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R E Mann

Publications and source records attributed to R E Mann.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1990

Changes in suicide rates after reductions in alcohol consumption and problems in Ontario, 1975-1983.

In this paper the relationships among suicide rates in Ontario for males, females and the total population, alcohol consumption, and other alcohol-related problems are examined for the period 1963-1983. Suicide rates, like other alcohol-related problems, were strongly correlated with per capita consumption over the total period. However, during the recent period of stabilization in consumption (1975-83), the correlations were markedly reduced and substantial differences in trends for males and females were observed. The contribution to these diverging trends of such factors as increased treatment of alcohol abuse, rising unemployment, and reduced use of tranquilizing drugs is discussed.

Adult↗
PubMed1989

"Cravings" are ambiguous: ask about urges or desires.

Despite the dictionary definition of "craving" (a strong desire), two studies indicate that a substantial percentage of persons with alcohol and drug problems use the word "craving" to mean any desire or urge, even a weak one, to use substances. Researchers and clinicians are advised to beware of this ambiguity of "craving" and to consider the conceptual status of "craving" in their work.

Adult↗
PubMed1989

Decreases in alcohol problems and increased Alcoholics Anonymous membership.

In this study, the impact of changes in rates of Alcoholics Anonymous (AA) membership and per capita consumption of alcohol on changes in rates of cirrhosis, drinking-driving charges and liquor act charges are examined for the 10 provinces of Canada over the period 1974-1983. Neither measure was significantly related to changes in cirrhosis rates. However, AA membership and consumption changes were associated, in an interactive manner, with changes in drinking-driving and liquor act charges.

Alcoholics Anonymous↗
PubMed1988

The relationship between alcohol-related traffic fatalities and per capita consumption of alcohol, Ontario, 1957-1983.

In this research, the impact of per capita consumption of alcohol on alcohol-related traffic fatalities in Ontario between 1957 and 1983 was examined. Three measures of alcohol involvement were selected. The first, drinking drivers (police reported) involved in fatal accidents, was a direct measure. The second and third, single-vehicle fatal accidents and nighttime fatal accidents, were surrogate measures. Also, three corresponding measures of fatal accidents not involving alcohol (normal drivers [police reported] involved in fatal accidents, multiple vehicle fatal accidents, and daytime fatal accidents) were chosen to control for general road safety trends. The results of regression analyses indicated that both per capita consumption and general road safety trends were significant contributors to all three measures of alcohol-involved fatalities. These and other recent data suggest that any effort to prevent alcohol-related problems such as liver cirrhosis through control of per capita consumption will also have a beneficial impact on alcohol-related accidents.

Accidents, Traffic↗
PubMed1988

Cognitions and alcohol-influenced performance: the impact of reinforcement contingencies.

The effects of different reinforcement conditions on self-reported cognitions and task performance under the influence of alcohol were examined. Four groups of male university students attended a series of four drinking sessions. During the sessions, the groups performed a visual tracking task under different reinforcement conditions which influence the speed of acquisition of behavioural tolerance to the impairing effects of alcohol. At the end of each session, subjects completed a questionnaire intended to elicit any thoughts, feelings, ideas or images they experienced during the session. Their responses were scored in categories related to alcohol effects, task performance and motivation. The groups differed significantly on numbers of self-reported cognitions related to general alcohol effects and to alcohol effects on task performance; these differences corresponded to differences in the speed of tolerance development. In the group that acquired tolerance most rapidly, several aspects of task performance were significantly correlated with cognitions. These data provide support for the suggestion that cognitive activity may be an important factor in individuals' responses to alcohol and other drugs.

Adult↗
PubMed1988

Reductions in liver cirrhosis mortality and morbidity in Canada: demographic differences and possible explanations.

In Canada, deaths from liver cirrhosis have declined by about 25% since 1974. To gain further insight into the nature of this decline, mortality rates for the years 1974-1984 and morbidity (hospital separation) rates for the years 1974-1980 were examined by age and sex and by province and sex. As well, survey data on drinking practices in Ontario were analyzed. Both mortality and morbidity declined over the time period involved, although variations over provinces, age groups, and sex were observed. The pattern of variations (largest declines in provinces with highest per capita alcohol consumption and in young to middle-aged males) strongly suggests decreased incidence of alcoholic liver cirrhosis. Among the factors which may be contributing to these declines are: the stabilization and small decreases in per capita consumption of alcohol; consumption pattern changes consistent with observed mortality and morbidity changes; expanded health promotion activities; and increases in the numbers of alcoholics receiving treatment.

Adolescent↗