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Biomedical subjects

L R Bernstein

Publications and source records attributed to L R Bernstein.

At least 55 records · Page 3Linked to original sources
PubMed1989

AP1/jun function is differentially induced in promotion-sensitive and resistant JB6 cells.

Tumor promoters may bring about events that lead to neoplastic transformation by inducing specific promotion-relevant effector genes. Functional activation of the transacting transcription factor AP-1 by the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) may play an essential role in this process. Clonal genetic variants of mouse epidermal JB6 cells that are genetically susceptible (P+) or resistant (P-) to promotion of transformation by TPA were transfected with 3XTRE-CAT, a construct that has AP-1 cis-enhancer sequences attached to a reporter gene encoding chloramphenicol acetyltransferase (CAT). Transfected JB6 P+, but not P- variants, showed TPA-inducible CAT synthesis. Epidermal growth factor, another transformation promoter in JB6 cells, also caused P+ specific induction of CAT gene expression. These results demonstrate an association between induced AP-1 function and sensitivity to promotion of neoplastic transformation.

Animals↗
PubMed1989

Practice patterns, attitudes and activities of Caucasian vs. Asian University of California-San Francisco PharmD graduates.

The results of a 1982 survey of graduates of the University of California at San Francisco (UCSF) doctor of pharmacy degree program were re-analyzed to explore whether cultural differences between Asian and Caucasian PharmD graduates affected professional practice patterns, attitudes and activities. Of the 732 respondents, 408 (56 percent) were Caucasians and 262 (36 percent) were Asians. Asian females had significantly fewer years of college education before entering pharmacy school and spend significantly fewer hours in the practice of pharmacy or related activities. Caucasians had a slightly higher grade point average than Asians. The mean score on the California State Board of Pharmacy Licensure Examination did not differ between the groups. For their first position following graduation, Asians predominated in operational positions, while Caucasians held clinical positions more frequently. Thirty-eight percent of Caucasians vs. 18 percent of Asians were taking or had completed postgraduate residency or fellowship training. An analysis of current jobs revealed that Asian males had the greatest increase in clinical positions when compared to the first position. Males of both ethnicities made the greatest gains in annual salary and in management positions compared to females.

Asian↗
PubMed1988

Detection of changes in spectral shape: uniform vs. non-uniform background spectra.

In most of the previous studies [(1987) Profile Analysis: Auditory Intensity Discrimination, Oxford Univ. Press] concerning the detection of a change in spectral shape, or 'profile analysis', the listener's task was to detect an increment to a single component of an otherwise equal-amplitude, multi-component background. We wished to determine whether listeners would exhibit sensitivity to changes in spectral shape if the spectrum of the background were not flat. The results of two experiments, like those of Green and Kidd [(1983) J. Acoust. Soc. Am. 73, 1260-1265], indicate that the spectrum of the background can deviate rather substantially from 'flat' before detection of the signal becomes more difficult. In a third experiment, we investigated how the function relating the threshold of the signal to the frequency of the signal would vary as the number of components in a flat multi-component background is altered. Our results indicate that as the number of components which compose the background is reduced from 21 to 3, thresholds for increments to the middle region of the spectrum are elevated rather considerably.

Acoustics↗
PubMed1988

Survey method for post-marketing drug surveillance: a demonstration.

Distinguishing characteristics of a community survey method for post-marketing drug monitoring are described, as are results of a pilot study of the method. Representative samples of outpatients treated with tricyclic antidepressants or benzodiazepine anxiolytics were identified in a clinic or pharmacy and interviewed at baseline and specified intervals thereafter in the home or by telephone. Data were collected by lay interviewers trained to use a detailed interview schedule designed with input from experts in pharmacology, relevant clinical disciplines, and survey research. The critical validity question was the degree to which predicted outcomes for the two well-studied drug classes matched observed outcomes. The analytic design involved two contrast groups, three measurement periods, and six key symptom measures. The latter were specific to the disorder (anxiety and depression), to the medications, or to neither the disorders nor the medication (neutral symptoms). Predictions took account of degree and direction of change, as well as differences in profile levels over time. Results conformed precisely to expectations. As one component of a comprehensive system, the method provides an opportunity to examine efficacy as well as safety under conditions that are typically absent or excluded in clinical trials. Data on patterns of prescribing by physicians and use by patients are valuable by-products that are immediately relevant for professional education and product liability. Advantages and limitations of the method are discussed.

Adult↗
PubMed1987

Some physical and psychological effects produced by selective delays of the envelope of narrow bands of noise.

One can construct narrow bands of noise that contain delays of either the envelope, the phase, or the carrier separately or in combination. Delayed and undelayed noises will have identical spectra if, and only if, both the envelope and the phase undergo delays of the same magnitude. To study lateralization of these signals, an acoustic pointing task was employed in which listeners varied the interaural intensitive disparity of a narrow band of noise (the pointer) so that it matched the position of a second, experimenter-controlled stimulus (the target) which contained symmetric interaural delays of only the envelope. Targets were narrow bands of noise with center frequencies chosen at octave intervals between about 500 Hz and about 4000 Hz. The smallest bandwidth was 100 Hz and the largest was 800 Hz. For high-frequency stimuli, delays of only the envelope of a narrow band of noise appear to mediate lateralization which is greatest for bands centered near 2000 Hz. For low frequencies, delays larger than 800 microseconds were required to produce acoustic images appreciably away from the midline. These findings confirm the notion that listeners are sensitive to interaural temporal disparities in the envelopes of high-frequency, complex stimuli.

Acoustic Stimulation↗
PubMed1987

Detection of simple and complex changes of spectral shape.

In most of the previous studies (see Green, 1987) concerning the detection of a change in spectral shape, or "profile analysis," the listener's task was to detect an increment to a single component of an otherwise equal-amplitude, multicomponent background. An important theoretical issue is whether listeners' sensitivity to more complex spectral changes can be predicted from these results. In the present investigation, the sensitivity of a single group of listeners to a wide variety of simple and complex spectral changes was determined. After collecting the data, it was noted that almost all the thresholds could be predicted by a simple calculation scheme that assumed detection of a change in spectral shape occurs when the addition of the signal to the flat, multicomponent background produces a sufficient difference in level between only two regions of the spectrum. Unfortunately, this scheme, while successful for our limited set of data, fails to account for other "profile" data, namely, those obtained when the number of components is altered.

Acoustic Stimulation↗
PubMed1987

Effect of postgraduate training on the careers of University of California Pharm.D. graduates.

Graduates of the University of California at San Francisco (UCSF) doctor of pharmacy degree program were surveyed to determine the effect of postgraduate pharmacy residency or fellowship training on the professional outcomes of these graduates. In 1982, a 39-item questionnaire was sent to 1061 UCSF School of Pharmacy alumni who had graduated in the years 1970 through 1981. The survey addressed several issues, including the graduates' general attitudes toward the profession of pharmacy, their practice patterns, and their professional activities. The response rate of the survey was 72%. Of the survey respondents, 30% had completed or were currently involved in a residency or fellowship program. Both postgraduates (PGs) and non-postgraduates (NPGs) indicated an overall satisfaction with life and the pharmacy profession as a whole. A greater fraction of PGs than NPGs worked in the hospital setting and held positions with varied job components (i.e., clinical, managerial, teaching, and operational activities). First-position salaries for both groups were the same regardless of postgraduate training status. Gender, rather than postgraduate status, was the major determinant of annual changes in salary, especially among men PGs. For managers, both men PGs and men NPGs had a greater change in mean salary per year of experience than their women counterparts. Of those graduates who did not hold management positions, men had a greater change in mean salary per year of experience than women. PGs had greater involvement in professional, educational, and publication activities than NPGs, and a smaller percentage of PGs than NPGs left the profession.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1986

Lateralization of bands of noise and sinusoidally amplitude-modulated tones: effects of spectral locus and bandwidth.

Lateralization of narrow bands of noise was investigated while varying interaural temporal disparity (ITD), center frequency, and bandwidth, utilizing an acoustic pointing task. Stimuli were narrow bands of noise centered at octave intervals between 500 Hz and 4 kHz with bandwidths ranging from 50-400 Hz. In a second experiment, lateralization for bands of noise and sinusoidally amplitude-modulated (SAM) tones, whose spectral content was constrained to be no lower than 3.8 kHz, was assessed. Overall, relatively large extents of laterality were obtained from all four listeners for ITDs of low-frequency bands of noise. Increasing the bandwidth of these noises did not yield consistent changes in the extent of laterality across ITDs and listeners. Most targets centered at high frequencies were lateralized near the midline. However, three of the four listeners did exhibit rather large displacements of the intracranial image when the bandwidth of the high-frequency noises was 400 Hz or greater. Interestingly, ITDs within high-frequency SAM tones were relatively ineffective. Thus, it appears that ITDs of relatively wide-band, high-frequency stimuli can mediate rather substantial extents of laterality. However, these effects are highly listener-dependent.

Acoustic Stimulation↗
PubMed1986

Lateralization of low-frequency tones and narrow bands of noise.

It is well known and universally accepted that people's ability to use ongoing interaural temporal disparities conveyed via pure tones is limited to frequencies below 1600 Hz. We wish to determine if this limitation is the result of the constant amplitude and periodic axis-crossings which characterize pure tones. To this end, an acoustic pointing task was employed in which listeners varied the interaural intensitive difference of a 500-Hz narrow-band noise (the pointer) so that the position of its intracranial image matched that of a second, experimenter-controlled stimulus (the target). Targets were either pure tones or narrow bands of noise (50 or 100 Hz wide). The narrow bands of noise were delayed interaurally in two distinct manners: Either the entire waveform or only the carrier was delayed. In the latter case, the envelopes and phase-functions of the bands of noise were identical interaurally. This resulted in noises which resemble the pure tone case in that the interaural delay is manifested as a constant phase-shift and resemble ordinary noises in that the envelope and phase are random functions of time. Surprisingly, it appears that all three targets were lateralized virtually identically regardless of frequency or bandwidth. Apparently, the dynamically changing envelopes and phases did not affect the listeners' use of interaural temporal disparities in any discernible fashion.

Acoustic Stimulation↗
PubMed1986

Impact of decentralized pharmacokinetics consultation service.

The effects of pharmacokinetics consultation by a pharmacist on the quality of drug therapy were studied in a 500-bed teaching hospital. Data were collected retrospectively for three time periods: three months before, four months during, and three months after a period of intervention by a pharmacist with special responsibilities for pharmacokinetic monitoring of patients on a medical team. For the four-month intervention period, data were also collected for a parallel group of patients managed by another medical team that included pharmacy residents and students. Patients were included in the study if they had received either an aminoglycoside or a theophylline preparation. The preintervention, postintervention, and parallel groups were random samples of patients on the study ward, and the intervention group included all patients admitted to the pharmacist intervener's medical team who had received a drug covered by the study. Of serum drug concentration determinations (SDCDs) in the pharmacist intervention phase, 54% were appropriate, compared with 16% before intervention, 21% in the postintervention phase, and 46% in the patients of the other medical team. In the pharmacist intervention group, greater numbers of SDCDs were obtained appropriately and used appropriately in making therapeutic decisions, as evidenced by more subsequent measurements in the therapeutic range. Pharmacist intervention did not affect the number of adverse drug reactions or medical specialty consultations or the average length of stay. Decentralized pharmacokinetics services can have a positive effect on the quality of serum drug concentration determinations, dosage adjustments, and drug therapy.

Aminoglycosides↗
PubMed1985

Lateralization of low-frequency, complex waveforms: the use of envelope-based temporal disparities.

Several recent investigations suggest that listeners either cannot or do not use envelope-based interaural temporal disparities (ITDs) to lateralize low-frequency sounds [G.B. Henning, J. Acoust. Soc. Am. 68, 446-453 (1980); G.B. Henning and J. Ashton, Hear. Res. 4, 185-194 (1981); G.B. Henning, Hear. Res. 9, 153-172 (1983)]. We believe listeners in those studies may have been unable to process envelope-based ITDs principally because of the types of stimuli utilized. In this study we employed an acoustic "pointing" task in which listeners varied the interaural intensitive difference of a 500-Hz narrow-band noise (the pointer) so that it matched the intracranial position of a second, experimenter-controlled stimulus (the target). Targets were sinusoidally amplitude-modulated tones centered on 500 Hz or 1 kHz, and modulated at 25, 50, or 100 Hz. Targets were presented with either the entire waveform delayed or with only the envelope delayed. The results suggest that delays of the envelope do affect the lateral position of low-frequency targets. However, the envelope-based cues appear to interact with those provided by the dominant fine structure.

Attention↗
PubMed1985

Lateralization of sinusoidally amplitude-modulated tones: effects of spectral locus and temporal variation.

It has long been recognized that listeners are sensitive to interaural temporal disparities (ITDs) of low-frequency (i.e., below 1600 Hz) stimuli. Within the last three decades, it has often been demonstrated that listeners are also sensitive to ITDs within the envelope of high-frequency, complex stimuli. Because these studies, for the most part, employed discrimination tasks, few data exist concerning the extent of laterality produced by ITDs as a function of the spectral locus of the stimulus. To this end, we employed an acoustic "pointing" task in which listeners varied the interaural intensity difference of a 500-Hz narrow-band noise (the pointer) so that it matched the intracranial position of a second, experimenter-controlled stimulus (the target). Targets were sinusoidally amplitude-modulated tones centered on 500 Hz, 1, 2, 3, or 4 kHz and modulated at rates ranging from 50 to 800 Hz. Targets were presented with either the entire waveform delayed or with only the envelope delayed. Our results suggest that: (1) for low-frequency targets, lateralization is influenced by ITDs in the envelope but is dominated by ITDs in the fine structure; (2) for high-frequency targets, envelope-based delays produce displacements of the acoustic images which are affected greatly by the rate of modulation; rather large extents of laterality could be produced with high rates of modulation; these data are consistent with those obtained previously in discrimination experiments; (3) for low rates of modulation (e.g., 100 Hz), delays of the entire waveform (both envelope and fine structure) produce much greater displacements of the acoustic image for low-frequency than for high-frequency targets (where fine-structure-based cues are not utilizable); (4) there appear to be no consistent relations among extent of laterality, rate of modulation, and the frequency of the carrier within and across listeners.

Adult↗
PubMed1985

Impact of clinical pharmacy services on prescribing on a cardiothoracic/vascular surgical unit.

A multi-faceted approach was used to study the impact of clinical pharmacy services on the cost of drug therapy on a cardiothoracic and vascular surgical service. Physician and nursing attitudes about the usefulness and likely effect of clinical pharmacist recommendations were also assessed. A cross-sectional design with a temporal factor was used to study physician prescribing of all pharmacologic classes, and particularly of antibiotics. Measurements were taken for nine months before the institution of clinical pharmacy services, 12 months during a clinical pharmacy service period, and for six months after the cessation of the services. A trend toward reduction in drug costs per patient day was observed on both services. This was observed for all pharmacologic classes, and when antibiotics were analyzed alone. The difference was significant when antibiotics were specifically analyzed on the vascular surgical service. The pharmacist's log and a survey of physicians' and nurses' attitudes toward clinical pharmacy services supported the above results.

Anti-Bacterial Agents↗
PubMed1985

Practice patterns, attitudes, and activities of University of California Pharm.D. graduates.

Graduates of the University of California at San Francisco (UCSF) Doctor of Pharmacy program from 1970 to 1981 were surveyed to determine their practice patterns, professional activities, and attitudes toward the profession of pharmacy. Of 1061 surveys mailed in September 1982, 752 (72%) were returned. A majority of respondents indicated that they would choose pharmacy as a profession again if starting over and that they would advise a friend to enter the profession. The private hospital setting was the practice site cited most frequently by respondents. Over one third of practicing pharmacists were actively enrolled in or had completed advanced pharmacy training. California was the practice location for 84% of respondents; only one third indicated that salary was very important or somewhat important in their decision to practice at their current location. A large percentage of respondents were involved in teaching, community service activities, and professional associations. Most entry-level UCSF Pharm.D. graduates are satisfied with their professional status and find opportunities for advancement.

Attitude of Health Personnel↗
PubMed1984

Development of a pediatric dosing sheet for use in the critical care setting.

Choosing the correct dose for pediatric patients in the critical care setting is made difficult by conflicting recommendations in the medical literature. Hence, the University of California at San Francisco (UCSF) Intensive Care Unit medical, pharmacy, nursing, and respiratory therapy staffs developed their own pediatric dosing guidelines, based on a review of the literature and the advice of pediatric and critical care specialists. The sheets have been successfully used in the unit for the past 6 years and are well received by both physicians, pharmacists, and nurses.

California↗
PubMed1983

Effect of clinical pharmacy services on prescribing on an orthopedic unit.

Prescribing patterns of physicians on a university-hospital orthopedic unit before, during, and after a clinical pharmacist's intervention were monitored and compared with patterns on a similar unit without clinical pharmacy services at another university hospital. The experimental and control groups consisted of 10% random samples of all patients on the study wards. Mean drug cost, number of doses, and number of courses of therapy for all drugs and for antibiotics were calculated. The data collection period consisted of 9 months (phase 1) before, 12 months (phase 2) during, and 6 months (phase 3) after clinical pharmacy services. Prescribing of postoperative prophylactic antibiotics was evaluated for compliance with guidelines of the experimental hospital's pharmacy and therapeutics committee. In the experimental group there was a consistent reduction from phase 1 to phase 2 in overall and antibiotic drug costs, number of doses, and number of courses of therapy per patient-day, but the differences were not significant. Length of stay decreased from phase 1 to phase 2, but the patterns were not significant over time or between experimental and control groups. For the experimental group, there was a significant reduction during phase 2 in the number of hours of antibiotic prophylaxis after removal of surgical drains, but prescribers' overall compliance with guidelines for postoperative antibiotic prophylaxis did not change significantly over time. In a subgroup receiving antibiotics, drug costs per patient-day at the experimental site were reduced from phase 1 to phase 2 for all drugs and for antibiotics. Of 1196 consultations, 76% were unsolicited; 83% of antibiotic-related problems were identified by the pharmacist.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1982

Utilization of antibiotics: analysis of appropriateness of use.

An antibiotic utilization review was performed for the purpose of determining the frequency and types of infectious diseases presenting to a large, teaching hospital emergency department, and the appropriateness of the use of antibiotics in this setting. In 27% of the visits a diagnosis of an infectious disease was made or an antibiotic was prescribed. The most common presenting diagnoses (comprising more than 75% of cases) were infections of the respiratory tract, skin, urogenital system, and gastrointestinal tract. Penicillins and sulfonamides were frequently prescribed in nearly two-thirds of cases. Antibiotic prescribing was determined to be appropriate in 78% of cases. Inappropriate use most often involved the use of prophylactic antibiotics in clean lacerations and the use of prophylactic antibiotic combination products following trauma to the eye.

Adolescent↗