Will the United States continue to allocate a growing proportion of its GDP to health care?

What policy options would improve the access, efficiency, and quality shortcomings found in the current U.S. health care system? This session will address the efficacy of the available policy alternatives and their likely interactions. What, for instance, are the cost implications of providing better insurance coverage and encouraging ongoing scientific progress? How should these desirable objectives be financed? Can better measures of quality and outcomes and more effective management systems help to balance our health care goals?Health care reform

Mechanism of T-Cell Lymphomagenesis: Transformation of Growth-Factor-Dependent T-Lymphoblastoma Cells to Growth-Factor-Independent T-Lymphoma Cells

In a previous paper we described the induction by x-irradiation or radiation-induced leukemia virus-in-oculation of two classes of lymphoid T-cell neoplasms: The first class, designated T-cell lymphoblastoma (TCLB), consists of growth-factor-dependent eudiploid cells that home to the spleen and give rise to splenic tumors on injection into syngeneic mice; the second class, designated T-cell lymphoma (TCL), consists of growth-factor-independent aneuploid or pseudodiploid cells that give rise to local tumors at the site of subcutaneous injection. This paper describes the generation of a family of growth-factor-independent aneuploid or pseudodiploid TCL cells after the injection into the thymus of growth-factor-dependent diploid TCLB cells. In contrast to the donor TCLB cells, the resulting TCL cells could be cloned in semisolid medium, produced local tumors at the site of subcutaneous injection, and proliferated in a growth-factor-independent fashion in vitro. The induced growth-factor-independent TCL cells were chromosomally and phenotypically unstable and continued to evolve both in vivo and in vitro. After propagation in the thymus, the cells often showed stable translocations in addition to the evolving aneuploidy. We propose that the chromosome abnormalities induced during the proliferation of growth-factor-dependent TCLB cells in the thymus constitute a general mechanism by which neoplastic cells progress from growth-factor dependency to independency

Phase transition of one dimensional bosons with strong disorder

We study one dimensional disordered bosons at large commensurate filling. Using a real space renormalization group approach we find a new random fixed point which controls a phase transition from a superfluid to an incompressible Mott-glass. The transition can be tuned by changing the disorder distribution even with vanishing interactions. We derive the properties of the transition, which suggest that it is in the Kosterlitz-Thouless universality class.Comment: 4 pages 3 embedded eps figure

Aboriginal socio-economic status: are there any evident changes?

As the relative poverty of Aboriginal people in the Australian context is increasingly gaining recognition, equity issues between Aboriginals and other Australians have become matters of urgent concern for policy formation and implementation. This paper provides a statistical overview of the economic and social deprivation of the Aboriginal population as a whole by examining Australian Bureau of Statistics (ABS) Census data from 1971 to 1986. The paper undertakes a comparative analysis between the Aboriginal and total population with respect to labour force characteristics, employment and unemployment, education, and individual incomes. The occupations and industry profiles of employed persons are also analysed. The analysis shows that levels of educational qualification, incomes and employment levels were substantially lower for Aboriginal Australians, while the reverse was true for unemployment and dependency ratios. Statistical data also reveal that Aboriginal employment status has declined between 1971 and 1986 relative to the total population, despite numerous Federal Government programs to improve their economic situation

Hypertensive cardiac failure due to an aberrant renal artery: report of a case in an African child

No Abstrac

Statistical analysis of the primary outcome in acute stroke trials

Common outcome scales in acute stroke trials are ordered categorical or pseudocontinuous in structure but most have been analyzed as binary measures. The use of fixed dichotomous analysis of ordered categorical outcomes after stroke (such as the modified Rankin Scale) is rarely the most statistically efficient approach and usually requires a larger sample size to demonstrate efficacy than other approaches. Preferred statistical approaches include sliding dichotomous, ordinal, or continuous analyses. Because there is no best approach that will work for all acute stroke trials, it is vital that studies are designed with a full understanding of the type of patients to be enrolled (in particular their case mix, which will be critically dependent on their age and severity), the potential mechanism by which the intervention works (ie, will it tend to move all patients somewhat, or some patients a lot, and is a common hazard present), a realistic assessment of the likely effect size, and therefore the necessary sample size, and an understanding of what the intervention will cost if implemented in clinical practice. If these approaches are followed, then the risk of missing useful treatment effects for acute stroke will diminish