Community participation in health care decision making: is it feasible?

Health care reform strategies proposed by provincial governments include decentralized funding and increased public participation in decision making. These proposals do not give details as to the public participation process, and a number of questions have been raised by the experience of some communities. Which citizens should form the decision-making group? What information do they need? What kinds of decisions should they make? What level of participation should they have? The results of a survey by Abelson and associates (see pages 403 to 412 of this issue) challenge the assumption that "communities" are willing to participate in health-care and social-service decision making. Willingness varied according to the composition of the groups polled, and participants'' support for traditional decision makers increased after the complexities of the decision-making process were discussed. However, whereas their study measured willingness to participate at one point in time only, experience gained from Ontario''s Better Beginnings, Better Futures project indicates that, given sufficient time, "ordinary" citizens are willing and can acquire the skills needed to decide how resources should be allocated for social services.     

Limb regeneration in axolotl: is it superhealing?

The ability of axolotls to regenerate their limbs is almost legendary. In fact, urodeles such as the axolotl are the only vertebrates that can regenerate multiple structures like their limbs, jaws, tail, spinal cord, and skin (the list goes on) throughout their lives. It is therefore surprising to realize, although we have known of their regenerative potential for over 200 years, how little we understand the mechanisms behind this achievement of adult tissue morphogenesis. Many observations can be drawn between regeneration and other disciplines such as development and wound healing. In this review, we present new developments in functional analysis that will help to address the role of specific genes during the process of regeneration. We also present an analysis of the resemblance between wound healing and regeneration, and discuss whether axolotls are superhealers. A better understanding of these animals' regenerative capacity could lead to major benefits by providing regenerative medicine with directions on how to develop therapeutic approaches leading to regeneration in humans.     

Abiotic nitrate incorporation in soil: is it real?

In acid forest soils nitrate (NO₃⁻) from anthropogenic nitrogen deposition is retained at levels beyond what can be explained by known biological mechanisms. A number of researchers have hypothesized that abiotic NO₃⁻ incorporation into soil organic matter might be responsible for this phenomenon, however studies have been limited to a few temperate forest sites. The goal of this study was to determine if abiotic NO₃⁻ incorporation is important across a wide range of soil types. We collected 44 soils from a number of different ecosystem types in North and South America and measured the extent of abiotic NO₃⁻ incorporation. Significant abiotic nitrate incorporation did not occur in any of the soils examined. We show that the apparent abiotic incorporation observed in previous studies is likely the result of iron interference with NO₃⁻ measurements. Our results suggest that abiotic NO₃⁻ incorporation is not a likely explanation for the high rates of NO₃⁻ retention observed in some ecosystems.     

Cytokines in rheumatoid arthritis: is it all TNF-alpha?

Anti-TNF-alpha therapy has shown clear efficacy in the treatment of rheumatoid arthritis (RA). Since some patients do not respond and the treatment is suspensive, combination therapy may be of interest. Other cytokines produced by monocytes such as IL-1, IL-12, IL-18 are also involved. The secretion of these cytokines is regulated by subsets of T-lymphocytes. Among these, IL-17 producing Th1 cells appear to contribute directly to the destructive process. Furthermore, this T-cell contribution enhances the action of monocyte derived proinflammatory cytokines. Using models of human RA synovium inflammation and bone resorption, ex vivo results suggest that combination therapy may be of interest. Acting on more than one cytokine may increase the percentage of responding RA patients as well as the degree of individual patient response.     

Male care in primates: does it ever reflect paternity?

Female mammals have internal fertilization, long gestation, and lactation. These basic facts of reproductive biology have important social consequences. Internal fertilization (accompanied by sperm competition) forces males either to face considerable uncertainty about paternity or to invest heavily in mate guarding. Long gestation increases the benefits of mate desertion for males. And because only females lactate, males have relatively less to contribute to rearing the young. Hence, it is not surprising that male mammals rarely assist their mates in caring for their young: Direct infant care by males occurs in fewer than 5 percent of all mammalian species.^1,2 In fact, many mammalian mothers attack males, even possible father of their offspring.³     

The plastid in Apicomplexa: what use is it?

An extrachromosomal genome of between 27 and 35 kb has been described in several apicomplexan parasites including Plasmodium falciparum and Toxoplasma gondii. Examination of sequence data proved the genomes to be a remnant plastid genome, from which all genes encoding photosynthetic functions had been lost. Localisation studies had shown that the genome was located within a multi-walled organelle, anterior to the nucleus. This organelle had been previously described in ultrastructural studies of several genera of apicomplexa, but no function had been attributed to it. This invited review describes the evolution of knowledge on the apicomplexan plastid, then discusses current research findings on the likely role of the plastid in the Apicomplexa. How the plastid may be used to effect better drug treatments for apicomplexan diseases, and its potential as a marker for investigating phylogenetic relationships among the Apicomplexa, are discussed.     

WHO in retreat: is it losing its influence?

WHO says it has three main functions: to set normative standards; to provide technical advice and assistance on medical matters; and to advocate changes in health policy. During its 46 year history the first two functions have been a constant and uncontroversial backbone through which WHO has earned its reputation for scientific excellence. The third function, advocacy, came to the fore with the launch of Health for All in 1977, after which WHO took a key role in influencing international health policy. WHO''s friends and critics alike now say that the organisation is losing its influence and retreating into its technical and biomedical shell. This article maps the changes in WHO''s approach over the past 46 years and considers whether fears about its loss of influence are justified.     

Disruption of pheromone communication in moths: is the natural blend really most efficacious?

It is widely assumed that a blend of pheromone components, that is qualitatively and quantitatively similar to the natural sex attractant, is the most effective mating disruptant for moths. However, the literature contains only limited evidence supporting this assumption. The authors discuss the importance of comparing the relative effectiveness of complete and incomplete pheromone blends when evaluating the potential of mating disruption for controlling pest moths.     

Estrogens and obesity: is it all in our heads?

Estrogens have preventative effects on weight gain and associated comorbidities, but the tissue-specific targets remain unknown. Here, Xu et al. (2011) demonstrate that ablation of estrogen signaling in two populations of hypothalamic neurons leads to weight gain and subsequent metabolic dysregulation and could be important target sites of estrogen actions.     

Inositol trisphosphate receptor in higher plants: is it real?

The receptor for D-myo-inositol 1,4,5-trisphosphate (InsP3-R) has been well documented in animal cells. It constitutes an important component of the intracellular calcium signalling system. Today the corresponding genes in many species have been sequenced and the antibodies against some of the InsP3-Rs are available. In contrast, very little is known about its plant counterpart. Only a few published works have dealt directly with this topic. This review summarizes the available relevant data and determines some properties of putative plant receptor(s) including the in silico search for its gene in plant genomes, in vivo evidence, its electrophysiology, the parameters of InsP3-induced calcium release and InsP3 binding, immunological cross-reactivity, and subcellular localization. Future progress in this area seems to be inevitable as, despite the efforts, its gene in plants has not been identified yet.