An ethics framework for organizational change.

The proliferation of managed care has introduced conflicts of interest in health care that can create tension in the traditional care provider-patient relationship. In order to address the emerging trends and potential ethical dilemmas presented by managed care, health systems must develop a framework for intentional ethical reflection. The article outlines the essential elements of a caring ethical framework and describes how one integrated health system created a framework of ethical guiding principles and an ethical organizational structure to facilitate integration of those principles throughout the organization.

Penetration of Sulfate Reducers through a Porous North Sea Oil Reservoir.

The presence of mesophilic benzoate-degrading sulfate-reducing bacteria in the water systems of three Norwegian oil platforms was investigated. Strain 4502 was isolated from the injection water system, and specific antibodies were produced against this isolate. It was present in the injection water system during a period of 3 years, but not in the in situ reservoir water. Later it was found in water samples collected from the oil field production system. This showed that strain 4502 had penetrated the reservoir together with the injection water and eventually reached the production well.

Distribution of thermophilic marine sulfate reducers in north sea oil field waters and oil reservoirs.

The distribution of thermophilic marine sulfate reducers in produced oil reservoir waters from the Gullfaks oil field in the Norwegian sector of the North Sea was investigated by using enrichment cultures and genus-specific fluorescent antibodies produced against the genera Archaeoglobus, Desulfotomaculum, and Thermodesulforhabdus. The thermophilic marine sulfate reducers in this environment could mainly be classified as species belonging to the genera Archaeoglobus and Thermodesulforhabdus. In addition, some unidentified sulfate reducers were present. Culturable thermophilic Desulfotomaculum strains were not detected. Specific strains of thermophilic sulfate reducers inhabited different parts of the oil reservoir. No correlation between the duration of seawater injection and the numbers of thermophilic sulfate reducers in the produced waters was observed. Neither was there any correlation between the concentration of hydrogen sulfide and the numbers of thermophilic sulfate reducers. The results indicate that thermophilic and hyperthermophilic sulfate reducers are indigenous to North Sea oil field reservoirs and that they belong to a deep subterranean biosphere.