societal norms, as these are heard in the initial attempts of their music industries to create their own versions of it. The paper deals with these practices as instances of the French, German, Greek and Italian contexts to institutionalize rock’n’roll according to their positions regarding the USA, their historical and political situations, and their cultural and musical past and present.
Silvia Helena Zem-Mascarenhas
Full Text Available Este estudo teve por objetivo conhecer a experiência da criança institucionalizada e foi norteado pelo referencial teórico do "Interacionismo Simbólico" e pelo referencial metodológico da "Teoria Fundamentada nos Dados". Os dados foram coletados por meio de duas etapas: a primeira compreendeu atividades em grupo e a segunda consistiu em entrevistas individuais. Os resultados mostraram que a institucionalização ocorreu por abandono e rejeição dos pais ou por decisão jurídica como medida de proteção à criança, tendo como contexto a pobreza de sua família. A experiência da criança é conflituosa com relação à institucionalização, pois percebe ter recursos materiais, mas sente falta da família, da casa, dos amigos, enfim, da vida fora dali.La puntería de este estudio era saber la experiencia del nino institucionalizado y fue dirigida por la referencia teorica del "Interacionismo Simbólico" y por la referencia metodologica del "Teoria Fundamentada en los Resultados". Los datos habían sido recogidos en dos etapas: primer entendia que las actividades del grupo y segunda etapa consistió en entrevistas personales. Los resultados habían mostrado que el institutionalization ocurrió para el abandono y el rechazo de los padres o para la decisión legal como mesure de la protección del nino, teniendo como contexto la pobreza de su familia. La experiencia del nino está estando en conflicto en lo referente a la institutionalización, porque mientras que he/she percibe la necesidad del beneficio material, él falta su familia, su hogar, sus amigos, y simplemente vida afuera.The aim of this study was to know the experience of the institutionalized child and was guided by the theoretical referential of the " Symbolic Interactionism " and by the methodological referential of the " Grounded Theory". The data had been collected in two stages: the first one understood group activities and second stage consisted of personal interviews
Thompson, Ronald G; Lizardi, Dana; Keyes, Katherine M; Hasin, Deborah S
This study examined whether the experiences of childhood or adolescent parental divorce/separation and parental alcohol problems affected the likelihood of offspring DSM-IV lifetime alcohol dependence, controlling for parental history of drug, depression, and antisocial behavior problems. Data were drawn from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a nationally representative United States survey of 43,093 civilian non-institutionalized participants aged 18 and older, interviewed in person. Logistic regression models were used to calculate the main and interaction effects of childhood or adolescent parental divorce/separation and parental history of alcohol problems on offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Childhood or adolescent parental divorce/separation and parental history of alcohol problems were significantly related to offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Experiencing parental divorce/separation during childhood, even in the absence of parental history of alcohol problems, remained a significant predictor of lifetime alcohol dependence. Experiencing both childhood or adolescent parental divorce/separation and parental alcohol problems had a significantly stronger impact on the risk for DSM-IV alcohol dependence than the risk incurred by either parental risk factor alone. Further research is needed to better identify the factors that increase the risk for lifetime alcohol dependence among those who experience childhood or adolescent parental divorce/separation.
Tak Erwin CPM
(intervention −40%; control −28% and in frequency of episodes (intervention −51%; control −42% in both groups; improvement of physical performance (intervention + 13%; control −4% was related to participation in the exercise program. Conclusions This study shows that improving physical performance is feasible in institutionalized older women by exercise. Observed reductions in UI were not related to the intervention. [Current Controlled Trials ISRCTN63368283
Katherine del Consuelo Camargo Hernández
Full Text Available Introduction: Cognitive impairment is one of the most frequent occurring problems in the older adult population as a result of ageing. Objective: To determine the degree of cognitive impairment of older adults institutionalized in two homes for the elderly in the metropolitan area of Bucaramanga, Santander in Colombia. Materials and methods: A quantitative study was made by using a cross-sectional descriptive design with a population of 165 and a sample of 60 older adults from two homes for the elderly, whose inclusion criteria were: age between 65 to 95 or more and presence or absence of chronic pathology. A non-probabilistic sampling was used for convenience, and the instrument MMSE (Mini-Mental cognitive exam was applied. Results: The older adult population who participated in the study is between the ages of 75 to 94. Most of them were male, had a primary school level, had family contact and the time for institutionalization was 1 to 5 years. Conclusions: 41.7% of older adults studied showed severe cognitive impairment and require nursing interventions focused on cognitive therapy.
Nunes, Everardo Duarte
This paper takes as its starting point the concepts that make up the process of institutionalization of a field of knowledge in the following phases: 1. Differentiation of subjects, methods and techniques of knowledge or existing disciplines, 2. The subject previously considered as peripheral is now seem as part of a particular field of knowledge, 3. The new field becomes significant in the set of an area and starts the standardization of recruitment of human resources, selection of experts and financial resources, and 4. Consolidation of the new field, building its culture within the scientific community, with its social networks of communication, scientific associations and its own publications. Our central objective is to analyze the role of the Ciência e Saúde Coletiva Journal in the process of institutionalization of the Collective Health; we situate the Collective Health and its stages, make a brief report on the history of scientific publications by emphasizing the Brazilian studies on the public health field, and work the early stages of the Journal.
Wright, John; Parry, Jayne; Scully, Edward
European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device.
Celso Sidinei Balzan
Full Text Available This paper is situated within the history of education and its purpose is to investigate the challenges of institutionalization of historical-critical pedagogy (PHC at the early elementary school years in municipal network Itaipulândia-PR. In it, we try to analyze briefly articulated with the proposals and actions carried out over several years, especially in 2010 itaipulandiense educational trajectory. These achievements currently make up the municipal public education policy that includes training programs that articulate with better working conditions, teaching and learning. Based on documents and literature review, discuss and seek to understand how the teachers of this county propositions developed from the study of the major challenges that the historical-critical pedagogy faces in Brazilian education, using experiences, educational programs and projects of State Governments and federal. In addressing the specific conditions that focus on education, the school and the organization of the teaching work through the analysis of its historical and educational history, we intend to analyze the process of institutionalization and implementation of this pedagogical trend in the early years of basic education in the municipality of Itaipulândia.
Binetti, Michael R
.... It looks at the manner in which security assistance guidance is developed and executed. An examination of national level policy and the guidance from senior military and civilian leaders highlights the important role of Security Force Assistance...
long before current conflicts developed. An Australian Armoured [sic] Corps Officer with experience in both the Solomon Islands and Iraq noted...and the national level policy. Despite some turnover and changes among the senior military and civilian leadership, the underlying tone has not
Lagoria, Consuelo Alfaro; Ballon, Lourdes Zegarra
Discusses the 1975 decision of the Peruvian government to designate Quechua as an official language. Specific programs carried out as a result of this law are analyzed and assessed with respect to their effects and implications. The problems encountered in producing instructional materials for languages which are fragmented into dialects are…
Rasche, Andreas; Gilbert, Dirk Ulrich
The United Nations Global Compact – which is a Global Public Policy Network advocating 10 universal principles in the areas of human rights, labor standards, environmental protection, and anticorruption – has turned into the world's largest corporate responsibility initiative. Although the Global...... Compact is often characterized as a promising way to address global governance gaps, it remains largely unclear why this is the case. To address this problem, we discuss to what extent the initiative represents an institutional solution to exercise global governance. We suggest that new governance modes...
Ibsen, Christian Lyhne; Navrbjerg, Steen Erik
Recent studies show that employer associations continue to exist in new ways despite internationalisation of the economy, liberalisation of markets and the decline of trade unions. This paradox raises two questions regarding EOs in today’s labour markets: Which employers join employer associations...... and what kind of services do EOs offer employers? This article explores these questions using two comprehensive surveys on EOs in Denmark – a prominent case of coordinated market economies. The main finding of the analyses is that collective activities vis-à-vis trade unions and government are still...
Weiner, Sharon A.
There is increasing recognition that information literacy is essential for individual and community empowerment, workforce readiness, and global competitiveness. However, there is a history of difficulty in integrating information literacy with the postsecondary educational process. This paper posits that a greater understanding of the…
Shawl, William F.
Three years ago, Golden West College (GWC) decided to make a major commitment to staff development as a means of revitalizing the college. This commitment was evidenced through the creation of the position of Dean of Educational Development, who is responsible solely for serving faculty needs; the Educational Development Center, which houses the…
Cohen-Kettenis, P.T.; Klink, D.T.
Young people with gender dysphoria are increasingly seen by pediatric endocrinologists. Mental health child specialists assess the adolescent and give advice about psychological or medical treatment. Provided they fulfill eligibility and readiness criteria, adolescents may receive pubertal
Brown, B.B.; Prinstein, M.J.
The period of adolescence involves growth, adaptation, and dramatic reorganization in almost every aspect of social and psychological development. The Encyclopedia of Adolescence offers an exhaustive and comprehensive review of current theory and research findings pertaining to this critical decade
The group included adolescents from secondary school and some students. The group had weekly sessions or twice on mounth. The adolescents had varied simptoms: depressive, anxiety, psychosomatic disorders, learning difficulties, cunduct problems. All of adolescents were common on many problems in social interactions. The goal of therapeutic work were: to increase assertiveness skills and to reduce the anxious in social situations. The adolescents in group raised a self-esteem and developed som...
Beatriz García Alpízar
characteristics of patients with dentures and its relation to oral lesions. Methods: A descriptive study was conducted with 93 institutionalized elderly using total prosthetics. We used chi square tests and relative risk to determine the association between variables: patient’s age, sex and oral hygiene; denture’s preservation, time and frequency of use and needs of rehabilitation; type and location of lesion, smoking habit, systemic diseases and medication used. Results: 78.5% of elderly presented lesions related to the use of prosthetics. Stomatitis sub-prosthesis was the most frequent injury. The presence of oral lesions was significant in those aged 80 and over (100%. 95.8% of dentures were deteriorated and all of them had 21 or more years of use. The risk of injury was 2.98 times higher in those with poor oral hygiene. 100% of diabetic and anemic elderly presented lesions. Conclusions: Oral lesions were closely related to local factors: denture’s preservation, oral hygiene, time of use of the prosthesis, and general factors such as increased age, systemic diseases and the medication used for their treatment.
Anastasopoulos, Dimitris; Soumaki, Eugenia; Anagnostopoulos, Dimitris
The article begins with a brief exploration of the various aspects of adolescent's psychic qualities as these are described in Greek mythology. It is argued that myths are an integral part of the way that adolescence is perceived and myths play an important role in adolescents' psychic and external world, as well as in their mythological thinking.…
de Goede, I.H.A.
This dissertation on “Development of Adolescent Relationships” addresses relationships with parents, friends, and romantic partners in adolescence from a developmental perspective. By studying both parent-adolescent relationships and peer relationships at the same time, as well as interrelations
Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study : an intervention study aimed at improvement in the management of neuropsychiatric symptoms in institutionalized people with young onset dementia
van Duinen-van den IJssel, J C L; Appelhof, B; Zwijsen, S A; Smalbrugge, M; Verhey, F R J; de Vugt, M E; Zuidema, S U; Koopmans, R T C M; Bakker, C
BACKGROUND: Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be associated
Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study: an intervention study aimed at improvement in the management of neuropsychiatric symptoms in institutionalized people with young onset dementia
Duinen-van den IJssel, J.C.L. van; Appelhof, B.; Zwijsen, S.A.; Smalbrugge, M.; Verhey, F.R.J.; Vugt, M.E. de; Zuidema, S.U.; Koopmans, R.T.C.M.; Bakker, C.
ABSTRACTBackground:Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be
Relations between institutionalization and organizational decision making: a case study - Companhia Paranaense de Energia - COPEL; As relacoes da institucionalizacao com a tomada de decisao organizacional: um estudo de caso - Companhia Paranaense de Energia - COPEL
Freitas, Marcos de [Companhia Paranaense de Energia (COPEL), Curitiba, PR (Brazil)], E-mail: firstname.lastname@example.org; Campos, Luciana Vital de; Machtura, Angela Cristina Pachu [Faculdades Integradas do Brasil (UniBrasil), Curitiba, PR (Brazil)
This article identifies the institutionalization of relations with the decision making in an organization. The varied reactions from individuals to institutional procedures have led to this study. The research has the basic assumption that the information from pre established procedures may compromise the decision and critical analysis on the part of individuals. The variability is a human factor to be considered in the process of institutionalization, standardization and the addition of bureaucratization. As for methodology, a study was conducted in the case of Companhia Paranaense de Energia - COPEL from the reference of the principal characteristics of institutionalization and decision-making by looking at the coincidences. The analysis of content occurred from structured interviews conducted with 10 managers and bibliographic documentary. The report described gives evidence of reflections on the action and participation of people in the use of standards that guide the conduct organizational. The institutionalization and decision-making relate to each other, and are interdependent concepts such as bureaucracy and organizational culture, contributing to the perception of individuals in their relations within organizations. (author)
Reppold, Caroline Tozzi; Hutz, Claudio Simon
Since the decade of 1980, the model of stress and coping proposed for the assessment of vulnerability of adoptive families emphasizes that the emotional adjustment of those adopted is moderated by variables such as institutionalization, the manner and age at which the adoption was revealed, the change of first name, and the contact with the biological family. The objective of this study was to investigate the relationship of these variables to the perceived parenting style, mood, and self-esteem of the adopted adolescents. Participants in the study were 68 adolescents, between the ages of 14 and 15, adopted during infancy through judicial channels. The adolescents responded to a questionnaire about the history of adoption and to scales of Parenting Styles, Depression and Self-esteem. The main results indicated that the late revelation of adoption and the change of the first name are connected to higher levels of depression and low self-esteem and to more frequent perceptions of negligent or authoritarian parenting style. The contact with the biological family was frequently mentioned among those who perceived their parents as authoritative and presented the best indicator of mood and self-esteem. These findings were discussed in light of the necessity for multidisciplinary actions which can improve the psychological adaptation of the adopting families.
Pereda, Noemí; Abad, Judit; Guilera, Georgina; Arch, Mila
To determine the extent of sexual victimization in four groups of Spanish adolescents based on their own reports. An observational, cross-sectional, multicenter study was conducted. Sexual victimization was assessed by seven questions included in the Juvenile Victimization Questionnaire. The samples were composed of 1,105 adolescents (mean age [M]=14.52, standard deviation [SD]=1.76) from seven secondary schools; 149 adolescents (M=14.28; SD=1.45) from 14 child and adolescent mental health centers; 129 adolescents (M=14.59, SD=1.62) institutionalized in 18 long-term (78.3%) and short-term (21.7%) residential centers belonging to the child protection system; and 101 adolescents (M=16.08, SD=0.99) recruited from three detention centers (77.2%) and five open regime teams or follow-up services for court orders for minors not requiring loss of freedom (22.8%). The extent of lifetime sexual victimization ranged from 14.7% of the adolescents in the community sample to 23.5% of youths attended in mental health services, 35.6% of youths involved in the juvenile justice system, and 36.4% of children protected by the child welfare system. Most of the victims were female, the only exception being the group of male victims from the juvenile justice system. Sexual victimization of children is widespread in Spain and its distribution differs depending on the group of children under study. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
Abdullah K. Shehabat
Full Text Available This paper explains how the two protagonists, Firdaus and Sara, successfully paved their own ways in search of self-liberation despite the authoritarian patriarchy and institutionalized religions that plagued them. El Saadawi's Woman at Point Zero and Yezierska’s Bread Givers represent the fruitful struggle these protagonists experienced as they come to forge an identity and be themselves. The paper argues that the protagonists manage to free themselves, establish their own spiritual homes at their own homes and assert the potentials of their femininity despite their endings. Empowered by the powers of reading, strong will and meticulous work, the protagonists were able to realize their own material independence and achieve their lifelong ambitions. However, through Firdaus' and Sara's journeys of breaking their silence, they were subject to different patterns of self-annihilation. While Firdaus was sentenced to death for killing a pimp, Sara embraced living under the hegemony of an authoritarian husband.
Lenders, C M; McElrath, T F; Scholl, T O
Prevention of unintended adolescent pregnancy is a primary goal of the American Academy of Pediatrics and of many health providers. Nevertheless, many adolescents become pregnant every year in America. Pediatricians therefore should be aware of nutritional recommendations for pregnant adolescents to provide optimal care. The importance of nutrition during pregnancy is here reviewed from a pediatric perspective. Pregnancy, particularly during adolescence, is a time of extreme nutritional risk. The adolescents most likely to become pregnant are often those with inadequate nutritional status and unfavorable socio-economic background. There is increasing evidence of competition for nutrients between the growing pregnant adolescent and her fetus. Also, the prenatal environment has been implicated in the development of obesity, cardiovascular disease, and diabetes in both the mother and her offspring. Many adolescents have poor diet quality and poor knowledge of appropriate nutrition; these habits may not change during pregnancy. Current knowledge and recommendations regarding the intake of energy, calcium, and folate are discussed in detail.
Portela, María Luz Pita Martin; Mónico, Amália; Barahona, Antonieta; Dupraz, Hernan; Sol Gonzales-Chaves, Macarena Maria; Zeni, Susana Noemi
The present study evaluated and compared vitamin D nutritional status and calcium-phosphorus metabolism in institutionalized women >65 y from two cities that have a similar sun irradiation index (heliophany). The study was carried out in women living in similar social-status institutions from geographic cities having a similar solar radiation index (Lleida, Spain, n=49, and suburban Buenos Aires, Argentina [BA], n=48) at the end of summer. Fish consumption was higher in the Lleida group, as was red-meat consumption in the BA group. In both groups mean calcium intake was 800 mg/d. The daily intake of vitamin D was higher in the BA group (P100 pg/mL were found in 24% and 20% of women in Lleida and BA, respectively. There was a marked increase in carboxy-terminal telopeptide cross-links of type I collagen levels and a decrease in 25OHD with an increase in PTH levels (Pbone alkaline phosphatase increased significantly only when the PTH concentration duplicated the reference range. Even at the end of summer, vitamin D deficiency/insufficiency was prevalent in the two studied institutionalized elderly women. In the narrow range of the dietary calcium intake (close to 800 mg/d) of both studied groups, secondary hyperparathyroidism was absent when 25OHD levels were >17 ng/dL, indicating changes in the regulation control of serum PTH and consequently the changes in this threshold. As a result, vitamin D deficiency must be reversed to avoid the increment in bone turnover and to ensure the endocrine and paracrine functions of vitamin D for overall health and well-being. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.
Bogaerts, An; Delecluse, Christophe; Boonen, Steven; Claessens, Albrecht L; Milisen, Koen; Verschueren, Sabine M P
Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity. Copyright © 2010 Elsevier B.V. All rights reserved.
Willem J R Bossers
Full Text Available OBJECTIVES: We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. METHODS: Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0. In phase 1 of the study, seventeen patients in the Exercise group (EG received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. RESULTS: Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003, Six-Minute Walk Test (p = .031, and isometric quadriceps strength (p = .012. CONCLUSIONS: The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. TRIAL REGISTRATION: trialregister.nl 1230.
Bossers, Willem J R; Scherder, Erik J A; Boersma, Froukje; Hortobágyi, Tibor; van der Woude, Lucas H V; van Heuvelen, Marieke J G
We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0). In phase 1 of the study, seventeen patients in the Exercise group (EG) received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG) received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003), Six-Minute Walk Test (p = .031), and isometric quadriceps strength (p = .012). The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. trialregister.nl 1230.
Sicras-Mainar, A; Rejas-Gutiérrez, J; Navarro-Artieda, R; Aguado-Jodar, A; Ruíz-Torrejón, A
To evaluate the use of resources and health costs in vulnerable elderly institutionalized patients with overactive bladder (OAB) treated with fesoterodine, tolterodine or solifenacin in routine medical practice. A multicenter retrospective study, from the records of patients treated during 2008-2010 in three geographical locations and starting treatment with antimuscarinic (fesoterodine, solifenacin and tolterodine) for OAB. The attribute of vulnerability was based on collecting at least 3 of the Vulnerable Elders Survey criteria-13, age>75 years, poor/average age for health and difficulty in at least one daily physical activity. morbidity, persistence and resource use and costs. Monitoring of patients was conducted over 52 weeks. A general linear model with covariates and bootstraping (1000) at random was used to construct the 95% CI of the cost differences between drugs. Records of 552 patients (50.8% women, mean age: 80.2 years) were analyzed. Treated with fesoterodine (N=58), solifenacin (N=252) or tolterodine (N=212). The use of absorbent was 20.7%, 29.4% and 33.0% (P=.186), respectively. Persistence to treatment was slightly greater with fesoterodine. The patient healthcare costs/year were lower with fesoterodine, €1,775 (1550-2014) vs. solifenacin €2,062 (1911-2223) and tolterodine €2,149 (1,978-2,307), P=.042, as a result of lower utilization visits and concomitant medication. Despite the potential limitations of the study, the vulnerable elderly non institutionalized patients with OAB treated with fesoterodine, compared to solifenacin or tolterodine were associated with lower resource utilization and healthcare costs. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.
Depressive symptoms and cognitive performance of the elderly: relationship between institutionalization and activity programs Sintomas depressivos e desempenho cognitivo nos idosos: relações entre institucionalização e realização de atividades
Mara Cristina F Plati
Full Text Available OBJECTIVE: The aim of this study was to assess the frequency of depressive symptoms and to evaluate cognitive performance of institutionalized versus non-institutionalized elderly subjects and to compare the effect of institutionalization and participation in the institution's activity programs on their cognitive performance. METHOD: A group of 120 elderly subjects with a mean age of 71 years and average schooling of 4.2 years was evaluated. The participants were divided into 3 groups: non-institutionalized (n = 37; institutionalized with activities (n = 37; institutionalized without activities (n = 46. The groups were matched for age, gender and educational level. The following assessment instruments were used: the Geriatric Depression Scale, the Mini-Mental State Examination, the Verbal Fluency Test and the computerized versions of the Hooper Visual Organization Test and the Boston Naming Test. The data were analyzed using one-way ANOVA and the Pearson's correlation test. RESULTS: The two groups of institutionalized elderly showed higher frequency of depressive symptoms when compared to non-institutionalized subjects and worse performance on the Verbal Fluency Test. The institutionalized group without activities had lower scores on Mental State Examination, Boston Naming Test and Hooper Visual Organization Test when compared to the other two groups (p OBJETIVO: Avaliar a freqüência de sintomas depressivos e o desempenho cognitivo de idosos institucionalizados e não institucionalizados. Comparar os escores nos testes em função da institucionalização e da realização de atividades oferecidas pela instituição. MÉTODO: Foram avaliados 120 idosos com idade média de 71 anos e escolaridade média de 4,2 anos, divididos em três grupos: Não institucionalizados (n = 37; Institucionalizados com atividade (n = 37; Institucionalizados sem atividade (n = 46. Os grupos foram pareados em função da idade, sexo e escolaridade. Foram aplicados os
The concern for the consequences of adolescent pregnancy are discussed. Childbirth among unmarried teenagers results in a higher incidence of low birth weight babies, a higher infant mortality and morbidity rate, a higher percentage of childbirth complications, a decreased likelihood of completing school, a higher risk of unemployment and welfare dependency, limited vocational opportunities, larger families, and vulnerability to psychological problems and distress. In 1988, 66% of all births to teens occurred outside of marriage. Out of wedlock live births to teens 14 years rose from 80.8% in 1970 to 92.5% in 1986, and for teens 15-19 years, 29.5% to 60.8%. 70% have a repeat pregnancy within the 1st year following their 1st childbirth. 50% have a 2nd child within 3 years. Most 2nd pregnancies occur in teenagers who are not using effective contractive methods, and the pregnancy is frequently unplanned and unwanted. The factors affecting the rate of 2nd pregnancy are age, race, marital status, education, and economic status. Teenage mothers tend to come from disadvantaged backgrounds, and childbearing compounds the poverty. Aid to families with dependent children 50% of payments were to teen mothers for the birth of their 1st child. Teen fathers are usually low income providers. The public costs are high. Some teen fathers abandon their children after birth, but many are interested in supporting their child. Specific programs to help prepare fathers are needed. Teenage mothers are stressed by child care arrangements, living arrangements, employment, school, relationships with peers, relationships with parents, housework and errands, health, finances, job counseling, community services, and child care information. Parents play an important role in guiding sexual involvement and early childbearing, and need to understand why teens get pregnant and to keep channels of communication open. Teens are influenced by media, peer pressure, lack of self-esteem, unhappiness
Full Text Available The group included adolescents from secondary school and some students. The group had weekly sessions or twice on mounth. The adolescents had varied simptoms: depressive, anxiety, psychosomatic disorders, learning difficulties, cunduct problems. All of adolescents were common on many problems in social interactions. The goal of therapeutic work were: to increase assertiveness skills and to reduce the anxious in social situations. The adolescents in group raised a self-esteem and developed some assertiveness skills: eye contact" and effective communication skills, persistence, refusing and requesting, giving and receiving critism, etc. The methods of work and techniques were based on principles of cognitive-behaviour therapy.
Full Text Available Este artigo aborda o tema da avaliação sob as perspectivas do potencial em promover transformações nas organizações, das condições à sua institucionalização e das estratégias a serem utilizadas com este fim. Parte das premissas da crença em 'mudar situações', da contribuição à 'compreensão da realidade', e dos 'sentidos dos atores' sobre a tomada de decisão. Embasa a abordagem na emergência de um novo profissionalismo na gestão dos serviços e organizações; na complexidade crescente dos problemas e no papel das 'redes' e sua relação com a governança, ressaltando a legitimidade que a avaliação necessita para influenciar decisões. Destaca três tipos de avaliação no plano da prática e do conhecimento: orientada para as metas, baseada na teoria e a que privilegia a perspectiva participativa e, reflete sobre a incapacidade de resposta aos problemas ao se utilizar apenas um tipo de avaliação. Apresenta como desafios à sua institucionalização: capacidades para realizar a avaliação, estratégia sólida de difusão dos resultados e capacidades à sua utilização. Finaliza constatando que a institucionalização da avaliação supõe mudanças importantes no uso do poder para tomar decisões nas administrações públicas e recomenda o questionamento permanente das possibilidades que os trabalhos dos avaliadores têm de serem utilizados corretamente e sobre os seus benefícios para a sociedade e as instituições.This article approaches the subject of evaluation under the perspectives of a potential to promote changing in organizations, of its institutionalization conditions and strategies to be used. It begins with the assumption of belief 'to change situation', of the contribution to 'reality understand' and of the 'actors senses' about decision making. This approach is supported by the rising of a new professionalism in services and organizations management; in the increased complexity of problems and in the
Full Text Available BACKGROUND: Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue. OBJECTIVE: The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +. METHODS: The identification of the fungi relied upon the combined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails. Both groups were institutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil. RESULTS: The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii, 11.11% Candida parapsilosis, 5.56% Candida glabrata, and 5.56% Trichosporon asahii. A third group displayed 16.70% filamentous fungi, like Fusarium sp, Aspergillus sp and Neoscytalidium sp (5.56% each. The interdigital scrapings presented a positivity rate of 14.29%. The agents were coincident with the fungi that caused the onychomycosis. In the control group, Candida guilliermondii was found at interdigital space in one person. CONCLUSION: Employing a combination of those identification methods, we found no difference between the etiology of the institutionalized elderly onychomycosis from that reported in the literature for the general population. FUNDAMENTOS: As infecções fúngicas superficiais se correlacionam com o agente etiológico, a resposta imune do hospedeiro, o local da lesão e o
Van Doorn, Muriel D.; Branje, Susan J. T.; Meeus, Wim H. J.
This study examines the relation between conflict resolution styles in parent-adolescent relationships and adolescent delinquency. Questionnaires about conflict resolution styles were completed by 284 early adolescents (mean age 13.3) and their parents. Adolescents also completed a questionnaire on delinquency. Hierarchical regression analyses…
Full Text Available Hélio L Furtado,1 Nelson Sousa,2 Roberto Simão,3 Fabio Dutra Pereira,1 José Vilaça-Alves2 1Castelo Branco University, Rio de Janeiro, Brazil; 2Research Center for Sport, Health, and Human Development, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; 3School of Physical Education and Sports, Rio de Janeiro Federal University, Rio de Janeiro, Brazil Purpose: To compare functional fitness (FF levels among independent-living (IL and day care (DC elderly women of different age groups and to analyze changes in FF after 8 months of participation in an exercise program intervention for the IL elderly women. Materials and methods: A total of 674 elderly women were divided into four IL groups with age in the range of 60–64 years (IL60–64, n=149, 65–69 years (IL65–69, n=138, 70–74 years (IL70–74, n=135, and 75–79 years (IL75–79, n=83, and four DC groups with age in the range of 60–64 years (DC60–64, n=35, 65–69 years (DC65–69, n=34, 70–74 years (DC70–74, n=47, and 75–79 years (DC75–79, n=53. The intervention consisted of a multimodal exercise training, 3 days per week for 8 months. Senior Fitness Test battery performances were obtained at baseline and after 8-month intervention. Results: Significant differences were identified between all IL groups and DC groups in all FF tests (P<0.001, except between IL70–74 and DC70–74 in the chair sit-and-reach. Analysis of covariance (ANCOVA identified significant improvements in all FF tests between pre- and posttests in the IL groups (P<0.001, except in the chair sit-and-reach for the IL70–74. ANCOVA also showed a significant declining performance in all FF tests for DC groups (P<0.001, except in the chair sit-and-reach for the DC70–74 and DC75–79. Conclusion: IL women are more fit than institutionalized DC elderly women. The multimodal training was effective in improving all FF components related to daily living activities, in all age groups
Andrey Yu. Mikhailov
Full Text Available This article is based on the methodology of intellectual history examines the process of secularization of Orthodoxy in the late Russian Empire 1860 – 1910-ies. The focus of the formulation of a scientific problem: consideration of secularization as indoctrination Orthodoxy and de-institutionalization of the Synod Church. Under the first attempt to synthesize the doctrine Orthodoxy with modernist ideologies (socialism, nationalism, secularism (laicism, under the second – the erosion of the church as an institution by dividing into various inner-group. As a consequence of early modern rationalization to 1830–1840 there are three ways of indoctrination orthodoxy as synthesis with modern ideology. Firstly, synthesis with a modernist nationalism in its evolution from the "civilian" to the "political". The concept of late imperial political nationalism (N.P. Ignatiev, A.A. Kireev, tied to version of neoslavyanofily (new slavyanofily (N.P. Aksakov, D.A. Khomyakov and civilizational theory (L. Leontiev, N.I. Danilevsky tried synthesize Orthodoxy and nationalism in the spirit of religious interpretation of the nation and society. Secondly, with social theories of modern European socialism and positivism. (archimandrite Fedor (Bukharev, S.N. Bulgakov, archimandrite Michael (Semenov, and others.. Thirdly, with a modernist secularism (laicism and liberalism: P.V. Valuev, D.A. Tolstoy, K.P. Pobedonostsev. De-institutionalization of the Synodal Church took place in the following ways. In the period of early modernity (1700–1840, konfessionaliztion (die Konfessionalisierung, happened embedding religious institution in the state organism (nationalization on the practical and theoretical level. The evolution from the early modernity to late modernity (1830–1860 itself has raise the question of the "internal" secularization as activation of layman or parishioner. Theory A.S. Khomyakov (new criteria and the nature of the Church as a divine
Full Text Available Los homicidios ocurren en todo el mundo, pero no están homogéneamente distribuidos, cambian por zonas geográficas: continentes, países, regiones; en periodos de tiempo largos o cortos o por lo grupos sociales: edad, sexo, clase social o etnia. ¿Por qué en unos países hay más homicidios que en otros? ¿Por qué en unos países disminuyen los asesinatos y en otros se incrementan? Las explicaciones sociales de la violencia han tenido dos vertientes fundamentales: las teorías que la atribuyen a la pobreza y la desigualdad y las teorías de la institucionalidad o las normas sociales. Para discutir esas teorías el artículo analiza y compara los cambios ocurridos en Colombia, Venezuela y Brasil en la primera década del siglo XXI donde respectivamente disminuye, aumenta y se mantiene igual la tasa de homicidios. Utilizando la medición de seis variables (pobreza, desigualdad, desempleo, riqueza nacional, desarrollo humano y gobierno de la ley y la técnica del análisis de trayectorias se encontró que la institucionalidad tiene una mayor fuerza explicativa en los cambios observados que la pobreza y la desigualdad. El texto concluye que la pobreza o la desigualdad influyen en la criminalidad y en los homicidios, aunque no de manera directa, sino mediadas por las instituciones.Homicides occur the world over, but they are not homogeneously distributed by geographical areas (continents, countries, regions, either over long or short periods of time, or in social groups, namely age, gender, social class or ethnicity. Why are there more homicides in some countries than in others? Why do killings increase in some countries, while they decrease in others? There are two fundamental schools of thought for social explanations of crime and violence: those attributing its origins to poverty and inequality and those blaming institutionalization or social norms. To discuss these theories, this paper analyzes and compares the changes in Colombia, Venezuela
Agbemenu, Kafuli; Schlenk, Elizabeth A
The purposes of this article are to identify and review comprehensive sex education programs (CSEPs) available to adolescent females in Kenya, East Africa, to discuss barriers to implementing CSEPs in Kenya, and to highlight the role of nurses in improving and institutionalizing available CSEPs in Kenya. Integrative review. A systematic search of six databases and other Internet sources was conducted to identify CSEPs currently available to adolescent girls in Kenya. Five CSEPs were identified. The CSEPs were evaluated using established criteria. All of the CSEPs were well designed and almost all were implemented with fidelity. Four of the five CSEPs met all of the criteria for well-designed CSEPs with only one showing lack of sustainability. Tuko Pamoja (We Are One) shows promise for wider implementation. CSEPs are a valid intervention leading to the reduction of teenage pregnancy, HIV/AIDS, and sexually transmitted infections. The reach of the identified CSEPs varies, and sustainability is challenging due to lack of government and community support, lack of funding, and unsustainable teaching modalities. Nurses can serve as liaisons between adolescents, the community, and the Kenyan government in promoting CSEPs. Nurses should be more readily utilized in educating community members and policy makers about the need for CSEPs in all Kenyan high schools. Nursing students can also be utilized in their community health role to teach curricula of CSEPs. Nurses should advocate for all adolescents to access reproductive health services and for all healthcare providers to provide comprehensive reproductive health care to them. © 2011 Sigma Theta Tau International.
Mahantesha, Taranatha; Nara, Asha; Kumari, Parveen Reddy; Halemani, Praveen Kumar Nugadoni; Buddiga, Vinutna; Mythri, Sarpangala
Aim: The aim of this study is to compare the oral hygiene status among institutionalized visually impaired children of age between 6 and 20 years given with Braille and audio instructions in Raichur city of Karnataka. Materials and Methods: A total of 50 children aged between 6 to 20 years were included in this study from a residential school for visually impaired children. These children were randomly divided into two equal groups. One group was given oral hygiene instructions by audio recor...
Discusses body image among adolescents, explaining that today's adolescents are more prone to body image distortions and dissatisfaction than ever and examining the historical context; how self-image develops; normative discontent; body image distortions; body dysmorphic disorder (BDD); vulnerability of boys (muscle dysmorphia); who is at risk;…
2 Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Nelson R ... of information concerning their bodies and ..... improve quality of healthcare services for adolescents – services that .... equipment, medicines, supplies and technology needed to ensure effective service provision to adolescents.
Schmidt, Heidi; Pedersen, Trine Lykke; Junge, Tina
Study Design Cross-sectional. Background Generalized joint hypermobility (GJH) may increase pain and likelihood of injuries and also decrease function and health-related quality of life (HRQoL) in elite-level adolescent athletes. Objective To assess the prevalence of GJH in elite-level adolescent...
Darabi, Katherine F.; And Others
Discusses fertility of Hispanic adolescents in the United States. Summarizes what is known about sexuality, contraception, pregnancy, and childbearing among male and female Hispanics of various countries of origin. Indicates Hispanic adolescent birthrates fall between those of non-Hispanic Whites and Blacks, but there is considerable within-group…
Perry, David G.; Pauletti, Rachel E.
This article summarizes and critiques recent trends in research and theory on the role of gender in adolescent development. First, gender differences in key areas of adolescent functioning are reviewed. Second, research on 3 constructs that are especially relevant to the investigation of within-gender individual differences in gender…
Drury, Stacy S.
Dr. Jay Giedd says that the main alterations in the adolescent brain are the inverted U-shaped developmental trajectories with late childhood/early teen peaks for gray matter volume among others. Giedd adds that the adolescent brain is vulnerable to substances that artificially modulate dopamine levels since its reward system is in a state of flux.
Henriksen, P W; Ingholt, L; Rasmussen, M
The objectives of this study were (a) to examine the association between various kinds of parental social support and adolescents' physical activity (PA) and (b) to examine whether various kinds of social support from mothers and fathers were differently associated with boys' and girls' PA. Data...... to understand why some adolescents are physically active and others are not....
Pedersen, Trine Pagh; Holstein, Bjørn E; Damsgaard, Mogens Trab
OBJECTIVE: To investigate (i) associations between adolescents' frequency of breakfast and family functioning (close relations to parents, quality of family communication and family support) and (ii) if any observed associations between breakfast frequency and family functioning vary...... (n 3054) from a random sample of forty-one schools. RESULTS: Nearly one-quarter of the adolescents had low breakfast frequency. Low breakfast frequency was associated with low family functioning measured by three dimensions. The OR (95 % CI) of low breakfast frequency was 1·81 (1·40, 2......·33) for adolescents who reported no close relations to parents, 2·28 (1·61, 3·22) for adolescents who reported low level of quality of family communication and 2·09 (1·39, 3·15) for adolescents who reported low level of family support. Joint effect analyses suggested that the odds of low breakfast frequency among...
Fortenberry, J Dennis
This article is part of a Special Issue "Puberty and Adolescence". Sexuality emerges as a major developmental element of puberty and the adolescent years that follow. However, connecting the sexuality that emerges with puberty and elements of adult sexuality is difficult because much adolescent sexuality research addresses the transition to partnered sexual behaviors (primarily coitus) and consequences such as unplanned pregnancy and sexually transmitted infections. This review proposes a framework of an expanded understanding of puberty and adolescent sexuality from the perspective of four hallmarks of adult sexuality: sexual desire; sexual arousal; sexual behaviors; and, sexual function. This approach thus addresses important gaps in understanding of the ontogeny of sex and the continuum of sexuality development from adolescence through the adult lifespan. Copyright © 2013 Elsevier Inc. All rights reserved.
Perry, J Christopher; Sigal, John J; Boucher, Sophie; Paré, Nikolas; Ouimet, Marie Claude
We examined childhood and early adult strengths and adverse experiences of a group of orphans given up at or near birth and raised in Quebec institutions into early adulthood. A follow-up interview of 81 adults (41 women, 40 men) at a mean age of 59.2 years included retrospective assessments of childhood experiences. Most participants reported multiple early adverse experiences, including, in descending order, unfair rules and excessive punishment, physical abuse, emotional neglect, witnessing violence, verbal abuse, physical neglect, sexual abuse, and serious illness. Adverse experiences were mainly due to lay caretakers, not peers or nuns. Twelve childhood strengths, such as self-protectiveness and athletic talent, were scored at each of four age periods, yielding a median score equivalent to one strength at each period. Over half had significant childhood attachments, but of limited intimacy. Childhood variables correlated with their respective variables in later adulthood. Overall, these older adults reported a high prevalence of adverse or traumatic childhood experiences, counterbalanced by modest levels of individual strengths and attachment relationships. Institutionalization of children--if unavoidable--must build in effective safeguards against adverse experiences.
Full Text Available This investigation had two objectives: a to compare the number of punitive and not punitive socialresponses reported toward three hypothetical situations of interpersonal tension, by a group of 39institutionalized for physical abuse children and girls, with that informed by a group of 34 not abusedchildren and girls inscribed to an educational institution, and b to compare the number of punitive andnot punitive responses that the physically abused children and girls referred in this situations. All thechildren had between eight and twelve age-years, among second and quarter educational degree and lowsocioeconomic levels. The three hypothetical situations of interpersonal tension were presented verballywith the support of six sheets (three for each sex and their responses were gathered in a quantitative waythrough the content analysis. The application of the test U of Mann Whitney didn’t throw significantdifferences among the two groups. Nevertheless, it was found a significant difference at intra-grouplevel, in accordance with the test of Wicolxon.
Sung, Huei-chuan; Lee, Wen-li; Li, Tzai-li; Watson, Roger
This experimental study aimed to evaluate the effects of a group music intervention on anxiety and agitation of institutionalized older adults with dementia. A total of 60 participants were randomly assigned to an experimental or a control group. The experimental group received a 30-min music intervention using percussion instruments with familiar music in a group setting in mid afternoon twice weekly for 6 weeks, whereas the control group received usual care with no music intervention. The Rating of Anxiety in Dementia scale was used to assess anxiety, and Cohen-Mansfield Agitation Inventory was used to assess agitation at baseline, week 4 and week 6. Repeated measures analysis of covariance indicated that older adults who received a group music intervention had a significantly lower anxiety score than those in the control group while controlling for pre-test score and cognitive level (F = 8.98, p = 0.004). However, the reduction of agitation between two groups was not significantly different. Anxiety and agitation are common in older adults with dementia and have been reported by caregivers as challenging care problems. An innovative group music intervention using percussion instruments with familiar music as a cost-effective approach has the potential to reduce anxiety and improve psychological well-being of those with dementia. Copyright © 2011 John Wiley & Sons, Ltd.
栗本, かおり; Kaori, KURIMOTO; 岩手県立大学社会福祉学部; FACULTY OF SOCIAL WELFARE IWATE PREFECTURAL UNIVERSITY
The purpose of this paper is to review the influence of adolescents' peer relationships on their psychosocial development. Adolescents influence on each other, though some psychosocial merit and demerit emerge in peer influence on adolescents. The merit improves adolescents' identity, self-esteem, satisfaction of life and happiness, provides support under the crisis as well. A case of the demerit can be seen as the negative peer pressure. Adolescents are willing to conform to the norm of peer...
Weymouth, Bridget B.; Buehler, Cheryl
Early adolescence is characterized by increases in parent-adolescent hostility, yet little is known about what predicts these changes. Utilizing a fairly large sample (N = 416, 51% girls, 91% European American), this study examined the conjoint and unique influences of adolescent social anxiety symptoms and parental intrusiveness on changes in parent-adolescent hostility across early adolescence. Higher mother and father intrusiveness were associated with increased mother- and father-adolescent hostility. An examination of reciprocal effects revealed that mother- and father-adolescent hostility predicted increased mother and father intrusiveness. Significant associations were not substantiated for adolescent social anxiety symptoms. These findings suggest that intrusive parenting has important implications for subsequent parent-adolescent interactions and that similar patterns may characterize some aspects of mother- and father-adolescent relationships. PMID:26346035
Weymouth, Bridget B; Buehler, Cheryl
Early adolescence is characterized by increases in parent-adolescent hostility, yet little is known about what predicts these changes. Utilizing a fairly large sample (N = 416, 51 % girls, 91 % European American), this study examined the conjoint and unique influences of adolescent social anxiety symptoms and parental intrusiveness on changes in parent-adolescent hostility across early adolescence. Higher mother and father intrusiveness were associated with increased mother- and father-adolescent hostility. An examination of reciprocal effects revealed that mother- and father-adolescent hostility predicted increased mother and father intrusiveness. Significant associations were not substantiated for adolescent social anxiety symptoms. These findings suggest that intrusive parenting has important implications for subsequent parent-adolescent interactions and that similar patterns may characterize some aspects of mother- and father-adolescent relationships.
Petit, A; Karila, L; Lejoyeux, M
Although experts have long thought that the problems of gambling involved only adults, recent studies tend to show that teenagers are also affected. The objective of this paper is to show the characteristics of pathological gambling in adolescents. This review focuses on the clinical features, prevalence, psychopathology, prevention and treatment of this disorder. A review of the medical literature was conducted, using PubMed, using the following keywords alone or combined: pathological gambling, dependence, addiction and adolescents. We selected 12 English articles from 1997 to 2014. Recent work estimate that between 4 and 8% of adolescents suffer from problem gambling, and the prevalence of pathological gambling is 2-4 times higher in adolescents than in adults. The term adolescent pathological gambler starts early around the age of 10-12 years, with a quick change of status from casual to that of problem gambler and player. Complications appear quickly and comorbidities are common. There is no curative pharmacological treatment approved by health authorities. Pathological gambling among adolescents has grown significantly in recent years and should be promptly taken care of. Further studies must be performed to improve our understanding of this problem among adolescents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Full Text Available Atopic dermatitis (AD is a chronic inflammatory skin disorder that typically occurs during childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typical onset in the first years of life and with a 10- 30% prevalence among young children. AD prevalence in adolescence has been estimated around 5-15% in European countries. AD persists from childhood through adolescence in around 40% of cases and some risk factors have been identified: female sex, sensitization to inhalant and food allergens, allergic asthma and/or rhinoconjunctivitis, the practice of certain jobs. During adolescence, AD mainly appears on the face and neck, often associated with overinfection by Malassezia, and on the palms and soles. AD persistence during adolescence is correlated with psychological diseases such as anxiety; moreover, adolescents affected by AD might have problems in the relationship with their peers. Stress and the psychological problems represent a serious burden for adolescents with AD and cause a significant worsening of the patients’ quality of life (QoL. The pharmacological treatment is similar to other age groups. Educational and psychological approaches should be considered in the most severe cases.
DeFilippis, Melissa; Wagner, Karen Dineen
Bipolar disorder is a serious psychiatric condition that may have onset in childhood. It is important for physicians to recognize the symptoms of bipolar disorder in children and adolescents in order to accurately diagnose this illness early in its course. Evidence regarding the efficacy of various treatments is necessary to guide the management of bipolar disorder in youth. For example, several medications commonly used for adults with bipolar disorder have not shown efficacy for children and adolescents with bipolar disorder. This article reviews the prevalence, diagnosis, course, and treatment of bipolar disorder in children and adolescents and provides physicians with information that will aid in diagnosis and treatment.
Lenjalley, Adrien; Radjack, Rahmeth; Ludot, Maude; Touhami, Fatima; Moro, Marie Rose
Radicalisation resonates with the psychological vulnerabilities of adolescents. The ups and downs encountered as they attempt to construct their identity and their need to dominate favour the destructive nature of young people lacking a sense of filiation and belonging. An adolescent's engagement corresponds to a search for limits, with an adherence to religious values and to a group to establish self-esteem. Subjectification, authorising the adolescent to separate themselves from their parents and their values through a period of crisis must be supported. Copyright © 2017. Published by Elsevier Masson SAS.
Thomas, Jerill K.
In this paper, the author attempted to outline a program, aimed at the middle and junior high school student, which would inform students of the extent, type and variation of physiological changes of early adolescence in order to relieve anxiety and augment self-acceptance through assurance. (Author/RK)
May 9, 2008 ... Adolescents with suicidal tendencies have a rather distinct set of problems compared with ... Disorders (4th edition, text revision) (DSM IV)1 represent a fairly standardised approach. ... Depressed mood. Reduced interest in ...
... themselves from Mom and Dad. The march toward autonomy can take myriad forms: less overt affection, more ... learning to anticipate the shifting currents of adolescent emotion, mothers and fathers may be struggling with some ...
Different pathological states occurring during adolescence, such as anorexia, bulimia and suicidal attempts are seen as possible manifestations of psychological defence mechanisms against the anxiety-provoking bodily changes of puberty and the necessary psychological transformations inherent to adolescence and sexual maturation. The changes of object of desire and some sexual risk behaviours are illustrated by clinical vignettes. Music is suggested to play a role in the mobilisation of emotions, bodily sensations and in the construction of an imaginary world and thus to be a factor--a part from biological and psycho-social ones--influencing the sexual behaviour of adolescents. Some communication techniques are suggested enabling access to adolescents on sexual matters - a domain of increasing public health importance.
Sanfilippo, J S
Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development
Dessole, Margherita; Melis, Gian Benedetto; Angioni, Stefano
Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies pr...
West, Joshua H; Lister, Cameron E; Hall, P Cougar; Crookston, Benjamin T; Snow, Paola Rivera; Zvietcovich, Maria Elena; West, Richard P
Background Sexting (sexual messaging via mobile devices) among adolescents may result in increased risky sexual practices, psychological distress and in some cases, suicide. There is very little research on sexting in developing nations, such as Peru. In particular, little is known about gender differences in the correlates of sexting. The purpose of this study was to determine the sexting prevalence and correlates of sexting among adolescent boys and girls in Cusco, Peru. Methods The study s...
Mallet, E; Gaudelus, J; Reinert, P; Le Luyer, B; Lecointre, C; Léger, J; Loirat, C; Quinet, B; Bénichou, J J; Furioli, J; Loeuille, G A; Roussel, B; Larchet, M; Freycon, F; Vidailhet, M; Varet, I
Although systematic vitamin D supplementation in adolescents remains debated, rickets is nevertheless a well recognized pathology in this age group. Adolescence is an at-risk period because of rapid growth, insufficient calcium intake and/or vitamin D status. Surveys have shown that calcium intake is insufficient (population at risk. Forty-one adolescents with rickets were hospitalized between 1985 and 2000. Most of the cases were from the Northern France: 20 from Paris and suburbs, eight from the North-West, four from the North, four from the North-East; five were from the Center of France. The mean age was 13 years and two months for the 28 girls, and 14 years and four months for the 13 boys. Eighty per cent of the adolescents were from immigrant families (33/41): 15 were from sub-Saharan Africa, ten from North Africa, six from Pakistan and two from Turkey. Two thirds of the adolescents were hospitalized in the 2nd quarter of the year. Some adolescents suffered from lower limb pain, 16 had deformations of lower limbs, particularly genu valgum, associated with pain; seven others had either muscle spasms (4), tetany (3). Serum calcium level was low (average 1.84 mmol/l: [1.1-2.5]), and serum 25-OH D level was extremely low. Radiographic characteristics observed were metaphyseal strips on the knees, with condensed edges at times, with the presence of bone demineralization. The treatment combined calcium and vitamin D, and was often administered intravenously when a hypocalcemia was detected. Rickets is not frequent in adolescents, but nonetheless this pathology is not exceptional, and the number of cases is probably under-estimated. Rickets affects immigrant adolescents in particular but nevertheless could also present a certain risk period for the general population.
Bloch, Michael H
Suicide is currently the second leading cause of death in young people ages 10-19 (CDC, 2015). Current statistics suggest that in the US one in every seven youths has seriously considered or made a plan to commit suicide and one in every 13 youths has attempted suicide in the previous year (CDC, 2015). Suicide represents a - if not the - major public health problem in adolescents. © 2016 Association for Child and Adolescent Mental Health.
María Belén Hirose
nationhood, by means of choreography, music, clothing and events. Folklore, consolidating by the time as a scientific discipline, was functional to the national project, giving the criteria for the creation of a dance repertoire taught in Buenos Aires and expanded to the whole country.In this article we will describe the historical development that enables folkloric dances teaching institutionalization in Argentina, as well as the effects of such institutionalization. We will explore the rol that different groups or individuals from the political, cultural or academic realm attributed to the teaching of folkloric dances, during the process of nation-state building. Keywords: dance; folklore; Argentina; teaching; Peronism
There is a considerable body of empirical research that has identified adolescent peer relationships as a primary factor involved in adolescent cigarette smoking. Despite this large research base, many questions remain unanswered about the mechanisms by which peers affect youths' smoking behavior. Understanding these processes of influence is key to the development of prevention and intervention programs designed to address adolescent smoking as a significant public health concern. In this paper, theoretical frameworks and empirical findings are reviewed critically which inform the current state of knowledge regarding peer influences on teenage smoking. Specifically, social learning theory, primary socialization theory, social identity theory and social network theory are discussed. Empirical findings regarding peer influence and selection, as well as multiple reference points in adolescent friendships, including best friendships, romantic relationships, peer groups and social crowds, are also reviewed. Review of this work reveals the contribution that peers have in adolescents' use of tobacco, in some cases promoting use, and in other cases deterring it. This review also suggests that peer influences on smoking are more subtle than commonly thought and need to be examined more carefully, including consideration of larger social contexts, e.g. the family, neighborhood, and media. Recommendations for future investigations are made, as well as suggestions for specific methodological approaches that offer promise for advancing our knowledge of the contribution of peers on adolescent tobacco use.
Accounting for the sedative and analgesic effects of medication changes during patient participation in clinical research studies: measurement development and application to a sample of institutionalized geriatric patients.
Sloane, Philip; Ivey, Jena; Roth, Mary; Roederer, Mary; Williams, Christianna S
To date, no system has been published that allows investigators to adjust for the overall sedative and/or analgesic effects of medications, or changes in medications, in clinical trial participants for whom medication use cannot be controlled. This is common in clinical trials of behavioral and complementary/alternative therapies, and in research involving elderly or chronically ill patients for whom ongoing medical care continues during the trial. This paper describes the development, and illustrates the use, of a method we developed to address this issue, in which we generate single continuous variables to represent the daily sedative and analgesic loads of multiple medications. Medications for 90 study participants in a clinical trial of a nonpharmacological intervention were abstracted from medication administration records across multiple treatment periods. An expert panel of three academic clinical pharmacists and a geriatrician met to develop a system by which each study medication could be assigned a sedative and analgesic effect rating. The two measures, when applied to data on 90 institutionalized persons with Alzheimer's disease, resulted in variables with moderately skewed distributions that are consistent with the clinical profile of analgesia and sedation use in long-term care populations. The average study participant received 1.89 analgesic medications per day and had a daily analgesic load of 2.96; the corresponding figures for sedation were 2.07 daily medications and an average daily load of 11.41. A system of classifying the sedative and analgesic effects of non-study medications was created that divides drugs into categories based on the strength of their effects and assigns a rating to express overall sedative and analgesic effects. These variables may be useful in comparing patients and populations, and to control for drug effects in future studies.
Jane A. Russo
Full Text Available Neste artigo apresentamos e discutimos os resultados parciais da investigação sobre a constituição do campo da sexologia contemporânea no Brasil, parte da pesquisa comparativa "Sexualidade, ciência e profissão na América Latina". Uma segunda onda sexológica surgiu no Brasil em finais dos anos 1970 no Rio de Janeiro, com um viés essencialmente clínico, e em São Paulo, com um viés educacional. A década seguinte marcou um período de institucionalização no qual são criadas as duas associações que hoje polarizam o campo em torno de uma sexologia mais eclética e multiprofissional e da chamada "medicina sexual", em geral dominada pelos urologistas. Discutimos os significados dessa polarização em termos das disputas profissionais subjacentes e das concepções de gênero implicadas em tais disputas.In this paper we present and discuss the preliminary results of an investigation on the constitution of the contemporary field of sexology in Brazil, which is part of the comparative research "Sexuality, science and profession in Latin America". A second sexology arose in Brazil in the late 70's in Rio de Janeiro, with an essentially clinical approach, and in São Paulo, with an educational approach. The following decade brought a period of institutionalization in which the two associations that nowadays dominate the sexological field were created. They represent the two main trends in modern sexology; a more eclectic and multiprofessional approach and the so-called "sexual medicine", dominated by urologists. We discuss the meanings of this polarization in terms of its underlying professional disputes and the gender assumptions implied in such disputes.
Philippe R Mutwa
Full Text Available INTRODUCTION: Adherence to combination antiretroviral therapy (cART is vital for HIV-infected adolescents for survival and quality of life. However, this age group faces many challenges to remain adherent. We used multiple data sources (role-play, focus group discussions (FGD, and in-depth interviews (IDI to better understand adherence barriers for Rwandan adolescents. Forty-two HIV positive adolescents (ages 12-21 and a selection of their primary caregivers were interviewed. All were perinatally-infected and received (cART for ≥ 12 months. Topics discussed during FGDs and IDIs included learning HIV status, disclosure and stigma, care and treatment issues, cART adherence barriers. RESULTS: Median age was 17 years, 45% female, 45% orphaned, and 48% in boarding schools. We identified three overarching but inter-related themes that appeared to influence adherence. Stigma, perceived and experienced, and inadvertent disclosure of HIV status hampered adolescents from obtaining and taking their drugs, attending clinic visits, carrying their cARTs with them in public. The second major theme was the need for better support, in particular for adolescents with different living situations, (orphanages, foster-care, and boarding schools. Lack of privacy to keep and take medication came out as major barrier for adolescents living in congested households, as well the institutionalization of boarding schools where privacy is almost non-existent. The third important theme was the desire to be 'normal' and not be recognized as an HIV-infected individual, and to have a normal life not perturbed by taking a regimen of medications or being forced to disclose where others would treat them differently. CONCLUSIONS: We propose better management of HIV-infected adolescents integrated into boarding school, orphanages, and foster care; training of school-faculty on how to support students and allow them privacy for taking their medications. To provide better care and
Lílian Gatto Gonçalves
residentes en asilos para protección. En entrevista, los ancianos respondieron las preguntas de instrumento pre-evaluado sobre la ocurrencia de caídas. Además de un análisis bivariado (Wald, se realizó un análisis por regresión de Poisson con cálculo de razones de prevalencia e intervalos de confianza de 95% ajustada para las variables de confusión. RESULTADOS: La prevalencia de caídas entre los ancianos asilados estudiados fue de 38,3%. Las caídas fueron más comunes en el ambiente del asilo (62,3%, siendo el cuarto el ambiente donde ocurrió el mayor número de caídas (23,0%. En el análisis ajustado, las caídas se mantuvieron asociadas con el color blanco de la piel, con los ancianos separados y divorciados, con la depresión, y mayor cantidad referida de medicamentos para uso continuo. CONCLUSIONES: El estudio muestra que la prevalencia de caídas entre los ancianos asilados es alta. A pesar de que algunos de los posibles factores asociados sean pasibles de prevención, aún ocurren caídas en lugares que deberían ser considerados seguros, como el cuarto del anciano.OBJECTIVE: The increase of life expectancy in developing countries has been a source of concern about quality of life and well-being of elderly people, especially regarding falls. The objective of the study was to assess the prevalence of falls in institutionalized elderly and to describe factors associated. METHODS: Cross-sectional study carried out in the city of Rio Grande (Southern Brazil. A total of 180 elderly (65 years old or more, living in institutions were included in the study. The elderly were interviewed and a pre-tested instrument with questions on falls was administered. In addition to a bivariate analysis (Wald, Poisson's regression analysis was conducted and prevalence ratios and 95% confidence intervals (95% CI adjusted for confounders were estimated. RESULTS: The prevalence of falls among institutionalized elderly was 38.3%. Falls were most frequently seen at the home premises
Kiekens, G; Bruffaerts, R; Nock, M K; Van de Ven, M; Witteman, C; Mortier, P; Demyttenaere, K; Claes, L
This study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping. A total of 946 Flemish (46%) and Dutch (54%) non-institutionalized adolescents (Mean age=15.52; SD=1.34, 44% females) were surveyed. Measures included the NSSI subscale of the Self-Harm-Inventory, the Dutch Quick Big Five Personality questionnaire, the Perceived Stress Scale and the Utrecht Coping List for Adolescents. Examination of zero-order correlations was used to reveal associations, and hierarchical regression analysis was used to reveal potential mediators which were further examined within parallel mediation models by using a bootstrapping-corrected procedure. Lifetime prevalence of NSSI was 24.31%. Neuroticism; perceived stress; and distractive, avoidant, depressive, and emotional coping were positively associated with NSSI engagement, whereas Agreeableness, Conscientiousness; and active, social, and optimistic coping were negatively associated with NSSI engagement. Observed relationships between personality traits and NSSI engagement were consistently explained by perceived stress and depressive coping. A higher versatility of NSSI was not associated with any Big Five personality trait, but was associated with higher scores on perceived stress and depressive coping and with lower scores on active and optimistic coping. Our study suggests that a specific personality constellation is associated with NSSI engagement via high stress levels and a typical depressive reaction pattern to handle stressful life events. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Branje, Susan J. T.; van Doorn, Muriel; van der Valk, Inge; Meeus, Wim
The current study examined the moderating role of conflict resolution on the association between parent-adolescent conflicts and adolescent problematic adjustment. Participants were 1313 Dutch early and middle adolescents who completed measures on conflict frequency, conflict resolution with parents, and internalizing and externalizing adjustment…
CONCLUSIONS Urban Children and Adolescents. Increasing prevalence of overweight and obesity and measures of regional (central) adiposity. High prevalence of markers of dysmetabolic state in urban adolescents. ~10% prevalence of dysglycemia in overweight / obese school children.
Kandel, Denise B.
The attributes of adolescents involved in marihuana and nonmarihuana-using peer groups are described. Adolescent subcultures are highly differentiated and involvement with peers does not necessarily entail rejection and estrangement from parents. (Author/AM)
van West, D.; Vermeiren, R.R.J.M.
Psychiatric comorbidity in adolescents who abuse substances is the rule rather than the exception, and common comorbidities include depression, anxiety disorder, bipolar disorder, conduct disorder, and Attention Deficit Hyperactivity Disorder (ADHD). Among adolescents, the presence of both mental
... some high-income countries. Rights of adolescents The rights of children (people under 18 years of age) to survive, ... the child rights convention, published guidelines on the right of children and adolescents to the enjoyment of the highest ...
SINCE THE CULTURALLY DISADVANTAGED STUDENT OFTEN MANIFESTS AN AVERSION TOWARD THE ACADEMIC AND HIGHLY INSTITUTIONALIZED EDUCATIONAL PROCESS WHICH NOW EXISTS, EDUCATORS MUST EXPLORE THE POSSIBILITIES INHERENT IN EDUCATIONAL TECHNOLOGY TO MAKE THIS PROCESS LESS FORMAL. PROGRAMED MATERIALS AND OTHER SELF-TUTORING DEVICES ADAPTED TO THE LEARNING NEEDS…
Full Text Available A ordem jurídica e a medida de internamento constituem-se como categorias centrais da análise de conteúdo das entrevistas de 15 jovens institucionalizados num Centro Educativo de Portugal, por prática de facto qualificado pela lei como crime. A técnica geradora de estrutura de discurso, usada como instrumento de validação comunicativa dos significados emergentes dos discursos, permite identificar as representações sociais que os jovens constroem sobre as categorias, a partir das quais o investigador realiza o seu próprio trabalho interpretativo. Os resultados apontam para uma concepção heterónoma do dever jurídico, sendo que os jovens associam ao internamento uma função, simultaneamente, educativa e sancionadora. Finalmente, este estudo pretende evidenciar as potencialidades de uma abordagem interpretativa em termos de investigação e intervenção.This study is based on the content analysis of interviews done with 15 young males institutionalized in a Re-Education Center in Portugal for offensive behavior and conflict with the law. The technique of generating discourse structure, used as a communication validity tool, allows the definition of law and institutionalization as the main categories. The main goal is to describe the social representations youngsters build about the categories, upon which the researcher performs her own interpretative work. The analyses revealed that youngsters conceive law in terms of its legal consequences, while perceiving institutionalization as an educational measure, in terms of their social rehabilitation, but also referring to it as a punishment element. This study aims at accounting for the potentialities of the interpretative approach concerning research and intervention.
Yazdi-Feyzabadi, Vahid; Omidvar, Nasrin; Keshavarz Mohammadi, Nastaran; Nedjat, Saharnaz; Karimi-Shahanjarini, Akram; Rashidian, Arash
The Iranian Health Promoting Schools (IHPS) program was first piloted and then formally established in Iran in 2011 as a framework to promote healthy environment and behaviors such as proper dietary practice among adolescents. This study examined the role of IHPS in improving the school food environment and snacking behaviors among adolescents. In this cross-sectional study, 1320 eighth grade students from 40 middle schools with IHPS and non-IHPS program were selected using a proportional stratified random sampling method. A modified 55-item qualitative Food Frequency Questionnaire was used to assess the frequency of consumption of healthy and unhealthy snacks in the studied adolescents. Mixed effect negative binomial regression models were used to analyze the data. The association was also adjusted for individual variables, including gender, socio-economic status, pocket money, family structure and nutritional knowledge level. No significant difference was observed between the average of healthy and unhealthy snack items in IHPS and non-IHPS schools (p > 0.05). On the basis of adjusted analysis, being from/in IHPS was not associated with weekly frequency consumption of unhealthy [prevalence rate ratio (PRR) = 0.99; 95% CI: 0.85-1.16] and healthy (PRR = 1.08; 95% CI: 0.96-1.2) snacks among the adolescents. There was no difference regarding school food environment and snacking behaviors in IHPS and non-IHPS schools. This might indicate that there has been a weakness in institutionalizing the comprehensive concepts of the HPS approach in the studied schools. Addressing the proper understanding of HPS approach and the need for development of HPS through matching and adaptability with health promotion actions to reach defined standards, is necessary. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Montemayor, Raymond; Clayton, Mark D.
The relationship between maternal employment and adolescent development is enormously complex, and no simple generalizations are possible. Many intervening variables alter the impact that maternal employment has on adolescent development. There is an urgent need to discover what impact this arrangement has on adolescent development. (CJ)
Reese, Elaine; Fivush, Robyn; Merrill, Natalie; Wang, Qi; McAnally, Helena
Adolescents' intergenerational narratives--the stories they tell about their mothers' and fathers' early experiences--are an important component of their identities (Fivush & Merrill, 2016; Merrill & Fivush, 2016). This study explored adolescents' intergenerational narratives across cultures. Adolescents aged 12 to 21 from 3 cultural…
Trickett, Penelope K.; Negriff, Sonya; Ji, Juye; Peckins, Melissa
Child abuse and neglect, often collectively called child maltreatment, are huge social problems affecting millions of children and adolescents in America. Adolescents are affected both by maltreatment which occurred during childhood with lingering effects and by maltreatment that continues into or begins in adolescence. Several decades of research…
Steinbeck, Katharine S; Lister, Natalie B; Gow, Megan L; Baur, Louise A
The increased prevalence of adolescent obesity and associated short-term and long-term complications emphasize the need for effective treatment. In this Review, we aim to describe the evidence for, and elements of, behaviour management and adjunctive therapies and highlight the opportunities and challenges presented by obesity management in adolescence. The broad principles of treatment include management of obesity-associated complications; a developmentally appropriate approach; long-term behaviour modification (dietary change, increased physical activity, decreased sedentary behaviours and improved sleep patterns); long-term weight maintenance strategies; and consideration of the use of pharmacotherapy, more intensive dietary therapies and bariatric surgery. Bariatric surgery should be considered in those with severe obesity and be undertaken by skilled bariatric surgeons affiliated with teams experienced in the medical and psychosocial management of adolescents. Adolescent obesity management strategies are more reliant on active participation than those for childhood obesity and should recognize the emerging autonomy of the patient. The challenges in adolescent obesity relate primarily to the often competing demands of developing autonomy and not yet having attained neurocognitive maturity.
Bouvard, M P; Doyen, C
With 1500 death each year, suicide does represent the second cause of death in young people (between 15 and 25 years). There is a clear increase of suicide rate during adolescence, with an higher rate of suicide attempts in females, but an higher mortality in boys. Suicidal behaviors in adolescents are clinically characterized by impulsivity, rhythmicity (during schooling) and seasonality. Risks factors are numerous. However, psychiatric disorders represent the main one, especially depressive states, conduct disorders and their association. In adolescents familial and environment events may have an important role in suicidal behaviors, especially the role of imitation behavior. These different factors interact and constitute dynamic models. The role of each factor can be involved differently considering the sex. Dangerosity of suicide in adolescents should not be under-estimated, as it has been the case in the past. It is particularly true if we consider the high rate of recidive (approximatively 50%) in this population. These data emphasized the importance of a careful evaluation of all suicidal adolescents more precisely of depressive symptoms and aggressive and/or delinquent behavior and of prevention.
West, Joshua H; Lister, Cameron E; Hall, P Cougar; Crookston, Benjamin T; Snow, Paola Rivera; Zvietcovich, Maria Elena; West, Richard P
Sexting (sexual messaging via mobile devices) among adolescents may result in increased risky sexual practices, psychological distress and in some cases, suicide. There is very little research on sexting in developing nations, such as Peru. In particular, little is known about gender differences in the correlates of sexting. The purpose of this study was to determine the sexting prevalence and correlates of sexting among adolescent boys and girls in Cusco, Peru. The study sample comprised 949 high school aged adolescents from Cusco, Peru. Adolescents responded to questions about demographics, sexting behavior, and risk/protective factors. Separate regression models were constructed to compare correlates of sexting for boys and sexting for girls. Twenty percent of the sample reported engaging in at least one instance of sexting. Boys reported higher rates of sexting than girls (35.17% vs. 13.19%, p = 0.000). Significant correlates for girls' sexting included having been cyberbullied and parental factors. For boys, hypertexting, fighting, parental factors, and parental rules about sexting were significant. Peruvian health officials with an interest in reducing the effects of sexting among adolescents may choose to target boys differently than girls. These efforts may include advising parents to set clear rules and expectations about sexting and the appropriate use of mobile devices.
Plunkett, Scott W.; Henry, Carolyn S.; Robinson, Linda C.; Behnke, Andrew; Falcon, Pedro C., III
Using symbolic interaction, we developed a research model that proposed adolescent perceptions of parental support and psychological control would be related to adolescent depressed mood directly and indirectly through self-esteem. We tested the model using self-report questionnaire data from 161 adolescents living with both of their biological…
Full Text Available Scoliosis is called idiopathic when no other underlying disease can be identified. The etiology of adolescent idiopathic scoliosis (AIS is still unknown despite many years of research effort. Theories on AIS's etiology have included mechanical, hormonal, metabolic, neuromuscular, growth, and genetic abnormalities. Skeletally immature patients with adolescent idiopathic scoliosis are at risk of curve progression. The adolescent onset of severe idiopathic scoliosis has traditionally been evaluated using standing posteroanterior radiographs of the full spine to assess lateral curvature with the Cobb method. Scoliosis in children of school age and above primarily occurs in girls. The therapeutic goal in children is to prevent progression. In children, scoliosis of 20 and deg; or more should be treated with a brace, and scoliosis of 45 and deg; or more with surgery. [Arch Clin Exp Surg 2014; 3(3.000: 174-182
Dibiasi, V; Sturgis, S H
Approaches employed in counseling pregnant adolescents at the Crittenton Clinic in Boston are described. Concentrating on concrete issues of management of the pregnancy -- supplying information and exploring the pros and cons of various alternatives are advocated; probing into the psychological and emotional background of the pregnant adolescent is discouraged. Counseling about contraceptives and taking into account each individual situation are considered essential. Case studies are reviewed and figures representing the attitudes and contraceptive use of patients 1 year after abortion are presented. It is considered important to establish a trusting relationship with the adolescent, which will increase the likelihood that she will return for follow-up and additional help if she needs it.
Full Text Available O artigo apresenta a trajetória das políticas sociais no Brasil e identifica, em cada etapa, o modelo de proteção social vigente. Afirma que a Constituição Federal de 1988, ao introduzir o conceito de Seguridade Social e criar o Sistema Único de Saúde, representou uma ruptura com o modelo tanto de Estado quanto de cidadania anteriores, em resposta à mobilização social que a antecedeu. A subordinação dos princípios de justiça e inclusão social, que orientaram o desenho desse novo padrão de proteção social, a uma política liberal e monetarista, tiveram importantes impactos na fase de implementação das políticas sociais. No entanto, os dilemas que atravessam tais políticas e, em particular, a construção do sistema único de saúde devem ser analisadas sob uma perspectiva teórica que compreende as convergências e divergências entre os três movimentos que caracterizaram a Reforma Sanitária brasileira, quais são: a subjetivação, a constitucionalização e a institucionalização.The article presents the trajectory of social policies in Brazil and identifies, at each stage, the existing social protection model. It affirms that the Federal Constitution of 1988, when it introduced the concept of Social Security and created the National Health Care System, represented a rupture with what came before. The subordination of the principles of justice and social inclusion, which guided the design of this new social protection model, to a liberal and monetarist policy had important impacts in the phase of implementation of the social policies. However, the dilemma that such policies go through and, in particular, the construction of the National Health Care System must be analyzed from a theoretical perspective that encompasses the agreements and disagreements between the three movements that characterize Brazilian Sanitary Reform, which are: subjectivation, constitutionalization and institutionalization.
Cristhiane Emy Kano
Full Text Available OBJETIVO: comparar os resultados audiológicos de idosos institucionalizados, levando-se em consideração duas classificações distintas. MÉTODOS: foram avaliados 40 idosos de ambos os sexos, com faixa etária superior a 60 anos. Após levantar a história clínica audiológica e de realizar otoscopia, foram obtidos os limares tonais (via aérea e via óssea dos indivíduos, com o uso de audiômetro Eymasa, dentro de cabina acústica. RESULTADOS: demonstraram que a classificação proposta pela Recomendação 02/1 do Bureau International d'Audio Phonologie, foi mais sensível quanto a caracterização da perda auditiva na população idosa. CONCLUSÃO: a classificação utilizada pela Recomentação 02/1 é a que melhor representa o grau de perda auditiva nesta população, uma vez que leva em consideração além das freqüências da fala (500, 1k e 2kHz, a freqüência de 4 kHz para o cálculo da média.PURPOSE: to compare the audiological results for institutionalized elderly, taking into consideration two distinct classifications. METHODS: we evaluated 40 elderly of both genders, over 60-year-old, after assessing the clinical history and conduct of audiological otoscopy, we obtained the pure tone (via air and bone of the individuals, by using the audiometer Eymasa within an acoustic cabin. RESULTS: the classification used by Recommendation 02/1 of Bureau International d'Audio Phonologie, was more sensitive about hearing loss characterization in the elderly population. CONCLUSION: the classification used by Recommendation 02/1, is the one that better represents hearing loss degree in this population, since it takes in consideration in addition to the speech frequencies (500, 1k and 2kHz, the frequency of 4kHz for calculating the mean value.
Estratégias de enfrentamento, dificuldades funcionais e fatores associados em idosos institucionalizados Coping strategies, functional difficulties, and associated factors in institutionalized elderly
Analise de Souza Vivan
Full Text Available O objetivo deste estudo é verificar as estratégias de enfrentamento utilizadas pelos idosos em face das dificuldades funcionais e a existência de associação entre o uso das estratégias e variáveis como sintomas depressivos, sexo, escolaridade, idade, estado civil e percepção da saúde. Participaram do estudo 103 idosos institucionalizados, que apresentavam necessidade de assistência em no mínimo uma atividade de vida diária. O delineamento foi transversal, com a utilização dos seguintes instrumentos: Ficha de Dados Pessoais, Escala de Atividades da Vida Diária, Breve Entrevista Internacional de Neuropsiquiatria Modificada, Mini-Exame do Estado Mental, Inventário de Estratégias de Coping e Escala de Depressão Geriátrica. As estratégias de enfrentamento mais utilizadas pela amostra foram a de autocontrole e resolução de problemas. Encontraram-se associações significativas entre as variáveis escolaridade e depressão. Os resultados da pesquisa sugerem que a avaliação das estratégias utilizadas em face de eventos estressores pode auxiliar na análise da situação e na adequação das estratégias escolhidas, ajudando também em processos de mudança no contexto clínico.The aim of this study was to analyze the strategies used by elderly people to cope with functional difficulties, and to investigate a possible association between such strategies and variables like depressive symptoms, gender, schooling, marital status, and self-perceived health. 103 institutionalized elderly individuals participated in the study. They required assistance for at least one activity of daily living. The study was cross-sectional and used the following indicators: Personal Data Chart, Activities of Daily Living Scale, Modified Mini International Neuropsychiatric Interview, Mini-Mental Examination, Coping Strategies Inventory, and Geriatric Depression Scale. The most widely used coping strategies in the sample were self-control and problem
Full Text Available Adolescent rampant caries is a new and growing challenge in Conservative Dentistry. It has the same etiology and pattern as that of nursing bottle syndrome. Herein, a case is presented in which the main cause of rampant caries is the patient′s habit of keeping cariogenic food in her mouth and going to sleep. Educating this etiology and introduction of preventive strategies not only assists in meeting the special oral needs of the adolescent population, but also helps to establish lifelong healthful habits.
The myths and prejudices that distort the reality and hide the true causes and effects of natural and social phenomena related to sexuality have a fertile ground in AIDS, given its obvious link to sex. The alarming spread of AIDS has been 1 result of these myths and prejudices. Human beings are sexual by nature; genital organs determine sex and also induce sexual behavior. It is by not fairly well accepted that an individual's sexuality exists from birth. Puberty usually begins at 12-16 years for both sexes. The physical changes of puberty terminate in the ability of the female to conceive and the male to procreate. The sexual excitation of adolescents resulting from production of various hormones can only be eliminated by some type of sexual satisfaction or sublimation. Sexuality, according to Freud, is an organizing principle of the personality. The sexual organs exist not merely for reproduction but to provide pleasure. Puberty signifies entry into active sex life. But the ideological structure of society, perpetuated by the family, schools, religion, the mass media, and other social institutions, sends confused signals to adolescents, requiring abstinence and virginity until marriage for women while encouraging sexual adventures for men. Adolescents are confronted by their new sexual feelings in the midst of a virtual bombardment of visual sexual stimuli from the mass media. It becomes impossible for adolescents to satisfy the requirements of appearances while also resolving the problems and pressures of their newly gained sexual maturity. Many adolescents become sexually active, and the problem is not to prevent sexual activity but to improve the conditions under which it occurs. Adolescents, lacking education and information about sex, begin their sex lives without protection. AIDS has now been added to the list of dire consequences that can result. A true sex education beginning in the home is needed to enable young people to develop healthy and full sex
Full Text Available Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies provide new options, in particular the use of serological markers.
Full Text Available Abstract There are numerous and intertwining factors that influence adolescent smoking and have to be considered when we develop and implement programmes and measures for the prevention and reduction of adolescent smoking. In different environments (schools, health system, local communities we have to reduce risk factors and strenghten protective factors through programmes incorporated in the system. The protective factors are low prevalence of smoking, healthy lifestyle, physical activity and good mental health, indicating the importance of links to programmes outside of the tobacco control.
Findings from an empirical research project on creativity, including controlled experimental assessment, indicate that the development of creative capacity occurs primarily during the adolescent period. Defined as the production of entities that are both new and valuable, creativity necessarily involves two specific types of cognition designated as the janusian and homospatial processes. Although there are precursors to the development of creativity during earlier childhood, both the motivation and the capacity to create appear first in the adolescent period. Important motivational factors derive from adolescent conflicts and developmental tasks such as the impetus to solve and consolidate issues relating to identity, the return of oedipal conflicts, and the pressures toward autonomy and independence. Engaging in creative types of fields and outlets helps generally to establish coherent identity during adolescence and beyond; the beginnings of a specific creative identity in adolescence are a necessary foundation for creative motivation and ability to create throughout life. The return of the oedipal conflict at the onset of puberty motivates the dual compliance and competition of the creatively disposed adolescent with his or her same-sex parent. The pressures toward autonomy and independence provide the motivational and affective substrate for the development of the homospatial and janusian processes. The homospatial process arises from the vacillating and concomitant experiences of autonomy (or separation) and connectedness. In the creatively disposed adolescent, one who activates and uses cognition to express and explore affect, the creative aspect of those experiences begins to be manifested in the concomitant cognitive separation and connection involved in superimposition of mental images. The janusian process arises from the experiences of rebellious oppositionality and intense emotional ambivalence. The creative cognitive aspect of these experiences is
Fleming, Nathalie; O'Driscoll, Teresa; Becker, Gisela; Spitzer, Rachel F
To describe the needs and evidence-based practice specific to care of the pregnant adolescent in Canada, including special populations. Healthy pregnancies for adolescent women in Canada, with culturally sensitive and age-appropriate care to ensure the best possible outcomes for these young women and their infants and young families, and to reduce repeat pregnancy rates. Published literature was retrieved through searches of PubMed and The Cochrane Library on May 23, 2012 using appropriate controlled vocabulary (e.g., Pregnancy in Adolescence) and key words (e.g., pregnancy, teen, youth). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Results were limited to English or French language materials published in or after 1990. Searches were updated on a regular basis and incorporated in the guideline to July 6, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, national and international medical specialty societies, and clinical practice guideline collections. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS/HARMS/COSTS: These guidelines are designed to help practitioners caring for adolescent women during pregnancy in Canada and allow them to take the best care of these young women in a manner appropriate for their age, cultural backgrounds, and risk profiles. 1. Health care providers should adapt their prenatal care for adolescents and offer multidisciplinary care that is easily accessible to the adolescent early in the pregnancy, recognizing that adolescents often present to care later than their adult counterparts. A model that provides an opportunity to address all of these needs at one site may be the preferred model of care for pregnant adolescents. (II-1A) 2. Health
... given in this review have the potential to increase sexual awareness in adolescents, encourage contraceptive use and improve adolescent reproductive and sexual health in the country. Keywords: Adolescent sexual behaviour, Adolescent health and development, secondary school students, adolescent pregnancy.
organizational change in the context of labor- management relations. One of their basic arguments is that the company and management have conflicting...planned organizational interventions. From the modest number of empirical studies on planned organizational change in a union- management context...new forms of work organization have emphasized the need to increase our understanding of oraganizational change processes. This paper has elaborated
Rothman, David J.
This vignette from the author's book, "The Reform of the Asylum: Between Conscience and Convenience in Progressive America," provides historical evidence of resistance to community placement of the mentally disabled. Resistance is due to the social convenience of custodial care and the self-interest of institutions and their employees.…
Phelps, Jacob; Dermawan, Ahmad; Garmendia, Eneko
Monetary valuation of the environment is increasingly embedded in policy. Despite broad claims that valuation is policy-relevant, there is widespread frustration that it has not widely improved environmental outcomes, that it obscures many other types of values, and presents unintended consequences.
Rais Abrarovich Burganov
Full Text Available The relevance of the topic is related to the recognition of the position that the full use of the institutional capacity and decrease of institutional constraints in the development of individual sectors of the economy leads to stabilization of the development of the entire national economy. Neglecting the institutions of economic branches negatively affect the trend of sustainable development of society. This work is devoted to the problems of institutional changes in the electricity sector. The subject concerns millions of households. Development of theoretical and methodological basis for the study of institutional relations of economy and energy will significantly influence the creation of the original effective energy strategy. Currently, imperfect institutional relations in the sphere of energy services reduce the efficiency of the driven activities. It is known that the problematic aspects of the institutional environment — keeping costs and externalities in pricing policies, the formation of the institutional environment saving, determination of the behavior of economic agents and the electricity market, etc. require permits. In general, scientific and practical significance of the study is large. The results of research of the institutional structure research of correlation between power engineering and economics based on agency approach will promote deepening of the theory of institutionalism at the sectoral economics level.
Nickelsen, Niels Christian
-which has before largely been treated in overview by institutionalism-plays an important role in the making of a routine. In my empirical study, I demonstrate that the concept and practice of the valve changes, and that it is identified in a number of ways, as it passes through the testing phase...... of production. I argue that the negotiation of these changes during test production is the fulcrum in the routinization of the production procedure. It is through these identity shifts that the valve is both reified, and rendered producible and applicable in the customer world....
Artiklen forklarer hvordan mikrokredit som en policy idé er blevet institutionaliseret på det transnationale niveau, samt hvilken rolle strategiske aktører spiller i den institutionelle forandring og styring af mikrokredit. Artiklen fokuserer i særlig grad på tre dominerende aktører: Grameen Bank...
Rosenheim, Eliyahu; Gaoni, Bracha
There are potentially healthy adolescents who display excessive reluctance to move toward independent decision and action. This research presents a clinical description of this "syndrome", conceptualizes it as a defensive maneuver against mourning over cherished childhood dreams and offers steps for therapeutic intervention. (Editor/RK)
Hendry, Leo B.; Patrick, Helen
Over 2,000 15-16 year old adolescents from central Scotland were surveyed to determine characteristics of high- vs. low-frequency television viewers. Personality characteristics, attitudes toward school and sports, and socioeconomic status were related to viewing habits. Sex of the viewer was found to be related to choice of programs. (GDC)
Hart, Daniel; Carlo, Gustavo
Themes in the papers in this special issue of the "JRA" on moral development are identified. We discuss the intersection of moral development research with policy concerns, the distinctive qualities of moral life in adolescence that warrant investigation, the multiple connotations of "moral", the methods typical of moral development research, and…
Discusses adolescent anxieties, rebelliousness, and media preferences in the 1990s, especially Hip Hop, and relates today's trends to past trends, from Sinatra to Break Dancing. Suggests classroom activities using music and music videos: analyzing fans; providing biographies, discographies, lyrics; writing reviews of albums and videos; studying…
Each innovation brings along many risks. One of the risks related with the Internet use is Internet addiction. The aim of this study is to examine Internet addiction in adolescence in terms of gender, Internet access at home and grades. The research design used was survey method. The study population consisted of second stage students attending…
Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and…
Marks, Peter E. L.; Cillessen, Antonius H. N.; Crick, Nicki R.
This study aimed to support the theory of popularity contagion, which posits that popularity spreads among friends spontaneously and regardless of behavioral changes. Peer nominations of status and behavior were collected annually between 6th and 12th grades from a total of 1062 adolescents. Longitudinal hypotheses were mostly supported using path…
Thorne, Craig R.; DeBlassie, Richard R.
Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)
Kleinjan, M.; Engels, R.C.M.E.; Brown, B.B.; Prinstein, M.J.
An overview of the prevalence, health consequences, and determinants of adolescents’ substance use is provided in this article on adolescence and addictions. Additionally, prevention and treatment efforts and the effectiveness are discussed. The emphasis is on alcohol, smoking, and cannabis use.
Le Prof.Feldmann, Prof. de psychiatrie à l'Université de Genève, donne une suite de la conférence du novembre 1967 en parlant des besoins de l'adolescent et l'aspect pratique, suivi d'une discussion
Pietrobelli, A; Flodmark, C E; Lissau, I
that despite the fact that childhood obesity is a crisis facing worldwide youth, it is necessary that action to control it must be taken now. All the six relevant levels (ie, family, schools, health professionals, government, industry and media) could be involved in prevention of child and adolescent obesity....
Presents descriptive data on a 5-year cohort of 20 adolescent murderers from England and Wales, and provides an outline of their pathway through the criminal justice system together with a framework for their ongoing individual therapy. Suggests refinement of categories of juvenile homicide and increased information sharing among professionals.…
It is increasingly necessary that pediatricians have greater knowledge of adolescent health. To begin with they should be familiar with the psychosocial development of this period, an issue which is imperative for the health care of the age group. With that purpose, this article reviews the normal adolescent psychosocial development. Adolescence is a stage that has been progressively prolonged, during which fast and big changes occur, that lead human beings to become biologically, psychologically and socially mature, and potentially able to live independently. Developmental tasks of this period are the establishment of identity and the achievement of autonomy. Although it is a process of high individual variability in terms of its beginning and end, the progression through stages, the synchrony of development between the various areas, and in other aspects, the psychosocial development of this period usually have common characteristics and a progressive pattern of 3 phases: early, middle and late adolescence. Psychological, cognitive, social, sexual and moral development of young people in each of them are described in this article. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
May 18, 2008 ... theories concur that adolescence is a distinct developmental period characterised by ... Thus the initial self-righteous black-and- white thinking of early ... their daughter temporarily needs to hole herself up in her dirty room ...
Morgan, Erin; Huebner, Angela
Adolescence is a time of many transitions for both teens and their families. It is important for both to understand what is happening to the teen physically, cognitively, and socially; how these transitions effect teens; what adults can do about it; and what resources are available.
Adler, Nancy E.; Ozer, Emily J.; Tschann, Jeanne
Reviews the current status of abortion laws pertaining to adolescents worldwide, examining questions raised by parental consent laws in the United States and by the relevant psychological research (risk of harm from abortion, informed consent, consequences of parental involvement in the abortion decision, and current debate). Discusses issues…
The nutritional disturbances are frequent by adolescents. That is a psychological defense against dependance toward the mother but also a middle to remain in a childish position i.e. either as a fat baby - in the fall of obesity- or as the ideal pre- or bisexual great child - in the case of anorexia.
Chapple, Eliot D.
Presented is the final report of a research project on the programed training and placement of nonpsychotic disturbed adolescents. Eleven chapters cover topics which include the following: psychiatry and the sociopaths and psychopaths; boys dealt with in the project; development of the programed interaction diagnostic interview; disturbances to…
Full Text Available Adolescence is the period in human growth and development that occurs after childhood and before adulthood, from ages 10 to 19 years. It is a period of dynamic brain development. During this period, adolescents learn from the social behavior and environmental surroundings of their community. Because of rapid urbanization without accounting for the basic health-care amenities, health disparities tend to arise. In this review, we have tried to describe the health profile of adolescents in urban India. Relevant articles were extracted from PubMed and related websites. Adolescents in urban areas perceive their physical environment as very poor. Social capital and social cohesion are very important in their development. Increasing child marriage and poor antenatal care among adolescents are key challenges in improving the reproductive and sexual health. More than half of adolescents are undernourished. About 56% of adolescent girls are anemic. At this time of fighting against under-nutrition, burden of overweight and obesity is increasing among the urban adolescents. Mass media use and increased sedentary lifestyle increase the risk factors for noncommunicable diseases. Labile mental and emotional behavior makes them prone to suicide and intentional self-harm. Another avoidable key challenge among adolescents is addiction. Urban living and regular media exposure are positively associated with smoking and alcohol consumption. Among unintentional injuries, road traffic accidents dominate the picture. Various health programs targeting adolescent health have been launched in the recent past.
Savickaite, Ruta; Dijkstra, Jan; Veenstra, René
Emerging adolescent sexual activity is considered a normative aspect of adolescent development and the transition to adulthood, however, there are potential risks involved when adolescents start having sex, such as teenage pregnancies, sexually transmitted infections, and undesirable long-term
Gearing, Robin E; MacKenzie, Michael J; Schwalbe, Craig S; Brewer, Kathryne B; Ibrahim, Rawan W
This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. Child Behavior Checklist and case history data were collected for 70 youths across four Jordanian care centers. Approximately 53% of the adolescents were identified as experiencing mental health problems, and 43% and 46% had high internalizing and externalizing scores, respectively. Ordinary least-squares regression models examining mental health functioning showed that male gender, care entry because of maltreatment, time in care, and transfers were the most significant predictors of problems. Paralleling international research, this study found high levels of mental health needs among institutionalized youths. The impact of transfers on functioning is particularly worrisome, given the standard practice of transferring youths to another facility when they reach age 12. Improving the institutional care model by requiring fewer transfers and offering family-based community alternatives may ameliorate risks of developing mental and behavioral problems.
The adolescent who comes for psychoanalytic treatment has probably experienced a developmental breakdown-a rejection of his or her body and a distorted image of himself or herself as being male or female. A critical requisite for work with such adolescents is an understanding of one's own adolescent development. The internal freedom of the psychoanalyst is an essential ingredient in the treatment of the adolescent. This means that the psychoanalyst of the adolescent can separate his own sexual life and thoughts from what is lived out in the analytic sessions and thus can ensure that the treatment will confront whatever is essential and that he will avoid deriving gratification from the treatment process through taking over the adolescent's body or feeling that he is secretly sharing the intimacies of the patient.
Relationship between cardiometabolic profile, vitamin D status and BsmI polymorphism of the VDR gene in non-institutionalized elderly subjects: Cardiometabolic profile, vitamin D status and BsmI polymorphism of the VDR gene in non-institutionalized elderly subjects.
Issa, Chahira Taha Mahd Ibrahim; Silva, Alexandre Sérgio; Toscano, Luciana Tavares; Medeiros, Marcia Silva; Persuhn, Darlene Camati; da Silva Diniz, Alcides; de Carvalho Costa, Maria José; Rodrigues Gonçalves, Maria da Conceição
This study aimed to evaluate the relationship between the cardiometabolic profile, vitamin D status and BsmI polymorphism of the VDR gene in non-institutionalized elderly subjects. A cross-sectional study was conducted with a random and representative sample of 142 elderly subjects selected by cluster and recruited from a municipal assistance program. Clinical, nutritional, biochemical and inflammatory profiles, oxidative stress and genotyping for the BsmI polymorphism were evaluated. Participants had mean age of 69.9 (7.0) years, BMI of 28.3 (4.4) kg/m(2) and 80.3% were women. The prevalence of a 25-hydroxyvitamin D [25(OH)D] status vitamin D levelDD≥75nmol/L]; this relationship was maintained only for women in the analysis by sex. The BsmI polymorphism showed allelic frequencies in the SUF group of B 49% and b 51% and in the INSUF/DEF group B 38% and b 62%. The frequency of bb homozygosity was significantly associated with lower serum total cholesterol and LDL cholesterol concentrations compared to Bb, both in the general population and in the SUF group. Among individuals with bb, the INSUF/DEF group showed higher levels of triglycerides and VLDL cholesterol. Blood glucose levels and oxidative stress were increased in elderly subjects with 25(OH)Dvitamin D status resulted in lower total and LDL cholesterol, but the benefit was lost when vitamin D insufficiency or deficiency was present. Copyright © 2016 Elsevier Inc. All rights reserved.
Lovecraft, A. L.; Meek, C. L.
the coming decades. The authors propose the institutionalization of rule sets based on adaptive governance principles which take advantage of several sets of international and national or subnational arrangements for protecting places. Respectively these could include World Heritage Sites, Marine Protected Areas, and state or provincial level management. However, current governance systems may not be adequately linked across interrelated services and the people who depend on them for their livelihoods. We propose an adaptive cross-scalar system of monitoring and governance focused on the sea ice services tied to marine and coastal areas. The design would account for the special properties of sea ice (e.g. creating uniform legal categories tied to ice rather than either land or sea) so that the system can continue to provide diverse services in a holistic fashion rather than piecemeal in isolated locations. Hence the need for a continuous refuge governing a singular “ice shed” in spite of national boundaries.
Simpson, Annabelle K; Magid, Viktoriya
Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population. Copyright © 2016 Elsevier Inc. All rights reserved.
Adolescence is the period of physical and psychological growth between childhood and adulthood. The author is a practicing obstetrician and gynecologist in New Delhi. Over the course of her medical career, she has identified many myths and misconceptions about adolescents and adolescence. With regard to male adolescents, masturbation-related myths may be the most frequently harbored. Male adolescents have a hormone-driven need to have sexual intercourse, frequently. Masturbation is a healthy, no-cost way to relieve sexual tension. There is neither need to pay a prostitute nor fear of contracting a sexually transmitted disease. A young man can masturbate virtually whenever he wants. Despite the guilt and misinformation implanted by adults that masturbation causes weakness, boys masturbate rather frequently. Also contrary to popular myth, the nocturnal emissions which may result in growing boys as a result of sexual excitement during a dream are completely normal and no reason for concern. Further, boys should not worry about penis size, for, when erect, they all work just fine. People grow at different rates. Menstruation starts when 17% of a woman's body weight is fat. The onset of menstruation may therefore start earlier in well-fed girls compared to in girls who are more lean. The frequency and duration of menses are not constant. Menstrual irregularity therefore does not necessarily mean that a young woman is pregnant or that professional medical treatment is required. Breasts, like penises, serve their intended function irrespective of size. The hymen is a membrane at the opening of the vagina. It may have a hole in the center or the side for the escape of menstrual blood. There are myths that an intact hymen is indicative of virginity, the hymen should be intact until marriage, and the first sexual experience should be painful for a woman. The hymen is elastic and even some prostitutes have been found to have intact hymens. The hymen also may tear due to a
Brook, Judith S.; And Others
This longitudinal study examined the relationship of three domains (personality/attitudinal orientations, peer relationships, and family socialization factors) with initiation into adolescent marihuana use. (Author/DB)
Engr E. Egbochukwu
skill training (SST) in fostering interpersonal behaviour among Nigerian adolescents. ..... communication problems (Akinade, 1988, Aremu, 1998, Ojekunle, 1999, .... Restructuring on the Enhancement of Self Esteem of Visually Impaired.
Christensen, Claire G; Bickham, David; Ross, Craig S; Rich, Michael
Using Ecological Momentary Assessment, we explored predictors of adolescents' television (TV) multitasking behaviors. We investigated whether demographic characteristics (age, gender, race/ethnicity, and maternal education) predict adolescents' likelihood of multitasking with TV. We also explored whether characteristics of the TV-multitasking moment (affect, TV genre, attention to people, and media multitasking) predict adolescents' likelihood of paying primary versus secondary attention to TV. Demographic characteristics do not predict TV multitasking. In TV-multitasking moments, primary attention to TV was more likely if adolescents experienced negative affect, watched a drama, or attended to people; it was less likely if they used computers or video games.
Zaltzman, Alina; Falcon, Bani; Harrison, Megan E
To review the existing literature on body image in adolescent pregnancy and explore concepts about the relationship between the two. A systematic review. Peer-reviewed articles were identified through MEDLINE (1946-present) and PsycINFO (1806-November 2013), conducted in any setting. Pregnant and postpartum adolescents ages 13-19 y. None. The outcome measures used in the studies reviewed varied: themes from focus groups, diary entry analysis, Pregnancy and weight gain attitude scale, Edinburgh postnatal depression scale, Parenting stress index, Eating disorder inventory, Tennessee self concept scale. The search yielded a total of 149 studies, of which 6 were relevant to the specific topic and age group. The very limited research shows a dichotomy in body image perception during pregnancy in adolescence; some studies show an increase in body image disturbance and dissatisfaction during pregnancy in adolescents, and other studies reviewed found that the majority of pregnant adolescents had positive body image and positive attitudes towards weight gain. A bidirectional link between depression and negative body image in adolescent pregnancy is suggested. The current research exploring the relationshp between body image and pregnancy in adolescence is limited, both in quality and quantity. Future research is needed to evaluate longitudinal models that will better inform about potential risk factors for body dissatisfaction during pregnancy in adolescence, including the possible role of depression. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Driscoll, Deborah A
Polycystic ovary syndrome (PCOS) is a common disorder among reproductive-age women, yet the diagnosis may be overlooked during adolescence. Although the clinical and metabolic features are similar to those found in adult women, it can be difficult to distinguish the young woman with PCOS from a normal adolescent. Irregular menses, anovulatory cycles, and acne are not uncommon in adolescent women. Adolescents with a history of premature pubarche, a family history of PCOS, Caribbean-Hispanic and African-American ancestry, and/or obesity are at risk for PCOS and deserve close surveillance. The laboratory evaluation of the adolescent with suspected PCOS or hyperandrogenism should be individualized based on the history, symptoms, and examination findings. The cornerstone of management of PCOS in adolescence includes either a combination oral contraceptive or progestin. Consideration of insulin-sensitizing agents, antiandrogens, topical treatments for acne, and various treatments for hair removal are dependent on the patient's symptoms and concerns. Healthy eating, regular exercise, and for the overweight adolescent, weight reduction, are encouraged to reduce the risk of cardiovascular disease and type II diabetes mellitus. Numerous studies have shown that weight loss and exercise decrease androgen levels, improve insulin sensitivity, and lead to the resumption of ovulation. Although initial studies suggest that Metformin may be particularly useful for treating the PCOS adolescent with insulin resistance and obesity, additional studies are needed to determine the efficacy and long-term outcome. Management of the adolescent with PCOS is challenging and requires a supportive, multidisciplinary team approach for optimal results.
Serefoglu, E C; Saitz, T R; La Nasa, J A; Hellstrom, W J
Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is recognized to be the most common surgically correctable cause of male infertility. However, the actual incidence in adolescents, pathophysiology and the association with male factor infertility all remain somewhat controversial. The most accurate diagnostic technique for identifying young men who will benefit from surgical treatment has yet to be established. Observations of testicular asymmetry and deteriorating semen quality helped establish current guidelines and recommendations for surgical treatment. Further studies, comparing observation with surgical intervention, are needed to refine the current indications for varicocoele repair in the adolescent male. © 2012 American Society of Andrology and European Academy of Andrology.
Fabrício de Souza
Full Text Available This paper aims to contribute towards the comprehension of the adhesion of adolescent to digital technologies and their usage in the search for or consolidation of relationships with their peers. The objective was to analyze the role of blogs in the maintenance and establishment of relationships among adolescents from the State of Espírito Santo, Brazil. Three boys’ blogs and three girls’ blogs were selected, and five pages of each blog were selected, in a total of 30 pages. Categories were elaborated from reading the posts left at the 30 pages and subsequently used to classify and quantify the posts. Messages and comments left at the blogs had a positive affective connotation, in search for approximation and contact with the blog owner. Messages were also noted for gender differences. It was concluded that some determined patterns of offline interaction guided the establishment of online relationships.
Brunelle, Julie; Milhet, Vanessa; Consoli, Angèle; Cohen, David
Juvenile mania is a concept widely developed but also highly debated since the 1990s. In the heart of this debate, Severe Mood Dysregulation (SMD) and "Temper Dysregulation disorder with Dysphoria" (recently integrated in DSM-5) showed their interest. Actually, the objective is to distinguish two clinical phenotypes in order to avoid confusion between (1) what would raise more of mood dysregulation with chronic manic like symptoms, and (2) bipolar disorder type I with episodic and acute manic episodes. Therapeutic stakes are major. In adolescents, even if DSM adult diagnostic criteria can be used and bipolar disorder type I clearly established, differential diagnostic at onset between acute manic episode and schizophrenia onset remain sometimes difficult to assess. Furthermore, it is crucial to better assess outcome of these adolescents, in terms of morbidity and potential prognosis factors, knowing that a younger age at onset is associated with a poorer outcome according to several adult studies. Therapeutic implications could then be drawn.
Steenberg, Christine Krohn
Endometriosis is a chronic disease with endometrial-like tissue located outside the uterus, resulting in inflammation, pelvic pain and infertility. Laparoscopic exploration is the only accurate diagnostic aid for disease recognition, and the time between symptom onset and final diagnosis can be up to 10 years. Endometriosis can already start in adolescence, and in order to make an earlier diagnosis, researchers are beginning to look for an association between specific characteristics, or mark...
Strasburger, Victor C
Considerable research now exists that the media may exert a powerful influence on adolescents' drug-taking behavior. Teens view an average of 2,000 beer and wine ads per year in the US. In addition, television shows, movies, and music videos contain considerable amounts of alcohol use. This article will discuss the available research and offers suggestions to make the media healthier for teenagers.
Ohm, Julie Juhye
The formation of ego identity in Asian American late adolescents attending Virginia Tech was examined within the frameworks of Erikson's psychosocial theory and Berry, Trimble, and Olmedo's model of acculturation. Ego identity was measured using the Achieved sub-scale of the Revised Version of the Extended Objective Measure of Ego Identity Status, an instrument based on the theoretical constructs of Erikson. Ethnic identity was measured using the Multigroup Ethnic Identity Measure and America...
Castillo Belen, Juan Ramon; Toirac Fernandez, Yosmel; Castillo Belen, Alexis; Columbie Cumba, Yolanda
The case report of an adolescent who visited the consulting room for presenting alopecia since 3 years ago, after the divorce of her parents is presented. Hypnosis was applied with imaging procedures such as the autoscopy and the immunostimulating therapy of the cellular immunity. The typical lesions of alopecia disappeared, so the patient's improvement was achieved, as well as a remarkable reduction of the treatment period. The use of the combined hypnoimmunotherapy is recommended to treat appropriately this type of dermatopathy