Infant mortality: a reflection of the quality of health.
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Health Services Accessibility↗
Biomedical subjects
C S Berger
Publications and source records attributed to C S Berger.
Effect of a changing health care environment on social work leaders: obstacles and opportunities in hospital social work.
The health care system is undergoing dramatic change in auspice, structure, and services delivery in response to an emphasis on market-driven, cost-containment strategies. Consequently, many hospital social work directors either have lost some of their administrative responsibilities or have expanded their span of control beyond social work services. This article examines the responses of social work administrators to the breadth of changes occurring throughout their hospitals; the major accomplishments of social work services within their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. As a result of examining the relationship between their actual and anticipated behavior and changes in the hospital and external environment, the authors found that social work leaders in hospitals understand the complexities and challenges of the world around them. Overall, they have exhibited commitment, competence, and confidence in shaping organizational change.
Hospital Administrators↗
Managed care and its implications for social work curricula reform: policy and research initiatives.
A multitude of social, economic, and health factors are forcing the health care industry to examine the effectiveness and efficiency of health and mental health care delivery. Managed care has emerged in this environment of cost containment, as a viable distributive mechanism for the allocation of health care resources. Schools of social work must consider additions and/or revisions to their curriculum, in order to adequately prepare social workers to practice in a managed care environment. A major barrier is the negative attitude held by many practitioners and educators towards managed care. This paper discusses the evolution of managed care, and the challenges to social work education, including the necessity for developing a more balanced view of managed care. Suggested curricular revisions are provided for two major content areas: policy and research.
Attitude of Health Personnel↗
Managed care and its implications for social work curricula reform: clinical practice and field instruction.
Managed care continues to be a major focus and debate within the health care field. Regardless of whether one is for or against managed care, it has become the predominant system for distributing finite health care resources. Many academicians and practitioners point to the uncertainty about the future of health care, and the role of social workers to practice within these new environments, schools of social work will need to integrate content related to managed care. Students should be exposed to a more balanced analysis of what is advantageous and problematic with managed care. This paper offers recommendations regarding ways in which the practice and field curriculum can be strengthened to more effectively prepare social workers for practice within a managed care environment.
Case Management↗
Modelling of the dynamic relationship between arterial pressure, renal sympathetic nerve activity and renal blood flow in conscious rabbits.
A linear autoregressive/moving-average model was developed to describe the dynamic relationship between mean arterial pressure (MAP), renal sympathetic nerve activity (SNA) and renal blood flow (RBF) in conscious rabbits. The RBF and SNA to the same kidney were measured under resting conditions in a group of eight rabbits. Spectral analysis of the data sampled at 0.4 Hz showed that the low-pass bandwidth of the signal power for RBF was approximately 0. 05 Hz. An autoregressive/moving-average model with an exogenous input (ARMAX) was then derived (using the iterative Gauss-Newton algorithm provided by the MATLAB identification Toolbox), with MAP and SNA as inputs and RBF as output, to model the low-frequency fluctuations. The model step responses of RBF to changes in SNA and arterial pressure indicated an overdamped response with a settling time that was usually less than 2 s. Calculated residuals from the model indicated that 79 5 % (mean s.d., averaged over eight independent experiments) of the variation in RBF could be accounted for by the variations in arterial pressure and SNA. Two additional single-input models for each of the inputs were similarly obtained and showed conclusively that changes in RBF, in the conscious resting rabbit, are a function of both SNA and MAP and that the SNA signal has the predominant effect. These results indicate a strong reliance on SNA for the dynamic regulation of RBF. Such information is likely to be important in understanding the diminished renal function that occurs in a variety of disease conditions in which overactivity of the sympathetic nervous system occurs.
Algorithms↗
The changing scene of social work in hospitals: a report of a national study by the Society for Social Work Administrators in Health Care and NASW.
The Society for Social Work Administrators in Health Care and NASW collaborated on a national study of the changes affecting social work services in a sample of 340 hospitals drawn from the member list of the American Hospital Association. The findings suggest that the changes affecting social work need to be viewed within the context of the dramatic changes occurring in the hospital and health care field. Although social work departments are experiencing decreases, these decreases often are not occurring at the same rate as those within the hospital overall. Growth is occurring in the types and scope of services. Social work is not being singled out for change, but it is critical that these trends continue to be monitored and proactive strategies used to enhance social work viability within a changing hospital environment.
Administrative Personnel↗
Review of chromosome studies in urological tumors. II. Cytogenetics and molecular genetics of bladder cancer.
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Chromosome Aberrations↗
Identification of masked and variant Ph (complex type) translocations in CML and classic Ph in AML and ALL by fluorescence in situ hybridization with the use of bcr/abl cosmid probes.
In the present study, three chronic myelogenous leukemia (CML) patients with variant Philadelphia (Ph) chromosomes (complex types), two CML patients with a masked Ph, one case with Ph positive acute lymphocytic leukemia (ALL), and one with Ph positive acute myelocytic leukemia (AML) were analyzed by standard cytogenetic techniques (G-banding), Southern blot studies, and fluorescence in situ hybridization (FISH) procedures using probes from portions of the bcr and abl genes. It has been previously shown that this FISH approach could detect the bcr/abl fusion event in CML patients with classic or variant (simple type) Ph. Our results demonstrate that this FISH assay can also detect the bcr/abl fusion status in CML patients with masked or variant (complex type) Ph chromosomes and in some patients with Ph positive ALL or AML.
Adult↗
Presence of telomeric sequences on deleted chromosomes and their absence on double minutes in cell line HL-60.
The issue of telomeric sequences on deleted chromosomes and double minutes (dmin) was investigated by examining the cell line HL-60 with fluorescence in situ hybridization using a human plasmid DNA sequence with 800 bp TTAGGG repeats. This cell line showed telomeric sequences on the deleted short arms of chromosomes 9 and 10, with the results suggesting that so-called terminal deletion may be, in fact, an interstitial deletion, or that telomeric sequences may be synthesized by telomerase after deletion. On the other hand, numerous dmin showed no evidence of hybridization with the telomeric probe. This suggests that the characteristics unequal distribution of dmin during mitosis may result from the lack of not only centromeres but also telomeres.
Chromosome Deletion↗
Application of fluorescence in situ hybridization in hematological disorders.
In the present study, chromosome changes in bone marrow (BM) or peripheral blood (PB) cells from 13 patients with malignant hematologic disorders were analyzed by classical cytogenetic techniques (G-banding) and fluorescence in situ hybridization (FISH) procedures using centromere specific probes for chromosomes 1, 6, 7, 8, 9, 12, 18, 13/21, and X, and a DNA probe specific for the long arm of chromosome Y. The cytogenetic data obtained with G-banding were in accord with those obtained by FISH to metaphase chromosomes. Most significantly, FISH to interphase nuclei offered reliable results and in some cases provided important information concerning crucial chromosome anomalies which were not or could not be completely detected by analyzing metaphase chromosomes. Our results indicate that FISH could be clinically valuable in five major areas: 1) marker chromosome identification; 2) identification of trisomy consistent with certain specific hematological neoplasms; 3) clonal evaluation post observation of a single cell with trisomy; 4) clonal evaluation post-sex-mismatched bone marrow transplantation (BMT); and 5) residual disease detection following clinical remission.
Adolescent↗
Analysis of a giant marker chromosome in a well-differentiated liposarcoma using cytogenetics and fluorescence in situ hybridization.
Well-differentiated liposarcomas (LPS) are cytogenetically very complex, characterized by giant marker chromosomes, ring chromosomes, and telomeric associations. We report a case of well-differentiated LPS in which the only cytogenetic anomaly was an additional giant marker. In an attempt to identify the origin of this marker, centromeric probes (chosen on the basis of the morphology of the marker) to chromosomes 1,2,3,4,6,7,8,9,10,11,12,16,17, and X and a shared satellite probe for chromosomes 1,5, and 19, were used with fluorescence in situ hybridization (FISH). This was successful at eliminating certain chromosomes as candidates for centromeric trisomy but could not identify the origin of the marker. This case is unusual in that it does not conform to the typical cytogenetic pattern for well-differentiated LPS and is the first known example with an apparently normal diploid karyotype with only one additional change.
Aged↗
Ring chromosome in a dermatofibrosarcoma protuberans.
We report the cytogenetic findings in a case of dermatofibrosarcoma protuberans in a 40-year-old male. Chromosome analysis revealed one clone consisting of +7, +11, +13, +14, +15, and a ring chromosome. This is consistent with two previously reported cases, each of which also had a single ring chromosome.
Adult↗
Cytogenetic and FISH studies of abnormal X chromosomes in a patient with ANLL.
We report a case of idic(X)(q13),r(X)(p22q13), and del(X)(:p11-->cen-->q11:) in a 71-year-old female patient with de novo acute nonlymphocytic leukemia (ANLL), FAB-M4. The abnormal X chromosomes of this patient were identified cytogenetically by G-banding technique and were further confirmed by fluorescence in situ hybridization (FISH) using an alpha-satellite probe to chromosome X centromere. The features of this are compared with other cases reported in the literature.
Aged↗
Cluster of trisomy 12 to tumors of the female genitourinary tract.
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Chromosomes, Human, Pair 12↗
Detection of monosomy in interphase nuclei and identification of marker chromosomes using biotinylated alpha-satellite DNA probes.
Nonradioactive in situ hybridization with chromosome-specific highly repetitive DNA probes is a fast and easy method for the detection of the number of chromosome copies in nonmitotic cells. In this study, we report the use of four biotinylated probes of the human alpha-satellite family recognizing the (peri)centromeric regions of chromosomes 3, 10, 16, and 17. The reliability of the probes was tested by hybridizations to metaphase chromosomes and interphase nuclei of normal blood lymphocytes, which showed a two signal score in 85%-94% and 82%-86% of the cells, respectively. In situ hybridization experiments with nuclei and metaphase spreads derived from the LXFS-650 cell line indicated monosomy for chromosomes 10 and 16 and the presence of two derivative chromosomes 17. These results were in accordance with the cytogenetic data obtained with GTG-banding and confirmed the monoclonality of the cell line. Furthermore, with this method the origin of an unclassified marker chromosome could be identified as a derivative of chromosome 3. Our results show that fluorescence in situ hybridization can be a useful tool in cancer cytogenetics for the detection of numerical aberrations in interphase nuclei and for the classification of marker chromosomes in addition to conventional cytogenetic techniques.
Biotin↗
Nonrandom cytogenetic changes in leiomyomas of the female genitourinary tract. A report of 35 cases.
Cytogenetic analysis of short-term cultures from 35 leiomyomas of the female genitourinary tract showed abnormal karyotypes in 14 cases. In 11 of 14 aberrant tumors, normal cells were also observed. Structural changes were most frequent, resulting in modal chromosome numbers in the diploid range. Our data confirm preferential breakpoint clusters at 7q, 12q14-15, and 14q23-24, mainly resulting from consistent, specific chromosome rearrangements such as t(12;14)(q14-15;q23-24) and del(7)(q21) or del(7)(q22q32). Together with previously published cases, we describe trisomy 12, ring chromosomes, and monosomy 22 as new additional recurrent findings in myomas. Statistical analyses of possible coherencies between tumor karyotype (abnormal versus normal) and clinicopathologic data, as well as age of the patients, menopausal status, and tumor size showed no correlations.
Adult↗
Cytogenetic findings in nine leiomyomas of the uterus.
Chromosomal analysis of nine benign leiomyomas of the uterus after short-term culture showed karyotypic abnormalities in four cases. All four exhibited multiple chromosome changes, including three cases characterized by complex chromosome rearrangements involving a number of chromosomes. Among others, these rearrangements included a translocation between chromosomes 12 and 14 in one case, a deletion of chromosome 7q in two cases, and both del(7q) and a complex translocation involving chromosomes 12 and 14 in another case. These results confirm the involvement of chromosomes 7, 12, and 14 in leiomyomas and indicate that benign tumors can also be characterized by complex cytogenetic changes.
Adult↗
Rearrangement of band 10q22 in leiomyoma and leiomyosarcoma of the uterus.
Cytogenetic analysis of a uterine leiomyoma from a 56-year-old woman revealed an interstitial deletion of chromosome 10, del(10)(q22q24), as the only chromosomal abnormality. Band 10q22 was also rearranged in a previously reported leiomyosarcoma of the uterus showing a t(10;17)(q22.1;p13) as the only change. These findings provide an additional example in soft tissue tumors for involvement of the same chromosomal regions in benign and malignant proliferation of cells from the same lineage.
Chromosome Banding↗