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Biomedical subjects

L Mann

Publications and source records attributed to L Mann.

At least 19 recordsLinked to original sources
PubMed2004

Hypofrontality in schizophrenia: a meta-analysis of functional imaging studies.

OBJECTIVE: Hypofrontality is not a well-replicated finding in schizophrenia either at rest or under conditions of task activation. METHOD: Studies comparing whole brain and frontal blood flow/metabolism in schizophrenic patients and normal controls were pooled. Voxel-based studies were also combined to examine the pattern of prefrontal activation in schizophrenia. RESULTS: Whole brain flow/metabolism was reduced in schizophrenia to only a small extent. Resting and activation frontal flow/metabolism were both reduced with a medium effect size. Duration of illness significantly moderated resting hypofrontality, but the moderating effects of neuroleptic treatment were consistent with an influence on global flow/metabolism only. Pooling of voxel-based studies did not suggest an abnormal pattern of activation in schizophrenia. CONCLUSION: Meta-analysis supports resting hypofrontality in schizophrenia. Task-activated hypofrontality is also supported, but there is little from voxel-based studies to suggest that this is associated with an altered pattern of regional functional architecture.

Frontal Lobe↗
PubMed2001

Designing a consumer friendly practice.

BACKGROUND: With the threat of corporate practice looming, smaller private general practices need to define their role in order to attract patients (consumers) and doctors, to build and maintain a successful practice. OBJECTIVE: To outline various means of instituting a consumer friendly practice. DISCUSSION: Consider what consumers want. Bearing in mind these aims, build the physical aspects of your practice to respond to the needs of consumers, and develop practice activity, philosophy and culture which satisfy the desires of consumers and those of the doctors and staff who work in your practice. Creating a consumer friendly practice attracts patients, Practice Incentive Payments, and prepares for accreditation. By developing such a culture, general practitioners can build, support and maintain the practice style they prefer, even in the face of competition.

Family Practice↗
PubMed2000

The epidemiology of serious eye injuries from the United States Eye Injury Registry.

BACKGROUND: Trauma remains a major problem throughout the world. The prognosis of severe eye injuries is commonly bleak. This paper focuses on the epidemiology of eye trauma, the role of ocular epidemiology, and identification and reduction of risk factors. METHODS: An analysis of the first 8,952 patients reported with severe eye injuries, defined as those eye injuries resulting in permanent and significant (measurable and observable on routine eye examination) structural and/or functional changes to the eye, from the United States Eye Injury Registry as of 31 July 1998. RESULTS: The age of patients entered was from the 1st year of life to 103 years. Fifty-eight percent of those injured were less than 30 years of age. The male to female ratio was 4.6:1, reaching 7.4:1 in the fourth decade of life. Almost half of the injuries involved the retina, and 77% of the injured eyes required one or more surgical procedures, including a large proportion which have undergone vitreoretinal surgical procedures. CONCLUSION: Injuries remain the most serious public health problem facing developed nations. Yet, a persistent inadequacy exists both in the standardized documentation of eye injuries and in their treatment. With appropriate surgical and medical intervention, a majority of the reported injured eyes recovered functional levels of visual acuity. It appears that glasses, including prescription glasses and even non-prescription sunglasses, can offer measurable protection which results in a lower incidence of severe eye injuries to those wearing glasses.

Adolescent↗
PubMed2000

Serious fireworks-related eye injuries.

OBJECTIVE: To analyze and compare epidemiological and clinical information on serious fireworks-related eye injuries from two affiliates of the United States Eye Injury Registry. METHOD: Retrospective review. RESULTS: In the Eye Injury Registry of Alabama (EIRA) database, 185 of the 4150 injuries (4.4%) were caused by fireworks. In the Hungarian Eye Injury Registry database, only two of the 1245 cases (0.1%, p=0.000001) were fireworks-related. In the EIRA, 79% of patients were males and 87% were under 31 years. A bystander was injured in 67% of the cases, being an average of 23 feet away; 39% of bystanders had a final vision < or =19/200. No injured person wore eye protection. Bottle rockets caused 80% of the 185 injuries. Overall, 20% of eyes had <5/200 final visual acuity. Twenty-five percent of bottle rocket-injured eyes, compared to 64% of those injured by other devices, had > or =20/40 final vision (p=0. 000004). CONCLUSIONS. The rate of fireworks-related serious eye injuries has not decreased in Alabama in the last 16 years; most patients are young males. Since bystanders are at a measurable risk even at a distance of 100 feet, wearing eye protection is recommended to both bystanders and operators. Bottle rockets cause most of the injuries and the more severe ones, and should be the prime target for prevention. The benefit of a strict and enforced legislative ban on private fireworks displays is demonstrated by the much lower incidence figure in Hungary. Such a ban should be considered in other countries where fireworks-related eye injuries are common.

Adolescent↗
PubMed1998

Use of monoclonal antibodies to identify serotypes of enterovirus isolates.

Nonpoliovirus enteroviruses cause a variety of diseases that are common in young children and adults. The "gold standard" for laboratory diagnosis of enteroviruses is cell culture isolation, followed by serotype identification by neutralization assay. These procedures are time-consuming and expensive. Rapid serotype identification of enteroviruses is important in differentiating nonpoliovirus enterovirus pathogens from vaccine strain polioviruses that can be shed for some time after vaccination. In the present investigation, we evaluated a rapid method for serotype identification of enteroviruses by indirect immunofluorescence assay (IFA) using commercially available monoclonal antibodies for polioviruses, coxsackieviruses type B, and six serotypes of commonly circulating echoviruses. Of 291 isolates of enteroviruses included in the study, 95 were polioviruses and 196 were nonpoliovirus enteroviruses. Two hundred thirty-four of these (38 polioviruses and 196 nonpoliovirus enteroviruses) were consecutively grown in the laboratory over a 5-year period. IFA identified the serotypes of 74% of the consecutive isolates and 71% of all enterovirus isolates by yielding a positive staining result. The levels of agreement in the identification of the enterovirus group between IFA and neutralization tests were 92% for consecutively grown isolates and 85% for all enterovirus isolates. The sensitivity of the IFA for the detection of viruses for which specific monoclonal antibodies were applied was 73% for polioviruses, 85% for coxsackieviruses type B, and 94% for echoviruses. Specificity was near 100% for polioviruses and coxsackieviruses type B and 94% for echoviruses. We conclude that IFA can be helpful as a preliminary test for serotype identification of enteroviruses. The results are most accurate when the test identifies the isolate as a poliovirus.

Antibodies, Monoclonal↗
PubMed1997

Youth suicide.

Despite these recognised constraints, increased knowledge of individual and family health problems in Australia will enable nurses to make a valuable contribution to this important Australian public health issue. However, the use of primary care or public health approach alone cannot ensure patient or community involvement in changing the various social structures that cause certain groups to be at high risk for a particular health problem. The world today needs nurses who can diagnose community health problems and institute measures to protect, advance, and monitor the health of populations as a whole, nurses who can care for the sick or the disabled, nurses who can teach people to care for themselves. By understanding and integrating these concepts with the illness prevention/ health promotional tenets of primary health care. Australian nurses will become the future leaders in individual, family, and community health and also have a substantial impact on the problem of adolescent suicide in Australia.

Adolescent↗
PubMed1996

Anti-TNFalpha therapy improves survival and ameliorates the pathophysiologic sequelae in acute pancreatitis in the rat.

BACKGROUND: Elevated levels of tumor necrosis factor-alpha (TNFalpha) have been measured in a lethal model acute pancreatitis (AP) and may contribute to the pathophysiologic sequelae of the disease. METHODS: To determine the significance of anti-TNFalpha therapy on survival and disease manifestations in a clinically relevant model of AP, a rat model was developed using a retrograde pancreatic ductal infusion of bile. Animals were randomized to no treatment (n = 30) or treatment with anti-TNFalpha antibody 15 minutes prior to induction of AP (n = 30). Five treated and 5 untreated rats were killed at various time periods up to 72 hours to provide temporal characterization of TNFalpha activity in AP. RESULTS: A burst Of TNFalpha activity in the serum of untreated pancreatitis animals between 1 and 3 hours after induction of the disease is prevented by pretreatment with anti-TNFalpha antibody. CONCLUSIONS: These findings provide a plausible mechanism for the improvement in biochemical and histologic parameters as well as in overall survival in an experimental model of acute pancreatitis in the rat.

Acute Disease↗
PubMed1996

Inhibition of TNF alpha improves survival in an experimental model of acute pancreatitis.

The development of systemic complications in acute pancreatitis is largely responsible for the mortality associated with this disease. The systemic sequelae encountered in acute pancreatitis are similar to those occurring in patients with septic shock, a syndrome of multiple organ failure thought to be related to overproduction of inflammatory cytokines. As with sepsis, data is mounting that cytokines, particularly TNF alpha, may play a central role in acute pancreatitis and mediate the systemic sequelae of the disease. We have previously shown elevated levels of TNF alpha in the serum of animals with experimental acute pancreatitis. In this study, we use a bile-infusion model of pancreatitis in the rat to show amelioration of disease severity as well as a distinct survival advantage by TNF alpha blockade using anti-TNF alpha polyclonal antibody. These data provide strong evidence that TNF alpha is a major contributor to the morbidity and mortality from acute pancreatitis.

Acute Disease↗
PubMed1995

As good as anyone: antenatal shared care at an inner Sydney hospital.

An exploratory survey design was used to assess satisfaction with antenatal care over a two-month period of women giving birth in an inner Sydney teaching hospital. Patients received obstetric services from private obstetricians, midwives, the hospital outpatient clinic, or 'shared care' between general practitioners and the outpatient clinic or birth centre. Insurance status and demographic information were collected across all groups. Shared care patients gave reasons why they chose that model of antenatal service. Ten per cent of women in the sample received shared care. Shared care patients were equally as satisfied as those in other modes of care in all but one factor--promptness of service (in which private obstetricians received higher ratings). They also judged shared care to have the advantages of being convenient, personal, and culturally appropriate. Significantly more patients in the shared care group were born overseas and they were less likely to hold private insurance. This paper discusses the results of the current study in the context of the Australian literature, explores some issues surrounding satisfaction research, and suggests further research arising from this work.

Australia↗
PubMed1993

Coping patterns in adolescent decision making: an Israeli-Australian comparison.

The decision coping patterns of Israeli and Australian adolescents were compared in a cross-national study using two samples of 1028 Israeli and 428 Australian high-school students (age range 13.5-14.4 years). Both samples were administered a scale which measured self-reported level of confidence in decision making and tendencies to use various decision-coping patterns. Israeli adolescents scored higher than Australian adolescents on Self confidence as decision makers and Vigilance, and lower on evasive behavior in decision making (Cop out). In both samples, boys outscored girls on Self confidence as decision makers and on Complacency, and scored lower on Panicky behavior. For both samples, it was found that decision coping patterns reduce to two distinct clusters--a vigilant strategy and maladaptive strategies (panic, evasion, and complacency), evidence that decision-coping patterns have cross-cultural validity.

Adaptation, Psychological↗
PubMed1991

Decision-making competence and self-esteem: a comparison of parents and adolescents.

This study examined the relationship between parents' and adolescents' confidence and competence in making decisions. Data were obtained from a survey sample of 584 adolescents, aged 12-18 years living in Adelaide, South Australia. Data were obtained from a sample of 352 parents of the adolescents by means of a mail survey. Parents' decision-making self-esteem was related to the self-esteem of young adolescents. The relationship was stronger for males than females. There was a relationship between mothers' decision-making competence and the competence of young female adolescents. Thus, partial support was provided for modelling theory in regard to the role of parents in the socialization of decision-making skills and confidence.

Adolescent↗
PubMed1991

A metacognitive analysis of decision making in adolescence.

Samples of 43 early (CA = 13 years) and 41 middle (CA = 15 years) adolescents were compared on three categories of metacognitive knowledge as they relate to decision making--person knowledge, task knowledge and strategy knowledge. Metacognitive knowledge was assessed using a 19-item questionnaire. Consistent with our hypothesis, middle adolescents showed significantly greater metacognitive knowledge than early adolescents on all three scales. Self-reported decision making style (using the Flinders Adolescent Decision Making Questionnaire) and decision making performance on a hypothetical scenario were also measured. Middle adolescents reported a more competent decision making style than early adolescents, while group differences on the scenario were not found. Adolescents completing the scenario scored significantly higher on all measures of decision making metacognition. Significant correlations were found between metacognitive knowledge of decision making, self-reported decision making style and performance on the decision scenario task. By middle adolescence understanding of what is involved in the activity of decision making is well developed. This growth in understanding, accompanied by changes in social domains, plays a part in decision execution and style.

Adolescent↗