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Biomedical subjects

H Flynn

Publications and source records attributed to H Flynn.

10 recordsLinked to original sources
PubMed2006

Persistence and the random bond Ising model in two dimensions.

We study the zero-temperature persistence phenomenon in the random bond +/-J Ising model on a square lattice via extensive numerical simulations. We find strong evidence for "blocking" regardless of the amount disorder present in the system. The fraction of spins which never flips displays interesting nonmonotonic, double-humped behavior as the concentration of ferromagnetic bonds is varied from zero to one. The peak is identified with the onset of the zero-temperature spin glass transition in the model. The residual persistence is found to decay algebraically and the persistence exponent theta(p) approximately = 0.9 over the range 0.1< or =p< or =0.9. Our results are completely consistent with the result of Gandolfi, Newman, and Stein for infinite systems that this model has "mixed" behavior, namely positive fractions of spins that flip finitely and infinitely often, respectively. [Gandolfi, Newman and Stein, Commun. Math. Phys. 214, 373 (2000).].

Journal Article↗
PubMed1999

Significance of prior episodes of depression in two patient populations.

Perhaps the single best predictor of current depression is a prior episode of depression. This study examined the significance of prior depressive episodes in a weighted sample of 425 primary medical care (PC) patients. It also compared the 53 PC patients with major depression with 93 depressed psychiatric patients with respect to percentage of recurrences versus 1st episodes. PC patients with prior depression were over 8 times more likely to be currently depressed than those without such a history. Having at least 1 prior episode of depression was modestly more sensitive, but less specific, than an elevated Center for Epidemiologic Studies--Depression Scale score in predicting current depression. Most currently depressed patients in both PC (85%) and psychiatry (78%) had prior episodes of depression. These findings highlight the importance of assessing history of depression in research and clinical practice.

Academic Medical Centers↗
PubMed1988

Regional and welfare perspectives on the public-private hospital dichotomy in New Zealand.

Concern with the social welfare implications of dual (public and private) hospital systems has grown over the last decade as national commitments to welfare state ideals have wavered in the continuing atmosphere of fiscal conservatism that has permeated through western democracies. New Zealand provides an excellent example of a health care system in which private hospitals have survived (and recently flourished) alongside those provided by the state. Following a brief survey of the evolution of the New Zealand hospital system, variations in the 'mix' of public and private hospitals are described at the (regional) Hospital Board District level. It is noted that competition for patients and funding between the public and private sectors occurs almost exclusively in the larger, urban hospital districts, and is invariably to the detriment of public hospitals. Districts with a substantial private hospital presence are found to have fewer resources in the public sector (relative to their population) than those which have few or no private hospitals. The welfare implications of this situation are explored. It is proposed that the maintenance of a dual hospital system in New Zealand has provided, in some parts of the country at least, a 'choice' for those able to afford private hospital charges or insurance coverage, but at the expense of those dependent solely upon a (shrinking) public sector.

Economics, Hospital↗
PubMed1985

Carnitine and glucuronic acid conjugates of pivalic acid.

The [1-14C]pivaloyloxyethyl ester of methyldopa administered to man and cynomolgus monkeys resulted in the elimination in the urine of 14C-pivalic acid metabolites. Pivaloyl glucuronide and pivaloyl carnitine were identified as the major radioactive urinary metabolites in monkey urine and human urine, respectively. N.m.r. analysis indicated that pivaloyl carnitine had a cyclic structure. Although the role of carnitine is in the transport of fatty acids across mitochondrial membranes, it may also function in the conjugation of carboxylic acid xenobiotics in humans.

Animals↗
PubMed1984

Urinary metabolites of the antiprotozoal agent cis-3a,4,5,6,7,7a- hexahydro-3-(1-methyl-5-nitro-1H-imidazol-2-yl)-1,2-benzisoxazole in the rat.

1H-NMR and MS were employed to identify 13 rat urinary metabolites of 14C-labeled cis-3a,4,5,6,7,7a- hexahydro-3-(1-methyl-5-nitro-1H-imidazol-2-yl)-1,2-benzisoxazole (MK-0436). The major free (unconjugated) metabolite was cis-3a,4,5,6,7, 7a-hexahydro-3-carboxamido-1,2-benzisoxazole; it was also the second most abundant metabolite released during hydrolysis of the conjugated fraction. All other identified metabolites were hydroxylated analogues substituted at C(4)-C(7a) of the cyclohexane ring. the 4-equatorial,5-axial,7a-triol was the second most abundant metabolite excreted in an unconjugated form. Four monohydroxy (5-axial, 6-axial, 6-equatorial, 7-equatorial) metabolites of the drug were identified; they were found in the conjugated fraction only and were released by hydrolysis. The 5-axial hydroxy compound is the major conjugated metabolite and is overall the most abundant of all the metabolites. Six dihydroxy metabolites were identified: one was found exclusively in the free state, three as conjugates only (including the 7-axial,7a-diol, which is the major dihydroxy species), and two both free and conjugated. A second triol was found both free and conjugated.

Animals↗
PubMed1977

Utilization review of the late adolescent patient in a mental health center: steps toward the development of criteria for the adequacy of assessment and treatment.

This study is concerned with an attempt to determine whether meaningful utilization review criteria could be productively generated by viewing a patient population from a developmental perspecitve. During a 2-year period, a multidisciplinary panel at Yale University sought to identify the sociodemographic, clinical, and administrative issues posed by late adolescents seeking treatment at the Connecticut Mental Health Center, New Haven. We sought to address the following questions: a) From what segment of the population were we drawing our adolescent patients? b) Who referred them for help? c) What kinds of problems led to referral? d) What were the diagnostic characteristics of the adolescent's evaluation? e) Under what conditions do adolescents terminate treatment? The charts of over 1222 adolescent patients were studied to help us answer these questions. Our investigation revealed that the adolescent patients seen at the Mental Health Center were sociodemographically and diagnostically heterogeneous. An increasingly large number of adolescents are referring themselves for evaluation and treatment, rather than being sent by schools, physicians, or social welfare agencies. The majority of patients seeking help come from blue collar or working class backgrounds mainly because of intrapsychic complaints of anxiety and depression. Upwardly mobile, they constitute a group who have completed their high school education, often live away from home, and are struggling with problems of defining an identity different from that of their family. Review of their charts indicated that significant sholastic, medical, and developmental information was frequently lacking or vaguely recorded. Our chart review also indicated that many clinicians did not ask their patients about symptoms relating to body functioning such as difficulties with sleeping, eating, or psychosomatic complaints. The study also discovered that it was difficult in the great majority of the charts reviewed to specify the adolescent's own perception of the difficulties which led them to seek help. Suggestions are then outlined for developing review criteria dealing with the emancipated adolescent, parental involvement in the treatment of the adolescent, treatment plans, and the termination of treatment. The comparative advantages of combining utilization review criteria from both a traditional "disease model" and a "developmental model" are discussed. The panel concluded that input from both perspectives is necessary in understanding the impact of a mental health delivery system upon adolescent patients, their family, and the community.

Adolescent↗
PubMed1976

The development and validation of a measure of the psychiatrist's authoritative domain.

In order to examine issues relevant to the authority which patients bestow upon psychiatrists the present authors constructed the Psychiatrist's Sphere of Influence Scale (PSIS). The PSIS is a 68-item Likert-type questionnaire which asks patients to specify the skills which they believe belong to the psychiatrist's authoritative domain. Patients being treated in day hospital (N=82), inpatient (N=113), and outpatient (N=121) settings were individually administered the PSIS along with various discriminant and construct validity measures. The findings indicated that the PSIS is an internally consistent, factorially complex, relatively stable measure of the roles which are ascribed to psychiatrists. Neither the social desirability nor the agreement response set represents important contaminants of the PSIS. Moreover, individual differences on the PSIS appear to be predictable, within broad limits, from patients' positions in the social structure, their preferred styles of help seeking in hospital and therapy settings, and their generalized orientations toward power and authority. A tendency to blur the boundaries between "psychiatric" and "nonpsychiatric" roles appears to be concentrated among patients who are middle-aged or older, minimally educated, of lower socioeconomic status, inclined toward an authoritarian conception of the good patient and the good hospital, and who endorse traditional family role relationships. The implications of these findings for the manner in which psychiatrists exercise their authority were discussed.

Adult↗