Chronic Dementing Conditions, Genomics, and New Opportunities for Nursing Interventions

Use of genomic assessments and interventions in psychiatric nursing practice

The purpose of this study was to determine the impact of a genomic educational session by measuring participants' application of the class content to their nursing care. A sample of 65 psychiatric nurses participated in a staff development activity and completed a survey. Every respondent reported use of a genomic assessment or intervention with a patient from their clinical practice. The mean use of genomic assessment and intervention items was 5.5 out of the possible 10 which were identified and described in the educational session, providing evidence that nurses are able to include genomic assessments and interventions when caring for a patient with a psychiatric disorder.

Impact of gene patents and licensing practices on access to genetic testing for Alzheimer disease

Genetic testing for Alzheimer disease includes genotyping for apolipoprotein E, for late-onset Alzheimer disease, and three rare autosomal dominant, early-onset forms of Alzheimer disease associated with different genes (APP, PSEN1, and PSEN2). According to researchers, patents have not impeded research in the field, nor were patents an important consideration in the quest for the genetic risk factors. Athena Diagnostics holds exclusive licenses from Duke University for three "method" patents covering apolipoprotein E genetic testing. Athena offers tests for apolipoprotein E and genes associated with early-onset, autosomal-dominant Alzheimer disease. One of those presenilin genes is patented and exclusively licensed to Athena; the other presenilin gene was patented but the patent was allowed to lapse; and one (amyloid precursor protein) is patented as a research tool. Direct-to-consumer testing is available for some Alzheimer disease-related genes, apparently without a license. Athena Diagnostics consolidated its position in the market for Alzheimer disease genetic testing by collecting exclusive rights to patents arising from university research. Duke University also used its licenses to Athena to enforce adherence to clinical guidelines, including elimination of the service from Smart Genetics, which was offering direct-to-consumer risk assessment based on apolipoprotein E genotyping.

Alzheimer disease in women: a clinical and genetics perspective

Upon completion of this activity, the learner will be able to: 1. Identify clinical and genetic characteristics and considerations associated with Alzheimer disease (AD). 2. Describe assessment and management strategies for AD. 3. Describe nursing implications for women and families with, or at risk for, AD.

Genomic health care: is the future now?

In some areas of health care, genomics is having a steadily increasing impact on clinical practice. Yet, in other areas, genomic developments are considered to be at the periphery of care. Health-care professionals from such areas might feel that the potential of genomics is exaggerated. To explore this issue, genetic nurse specialists were invited to submit case studies and to identify barriers and facilitators in incorporating genomics into mainstream nursing practice. Twenty-five cases were submitted and a total of 10 barriers and seven facilitators were identified. These cases were presented as a basis for debate in a session conducted at the 2006 Annual Conference of the International Society of Nurses in Genetics. The majority of delegates agreed that genomics would have a profound effect on health care and nursing within the next 5 years, particularly in oncology. That nurses do not see genomics as being relevant to their practice was identified as the greatest barrier, by a narrow majority. Specialist nurses in any field have a role in acting as agents of change, educators, and consultants to non-specialists. It is clear that genetics nurse specialists still have a considerable challenge in raising awareness about the relevance of genomics to mainstream nursing practice.