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Biomedical subjects

B D Weiss

Publications and source records attributed to B D Weiss.

At least 19 recordsLinked to original sources
PubMed1995

Literacy skills and communication methods of low-income older persons.

The objectives of this study were to (a) characterize the literacy skills of low-income, community-dwelling, older adults, (b) determine how they obtain information, and (c) determine whether they have difficulty understanding written information provided by clinicians. We studied 177 subjects (mean age 72.2, range 60-94). None had cognitive or visual impairments that precluded assessing literacy. Reading skills were tested, sociodemographic data were recorded, and information was collected on whether subjects have trouble understanding information given to them by health providers. Data analysis determined if literacy was associated with how subjects obtain and understand medical information. The subjects' mean reading skills were at grade level 5, below those of the general US population. One-fourth of subjects reported difficulty understanding written information from clinicians; this was more frequent among poor readers (P = 0.0002). Ninety-seven percent of subjects, regardless of literacy, reported that television was their primary source of information. Health information for low-income seniors should be transmitted through literacy-appropriate communication methods.

Age Factors↗
PubMed1995

Literacy and performance on the Mini-Mental State Examination.

OBJECTIVE: Mini-Mental State Examination (MMSE) scores are associated with age, education, and ethnicity. The objective of this research was to determine the relationship between MMSE and literacy. DESIGN: Cross-sectional. SETTING: A Community population in Tucson, Arizona. PARTICIPANTS: Senior citizens in public assistance housing. MEASUREMENTS: MMSE score, reading level, and sociodemographic variables. MAIN RESULTS: A total of 214 subjects were tested. The mean age was 72.3 (+/- 8.01), and the mean education level was 10.3 years (range 0-20 years). Reading levels ranged from grade 0 (non-reader) to 8 (maximum value for the test used). with a mean of 4.8 (+/- 2.8). MMSE scores ranged from a mean of 21.9 (+/- 4.6) for non-readers to a mean of 28.0 (+/- 2.0) for subjects with > or = 8th grade reading skills. Multiple regression using reading level, education, age, and ethnicity as independent variables, and MMSE score as the dependent variable, showed the highest correlation was between MMSE and reading level (R2 = .265). Education level made only a small additional contribution; age and ethnicity did not enter the regression equation. Correlations between reading level and individual MMSE subsections were highest between reading level and MMSE language items (r = .499). CONCLUSIONS: The correlation between MMSE score and reading skills is stronger than the correlation with other sociodemographic variables. Proper interpretation of MMSE scores requires knowledge of patients' reading levels.

Aged↗
PubMed1994

Illiteracy among Medicaid recipients and its relationship to health care costs.

Poor literacy is associated with poor health status, but whether illiteracy is also linked to higher medical care costs is unclear. We characterized the literacy skills of 402 randomly selected adult Medicaid enrollees to determine if there was an association between literacy skills and health care costs. Each subject's literacy skills were measured with a bilingual (English/Spanish) reading-assessment instrument. We also reviewed each subject's health care costs over the same one-year period. The mean reading level of this Medicaid population was at grade 5.6. Mean annual health care costs were $4,574 per person. There was no significant relationship between literacy and health care costs. While there are compelling reasons to improve poor reading skills among Medicaid enrollees, illiteracy in this population does not appear to contribute to the high cost of providing government-sponsored care.

Adolescent↗
PubMed1994

Clinical syndromes associated with bicycle seats.

Symptoms related to the bicycle seat are common among cyclists. Skin problems, such as chafing, ischial tuberosity pain, folliculitis, and ulceration are particularly common. Although rarely serious, these problems may cause significant discomfort and interfere with a cyclist's ability to ride. Numerous preventive measures have been recommended to prevent these problems, mostly related to seat position, seat construction, and bicycling pants. Little research is available, however, to support any of these recommendations. Research does indicate that use of skin creams is not effective for prevention of bicycle-related skin problems.

Bicycling↗
PubMed1994

Bicycle-related head injuries.

Bicycle-related head injuries are an important cause of injury and death in the United States, especially among children. There is evidence that widespread use of protective bicycle helmets could markedly decrease the rate of serious head trauma among injured bicyclists, but most cyclists do not wear helmets. Efforts to increase the rate of helmet use have been undertaken in physicians' offices, schools, community-wide programs, and through legislative initiatives. Although some of these interventions have increased helmet use, none has been shown to result in helmet use by the majority of bicyclists.

Bicycling↗
PubMed1992

Inhibition of tumor implantation at sites of trauma by Arg-Gly-Asp containing proteins and peptides.

We report on the inhibition of wound implantation by TA3Ha mammary carcinoma cells by Arg-Gly-Asp containing proteins and peptides using a hepatic wedge resection model. Intravenously injected TA3Ha cells rarely form tumor in the liver of syngeneic mice, but after hepatic wedge resection, 45% (107/240) of the mice develop tumors in the hepatic wound. Hepatic wound implantation is significantly (P = 0.01) inhibited by pretreating the cells with whole mouse plasma, but not with fibrinogen-depleted plasma or serum. Tumor inhibition is also achieved by pretreatment of cells with fibrinogen (P = 0.05-0.0004), fibronectin (P = 0.007) and laminin, but not by albumin. The active domain appears to be the RGDS sequence since the deca- and tetrapeptides containing RGDS inhibit wound implantation (P less than 0.05). However, the tetrapeptide Arg-Gly-Glu-Ser has no such activity. None of these agents affects ascites tumor formation by the intraperitoneally injected cells, suggesting that anchorage independent growth of cells is not affected. We propose that proteins and peptides containing RGD occupy the binding sites and prevent the cells from interacting with cell adhesion proteins in healing wounds. Proteins and/or peptides containing RGD may be useful for preventing local recurrence in postsurgical cancer patients.

Animals↗
PubMed1992

Trends in bicycle helmet use by children: 1985 to 1990.

Research has demonstrated that helmets protect against head injury during bicycle crashes. Several investigators have shown that large-scale, community-wide programs can increase the rate of helmet use by children. The objective of this research was to determine whether helmet use had changed over a 5-year period in a community with no formal programs designed to increase the use of helmets. In 1985 and again in 1990, project staff observed student bicyclists arriving at four elementary schools, three middle schools, three high schools, and one university campus. The same schools were used both years. There was no significant increase in the percentage of students who used helmets at the middle schools (0 both years), the high schools (1.85% vs 1.45%), or the university (10.0% vs 4.0%). At the four elementary schools, helmet use increased from 1.85% in 1985 to 17.1% in 1990. Much of this increase was attributable to one school at which helmet use increased from 4.4% to 21.4%. This school, and no others, had begun teaching about helmet use in the classroom. The results suggest that (1) helmet use will not increase at the middle school level or higher without specific interventions and (2) simple, low-cost, classroom interventions can increase helmet use by elementary school children.

Adolescent↗
PubMed1991

The relationship between literacy and health.

In non-industrialized countries, populations with the lowest literacy rates have the poorest health status. In the United States, however, there is no published research on whether illiteracy, independently of other sociodemographic factors, is related to health status. There are numerous plausible mechanisms by which such a relationship could occur. For example, published reports indicate that most information handouts, consent forms, and other materials for patients are written at reading levels too difficult for most American adults. These and other findings may have important implications in the health care of underserved populations. Research is needed to determine the health effects of impaired literacy skills among Americans, and to develop non-literacy-dependent methods for providing patient education, obtaining informed consent, and administering diagnostic tests.

Educational Status↗
PubMed1991

Nonpharmacologic treatment of urinary incontinence.

Standard therapy for urinary incontinence often includes pharmaceutical agents that carry a risk of side effects or interactions with other drugs. As an alternative, several nonpharmacologic management approaches are available. Scheduled voiding regimens are effective for patients who have uninhibited detrusor contractions, even when cognitive impairment is present. In motivated patients, pelvic muscle exercise is effective for stress incontinence. These methods are safe and inexpensive, and studies indicate that they can be as effective as or more effective than pharmaceutical agents. Other nonpharmacologic approaches to management include biofeedback techniques and electrical stimulation therapy.

Behavior Therapy↗
PubMed1991

The cervical cap.

The cervical cap is a barrier contraceptive method with an efficacy similar to that of the diaphragm. It has several advantages over other barrier contraceptives. In particular, it can be left in place for up to 48 hours, and repeated applications of spermicide are not necessary, even if sexual intercourse occurs more than once. In addition, the side effects seen with other barrier methods do not occur with the cervical cap. In some women, Papanicolaou tests may become abnormal, especially during the first three months of cap use. Therefore, careful monitoring of cervical cap users is essential.

Contraceptive Devices, Female↗
PubMed1990

Patient satisfaction survey instrument for use in health maintenance organizations.

The objective of this research was to devise a survey instrument specifically applicable to prepaid health care plans that could accurately predict whether patients would disenroll from their current plan because of dissatisfaction when given the opportunity to do so. A "prequestionnaire" was sent to all employees at a southwestern university whose employee benefit package included the option of selecting one of several health maintenance organizations (HMOs) as a source of health care. The prequestionnaire included 90 variables reported in the literature as related to patient satisfaction. The prequestionnaire was mailed two months before "open enrollment," the time at which subjects would have the opportunity, if desired, to change HMOs. After open enrollment, a "postquestionnaire" was sent to the same subjects, asking whether or not they did change plans during open enrollment. There were 2,365 respondents enrolled in HMOs who formed the study population. Of these, 189 (8.0%) changed HMOs during open enrollment. Discriminant function analysis was used to identify prequestionnaire variables which were predictive that subjects had changed plans; 10 variables were identified. They were combined into a survey instrument, which can be scored to predict an individual subject's probability of changing plans.

Arizona↗
PubMed1990

Comprehensive geriatric assessment recommendations: adherence of family practice residents.

A study was performed to determine whether family practice residents followed recommendations made by a comprehensive geriatric assessment clinic. Of 109 consecutive consultations, 27 patients had follow-up visits with family practice residents who participated in the assessment and who subsequently served as their primary care physicians. Adherence of residents to 437 clinic recommendations was monitored for 90 days by medical record review. Although recommendations to begin or increase a medication were followed 85.4% of the time, residents followed recommendations to stop or decrease medications less than 65% of the time. Recommendations to order a specific laboratory test or x-ray examination were acted on 70.3% of the time. Preventive recommendations were followed only 54.3% of the time. Residents' adherence to team-based care plans varied widely by type of recommendation. Special efforts are needed to increase compliance with comprehensive geriatric assessment clinic recommendations, particularly those for preventive services.

Aged↗
PubMed1990

Publications by family physicians in non-family medicine journals.

Why do some family physician (FP) authors submit manuscripts to non-family medicine journals instead of to family medicine journals? This study identified all 32 FP-authored articles that were published in several widely read non-family medicine journals over a 4-year period. Twenty-nine (90.6%) of the FP authors thus identified responded to a questionnaire soliciting the article's publication history. Of the 29, only one author had initially submitted his article to a family medicine journal. The most common reason cited by the other authors for not submitting to a family medicine journal was a perception that the non-family medicine journals had wider readership and prestige than family medicine journals. Other authors indicated that institutional promotion and tenure committees give less weight to publications in family medicine journals and, therefore, these authors felt it was preferable to publish in non-family medicine journals.

Faculty, Medical↗