==================================HSR11================================== 11. Treatment programs, standards and guidelines for psychiatric residential treatment centers (or long-term care facilities) for children and adolescents. 1 UI - 87118600 AU - Allen JG ; Colson DB ; Coyne L ; Dexter N ; Jehl N ; Mayer CA ; Spohn HE TI - Problems to anticipate in treating difficult patients in a long-term psychiatric hospital. AB - In a previous report, the authors identified four dimensions of patient pathology associated with treatment difficulty: withdrawn psychoticism, character pathology, violence-agitation and suicidal-depressed behavior. In a subsequent study, they linked these dimensions to patterns of countertransference. The present research extends the two prior reports by examining the relations of the patient pathology dimensions to staff members' dissatisfaction with four areas of treatment: interpersonal approaches, structure and control, quality of teamwork, and medication. The major findings are: withdrawn psychoticism primarily relates to dissatisfaction with interpersonal treatment approaches; character pathology entails dissatisfaction with the level of structure and control; violence-agitation poses particular problems for teamwork; and suicidal-depressed behavior is unrelated to dissatisfaction with any dimension of treatment. The authors propose that these various problems in treatment are, in part, mediated by patterns of countertransference which they described in the prior paper. These findings should help staff members to focus their attention on areas of treatment in which problems are bound to arise in work with different types of difficult patients. MH - Adolescence ; Adult ; Countertransference (Psychology) ; Depressive Disorder/THERAPY ; Female ; Hospitalization ; *Hospitals, Psychiatric ; Human ; Long Term Care ; Male ; Mental Disorders/PSYCHOLOGY/*THERAPY ; Middle Age ; Personality Disorders/THERAPY ; Psychotic Disorders/THERAPY ; Suicide/PREVENTION & CONTROL SO - Psychiatry 1986 Nov;49(4):350-8 2 UI - 87110054 AU - Turner TH ; Dossetor DR ; Bates RE TI - The early outcome of admission to an adolescent unit: a report on 100 cases. AB - Data are presented on the outcome of 100 adolescents after discharge from an adolescent inpatient unit. Outcome is recorded in terms of placement at home, day care provision, and partial or full-time residential care provision, relating this to diagnosis, sex, age, duration of admission and evidence of family pathology. Of these only duration of admission was significantly related to outcome. More than two thirds (69 per cent) of all patients are discharged home. At six months, of those traced, 82 per cent are at home. Stability of outcome is the norm. This reflects the bio-psycho-social approach of the unit and refutes the notion that psychiatric institutional care for adolescents merely predicts a continued need for therapeutic resources. MH - Adolescence ; Family ; Female ; Follow-Up Studies ; Human ; Length of Stay ; Male ; Mental Disorders/PSYCHOLOGY/*THERAPY ; Psychiatric Department, Hospital ; Psychotic Disorders/PSYCHOLOGY/THERAPY ; Residential Facilities SO - J Adolesc 1986 Dec;9(4):367-82 3 UI - 87101802 AU - Felce D ; de Kock U ; Thomas M ; Saxby H TI - Change in adaptive behaviour of severely and profoundly mentally handicapped adults in different residential settings. AB - A demographic sample of 28 severely and profoundly mentally handicapped adults with a mental age of four years and below were assessed on Part 1 of the Adaptive Behavior Scale (ABS) at three points 18 months apart. The Griffiths Mental Development Scales and Reynell Developmental Language Scales were also conducted at the first and last assessment points. The subjects were resident in either a small community-based home, the parental home or other residential institutions. The small-home group showed the greatest adaptive behaviour change particularly in the areas of independent functioning, domestic skills and self-direction and on the scale total. Although reservations are expressed on the accuracy of assessment, the ABS data and the comparative result received some validation from the mental age and language assessments. Gains were independent of subject characteristics. The study adds to the literature showing adaptive behaviour gains arising from transfer from institutional to more normal residential environments. However, in attributing the results found to the general characteristics of the residential settings, the explicit programming emphasis of the small-home service should not be overlooked. MH - Adolescence ; Adult ; Aged ; Female ; Halfway Houses ; Home Nursing/ PSYCHOLOGY ; *Hospitalization ; Human ; Male ; Mental Retardation/ *PSYCHOLOGY/REHABILITATION ; Middle Age ; Psychiatric Department, Hospital ; Psychological Tests ; *Social Adjustment SO - Br J Psychol 1986 Nov;77 ( Pt 4):489-501 4 UI - 87073328 AU - Friedman AS ; Glickman NW ; Kovach JA TI - Comparisons of perceptions of the environments of adolescent drug treatment residential and outpatient programs by staff versus clients and by sex of staff and clients. AB - The Moos Community Oriented Program Environment Scale (COPES) was administered to 482 adolescent clients and 291 drug counselors in 30 outpatient and 27 residential drug treatment programs. Both clients and staff of residential programs were found to rate their programs more positively than did clients and staff of outpatient programs in the following specific ways: "encourage and provide more support:; "provide more practical help:, such as training; "more concern with clients' personal problems:; and "encourage clients to argue, express anger, and display aggressive behavior:. The only COPES factor on which the outpatient programs were perceived as superior to residential programs was "spontaneity: ("The program encourages clients to act openly and to express their feelings openly:). Across both types of programs, staff perceived the programs significantly more positively than did clients. The male staff ratings were the most positive of the ratings of the four subgroups. Female clients rated the program environments more positively than did male clients, but female staff did not rate the program environments more positively relative to male staff. Since the female staff ratings tend to be somewhat more similar to the ratings of the clients, both male and female, than did the male staff ratings, it might seem reasonable to hypothesize that the female staff ratings are more valid than the male staff ratings. MH - Adolescence ; *Ambulatory Care Facilities ; Comparative Study ; *Environment ; Female ; Health Occupations ; Human ; Male ; *Perception ; *Residential Facilities ; Sex Factors ; Substance Abuse/PSYCHOLOGY/ *THERAPY ; Support, U.S. Gov't, P.H.S. SO - Am J Drug Alcohol Abuse 1986;12(1-2):31-52 5 UI - 87006552 AU - Lehman AF ; Possidente S ; Hawker F TI - The quality of life of chronic patients in a state hospital and in community residences. AB - Amidst the controversy about the effects of deinstitutionalization, the well-being of the chronic mentally ill in different treatment settings remains unclear. This study examined objective and subjective quality-of-life experiences of four groups of chronic patients categorized according to whether they were inpatients of a state hospital or residents of a supervised community residence and whether their current length of stay had been less than or greater than six months. Regardless of length of stay, the community residents perceived their living conditions more favorably, had more financial resources, and were less likely to have been assaulted in the past year than the inpatients. The study illuminates the problematic living conditions of state hospitals and the benefits of appropriately designed community-based residences for the chronic mentally ill. MH - Adolescence ; Adult ; Aged ; Chronic Disease ; Female ; *Halfway Houses ; *Hospitals, Public ; *Hospitals, State ; Human ; Length of Stay ; Male ; Mental Disorders/*REHABILITATION ; Middle Age ; Personal Satisfaction ; *Quality of Life SO - Hosp Community Psychiatry 1986 Sep;37(9):901-7 6 UI - 87003702 AU - Cohen NA TI - Quality of care for youths in group homes. AB - This paper analyzes findings pertaining to quality of care issues concerning group home care for adolescents in the greater Los Angeles County area during 1978-1979. The issues include normalization, institutionalization, treatment goals, continuity of care, and qualifications of child welfare staff, particularly child care workers. Recommendations for improvement are offered. MH - Adolescence ; *Child Abuse ; Halfway Houses/*STANDARDS ; Health Services Needs and Demand ; Human ; Juvenile Delinquency/*REHABILITATION ; *Quality Assurance, Health Care SO - Child Welfare 1986 Sep-Oct;65(5):481-94 7 UI - 86322244 AU - Atkinson WL ; Arden NH ; Patriarca PA ; Leslie N ; Lui KJ ; Gohd R TI - Amantadine prophylaxis during an institutional outbreak of type A (H1N1) influenza. AB - In January 1984, an outbreak of influenza caused by A/Victoria/7/83-like virus, a new H1N1 variant, occurred in an institution for mentally handicapped children and adults. During the first 18 days of the outbreak, 35 (81%) of 43 residents in two housing modules became ill, nearly all of whom had received influenza vaccine the previous autumn. Amantadine hydrochloride prophylaxis was initiated in two other housing modules and was continued for 28 days. While factors influencing the risk of introduction and secondary spread of influenza virus were comparable in all four modules, only ten (16%) of 63 residents who received amantadine were infected, only one of whom became symptomatic. Most side effects associated with amantadine were mild, but residents with active, preexisting major-motor seizure disorders demonstrated an increase in seizure activity compared with the previous eight-month period; those who took the maximum daily dose of amantadine hydrochloride (200 mg) and those who were also taking anticonvulsants other than phenobarbital were at highest risk. MH - Adolescence ; Adult ; Amantadine/ADVERSE EFFECTS/*THERAPEUTIC USE ; Anorexia/CHEMICALLY INDUCED ; Child ; Cross Infection/OCCURRENCE/ *PREVENTION & CONTROL ; Disease Outbreaks/OCCURRENCE/*PREVENTION & CONTROL ; Female ; Human ; Influenza/OCCURRENCE/*PREVENTION & CONTROL ; Influenza Vaccine ; Louisiana ; Male ; Mental Retardation ; Middle Age ; Residential Facilities ; Seizures/CHEMICALLY INDUCED SO - Arch Intern Med 1986 Sep;146(9):1751-6 8 UI - 86313066 AU - Brunger JB TI - The young chronic client in mental health today. AB - Due to the nature of the work with this demanding population, who, in spite of all efforts, demonstrates only minimal changes at best, nurses need aggressive management of their own lives. Burnout is rampant. Work with this type of client is not for everyone. Programs need to offer staff the opportunity to work with these clients only if the staff is capable and desires the challenge. It is necessary to set realistic goals and expectations with clients and to learn to accept tiny changes. Nurses must help the client become more realistic in their expectations of what will be achieved. It is important to note that the therapist may scare the client into regressed behavior by being too hopeful, by pushing them too far too fast, and by allowing them to go too fast. Caution should be taken with respect to encouragement and expectations of normalcy. If goals are too high and the client "fails,: the therapist perceives that he/she is the one who failed. The patient who manages to achieve a level of functioning that enables him to interface with the outside often finds a world that is cold, demanding, and cruel--one that is easier to escape from than to deal with. One must be flexible and accessible to the client--involved with honest detachment. For the nurse therapist to serve this population requires sophistication in the theories of child and adolescent suicide, crisis intervention, aggression management, chemical abuse and use, and the ability to negotiate housing, money, food, services--things which have previously been the domain of others.(ABSTRACT TRUNCATED AT 250 WORDS) MH - Adolescence ; Adult ; Age Factors ; Chronic Disease ; Emergency Services, Psychiatric ; Family Therapy ; Female ; Hospitalization ; Human ; Long Term Care ; Male ; Mental Disorders/*NURSING/OCCURRENCE/THERAPY ; Nurse-Patient Relations ; Outpatients ; Substance Abuse/COMPLICATIONS SO - Nurs Clin North Am 1986 Sep;21(3):451-9 9 UI - 86311144 AU - Busto U ; Sellers EM ; Naranjo CA ; Cappell H ; Sanchez-Craig M ; Sykora K TI - Withdrawal reaction after long-term therapeutic use of benzodiazepines. AB - We conducted a double-blind, placebo-controlled trail in which 40 patients who had undergone long-term therapy with benzodiazepines were switched to placebo or to diazepam in a dose approximately equivalent to their usual dose of the benzodiazepine; the dose of diazepam was then tapered during an eight-week period. Patients were assessed clinically and psychologically and had weekly sessions of behavioral therapy. The subjects who received placebo had more symptoms, assessed their symptoms as more severe, and stopped taking the study drug at a higher rate than those receiving the tapering doses of diazepam. The subjects in the placebo group also had symptoms shortly after being switched to placebo, whereas those in the diazepam group had symptoms much later. Some withdrawal symptoms were distinct from those of anxiety (e.g., tinnitus, involuntary movement, and perceptual changes). Withdrawal symptoms occurred earlier in patients who had received short-acting benzodiazepines than in those who had received long-acting benzodiazepines. Symptoms gradually disappeared over a four-week period in both the placebo and the diazepam groups. Serial determination of plasma benzodiazepine concentrations was a useful way to assess compliance, treatment outcome, and relapse during withdrawal. We conclude that a clinically important, mild, but distinct withdrawal syndrome occurs after discontinuation of long-term therapeutic use of benzodiazepines. MH - Adolescence ; Adult ; Aged ; Anxiety/ETIOLOGY ; Benzodiazepines/ ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS/BLOOD ; Diazepam/THERAPEUTIC USE ; Double-Blind Method ; Female ; Flurazepam/ADVERSE EFFECTS ; Human ; Long Term Care ; Lorazepam/ADVERSE EFFECTS ; Male ; Middle Age ; Oxazepam/ ADVERSE EFFECTS ; Patient Compliance ; Placebos ; *Substance Withdrawal Syndrome ; Support, Non-U.S. Gov't ; Time Factors SO - N Engl J Med 1986 Oct 2;315(14):854-9 10 UI - 86299465 AU - Randolph FL ; Lindenberg RE ; Menn AZ TI - Residential facilities for the mentally ill: needs assessment and community planning. AB - The planning and development of community-based facilities for the mentally ill have been hindered by many factors, one of which is the lack of an acceptable methodology for determining the housing needs of this population. This paper describes a consumer-oriented needs assessment strategy that provides a basis for planning residential facilities for the mentally ill. Survey results provided detailed descriptions of the population in need of residential programs, the types of facilities needed, the total volume of need for each, and the distribution of need. Implications for program planning are discussed as well as the advantages and disadvantages in utilizing this approach for establishing a basis for residential facilities planning for the mentally ill. MH - Adolescence ; Adult ; Aged ; Community Mental Health Centers/ *ORGANIZATION & ADMIN. ; Community Mental Health Services/ORGANIZATION & ADMIN. ; Crisis Intervention ; *Deinstitutionalization ; Foster Home Care/ ORGANIZATION & ADMIN. ; Halfway Houses/*ORGANIZATION & ADMIN. ; Hawaii ; Health Planning/*ORGANIZATION & ADMIN. ; Health Services Accessibility/ TRENDS ; Health Services Needs and Demand/*TRENDS ; Health Services Research/*TRENDS ; Hospitalization/TRENDS ; Human ; Mental Disorders/ *THERAPY ; Middle Age ; Support, U.S. Gov't, P.H.S. SO - Community Ment Health J 1986 Summer;22(2):77-93 11 UI - 86281668 AU - McAlpine C ; Singh NN TI - Pica in institutionalized mentally retarded persons. AB - 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. MH - Adolescence ; Adult ; Age Factors ; Aged ; Child ; Child, Preschool ; Female ; Human ; Male ; Mental Retardation/*COMPLICATIONS ; Middle Age ; Pica/*COMPLICATIONS ; Residential Facilities ; Support, Non-U.S. Gov't SO - J Ment Defic Res 1986 Jun;30 ( Pt 2):171-8 12 UI - 86281663 AU - Dupont A ; Vaeth M ; Videbech P TI - Mortality and life expectancy of Down's syndrome in Denmark. AB - Based on the register of all persons registered in the Danish National Service for the Mentally Retarded (DNSMR) with a diagnosis of Down's syndrome in the period 1 January 1976-31 December 1980, the persons were followed until 31 March 1984 (a total of 2412 Down's syndrome patients). The difference in mortality for patients in institutions and living outside was significant, with a higher mortality for women with residence in institutions than women living outside. Among males the mortality rate was not significantly different between the two types of residents. Of the total group, a survival rate of 82.4 was found at the end of the age group 5-9 years and this result is similar to recent results from Salford and Japan. Although the life expectancy for the Down's syndrome group has increased, the life expectancy for Down's syndrome at any given age compared with life expectancy for the background population during the above mentioned period was still lower. MH - Adolescence ; Adult ; Aged ; Child ; Child, Preschool ; Denmark ; Down's Syndrome/*MORTALITY ; Family ; Female ; Human ; Infant ; Infant, Newborn ; *Life Expectancy ; Male ; Middle Age ; Residential Facilities SO - J Ment Defic Res 1986 Jun;30 ( Pt 2):111-20 13 UI - 86271480 AU - Dean HJ ; Friesen HG TI - Growth hormone therapy in Canada: end of one era and beginning of another. AB - This paper reviews the difficulties in diagnosing a true deficiency of growth hormone (GH), the long-term results of therapy, the Canadian experience in treating GH deficiency, including the contributions made by the Medical Research Council's Therapeutic Trial of Human Growth Hormone, and the occurrence of Creutzfeldt-Jakob disease in recipients of GH therapy. It also speculates on potential alternatives to treatment with GH derived from human pituitaries. MH - Adult ; Canada ; Child ; Drug Contamination ; Growth Disorders/*DRUG THERAPY ; Human ; Jakob-Creutzfeldt Syndrome/ETIOLOGY ; Long Term Care ; Recombinant Proteins/THERAPEUTIC USE ; Review ; Somatotropin/DEFICIENCY/ *THERAPEUTIC USE ; Somatotropin Releasing Hormone/SECRETION ; Support, Non-U.S. Gov't SO - Can Med Assoc J 1986 Aug 15;135(4):297-301 14 UI - 86246294 AU - Harrington WA ; Honda GJ TI - The roles of the group home direct care worker. AB - An attempt is made to make clear statement concerning the roles of the direct care worker in group home treatment programming. For several reasons these roles have not been adequately defined over time. The roles include descriptions of the direct care worker as therapeutic counselor, as manager, as teacher and as relationship builder. The direct care worker is identified as a generalist, a role on the treatment team that is no less important than the role played by the social worker and the psychologist. In the final analysis the professionalization of the direct care worker will depend upon the development of a national focus which can be translated into real college preparatory curricula; into standards which can be utilized to develop certification procedures, and into a hierarchy of jobs for which the direct care worker is the first step. MH - Acting Out ; Adolescence ; Child ; Counseling ; *Halfway Houses ; Human ; Interprofessional Relations ; Mental Disorders/*THERAPY ; Patient Care Planning ; *Patient Care Team ; Professional-Patient Relations ; *Residential Treatment ; Social Environment SO - Community Ment Health J 1986 Spring;22(1):27-38 15 UI - 86230385 AU - Shannon GW ; Bashshur RL ; Lovett JE TI - Distance and the use of mental health services. AB - The inverse relationship between distance from mental health services and their use has been noted over many decades and on several continents. Although many factors--diagnostic, socioeconomic, and nosocomial--may modify this correlation, its persistence is remarkable. As other barriers to use are diminished, distance remains a mutable variable for planning more effective use of many health care services. MH - Adolescence ; Adult ; Ambulatory Care Facilities/UTILIZATION ; Commitment of Mentally Ill/TRENDS ; Community Mental Health Centers/UTILIZATION ; Europe ; Female ; Hospitals, Psychiatric/UTILIZATION ; Hospitals, State/ UTILIZATION ; Human ; Long Term Care ; Male ; Mental Disorders/OCCURRENCE/ THERAPY ; Mental Health Services/*UTILIZATION ; Middle Age ; Public Policy ; Referral and Consultation ; Research ; Socioeconomic Factors ; Time Factors ; Travel ; United States SO - Milbank Q 1986;64(2):302-30 16 UI - 86239386 AU - Adkins WN Jr TI - Rett syndrome at an institution for the developmentally disabled. AB - Rett syndrome (RS) is a condition apparently limited to females characterized by normal early development followed by the abrupt loss of acquired function and beginning autistic behavior in late infancy. Manifestations in RS include decelerating head growth, unusual "hand-writing: movements, gait apraxia, neuromuscular tone disturbance, and seizures. No biochemical, hematologic, cytologic, or cytogenetic procedures have been shown to confirm the diagnosis of RS. With the exception of one family with 2 affected half-sisters, all cases have been sporadic. Six profoundly retarded residents of Central Wisconsin Center have manifestations of RS. Three are microcephalic and 3 have head circumferences at or below the 10th centile. All have seizures or abnormal EEG findings and all were ascertained on the basis of characteristic hand movements. No case of precocious puberty was observed. Two patients had severe scoliosis which was surgically treated. Detailed neuropathologic examination should be sought for every case of RS. The development of clearly defined minimal diagnostic criteria and the establishment of an international registry are desirable. MH - Adolescence ; Adult ; Case Report ; Child ; Electroencephalography ; Female ; Human ; Mental Retardation/COMPLICATIONS/*DIAGNOSIS ; Microcephaly/COMPLICATIONS ; Movement Disorders/COMPLICATIONS/*DIAGNOSIS ; Physical Examination ; Residential Facilities ; Scoliosis/COMPLICATIONS ; Seizures/COMPLICATIONS ; Stereotyped Behavior ; Syndrome SO - Am J Med Genet 1986;24 Suppl 1:85-97 17 UI - 86197007 AU - Rose M TI - The design of atmosphere: ego-nurture and psychic change in residential treatment. AB - This paper concerns the very special nature of Peper Harow, a residential establishment for disturbed young people. The paper explores the means by which adolescents become absorbed in, and are helped to identify with, the goals of a therapeutic community, and draws on symbols and metaphors from literature to illustrate the treatment process. Examples are given from the life of the community, and attempts are made to capture the atmosphere of a unique establishment. MH - Adolescence ; Cannabis Abuse/PREVENTION & CONTROL ; Case Report ; Child Development ; Environment ; Facility Design and Construction ; Female ; Human ; Learning ; Male ; Mental Disorders/THERAPY ; Residential Facilities ; *Therapeutic Community SO - J Adolesc 1986 Mar;9(1):49-62 18 UI - 86197006 AU - Bloor MJ TI - Problems of therapeutic community practice in two halfway houses for disturbed adolescents: a comparative sociological study. AB - Materials gathered from a participant observation study of two therapeutic communities for disturbed adolescents were used to highlight the respective problems of two contrasting approaches to therapy. Whereas one community pursued the principles of programming and instrumental intervention, the other community's approach centred on minimal supervision and reality confrontation; the two communities mirrored, at a micro-level, wider divisions of practice within the therapeutic communities movement. MH - Adolescence ; Adult ; Case Report ; Comparative Study ; Female ; Group Processes ; *Halfway Houses/METHODS ; Human ; Male ; Mental Disorders/ REHABILITATION ; Psychiatric Aides ; Support, Non-U.S. Gov't ; *Therapeutic Community SO - J Adolesc 1986 Mar;9(1):29-48 19 UI - 86169564 AU - Holt PA ; Goodall B ; Lees EM ; Hambling MH TI - Prevalence of hepatitis B markers in patients and staff in a hospital for the mentally handicapped. AB - Patients and staff at a hospital for the mentally handicapped were screened for markers of infection with hepatitis B virus. Of 436 patients, 14 (3.2%) were carriers of hepatitis B surface antigen (HBsAg), of whom four were carriers of hepatitis B e antigen (HBeAg) and were considered to be 'infectious'. One-quarter of the patients had markers of hepatitis B infection. Males were four times more likely to have markers than females; and 13 of the 14 carriers of HBsAg were male. Patients with Down's Syndrome (DS) were six times more likely to be HBsAg positive, but were not more likely to have markers of infection than other patients. Phenytoin therapy did not predispose to carriage of HBsAg. Of 439 staff members, 26 (5.9%) had markers of hepatitis B infection. It was not considered that staff were at increased risk of infection with hepatitis B virus at the hospital, and that post-exposure prophylaxis for hepatitis B should continue. It is suggested that patients with DS who are not immune to hepatitis B should be offered immunization. MH - Adolescence ; Adult ; Age Factors ; Aged ; Child ; Down's Syndrome ; Female ; Great Britain ; Hepatitis B/*OCCURRENCE ; Hepatitis B e Antigens/ ANALYSIS ; Hepatitis B Antibodies/*ANALYSIS ; Hepatitis B Antigens/ *ANALYSIS ; Hepatitis B Surface Antigens/ANALYSIS ; Human ; Male ; *Mental Retardation ; Middle Age ; Personnel, Hospital ; *Residential Facilities ; Sex Factors ; Support, Non-U.S. Gov't SO - J Hosp Infect 1986 Jan;7(1):26-33 20 UI - 86155697 AU - Perrillo RP ; Strang S ; Lowry OH TI - Different operating conditions affect risk of hepatitis B virus infection at two residential institutions for the mentally disabled. AB - The prevalence of hepatitis B virus markers was determined in two residential institutions for the mentally disabled which exhibited major differences in operating policies. Eighty per cent of 91 clients and 16% of 92 employees at institution A had positive tests for hepatitis B virus markers, including two staff members and one client with serologic evidence of recent infection (immunoglobulin M antibody to hepatitis B core antigen). In contrast, 34% of 395 clients and 8% of 294 workers at institution B were positive for hepatitis B virus markers, and none of the staff demonstrated evidence of recent infection. The observed differences in seroprevalence were likely to have been influenced by substantial disparities in living conditions, staff-to-client ratios in critical areas, and level of employee experience. In addition to significant institutional differences, seroprevalence was associated with severity of mental retardation in clients and duration of employment in staff. This study emphasizes the importance of local policies in the prevention of hepatitis B virus infection at residential institutions for the mentally disabled. MH - Adolescence ; Adult ; Age Factors ; Allied Health Personnel ; Child ; Child, Preschool ; Comparative Study ; Employment ; Female ; Hepatitis B/ *IMMUNOLOGY/OCCURRENCE ; Hepatitis B Core Antigens/*IMMUNOLOGY ; Hepatitis B Surface Antigens/*IMMUNOLOGY ; Human ; *Institutionalization ; Male ; *Mental Retardation ; Missouri ; Residential Facilities ; Time Factors SO - Am J Epidemiol 1986 Apr;123(4):690-8 21 UI - 86127440 AU - Zonia SC ; Goff GA TI - Communicable illnesses in the mentally retarded and nonretarded populations of three Michigan counties. AB - Fourteen categories of communicable diseases reported on a weekly basis to state public health officials were considered. Mentally retarded persons living in a three-county area were compared with the counties' general population over a 4-year period. Results indicated that retarded persons had a significantly higher prevalence rate of 6 of the 14 communicable diseases and a higher probability rate for 3 of the diseases studied than did the general population. The few illnesses that the retarded population did contract, however, occurred at a much higher rate than that of the nonretarded population. MH - Adolescence ; Adult ; Aged ; Child ; Child, Preschool ; Communicable Diseases/COMPLICATIONS/*OCCURRENCE ; Female ; Human ; Infant ; Infant, Newborn ; Male ; Mental Retardation/*COMPLICATIONS ; Michigan ; Middle Age ; Residential Facilities SO - Am J Ment Defic 1986 Jan;90(4):453-6 22 UI - 86127435 AU - MacDonald L ; Barton LE TI - Measuring severity of behavior: a revision of Part II of the Adaptive Behavior Scale. AB - This study was designed to: (a) assess the degree to which rehabilitation staff rate the severity of maladaptive behaviors on Part II of the AAMD Adaptive Behavior Scale (ABS) and, on the basis of the obtained rating, (b) develop a socially validated revision of the scoring system to allow more accurate classification of mentally retarded individuals as having mild, moderate, or severe behavior problems. On the basis of the modal ratings obtained from various service agencies for "occasionally: and "frequently: on Part II of the ABS, we constructed a revised scoring system. Preliminary use of the scoring system suggests satisfactory agreement between "severity profile: scores and subjective ratings of individuals classified by service agencies as demonstrating mild, moderate, or severe behavior problems. MH - Adolescence ; Adult ; *Behavior ; Female ; Human ; Male ; Mental Retardation/*PSYCHOLOGY ; Psychiatric Aides ; Psychometrics ; Residential Facilities SO - Am J Ment Defic 1986 Jan;90(4):418-24