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To investigate the effects of supplemental Se on the transfer of Se to nursing pigs when sows are fed diets containing a Se level above the NRC recommendation (0.15 ppm), sows were fed diets containing no supplemental Se or supplemental (0.3 ppm) Se from sodium selenite or Se yeast. A nonSe-fortified corn-soy-bean meal basal diet with a high endogenous Se content served as the negative control (0.20 to 0.23 ppm Se). Fifty-two sows were fed diets from 60 d prepartum until 14 d of lactation. Six sows per treatment were bled at 60 and 30 d prepartum, at farrowing, and at 14 d postpartum to measure serum Se concentrations. Colostrum was collected within 12 h postpartum, and milk was collected at 14 d of lactation. Blood was obtained from 3 pigs each from 12 litters per treatment at birth and at weaning (d 14), and pooled serum was analyzed for Se and immunoglobulin G concentrations and glutathione peroxidase activity. Regardless of treatment, serum Se in sows declined throughout gestation and gradually increased during lactation. Sows fed Se yeast tended (P < 0.06) to have greater serum Se at farrowing than sows fed unsupplemented diets. Colostrum and milk (d 14) Se concentrations increased (P < 0.01) when sows were fed Se from yeast but not from sodium selenite. At birth, serum Se was increased (P < 0.01) for pigs whose dams were fed Se yeast compared with pigs from sows fed the basal diet. At 14 d of age, there was no difference in serum Se concentration of pigs from dams fed any of the treatments. Pig serum immunoglobulin G concentrations and glutathione peroxidase-1 activity were unaffected by dietary Se source. Supplementation of gestating and lactating sow diets with Se (0.3 ppm) from an organic or inorganic source reduced the number of stillbirths per litter. However, only pigs born to sows fed organic Se (Se yeast) had greater serum Se at birth. Organic Se increased Se concentration of colostrum and 14-d milk to a greater degree than inorganic Se. [ABSTRACT FROM AUTHOR]

Organizations like the United Nations Children's Fund (UNICEF) have created systems to respond to the daunting problems of malnutrition and disease throughout the world. Such systems include UNICEF's GOBI program and the World Health Organization's Health for All plan. U.S. healthcare administrators have been slow to join in these efforts. They are preoccupied with trying to financially sustain their organizations in a technologically and bureaucratically complex society and find it difficult to feel responsible for other countries' health needs. Nevertheless, Catholic healthcare providers have joined the international efforts in a number of ways. Some have initiated programs to address a specific need for a limited period, and others have made long-term commitments to specific foreign communities. But most of these projects are limited, ad hoc efforts. A number of challenges face Catholic healthcare providers. They must continue to respond to specific needs, establish institutional links with organizations abroad to address longer-term needs, and use their professional and political leverage to influence structural changes to get at the root of chronic health problems in poor countries.

When Catholic health care providers become involved in a joint venture, they put at risk not only their financial and legal resources but also their "moral capital," that is, their tradition of healing in Jesus Christ's name. Since collaborative arrangements may offer the only way to respond to persons in need, organizations that are contemplating joint ventures must assess in moral terms the "return" on such arrangements. The joint ventures fraught with the greatest moral risk are those between hospitals and physicians. In such arrangements, the patient's best interests may be compromised by the economic interests of both the physicians and the provider. Although both the law and the American Medical Association seem reluctant to prohibit entrepreneurial activity that places physicians in conflict-of-interest situations, they have established disclosure requirements to help safeguard patient interests. Moral tensions also are inherent in managed care plans such as health maintenance organizations and preferred provider organizations. The emphasis on gatekeeping to avoid unnecessary medical procedures and the potential for excluding persons in need who cannot afford to participate in such plans are two serious concerns. The patient's right to confidentiality also may be threatened in capitated systems, which rely on complex utilization review procedures that expose the patient's records to a wide circle of people. Each ethical issue will not arise in every potential joint venture. The sooner an organization can name the key values it wants to protect, however, the easier it will be for potential partners to work together and to build into the joint venture safeguards for these values.