Fundus contact lenses for closed pars plana vitrectomy.
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In reviewing all the responses from the private practitioners and clinicians in Departments of Ophthalmology throughout the United States and Canada, it would appear that the majority of individuals are quite happy with the automated perimeters they have purchased. Clinicians should be aware that this is a rapidly changing field and several devices which were previously available are no longer being manufactured. In addition, because of the competition which has recently developed in the automated perimetry industry, prices are continuing to come down. Some practitioners have been unhappy with the fact they paid a higher price for a device which is currently selling at a lower price. However, a similar phenomenon has happened in the computer world and is to be expected as competition increases. The major problems which seem to be of concern to all ophthalmologists, are the difficulty in interpreting data and the management of the data. We believe one of the major frustrations of all practitioners using automated perimeters relates to the fact that this is a totally new technique, which requires time and practice to gain familiarity. In general, it would appear that most of the practitioners have been happy with the service provided by various companies, although there are a few exceptions. Read the enclosed responses and develop your own conclusions. We hope you find the information useful.
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Regulation of drugs from the public administration is an activity which is produced in different countries independently from the sanitary model they own. In the field of public financing of drugs there have been several measures to improve the efficiency of their use. However, the analysis of the impact of these measures is complex and this may justify the shortage of objectivable results, especially at long term. The objective of this study is to perform a systematic review of such measures due to the need to have information about the different alternatives before making a decision. The introduction of an isolated measure is in many cases compensated by other changes in other regulating or aiding fields which suggests the creation of an integral strategy which affects different fields (supply/demand of drugs and prescribers). It seems necessary to suggest a social debate taking as a basis the scientific information available at the moment and promote the taking of decisions which lead to a rational use of the available pharmacological resources.
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BACKGROUND: In 1991 the University HealthSystem Consortium (UHC), an alliance of 70 academic health centers, began its patient satisfaction benchmarking project. The survey, adapted from the Picker Institute survey, was pilot tested in 1992 and has been in use since 1993. Each year the project's steering committee refines the survey on the basis of member needs and survey item performance. KEY FINDINGS: Findings have shown that the survey can document the effects of specific quality improvement efforts, that patients from different medical services report different levels of satisfaction with their care, and that physician and nursing care have had the greatest impact on overall satisfaction. USING THE RESULTS: Each participating organization receives concise narrative reports of the survey results, with priorities for improvement efforts clearly highlighted. A five-to six-page Executive Summary provides the organization's executive team with a quick overview of the results, as well as a summary of the areas where quality improvements are most needed. A longer Managers' Report provides a more detailed analysis of the findings for quality managers and department heads. Sections for each major area of care can be copied and distributed as "stand alone" reports to the appropriate decision makers. For example, the section on nursing care can be distributed to the chief nursing officer and nurse managers. For each key aspect of the patient's experience, best practices for maintaining patient satisfaction are identified from across the hospitals and compiled into a catalogue. LESSONS LEARNED: The UHC patient satisfaction benchmarking program has created ongoing communication among the participating hospitals, whose staff members have been willing to share problems encountered and possible solutions.
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A complete list of microsporidians parasitic in fish is presented; in each species, the host(s), site of infection and the known geographical distribution is given. Species of a total of 14 genera can be found in fish hosts. These genera do not occur in other hosts and include 80 named species plus 29 records only designated as 'sp.' The collective group Microsporidium includes 15 species plus 30 records only designated as 'sp.' Described species with incorrect generic assignment number seven species and there are six hyperparasitic species infecting other fish parasites. Thus the total number of microsporidians which may be encountered in fish is 108 named and 59 innominate species.