Mental Retardation Center Research Articles

Intestinal Parasitic Infections in Mental Retardation Center of Bandar Abbas, Southern Iran

The present study aimed to evaluate the prevalence of intestinal parasitic infection among mentally retarded individuals and the staff of the center in Bandar Abbas, south of Iran. This cross-sectional study was conducted in central institution for mentally retarded in Bandar Abbas, Hormozgan Province, from 2016 to 2017. A triple fecal specimen was collected from each one of the 163 participants and were evaluated using wet mount and formalin-ethyl acetate methods. Trichrome and Ziehl-Neelsen staining were used to confirm suspected cases of protozoa. As well as Baermann and Harada-Mori techniques and agar plate culture were implemented to diagnosis of Strongyloides stercoralis. Overall, 163 subjects were examined including 126 mentally retarded individuals and 37 personnel. Ninety (55.2%) cases of participants were infected with at least one of the intestinal parasites, 69 (54.7%) of mentally retarded and 21 (56.7%) of personnel. Twenty-six mentally retarded individuals were infected with S. stercoralis (20.6%), Blastocystis hominis 30.2%, Entamoeba coli 25.4%, Giardia lamblia 5.6%, Enterobius vermicularis 1.6%, Hymenolepis nana 0.8% and Iodamoeba butschlii 1.6%. Twelve staff (32.4%) harbored B. hominis, E. coli 27%, S. stercoralis 2.7%, G. lamblia 10.8%, H. nana 2.7% and Endolimax nana 2.7%. High rate of intestinal parasites particularly, S. stercoralis compared to the most recent studies of general population. Therefore, regular screening and tracking the positive cases, disinfection of the living environment, training and financing of the staff, increasing the number of the workers, recruiting of professionals and trained personnel in these centers are suggested.

The Retina as a Window to the Brain in Vulnerable Neonates

Fifty years ago, Kinsey1 published the results of a cooperative study of what was then called retrolental fibroplasia (RLF) and the use of oxygen. Infants who weighed <1.5 kg and survived the first 48 hours were enrolled in this multicenter study. Of the 590 survivors who had an adequate eye examination, 533 infants had received curtailed oxygen and 53 had received routine oxygen. Of those infants who received routine oxygen, 38 (75%) had vascular changes of RLF (stage 1–3 retinopathy of prematurity [ROP]) and 12 (25%) had cicatricial RLF (stage 4–5 ROP). Among the 533 infants with curtailed oxygen, 178 had vascular changes (33%) of RLF and 35 (7%) had cicatricial RLF. This trial, sponsored by the National Society for the Prevention of Blindness and the National Institute of Neurologic Disease and Blindness, was notable for providing a multicenter clinical trial that halted the indiscriminate use of oxygen, which had been responsible for the blinding of thousands of children. This therapeutic misadventure had occurred because of medicine's ability to introduce the technology of supplemental oxygen in incubators without ways of measuring the physiologic impact on the preterm infant. At that time, there was no consistent ability to measure arterial blood gases, no uniform classification system for ROP, and limited opportunities for collaboration between neonatologists, ophthalmologists, neurodevelopmentalists, and epidemiologists.2–4 From this study, as well as the tort legal system that was quickly and vigorously pursued by the American Bar, a <40% restricted–supplemental oxygen policy was implemented in NICUs. In 1960, Avery5 demonstrated the down side of this restricted-oxygen era by … Address correspondence to Michael E. Msall MD, University of Chicago Pritzker School of Medicine, Kennedy Mental Retardation Center, Comer Children's and LaRabida Children's Hospitals, 5841 S Maryland Ave, MC0900, Chicago, IL 60637. E-mail: mmsall{at}peds.bsd.uchicago.edu

Clinicians' adherence to an algorithm for pharmacotherapy of depression in the Texas public mental health sector.

This study evaluated clinicians' adherence to the major depressive disorder algorithm of the Texas Implementation of Medication Algorithms (TIMA) as a component of usual care in the Texas public mental health system. Data were collected from two Texas Department of Mental Health and Mental Retardation centers between April and December 2000. Clinician adherence measures included documentation of outcome measures, prescribing patterns (correct medications, therapeutic dosing, dosage increases, and appropriate medication changes), and visit frequency. Clinicians had consistently high adherence to appropriate drug regimens, at appropriate dosages. Variability in attempts to increase dosages when warranted, visit frequency, and documentation of patient outcome measures between clinicians were seen. The results suggest that implementation of medication algorithms is possible in the public mental health sector.

Landmark Hospital Celebrates Birth of American Psychiatry

Back to table of contents Previous article Next article Community NewsFull AccessLandmark Hospital Celebrates Birth of American PsychiatryTricia DychTricia DychSearch for more papers by this authorPublished Online:6 Jul 2001https://doi.org/10.1176/pn.36.13.0018Pennsylvania Hospital, the nation’s first hospital, is celebrating a unique milestone in the field of medicine and psychiatry in the United States—the 250th anniversary of the creation of the hospital, the birth of formalized American medicine, and the start of the field of psychiatry.The Philadelphia institution was established on May 11, 1751, by Benjamin Franklin and Dr. Thomas Bond, who saw the need to “care for the sick-poor and insane who were wandering the streets of Philadelphia.” A few months later, the first patients were admitted, and six were treated for psychiatric illness.“It is an honor to lead this institution’s psychiatric services during this remarkable time,” said Jody J. Foster, M.D., M.B.A., interim chair of the department of psychiatry. “It is incredible to work in the same place where psychiatry was born and to walk the same halls as Franklin, Bond, and psychiatry’s most prominent forefathers, Benjamin Rush and Thomas Story Kirkbride.”Dr. Benjamin Rush’s “tranquilizing chair” was used to restrict the blood flow to the patient’s brain.From the time the hospital was established to 30 years later when Dr. Benjamin Rush came to Pennsylvania Hospital, psychiatric patients were treated as if they were possessed by demons. It was Rush, a signer of the Declaration of Independence and an esteemed military physician, who first believed that mental illness was a disease of the mind. It was because of this and his writing of a now classic work, “Observations and Inquiries upon Diseases of the Mind,” published in 1812, that he became known as the “father of American psychiatry.”“Although by today’s standards the care provided was horrific and usually ineffective, Rush and his colleagues truly believed they were providing the most appropriate and compassionate treatment possible,” explained Foster.In 1841 the hospital opened the doors of what became known as the Institute of Pennsylvania Hospital. By this time, Dr. Kirkbride was in charge, and treatment for the mentally ill took a new, enlightened direction.Kirkbride practiced what was known as “moral treatment” and believed those with mental illness could be cured. Kirkbride strongly influenced the construction of the Institute and made sure it provided patients with many recreational and educational opportunities to help prepare them to return to society.In 1844 Kirkbride hosted a meeting of the 13 superintendents of the U.S. hospitals for the insane, which led to the creation of what is now known as the American Psychiatric Association, the nation’s first specialty medical society.During its 150-plus years in operation, the Institute gave rise to 12 APA presidents—more than any other hospital in the country.“Although economic forces closed the doors of the Institute in 1997,” explained Foster, “our Behavioral Health Service continues to thrive, and our recent merger with the University of Pennsylvania Health System has expanded our opportunities tremendously.”The hospital continues to provide unparalleled psychiatric care via both inpatient and outpatient programs, many of which are offered through the hospital’s Hall-Mercer Community Mental Health and Mental Retardation Center. The institution remains committed to teaching and trains psychiatry residents from the University of Pennsylvania and runs an independent psychology internship program.“The strength behind the Penn system has only expanded the hospital’s opportunities for education, research, and the continued provision of superior care,” said Foster. “Psychiatry is as important to Pennsylvania Hospital as it was in 1751 and 1841.”APA returns to the city of its birth next year to hold its 2002 annual meeting there. ▪Ms. Dych is director of public affairs at Pennsylvania Hospital, Philadelphia. ISSUES NewArchived

Tailoring and Individualizing Housing Programs for Homeless Persons with Chronic Mental Illness

1Massachusetts Mental Health Center, Boston, Mass. 2Department of Psychiatry, Harvard Medical School, Boston, Mass. 3Tri-City Mental health and Retardation Center and Community Health Link, Worcester, Mass. Reprint requests: Eileen C. Reilly, MD, Massachusetts Mental Health Center, 74 Fenwood Rd., Boston, MA 02115.

Struggles in Transformation: A Study in TQM, Leadership, and Organizational Culture in a Government Agency

Listen to the experts in total quality management (TQM), and you will repeatedly hear that the key to successful implementation of TQM is to at the of the organization, and then, with constancy of purpose, proceed downward (Deming, 1986; Imai, 1986; Townsend, 1990). What does begin at the top mean in practice? What is its significance in relation to the everyday behavior of the organization? This article describes the efforts undertaken and lessons learned by the Texas Department of Mental Health and Mental Retardation (TDMHMR) as it began the transformation of the agency culture in keeping with a TQM model. The story is not complete, far from it. Although there have been successes over the past four years, these have been marked by a series of struggles that has its roots in a mixture of uncertainty regarding the next step to take and in the need for the agency's senior managers to personally transform the way they go about their work. We have come to realize that if the transformation of our agency culture is to occur, it must be preceded by a personal transformation. The struggle encountered in making this personal transformation is the subject of this study. Establishing the Context: The TDMHMR Vision While we have encountered many issues in our four-year implementation of TQM, the most significant has been the need for the agency senior managers to change the way they conceptualize and approach their work. That is, the senior managers must become the leaders of the agency.(1) In our experience, if this personal transformation does not occur, it is unlikely that our effort to transform our agency culture will be successful. Much has been written on the behaviors that distinguish managers from leaders (Conger, 1989; Marconi, 1993). Leadership is the first of the seven Malcolm Baldrige Award categories. Workshops on leadership skills abound. In preparation for our TQM journey, we became familiar with much of this literature and attended more than our share of workshops.(2) In retrospect, however, our knowledge was more literary than experiential. We knew the concepts and believed that we had thought through them carefully. Yet, at the time, we lacked an appreciation for the meaning that only experience can provide. It is from our experience that we derive our emphasis on the importance of personal transformation. From our efforts, we have discovered that it is one thing to embrace the concepts of leadership, to espouse them in speech, but it is quite another to change the way one personally approaches his or her job. Why Change: TQM in TDMHMR Why must managers change both the conceptualization of their responsibilities and the way they work to meet these responsibilities? What makes this change important and not just a by-product of an allegiance to a different management philosophy? Because further transformation of the TDMHMR agency culture is contingent on this change. To understand the nature of this contingency, we need to review our involvement with TQM, and where it has taken us. TDMHMR is a configuration of 13 state schools providing services to people with mental retardation, 8 state psychiatric hospitals, 35 community mental health and mental retardation centers, 5 state community centers, 1 residential treatment center for emotionally disturbed youth, and a central office which is headquarters for the system. As a public provider of mental health and mental retardation services, our mission is to provide services to the 17 million citizens of Texas. In 1994, we served over 150,000,000 Texans with a biennial budget of almost $2.4 billion. We provide services to people who have little, if any, insurance and who otherwise cannot afford to obtain services. As a public provider operating in an environment where the old ways of doing things were drawing increasing fire, we were seduced by the customer appeal of TQM. As with most seductions, we began our relationship with TQM somewhat ignorant of some of its deeper concepts. …

To observe or not to observe? What are the questions?: Gene P. Sackett. University of Washington, Psychology, Regional Primate Research Center, Child Development and Mental Retardation Center

To observe or not to observe? What are the questions?: Gene P. Sackett. University of Washington, Psychology, Regional Primate Research Center, Child Development and Mental Retardation Center

Y-Specific DNA Sequences in Male Patients with 46, XX and 47, XXX Karyotypes

Genetics Division and Mental Retardation Center, The Children's Hospital; Departments of Pediatrics and Genetics, Harvard Medical School; The Howard Hughes Medical Institute, Boston, Massachusetts; and Clinical Cytogenetics, Stanford University Hospital. Stanford, California Am. J. Med. Genet. 28: 393, 1987

Y-Specific DNA Sequences in Male Patients with 46, XX and 47, XXX Karyotypes

Genetics Division and Mental Retardation Center, The Children's Hospital; Departments of Pediatrics and Genetics, Harvard Medical School; The Howard Hughes Medical Institute, Boston, Massachusetts; and Clinical Cytogenetics, Stanford University Hospital. Stanford, California Am. J. Med. Genet. 28: 393, 1987

Cost-outcome analysis and service planning in a CMHC.

The outcome of outpatient treatment of 497 children and 396 adults at a large community mental health and mental retardation center was associated with cost of services and with clients' number of sessions, length of stay, and density of treatment. The cost of one hour of outpatient services averaged $53.15 for adults and $52.32 for children. Treatment outcome was not directly related to cost of treatment, but clients who regressed used more resources than did clients whose conditions remained the same. Adults who improved were in therapy for a shorter period than were adults who became worse, but they were treated more times per month. The cost-outcome analysis methodology described here can be useful in forecasting the effects of budget reductions on case mix and treatment outcome, in developing effective service models for various funding levels, and in identifying optimal caseloads.

Evaluating the quality of training delivered by direct‐care staff in a state mental retardation center

AbstractThis study evaluated a center‐wide training system in a state‐operated mental retardation center. Staff performance was assessed under varying conditions with collateral measures collected on resident behavior. The quality of training delivered by direct‐care staff was measured following the completion of an inservice training program and when individual feedback and praise were available or a group contingency where feedback, praise, and money were available. Inservice training was not found to be sufficient to maintain staff training skills. Providing feedback and praise had mixed results in maintaining staff behavior. A group contingency using feedback, praise, and money was found to be immediately effective in improving and maintaining staff behavior. Collateral measures on student behavior were also provided that indicated that consistent, quality training by staff resulted in increased student skill acquisition. These results are discussed within the framework of conducting research in applied settings.

Development of a rating scale to assess social skill deficits in mentally retarded adults.

In the current study, two experiments were conducted to establish the reliability of a scale developed with persons of normal intelligence for the assessment of social skill deficits and excesses of the mentally retarded. The experiment was divided into two studies. The first was aimed at establishing which of the 100 items could be accurately rated by having pairs of staff independently score 22 mild and moderately retarded adults who were outpatients at a local community mental health center. A correlation of r = .30 was established as a minimum cut off for reliability. With this criterion, 57 items were selected from the scale for further testing. In the second study, 207 different patients from the same outpatient clinic, from the mental retardation center of a nearby state psychiatric hospital and from Champaign, Illinois, were assessed on the 57-item Social Performance Survey Schedule. A factor analysis was then run and four subscales of the assessment instrument were established. Implications of the findings are discussed.

Computerizing an integrated clinical and financial record system in a CMHC: a pilot project.

The authors describe the three-year experience of a mid-sized community mental health center in designing and installing an automated Staff/Management Information System (S/MIS). The purpose of the project, piloted at the heart od Texas Region Mental Health Mental Retardation Center (HOTRMHMR) in Waco, Texas, was to examine the feasibility of a comprehensive data system operating at a local level which would create an effective audit trail for services and reimbursement and serve as a viable mechanism for the transmission of center data to a state system via computer tapes. Included in the discussion are agency philosophy, costs, management attitudes, the design and implementation process, and special features which evolved from the fully integrated system.

The long-term patient in the community: life style patterns and treatment implications.

A sample of 99 long-term patients at an urban community mental health-mental retardation center were interviewed to determine how they spent their time and their degree of happiness with their lives and the services they received at the center. More than half the patients were considered by center staff to be only mildly or moderately impaired, but as a group they were distinguished by low levels of educational, financial, and vocational achievement; only 13 per cent were working more than half time. Most of the patients considered themselves happy, but their life style was oriented toward health and social relationships and lacked a work-task orientation. The authors conclude that the patients' life style meshes closely with the orientation of the treatment system; neither places emphasis on achievement of noninterpersonal tasks or enhancement of a work orientation. The authors believe that many chronic users of community mental health services have the potential to work and that practically all could benefit from the ego-enhancing experiences resulting from the successful accomplishment of tasks and development of skills. Therefore they feel programming for long-term patients should address deficits in work and achievement motivation.

A mental health center's aftercare specialty service for discharged state hospital patients.

To serve discharged state hospital patients from its catchment area, a mental health and retardation center established an ambulatory community service that has total responsiblity for the community care of those patients. The service is staffed primarily by mental health workers and nurses. They become members of the neighborhood-based teams on the state hosptial unit and take part regularly in discharge planning with patients and hospital staff. They also provide a range of continuing outpatient and support services, including medication review, development of housing placements and recreational activities, and psychiatric follow-up. The service operates as a specialized, autonomous unit, which allows it to shift staff resources in line with changes in patient and program needs, to allocate time for program development, and to pressure other agencies to develop needed services.

Expandable polyfoam for constructing adaptive equipment.

Journal Article Expandable Polyfoam for Constructing Adaptive Equipment Get access David Sommers, PhD, David Sommers, PhD 1Dr. Sommers is Director of Activities, Ms. McNemar and Ms. Grove are instructors, and Ms. Lesh and Ms. Reed are staff physical therapists with the Western Maryland I Mental Retardation Center, 1380 Marshall St, Hagerstown, MD 21740. Search for other works by this author on: Oxford Academic Google Scholar Pat McNemar, AA, Pat McNemar, AA 1Dr. Sommers is Director of Activities, Ms. McNemar and Ms. Grove are instructors, and Ms. Lesh and Ms. Reed are staff physical therapists with the Western Maryland I Mental Retardation Center, 1380 Marshall St, Hagerstown, MD 21740. Search for other works by this author on: Oxford Academic Google Scholar Ellen Lesh, MEd, Ellen Lesh, MEd 1Dr. Sommers is Director of Activities, Ms. McNemar and Ms. Grove are instructors, and Ms. Lesh and Ms. Reed are staff physical therapists with the Western Maryland I Mental Retardation Center, 1380 Marshall St, Hagerstown, MD 21740. Search for other works by this author on: Oxford Academic Google Scholar Sally Reed, BS, Sally Reed, BS 1Dr. Sommers is Director of Activities, Ms. McNemar and Ms. Grove are instructors, and Ms. Lesh and Ms. Reed are staff physical therapists with the Western Maryland I Mental Retardation Center, 1380 Marshall St, Hagerstown, MD 21740. Search for other works by this author on: Oxford Academic Google Scholar Cheryl Grove, BA Cheryl Grove, BA 1Dr. Sommers is Director of Activities, Ms. McNemar and Ms. Grove are instructors, and Ms. Lesh and Ms. Reed are staff physical therapists with the Western Maryland I Mental Retardation Center, 1380 Marshall St, Hagerstown, MD 21740. Search for other works by this author on: Oxford Academic Google Scholar Physical Therapy, Volume 60, Issue 3, 1 March 1980, Pages 310–311, https://doi.org/10.1093/ptj/60.3.310 Published: 01 March 1980 Article history Received: 09 May 1979 Accepted: 07 November 1979 Published: 01 March 1980

LETTERS

BirthVolume 7, Issue 1 p. 40-41 LETTERS Bonnie Worthington-Roberts Ph.D., Bonnie Worthington-Roberts Ph.D. Associate Professor and Chief Nutrition Section, Child Development and Mental Retardation Center, WJ-10 University of Washington Seattle, WA 98195Search for more papers by this author Bonnie Worthington-Roberts Ph.D., Bonnie Worthington-Roberts Ph.D. Associate Professor and Chief Nutrition Section, Child Development and Mental Retardation Center, WJ-10 University of Washington Seattle, WA 98195Search for more papers by this author First published: March 1980 https://doi.org/10.1111/j.1523-536X.1980.tb01367.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume7, Issue1March 1980Pages 40-41 RelatedInformation

An Integrated System for Computerized Patient Records

A community mental health--mental retardation center developed a computerized problem-oriented record system specifically for use in a full-service community mental health center. It is based on an integrated set of clinical forms that covers all levels of a client's involvement with the center, beginning with his contact as a prospective client and including intake, treatment planning, treatment, and discharge. Most of the forms are computer-generated. Special features of the system include its capability to prompt the clinician about scheduled treatment sessions, follow-ups, and other activities and a scale that rates the client's level of functioning and is keyed to a specially developed master problem list. The authors describe each of the clinical forms used in the system.

Behavioral Training by Paraprofessionals for Families of Developmentally Disabled Persons

An innovative system to deliver behavioral services was developed to extend a residential facility's community outreach and provide an alternative to institutionalization. The successful implementation of this program suggests a way to combine clinical service and staff training at the bachelor-technician career ladder step in psychology and related disciplines. Specifically, a team of behavior technicians delivered the skills of a mental retardation center to families of disabled children and adults formerly beyond the center's range. Parents were taught specific modification procedures to lessen the likelihood of disruptive behavior and to hasten the acquisition of new developmental skills by their children.

Preparation of mental health personnel for the delivery of mental retardation services

The developmental experience of an urban community mental health-mental retardation center is presented as a guiding model for other community mental health centers interested in "tooling up" their mental retardation services. Surveying personnel needs, establishing educational objectives tailored to personnel, presenting specific knowledge about mental retardation, clarifying mandates for community mental health-mental retardation service, and two conceptual frameworks for service delivery are elaborated.