The availability of 200 different restriction enzymes, each recognizing different sequences in DNA, has been invaluable in studying cancer genetics. It is hoped that current advances in protein engineering will facilitate the creation of novel restriction enzymes with tailor-made sequence specificities. This will further improve the applicability of restriction enzymes in cancer genetics.
INTRODUCTION This study examines how a colorectal surgeon can use a regional cancer genetics service to deal safely and efficiently, with community referrals for colorectal cancer screening on the basis of family history.PATIENTS AND METHODS A retrospective review of consecutive asymptomatic people with a strong family of colorectal cancer referred by the surgeon to the genetics service over a 30-month period. RESULTS A total of 45 people were referred by the surgeon to the cancer genetics service. Following official verification of family histories, 15 were thought to be in a low-risk category for developing colorectal cancer, 18 were moderate risk, 4 had a high-to-moderate risk and 2 satisfied the criteria for HNPCC. After official authentication, it was discovered that 20% of people had mistakenly informed the surgeon of important inaccuracies in their family history.CONCLUSIONS The cancer genetics service seeks to identify accurately those at increased risk of developing colorectal cancer due to their family history. It has the time, resources and expertise to verify officially a family history that cannot be properly done in a busy surgical clinic. This study shows that it can provide a valuable role for correctly identifying and counselling people who truly require screening due to their familial predisposition for colorectal cancer.
Background/objectives The certification process to register patients as sight impaired or severely sight impaired is undertaken by consultant ophthalmologists, in the UK. We sought to assess the agreement between optometrists and a consensus panel, in identifying patient eligibility for certification, relative to the agreement between ophthalmologists and the consensus panel. Methods The consensus panel (4 consultant ophthalmologists and 3 optometrists with a formal accreditation in low vision), 30 consultant ophthalmologists and 99 low vision optometrists reviewed 40 randomly selected abridged cases. The eligibility outcomes from the ophthalmologists and the optometrists were compared with the consensus panel outcomes. Results For ophthalmologists and optometrists, the median (IQR) number of cases in which there was agreement with the consensus panel was 33.0 (31.0, 33.0) and 36.0 (34.0, 36.5), respectively. In severely sight impaired cases, the probabilities of agreeing on eligibility for certification were 76.0% (95% CIs 71.4%, 80.1%) for ophthalmologists and 61.8% (59.0%, 64.6%) for optometrists. In sight impaired cases, the corresponding values were 51.6% (46.7%, 56.4%) for ophthalmologists and 72.2% (69.8%, 74.5%) for optometrists. In cases of bilateral atrophic age-related macular degeneration (AMD), both groups were more likely to agree with the consensus panel and the differences between optometrists and ophthalmologists were less marked. Conclusions Optometrists demonstrated a comparable agreement relative to ophthalmologists, with the consensus panel on the eligibility of randomly selected, abridged cases for certification. The findings support the clinical decision-making ability of low vision optometrists in the certification of patients with vision impairment and provide evidence in support of policy change to allow low vision optometrists to certify individuals with atrophic AMD.
In reviewing this report I would like to state at the outset that my analysis and evaluation are made mainly from the standpoint of a researcher and staff developer whose main interests are improving teaching-learning processes. Since reading this book I have had the opportunity to discuss the subject with a number of staff developers, faculty, students and administrators in higher education in universities in different countries; my comments are based in part on these discussions.This report is an additional important testimony to the growing concern among researchers, staff developers and administrators in higher education about the inadequacy of students' learning skills. Moreover, there is a growing feeling among staff developers that too much emphasis has been given in the past to efforts to improve teaching while neglecting learning skills and processes.In this Australian survey of the problem, the authors point out that "students vary in their ability to study and learn effectively". However, while early research in this field concentrated on cognitive skills, and led to the development of Study Skills Centers and packaged programs, the new trend is to include activity which involves the whole person. Study counselling today is as concerned with helping students with motivational and organizational aspects of study difficulties as with developing conventional, practical study skills.The chapter on current approaches summarizes succinctly recent research and practices and the reviewer found it very helpful in triggering and supplementing discussions with staff developers and administrators concerned with the problem. It should be pointed out, however, that this book relies basically on research and reports published in the U.K., and is somewhat lacking on documentation from other countries and in particular the U.S. However, it does mention, and quotes, the important research of Ference Marton and the Gothenburg group, which has greatly influenced research and development in this area in the U.K. and in particular the Lancaster group.Most of the report is devoted to a detailed account of the learning skills project carried out at the University of Melbourne, its results, conclusions and recommendations. However, from this discussion in several countries it appears that these results are quite common and are applicable to students in different cultures, and could provide a basis for action in this area. Those who wish to conduct their own research in this area will find this report an excellent model which they could apply in their own institution and thus produce the data needed to convince their colleagues of the importance of this neglected aspect of higher education.This report is written in a clear, simple and concise style and is likely to appeal to decision-makers. I will recommend it as required reading to staff developers, researchers and other interested people in higher education for both its content and format.
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