Group Residential Facilities Research Articles

Guideline for the diagnosis and treatment of scabies

Background: Scabies is a highly contagious skin disease caused by scabies mite infestation, resulting in intense itching. In 2023, the Korean Dermatological Association is actively implementing the “Eradication of Scabies, National Health Project” as a key initiative. Under this project, educational programs for sanatoriums and other group residential facilities, as well as nationwide public awareness campaigns, are being conducted. An expert committee of dermatologists has developed standardized clinical guidelines for the diagnosis and treatment of scabies.Current Concepts: The clinical presentation of scabies varies depending on the age and health status of the patient, the number of scabies mites, and the mode of transmission. Characteristic skin symptoms include intense itching that worsens at night and the presence of burrows and red, inflamed papules on typical areas such as finger webs, inner wrists, scrotum, and around the umbilicus. In older adults or immunocompromised infants, scabies may involve the scalp, face, palms, and soles. Atypical skin findings such as excessive hyperkeratosis, nodules, and other unusual manifestations may also occur.Discussion and Conclusion: Using the scabies diagnostic and treatment algorithm, healthcare professionals in Korean clinical settings can make rapid medical decisions when examining patients with scabies. This algorithm provides a systematic and straightforward approach to diagnosing and treating scabies effectively and improves patient care and management in real time.

Epidemiology and pathogenesis of scabies

Background: Scabies infestation is known to be more common in hot and humid climates, areas with low medical accessibility, and households with many family members living together. Recently, the number of collective residence facilities for chronic patients and elderly people has increased in developed countries. Furthermore, mass infections are occurring in these facilities.Current Concepts: The cause of scabies infestation is <i>Sarcoptes scabiei</i> var. <i>hominis</i>. It takes about 9 to 15 days for an egg to hatch and grow into an adult mite. Adult mites have an oval body and four pairs of legs. Female mites lay eggs and live for 4 to 6 weeks. In order to spread, mites from an existing host must transfer to a new host. Therefore, external environments such as temperature and humidity are advantageous for the survival of mites, and the closer the distance to other hosts, the higher the infestation rates. In general, scabies infestation induces T helper (Th) 1 cell-mediated reaction, which can prevent the proliferation of mites to some extent. However, in crusted scabies infestations, Th2 cell-mediated response is mainly induced. This response does not suppress the proliferation of the mites and makes them more contagious.Discussion and Conclusion: It is necessary to keep in mind and accurately know the characteristics of scabies when diagnosing skin diseases. The Korean Society of Dermatology has selected eradication of the scabies infestation as a key project and is actively providing support to group residential facilities such as nursing hospitals.

A Descriptive Study on Psychological Well-Being in Relation to Demographic Variables in Adolescent Orphans of Kashmir Valley

Background: The United Nations Children’s Fund and global partners define an orphan as a child who has lost one or both parents. Orphanages, children’s villages, or other group residential facilities generally fail to meet young people’s emotional and psychological needs. Research indicates that orphaned youth face more negative psychosocial challenges than their younger counterparts do. This study was carried out to find out the association of the psychological well-being of adolescent orphans with the selected demographic variables. Methods: A descriptive, cross-sectional study was carried out among 115 adolescent orphans in orphanage of the Srinagar district between July 2020 and February 2021 using standardized psychological well-being scale given by Carol Ryff. Association of psychological well-being, with its dimensions, and selected demographic variables were assessed. Results: Group mean difference on psychological well-being revealed that double-orphan adolescents have significantly lower psychological well-being as compared to the half-orphan adolescents. The study also revealed that habitat was significantly associated with overall psychological well-being and one of the dimensions of psychological well-being, i.e., positive relations with others. Educational status was found to have a significant association with the autonomy dimension of psychological well-being only, where as the type of orphan shows a significant association with overall psychological well-being and self-acceptance dimension of psychological well-being. Time spent in orphanage also shows significant association with purpose in life and self-acceptance dimension of psychological well-being. Conclusions: There is a need for organized social support to improve the physical and psychological health of orphans.

Communication Supports in Congregate Residential Care Settings in Ohio

Background Communication skills are important to the pursuit of increased self‐determination in individuals with disabilities. The aim of this investigation was to gather information about communication supports in state‐run residential care facilities in Ohio, and to compare findings with a previous investigation on this topic examining such perceptions in group home environments.Methods An online survey was adapted from DeSimone & Cascella [Journal of Developmental and Physical Disabilities, 17, 2005, 1] to examine perceptions of habilitation managers regarding the quality of communication supports in their settings. Perceptions of communication supports by program manager‐level staff in larger group residential facilities had not been previously investigated.Results Respondents reported a generally high quality of communication supports provided in their settings. Despite this general level of perceived quality, certain quality indicators related to supports for communication were relatively lower across respondents and were consistent with DeSimone & Cascella.

Dialectical Behavioral Therapy and EMDR for Adolescents in Residential Treatment: A Practical and Theoretical Perspective

ABSTRACT DBT and EMDR as primary treatment methods provide effective treatment for adolescents in the setting of group residential facilities. Regardless of the intensity of the pathology or the length of stay, these compatible treatment methods provide adolescents with significant decreases in the impact of traumatic memories and increased emotional regulation skills. The methods have been empirically supported as effective in a variety of settings and with a diversity of age groups. They are well suited for use in a residential environment and can constitute a powerful, effective method for dealing with Post Traumatic Stress Disorder, Bipolar Disorder, Major Depression, Anxiety Disorders, Substance Abuse, and other disorders.

Using the CBCL to determine the clinical status of children in state custody

This manuscript reviews information on past use of the CBCL to describe the clinical status of children in state custody and the results of a recent study of a representative statewide sample. The sample included a random sample of children in state custody, including those in foster care, kinship care, group residential facilities, and state institutions. One third (34%) of the children in state custody were reported as having significant behavior problems. The narrow band scales reflecting greatest difficulties included Aggressive, Delinquent, and Withdrawn behavior. The youngest teenage group was significantly more likely to have Internalizing problems in the clinical level, and those living in family homes were more likely to have scores in the non-clinical range than those in foster homes or group placements. There were no effects of gender, race, adjudication status, or length of time in custody. Implications for policy makers, caseworkers, and researchers are discussed.

Canadian Maternity Homes and the Young Adolescents they Serve

Background: the scope of maternity home services for pregnant teenagers across Canada is unknown. We sought to identify and describe ail of the group residential facilities for pregnant women admitting teenagers in Canada, and to develop a profile of the youngest adolescents living therein.Methods: we consulted the social welfare departments of the major cities in each province, enquiring as to the existence of local maternity homes. In turn, maternity homes that were contacted served to help locate additional similar facilities. After a systematic and exhaustive effort, a nationwide roster of maternity homes was assembled. An official at each maternity home was asked to provide information through a postal questionnaire. The collected data were then organized, tabulated, and analysed.Results: we found a total of 28 maternity homes admitting girls under the age of 18 years (range: Ontario 13; Alberta, New Brunswick, and Prince Edward Island (0), and 26 (93%) completed and returned our questionnaire. Licenses from regulatory agencies were held by 22 homes (85% of respondents), girls dependent on illicit drugs or alcohol were admitted by 13 homes (50% of respondents), and the Salvation Army sponsored a total of eight of the 28 maternity homes. Median values for some characteristics were: years in operation, 57; age of youngest current resident, 15 years; typical length of stay, seven months; bed capacity, 14; number of full-time employees, seven; annual deliveries, 16; annual adoptions, two. The most common funding sources were city or provincial public funds as reported by 25 homes (96% of respondents) and the least common was the federal government reported by three homes (12% of respondents). Benefits included: private rooms in 25 homes (96%) ; social work services from 22 homes (85%) ; classes by a certified childbirth educator provided by 16 homes (62%) ; accredited on-site schooling available in 13 homes (50%) ; and vocational training arranged by six homes (23%). Prenatal care through private physicians was reported by 19 homes (73%) and through hospital based prenatal clinics by 17 homes (65%). AH deliveries were conducted in hospitals. A sampling of 48 of the youngest pregnant teenagers served in the past year revealed: median age 15 (range: [13–18]; 32 were white [67%], 11 were Native American [23%], two were African American [4%], two were Hispanic [4%], and one was Asian [2%]). There were 25 alleged victims of sexual abuse (52%) ; 26 alleged victims of physical abuse (54%) ; seven exchanged sex for food and shelter (15%); five exchanged sex for illicit drugs (10%); 13 abused illicit drugs or alcohol (27%) ; 11 had been convicted of a criminal offense (23%) ; none sold illicit drugs. Independent living and parenting skills classes were taken by 44 of the girls (91%).Conclusion: in Canada, group residential placement and services are available to pregnant teenagers who face a variety of serious psychosocial risk factors.

Problems associated with homelessness and young pregnant teenagers

Study Objective: Homelessness is a major complication to adolescent pregnancy. We hypothesized that homelessness was associated with an increased incidence of other psychosocial and health risk factors for young pregnant teens.Design, Setting, Participants: We conducted a nationwide study of homeless young pregnant teens living in group residential facilities and of a control population of young pregnant teens living at home with their families. Clinical social workers involved in services for these patients were located by consulting a national directory of maternity homes and through contact with hospital-based social service departments randomly selected through long-distance telephone information. After a telephone conversation detailing the nature of the project, questionnaires were mailed to each social worker. They were to complete a questionnaire for each of the two youngest pregnant teens cared for at their facility in the previous 12 months. The data from the returned questionnaires were evaluated by chi-square analysis and Fisher's exact test.Main Outcome Measures: We distributed 736 questionnaires and collected data on 509 subjects (278 homeless, 231 controls) from 191 cities throughout the United States. The return rates were 69.1% from each group. There were no significant differences between the two groups in median age (14 years), race (50 and 42% white, 32 and 39% black, 10 and 14% Hispanic), school grade level (8th), or dropout rates (19 and 18%).Results: Findings included a greater likelihood for those in the homeless group to be under the guardianship of a social service agency (29 vs. 3%, p < .001), to be known to family court (54 vs. 13%, p < .001), to have been declared by the courts to be “a person in need of supervision” (43 vs. 7%, p < 0.001), and to have been convicted of a criminal offense (12 vs. 0%, p < .001). Homeless young pregnant teens were likely to have been victims of physical abuse (47 vs. 9%, p < .001), victims of sexual abuse (46 vs. 16%, p < .001), to have abused illicit drugs or alcohol (24 vs. 7%, p < .001), to have sold illicit drugs (3 vs. 0%, p < 0.01), to have exchanged sex for drugs (6 vs. 0%, p < .001), and to have exchanged sex for food and shelter (9 vs. 0%, p < .001).Conclusions: Homelessness should alert prenatal care providers to the expected coexistence of numerous additional psychosocial and health risk factors in young pregnant teens.

Maternity homes for adolescents: A national portrait

Study Objective: The extent to which maternity homes across our nation provide services for homeless, pregnant girls is unknown. We initiated the first investigation to identify and describe all of the group residential facilities in the United States for pregnant adolescents under the age of 18 years.Design: We created a national list of maternity homes on a state-by-state basis through information gathered from local human services departments, local WIC offices, and from maternity homes that were aware of others in their region. We contacted an official at each maternity home by telephone to confirm the nature of the facility and to seek their participation in the project by answering a 28-item questionnaire to be sent by mail. Unreturned questionnaires were followed by a reminder letter and a duplicate questionnaire. The collected data were then organized and tabulated.Results: From all 50 states, we found and contacted by telephone 215 maternity homes admitting girls under the age of 18 years (the number of homes ranged from 19 in California, to 0 in Wyoming) and a total of 174 (81%) completed and returned our postal questionnaire. Of responding homes, 10% had been in operation 100 years or more, 29% admitted girls dependent on illicit drugs or alcohol, 59% functioned as part of a larger organization, 20% were unlicensed, 89% received private donations, 23% received federal funds, and 42% offered private rooms. The most frequent maternal bed capacity was eight. Typically they had from two to four full-time employees. Benefits provided included childbirth classes (84%), social services (90%), dietary counseling (49%), accredited, on-site schooling (35%), and vocational training (54%). Prenatal care was mostly provided through private physicians (63%) and hospital-based prenatal clinics (59%), with 99% of deliveries in hospitals. The most frequent age of residents was 16 years, staying an average of 4.7 months antepartum and 2.4 months postpartum. The most frequent maximum allowed length of stay was up to 9 months. The mean number of babies bora per responding home in 1991 was 29.4.Conclusion: In the United States, maternity homes for adolescents are an important source of services for approximately 6,000 pregnant teens each year.

A Typology of Social Climates in Group Residential Facilities for Older People

A typology of the social climates of group residential facilities for older people was developed by a cluster analysis of seven social climate attributes obtained on a national sample of 235 nursing homes, residential care facilities, and congregate apartments. The analysis yielded six distinct types of social climate: Supportive, Self-Directed; Supportive, Well-Organized; Open Conflict; Suppressed Conflict; Emergent-Positive; and Unresponsive. Facility and resident characteristics were related to social climate type. In addition, the type of social climate was related to resident adaptation. Supportive, Self-Directed and Supportive, Well-Organized facilities had residents who rated higher in well-being and levels of self-initiated activities and who used fewer health services. A configural approach to describing social climates and their determinants and effects may help to develop more humanistic residential facilities and to better match individual residents to appropriate housing placements.

Validity of the Sheltered Care Environment Scale: Conceptual and methodological issues.

The Sheltered Care Environment Scale (SCES) was developed primarily to measure social climate as an attribute of a setting. As such, the SCES was designed to maximize differences between facilities and minimize differences among individuals within a setting. However, Smith and Whitbourne (1990) assessed the validity of the SCES as a measure of individual differences in perceptions of a shared environment. Moreover, they redefined the content coverage of 2 of the SCES subscales (Independence and Physical Comfort), to encompass attributes the SCES is not intended to measure. In general, preliminary evidence indicates that the SCES subscales provide reasonably reliable and valid indices of the social climate of group residential facilities.

Determinants of Interpersonal Support and Self-Direction in Group Residential Facilities

This study examined the determinants of residents' and staff's judgments of interpersonal support and self-direction in group residential facilities for older people. The Multiphasic Environmental Assessment Procedure (MEAP) was used to assess social climate dimensions and their determinants in a national sample of 244 facilities. Residents saw more interpersonal support and self-direction in facilities with more physical resources (comfort and staff facilities) and policies providing more autonomy. A similar pattern was found for staff's perceptions of self-direction. Residents and staff also viewed facilities as providing more interpersonal support and self-direction when residents were more socially competent. Larger facility size was associated with residents' assessments of more conflict, and a higher staff-resident ratio was related to residents' judgments of having less independence and influence. These findings may help to improve residential facilities by suggesting factors that can be targeted in interventions to improve the social climate.