Priority setting in health authorities: a novel approach to a historical activity.

As resources in health care are scarce, health authorities and other health organizations are charged with determining how best to spend limited resources. While a number of formal approaches to priority setting within health authorities have been used internationally, there has been limited success with such activity, particularly across major service portfolios. This participatory action research project instituted a novel priority setting framework, coined macro-marginal analysis (MMA), in a fully integrated urban health region in Alberta, Canada.

Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA).

Background: Program budgeting and marginal analysis (PBMA) is a framework for setting priorities in health care, used internationally over the last 25 years in Britain, Australia and New Zealand. However, the framework has undergone limited evaluation, and insight into how such evaluation should even take place is not found in the literature.

Methods: Seven PBMA case studies were conducted in three Canadian health regions to examine the feasibility of applying the PBMA framework.

Successful treatment of posttransplant lymphoproliferative disorder in a renal transplant patient by autologous peripheral blood stem cell transplantation.

Posttransplant lymphoproliferative disorder (PTLD), a well recognized complication of organ transplantation, comprises a wide spectrum of heterogeneous lymphoid proliferations ranging from self-limiting mononucleosis through aggressive monoclonal non-Hodgkin's lymphoma (NHL). There has been marginal success in treating PTLD using a number of treatment modalities, including combination chemotherapy. There have been few reports of the use of high dose chemotherapy with stem cell rescue as a treatment for PTLD.

Selected glimpses into the activation and function of Src kinase.

Since the discovery of the v-src and c-src genes and their products, much progress has been made in the elucidation of the structure, regulation, localization, and function of the Src protein. Src is a non-receptor protein tyrosine kinase that transduces signals that are involved in the control of a variety of cellular processes such as proliferation, differentiation, motility, and adhesion. Src is normally maintained in an inactive state, but can be activated transiently during cellular events such as mitosis, or constitutively by abnormal events such as mutation (i.

Localization of retinoid binding proteins, retinoid receptors, and retinaldehyde dehydrogenase in the chick eye.

Retinoids have many functions in the eye, including, perhaps, the visual guidance of ocular growth. Therefore, we identified where retinoid receptors, binding proteins, and biosynthetic enzymes are located in the ocular tissues of the chick as a step toward discovering where retinoids are generated and where they act. Using antibodies to interphotoreceptor retinoid binding protein (IRBP), cellular retinol binding protein (CRBP), cellular retinoic acid binding protein (CRABP), cellular retinaldehyde binding protein (CRALBP), retinaldehyde dehydrogenase (RALDH), and retinoic acid receptors (RAR and RXR), we localized these proteins to cells in the retina, retinal pigmented epithelium, choroid and sclera of the chick eye.

Cholinergic amacrine cells are not required for the progression and atropine-mediated suppression of form-deprivation myopia.

Muscarinic cholinergic pathways have been implicated in the visual control of ocular growth. However, the source(s) of acetylcholine and the tissue(s) which regulate ocular growth via muscarinic acetylcholine receptors (mAChRs) remain unknown. We sought to determine whether retinal sources of acetylcholine and mAChRs contribute to visually guided ocular growth in the chick.

The orphan receptor BmHNF-4 of the silkmoth Bombyx mori: ovarian and zygotic expression of two mRNA isoforms encoding polypeptides with different activating domains.

Two silkmoth nuclear receptor isoforms, BmHNF-4a and BmHNF-4b, that are related to the mammalian orphan receptor HNF-4, were characterized. Their characterization revealed that they differ from each other only in their 5' UTR and N-terminus of the predicted polypeptides. In ovarian tissue, the two receptors are expressed as a delayed response to 20-hydroxy-ecdysone and their expression increases during vitellogenesis.

Integrated map of the Schizosaccharomyces pombe genome.

A restriction map of the entire Schizosaccharomyces pombe genome was constructed using two restriction enzymes (BamHI and PstI) that recognize 6 bp. The restriction map contains 420 minimally overlapping clones (miniset) and has 22 gaps. We located 126 genes, marker fragments of DNA (NotI and SfiI linking clones), and 36 transposable elements by hybridization to unique restriction fragments.

Fixation-dependent organization of core histones following DNA fluorescent in situ hybridization.

We have evaluated the effects of different DNA denaturation protocols commonly used in DNA fluorescent in situ hybridization (FISH) experiments on chromatin structure using indirect immunofluorescence. The use of antibodies to acetylated histones H3 and H4 demonstrates that the different procedures differ considerably in their extent of histone displacement. Procedures involving paraformaldehyde fixation were found to be compatible with the structural preservation of acetylated chromatin organization by indirect immunofluorescence.

Narrative ethics: a means to enrich medical education.

The study of literature and medicine enriches the humanistic skills of medical students and physicians. In particular, the study of medical ethics through the lens of narrative enlightens the moral imagination, and provokes moral reflection. In this article, examples will be discussed with the analysis of two books used in a medical-ethics curriculum.

The evolution of the concept of brain death.

The definition of death has taken many forms throughout history. Because of advances in critical care and developments in transplantation, a new definition of death has evolved over the past 30 years. The first accounts of brain death were published in 1959, in relative obscurity.