Purpose: The purpose of the study was to evaluate the quality of content of optometrist-initiated glaucoma referral letters arriving at the appointment booking centre at Moorfields Eye Hospital (MEH). Methods: The minimum standard of information required for an ophthalmologist to determine the appropriateness and urgency of glaucoma suspect referral was determined, and criteria for three standards of referral letter formulated: ÔIdealÕ, ÔAcceptableÕ and ÔFailÕ. These standards were applied to a prospective review of all optometrist-derived referrals for glaucoma or suspected glaucoma cases arriving in the MEH booking centre over a 4-month period. The contents of each letter were scrutinised and classified based on the criteria within each standard. Results: Forty-nine per cent of referral letters were found to be of ÔacceptableÕ quality, 7% ÔidealÕ quality and the remainder classed as ''fail''. The main reason for failure was an omission of nonclinical information, including patient and/or referring practice details, although 26% of letters failed to include an optic disc evaluation and 6% failed to provide intra-ocular pressure measurements. Twothirds of ÔacceptableÕ letters did not reach the ÔidealÕ standard due to a lack of discussion of risk factors, visual field analysis or recommendations for referral speed. Discussion: The information gleaned from this prospective study indicates a need to improve the quality of optometristsÕ glaucoma referral letters, particularly with respect to completion of all the items set out on the General Ophthalmic Services (GOS) 18 referral form.

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Prior studies in general suggest a positive association between auditor tenure (the length of an auditor–firm relationship) and reporting quality (the informational content of reported earnings). In this study, we present evidence that the association is reversed when clients represent increased litigation risks to their auditors. Featuring downward biases in reported earnings as a measure of reporting quality that stem from auditors’ minimization of costs from potential audit errors, we argue that the magnitude of such downward bias decreases in auditors’ experiences with their clients (tenure improves reporting quality). Furthermore, we predict that longer auditor tenure is associated with larger downward bias for firms with increased audit risks (tenure impairs reporting quality). Using non-operating accruals as proxy for downward bias in reported earnings, we find robust empirical evidence in support of our prediction.

In this paper, we provide evidence that banks with a low level of capitalization have reduced their commitment with respect to lines of credit after the introduction of the Basle Accord. A bank's lending behavior reflects its level of commitment towards borrowers, which in turn affects the level of effort it exerts on screening and monitoring the activities of borrowers. We find that the post-Basle Accord market reaction to the announcement of lines of credit issued by banks with a low level of capitalization is significantly lower than the reaction to other types of bank credit announcements. We interpret this result as evidence that some banks have a low level of commitment associated with lines of credit after the Basle Accord. Copyright Springer Science+Business Media, LLC 2007Bank capitalization, Credit agreements, Basle Accord,