NPs play major role in promoting sexuality among institutionalized elderly.
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The population of a large Canadian institution, providing rehabilitative and health care for the mentally retarded, received oculo-visual assessments in an optometric clinic established in the hospital by the University of Waterloo, School of Optometry. The ocular and visual anomalies of 1242 residents have been compiled and analyzed. This paper reports the results and discusses their implications. The size of the sample makes the data useful in planning vision care delivery to the mentally retarded. Comparisons are made to similar data obtained from a concurrent study of a community sample and to studies from vision literature.
Investigators have found a higher incidence of refractive error and eye disease in the mentally retarded population, so a study was needed to determine the extent of vision services available to this population. A survey requesting information on frequency of eye examinations and vision screenings was mailed to administrators of Illinois State and private residential facilities for the mentally retarded. The results indicate that vision services in these institutions are inadequate.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Until now, no evaluation of phenytoin dosing methods has been undertaken in a large group of patients, to our knowledge. The goal of this study was to determine which of eight different dosing methods most accurately predicts a phenytoin steady-state concentration. Seventy-six patients were chosen, retrospectively, from a state-funded institution for the mentally retarded. Eligibility criteria included two or more different doses of phenytoin and corresponding plasma concentrations. Relative predictive performance was determined by comparing results of simple linear regression. Also, relative bias and precision were determined by comparing mean prediction errors, root mean squared errors, and respective 95% confidence intervals. Of the methods requiring one dose-concentration pair, Rambeck's nomogram was the best predictor of phenytoin concentrations. The methods requiring two known doses and plasma concentrations were more accurate. Their predictive performance was equivalent, although use of the Tozer equation might be preferred for its convenience. None of the methods tested were sufficiently precise to substitute for confirmatory serum phenytoin concentrations.
The importance of urinary tract infection in elderly populations and some of the unique features in its evaluation and therapy are becoming better recognized. In elderly populations in the community there are concerns about increasing antimicrobial resistance in infecting organisms. In postmenopausal women, the importance of vaginal estrogen deficiency as a factor which promotes urinary tract infection is becoming increasingly recognized, leading to therapeutic strategies other than antimicrobials. For elderly residents of long term care facilities, urinary tract infection is very common, and most frequent in those with the greatest functional impairment. Whilst it is recognized that asymptomatic bacteriuria should not be treated, the diagnosis of urinary tract infection in this population often presents a dilemma. In particular, the urine culture is useful only in excluding urinary tract infection, not in making a diagnosis of symptomatic infection. There has been a tendency to manage all clinical deterioration in long term care facility residents who have positive urine cultures as urinary tract infection, contributing to excess antimicrobial use and heightening the problem of antimicrobial resistance. Recently published guidelines and commentaries attempt to address this problem.
Experimental projects have demonstrated the technical feasibility of systems of accessible, affordable health care. These projects have relied extensively on non-professional community health workers. However, large-scale implementation of these schemes will require new management procedures that are both responsive to rural health needs and congruent with national institutions. This paper identifies the need to establish institutional mechanisms to mobilize essential inputs, promote acceptance by beneficiaries, maintain quality standards, recruit and retain field staff, and achieve accountability for resources. It then outlines methods for developing these institutions. It stresses the need for both formal, bureaucratic organizations and informal organizations of clients. It also identifies the need to consider administrative and institutional resources in determining the appropriateness of a health care technology.
Explore the source record for details and available documents.
The purpose of the study was to explore drug use of elderly incontinent female nursing home residents, to identify potential drug--drug interactions, and to identify the number and categories of drugs taken having the potential to cause urinary incontinence. The medication administration records of 84 female residents were examined. The drugs were categorized by therapeutic classification as designated by the American Hospital Formulary Service. Potential drug--drug interactions were identified using The Hansten Drug Interaction Knowledge Base Program, a microcomputer version of Hansten's (1985) book Drug Interactions. Data were computer-coded and analysed using the Statistical Analysis System (SAS). A total of 454 drugs was taken by the 84 subjects, with an overall average of 5.40 drugs per person. The most frequently taken drugs were gastrointestinal drugs, central nervous system agents, electrolytic, caloric, and water balance drugs, and cardiovascular drugs. Fifty per cent (n = 42) of the subjects were identified as having 119 potential drug-drug interactions. Seventy per cent (n = 59) of the subjects were taking a drug having the potential to cause urinary incontinence. Suggestions for future research are presented.
Suffering is a phenomenon with physical and emotional components. Although several studies have drawn attention to the needs of, and demands placed on families who provide care for patients with a diagnosis of cancer at home, few have discussed the suffering which many of these caregivers experience. This paper will illustrate the phenomenon of suffering as seen in the responses made by family caregivers of patients with cancer. Eighty-three family caregivers drawn from a probability sample of patients with a diagnosis of cancer were interviewed in their homes to determine needs they encountered in their caregiving roles. The caregivers consisted of 43 males and 40 females, with mean ages of 53 and 54 years respectively. Families not only identified their needs, they also indicated several areas which were for them sources of suffering. The findings revealed that family suffering often stemmed from fear of loneliness; uncertainty about the future (their own and that of the patients); lifestyle disruption; communication breakdown; lack of support; and their sense of helplessness. These findings suggest that health professionals, particularly nurses, who work with families in their homes, must be alert and sensitive to cues and circumstances which could indicate suffering, and in so doing, take the necessary steps to ameliorate their situation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Pica, an eating disorder, is commonly observed in infants, young children and in developmentally delayed persons. The behaviour is regarded as pathological if it persists beyond the age of about 18 months. The present study was designed to study the prevalence of pathological pica in a state residential institution for mentally retarded persons. Of the total sample of 607 residents, 56 or 9.2% were identified and observed to engage in pica. The occurrence of pica was related to the degree of retardation and age of the residents. Observational data showed that the occurrence of pica varied in frequency across four different settings, both within and between subjects. A wide variety of objects were used for pica including clothing, dirt, dust and fluff off the floor, toys, paper, and grass. Medical case notes showed that only a small number of the residents engaging in pica suffered from the commonly known problems associated with pica.