ABSTRACT
A group of 30 community physicians who practiced in northeastern United States and who participated in the Cancer Prevention in Community Practice project in 1988 were interviewed five years later. The aim of the interviews was to assess the long-term impact of the preventive services office system which had been introduced by the project. The qualitative analysis of interviews revealed three distinct physician philosophies about the provision of preventive services: a Request Only focus, responding to specific patient inquiries about prevention but taking no initiative to recommend indicated services; a Health Maintenance Visit focus, providing indicated services only during visits specifically scheduled for preventive care; and an Opportunistic Prevention focus, providing indicated preventive services at every chance. Physicians demonstrated these philosophies in their overall view of disease prevention, perceived obstacles to delivery of preventive care, as well as in their continued use of flow sheets and their impression of the value of the Cancer Prevention in Community Practice project. The long-term impact of the office system was the most apparent in the Opportunistic Prevention group. We conclude that the durability of a preventive services office system is influenced by a physician's preventive care philosophy.
Subject(s)
Attitude of Health Personnel , Neoplasms/prevention & control , Practice Management, Medical/statistics & numerical data , Preventive Health Services/organization & administration , Adult , Female , Health Care Surveys , Humans , Male , Middle Aged , New Hampshire , Philosophy, Medical , VermontABSTRACT
The use of partial restriction digests for mapping complex genomes by pulsed-field gel electrophoresis has been limited by the difficulty of consistently obtaining these digests in agarose, which is a necessary matrix for high-molecular-weight DNA. Enzyme cleavage in agarose is faster then diffusion for most of the enzymes which cleave infrequently. We have developed a method for the production of partial digests in agarose for the endonuclease NotI (5' . . . GC/GGCCGC . . . 3') which circumvents the diffusion problem by using the blocking methylase M. BspRI (5' . . . GGmCC . . . 3'), which competes for the same sites. Using various ratios of the methylase and endonuclease results in partial digests in any size range desired. We report the successful application of this technique to the production of NotI partial digests of human genomic DNA for the mapping of the ABL locus of human chromosome 9.
Subject(s)
Chromosomes, Human, Pair 9 , DNA-Cytosine Methylases/pharmacology , Deoxyribonucleases, Type II Site-Specific , Genes, abl , Restriction Mapping , Base Sequence , Binding, Competitive , DNA, Neoplasm/genetics , DNA, Neoplasm/metabolism , Deoxyribonucleases, Type II Site-Specific/antagonists & inhibitors , Electrophoresis, Agar Gel , Genetic Markers , Humans , Leukemia/pathology , Methylation , Philadelphia Chromosome , Substrate Specificity , Tumor Cells, CulturedABSTRACT
The genes for two of the hematopoietic growth factors, interleukin-4 and interleukin-5, are located on a small segment of chromosome 5 (q23-31), which is frequently deleted in myeloid disorders. Using pulsed-field gel electrophoresis, we demonstrate physical linkage of these two genes and present a long-range restriction map of the locus. The two genes are closely linked (maximum separation, 310 kb) and appear to be separated by an HTF island. We were unable to physically link these genes to two other closely related hematopoietic growth factor genes, interleukin-3 and granulocyte/macrophage colony-stimulating factor, which also map to this region of the genome. The clustering of these and other growth-related genes suggests that a higher order of genetic organization exists in this region of the chromosome.
