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Biomedical subjects

M Bergner

Publications and source records attributed to M Bergner.

At least 37 records · Page 2Linked to original sources
PubMed1988

The cost and efficacy of home care for patients with chronic lung disease.

A randomized controlled trial was conducted to assess efficacy and cost of sustained home nursing care for patients with chronic lung disease. Three hundred one patients were randomly assigned to a respiratory home care group (RHC) that received care from respiratory home care nurses, a standard home care group (SHC) that received care from regular home care nurses, or an office care group (OC) that received whatever care they needed except for home care. Patients were followed for 1 year. At the end of the study year, there was no difference in survival, pulmonary function, or everyday functioning among the three groups. Average annual cost of care for all study patients was $7,647 (1981-82 dollars). The average annual health care costs for patients in the RHC group was $9,768; for those in the SHC group, $8,058; and for those in the OC group, $5,051 (F = 6.45, df = 2/298, P = 0.02). These results suggest that the current policy of limited coverage of home nursing services by Medicare and other third-party payers may be appropriate.

Activities of Daily Living↗
PubMed1988

Vasomotor tone of isolated porcine coronary veins in response to acetylcholine, noradrenaline, and histamine.

The reactivity of isolated porcine coronary venous segments to acetylcholine, noradrenaline, and histamine was tested in organ bath experiments. Acetylcholine dilated precontracted venous preparations endothelium-dependently. This relaxation was inhibited by atropine indicating the muscarinic nature of this response. Noradrenaline contracted the vessels by an alpha-adrenergic mechanism, whereas beta-receptor-induced dilatation could not be seen. Histamine induced contraction of porcine venous preparations via H1-receptors. These results suggest that the coronary venous system is involved in the regulation of the coronary blood flow in addition to metabolic mechanisms and to nervous influences on the arterial side.

Acetylcholine↗
PubMed1987

The prevalence of pain in four cancers.

Although pain is widely recognized as a major problem in cancer patients, most studies have concentrated on pain among those with advanced or terminal cancer in specialized treatment settings. The study reported here gives a more complete picture of the problem of pain among cancer patients by providing data generalizable to those in early as well as late stages of the disease, and receiving care in the community as well as specialized treatment centers. Having included measures of several distinct features of pain, this study also provides a more complete understanding of the cancer patient's day-to-day pain problem than earlier investigations. The findings presented here indicate that serious pain may occur in all cancer stages, and often represents an ongoing medical problem. The data suggest that many patients may benefit from earlier and more aggressive use of available antipain treatment methods.

Analgesics↗
PubMed1987

The influence of selected urinary constituents on the adhesion process of Escherichia coli to human uroepithelial cells.

In the pathogenesis of infectious diseases, great importance is attached to the problem of adhesion of bacteria to cells. In 100 urine specimens from normal test persons, patients with infections of the lower urinary tract, with chronic pyelonephritis and glomerulonephritis were studied. The adhesion of strains of Escherichia coli to human uroepithelial cells depended on the concentration of single urinary factors. While increased concentrations of urea and creatinine favored the adhesion process, a statistically significant negative influence was found with regard to potassium, immunoglobulins and pH value. Considering the multifactorial effects of the urinary constituents, we found in a multivariate comparison that none of the studied physiological features alone exerts a fundamental influence upon adhesion, but in their entirety they determine the environmental conditions for the adhesion of bacteria to cells in the urine.

Adult↗
PubMed1987

[Filling behavior of pneumatically driven artificial ventricles of the membrane type in vitro].

The filling behaviour of pneumatically driven artificial hearts is an essential determinant of its pumping function. The artificial ventricles developed in Rostock were investigated by means of a hydraulic circulation model for analysis of the influence of different parameters on the filling time. The filling rate is decided by the flow resistance of the inlet valve. Additional resistances are given by the rigidity of the membrane and the flow resistances of the drive line and the drive.

Heart, Artificial↗
PubMed1986

Cost and outcome of care for patients with chronic obstructive lung disease. Analysis by physician specialty.

We studied the effect of physician specialization and board certification on costs and outcome of health care for a group of 213 patients with chronic lung disease followed prospectively for a year. Linear, semilogarithmic, and logistic regressions were used to control for differences in pulmonary function, functional ability, and sociodemographic characteristics. The cost of health services during the year was estimated from the total charges incurred. Patient's pulmonary function, functional ability, number of medical conditions, and insurance status were significant predictors of total cost. Combinations of these variables were important determinants of institutional days, outcome health status, and survival. Physician specialization and board certification were not significant descriptors of total costs or outcomes, although large variances limited the power of these findings. We conclude that differences in characteristics of primary care physicians do not appear to affect significantly the total cost or outcome of care for patients with moderate to severe chronic lung disease.

Aged↗
PubMed1986

Development of a measure of job satisfaction for dentists and dental auxiliaries.

This paper describes the development of a multidimensional, 38-item measure of job satisfaction appropriate for dentists, dental hygienists, and dental assistants. Items were grouped into the following 12 subscales: income, recognition, opportunity to develop professionally, time to develop professionally, responsibility, non-patient tasks, staff relations, quality of care, leisure time, fatigue, time pressure and general satisfaction. The measure was developed from a set of 45 items included in questionnaires administered to dentists and staff of 126 dental practices in Washington State, USA. Questionnaires were returned by 117, 121 and 106 dentists; 69, 80, and 82 hygienists; and 322, 329, and 320 assistants, respectively, in each of the 3 yr (1979, 1980, 1981). Factor analysis (principal components analysis with varimax rotation) plus categorization of items by a panel of professionals were used to initially group items into subscales. Contribution to internal consistency was the final criterion for an item's inclusion in a subscale. Internal consistency reliability of subscales ranged from 0.68 to 0.95. Statistically significant relationships were found between individual job satisfaction subscales and intent to change job for hygienists and assistants.

Dental Assistants↗
PubMed1985

Development and validation of a measure of dental patient satisfaction.

As part of the Washington State Dental Auxiliaries Project, a 42-item measure of patient satisfaction with dental care was developed. The measure is comprised of 13 subscales: dentist-patient relations, technical quality of care, access, patient waiting time, cost, facilities, availability, continuity, pain, auxiliaries performing expanded duties, staff-patient relations, staff technical quality of care, and office atmosphere. The measure was developed from a set of 52 items included in a questionnaire administered to the patients of private dental practices in Washington state. Usable questionnaires were returned by 30.8% of patients receiving questionnaires in 1979, 40.1% in 1980, and 34.0% in 1981. Factor analysis plus categorization of items by a panel of professionals were used initially to group items into subscales. Contribution to internal consistency was the final criterion for an item's inclusion in a subscale. Internal consistency of subscales ranged from 0.44 to 0.80. The concurrent validity of subscales was assessed by relating patient satisfaction to characteristics of the dental practices. The following statistically significant relationships between subscales and criterion variables were observed: dentist-patient relations and percent of patients seen by the dentist; access and number of weeks appointments must be booked in advance; patient waiting time and actual patient waiting time; continuity of care and percent of patients seen by the dentist; auxiliaries performing expanded duties and delegation to auxiliaries; and staff technical quality and percent of hygienist restorations with satisfactory quality. Each relationship was in the expected direction.

Adult↗
PubMed1985

Delegation of expanded functions to dental assistants and hygienists.

One hundred and twenty-six dental offices in Washington State kept a record of each time an expanded function was performed by the dentist, hygienist, or assistant. There were five two-week recording periods starting in February 1979 and ending in February 1981. Consistent with increasing productivity, dentists most frequently delegate tasks to dental assistants rather than dental hygienists and delegate an individual task consistently if it is delegated at all. For tasks that may be delegated to the assistant, a relationship was found between the per cent of dentists delegating an individual task and the amount of the dentist's time that is freed through delegating that task. From the perspective of quality of care, the per cent of dentists who delegate a task was inversely related to the complexity of the task.

Dental Assistants↗
PubMed1985

Health status of survivors of cardiac arrest and of myocardial infarction controls.

We interviewed 308 survivors of out-of-hospital cardiac arrest and matched controls who had suffered a myocardial infarction. The Sickness Impact Profile (SIP) scores of controls were somewhat lower (better) than those of cases, but responses of cases and controls to additional questions about stair climbing, irritability and mood were virtually identical. Half as many (18 per cent) controls as cases (38 per cent) reported poorer memory function; nevertheless, 63 per cent of cases and 79 per cent of controls who had been working outside the home at the time of the event were employed at the time of the interview.

Activities of Daily Living↗
PubMed1985

A cross-cultural comparison of health status values.

The extent to which the values attached to health states are similar in different cultures or social groups is important for understanding health and illness behaviors and for developing standardized health status measures. A cross-cultural study was conducted to compare the health status values obtained in a United States population (Seattle, Washington) with those from another English-speaking culture (London, England) on the Sickness Impact Profile, a standardized measure composed of 136 items. London judges rated the severity of dysfunction described in each item on an equal interval scale using the same methods of scaling and analysis employed in the Seattle study. A regression of English mean item values on US mean values yielded a slope of 1.00 and an intercept of -0.07, indicating that judges gave strikingly similar ratings to most items. Agreement was higher at the more severe end of the dysfunction continuum than at the least severe end, a finding consistent with the notion that what constitutes health is more difficult to define than what constitutes illness. While a universal conception of dysfunction may exist in English-speaking societies, the social and cultural determinants of health status values deserve more systematic study.

Activities of Daily Living↗
PubMed1984

Health status of survivors of out-of-hospital cardiac arrest six months later.

The health status of long-term survivors of out-of-hospital cardiac arrest was studied six months after the event. Although Sickness Impact Profile scores for arrest survivors were higher (worse) than scores of enrollees in a prepaid closed panel health plan, in most cases problems of survivors were not incapacitating. Approximately three-fifths of survivors reported same or better memory function and stair climbing ability compared to that at time of arrest. Three-fifths of those who had been working continued to do so.

Activities of Daily Living↗
PubMed1984

The effects of continuing education in dental practice management.

A representative sample of 122 Washington State general dental practices received continuing education in the efficient utilization of auxiliaries. Dentist and staff attended a two-day workshop where goals for change in delegation to auxiliaries, scheduling, and communication were developed. The continuing dental education was individualized, required the practice to set explicit goals for change, involved both the dentist and staff in the decision-making process, and included in-office follow-up and consulting. Evaluation of the course's effects demonstrated that such a course in practice management can have a positive effect on delegation to auxiliaries, practice output, and dentist income. Degree of participation varied considerably across the 113 practices that completed the continuing education. The positive results of the training were dependent upon the practice implementing the goals for organizational change that it had set. The effects of the continuing education take time to become apparent and are sequential with changes in delegation to auxiliaries occurring first and increases in volume of services and income occurring later.

Consumer Behavior↗
PubMed1983

Service factors and health status of survivors of out-of-hospital cardiac arrest.

To determine how emergency service factors affect the health status of survivors of out-of-hospital cardiac arrest, 424 survivors were studied six months later. The principal research tool was the Sickness Impact Profile (SIP), a behaviorally-based instrument for measuring sickness-related dysfunction. Time to initiation of care and time to definitive care were significantly related to dysfunction. The critical time intervals can be influenced by the manner in which communities provide emergency care.

Emergency Medical Services↗