In the 1990s medical practices received increasing pressure to demonstrate quality of care and accountability. In 1991 a nonprofit organization called the National Committee for Quality Assurance (NCQA) began accrediting managed care organizations (MCOs) to help purchasers and consumers of managed healthcare select plans based on quality and value, instead of price and provider network only. In the following years the NCQA also accredited managed behavioral healthcare organizations (MBHOs), credentials verification organizations (CVOs) and physician organizations (POs). Almost half of US health managed care organizations (HMOs) covering about 75% of all HMO participa nts were involved in NCQA's voluntary accreditation program. More information about NCQA appears at its website at http://www.ncqa.org.

1 Is there any role for heparin in management of septic shock?

2 Is there more adrenaline (epinephrine) or noradrenaline (norepinephrine) produced in shock? From where do these substances come from?

3 I hear conflicting views as to whether activated protein C is useful in shock.

4 Why does both vasoconstriction and vasodilatation occur in shock?

5 Are pulmonary artery (PA) catheters dangerous?

6 In most hospitals, what is the difference between a high-dependency unit (HDU) and an intensive care unit (ITU) and what is 'step down' care?

7 What is the difference between acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) from a practical point of view?

8 What is the role of inhaled nitric oxide (NO) in acute respiratory distress syndrome (ARDS)?

9 What is meant by 'positive' pressure ventilation?

10 Why is an electroencephalogram (EEG) not used in all countries to evaluate possible brain death.