PubMed Health⌕ Search

Biomedical subjects

M Weinrich

Publications and source records attributed to M Weinrich.

At least 19 recordsLinked to original sources
PubMed2001

Training agrammatic subjects on passive sentences: implications for syntactic deficit theories.

We trained two subjects with chronic agrammatic aphasia on production of passive sentences using a computerized, iconic-based communication system. After training, one of the subjects demonstrated significant improvements in his abilities to comprehend and verbally produce English passive voiced sentences, including sentences with conjoined subjects and objects. These results suggest that agrammatism does not represent a fixed syntactic deficit.

Aged↗
PubMed2001

Left ventricular-right atrial fistula complicating redo mitral valve replacement.

We describe the case of a 58-year-old female patient who underwent redo mitral valve replacement and remained in heart failure. The diagnosis of a left ventricular-right atrial fistula was made. The fistula was closed surgically with a patch of autologous pericardium. The patient improved immediately after the operation and has been asymptomatic since.

Female↗
PubMed2001

Home- and community-based long-term care: lessons from Denmark.

PURPOSE: Denmark is cited as a model in the development of home- and community-based systems for the frail elderly population. We examined the results of this natural experiment and considered implications for U.S. policy. DESIGN AND METHODS: We used international comparative policy analysis, including site visits and semistructured interviews with Danish leadership in conjunction with a review of published literature, reports, and administrative data from Denmark and the United States. RESULTS: After 12 years of implementing integrated systems for home- and community-based services in 275 municipalities, growth in Danish long-term care expenditures has leveled off; expenditures appear to be decreasing for the over-80 population and have dropped as a percentage of the gross domestic product. Access to and quality of long-term care services appear to remain generally satisfactory. During this period, comparable expenditures in the United States have increased, and deficits in access and quality persist. IMPLICATIONS: These findings should be of interest to state and federal policy makers considering strategies to reduce the rate of growth in Medicaid and Medicare expenditures for elders and to expand home- and community-based services.

Aged↗
PubMed2001

Protecting the most vulnerable: home mechanical ventilation as a case study in disability and medical care: report from an NIH conference.

Patients requiring chronic mechanical ventilation represent a particularly vulnerable segment of the expanding population of individuals with chronic disabilities. Many of these individuals can live successfully at home, but face significant obstacles. Current policies in health care coverage, durable medical equipment coverage, eligibility for assisted living, and licensing of caregivers all restrict the abilities of these individuals to live in the community. Prolonged home mechanical ventilation was pioneered in France, where a current international "best practice" provides a model for developing comprehensive, cost-effective care for these individuals.

Home Care Services↗
PubMed2001

Home is where the help is: community-based care in Denmark.

Policy regarding long-term care has been an issue of rising national concern. In this paper we examine the transition of Danish long-term care policy with special attention to Skaevinge, the first community in Denmark to integrate institutional and community-based services for the elderly. Recent studies on the variation between costs and services in Danish communities and the results of U.S. studies on community-based care suggest that successful implementation of integrated institutional and community-based long-term care is feasible in the United States. Lessons from Denmark highlight conditions that will facilitate success in this endeavor.

Aged↗
PubMed2001

Obstacles to prostate cancer screening in African-American men.

The purpose of this correlational study was to measure structural obstacles to a free prostate cancer screening. The sample consisted of 549 men, 69% who were African-American. The men attended a prostate cancer educational program and were offered free prostate cancer screening at their physician of choice. Structural obstacles that were predictors in screening participation were "making an appointment" (p = 0.02), "planning for an appointment" (p = 0.05), and "reminders of prostate cancer screening" (p = 0.02). The demographic variables of race and marital status were also predictors of screening participation. Implications for health education are given.

Adult↗
PubMed2000

Provision of methadone treatment in primary care medical practices: review of the Scottish experience and implications for US policy.

CONTEXT: Under new proposed regulations, US physicians outside of traditional methadone clinics could prescribe methadone to patients with opioid dependence. No large-scale evaluations of US programs in which methadone maintenance is provided by primary care physicians are available, but primary care physicians in Scotland have participated in such programs on a large scale. OBJECTIVE: To review the history, operation, and outcome data on the efficacy and safety of 2 Scottish primary care-based opioid agonist treatment programs to derive lessons for the US context. DESIGN AND SETTING: Naturalistic study of programs in Edinburgh and Glasgow, Scotland, with data obtained through site visits and interviews conducted in 1996 and 1998, as well as from published reports and retrospective analysis of electronic databases. MAIN OUTCOME MEASURES: Proportions of injection drug users who were enrolled in the methadone maintenance programs, average methadone doses in the programs, and methadone-related deaths. RESULTS: A total of 60% to 80% of injection drug users in Edinburgh and 41% to 73% of those in Glasgow were enrolled in methadone maintenance in 1998-1999. Dose levels are consistent with US recommendations (for Edinburgh in 1998, 61 mg; for Glasgow in 1994-1996, 54 mg). The Glasgow program required supervised consumption of methadone in community pharmacies for the first year and experienced significantly fewer methadone-related deaths than Edinburgh in 1997 (17 vs 30 deaths; P<.0001). Programs in both Edinburgh and Glasgow provided support to primary care physicians and achieved levels of general practitioner participation of 59% (1998) and 30% (1999), respectively. CONCLUSIONS: The Scottish experience indicates that prescription of methadone in office-based settings can expand access to an important treatment modality. Primary care physicians safely prescribed methadone for maintenance treatment when provided with adequate support. Diversion of methadone was minimized by requiring supervised consumption in community pharmacies.

Delivery of Health Care↗
PubMed2000

Effects of psychological distress on blood pressure in adolescents.

This cross-sectional survey measured relationships among blood pressure and measures of psychologic distress, family structure, and economic status in a sample of adolescents exposed to Hurricane Hugo. Spielberger's Anger Scale and Derogatis' Brief Symptom Inventory were used. Data analysis revealed 5% of the 1079 adolescents were hypertensive. Multiple regression analyses revealed the following predictors of higher diastolic blood pressure: African-American race, recipient of subsidized lunch, exposure to Hurricane Hugo, and higher anger-in scores in males. The effects of a catastrophic event such as a hurricane on blood pressure and the effects of introjected anger have implications for both health care consumers and providers.

Adaptation, Psychological↗
PubMed1999

Representation of linguistic rules in the brain: evidence from training an aphasic patient to produce past tense verb morphology.

We trained a patient with expressive aphasia and a deficit in phoneme-to-grapheme conversion to produce spoken English verbs with correct tense morphology. After training, he showed evidence of generalization to production of written regular, but not irregular, verbs in a sentence completion task. These data support dual-route, rule-based models within the brain for morphosyntactic operations.

Aged↗
PubMed1999

[Nature and frequency of the existence of mold fungi in garbage cans for biological waste and the resultant airborne spore pollution].

In organic waste, numerous mold fungi and other microorganisms develop sometimes within a few hours only which decompose the organic material already in the collecting containers generating heat and odor. With regard to the emission of mold fungus spores out of garbage cans for bio-waste and the potential environmental-hygienic danger connected with it, considerable worries have been expressed recently. A wide spectrum of mold fungi can be found in bio-waste in strongly varying concentrations. No noticeable difference could be ascertained between the settlement structure areas and the cities respectively as to the fungus concentration in the bio-waste substrate. A. fumigatus and A. niger can be recommended as leading spores for the behavior of the total concentration of fungi in the bio-waste due to their frequency of detection and their seasonal dynamism. The intensity of the air spore pollution through emission of mold fungus spores correlates closely with the climatic conditions, such as variations of temperature, relative humidity and solar radiation. The airborne release of mold fungus spores out of garbage cans for bio-waste and the formation of a respective exposure connected with it is judged as harmless for healthy persons. Risk patients and persons having a weakened immune system or assumed to have such a one due to an existent basic illness and/or other reasons should avoid any handling of bio-waste as well as any other waste if possible.

Air Microbiology↗
PubMed1998

Urinary symptoms as a predictor for participation in prostate cancer screening among African American men.

BACKGROUND: There are minimal data on the influence of urinary symptoms and participation in prostate cancer screening in African American men. METHODS: This correlational study examined the influence of urinary symptoms on 1) participation in a free prostate cancer screening program and 2) abnormal screening results. The 1,402 African American men in the South Carolina Prostate Cancer Project (SCPCP), mean age of 50 years, completed a survey that included self-reported urinary symptoms, participated in a prostate cancer educational program, and received a free prostate cancer screening consisting of a digital rectal examination (DRE) and prostate-specific antigen (PSA) from their personal physician. RESULTS: One in 5 men reported the presence of urinary symptoms. Over 60% of the 1,402 men participated in the free CaP screening. Among the 852 men who participated in the free prostate cancer screening, 73 (8.6%) had abnormal screening results as classified by abnormal DRE and/or PSA >4.0 ng/ml. Urinary symptoms were significant predictors, both of participation in screening (OR = 1.30, CI = 1.00, 1.70) and of obtaining an abnormal screening result (OR = 1.78, CI = 1.17, 2.72). CONCLUSIONS: Prostate cancer health education needs to include the fact that prostate cancer, in its early stages, has no urinary symptoms.

Adult↗
PubMed1998

Increasing prostate cancer screening in African American men with peer-educator and client-navigator interventions.

BACKGROUND: Few African American men participate in prostate cancer screening, although they have higher prostate cancer incidence and mortality rates. METHODS: This study documents the benefits of two educational methods; the peer-educator method and the client-navigator method, in increasing their participation. RESULTS: Sixty-one percent of the 1,211 African American men who received an educational program on prostate cancer participated in the free prostate cancer screening. Men who received the peer-educator method intervention, which included a testimony in support of prostate cancer screening given by an African American man, were more likely to participate, p = 0.04, than were men who received a standard educational program. Also, men who received the client-navigator method intervention, which included 1) a phone call aimed at overcoming screening barriers and 2) reminders for screening, were more likely to participate, p = 0.0001. CONCLUSIONS: More African American men will participate in prostate cancer screening following the peer-education and client-navigator interventions.

Black or African American↗
PubMed1998

Beyond managing Medicaid costs: restructuring care.

The apparent success of managed care plans in controlling medical costs has made the prospect of managed care for Medicaid recipients attractive for state health policy makers. However, because the principles upon which managed care was created do not apply to the most costly segments of the Medicaid population, efforts to address their needs through traditional managed care strategies are likely to be self-defeating. The Maryland Medicaid database was used to review and analyze the successes and failures of managed care Medicaid initiatives to date. This review led to the suggestion that the integration of specialized systems for specific subgroups of the Medicaid population into managed care, in conjunction with broader public policies, could lead to improved quality and lower costs.

Adolescent↗
PubMed1998

Prostate cancer education in African American churches.

The use of churches as recruitment sites of African Americans into health promotion activities is a popular theme in the 1990s literature. This research measured the impact of previous exposure to cancer on participation in an educational program and a free prostate cancer screening. Cues to action from the Health Belief Model provided the conceptual framework. Over 500 men attended a prostate cancer educational program at their church. Men who participated in the educational program and completed the questionnaire were given a voucher that they could take to their doctor of choice for a free prostate cancer examination. Having a member of the congregation who was previously diagnosed with cancer was a significant cue to attendance at the educational program (P = 0.03). Recommendations for future cancer screening in churches are given.

Black or African American↗
PubMed1998

Predictors of participation in prostate cancer screening at worksites.

Unfortunately, African American men have a higher incidence of and a higher mortality rate for prostate cancer than White men but are less likely to participate in prostate cancer screening. This correlational survey research identifies predictors for participation in a free prostate cancer screening in 179 men, 64% of whom are African American. Each man was invited to see his personal physician for a free prostate cancer screening following a prostate cancer educational program given at his worksite. Forty-seven percent of the African American men went to their personal physician following the educational program and received a digital rectal examination (DRE) and a prostate specific antigen (PSA) screening. In the original cohort of educational program attendees, only 16% of the African Americans had obtained a DRE in the previous 12 months. However, 44% subsequently did participate in free DRE screening. Similarly, only 6% of the African American men had received a PSA screening in the previous 12 months, yet 42% obtained a PSA screening after the educational program, a sevenfold increase. Implications for allocating limited resources for education and screening to the high-risk group of African American men are discussed. This study's model of a prostate cancer educational program at worksites followed by attendees visiting their personal physician for screening could be replicated throughout the United States to increase African American men's participation in prostate cancer screening.

Adult↗
PubMed1997

Generalization from single sentence to multisentence production in severely aphasic patients.

Multisentence production was examined in three nonfluent aphasic patients who had undergone a single sentence production training program using a computerized visual communication system (C-VIC). Patients were required to describe videotaped vignettes in English and using C-VIC. C-VIC allowed for an investigation of production abilities previously impossible to measure in severely aphasic patients, since C-VIC does not require internal generation of appropriate lexical items or phonological and articulatory realization. Results are discussed in the context of language production models in an attempt to determine the breakdown(s) in the production system that result in difficulty in trying to produce multiple sentences.

Adult↗
PubMed1997

Remediating production of tense morphology improves verb retrieval in chronic aphasia.

Production of tense markers in C-VIC, a computerized visual communication system, was utilized as a treatment for three patients with severe expressive aphasia. Patients practiced constructing C-VIC tense marked sentences and then producing English equivalents. After training, all patients demonstrated significant improvements in English verb retrieval and production of correct tense morphology. Generalization of morphological rules for past tense production was seen for regular, but not irregular verbs. These results support the LaPointe and Dell (1989) extension of the Garrett (1975, 1992) model specifying a search through so-called verb phrase notion stores as a process mediating transition from functional to positional levels, but also suggest an additional constraint on the output of the verb notion store search.

Adult↗