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PubMed · 7133638

Micronics and overrefraction.

C N Sims
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Abstract

Phoropter overrefraction, aided by a TI 58 or 59 calculator and programmed module, was evaluated as a routine procedure in 5,350 refractions. This technique provided increased patient acceptance of their glasses, better use of paramedical personnel, decreased refraction time, and improved cost efficiency of refracting. There was a 74% reduction of spectacle remakes and a 37.5 to 50% increase in refractions performed daily. This technique was compared to the previous 2,813 refractions using the conventional technique of refracting and to 2,600 refractions aided by an objective refractor. This study supports the thesis that overrefraction gives a higher degree of correlation of the images seen by the patient during the refraction procedure and the images seen with the final dispensed glasses. This correlation is possible because many of the variables in the refraction technique, refractor lens systems, or trial lenses, are reduced with the overrefraction technique.

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Costs and Cost AnalysisEyeglassesHumansMicrocomputersOphthalmologyRefraction, OcularJournal Article

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C N Sims. 1982. Micronics and overrefraction.. https://doi.org/10.1016/s0161-6420(82)34697-7

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Cost implications of random mandatory drugs tests in prisons.

BACKGROUND: Compulsory urine testing of prisoners for drugs, a control initiative, was introduced in eight prisons in England and Wales early in 1995. Despite no evidence of effectiveness, testing was extended to all prisons in England and Wales by March 1996. We consider the cost of testing. METHODS: We combined the costs of refusals, confirmatory tests, punishment of confirmed positives for cannabis or for class A drugs to estimate the average costs of random compulsory drugs testing. These costs were then compared to: i) the healthcare budget for a prison; and ii) the cost of putting in place a credible prisons' drugs reduction programme. We then used Scottish data on incarceration and regional prevalence of injecting drug users to estimate the extent of the injecting drug use problem that prisons face. FINDINGS: Costs per 28 days of the random mandatory drugs testing control initiative in an establishment for 500 inmates where refusal rate is a) 10% or b) nil; and 35% of urine samples test positive, one tenth of them for class A drugs were estimated at between a) 22,800 UK pounds and b) 16,000 UK pounds per 28 days [a) $US35,100 and b) $US24,600]. This cost was equivalent to twice the cost of running a credible drugs reduction and rehabilitation programme, and around half the total healthcare expenditure for a prison of 500 which averaged 41,114 UK pounds per 28 days [$US64,860]. Major cost-generating events were the punishment of refusals--over one third of cost a)--and testing positive for cannabis--over 50% of cost a). In Scotland, around 5% of injecting drug users (IDUs) are incarcerated at any time: 5% of Lothian's drugs care, treatment and prevention costs and 2.5% of its HIV/AIDS prevention budget in 1993-94 amounted to 101,300 UK pounds per annum--or 7770 UK pounds per 28 days ($US11,970)--and about 35% of monthly MDT costs. INTERPRETATION: We suggest that 5% of current resources for drugs prevention and treatment and for IDU-targetted HIV/AIDS prevention should be directed towards the prisons because in the prisons, where 5% of the clients are at any time, injectors have less access to harm reduction measures than on the outside.

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