Future directions in antler research

Through a series of interrogatories, unsolved problems of antler evolution, anatomy, development, physiology, and pathology are probed, with commentaries on the following prospects for future research:

• 1. How could these improbable appendages have evolved mechanisms to commit suicide, jettison the corpse, and regenerate new ones every year?
• 2. By what developmental processes are antlers able to prescribe their own morphogenesis with mirror image accuracy year after year and in some cases produce deliberate asymmetries?
• 3. What causes the scalp to transform into velvet skin as a deer's first antlers develop?
• 4. Why do healing pedicle stumps give rise to antler buds instead of scar tissue?
• 5. How is the unprecedented rate of antler elongation related to the diameter and length of the structure to be grown?
• 6. How come wound healing by pedicle skin is held in abeyance for several months until new growth resumes?
• 7. How is it that tropical deer regenerate antlers at any time of year, while in temperate zones deer do so in seasonal unison?
• 8. How do deer find enough calcium to make such massive antlers in only a few months?
• 9. What is the nature of the bizarre tumors that some antlers grow following castration? © 1995 Wiley-Liss, Inc.

     

Future directions of multiple behavior change research

Non-communicable diseases (i.e., chronic diseases including cardiovascular disease, cancer, chronic respiratory disease, diabetes and obesity) result in 36 million deaths each year. Individuals’ habitual participation in a single health-risk behaviors substantially contribute to morbidity and mortality (e.g., tobacco use, daily fast food intake, etc.); however, more concerning is the impact of typically co-occurring or clustering of multiple health-risk behaviors. This burden can be minimized through successful cessation of health-risk behaviors and adoption of healthy behaviors; namely healthy lifestyle adoption or multiple health behavior change (MHBC). MHBC is a developing field and future research recommendations are provided to advance MHBC research. A valid measure of MHBC (i.e., lifestyle) is warranted to provide the needed basis for MHBC investigations and evaluations. MHBC is thought to occur through shared co-variation of underlying motivating mechanisms, but how these relationships influence behavior remains unclear. A better understanding of the relationship between behaviors and the related motivating mechanisms (and potential cross-relationship of influences) is needed. Future research should also aim to improve lifestyles through understanding how to change multiple health behaviors. Finally, MHBC research should target the development of sustainable interventions which result in lasting effects (e.g., capacity, systems, policy and environmental changes), with dissemination considered during development. Focusing MHBC research in these areas will increase our understanding and maximize the impact on the health of populations.     

Future directions in research on consumer-provider communication and adherence to cancer prevention and treatment

The goal of this paper is to examine emerging issues in consumer-provider communication and patient adherence to cancer prevention, screening, diagnosis, treatment, and coping with survivorship. Many factors that have been shown to affect adherence can be supported or hindered by provider-patient communication, including the provider-patient relationship, patients' beliefs, social and cultural norms, family and social support, mood, and behavioral management. Six research questions are posed, and substantive and methodological recommendations are offered for empirical research on the measurement and achievement of patient adherence.     

Future directions for doll play narrative research: a commentary

Past research into doll play narratives has been productive in elucidating children's inner experiences, their determinants, and their role in child behaviour problems. The current volume takes this work forward in several directions: first, it indicates the value of designing story stems and coding schemes to address more specific questions about the developmental process of specific syndromes. Second, contributions demonstrate the "added value" provided by children's narratives, over and above information derived from other sources. Third, this recent research enhances our understanding of the role of parental representations and states of mind in influencing children's narratives; how these may come to influence child functioning via co-constructed parent - child dialogues is an important area for future research. Finally, possibilities of extending the clinical utility of doll play narratives are explored.     

Future vision of the GDB human genome database

In 1973, scientists assembled at the first Human Gene Mapping Workshop to discuss the 64 human genes mapped at that time. In 1989, the GDB Human Genome Database was created to store information on 1, 700 mapped human genes. Ten years later, as the human genome project closes in on the release of the complete DNA sequence holding as many as 100,000 human genes, GDB is evolving to continue to meet the needs of the scientific community. Well known as a resource for data which has been stringently reviewed as part of the curation process, GDB prepares to continue to provide a compilation of the human genome including maps, map objects, polymorphisms, and mutations. As more sites across the Internet are established to share biological information, it becomes increasingly burdensome for the scientist to collect data from all sources of a particular domain. In an attempt to reduce this burden, GDB continues to load data from large genome centres and accept submissions from researchers around the world. Moreover, GDB looks to provide a mechanism to link gene-related information to the human reference sequence. In doing this, GDB plans to establish federated linkages with "boutique" databases around the world that could contain enormous amounts of valuable information about specific genes or chromosomes.     

Future directions in biomaterials

Biomaterials have made a great impact on medicine. However, numerous challenges remain. This paper discusses three representative areas involving important medical problems. First, drug delivery systems; major considerations include drug-polymer interactions, drug transformation, diffusion properties of drugs and, if degradation occurs, of polymer degradation products through polymer matrices developing a more complete understanding of matrix degradation in the case of erodible polymers and developing new engineered polymers designed for specific purposes such as vaccination or pulsatile release. Second, cell-polymer interactions, including the fate of inert polymers, the use of polymers as templates for tissue regeneration and the study of polymers which aid cell transplantation. Third, orthopaedic biomaterials, including basic research in the behaviour of chrondrocytes, osteocytes and connective tissue-free interfaces and applied research involving computer-aided design of biomaterials and the creation of orthopaedic biomaterials.     

From human genome to cancer genome: The first decade

The realization that cancer progression required the participation of cellular genes provided one of several key rationales, in 1986, for embarking on the human genome project. Only with a reference genome sequence could the full spectrum of somatic changes leading to cancer be understood. Since its completion in 2003, the human reference genome sequence has fulfilled its promise as a foundational tool to illuminate the pathogenesis of cancer. Herein, we review the key historical milestones in cancer genomics since the completion of the genome, and some of the novel discoveries that are shaping our current understanding of cancer.     

Future directions in consultation-liaison psychiatry

Consultation-liaison psychiatry in the United States has had to reassess its priorities with the change in health care economics in the 80 s. Liaison programs and educational programs for primary care staff are jeopardized. The emphasis has shifted from liaison to reimbursable consultation activities. Hospital stays are shorter with emphasis on outpatient and prepaid settings. Less expensive health care professionals are often asked to see patients previously evaluated by psychiatrists. This paper will discuss the need for focused cost-effective liaison services in this climate. Funding strategies for consultation-liaison programs, models of staffing consultation-liaison services, continuity of care from inpatient to outpatient services, integration of consultation-liaison psychiatrists in prepaid health care settings, primary-care educational programs, and psychosocial intervention programs for high-risk primary-care patients will be discussed.     

Future directions in reproductive medicine.

Major advances in assisted reproductive technology and fertility enhancement in the last decade are discussed in this article. Sustained research efforts have led to refinement in in vitro fertilization and related technologies. Other therapeutic innovations such as the use of newer pharmacologic agents and surgical procedures to preserve reproduction function are highlighted. Future directions and anticipated developments are briefly reviewed.     

Future directions in graduate medical education

Public perception that the challenges of meeting medical manpower and facility needs and of providing access to complex medical care have been met, coupled with concerns over mounting costs of medical care, will significantly reduce commitment to funding of graduate medical education. There will be reduced funding for longer educational programs and subspecialties and for foreign medical graduates, but not for primary care specialties and US medical graduates. The medical care system must ensure that each US medical graduate has access to the postgraduate education necessary as preparation for practice. The system will be challenged to develop necessary techniques for funding that education. An all-payor's system based on health insurance premiums, funds from the faculty practice plans, and sponsored programs carrying obligations of future service are reasonable possibilities for meeting funding needs.