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Biomedical subjects

M L Berk

Publications and source records attributed to M L Berk.

At least 37 records · Page 2Linked to original sources
PubMed1992

The concentration of health expenditures: an update.

An earlier study tracing trends in health spending from 1928 to 1980 found health expenditures concentrated among the top 1 percent of those spending money for health care. In an update to that study, the authors found that that trend toward concentration has increased. In 1987 the tope 1 percent of spenders accounted for 30 percent of health spending, up from 26 percent in 1970 and 29 percent in 1980. In contrast, the bottom half of the population in terms of spending accounted for only 3 percent of total spending in 1987. The average expenditure for the top 1 percent of spenders in 1987 was $47,331. Nearly half of those top spenders in 1987 were elderly. Also, more than 16 percent were black, up from nearly 10 percent in 1980.

Black or African American↗
PubMed1991

Distribution and hypothalamic projection of tyrosine-hydroxylase containing neurons of the nucleus of the solitary tract in the pigeon.

The avian nucleus of the solitary tract has an extensive subnuclear organization. Several subnuclear cell groups can be distinguished on the basis of cytoarchitectonic criteria. In general, the subnuclei of the medial division of the nucleus of the solitary tract receive gastrointestinal afferents, whereas the subnuclei of the lateral division of the nucleus of the solitary tract receive cardiopulmonary afferents. Forebrain afferents to the nucleus of the solitary tract are segregated to medial and lateral subnuclei, which are located at the periphery of the nucleus. These peripheral subnuclei of the nucleus of the solitary tract are also the source of ascending axonal projections to the forebrain. In this study, the tyrosine hydroxylase (initial enzyme for catecholamine synthesis) content of the anteromedial hypothalamic projecting neurons of the nucleus of the solitary tract is determined by use of a combined retrograde fluorescent dye-immunofluorescence method. Fast Blue implanted into the anteromedial hypothalamus (in the region of the nucleus periventricularis magnocellularis) resulted in the retrograde labeling of neurons in the caudal two-thirds of the nucleus of the solitary tract. At levels rostral to the obex, dye-labeled cells were mostly observed in the dorsally located subnuclei medialis superficialis pars posterior and lateralis dorsalis pars posterior and in the ventrally located subnucleus medialis ventralis pars posterior. More centrally located subnuclei contained few labeled cells, if any. For example, subnucleus medialis intermedius pars posterior only had a few retrogradely labeled cells, whereas the centrally located subnucleus medialis dorsalis pars posterior was almost devoid of labeled cells. At levels caudal to the obex, many retrogradely labeled neurons of the nucleus of the solitary tract were observed. Neurons immunoreactively labeled for tyrosine hydroxylase were mostly found within subnuclei, which contain anteromedial hypothalamic projection neurons. In subnuclei medialis superficialis pars posterior and lateralis dorsalis pars posterior, 87% of the retrogradely dye-labeled cells were also immunoreactively labeled, whereas in the caudal nucleus of the solitary tract (at levels caudal to the obex), 68% of the retrogradely labeled cells were immunoreactively labeled. Not all tyrosine hydroxylase containing cells had projections to the implantation site in the anteromedial hypothalamus since only 40% of the immunoreactive cells in the caudal nucleus of the solitary tract and 59% of the immunoreactive cells in the subnucleus medialis superficialis pars posterior were retrogradely labeled with Fast Blue.(ABSTRACT TRUNCATED AT 400 WORDS)

Amidines↗
PubMed1991

The health care of poor persons living in wealthy areas.

This paper describes the problems inherent in targeting new health care initiatives to disadvantaged communities rather than to disadvantaged persons in the 100 wealthiest counties in the United States. The barriers to care experienced by such persons are generally comparable to those of other poor persons. Deprivations in access to care appear to be caused by poverty per se and not by the characteristics of the places in which the poor live. It is suggested that per capita income not be used as a criterion for the allocation of health care resources. The actual number of poor persons in a geographic area is a better criterion for determining the need for public health care programs.

Cost Allocation↗
PubMed1987

Projections of the lateral hypothalamus and bed nucleus of the stria terminalis to the dorsal vagal complex in the pigeon.

The dorsal vagal complex is composed of the nucleus tractus solitarii (Nts) and the dorsal motor nucleus of the vagus (DMN X). In the pigeon, these nuclei are composed of cytoarchitectonically well-defined subnuclear groups, which have connections that are partially segregated to specific organs (Katz and Karten: J. Comp. Neurol. 218:42-73, '83b, J. Comp. Neurol. 242:397-414, '85). The present study sought to determine whether forebrain afferents to Nts-DMN X are differentially distributed to specific subnuclei and thereby modulate the functions of specific organs. Forebrain afferents to the dorsal vagal complex were determined by retrograde tracing techniques. Labeled perikarya were found in the bed nucleus of the stria terminalis (BNST), ventral paleostriatum, and stratum cellulare externum (SCE) of the lateral hypothalamus, and in the medial hypothalamus, nucleus periventricularis magnocellularis (PVM), which is the avian homologue to a portion of the mammalian paraventricular nucleus. The pattern of axonal distribution to Nts-DMN X subnuclei from the BNST-ventral paleostriatum and SCE were investigated by anterograde tracing techniques. These experiments revealed axonal projections distributed to specific Nts-DMN X subnuclei. However, there is a high degree of overlap of the axonal projections to Nts-DMN X subnuclei from BNST-ventral paleostriatum and SCE, as well as from PVM (Berk and Finkelstein: J. Comp. Neurol. 220:127-136, '83). Labeled fibers from BNST-ventral paleostriatum and SCE project heavily to Nts subnuclei medialis superficialis, lateralis dorsalis, and medialis ventralis and to DMN X subnucleus ventralis parvicellularis. Fewer labeled fibers were found in Nts subnucleus medialis intermedius and extremely sparse labeling was found in Nts subnucleus medialis dorsalis. The Nts and DMN X subnuclei that receive forebrain projections also have peripheral connections with the aortic nerve, crop, esophagus, glandular stomach, and caudal abdominal organs. Thus, the forebrain could modulate the functions of these segments of the cardiovascular and digestive systems.

Animals↗
PubMed1987

Health insurance coverage of the working poor.

This study examines the working poor, and their pattern of health insurance coverage. The data indicate that in 1977 almost 22% of the working poor lack health insurance throughout the year. Moreover, children of the working poor were almost twice as likely as children of the poor nonemployed to be without coverage. The implications of the Omnibus Budget Reconciliation Act of 1981 (OBRA) which restricted the working poor's eligibility for Medicaid are discussed. It is argued that being employed, in itself, does not guarantee poor people access to medical care and may, in fact, serve to restrict it.

Health Benefit Plans, Employee↗
PubMed1987

The importance of distinguishing Hispanic subpopulations in the use of medical care.

Rather than analyzing Hispanics as a homogeneous population, this paper uses the 1977 National Medical Care Expenditure Survey in order to make separate national estimates for Cubans, Puerto Ricans, and Mexicans. Utilization of various health services by these three groups is discussed, as well as their insurance coverage, mean annual expenses by source of payment, and health status indicators. The analysis has a descriptive as well as multivariate component and focuses specifically on the use of physician and hospital services and prescribed medicines. It is found that Puerto Ricans are almost twice as likely as Mexicans, and over four times as likely as Cubans, to be covered by Medicaid; Cubans, on the other hand, are most often privately insured. Of the three groups, Puerto Ricans have the highest annual expenses and are most likely to have at least one physician visit. The number of visits for those with a visit, however, is identical across the groups. The paper discusses the policy implications of these findings, as well as the methodologic implications of classifying various Hispanic subgroups into one all-encompassing category.

Adolescent↗
PubMed1986

The reporting of stigmatizing health conditions: a comparison of proxy and self-reporting.

Previous studies have found that self-respondents tend to report a greater number of health problems than do household proxies. It has not been clear, however, if such results indicate reporting bias or reflect underlying health differences in the self-respondent and household proxy populations. Verification data from a survey of medical providers were examined in conjunction with the results of a national household survey. Our analysis indicates that the use of proxies does not increase misreporting. Overall reporting error between self-respondents and proxy-respondents is comparable on reports of mental illness. When physical stigmatizing conditions are examined, the use of proxies actually appears to be preferable to interviewing respondents directly.

Community Participation↗
PubMed1985

Ascending projections of the mammillary region in the pigeon: emphasis on telencephalic connections.

The ascending projections of the mammillary region of the hypothalamus and adjacent posterolateral hypothalamus were investigated by autoradiographic and horseradish peroxidase histochemical techniques. Analysis of the anterograde data revealed that the main contingent of mammillary fibers ascends in the medial forebrain bundle (MFB) in the lateral hypothalamic area. These fibers distribute to a number of telencephalic regions via three pathways. (1) Fibers course dorsomedially into the medial and lateral parts of the septum and continue into the hippocampus with a dense terminal field in the parahippocampal area. (2) Laterally coursing fibers project to area corticoidea dorsolateralis, area temporo-parieto-occipitalis, cortex piriformis, and the posterior part of archistriatum. (3) The fibers remaining in the MFB ascend into the "ventral paleostriatum," olfactory tubercle, and into the lateral and ventral borders of the rostral portion of lobus parolfactorius (LPO). Numerous fibers leave the LPO region and course dorsally into the deep layer of the Wulst, hyperstriatum dorsale (HD). Many fibers continue dorsolaterally through the HD and enter an unnamed region of the dorsolateral telencephalon (lateral to the vallecula) at the level of the olfactory bulb. Retrograde transport experiments revealed that the perikarya of origin-of-fiber projections to the parahippocampal area and to the rostral, dorsolateral telencephalon reside not only in nucleus mammillaris lateralis but also in posterolateral hypothalamic cells rostral and dorsal to this nucleus. The projection of these hypothalamic cells to the hippocampal formation and many other telencephalic regions in birds suggests that these cells are similar to the mammalian supramammillary nucleus and posterolateral hypothalamus rather than the mammillary nuclei.

Animals↗
PubMed1985

Use of home health services: some findings from the National Medical Care Expenditure Survey.

Data from the National Medical Care Expenditure Survey (NMCES) are used to produce national estimates of the use and sources of payment for home health care services for various demographic groups. The findings indicate that age and health status are strongly associated with home health care use and the vast majority of home health care services are delivered to this population. Nevertheless, there are a large number of younger, relatively healthy people who also use home health care services. Such use is generally non-intensive, often involving only a single visit. In addition it was found that private insurance is only rarely mentioned as a source of payment for home health care.

Age Factors↗
PubMed1985

The employed uninsured and the role of public policy.

Although most private health insurance is obtained through the workplace, important gaps remain in the present system of employment-related coverage. National survey data reveal that more than 9 million persons with employment experience are uninsured, who, with their uninsured dependents, account for three-quarters of all persons who lack coverage. This paper examines the circumstances and characteristics of the employed uninsured, including their opportunity to secure health insurance fringe benefits, their medical care use and expenditures, and the benefits available in private insurance that is not work related. Alternative public policy responses to the problem of lack of health insurance coverage are also considered.

Adolescent↗
PubMed1984

Survey of physician acceptance of the pneumococcal vaccine.

A group of 251 randomly selected physicians completed a survey designed to study their attitudes toward, knowledge about, and use of pneumococcal vaccine. Eighty-five percent of respondents believed the vaccine had been proven effective. For the use of the vaccine, respondents supported broad indications, including chronic lung disease, alcoholism, and congestive heart failure. Some respondents expressed concern about the safety of the vaccine. Physicians who learned about the vaccine from continuing medical education programs, colleagues, and pharmaceutical representatives were likely to use the vaccine more often than those who did not.

Attitude of Health Personnel↗