New genomic resources for the honey bee(Apis mellifera L.): development of a deep-coverage BAC library and a preliminary STC database.

We have constructed a bacterial artificial chromosome (BAC) library for a European honey bee strain using the cloning enzyme HindIII in order to develop resources for structural genomics research. The library contains 36,864 clones (ninety-six 384-well plates). A random sampling of 247 clones indicated an average insert size of 113 kb (range = 27 to 213 kb) and 2% empty vectors.

Clinical decisions regarding HbA1c results in primary care: a report from CaReNet and HPRN.

Objective: To describe decisions made by primary care providers on elevated HbA(1c) results and their reasons for not intensifying therapy.

Research Design And Methods: In this cross-sectional study, a provider survey was administered in two practice-based research networks when HbA(1c) results were reviewed on all nonpregnant patients >18 years old with type 2 diabetes. Univariate and Mantel-Hantel analyses assessed associations between patient characteristics and clinical decisions.

Effect of the RSPCA Freedom Food Scheme on the welfare of dairy cattle.

To evaluate the effect of the Royal Society for the Prevention of Cruelty to Animals Freedom Food (FF) scheme on the welfare of dairy cattle in England, 28 FF and 25 non-FF farms were assessed during the winter of 2000 to 2001. The assessments were based on a protocol which included the examination of the farms' records, the farmers' estimates of the incidence of disease, and independent observations of the behaviour and physical condition of the cows. The data were analysed to identify which measures of welfare were affected by FF membership and to assess the number of farms on which intervention would be required, as defined by a panel of 50 experts.

Assessment of the welfare of dairy cattle using animal-based measurements: direct observations and investigation of farm records.

A protocol was developed by consultation with experts on the welfare of cattle to use direct observations of cattle and an examination of farm records to assess welfare. Fifty-three dairy farms in England were visited and assessed during the winter of 2000/01. The findings were compiled and the results of the welfare measurements were examined by 50 experts who indicated at what level they considered that improvement was required.

Database design to ensure anonymous study of medical errors: a report from the ASIPS Collaborative.

Medical error reporting systems are important information sources for designing strategies to improve the safety of health care. Applied Strategies for Improving Patient Safety (ASIPS) is a multi-institutional, practice-based research project that collects and analyzes data on primary care medical errors and develops interventions to reduce error. The voluntary ASIPS Patient Safety Reporting System captures anonymous and confidential reports of medical errors.

The somatization in primary care study: a tale of three diagnoses.

Somatization is a common phenomenon that has been defined in many ways. The two most widely used diagnoses, Somatization Disorder (SD) and Abridged Somatization Disorder (ASD), are based on lifetime unexplained symptoms. However, reports indicate instability in lifetime symptom recall among somatizing patients.

Utilization of breast cancer screening in a clinically based sample of women after BRCA1/2 testing.

We conducted a prospective, observational study to determine breast cancer screening practices among self-referred high-risk women who pursued genetic testing for BRCA1 and BRCA2 mutations. Of the 107 unaffected women included in this study, 41 were BRCA1/2 carriers and 66 women tested negative for a mutation previously identified in their family. All of the women underwent comprehensive pre- and posttest genetic counseling, and completed baseline and 12-month follow-up telephone interviews.

Patient perspectives on the doctor of the future.

Background And Objectives: Health care reform has been the subject of considerable debate, particularly among those in politics, insurance, and business. Patients, however, have largely been ignored in this discussion. As the role of the health care consumer receives increased attention, it is important to consider patient values and preferences for a future system of care.

Tobacco cessation counseling among underserved patients: a report from CaReNet.

Objectives: The purpose of our study was to determine the frequency of smoking cessation counseling in relation to insurance status in a practice-based research network.

Study Design: We administered a modified National Ambulatory Medical Care Survey (NAMCS), with an additional payment category to identify uninsured patients, quarterly to 100 random patients at each practice site for 1 year.

Population: The study population included the patients at the 7 practices within the Colorado Research Network (CaReNet), associated with the Department of Family Medicine, University of Colorado Health Science Center.

An integrated physical and genetic map of the rice genome.

Rice was chosen as a model organism for genome sequencing because of its economic importance, small genome size, and syntenic relationship with other cereal species. We have constructed a bacterial artificial chromosome fingerprint-based physical map of the rice genome to facilitate the whole-genome sequencing of rice. Most of the rice genome ( approximately 90.

Breast and ovarian cancer screening practices in healthy women with a strong family history of breast or ovarian cancer.

Studies in women with a family history of cancer demonstrate a wide variability in the uptake of cancer screening measures. Little data exist regarding the breast and ovarian cancer screening practices of women who are members of hereditary breast cancer families. In order to address this issue, we examined the screening behaviors and the determinants of screening in a clinic based group of 216 women with a strong family history of breast or ovarian cancer who were participating in a free genetic counseling and testing research program.

All in the family: evaluation of the process and content of sisters' communication about BRCA1 and BRCA2 genetic test results.

Despite the potential importance of family communication, little is known about the process and content of communicating BRCA1/2 test results to relatives. The objectives of this observational study were to describe the process and content of communicating BRCA1/2 test results to sisters, and to evaluate whether the proband's carrier status influenced communication outcomes. Participants were 43 women who were the first family member to have genetic testing (probands).

Impact of BRCA1/BRCA2 mutation testing on psychologic distress in a clinic-based sample.

Purpose: Despite the increasingly widespread availability of BRCA1 and BRCA2 genetic testing, little is known about the psychologic impact of such testing in the clinical setting. The objective of this study was to examine the long-term psychologic impact of receiving BRCA1/2 test results within a clinic-based testing program.

Patients And Methods: The participants were 279 high-risk women who underwent genetic counseling and testing for alterations in the BRCA1/2 genes.

The effect of families on the process of outpatient visits in family practice.

Objectives: Our goal was to describe how physician knowledge of patients' families affects the processes of patient care in family practices.

Study Design: Using a multimethod comparative case study design, detailed dictated field notes were recorded after direct observation of patient encounters and the office environment as part of the Prevention and Competing Demands in Primary Care Study. We identified domains of outpatient visits in which patients were accompanied by a family member or in which family-oriented content was discussed.

Tryptophan hydroxylase gene variant and smoking behavior.

Approximately 50% of the variance in smoking behavior is attributable to genetic factors. Genes in the serotonin system are plausible candidates because of serotonin's role in mood regulation. The present study examined the association of smoking behavior with a polymorphism in the TPH gene, which codes for a rate limiting enzyme in the biosynthesis of serotonin.

Effects of coping style and BRCA1 and BRCA2 test results on anxiety among women participating in genetic counseling and testing for breast and ovarian cancer risk.

Using the monitoring process model (MPM), the authors examined the immediate effects of coping style and test results on the psychological distress of women at increased risk for breast and/or ovarian cancers. Cases selected for analysis were 107 probands and relatives of positive probands participating in genetic counseling and testing for heritable cancer risk. Specifically, the authors explored the relationships among coping style (high and low monitoring), test results (BRCA1 and BRCA2 mutation carrier and noncarrier status), and psychological distress (state anxiety).

Nicotine metabolism and CYP2D6 phenotype in smokers.

We tested the hypothesis that the polymorphic enzyme CYP2D6 is related to nicotine metabolism in 261 healthy subjects enrolling in a smoking cessation clinic. Subjects completed a questionnaire, were given dextromethorphan, and contributed a urine and blood sample. The CYP2D6 phenotype (based on a determination of dextromethorphan and metabolites in an aliquot of overnight urine) and genotype (based on characterization of CYP2D6 variant alleles by a PCR-based method on a subset) were determined.

Student perspectives on primary care preceptorships: enhancing the medical student preceptorship learning environment.

Background: Medical students participate in a longitudinal (3-year) primary care preceptorship to assist them in developing skills in interviewing and examining patients in an ambulatory care setting.

Purpose: To identify from a student's perspective important context and process issues in a longitudinal preceptorship.

Methods: The investigators used an "editing" style of analysis to identify significant themes across 24 medical student focus groups held between October 1995 and December 1997.

Parental communication of BRCA1/2 genetic test results to children.

The aim of this study was to evaluate the likelihood, correlates, and psychological impact of parental communication to children of parents' BRCA1/2 genetic test results for breast cancer risk. Subjects were 133 adult members of high risk families. Sociodemographic, clinical, and psychological distress variables were assessed during a baseline telephone interview conducted prior to patient education and test result notification.