Operating room time as a limited resource: ethical considerations for allocation

Scheduling surgical procedures among operating rooms (ORs) is mistakenly regarded as merely a tedious administrative task. However, the growing demand for surgical care and finite hours in a day qualify OR time as a limited resource. Accordingly, the objective of this manuscript is to reframe the process of OR scheduling as an ethical dilemma of allocating scarce medical resources. Recommendations for ethical allocation of OR time—based on both familiar and novel ethical values—are provided for healthcare institutions and individual surgeons.

THE SOUTHEASTERN VEGETABLE CROPS GUIDELINES AND SEVEW MEETING

Initiated by DC Sanders, the Southeastern Vegetable Crops Guidelines (SVCG) represents a major regional collaborative effort of Extension Specialists from Alabama, Louisiana, Georgia, Mississippi, North Carolina, and South Carolina whose aim is to produce an annually updated, all-in-one, fits on the dashboard of your truck reference for commercial vegetable growers and Extension workers for the Southeastern US. The first edition was developed in 1998 and published in 1999 as a “for pay” publication, but subsequent editions have employed a partnering with a corporate sponsor and publication company resulting in faster turnaround for printing and a no-cost publication. Each August, a team of Extension Vegetable Specialists, Extension Plant Pathologist, Extension Weed Specialists and Extension Entomologist from around the southeastern US meet for the Southeastern Extension Vegetables Workers (SEVEW) meeting. At this 2-day meeting, the participants' primary focus is to review, rewrite, refine, and update the current year's recommendations for the next edition of the SVCG. Although this publication is mainly used by the states listed, researchers and specialists from other states (FL, KY, OK, VA, TN) annually participate in this meeting. The SEVEW meeting has developed into an opportune forum for dialogues and exchanges updating each other as to the present critical issues in our respective states. Several land-grants are in the process of or are counting the SVCG/SEVEW as part of their federally-mandated multistate programming. Additionally, the SEVCG and SEVEW meeting are officially recognized as a Regional Project by CSREES. The 2005 edition can be found at http://www.aces.edu/dept/com_veg/2005_SEVCG.pdf.

EVIDENCE FROM ELECTRON MICROGRAPHS FOR THE PASSAGE OF MATERIAL THROUGH PORES OF THE NUCLEAR MEMBRANE

1. The nurse cells of Rhodnius possess nucleoli that stain with Heidenhain's hematoxylin but give a negative Feulgen reaction. In localized positions adjacent to the nuclear membrane are seen masses of material both within the nucleus and the adjoining cytoplasm that stain with Heidenhain's hematoxylin, but, like the nucleolus, give a negative Feulgen reaction. 2. Electron micrographs of the nurse cells of Rhodnius reveal the nuclear membrane to contain pores approximately 400 A in diameter. 3. In electron micrographs the nucleolus is seen to be composed of a reticulum containing tightly packed granules. Between the centrally located nucleolus and the nuclear membrane are observed relatively small bunches of granules of the same relative size as those occurring in the nucleolus. Aggregated at certain positions adjacent to the nuclear membrane both within the nucleus and in the adjoining cytoplasm are irregularly shaped masses of granules. Certain of these masses within the nucleus are seen to be continuous with those in the cytoplasm through narrow isthmuses of material extending through pores of the nuclear membrane. Other masses of granules show evidence of preparing to enter the pores by projecting tongues of material toward and into them. In the adjacent cytoplasm pear-shaped masses of granules are seen in front of and in contact with the pores which suggests that they were fixed in the process of or just after completing passage through the pores.