Biomedical subjects
Publications and source records attributed to R F Lewis.
The birthweight distributions of Black and White infants in South Carolina were compared for the paired-year periods 1975-76 and 1985-86. No discernible changes in birthweight distributions between the two time periods were observed especially among Black infants. The distributions among White infants reflected an overall improvement in birthweight most noticeably above 2500g.
Clinical features, treatment and outcome were assessed retrospectively by means of a questionnaire in 174 patients in general practice whose vaginal swabs yielded beta-haemolytic streptococci. These were compared with 96 patients whose swabs yielded no recognized microbial pathogens. Patients with group B streptococci did not differ in any of these parameters from the control group, but those with group A streptococci were more likely to have vaginal soreness, a purulent discharge, and to respond to anti-streptococcal antibiotics. Implications for laboratory reporting are discussed.
The Tax Equity and Fiscal Responsibility Act of 1982 provided a full-risk Medicare capitation financing option for health maintenance organizations and competitive medical plans. Two rounds of demonstrations were conducted, followed by the publication of final regulations in January 1985. The first-round demonstration at Marshfield, Wis, was operational for 28 months. Thirty-seven percent of all resident beneficiaries enrolled. Aggregate losses exceeded $3 million (11.6% of revenue). Management implemented increasingly more stringent utilization review. Overall hospital utilization declined 261.7 days per 1000 from fiscal year 1981 to 1982; nonetheless, federal reimbursement was insufficient to meet program costs and the demonstration was terminated. The central reimbursement method used in Medicare risk contracting (adjusted average per capita cost) does not adequately control for enrollment selection, unmet medical need, or recent regional cost variations. Reimbursement set at 95% of estimated fee-for-service costs does not recognize, and in the long run will not support, an efficiently operating delivery system.
A new library building at the University of California Medical Center, San Diego provides 7,100 net square feet, seating for 100 readers, and a stack capacity of 23,000 volumes. The building contains three split-level floors with conventional reference and circulation services, a combination of group and single seating, rapid copying machines, audiovisual facilities, a public elevator, and an electronic security system for the protection of library materials. The library, intended primarily for the use of health care professionals and students in their third and fourth years of medical school, serves a teaching hospital and its associated research facilities.
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Predicted that simple tests that require attention and motor speed would be able to differentiate paranoid schizophrenics from brain-damaged patients better than more complex, problem-solving neuropsychological tests. The strategy was to improve discrimination between schizophrenic and brain-damaged patients by selecting a schizophrenic subgroup with a recognized cognitive strong point. Fourteen organic, 14 paranoid schizophrenic, and 14 nonpsychotic psychiatric patients matched for sex, education, and IQ were tested. As predicted, the attention and speed measures differentiated the brain-damaged and paranoid groups, while the four more complex measures from the Halstead-Reitan Battery did not separate the groups. There were no significant differences between the two psychiatric groups.
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Results of a 1967/68 survey of reference practices and policies in U. S. medical school libraries are presented. The information was obtained through questionnaires sent to the libraries of medical schools having students currently enrolled; eighty-five replies were returned.
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The National Library of Medicine has established at the Biomedical Library, UCLA, a remote MEDLARS search station. The agreement between the libraries provided that the Biomedical Library in cooperation with the UCLA Health Sciences Computing Facility would reprogram MEDLARS for the IBM 7094 computer, provide personnel to be trained in machine searching at NLM, and engage in a pilot demonstration of search service to the medical staff of UCLA. This paper describes the place of the search section in the organization of the Biomedical Library and the training of personnel at NLM (the article by Garvis in this issue of the Bulletin relates the problems encountered in making two different computer systems compatible). Search service had not begun when this paper was written; it was scheduled to begin late in 1965. Plans for the future include the enlargement of the UCLA MEDLARS staff and extension of search service to a larger geographical area.