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Biomedical subjects

J J Bergman

Publications and source records attributed to J J Bergman.

52 records · Page 3Linked to original sources
PubMed1984

Measuring functional impairment associated with pain: psychometric analysis of an exploratory scoring protocol for activity pattern indicators.

Behavioral science theorists who study pain have advocated the development of measures designed to assess aspects of behavior. Recently, Diller , Fordyce , Jacobs, and Brown developed a 64-item self-report activity measure. Assessment of functional impairment associated with pain is a potentially appropriate application for the Activity Pattern Indicators (API). The API provides a description of actual functioning; frequency of behavior is the unit of measurement. Currently, no agreed upon scoring protocol is available for this measure. We propose to design, in accordance with measurement theory, a psychometrically sound yet practical scoring protocol. The API data presented allow an acceptable degree of reliability and sensitivity to group differences. Results of the present study support continued psychometric exploration of: the current scoring protocol, alternative scoring protocols, and the Activity Pattern Indicators.

Activities of Daily Living↗
PubMed1983

How useful are symptoms in the diagnosis of Candida vaginitis?

Two hundred four female subjects symptomatic and asymptomatic for genitourinary disease were evaluated for Candida vaginitis. All were questioned regarding the presence or absence of a variety of symptoms related to the genitourinary system, including vaginal discharge, its color, if present, pruritus, dysuria, and the like. Additionally, all subjects were cultured for Candida by use of Sabouraud agar. Thirty-six subjects demonstrated cultures positive for Candida. Of 36 totally asymptomatic subjects, 4 had positive cultures, yielding a prevalence (18 percent) and asymptomatic positive rate (11 percent) consistent with those reported in the literature. All genitourinary symptoms individually and in combinations proved to be very poor predictors of the presence of Candida on culture. The study concludes that the diagnosis of Candida vaginitis cannot be made based on symptoms alone. A suggestion describing the office workup of Candida vaginitis is presented.

Adolescent↗
PubMed1983

Breast self-examination: historical perspective and current progress.

During its 30 years as an examination technique, breast self-examination (BSE) has developed from an idea proposed by a chapter of the American Cancer Society to a standard recommendation of many health care professionals. While screening for breast carcinoma has been documented as a valuable undertaking, a majority of the studies are concerned with physician examination and the use of xeromammography. BSE as an individual factor has not been adequately studied. Since several studies propose that BSE is indeed effective, while others refute that contention, the results of well-controlled prospective studies are needed. The current literature is at least supportive of BSE, which should be encouraged while controlled trials are analyzed.

Breast Neoplasms↗
PubMed1982

A seed money grant program for family medicine research.

It appears that the seed money allocation process instituted by the University of Washington Department of Family Medicine one year ago has facilitated the launching of several pilot studies by removing small but significant financial barriers. Expressions of concern about the equitable allocation of departmental resources for research have abated, and energies have focused increasingly on how to do research and less on how to fund it. The funds and in-kind resources allocated have helped promote collaboration between community practitioners and academic researchers. The seed money program has assisted relatively inexperienced researchers to obtain valuable research experience which will make future applications for external grant support more credible and competitive.

Academic Medical Centers↗
PubMed1982

Outpatient termination of pregnancy: experience in a family practice residency.

At the University of Washington Family Medicine Clinic, termination of pregnancy procedures were performed on 260 patients. Their records were reviewed, and an analysis was completed on demographic data, technical procedure parameters, and complication rates during and following the procedure. The majority of patients were not primigravida. Fifteen percent were between six and eight weeks of gestation. Following the procedure, 3.8 percent had excessive bleeding, and 2.7 percent developed endometritis at rates comparable to those found in the obstetrics and gynecology literature. No known perforations occurred. Outpatient termination of pregnancy performed on selected patients in a family practice setting can be a procedure of low morbidity.

Abortion, Induced↗
PubMed1982

Physician knowledge of sodium content of common foods.

Knowledge of sodium content of common foods was secured from 49 physicians attending a family practice review course, 91 persons attending a health sciences open house, and 6 dieticians. Although physicians reported they commonly provide advice on sodium restriction, their scores (mean, 6.4 of 14 correct) were comparable to those of the general public (6.0). As expected, the dieticians' score (10.3) was higher. No difference in physician score with years of practice experience was detected. Several actions to remedy this apparent deficiency in physician knowledge are suggested.

Diet, Sodium-Restricted↗
PubMed1982

After-hours calls: a five-year longitudinal study in a family practice group.

The provision of health care outside of regular hours is one of the major challenges in any primary care practice and an important focus of residency teaching in family medicine. In this study were studied the volume and pattern of after-hours calls in a residency based group family practice at the end of the first and fifth year of the practice's existence. During the five-year study interval, the number of registered patients in the practice tripled, whereas the number of scheduled patient visits doubled. After-hours phone calls increased 40 percent, visits 70 percent, and hospitalizations 50 percent. The distribution of calls during the week remained stable over the five-year period, and the problems prompting the calls changed little except for an increase in traumatic injuries and obstetrics, paralleling changes in the services offered by the practice. After-hours utilization decreased as a function of practice volume, suggesting that practice maturation decreases unscheduled demand for medical care. The burden of after-hours calls increased, however, because of the absolute growth in practice size. Residents handled the vast majority of the calls without consultation in both time periods. The rates and patterns of after-hours utilization are strikingly similar to those reported in other studies.

Academic Medical Centers↗
PubMed1981

Wrist and digital nerve blocks.

Wrist and digital nerve blocks are useful for the management of many common problems of the hands and fingers, including fractures, lacerations, and infections requiring drainage. The principal nerves in the wrist (radial, median, and ulnar), and the digital nerves in the hand or fingers are anatomically superficial. They can be easily located and are accessible for percutaneous injection of anesthetic agents such as lidocaine (Xylocaine), bupivacaine (Marcaine), and mepivacaine (Carbocaine). Careful selection of the anesthetic agent and type of nerve block can provides safe and effective anesthesia for many surgical procedures of the hands and fingers.

Anesthetics, Local↗
PubMed1980

The use of drugs for unlabeled indications.

A chart review of 500 drug uses during a three-month period in a family practice clinic showed that 46 (9.2%) were for indications not included in the Food and Drug Administration-approved labeling. Dipyridamole was the drug most frequently and consistently prescribed for unlabeled indications. On no occasion did the chart show that patients were informed that a drug was being prescribed for an unlabeled indication. Unlabeled indications most frequently encountered in the chart review were also frequently mistaken by family practice residents and faculty responding to a questionnaire as being included in FDA-approved labeling. The indications as listed in the manufacturers' literature (eg, package insert, Physician's Desk Reference) often do not reflect how drugs are used in clinical practice.

Drug Evaluation↗
PubMed1980

An updated protocol for pediatric health screening.

Pediatric health screening comprises a significant component of a family physician's practice. A variety of protocols exist for pediatric screening yet many of the diseases included in such screening have marginal supportive evidence in the literature. This article examines 14 areas commonly included in pediatric health screening. Each is evaluated based on a thorough literature review, according to basic criteria necessary to justify periodic screening. Specific recommendations are made which are considered to be practical and appropriate in practice. These have been incorporated into the protocols currently used at the University of Washington Family Medical Center.

Adolescent↗
PubMed1979

Appendicitis associated with recent barium study.

There have been several reports of "barium-induced" appendicitis in the literature. When confronted with a possible case of this phenomenon, a review of the literature on the subject was carried out. The suggestion is made that there is no evidence to support a cause-effect relationship between barium retained in the appendix and appendicitis. Diseased appendices can be marked by retained barium and a higher likelihood may then exist for the subsequent development of appendicitis. Following the finding of prolonged retention of barium after contrast study, it is recommended that the patient be instructed as to the possibility of developing symptoms of acute appendicitis. Patients who present with symptoms of appendicitis should be questioned as to history of recent barium study, and x-rays should be reviewed with the possibility of finding appendoliths.

Adult↗
PubMed1979

Failed appointments: a review.

Failed appointments disrupt office operations. Most studies involved hospital clinics with low socioeconomic populations, which have shown fail rates between 19 and 28 percent. Family practice centers report fail rates which vary from 5 to 11 percent. Young adults, adults with young children, and patients in low socioeconomics groups tend to increase the fail rate. Sex and race are probably not a factor. Reasons for failing appointments include communication problems, the absence of a sense of urgency for keeping the appointment, and the lack of a personal physician. An interval greater than two weeks between appointment scheduling and the appointment date places patients most at risk for failing the appointment. Mail and telephone reminders significantly reduced the fail rate and are cost efficient. Incentives are also used in reducing the fail rate. By examining the process, the patients, the provider, and the environment with respect to appointment keeping behavior, a more quantitative approach to research on the subject can be effected.

Ambulatory Care↗
PubMed1978

Chronic pain: a review for the family physician.

The challenge of effective management of chronic pain frequently confronts the family physician. Successful management relies on the physician's skill in integrating fundamental concepts in the pathophysiology, psychodynamics, and diagnostic and therapeutic modalities associated with chronic pain syndromes. The use of time-contingent rather than pain-contingent therapy in the prevention of the chronic pain state is advocated.

Anxiety↗
PubMedDate not supplied

The locum tenens experience: a comparison with a university faculty practice.

A locum tenens experience may be an effective mechanism by which the academic family physician can periodically enhance his or her clinical skills. This report compares the content of one of the author's locum tenens sessions to that of his university based practice. The locums resulted in an exposure to a concentrated, wide-spectrum practice highlighted by acute medical and surgical problems--in comparison with a more continuity-oriented university profile. Academic family physicians who realize high levels of nonclinical obligations may find the routine scheduling of a locum tenens rotation a valuable clinical adjunct.

Clinical Competence↗