BACKGROUND Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia. METHODS A randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of demen...

OBJECTIVE To examine whether the presence of motor signs has predictive value for important outcomes in Alzheimer disease (AD). METHODS A total of 533 patients with AD at early stages (mean Folstein Mini-Mental State Examination [MMSE] 21/30 at entry) were recruited and followed semiannually for up to 13.1 years (mean 3) in five University-based AD centers in the United States and European Un...

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 ...

This study assessed the antecedents of continued use of an education program to prevent passive smoking in infants. It consists of a booklet for parents and a manual for health professionals describing a five-step procedure for discussing passive smoking. A questionnaire was sent to 67 managers, 670 nurses, and 335 physicians working in well-baby clinics (response rate: 70%, 53%, 47% respective...

Complex organizations spend significant resources acquiring new processes and technologies . However, there is no assurance that organizational members will embrace these technologies once they are adopted . Organizational leaders have a strong incentive to ensure that new practices persist, and that technological changes become so routine as to be taken for granted : a process called instituti...

BACKGROUND 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. W...

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. Resp...

PURPOSE The purpose of this study was to identify reliable predictors of nursing home entry over a 3-year period in a sample of 3,944 persons with dementia who resided in a home setting at baseline. Strengths of the analysis include a multiregional recruitment strategy, incorporation of salient caregiver characteristics, and a 3-year prospective design that allows for the modeling of change in ...

OBJECTIVE To identify predictive indicators of institutionalization of the elderly. METHODS A case-control study was carried out with 991 elderly individuals in the city of Pelotas, (Southern Brazil), from 2007 to 2008. The cases of institutionalized elderly adults (n = 393) were detected using a census of all long-stay institutions for the elderly in the city. The population controls (n = 59...