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At least 829 records · Page 46Linked to original sources
PubMed1982

A seed money grant program for family medicine research.

It appears that the seed money allocation process instituted by the University of Washington Department of Family Medicine one year ago has facilitated the launching of several pilot studies by removing small but significant financial barriers. Expressions of concern about the equitable allocation of departmental resources for research have abated, and energies have focused increasingly on how to do research and less on how to fund it. The funds and in-kind resources allocated have helped promote collaboration between community practitioners and academic researchers. The seed money program has assisted relatively inexperienced researchers to obtain valuable research experience which will make future applications for external grant support more credible and competitive.

Academic Medical Centers↗
PubMed1997

Pediatric facial fractures: a demographic analysis outside an urban environment.

This study reviews all pediatric facial fractures treated operatively at the C.S. Mott Children's Hospital of the University of Michigan over a 5-year period. Previous series of pediatric facial fractures have been collected at large urban centers and may not be representative of all practice environments. Our institution is a level 1 trauma center that serves a patient population primarily from suburban and rural regions throughout the state. Referral and practice patterns at our institution gave us an important opportunity to analyze differences in patient care and management secondary to venue, and challenge the assumptions made by studies collected at large urban centers. We reviewed 80 fractures in 62 patients. Patient age ranged from 2 to 18 years old with the majority of patients (58%) between 15 and 18 years old. Most fractures resulted from motor vehicle accidents (43%) and there were no firearm injuries. Fracture sites included the mandible (38%), the frontonasoethmoid region (35%), the midface (17%), and the orbit (10%). Only two operative complications were reported. There were no cervical spine injuries. Median patient age was higher and mechanism of injury differed in our study compared with urban studies. Rapid changes in the health care delivery system and the emergence of managed care demand accurate demographic updates for the efficient allocation of valuable resources. Our results showed important differences with previous studies and imply that assumptions and analysis of the care of pediatric facial fractures based solely on data collected at large urban centers may be too parochial, and therefore subsequent health care decisions of resource allocation arrived at without respect to practice environment could be erroneous.

Adolescent↗
PubMed1992

Equity and solidarity: the context of health care in The Netherlands.

The current debate on health care resource allocation in the Netherlands is characterized by a social context in which two values are generally and traditionally accepted as being equally fundamental:solidarity and equity. We will present an outline of the distinctive features of the Dutch health care system, and analyze the present state of affairs in the resource allocation debate. The presuppositions of the political call for constraint and (renewed) government supervision and the role of the specific value context in recent proposals for reconstruction of the Dutch health care system will be evaluated.

Attitude to Health↗
PubMed1984

Ethics and psychiatric research: problems and justification.

The discussion of ethics in psychiatry continues to increase. Research in psychiatry, like all medical research, is of ethical concern because it often involves risks to subjects so that others may benefit. It also involves the allocation of monetary and human resources. In recent years these concerns have been brought to the forefront of professional and public attention. The authors consider the problem of justifying resource allocations and the risks involved in psychiatry research, survey some of the special problems faced by researchers in this field, and give a brief account of present government regulations that pertain to research ethics in psychiatry.

Behavioral Research↗
PubMed1997

Disability-adjusted life years: a critical review.

The disability-adjusted life year (DALY) has emerged in the international health policy lexicon as a new measure of the 'burden of disease'. We argue that the conceptual and technical basis for DALYs is flawed, and its assumptions and value judgements are open to serious question. In particular, the implications of age-weighting and discounting are found to be unacceptable. Moreover, the proponents of DALYs do not distinguish between the exercises of measuring the burden of disease and of allocating resources. But the appropriate information sets for the two exercises are quite different. Allocating resources by aggregate DALY-minimization is shown to be inequitable.

Age Factors↗
PubMed1995

Why bioethicists have nothing useful to say about health care rationing.

Bioethicists are increasingly commenting on health care resource allocation, and sometimes suggest ways to solve various rationing dilemmas ethically. I argue that both because of the assumptions bioethicists make about social reality, and because of the methods of argument they use, they cannot possibly make a useful contribution to the debate. Bioethicists who want to make a practical difference should either approach health care resource allocation as if the matter hinged upon tribal competition (which is essentially what it does), or they should do political philosophy in the traditional sense, and examine the health system from the outside.

Attitude of Health Personnel↗
PubMed2026

Turnip mosaic virus alters phosphorus metabolism and shoot-root allocation without resource competition.

Plant viruses affect production through symptom induction in host plants. These symptoms could partially arise from nutrient deprivation: The resource competition hypothesis posits that massive viral replication deprives hosts of essential nutrients, yet direct evidence for phosphorus (P) competition is lacking. Moreover, it is reported that biotic stresses can lead to alterations on P metabolism. Using a hydroponic system enabling separate analysis of shoots and roots in adult Arabidopsis thaliana plants, we investigated whether Turnip mosaic virus (TuMV) drawed significant P internal pools leading to P competition or altered P metabolism. TuMV genomic RNA represented < 0.3% of the P pool allocated to 18S rRNA, refuting the resource competition hypothesis. Instead, TuMV induced a marked shoot-to-root P redistribution: Shoot/Root Pi and Porg changed from 1.7 to 1.04 to 0.71 and 0.68, respectively. This altered partitioning correlated with organ-specific gene expression changes: high-affinity transporters PHT1; 4 and PHT1; 5 were co-induced in shoots, whereas immunity-related PHT1; 4 was uniquely repressed in roots. The senescence-associated gene SEN1 showed opposite regulation between organs (repressed in shoots, induced in roots), distinguishing virus-induced responses from canonical senescence. Multivariate analysis revealed that shoots and roots only partially share physiological and molecular responses to TuMV. The virus reprograms phosphorus metabolism through organ-specific changes, not through resource depletion, and roots act as a distinct hub integrating infection response, senescence, and nutrient dynamics. This study advances the understanding of growth-defense trade-offs in plant mineral nutrition and identifies new targets for maintaining crop productivity under biotic stress.

Arabidopsis↗
PubMedDate not supplied

Making tough resource decisions. A process for considering both values and costs.

Effective resource management involves prospective decision making, including setting priorities. This enables healthcare facilities to provide services that are consistent with institutional commitments and, under some circumstances, to limit or deny services that are inconsistent with those commitments. The challenge is to apply explicit moral analysis to resource allocation efforts to ensure that facilities are treating patients consistently and fairly. Not only are allocation decisions unavoidable, they also can promote holistic, socially responsible medical practice. But current mechanisms, which are largely hidden from view and informal, can negatively affect important relationships with constituents. The just allocation of our precious healthcare resources rests on values that can either conflict with or complement one another. The core values in resource management include respect for persons, professional integrity, due process, informed consent, stewardship, and the common good. An interdisciplinary team of providers should oversee an ongoing review of resource management mechanisms. The group should meet regularly to look at how the mechanism works, what its goals are, what unit of care it evaluates, and what measurements are used to reach the goals. The measures might include severity of illness, effectiveness, cost, and social factors. Examining questions related to each of these areas can help the group determine whether an existing or proposed resource management mechanism is morally defensible.

Aged↗