Biomedical subjects
Publications and source records attributed to W Berg.
A forced-choice preference assessment was conducted in which two dependent measures were used to select preferred stimuli: (a) approach responding and (b) latency to the first aberrant response. Stimuli identified as preferred based on both dependent measures were then evaluated during treatment. The results suggested that latency may be a useful measure in the selection of preferred stimuli during forced-choice assessments.
We conducted a functional analysis of distinct topographies of aberrant behavior displayed by 4 clients. We first analyzed the behaviors in an aggregate fashion and then separated the behaviors to formulate hypotheses about the maintaining variables for each behavior. The procedures were used in a two-phase experiment. During Phase 1, two extended functional analyses were completed, one in an inpatient unit and one in a special education classroom. During Phase 2, two brief functional analyses were completed in an outpatient clinic. Results indicated that hypotheses of separate functions for distinct behaviors can be generated using both extended and brief functional analyses when the results are graphed in the aggregate and are separated by response topography. The results also suggest that these methods can improve the accuracy of data interpretation and treatment selection.
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We have developed a rapid and sensitive micro-radioimmunoassay for the detection of cellular cAMP. The assay employs a simple method for preparing cellular lysates that requires as few as 500 cells per data point. Cellular lysates are incubated with cAMP-specific antibody complexes and [125I]cAMP in 96-well plates, harvested onto glass fiber filters and analyzed using a commercial autoradiograph imaging system. This method provides significant savings in reagents and may be particularly useful in situations where only a limited number of cells are available.
Although issues relating to cost and cost containment have assumed an increasingly important role in the delivery of health care services, relatively few attempts have been made to assess the costs and benefits of social work services in a hospital setting. This article examines a program that provides social work services in a general hospital's emergency department on a 24-hour, seven-day-a-week basis. The cost of these services is assessed through the output value index, a form of cost-benefit analysis in which the estimated value of the program's output is contrasted with the estimated investment of resources to maintain the program. The results suggest that the program was operated at a marginal cost to the hospital and that cost may have been outweighed by tangible and intangible program benefits.
We conducted descriptive and experimental analyses of aberrant behavior in school settings with 2 children with autism, using teachers as assessors. Experimental functional analyses carried out by the investigators were followed by training teachers to conduct a descriptive analysis and a classroom experimental analysis. A comparison of the assessment procedures showed that each procedure identified negative reinforcement as a maintaining variable for aberrant behavior. The teacher implemented an intervention based on the assessment with mixed results. We then replicated the initial results by having the first teacher train a second teacher to carry out the two assessment procedures. The results of these analyses were also in agreement, again identifying negative reinforcement as a variable maintaining aberrant behavior. An intervention based on negative reinforcement was then successfully implemented. These results suggest the applicability and utility of functional analyses carried out in school settings.
Portable computing devices generally are classified into four categories: laptop, palmtop, notebook, and pen-based computers. If a portable unit weighs over eight pounds, call it a laptop. If a stylus is used to input data, call it pen-based or a pen computer. Palmtops frequently are electronic organizers or resources: Sharp's Wizard line stores appointments and addresses; Franklin's Med-Spell contains Stedman's medical dictionary. Notebooks often incorporate a QWERT keyboard, and sometimes include a pointing device. NEC's notebooks in 1988 were the first sub-laptop computers. According to a 1992 report from Market Intelligence Research Corp., Mountain View, Calif., 4.6 million sub-laptops were sold in 1991 for $2.6 billion. By 1998 the market may reach $25 billion. The report predicts that one sub-category of pen computers, which are designed to be held in one hand while information is input with a pen-like stylus, will prove most useful to the health-care industry. Pen tablets, as opposed to pen clipboards, use faster, more expensive processors, store more data, and "are expected to allow [caregivers] to carry full patient charting with them ... and allow information to be recorded directly to patient files." Sub-laptops are on-line in many healthcare facilities: Greenwich hospital, Stanford University Medical Clinic, Humana Hospital Audubon, Rancho Los Amigos Medical Center, and others.
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A computer analysis of more than 214,000 urinary stone analysis data recorded in 13 analysis centres in the GDR between 1970 and 1985 was performed. The relative frequencies of urinary stone constituents as pure substances and as main and secondary constituents were determined. Forty-eight percent of all calculi were monomineralic, and the sex ratio (male/female) was 1.96. In the so-called average calculus, mainly whewellite makes up 60.9% of its substance, weddellite 11.8%, uric acid 10.9%, apatite 4.76%, struvite 4.13%, ammonium urate 0.33%, and cystine 0.2%. Artefacts were found in 2.6% of the cases. Trend analysis shows a marked increase in the amount of whewellite and a reduction in the amounts or uric acid, struvite and cystine.
The Ni2+/S2O4(2-)-test makes semiquantitative assessment of cystine concentration in urine possible. The reaction principle of the method is based on the formation of a nickel/cysteine/sulfide complex of brown colour. Visual test evaluation is done by classifying the colour intensity of the sample/reagent mixture according to an exact colour shade. Each colour shade on a colour reference table is correlated to a certain range of cystine concentration. Cystine determination is described in detail for two ranges (0.60 and 1.25 mmol/l).
A simple, reproducible method for measuring the volume of pressure sores is described. The sore is covered with a transparent film which follows the previous skin as much as possible. An isotonic solution is injected through the film; the amount of fluid required to fill the sore represents the sore volume.
We propose the use of a combined version of the alternating treatments and multiple baseline designs in situations in which a traditional baseline (no treatment) condition either does not provide an adequate contrast condition or is not feasible or practical due to clinical constraints. We refer to this design as a sequential alternating treatments design because two treatments are initially implemented in a random or counterbalanced fashion and are followed by a sequential change in one or both treatments across settings, subjects, or tasks. The effects of the independent variables are assessed first by analyzing the two series of data points representing the different treatments (relative effects) and then by assessing changes in one or both series, as application of the alternative treatment is introduced sequentially. The sequential application of treatment provides an analysis of control in the same manner as the multiple baseline design; the initial alternating treatments phase provides a contrast condition in much the same manner as a baseline condition. Applications of this design to the assessment of peer training and self-injurious behavior are described.
We evaluated the separate treatment components of a functional communication training program for 3 severely handicapped persons who each displayed different topographies of aberrant behavior. Following a functional analysis of maintaining conditions for inappropriate behavior (self-injury, stereotypy, aggression), each participant was trained to emit a communicative response that functioned to solicit reinforcement. For 2 participants, consequences (time-out or graduated guidance) for inappropriate behavior were also included. Treatment continued until the participants emitted the communicative response independently and no occurrences of inappropriate behavior were observed for at least two sessions. Following treatment, the separate contributions of the treatment components for communicative responding and for inappropriate behavior were evaluated with a reversal design. The results indicated that both sets of treatment components were necessary for maximal control over aberrant behavior. These results are discussed in relation to the efficiency, history, and control over reinforcement of both appropriate and inappropriate responses.
Delayed diagnosis, apparently due to insufficient knowledge of partly simple methods of cystine determination and their practical application, is often a particular problem in the treatment of cystine lithiasis. The present paper gives a survey of a variety of laboratory methods to determine cystine in the urine both qualitatively and quantitatively. Their applicability in various diagnostic situations is discussed. In clinico-chemical routine, colorimetric cystine determinations using Brands test, but partibularly the nickel/dithionite reagent, is an established and reliable laboratory method. Possibilities of its use as quick screening assays are described.
In this study a method o the semiquantitative determination of the crystallization tendency for calcium oxalate in urine is described. It is based on the addition of a well-defined amount of ammonium oxalate (31.3 nmol) to a urine sample (30 ml). The so caused clouding of the urine is measured by a photometer 20 min later. The method guarantees an acceptable reproducibility and is simple to be performed in each clinical laboratory. The results of mathematical correlation and discriminant analysis show that the calcium concentration influences the crystallization of calcium oxalate as most of all urinary constituents. Furthermore, evidence of a high specificity of the method is given by a reclassification rate of about 80% in the discriminant analytical computation.
The pharmacokinetics and pathophysiology of oxalic acid in human organism are presented. In the formation of urinary calculi the level of urinary oxalic acid is important, but the knowledge of metabolism and various disturbances is the guide of a successful treatment and metaphylaxis. Therefore, the diagnostics is a prerequisite for successful dietetic and therapeutic measures as shown in absorptive hyperoxaluria.
By oral administration of 14C-labelled oxalic acid (2.2 microns Ci; 2 mg), the mean enteral oxalate absorption in 24-h urines (collecting intervals 3, 3, 6, 12 h) of 19 healthy control subjects was determined to be 8.3%. It was 14.6% (alpha less than 1%) in 20 patients with recurrent idiopathic calcium-oxalate lithiasis. The differences in absorption were most marked in the first two 3-h urines. Under the test conditions described, maximum excretion of 14C oxalate had already occurred after 3 h (55%-57%); after 6 h it was about 85%, and after 12 h 95% of the total activity in the 24-h urine. In 68% of the control subjects, the oxalate absorption values were below 10%; in 32% they were less than or equal to 15%. For the group of lithiasis patients, these findings suggest a metabolic disorder of gastrointestinal origin. In 40%, the oxalate absorption rates were clearly above 15%. The test method described is simple to carry out and can be recommended for the assessment of idiopathic calcium-oxalate lithiasis.
For five samples of our 5th international ring test for the quality control of methods of urinary calculus analysis we received 46 results from 19 countries obtained by means of ten different methods. The mean standard of quality (SQ) for all participants with quantitative methods is 2.11. Most laboratories employed X-ray diffraction (n = 21; SQ = 2.09) for quantitative calculus analysis. The mean deviation (delta x) per component from the ideal composition is fortunately low--about 0.10 molar parts for all participants, 0.06 molar parts for X-ray and infrared spectroscopy technique together. From the aspect of accuracy, the physical methods of analysis, X-ray diffraction and IR spectrophotometry, are clearly superior to all other analytical techniques.