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If incentives were the sole difficulty, a complex but far-sighted arrangement might carefully set prices that would avoid the unseemly prices and profits that aroused interest in controls in the first place, without impeding socially desirable research. But other inevitable problems in price controls reveal the futility of such an effort. Complexity and the Entrenchment of Vested Interests. The history of price controls demonstrates that once in place, controls have a life of their own.122 The unavoidable tendency toward mind-numbing complexity became obvious during the wage and price controls of the Nixon administration, even for such apparently highly standardized products as refined gasoline. The Medicare system itself is another prime example with arbitrary, contentious, and highly detailed controls over payments for medical technology, physicians, and other services. 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The need for better epidemiological data regarding the prevalence of trachoma in general, and among children and women in particular is being driven by different motivations. First, the highest rates of trachoma infections are found in the poorest areas of the world and thus, the understanding is that in the context of utter poverty, women and children are the most vulnerable. Greater information on prevalence stratified by age and gender would allow resources to be used most effectively and efficiently by directing them to areas where transmissions of infections and cases of blindness are occurring most often. That is, the improved data on prevalence among children and women would identify areas where they are most affected and be a proxy indicator of the levels in the community. Second, the immediate and distal consequences of blindness for women may be understood to be so burdensome that there is a pressing need to identify the localities where women are the worst affected. Third, a prior commitment to improve the health and wellbeing of these two groups in particular may be driving the search for more accurate and robust information on the determinants, levels, and consequences of infections among these two groups. Indeed, the available data evidences that there are more infections among children than adults, and in most high prevalence countries, there are more infections and consequent cases of blindness in adult women than men. It also seems to be a well-established understanding that the highest rate of transmissions of infections occurs between children. This has lead researchers to conclude that women are burdened with more trachoma infections because as primary caregivers of children they have repeated exposure to the infected secretions of children. There is uncertainty however, as to whether the exposure to the infected secretions of children fully explains the higher rate among women. Another factor in the higher number of incidences among adult women may be that women are biologically more vulnerable to chlamydia trachomatis infections than men, particularly during childbearing years. Furthermore, there is modest data about communities where the levels of trachoma infections and consequent blindness are thought to be equal among women and men, though it still remains uncertain as to whether such parity remains at different levels of endemicity.5 The various determinants of trachoma infections include limited access to water, lack of garbage collection, absence of latrine toilet, low frequency of face washing, poor personal hygiene, presence of flies, animals kept inside house, and poor indoor air quality. Aside from generalizing that these determinants are associated with extreme poverty, there is little conclusive data on the relative importance of the various determinants. Very few studies have sought to determine the many ways in which women are exposed to these determinants in particular locations. Moreover, very few studies or operational research has been undertaken to determine the level of influence women have over these determinants. In contrast to the inconclusive data on the determinants and prevalence of trachoma infections, there has been substantial progress in understanding the natural history of the disease; the clinical, biomedical consequences of infection, for example, deamamine effects. There is another method that is popular among people with a chemistry and math education, but anyone can use it. Find out the concentration of medication you have. Remember, the drug order is 2 mg of Lidocaine 20% and a bag of 500 ml Normal Saline. First convert the 2 Gms of Lidocaine into mgs which equals 2000 mg. This needs to be done because the order is in milligrams per minute. We always divide the amount of solution into the amount of drug. Divide 500 ml into 2000 mg Lidocaine 2 Gm 2000 mg. The answer you get is 4 mg ml. The formula is now set up as follows: IV Bag Amount ml ; X dose ordered mg min ; X drip set gtts ml ; 30 drops per minute Drug on hand mg ; Another method found useful is the following: Drug order 2 mg min ; X IV drip set 60 gtts ml ; Drug Concentration 4mg ml X 1 minute.
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