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Biomedical subjects

Anne Morris

Publications and source records attributed to Anne Morris.

12 recordsLinked to original sources
PubMed2007

Conversion disorder in Australian pediatric practice.

OBJECTIVES: To describe the incidence and clinical features of children presenting to Australian child health specialists with conversion disorder. METHOD: Active, national surveillance of conversion disorder in children younger than 16 years of age during 2002 and 2003. RESULTS: A total of 194 children were reported on. The average age was 11.8 years; 23% were younger than 10 years of age. Presentations were complex, with 55% presenting with multiple conversion symptoms. The most common presentations were disturbance of voluntary motor function (64%), sensory symptoms (24%), pseudoseizure (23%), and respiratory problems (14%). Hospital admission was required for 70%, with an average stay of 10.2 days. Antecedent stressors were also reported in 62% and a history of mental health concerns in 42%, with 14% of children taking psychotropic medications for comorbid anxiety or depression. The incidence of conversion disorder in Australian specialist child health practice is estimated to be between 2.3 and 4.2/100,000. CONCLUSIONS: Conversion disorder is associated with a significant burden for the child, family, and the health system. This study emphasizes the comorbidity with anxiety, depression, and symptoms of pain and fatigue. It also highlights the potential impact of "commonplace" stressors such as family conflict and children's loss of attachment figures.

Adolescent↗
PubMed2006

Organizational and individual factors affecting consumer outcomes of care in mental health services.

The impact of organizational and individual factors on outcomes of care were assessed for 424 adult consumers with chronic mental illness who were receiving services from one of 14 Community Mental Health Organizations (CMHOs) in Colorado over a 30-month period, as part of a larger statewide evaluation of the impact of Medicaid capitation on mental health services. Data on organizational culture and climate were aggregated from surveys of staff and administrators conducted within CMHOs over a two-year period corresponding to the collection of consumer outcome and service utilization data. Growth curve analyses were conducted on consumer perceptions of physical and mental health, and on quality of life (QOL). Analyses indicated a significant cross-level effect of organizational culture and climate on improvements in consumer perceptions of physical and mental health, but not on a "quasi-objective" index of QOL. Individual characteristics, such as age, diagnosis, gender, and ethnicity, were significant predictors of outcomes. Being older, female, an ethnic minority, and having a diagnosis of schizophrenia all predicted poorer outcomes among consumers. These findings are discussed in terms of their implications for policy and future research.

Adult↗
PubMed2005

Tenofovir-associated acute and chronic kidney disease: a case of multiple drug interactions.

Tenofovir therapy in patients with human immunodeficiency virus (HIV) infection has been associated with acute renal failure (ARF) and Fanconi syndrome. In the past 2 years, we diagnosed tenofovir-associated ARF in 5 HIV-infected patients who were receiving tenofovir therapy and who had classic findings of acute tubular necrosis, and we compared findings for our patients with data on 22 patients described in the literature. The mean serum creatinine level increased from 0.9 to 3.9 mg/dL, and it decreased to 1.2 mg/dL during recovery. ARF resolved in 22 of 27 patients after discontinuation of tenofovir therapy. The most common drugs given with tenofovir were ritonavir or lopinavir-ritonavir (21 of 27 patients), atazanavir (5 of 27 patients), and didanosine (9 of 27 patients). Tenofovir-associated ARF manifests as acute tubular necrosis that may not resolve with tenofovir withdrawal. Tenofovir is associated with multiple drug interactions, leading to an increased risk of ARF. Frequent monitoring of renal function is warranted for any patient receiving these combinations.

Adenine↗
PubMed2005

Compositional and sensory characteristics of three native sun-dried date (Phoenix dactylifera L.) varieties grown in Oman.

Three native sun-dried date varieties grown in Oman, namely, Fard, Khasab, and Khalas, were examined for their proximate composition, sugars, dietary fiber, minerals, and organic acids as well as sensory characteristics. The study was conducted on sun-dried dates due to their higher consumption compared with fresh dates. All results are expressed as mean value +/- standard deveiation (n = 3) on a fresh weight basis except for sensory analysis. Date varieties were found to be low in fat and protein, but rich in sugars, dietary fiber, and minerals. They were found to be a good source of energy (278-301 kcal/100 g), due to the high sugar content. Total sugar content ranged from 56.1 to 62.2 g/100 g, being lowest in Khasab and highest in Khalas. Total dietary fiber content of dates varied from 6.26 to 8.44 g/100 g, of which 84-94% was insoluble fiber. Twelve minerals were studied in dates, among which the major minerals were potassium, calcium, magnesium, and phosphorus. Date varieties were also found to be an excellent source of selenium (ranging from 0.36 to 0.53 mg/100 g). Six organic acids were positively identified, among which malic acid predominated in all varieties. Differences (p < 0.05) in the contents of dietary fiber, organic acids, and certain minerals were observed among the three date varieties examined. Descriptive sensory analysis showed that among the nine sensory attributes studied, only the attributes color and desirability were rated as being of significantly (p < 0.01) higher intensity in Fard than in Khasab, whereas flesh firmness was lower (p < 0.01). Thus, these results suggest that although all three dates serve as a good source of vital nutrients, the Khalas variety, which is considered as premium quality, had significantly higher contents of sugar and selenium and a significantly higher energy value than the other varieties studied.

Arecaceae↗
PubMed2005

Comparison of antioxidant activity, anthocyanins, carotenoids, and phenolics of three native fresh and sun-dried date (Phoenix dactylifera L.) varieties grown in Oman.

Fresh and sun-dried dates of three native varieties from Oman, namely, Fard, Khasab, and Khalas, were examined for their antioxidant activity and total contents of anthocyanins, carotenoids, and phenolics, as well as free and bound phenolic acids. All results are expressed as mean value +/- standard deviation (n = 3) on a fresh weight basis. Fresh date varieties were found to be a good source of antioxidants (11687-20604 micromol of Trolox equiv/g), total contents of anthocyanins (0.24-1.52 mg of cyanidin 3-glucoside equiv/100 g), carotenoids (1.31-3.03 mg/100 g), phenolics (134-280 mg of ferulic acid equiv/100 g), free phenolic acids (2.61-12.27 mg/100 g), and bound phenolic acids (6.84-30.25 mg/100 g). A significant (p < 0.05) amount of antioxidants and carotenoids was lost after sun-drying of dates, whereas the total content of phenolics and free and bound phenolic acids increased significantly (p < 0.05). Anthocyanins were detected only in fresh dates. Date varieties had different levels and patterns of phenolic acids. Four free phenolic acids (protocatechuic acid, vanillic acid, syringic acid, and ferulic acid) and nine bound phenolic acids (gallic acid, protocatechuic acid, p-hydroxybenzoic acid, vanillic acid, caffeic acid, syringic acid, p-coumaric acid, ferulic acid, and o-coumaric acid) were tentatively identified. Of the date varieties studied, Khalas, which is considered to be premium quality, had higher antioxidant activity, total carotenoids, and bound phenolic acids than other varieties. These results suggest that all date varieties serve as a good source of natural antioxidants and could potentially be considered as a functional food or functional food ingredient, although some of their antioxidant constituents are lost during sun-drying.

Anthocyanins↗
PubMed2004

National study of infants hospitalized with pertussis in the acellular vaccine era.

BACKGROUND: In Australia in 1999 acellular pertussis vaccine (DTPa) replaced locally manufactured whole cell vaccine given at 2, 4 and 6 months of age with coverage of about 95% by 12 months of age. Few data are available on pertussis hospitalizations or sources of infection in countries exclusively using DTPa. METHODS: In 2001 national active monthly surveillance of infant hospitalizations for pertussis was conducted through the Australian Pediatric Surveillance Unit, which surveys all child health specialists monthly. A standard questionnaire was completed for notified cases. RESULTS: There were 140 infants reported (median age at diagnosis, 8 weeks). The rate of hospitalization in indigenous infants was significantly higher than in nonindigenous infants (P < 0.01). Of 97 (69%) infants who had not been vaccinated for pertussis, 63 (65%) were <8 weeks old (before the first scheduled dose of DTPa vaccine). Of 76 infants age > or =8 weeks, only 28 (37%) were appropriately immunized for age. Of 68 coughing contacts whose ages were known, 46 (68%) were adults, usually one of the infant's parents. Of 32 child contacts 16 (50%) were siblings. Four infants <6 weeks old died. CONCLUSION: Despite universal vaccination with DTPa in Australia, pertussis remains an important cause of hospitalization, morbidity and death in infants, most of whom were too young to be vaccinated or had missed vaccinations. The most common source of infection was a parent. Strategies to improve pertussis control in countries with high DTPa coverage could include adult-formulated booster pertussis vaccines for adolescents and recent parents and/or accelerated pertussis vaccine schedules for infants.

Australia↗
PubMed2002

Contextual factors affecting job satisfaction and organizational commitment in community mental health centers undergoing system changes in the financing of care.

This study examines the relationship between contextual factors and job satisfaction and organizational commitment among a sample of 148 administrators and staff in 17 community mental health centers undergoing the transition from fee-for-service (FFS) reimbursement to capitation of Medicaid-funded mental health services in Colorado. Hierarchical linear modeling was used to assess both organizational level factors as well as factors at the individual level of analysis in relation to job satisfaction and organizational commitment. Results indicated significant associations between type of financing for Medicaid-funded services and organizational commitment. Direct, nonprofit capitation was positively linked to organizational commitment, relative to traditional FFS reimbursement. Aggregate perceptions about the organization, including its culture and climate, and the formalization of policies and procedures were strongly linked to job attitudes, over and above individual perceptions about the organization. Individual perceptions of the organization were also related to job attitudes as was respondent level within the hierarchy of the organization. These findings are discussed in terms of their implications for research and intervention in mental health service settings.

Attitude of Health Personnel↗
PubMedDate not supplied

Pilot study of saquinavir and lopinavir/ritonavir twice daily in protease inhibitor-naive HIV-positive patients.

PURPOSE: Protease inhibitor (PI)-naive patients may have limited reverse transcriptase inhibitor (RTI) options due to resistance and/or toxicity. Effective, well-tolerated nucleoside reverse transcriptase inhibitor (NRTI)-sparing regimens are therefore needed. METHOD: This prospective study evaluated the efficacy and safety of saquinavir/lopinavir/ritonavir (1000/400/100 mg bid) in PI-naive patients over 48 weeks. The regimen could be intensified with NRTIs if patients did not achieve virologic suppression by 12 weeks. The primary study endpoint was virologic suppression at 48 weeks. Additional study objectives included assessment of safety, CD4 cell counts, blood lipids, PI trough levels, and anthropometrics. RESULTS: Of the 20 PI-naive study participants, 16 completed 48 weeks of study treatment, with no discontinuations attributed to virologic failure. Fourteen of 16 patients achieved virologic suppression with only the PIs; 2 patients required tenofovir intensification to achieve complete suppression. Median CD4 counts increased significantly over 48 weeks. Adverse events were generally mild and manageable. Extreme lipid elevations were uncommon, although moderate lipid elevations occurred in the majority of patients. Most patients reported some degree of central fat accumulation. CONCLUSION: Our study demonstrates that saquinavir/lopinavir/ritonavir 1000/400/100 mg bid with tenofovir intensification is a potent nucleoside-sparing regimen for PI-naive patients, associated with durable HIV suppression and improved CD4 cell counts. Fat accumulation and metabolic changes observed in this study warrant confirmation from ongoing trials.

Adult↗