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Canadian universities go shopping for research scientists
Spain rejects “social” reasons to deny access to transplantation he Spanish Ministry of Health warned on Oct 13 that “social reasons can never constitute a counter-indication for transplantation” after a report written by doctors from a Madrid hospital suggested that a homeless man could undergo a heart transplant “as long as his sociolaboural situation would improve”. The Ministry also stated that an indication for transplantation can only be established by an officially authorised transplantation unit. Once a unit permits an operation, its decision “must be communicated to the National Transplant Organisation (ONT)” and the patient will join a waiting-list. All patients on such programmes should always be considered “on an equal basis to other patients, and priority is to be based on previously established clinical urgency levels”, concluded the Minsitry’s guidelines. The Ministry’s statement follows the case of Abdelhak Chaib, a 52 year old man from Sahara, Africa, who was diagnosed with chronic
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only requirement for a patient’s entry ischaemic cardiomyopathy and severe onto a waiting list, even though a contractile dysfunction in June, 1998, patient’s “social situaat the arrhythmia unit tion may affect the of the Hospital Ramón graft feasibility”. y Cajal in Madrid. The Spanish José Perales, deputy Minister of Health, director of the hospiJosé Manuel Romaytal, told the El Pais Beccaría, said that “for newspaper that “any transplantation, no cittransplantation has to izen can be discrimitake account of the nated on social general conditions of grounds”. The ONT the patient including has done transplantahis or her sociotions on illegal immilaboural situation”. Equal access for all grants and had given Organs for transplanthem complete health-care coverage tation are scarce and the process before now, he noted. requires long sick-leave and longMeanwhile, the NHS has term immunosuppressive therapy, requested the hospital do an exhauswhich means that patients must have tive review to decide if proceedings an “appropriate social setting and a will be started against the doctors steady household”, he argued. who signed Chaib’s medical report. Spokespersons for the ONT and Chaib’s case was reviewed on Oct 19 the National Health Service (NHS) by doctors from the Hospital Doce de agreed that the conditions applied by Octubre in Madrid. Hospital Ramón y Cajal’s doctors were inappropriate and unwise. Medical criteria should be the X avier Bosch
Canadian universities go shopping for research scientists
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he Canadian government unveiled a Can$300-million initiative on Oct 12, at the autumn opening of parliament, to allow Canadian universities to hire 2000 “21st Century Chairs of Research Excellence” during the next few years to help combat the “brain drain” to other countries, mainly the USA. “It is a plan for brain gain, not brain drain”, said Prime Minister
Jean Chretien. He added that 400 new research posts would be established annually. Funding for the renewable posts will form two tiers of awards and will be for 5–7 years. Senior researchers will receive $200 000 per year, while junior posts valued at $100 000 per year will be issued to “attract rising stars, who will be the leaders of tomorrow”. Universities will each be given a set number of posts based
on the success of their researchers in recent grant-council competitions. At least 40% of the positions are projected to be in biomedical and health sciences, which prompted the president of the Canadian Medical Research Council, Henry Friesen, to laud the initiative as a means of positioning Canada’s economy “to compete on a world stage”. Wayne Kondro
Doctors in Denmark try to reduce the number of blood transfusions octors in Denmark are trying to limit the amount of blood used in hospitals. Denmark has a high rate of blood use relative to its population size, and this must be changed, says Joergen Georgsen of the clinical immunology department of the University Hospital of Odense, Denmark. “If a patient is to have a new hip in Denmark, he or she is almost certain to receive blood during surgery. But in Holland the patients are just as certain not to receive any blood for the same kind of surgery. We unnecessarily use too much blood for transfusions, and now we want to do something about it”, says Georgsen.
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To assess hospital blood use, the Danish Society for Clinical Immunology is surveying blood usage by all doctors in Denmark. This survey is in line with the Danish National Board of Health’s recommendations, which also suggested the creation of blood-transfusion councils across the country. The Board noted that while other countries have lowered their blood use during the 1990s Denmark’s consumption remains unchanged. “The most important reason to lower the use of blood is that it is a treatment with side-effects and large costs. Patients occasionally get the wrong blood, and at the same time
run a risk of getting infected . . . If Denmark could reduce its use of blood to the level of Norway, it would mean a cost reduction of more than 100 million Danish kroner [US$14·5 million] a year”, says Georgsen. Doctors believe that the problem is mainly a matter of hospital culture and habits. For example, doctors noted that at the Oslo Heart Centre in Norway only 2% of the patients get a blood transfusion during surgery compared with 50% of patients at the University Hospital in Odense. Kaare Skovmand
THE LANCET • Vol 354 • October 23, 1999
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only requirement for a patient’s entry ischaemic cardiomyopathy and severe onto a waiting list, even though a contractile dysfunction in June, 1998, patient’s “social situaat the arrhythmia unit tion may affect the of the Hospital Ramón graft feasibility”. y Cajal in Madrid. The Spanish José Perales, deputy Minister of Health, director of the hospiJosé Manuel Romaytal, told the El Pais Beccaría, said that “for newspaper that “any transplantation, no cittransplantation has to izen can be discrimitake account of the nated on social general conditions of grounds”. The ONT the patient including has done transplantahis or her sociotions on illegal immilaboural situation”. Equal access for all grants and had given Organs for transplanthem complete health-care coverage tation are scarce and the process before now, he noted. requires long sick-leave and longMeanwhile, the NHS has term immunosuppressive therapy, requested the hospital do an exhauswhich means that patients must have tive review to decide if proceedings an “appropriate social setting and a will be started against the doctors steady household”, he argued. who signed Chaib’s medical report. Spokespersons for the ONT and Chaib’s case was reviewed on Oct 19 the National Health Service (NHS) by doctors from the Hospital Doce de agreed that the conditions applied by Octubre in Madrid. Hospital Ramón y Cajal’s doctors were inappropriate and unwise. Medical criteria should be the X avier Bosch
Canadian universities go shopping for research scientists
T
he Canadian government unveiled a Can$300-million initiative on Oct 12, at the autumn opening of parliament, to allow Canadian universities to hire 2000 “21st Century Chairs of Research Excellence” during the next few years to help combat the “brain drain” to other countries, mainly the USA. “It is a plan for brain gain, not brain drain”, said Prime Minister
Jean Chretien. He added that 400 new research posts would be established annually. Funding for the renewable posts will form two tiers of awards and will be for 5–7 years. Senior researchers will receive $200 000 per year, while junior posts valued at $100 000 per year will be issued to “attract rising stars, who will be the leaders of tomorrow”. Universities will each be given a set number of posts based
on the success of their researchers in recent grant-council competitions. At least 40% of the positions are projected to be in biomedical and health sciences, which prompted the president of the Canadian Medical Research Council, Henry Friesen, to laud the initiative as a means of positioning Canada’s economy “to compete on a world stage”. Wayne Kondro
Doctors in Denmark try to reduce the number of blood transfusions octors in Denmark are trying to limit the amount of blood used in hospitals. Denmark has a high rate of blood use relative to its population size, and this must be changed, says Joergen Georgsen of the clinical immunology department of the University Hospital of Odense, Denmark. “If a patient is to have a new hip in Denmark, he or she is almost certain to receive blood during surgery. But in Holland the patients are just as certain not to receive any blood for the same kind of surgery. We unnecessarily use too much blood for transfusions, and now we want to do something about it”, says Georgsen.
D
1454
To assess hospital blood use, the Danish Society for Clinical Immunology is surveying blood usage by all doctors in Denmark. This survey is in line with the Danish National Board of Health’s recommendations, which also suggested the creation of blood-transfusion councils across the country. The Board noted that while other countries have lowered their blood use during the 1990s Denmark’s consumption remains unchanged. “The most important reason to lower the use of blood is that it is a treatment with side-effects and large costs. Patients occasionally get the wrong blood, and at the same time
run a risk of getting infected . . . If Denmark could reduce its use of blood to the level of Norway, it would mean a cost reduction of more than 100 million Danish kroner [US$14·5 million] a year”, says Georgsen. Doctors believe that the problem is mainly a matter of hospital culture and habits. For example, doctors noted that at the Oslo Heart Centre in Norway only 2% of the patients get a blood transfusion during surgery compared with 50% of patients at the University Hospital in Odense. Kaare Skovmand
THE LANCET • Vol 354 • October 23, 1999