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Biomedical subjects

R E Mann

Publications and source records attributed to R E Mann.

At least 19 recordsLinked to original sources
PubMed1999

Reasons for living versus reasons for dying: examining the internal debate of suicide.

The Reasons for Living vs. Reasons for Dying (RFL/RFD) Assessment was used to obtain suicidal outpatients' top five reasons for living and for dying, respectively. Forty-nine suicidal university counseling center patients provided 173 RFL and 145 RFD responses. These responses were organized into eight RFL coding categories and nine RFD coding categories. Two coders trained in the RFL/RFD coding system showed high levels of interrater reliability (KRFL = .81; KRFD = .80). Chi-square results for RFL and RFD coding categories showed that the coding categories were not equally salient to these suicidal patients.

Adult↗
PubMed1998

Changes in liver cirrhosis death rates in different countries in relation to per capita alcohol consumption and Alcoholics Anonymous membership.

OBJECTIVE: This study examines how trends in liver cirrhosis relate to per capita alcohol consumption and Alcoholics Anonymous (AA) membership in 33 countries between 1965 and 1991. It was expected that reductions in liver cirrhosis deaths seen in many countries would be related to both decreased consumption and increased AA membership. METHOD: Data on liver cirrhosis death rates, alcohol consumption and AA membership were gathered from a variety of international sources. The data were analyzed with regression analyses (Ordinary Least Squares). RESULTS: Cirrhosis deaths and alcohol consumption levels were positively related in all analyses. In two of the four analyses, the negative relationship between cirrhosis deaths and AA group rates was marginally significant. CONCLUSIONS: Liver cirrhosis rates were strongly related to alcohol consumption and showed some relationship to AA group rates. The modest impact of AA may be due to the weakness of the true relationship but also to incompleteness in the cirrhosis and AA data in some countries.

Alcohol Drinking↗
PubMed1998

Adolescents, bush parties and drinking-driving.

OBJECTIVE: We describe the prevalence of bush party (an outdoor gathering of youth) attendance and examine predictors of attendance and of driving after drinking at bush parties. METHOD: The 1995 Ontario Student Drug Use Survey (OSDUS) data on students (n = 1,853) in schools across the province in grades 7, 9, 11 and 13 are employed to estimate prevalence of bush party attendance within the previous 12 months. The 1994 Graduated Licensing Study (GLS), a multi-community survey of drivers (n = 1,157, 53.6% male) in grades 11 and 12 in Ontario, data are employed to study predictors of attendance and of drinking-driving. RESULTS: Based on the OSDUS, the prevalence of bush party attendance is 37.6%. Based on the GLS, 38.4% attended bush parties, and among attenders 71.5% drank at bush parties, 63.5% observed drinking-driving, 16.1% rode with a drinking-driver and 16.6% drove after drinking at bush parties. Logistic regression reveals that attendance at bush parties is positively associated with number of other places alcohol was consumed, tobacco use, number of alcohol-related problems, number of kilometers ever driven, sensation seeking and northern residents. Among attenders who drank at bush parties, males were three and a half times more likely to drive after drinking at a bush party, and the probability of drinking and driving increased with the number of other drugs used. CONCLUSIONS: Despite important differences in the design and purpose of the two surveys, both indicate that bush party attendance is prevalent among adolescents. Driving after drinking at these events is common and warrants community action.

Adolescent↗
PubMed1996

Does increased spending on alcoholism treatment lead to lower cirrhosis death rates?

The purpose of this study was to see if recent changes in the funding of alcoholism programmes in the United States were related to changes in liver cirrhosis death rates. Data on per-capita spending, per-capita alcohol consumption and cirrhosis death rates were gathered from various sources for the years 1979 and 1989 for the 50 states and the District of Columbia. Regression analysis showed that greater increases in spending on alcoholism across US states were associated with greater declines in cirrhosis mortality rates. Since alcohol-related deaths cause large productivity losses and treatment is relatively cheap this creates large savings for society.

Alcoholism↗
PubMed1996

Alcohol-related measures as factors in traffic fatalities.

OBJECTIVE: The purpose of this study was to determine if alcohol-related measures (per capita consumption, drinking-driving arrest rate, alcohol abuse treatment rate and Alcoholics Anonymous [AA] membership rate) were related to differences between states in traffic fatality rates (total and alcohol-related). METHOD: Fatality rates were regressed onto the alcohol-related variables, using state level data for 1982 and 1990 as well as measures of relative change between the 2 years. RESULTS: Fatality rates demonstrated significant positive relationships with per capita consumption and drinking-driving arrest rates, and significant negative relationships with AA membership rates, for the years 1982 and 1990. Also, changes in per capita consumption were significantly and positively related to changes in both traffic fatality measures. CONCLUSIONS: Per capita alcohol consumption measures were the strongest and most consistent determinants of traffic fatality measures. The negative relationship between AA membership rates and traffic fatality measures for 1982 and 1990 suggests a beneficial impact of AA on these measures at the aggregate level, although other explanations are possible.

Accidents, Traffic↗
PubMed1995

Changes in cancer mortality rates and per capita alcohol consumption in Ontario, 1963-1983.

Data on Ontario per capita alcohol consumption and alcohol-related cancer mortality rates from 1963 to 1983 generally correlated positively and significantly. Correlations for the period of rising consumption (1963-1974) were similar to those observed for the total period, but during the period of stabilization and decline of alcohol consumption the magnitude of nearly all relationships decreased substantially. The overall positive and significant correlation between per capita alcohol consumption and various cancer site mortality rates may be partly due to lag effects from the period when consumption was on the rise.

Adolescent↗
PubMed1995

Treatment, health promotion and alcohol controls and the decrease of alcohol consumption and problems in Ontario: 1975-1993.

We report information on trends in alcohol problems, alcohol consumption, alcohol availability and prevention measures in Ontario for the period 1975-1993. Problem measures show substantial declines over the period. Measures of consumption have declined as well, but not as much as problem measures. Economic availability (relative price) has remained stable, while physical availability has increased. Prevention measures show substantial increases over the period.

Accidents, Traffic↗
PubMed1994

Rehabilitation for convicted drinking drivers (second offenders): effects on mortality.

The mortality experience of convicted drinking drivers (second offenders) (N = 347) randomly assigned to rehabilitation and control groups in two Ontario cities was examined. Over a follow-up period ranging between 8 and 13 years, 14 (11.0%) of the controls and 17 (7.7%) of the rehabilitation group died. Direct comparisons of the randomly assigned control and treatment groups revealed a tendency for lower total mortality and significantly lower mortality from accidental and violent death in those assigned to rehabilitation. Additional comparisons involving a combined rehabilitation group (N = 487) (rehabilitation participants randomly and not randomly assigned) confirmed these observations.

Accidents, Traffic↗
PubMed1993

Recent liver cirrhosis declines: estimates of the impact of alcohol abuse treatment and alcoholics anonymous.

This paper examines the proposition that increased treatment for alcohol abuse and Alcoholics Anonymous (AA) membership can account for a large part of the recent declines in cirrhosis mortality and morbidity. Data on treatment and AA membership in the USA between 1979 and 1987 and in Ontario between 1975 and 1986 are used, together with estimates of cirrhosis risk and the likely impact of treatment and AA membership. The results show that increased treatment levels and AA membership could account for all of the reductions in cirrhosis deaths and hospital admissions in Ontario. In the USA all of the deaths and about 40% of the admissions could be accounted for by these factors.

Alcohol Drinking↗
PubMed1993

Mortality in a sample of convicted drinking drivers.

Mortality rates for 639 drinking drivers were calculated. The sample consisted of all individuals convicted of a second offence in two Ontario cities (Oshawa and North Bay) between 1973 and late 1978. There were 53 deaths (51 males, 2 females) in the sample prior to the end of 1986. Among males, significant excess total mortality was observed (Standardized Mortality Ratio = 1.7); similar trends were observed among females. Age-related excess mortality and excess mortality by cause were strikingly similar to mortality patterns observed among alcoholics.

Accidents, Traffic↗
PubMed1992

Preserving humanity in an age of technology.

Preserving humanity in the present technological age can be a challenge for all health care workers, but perhaps particularly for staff working within an intensive care environment. This article highlights some of the potential effects of such technology on staff, patients and relatives, particularly bringing to light some of the disadvantages brought about by the use of such technology. Areas considered include the role of nurses within a technological environment, patients' and relatives' reactions to technology, the potential effect on autonomy and responsibility for both patients and nurses, economic issues, and finally ethical and moral issues raised by the advent of further technology. Despite many positive contributions to nursing care which arise from the use of technology, there are disadvantages attributed to technology which have only been mentioned superficially in previous literature on this subject. The question arises as to whether nurses are able to balance preserving the humanity of patients with the extensive use of technology in an intensive care environment today.

Humanism↗
PubMed1991

Sentence severity and the drinking driver: relationships with traffic safety outcome.

While a major response to the drinking-driving problem has been to increase penalties for drinking-driving offences, the impact of sentence severity on the driving behaviour of offenders (specific deterrence) remains unclear. In this research, relationships between aspects of sentence severity (license suspension, fine, jail term, assignment to probation, or temporary absence programmes) and postconviction accidents and drinking-driving convictions were examined, while controlling statistically for demographic and previous driving record factors. License suspensions were consistently associated with traffic safety benefits. However, increasing severity of other aspects of punishment seemed unrelated to outcome or was associated with increased traffic safety problems. As well, important differences between first, second, and multiple offenders were observed, which may be related to the impact of different aspects of sentence severity on driving behaviour.

Accidents, Traffic↗
PubMed1991

Factors in recent reductions in liver cirrhosis deaths.

Since the mid-1970s, there have been substantial declines in liver cirrhosis deaths in many Western countries following a long period of increases. There is variability in the pattern of changes observed: in a sample of 29 countries between 1974 and 1982-83, seven countries showed a significant linear decline, three revealed a curvilinear pattern, increases were observed in six and the rest (13) showed no notable changes. Although reductions in per capita consumption of alcohol may be a contributing factor, these reductions do not seem to account for all of the decreases in cirrhosis deaths that have been observed. Among other factors that might contribute, changes or increases in treatment for alcohol abuse and AA membership have been most strongly linked to these declines; changes in patterns of consumption, dietary habits, prevention efforts and reduced exposure to predisposing factors may also be involved. In view of the importance of these declines for the understanding and prevention of alcohol problems, further research on this issue, perhaps involving international collaborative studies, is needed.

Alcoholism↗
PubMed1991

Reductions in cirrhosis deaths in the United States: associations with per capita consumption and AA membership.

Cirrhosis mortality and morbidity rates have declined in many jurisdictions, including the U.S., in recent years. Previous research in Canada and Europe suggests that these declines are linked to changes in per capita consumption of alcohol and changes in the availability and/or utilization of services to reduce abusive drinking (e.g., treatment, Alcoholics Anonymous). In this study, changes in cirrhosis death rates in the 50 U.S. states and the District of Columbia between 1974 and 1983 were regressed onto changes in per capita consumption (1974-83). AA membership (1974-83) and alcoholism treatment (1979-82). No significant relationship between treatment and cirrhosis changes was observed; however, the measure of change in treatment may not reflect the full extent of changes that occurred in the 1974-83 period. As predicted, decreases in per capita consumption and increases in AA membership were significantly associated with decreases in cirrhosis rates.

Alcohol Drinking↗
PubMed1990

Are increases in treatment levels and Alcoholics Anonymous membership large enough to reduce liver cirrhosis rates?

Recent reductions in liver cirrhosis morbidity and mortality rates have been noted in many Western countries. We have previously observed that these declines are associated with increases in treatment for alcohol abuse over regions of Ontario, and increases in Alcoholics Anonymous (AA) membership over American states. One important question is whether the potential impact of treatment and AA membership increases could be large enough to have an impact on population cirrhosis rates. We explore this issue using estimates of the effects of treatment and AA membership, and of the likelihood of alcohol abusers developing cirrhosis, derived from the research literature. The results suggest that increases in treatment and AA membership could indeed have made important contributions to declines in cirrhosis mortality and morbidity in Ontario (1975-82) and the USA (1979-82).

Alcoholics Anonymous↗