The role of the family in medical decisions. Introductory editorial.
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Biomedical subjects
Publications and source records attributed to H Brody.
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Although continuity of care occupies a central position in the definition of primary care and is invoked as having evident importance in practice, research on the value of continuity has produced confusing and conflicting results. These results may be due to a lack of clarity in the definition of continuity of care. In this paper, the authors suggest that continuity includes three elements--cognitive, management, and relationship. Exploration of each of the elements expands the understanding of continuity in medical practice. Continuity of care can be evaluated in both undergraduate and residency programs by the application of criteria offered in this paper.
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The cell division inhibition gene sfiC and the excisable element e14, both associated with the SOS response in Escherichia coli, are located at 25 min on the E. coli map. Blotting with a fragment of e14 DNA showed a strict correlation between the presence of e14 and the sfiC+ genotype. Introduction of only e14 into a recA- sfiC- strain made the strain sfiC+. These results show that the sfiC gene is part of e14.
Ethics, as generally defined, tries to answer the question, "What ought to be done in a given situation, all things considered?" Answering this question in primary care is hampered by some common and recurring misunderstandings--some arising from physicians' misunderstanding of ethical concepts and vocabulary and some arising from ethicists' misplaced emphasis and ignorance of medical settings. Examination and clarification of these misunderstandings illuminate the nature of primary care ethics and the role of the practicing physician.
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Nineteen unembalmed (fresh) cadavers were used in 21 experiments to test restraint systems in automobile impact studies. Some were mounted in a rearward firing sled; others were placed in standard cars during collisions. Prior to and after testing, each cadaver was evaluated. After each experiment a postmortem examination was performed. High-speed registering cameras (1,000 to 2,000 frames per second) were used and multiple telemetric recordings were made. The radiographic and pathologic changes were similar to those seen in patients following high-velocity accidents. Results were compared with those of car accident victims admitted dead on arrival to one of our hospitals. This study is a progress report. The results are being used to improve existing restraint systems and to evaluate experimental models.
The genetic element e14 is a natural component of the Escherichia coli K-12 chromosome. On induction of the SOS pathways, e14 excises as a 14.4-kilobase circle. We report here on the reintegration of e14 into the chromosome of cured (e14 degrees) E. coli K-12 derivatives. Using a Tn10 insertion mutant of e14, we found that reintegration occurred specifically at the locus originally occupied by e14 and with the same orientation. The reintegration event required neither the RecA nor the RecB functions. The attachment site of the free form was located within a 950-base-pair HindIII-AvaI fragment and shared sufficient homology with the host attachment site to form detectable DNA-DNA hybrids. Even though E. coli C and B/5 did not contain e14, they did possess a HindIII restriction fragment that hybridized to the free e14 attachment fragment. E. coli C could be transformed with e14-1272::Tn10, resulting in integration at this site of homology. The Tn10 mutants were also used in mapping the point of e14 attachment. We found the following sequence: fabD purB atte14 umuC. Furthermore, analysis of a recombinant plasmid that contained both the e14 attachment site and the purB locus showed that these two loci occur within 11 kilobases of each other.