Reviewing admissions policies under PPS.
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Biomedical subjects
Publications and source records attributed to F Miles.
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Three experiments explored human performance in discrimination of pigmented skin lesions from photographic slides. Experiment 1 showed that latent ability in identifying early melanoma was low, and some benign lesions tended to be falsely identified as serious. Performance overall did not decline when viewing time was reduced, suggesting that judgments could be made on the general appearance of lesions. Experiment 2 showed that enlargement of stimuli had no effect. Experiment 3 showed that performance was better with pictorial examples than with written descriptions for some classes of lesion, but for melanoma performance improved with longer viewing time when information was provided, suggesting that an opportunity to scrutinize could be beneficial. Guidelines to the public should distinguish melanoma from benign lesions and stress the importance of seeking prompt medical attention for suspicious lesions.
The prevalence of human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 infection in 1992 and 1993 was determined by testing 2,152 specimens from injection drug users living in 11 geographic areas in Spain. Results obtained by an authentic HTLV-1 and -2 test were compared with those obtained by an HTLV-1 assay. HTLV infection was identified in 7 of 11 regions, with an overall prevalence of 2.5% (range, 0.4 to 11.5%). Fourty-four (81%) of 54 subjects were infected with HTLV-2; the viral strains in the remaining 10 subjects could not be serologically typed. Underestimation of HTLV infection because of the low sensitivities of HTLV-1 enzyme immunoassays for HTLV-2 antibody was relatively low (< 20%). Therefore, previous epidemiologic findings generated with HTLV-1 enzyme immunoassays appear to be reasonably accurate. Our results suggest that the rate of HTLV infection may have been increasing recently among Spanish drug users.
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Virginia Hospital Association should send a clear message to both the states and HCFA that Medicaid providers are entitled, as a matter of right, to challenge their Medicaid rates in federal courts on both substantive and procedural grounds. Accordingly, it is legally incumbent upon the states and HCFA to make the plan amendment process meaningful in terms of state submissions and HCFA's review and approval. Only direct provider participation can ensure this result.