1
|
Patterson E, Plunkett R, Goldsmith-Milne D. Clinical education models in rural practice settings: A scoping review. Nurse Educ Pract 2024; 75:103906. [PMID: 38310708 DOI: 10.1016/j.nepr.2024.103906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/06/2024]
Abstract
AIM The objective of this review is to identify and synthesize the literature on clinical nursing education models in rural settings, with the goal of developing a better understanding of effective clinical education models suitable for rural nursing education. BACKGROUND Clinical education is an integral part of nursing education, yet very little clinical education occurs in rural and remote areas. This leaves the rural landscape vulnerable to inadequate health care staffing because many graduates will begin their nursing practice in the geographical areas where they studied. The rural nursing workforce is currently insufficient to meet the health care needs of rural populations. This insufficiency is likely to worsen because statistical trends suggest that rural and remote communities might be among the worst affected by the global nursing shortage. Many new graduate nurses are ill prepared for rural nursing practice, primarily due to limited exposure to rural nursing content and rural clinical experiences in their entry-to-practice education. Increasing opportunities for nursing students to learn in rural clinical settings will likely support the recruitment and retention of nurses in rural practice. Despite the key role of rural nursing education in sustaining the rural health workforce, little is known about rural clinical learning in nursing education. DESIGN A scoping review. METHODS This scoping review was conducted using the steps outlined by Arksey and O'Malley with updated methodological guidance from the Joanna Briggs Institute. RESULTS Of 1880 potential data sources, 82 were included in data analysis. Although no distinct model of rural clinical nursing education could be identified, several features of clinical nursing education were described in the context of rural clinical learning. Preceptorship was the most used mentorship/clinical supervision model (n=41). The most common placement design was a block model design (n=41) lasting between one and 16 weeks, with most learners engaging in episodic care with individual clients (n=42). Interestingly, 24 sources reported learners engaging in rural clinical education across multiple contexts (e.g., acute care, home care, and primary care). CONCLUSION These findings suggest there exists great variability in rural clinical learning opportunities for nursing students. Academic practice partnerships could continue to be leveraged to provide learners with rural clinical education that meets the needs of both the educational institution as well as the rural communities in which learning takes place. An area of further research would be to focus on formal evaluation of the effectiveness of clinical education models in the rural context.
Collapse
Affiliation(s)
- Erin Patterson
- Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, Ontario N2G 4M4, Canada.
| | - Robyn Plunkett
- Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, Ontario N2G 4M4, Canada
| | - Danya Goldsmith-Milne
- Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, Ontario N2G 4M4, Canada
| |
Collapse
|
2
|
Quarmby LM, Hotton M, Jenner S, Kalthoff J, Patterson E, Scholcz A, Springham E. Psychological support during a pandemic: an intervention for hospital teams. Occup Med (Lond) 2023:kqad107. [PMID: 37941463 DOI: 10.1093/occmed/kqad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic placed unprecedented stress on healthcare professionals and resulted in teams being scattered by shielding, working from home and redeployment. The Recovery, Readjustment and Reintegration programme (R3P) was implemented and evaluated in an acute NHS hospital Trust with the aim of supporting those staff involved. AIMS To explore the impact of offering themed reflective sessions to staff in an acute hospital and to disseminate this learning for application in other settings and future pandemics. METHODS During the initial recovery phase of the pandemic, all Trust staff were invited to attend an R3P where themed discussions were facilitated by psychologists. Feedback was requested pre- and post-session, and a mixed-methods design was followed to gain quantitative and qualitative information. RESULTS A total of 430 staff members attended an R3P between April 2021 and January 2022. A significant majority found attendance helpful and agreed that it had provided them with the opportunity to reflect on their own and their teams' experience of pandemic working and led them to feel more supported by their organization. CONCLUSIONS Finding meaning in experiences through facilitated reflective discussion can help limit the negative psychological impact of working in an acute hospital during a pandemic. Staff are likely to benefit from such opportunities in any future pandemic recovery phase.
Collapse
Affiliation(s)
- L M Quarmby
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - M Hotton
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - S Jenner
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - J Kalthoff
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - E Patterson
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - A Scholcz
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - E Springham
- Psychological Medicine Centre, Staff Support Service, Russell Cairns Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| |
Collapse
|
3
|
Rojas LA, Sethna Z, Soares KC, Olcese C, Pang N, Patterson E, Lihm J, Ceglia N, Guasp P, Chu A, Yu R, Chandra AK, Waters T, Ruan J, Amisaki M, Zebboudj A, Odgerel Z, Payne G, Derhovanessian E, Müller F, Rhee I, Yadav M, Dobrin A, Sadelain M, Łuksza M, Cohen N, Tang L, Basturk O, Gönen M, Katz S, Do RK, Epstein AS, Momtaz P, Park W, Sugarman R, Varghese AM, Won E, Desai A, Wei AC, D'Angelica MI, Kingham TP, Mellman I, Merghoub T, Wolchok JD, Sahin U, Türeci Ö, Greenbaum BD, Jarnagin WR, Drebin J, O'Reilly EM, Balachandran VP. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer. Nature 2023; 618:144-150. [PMID: 37165196 PMCID: PMC10171177 DOI: 10.1038/s41586-023-06063-y] [Citation(s) in RCA: 172] [Impact Index Per Article: 172.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/06/2023] [Indexed: 05/12/2023]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is lethal in 88% of patients1, yet harbours mutation-derived T cell neoantigens that are suitable for vaccines 2,3. Here in a phase I trial of adjuvant autogene cevumeran, an individualized neoantigen vaccine based on uridine mRNA-lipoplex nanoparticles, we synthesized mRNA neoantigen vaccines in real time from surgically resected PDAC tumours. After surgery, we sequentially administered atezolizumab (an anti-PD-L1 immunotherapy), autogene cevumeran (a maximum of 20 neoantigens per patient) and a modified version of a four-drug chemotherapy regimen (mFOLFIRINOX, comprising folinic acid, fluorouracil, irinotecan and oxaliplatin). The end points included vaccine-induced neoantigen-specific T cells by high-threshold assays, 18-month recurrence-free survival and oncologic feasibility. We treated 16 patients with atezolizumab and autogene cevumeran, then 15 patients with mFOLFIRINOX. Autogene cevumeran was administered within 3 days of benchmarked times, was tolerable and induced de novo high-magnitude neoantigen-specific T cells in 8 out of 16 patients, with half targeting more than one vaccine neoantigen. Using a new mathematical strategy to track T cell clones (CloneTrack) and functional assays, we found that vaccine-expanded T cells comprised up to 10% of all blood T cells, re-expanded with a vaccine booster and included long-lived polyfunctional neoantigen-specific effector CD8+ T cells. At 18-month median follow-up, patients with vaccine-expanded T cells (responders) had a longer median recurrence-free survival (not reached) compared with patients without vaccine-expanded T cells (non-responders; 13.4 months, P = 0.003). Differences in the immune fitness of the patients did not confound this correlation, as responders and non-responders mounted equivalent immunity to a concurrent unrelated mRNA vaccine against SARS-CoV-2. Thus, adjuvant atezolizumab, autogene cevumeran and mFOLFIRINOX induces substantial T cell activity that may correlate with delayed PDAC recurrence.
Collapse
Affiliation(s)
- Luis A Rojas
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Zachary Sethna
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kevin C Soares
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cristina Olcese
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nan Pang
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erin Patterson
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jayon Lihm
- Computational Oncology Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicholas Ceglia
- Computational Oncology Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pablo Guasp
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander Chu
- Computational Oncology Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rebecca Yu
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Adrienne Kaya Chandra
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Theresa Waters
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer Ruan
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Masataka Amisaki
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Abderezak Zebboudj
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Zagaa Odgerel
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - George Payne
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Ina Rhee
- Genentech, San Francisco, CA, USA
| | | | - Anton Dobrin
- Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michel Sadelain
- Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marta Łuksza
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Noah Cohen
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura Tang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Olca Basturk
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mithat Gönen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Seth Katz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Richard Kinh Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew S Epstein
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Parisa Momtaz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Wungki Park
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ryan Sugarman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anna M Varghese
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Won
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Avni Desai
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alice C Wei
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael I D'Angelica
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - T Peter Kingham
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Taha Merghoub
- Meyer Cancer Center, Weill Cornell Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Jedd D Wolchok
- Meyer Cancer Center, Weill Cornell Medicine, Weill Cornell Medical College, New York, NY, USA
| | | | - Özlem Türeci
- BioNTech, Mainz, Germany
- HI-TRON, Helmholtz Institute for Translational Oncology, Mainz, Germany
| | - Benjamin D Greenbaum
- Computational Oncology Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Physiology, Biophysics and Systems Biology, Weill Cornell Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - William R Jarnagin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeffrey Drebin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eileen M O'Reilly
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Vinod P Balachandran
- Immuno-Oncology Service, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| |
Collapse
|
4
|
Patterson E, Stokes P, Cutajar D, Rosenfeld A, Baines J, Metcalfe P, Powers M. High-resolution entry and exit surface dosimetry in a 1.5 T MR-linac. Phys Eng Sci Med 2023; 46:787-800. [PMID: 36988905 DOI: 10.1007/s13246-023-01251-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
The magnetic field of a transverse MR-linac alters electron trajectories as the photon beam transits through materials, causing lower doses at flat entry surfaces and increased doses at flat beam-exiting surfaces. This study investigated the response of a MOSFET detector, known as the MOSkin™, for high-resolution surface and near-surface percentage depth dose measurements on an Elekta Unity. Simulations with Geant4 and the Monaco treatment planning system (TPS), and EBT-3 film measurements, were also performed for comparison. Measured MOSkin™ entry surface doses, relative to Dmax, were (9.9 ± 0.2)%, (10.1 ± 0.3)%, (11.3 ± 0.6)%, (12.9 ± 1.0)%, and (13.4 ± 1.0)% for 1 × 1 cm2, 3 × 3 cm2, 5 × 5 cm2, 10 × 10 cm2, and 22 × 22 cm2 fields, respectively. For the investigated fields, the maximum percent differences of Geant4, TPS, and film doses extrapolated and interpolated to a depth suitable for skin dose assessment at the beam entry, relative to MOSkin™ measurements at an equivalent depth were 1.0%, 2.8%, and 14.3%, respectively, and at a WED of 199.67 mm at the beam exit, 3.2%, 3.7% and 5.7%, respectively. The largest measured increase in exit dose, due to the electron return effect, was 15.4% for the 10 × 10 cm2 field size using the MOSkin™ and 17.9% for the 22 × 22 cm2 field size, using Geant4 calculations. The results presented in the study validate the suitability of the MOSkin™ detector for transverse MR-linac surface dosimetry.
Collapse
Affiliation(s)
- E Patterson
- Centre of Medical and Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.
| | - P Stokes
- Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - D Cutajar
- Centre of Medical and Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - A Rosenfeld
- Centre of Medical and Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - J Baines
- Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, QLD, Australia
- College of Science and Engineering, James Cook University, Townsville, QLD, Australia
| | - P Metcalfe
- Centre of Medical and Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - M Powers
- Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, QLD, Australia
- College of Science and Engineering, James Cook University, Townsville, QLD, Australia
| |
Collapse
|
5
|
Xiao Y, Guo J, Dong Z, Richardson A, Patterson E, Mangrum S, Bybee S, Bertolini E, Bartlett M, Chuck G, Eveland AL, Scanlon MJ, Whipple C. Boundary domain genes were recruited to suppress bract growth and promote branching in maize. Sci Adv 2022; 8:eabm6835. [PMID: 35704576 PMCID: PMC9200273 DOI: 10.1126/sciadv.abm6835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Grass inflorescence development is diverse and complex and involves sophisticated but poorly understood interactions of genes regulating branch determinacy and leaf growth. Here, we use a combination of transcript profiling and genetic and phylogenetic analyses to investigate tasselsheath1 (tsh1) and tsh4, two maize genes that simultaneously suppress inflorescence leaf growth and promote branching. We identify a regulatory network of inflorescence leaf suppression that involves the phase change gene tsh4 upstream of tsh1 and the ligule identity gene liguleless2 (lg2). We also find that a series of duplications in the tsh1 gene lineage facilitated its shift from boundary domain in nongrasses to suppressed inflorescence leaves of grasses. Collectively, these results suggest that the boundary domain genes tsh1 and lg2 were recruited to inflorescence leaves where they suppress growth and regulate a nonautonomous signaling center that promotes inflorescence branching, an important component of yield in cereal grasses.
Collapse
Affiliation(s)
- Yuguo Xiao
- Department of Biology, Brigham Young University, 4102 LSB, Provo, UT 84602, USA
- Donald Danforth Plant Science Center, St. Louis, MO 63132, USA
| | - Jinyan Guo
- Department of Biology, Brigham Young University, 4102 LSB, Provo, UT 84602, USA
| | - Zhaobin Dong
- Plant Gene Expression Center, Albany, CA 94710, USA
| | - Annis Richardson
- Plant Gene Expression Center, Albany, CA 94710, USA
- Institute of Molecular Plant Sciences, School of Biological Sciences, University of Edinburgh, Edinburgh, EH9 3BF, Scotland, UK
| | - Erin Patterson
- Biology Department, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Sidney Mangrum
- Department of Biology, Brigham Young University, 4102 LSB, Provo, UT 84602, USA
| | - Seth Bybee
- Department of Biology, Brigham Young University, 4102 LSB, Provo, UT 84602, USA
| | | | - Madelaine Bartlett
- Biology Department, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - George Chuck
- Plant Gene Expression Center, Albany, CA 94710, USA
| | | | - Michael J. Scanlon
- Plant Biology Section, School of Integrative Plant Science, Cornell University, Ithaca, NY 14853, USA
| | - Clinton Whipple
- Department of Biology, Brigham Young University, 4102 LSB, Provo, UT 84602, USA
- Corresponding author.
| |
Collapse
|
6
|
Sethna Z, Luksza M, Rojas L, Soares K, Leung J, Lihm J, Hoyos D, Dobrin A, Kappagantula R, Makohon-Moore A, Johns A, Gill A, Amisaki M, Guasp P, Zebboudj A, Yu R, Chandra AK, Odgerel Z, Sadelain M, Patterson E, Iacobuzio-Donahue C, Greenbaum B, Balachandran V. 824 High quality neoantigens are immunoedited in long-term pancreatic cancer survivors. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundCancer immunoediting predicts that T cells selectively kill tumor cells expressing immunogenic mutations (neoantigens) resulting in less immunogenic clones to outgrow in tumors.1 Although established through longitudinal studies of how tumors evolve in immune-proficient and -deficient mice,1 2 whether the human immune system naturally targets neoantigens to edit tumors, and the principles that identify the edited neoantigens, remains unclear.MethodsTo investigate if immune selective pressures on neoantigens alter how human tumors evolve, we longitudinally studied how 70 human pancreatic ductal adenocarcinomas (PDACs) - a poorly immunogenic cancer largely presumed to not be subject to immunoediting - evolved over 10 years. We use exome sequencing, neoantigen identification, and clonal reconstruction to compare how primary PDACs evolve to recurrence in rare long-term PDAC survivors previously shown to have more immunogenic tumors3 (n = 9 patients, n = 9 primary, 22 recurrent tumors), to short-term survivors with less immunogenic primary tumors (n = 6 patients, n = 6 primary, 33 recurrent tumors). To identify immunogenic “high quality” neoantigens, we use neopeptide-T cell functional assays and computational modeling to extend and apply a previously developed neoantigen quality model3 4 by predicting high quality neoantigens as arising from amino acid substitutions with sufficient antigenic distance from cognate wild-type peptides to differentially bind the MHC or activate a T cell.ResultsCompared to short-term survivors, we observe that long-term survivors evolve fewer recurrent tumors with longer latency, and distinct tissue tropism. To evaluate if differential immune pressures explained these differences, we discover that despite longer times to evolve, long-term survivors evolve genetically less heterogeneous tumors with fewer clones, fewer nonsynonymous mutations, and fewer neoantigens. To identify if high quality neoantigens are selectively edited in recurrent tumors of long-term survivors, we observe that neoantigens with greater antigenic distance (“less self”) are more depleted in primary and recurrent tumors of long- compared to short-term survivors. Furthermore, we find that long-term survivors evolve markedly fewer new neoantigens of strikingly lower quality, to indicate clones with high quality neoantigens are immunoedited.ConclusionsWe submit longitudinal evidence that the human immune system naturally edits neoantigens in PDAC. Furthermore, we present a model that describes how cancer neoantigens evolve under immune pressure over time, with implications for cancer biology and therapy. More broadly, our results argue that immunoediting is a fundamental cancer suppressive mechanism that can be quantified to predict tumor evolution.AcknowledgementsThis work was supported by NIH U01 CA224175 (V.P.B), a Stand Up to Cancer Convergence Award (B.D.G, V.P.B.), a Damon Runyon Clinical Investigator Award (V.P.B), and the Avner Pancreatic Cancer Foundation (A.J, A.G). Services by the Integrated Genomics Core were funded by the NCI Cancer Center Support Grant (P30 CA08748), Cycle for Survival, and the Marie-Josée and Henry R. Kravis Center for Molecular Oncology.ReferencesShankaran V, et al. IFNgamma and lymphocytes prevent primary tumour development and shape tumour immunogenicity. Nature 2001;410:1107–1111.Matsushita H, et al. Cancer exome analysis reveals a T-cell-dependent mechanism of cancer immunoediting. Nature 2012;482:400–404.Balachandran VP, et al. Identification of unique neoantigen qualities in long-term survivors of pancreatic cancer. Nature 2017;551:512–516.Łuksza M, et al. A neoantigen fitness model predicts tumour response to checkpoint blockade immunotherapy. Nature 2017;551:517–520.Ethics ApprovalThis study was performed in strict compliance with all institutional ethical regulations and approved by the institutional review boards of Memorial Sloan Kettering Cancer Center (MSK), the Garvan Institute of Medical Research, and the The Johns Hopkins Hospital (JHH). We obtained informed consent from all patients.
Collapse
|
7
|
Luksza M, Sethna Z, Rojas L, Soares K, Elhanati Y, Lihm J, Hoyos D, Kappagantula R, Moore AM, Patterson E, Iacobuzio-Donahue C, Greenbaum B, Balachandran VP. Abstract LB005: High quality neoantigens are immunoedited in long term survivors of pancreatic cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-lb005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cancer immunoediting, a hallmark of cancer, predicts that lymphocytes recognize tumor-specific mutations (neoantigens) to kill immunogenic tumor cells and select less immunogenic clones to survive in immunocompetent hosts. Yet, though proven in mice, whether immunoediting governs how human tumors evolve naturally, and the principles of how the immune system edits tumors remain unclear. Here, we report that T cell rich tumors of rare long-term survivors of human pancreatic ductal adenocarcinoma longitudinally lose immunogenic features predicted by a fitness model based on immune recognition of high quality neoantigens. We find that compared to T cell poor tumors in short-term survivors, long-term survivors evolve less immunogenic recurrent tumors over 10 years with fewer clones, fewer neoantigens, and new neoantigens of markedly lower quality, to indicate that the immune system edits lower fitness clones with high-quality neoantigens. To explore if the immune system more broadly selects against non-self-like changes in host genomes, we define a minimal amino acid substitution distance sufficient for T cell receptors to discriminate self from non-self mutations. We find that both primary and recurrent tumors in long but not short-term survivors are enriched in self-like mutations, to suggest that the immune system depletes non-self-like mutations. Thus, we submit longitudinal evidence that the immune system edits neoantigens to sculpt recurrent human pancreatic ductal adenocarcinomas, a lethal tumor largely considered resistant to endogenous immune attack. Furthermore, we demonstrate that the neoantigen quality fitness model predicts how immune pressure changes tumor cell populations over time, with significant implications for cancer biology and immunotherapy. More broadly, our results argue that cancer immunoediting is a fundamental principle of how human cancers evolve in immunocompetent hosts.
Citation Format: Marta Luksza, Zachary Sethna, Luis Rojas, Kevin Soares, Yuval Elhanati, Jayon Lihm, David Hoyos, Rajya Kappagantula, Alvin M. Moore, Erin Patterson, Christine Iacobuzio-Donahue, Benjamin Greenbaum, Vinod P. Balachandran. High quality neoantigens are immunoedited in long term survivors of pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB005.
Collapse
Affiliation(s)
- Marta Luksza
- 1Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, NY
| | | | - Luis Rojas
- 2Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kevin Soares
- 2Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Jayon Lihm
- 2Memorial Sloan Kettering Cancer Center, New York, NY
| | - David Hoyos
- 2Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | | | | |
Collapse
|
8
|
Affiliation(s)
- Madelaine Bartlett
- Biology Department, University of Massachusetts Amherst, 611 North Pleasant Street, Amherst, MA, 01003-9297, USA
| | - Erin Patterson
- Biology Department, University of Massachusetts Amherst, 611 North Pleasant Street, Amherst, MA, 01003-9297, USA
| |
Collapse
|
9
|
Patterson E, Ryan PM, Wiley N, Carafa I, Sherwin E, Moloney G, Franciosi E, Mandal R, Wishart DS, Tuohy K, Ross RP, Cryan JF, Dinan TG, Stanton C. Gamma-aminobutyric acid-producing lactobacilli positively affect metabolism and depressive-like behaviour in a mouse model of metabolic syndrome. Sci Rep 2019; 9:16323. [PMID: 31704943 PMCID: PMC6841999 DOI: 10.1038/s41598-019-51781-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/20/2019] [Indexed: 12/22/2022] Open
Abstract
Metabolic and neuroactive metabolite production represents one of the mechanisms through which the gut microbiota can impact health. One such metabolite, gamma-aminobutyric acid (GABA), can modulate glucose homeostasis and alter behavioural patterns in the host. We previously demonstrated that oral administration of GABA-producing Lactobacillus brevis DPC6108 has the potential to increase levels of circulating insulin in healthy rats. Therefore, the objective of this study was to assess the efficacy of endogenous microbial GABA production in improving metabolic and behavioural outcomes in a mouse model of metabolic dysfunction. Diet-induced obese and metabolically dysfunctional mice received one of two GABA-producing strains, L. brevis DPC6108 or L. brevis DSM32386, daily for 12 weeks. After 8 and 10 weeks of intervention, the behavioural and metabolic profiles of the mice were respectively assessed. Intervention with both L. brevis strains attenuated several abnormalities associated with metabolic dysfunction, causing a reduction in the accumulation of mesenteric adipose tissue, increased insulin secretion following glucose challenge, improved plasma cholesterol clearance and reduced despair-like behaviour and basal corticosterone production during the forced swim test. Taken together, this exploratory dataset indicates that intervention with GABA-producing lactobacilli has the potential to improve metabolic and depressive- like behavioural abnormalities associated with metabolic syndrome in mice.
Collapse
Affiliation(s)
- E Patterson
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - P M Ryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - N Wiley
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - I Carafa
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.,Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - E Sherwin
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - G Moloney
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - E Franciosi
- Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - R Mandal
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - D S Wishart
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada.,Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.,National Institute for Nanotechnology, Edmonton, Alberta, Canada
| | - K Tuohy
- Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - R P Ross
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - J F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - T G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - C Stanton
- APC Microbiome Ireland, University College Cork, Cork, Ireland. .,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.
| |
Collapse
|
10
|
Patterson E, Jennings C, Mazzacano A, Naidoo S. Barriers and facilitators to integrating a lifestyle intervention into primary health care settings in Country SA. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Jennings C, Patterson E, Mazzacano A, Naidoo S. Multi-site implementation and initial uptake of a physical activity and nutrition program in Country SA. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Kooyers NJ, Colicchio JM, Greenlee AB, Patterson E, Handloser NT, Blackman BK. Lagging Adaptation to Climate Supersedes Local Adaptation to Herbivory in an Annual Monkeyflower. Am Nat 2019; 194:541-557. [DOI: 10.1086/702312] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
13
|
Edgar K, Gill E, Patterson E, Hargey C, Moez A, Grieve D. Adverse cardiac remodelling in experimental diabetes is regulated by endothelial Nox4 NADPH oxidase-derived reactive oxygen species. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
14
|
Saari M, Xiao S, Rowe A, Patterson E, Killackey T, Raffaghello J, Tourangeau AE. The role of unregulated care providers in home care: A scoping review. J Nurs Manag 2018; 26:782-794. [DOI: 10.1111/jonm.12613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 01/07/2023]
Affiliation(s)
| | - Sarah Xiao
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| | - Alissa Rowe
- Southwest Local Health Integration Network; London ON Canada
| | - Erin Patterson
- School of Health & Life Sciences & Community Services; Conestoga College Institute of Technology and Advanced Learning; Kitchener ON Canada
| | - Tieghan Killackey
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| | - Julia Raffaghello
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| | - Ann E. Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| |
Collapse
|
15
|
Knobloch MJ, Chewning B, Musuuza J, Rees S, Green C, Patterson E, Safdar N. Leadership rounds to reduce health care-associated infections. Am J Infect Control 2018; 46:303-310. [PMID: 29102425 DOI: 10.1016/j.ajic.2017.08.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Evidence-based guidelines exist to reduce health care-associated infections (HAIs). Leadership rounds are one tool leaders can use to ensure compliance with guidelines, but have not been studied specifically for the reduction of HAIs. This study examines HAI leadership rounds at one facility. METHODS We explored unit-based HAI leadership rounds led by 2 hospital leaders at a large academic hospital. Leadership rounds were observed on 19 units, recorded, and coded to identify themes. Themes were linked to the Consolidated Framework for Implementation Research and used to guide interviews with frontline staff members. RESULTS Staff members disclosed unit-specific problems and readily engaged in problem-solving with top hospital leaders. These themes appeared over 350 times within 22 rounds. Findings revealed that leaders used words that demonstrated fallibility and modeled curiosity, 2 factors associated with learning climate and psychologic safety. These 2 themes appeared 115 and 142 times, respectively. The flexible nature of the rounds appeared to be conducive for reflection and evaluation, which was coded 161 times. CONCLUSIONS Each interaction between leaders and frontline staff can foster psychologic safety, which can lead to open problem-solving to reduce barriers to implementation. Discovering specific communication and structural factors that contribute to psychologic safety may be powerful in reducing HAIs.
Collapse
Affiliation(s)
- Mary Jo Knobloch
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; William S. Middleton Memorial Veterans Hospital, Madison, WI.
| | | | - Jackson Musuuza
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Susan Rees
- University of Wisconsin Hospitals and Clinics, Madison, WI
| | | | - Erin Patterson
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Nasia Safdar
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; William S. Middleton Memorial Veterans Hospital, Madison, WI
| |
Collapse
|
16
|
Saari M, Patterson E, Kelly S, Tourangeau AE. The evolving role of the personal support worker in home care in Ontario, Canada. Health Soc Care Community 2018; 26:240-249. [PMID: 29119635 DOI: 10.1111/hsc.12514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2017] [Indexed: 06/07/2023]
Abstract
To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home-care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home-care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team-based approach to the delivery of home-care services be considered. Utilisation of a team-based model can help establish positive relationships among home-care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills.
Collapse
Affiliation(s)
- Margaret Saari
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave West, Waterloo, ON, Canada
- Saint Elizabeth Research Centre, Saint Elizabeth Health Care, 90 Allstate Parkway, Suite #300, Markham, ON, Canada
| | - Erin Patterson
- School of Health & Life Sciences and Community Services, Conestoga College, Kitchener, ON, Canada
| | - Shawna Kelly
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Krembil Neuroscience Program, University Health Network, Toronto, ON, Canada
| | - Ann E Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
17
|
Saari M, Patterson E, Killackey T, Raffaghello J, Rowe A, Tourangeau AE. Home-based care: barriers and facilitators to expanded personal support worker roles in Ontario, Canada. Home Health Care Serv Q 2017; 36:127-144. [DOI: 10.1080/01621424.2017.1393482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Margaret Saari
- Saint Elizabeth Research Centre, Saint Elizabeth Health Care, Markham, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Erin Patterson
- School of Health & Life Sciences & Community Services, Conestoga College Institute of Technology and Advanced Learning, Kitchener, Ontario, Canada
| | - Tieghan Killackey
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Julia Raffaghello
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Alissa Rowe
- Southwest Community Care Access Center, London, Ontario, Canada
| | - Ann E Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
18
|
Nyberg G, Patterson E, Jonsson M, Hökby S. Elevhalsoportalen.se: How Swedish schools utilize a novel student health promotion webtool. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Nyberg
- Centre for Epidemiology and Community medicine (CES), Stockholm County Council (SLL), Stockholm, Sweden
| | - E Patterson
- Centre for Epidemiology and Community medicine (CES), Stockholm County Council (SLL), Stockholm, Sweden
| | - M Jonsson
- Centre for Occupational and Environmental Medicine, (CAMM), Stockholm County Council (SLL), Stockholm, Sweden
| | - S Hökby
- Centre for Occupational and Environmental Medicine, (CAMM), Stockholm County Council (SLL), Stockholm, Sweden
| |
Collapse
|
19
|
Knobloch MJ, Thomas KV, Patterson E, Zimbric ML, Musuuza J, Safdar N. Implementation in the midst of complexity: Using ethnography to study health care-associated infection prevention and control. Am J Infect Control 2017; 45:1058-1063. [PMID: 28774756 DOI: 10.1016/j.ajic.2017.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/21/2017] [Accepted: 06/22/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Contextual factors associated with health care settings make reducing health care-associated infections (HAIs) a complex task. The aim of this article is to highlight how ethnography can assist in understanding contextual factors that support or hinder the implementation of evidence-based practices for reducing HAIs. METHODS We conducted a review of ethnographic studies specifically related to HAI prevention and control in the last 5 years (2012-2017). RESULTS Twelve studies specific to HAIs and ethnographic methods were found. Researchers used various methods with video-reflexive sessions used in 6 of the 12 studies. Ethnography was used to understand variation in data reporting, identify barriers to adherence, explore patient perceptions of isolation practices and highlight the influence of physical design on infection prevention practices. The term ethnography was used to describe varied research methods. Most studies were conducted outside the United States, and authors indicate insights gained using ethnographic methods (whether observations, interviews, or reflexive video recording) as beneficial to unraveling the complexities of HAI prevention. CONCLUSIONS Ethnography is well-suited for HAI prevention, especially video-reflexive ethnography, for activating patients and clinicians in infection control work. In this era of increasing pressure to reduce HAIs within complex work systems, ethnographic methods can promote understanding of contextual factors and may expedite translation evidence to practice.
Collapse
|
20
|
Wong M, Saari M, Patterson E, Puts M, Tourangeau AE. Occupational hazards for home care nurses across the rural-to-urban gradient in Ontario, Canada. Health Soc Care Community 2017; 25:1276-1286. [PMID: 28215055 DOI: 10.1111/hsc.12430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this paper was to describe occupational hazards for nurses working in home care (HC) and explore how they differ across the rural-to-urban gradient. Responses (n = 823) from a cross-sectional survey conducted in 2012 of HC nurses registered to practise nursing in the Province of Ontario, Canada were used. Using chi-square analysis and posthoc pairwise tests with a Bonferroni correction, 14 occupational hazards were individually tested for differences between four geographical settings (rural, town, suburban or urban areas). Our study reports that in addition to common occupational hazards that all HC nurses experience, the frequency of experiencing some hazards varies based on geographic setting. These specific hazards include exposure to: aggressive pets, environmental tobacco smoke, oxygen equipment, unsafe neighbourhoods and pests. Findings from this study suggest that a relationship exists between where a patient's home is located and the types of occupational hazards that may be experienced by HC staff. This research is useful for HC organisations in developing staff training programmes to recognise and manage occupational hazards that workers are likely to encounter. Home healthcare and policy leaders may use these findings to develop and implement educational and other strategies to reduce risk and manage exposures across the rural-to-urban gradient.
Collapse
Affiliation(s)
- Matthew Wong
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Margaret Saari
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Erin Patterson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ann E Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
21
|
Nolan JA, Skuse P, Govindarajan K, Patterson E, Konstantinidou N, Casey PG, MacSharry J, Shanahan F, Stanton C, Hill C, Cotter PD, Joyce SA, Gahan CGM. The influence of rosuvastatin on the gastrointestinal microbiota and host gene expression profiles. Am J Physiol Gastrointest Liver Physiol 2017; 312:G488-G497. [PMID: 28209601 DOI: 10.1152/ajpgi.00149.2016] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 02/01/2017] [Accepted: 02/08/2017] [Indexed: 01/31/2023]
Abstract
Statins are the most widely prescribed medications worldwide for the treatment of hypercholesterolemia. They inhibit the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-R), an enzyme involved in cholesterol synthesis in higher organisms and in isoprenoid biosynthesis in some bacteria. We hypothesized that statins may influence the microbial community in the gut through either direct inhibition or indirect mechanisms involving alterations to host responses. We therefore examined the impact of rosuvastatin (RSV) on the community structure of the murine gastrointestinal microbiota. RSV was orally administered to mice and the effects on the gut microbiota, host bile acid profiles, and markers of inflammation were analyzed. RSV significantly influenced the microbial community in both the cecum and feces, causing a significant decrease in α-diversity in the cecum and resulting in a reduction of several physiologically relevant bacterial groups. RSV treatment of mice significantly affected bile acid metabolism and impacted expression of inflammatory markers known to influence microbial community structure (including RegIIIγ and Camp) in the gut. This study suggests that a commonly used statin (RSV) leads to an altered gut microbial composition in normal mice with attendant impacts on local gene expression profiles, a finding that should prompt further studies to investigate the implications of statins for gut microbiota stability and health in humans.NEW & NOTEWORTHY This work demonstrates that rosuvastatin administration in mice affects the gastrointestinal microbiota, influences bile acid metabolism, and alters transcription of genes encoding factors involved in gut homeostasis and immunity in the gastrointestinal tract.
Collapse
Affiliation(s)
- J A Nolan
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland
| | - P Skuse
- Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, Cork, Ireland
| | - K Govindarajan
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland
| | - E Patterson
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, Cork, Ireland
| | | | - P G Casey
- APC Microbiome Institute, University College Cork, Cork, Ireland
| | - J MacSharry
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland.,School of Medicine, University College Cork, Cork, Ireland; and
| | - F Shanahan
- APC Microbiome Institute, University College Cork, Cork, Ireland
| | - C Stanton
- APC Microbiome Institute, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, Cork, Ireland
| | - C Hill
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland
| | - P D Cotter
- APC Microbiome Institute, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, Cork, Ireland
| | - S A Joyce
- APC Microbiome Institute, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland.,School of Medicine, University College Cork, Cork, Ireland; and
| | - C G M Gahan
- APC Microbiome Institute, University College Cork, Cork, Ireland; .,School of Microbiology, University College Cork, Cork, Ireland.,School of Pharmacy, University College Cork, Cork, Ireland
| |
Collapse
|
22
|
Abstract
This article discusses the results of a 2015 study of Canadian university copyright officers, which were presented at the ABC Copyright Conference in Halifax in May 2016. The study’s primary aim was to generate a snapshot of this emerging profession. Who are the people occupying copyright positions at Canadian universities? What do they call themselves? What is their academic background? What kind of copyright education and training do they have? Where do they fit into the structure of the organization? The study’s secondary aim was to probe the intersection of copyright and academic freedom: not the academic freedom of faculty members in creating and using copyright-protected works, but the academic freedom of the copyright officer in interpreting copyright, providing copyright information, teaching and writing about copyright, and engaging in advocacy efforts. The results indicate that the typical Canadian university copyright officer holds an MLS degree or equivalent but has no formal copyright or legal education; works exclusively as a copyright officer within the library system; and is very new to copyright work. Just under half of the copyright officers surveyed have academic freedom, and of those, almost none have considered the implications of this for their copyright work. The author argues that the position of university copyright officer should have faculty status so that the copyright officer can exercise academic freedom as they negotiate the changing and contentious copyright landscape.
Cet article décrit les résultats d’une enquête menée en 2015 auprès des agents du droit d’auteur dans les universités canadiennes. Ces résultats ont d’abord été présentés lors du congrès ABC Copyright qui a eu lieu en mai 2016 à Halifax. Cette enquête avait comme objectif principal de fournir un portrait de la situation actuelle de cette profession émergente. Qui sont les personnes qui occupent des postes en droit d’auteur dans les universités canadiennes? Quelle est leur formation universitaire? Quel type de formation en droit d’auteur ont-ils reçue? Où se trouvent-ils au sein de la structure organisationnelle? Le second objectif était de mieux comprendre l’intersection entre le droit d’auteur et la liberté académique. Il ne s’agit pas de la liberté académique du corps professoral à créer et utiliser des ouvrages protégés par le droit d’auteur, mais plutôt de la liberté académique de l’agent du droit d’auteur à interpréter le droit d’auteur, à fournir des informations portant sur le droit d’auteur, à enseigner et à écrire au sujet du droit d’auteur et à défendre des intérêts. Les résultats montrent que l’agent du droit d’auteur typique travaillant dans une université canadienne détient une maîtrise en science de l’information ou son équivalence, mais celui-ci n’a aucune formation formelle en droit ou en droit d’auteur; il travaille exclusivement en tant qu’agent du droit d’auteur au sein de la bibliothèque; et le domaine lui est nouveau. Un peu moins de la moitié des agents du droit d’auteur interrogés disent tirer profit d’une liberté académique et, parmi ceux-ci, pratiquement aucun n’a considéré les implications de cette liberté sur leur travail en droit d’auteur. L’auteur croit que le poste d’agent du droit d’auteur devrait avoir un statut équivalent à celui d’un professeur afin que l’agent puisse exercer sa liberté académique lorsqu’il transige avec la réalité changeante et contentieuse liée au droit d’auteur.
Collapse
|
23
|
Hoban AE, Moloney RD, Golubeva AV, McVey Neufeld KA, O'Sullivan O, Patterson E, Stanton C, Dinan TG, Clarke G, Cryan JF. Corrigendum to "Behavioural and neurochemical consequences of chronic gut microbiota depletion during adulthood in the rat" [Neuroscience 339 (2016) 463-477]. Neuroscience 2017; 344:418. [PMID: 28089601 DOI: 10.1016/j.neuroscience.2017.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A E Hoban
- APC Microbiome Institute, University College Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Ireland
| | - R D Moloney
- APC Microbiome Institute, University College Cork, Ireland
| | - A V Golubeva
- APC Microbiome Institute, University College Cork, Ireland
| | | | - O O'Sullivan
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - E Patterson
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - C Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - T G Dinan
- APC Microbiome Institute, University College Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Ireland
| | - G Clarke
- APC Microbiome Institute, University College Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Ireland
| | - J F Cryan
- APC Microbiome Institute, University College Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Ireland.
| |
Collapse
|
24
|
Hoban A, Moloney R, Golubeva A, McVey Neufeld K, O’Sullivan O, Patterson E, Stanton C, Dinan T, Clarke G, Cryan J. Behavioural and neurochemical consequences of chronic gut microbiota depletion during adulthood in the rat. Neuroscience 2016; 339:463-477. [DOI: 10.1016/j.neuroscience.2016.10.003] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/05/2016] [Accepted: 10/02/2016] [Indexed: 12/22/2022]
|
25
|
Abstract
Adverse events, or accidents, in healthcare can have significant clinical outcomes including loss of property, health (morbidity), and life (mortality). Healthcare accidents have features that make post-event investigations particularly difficult. The investigation and analysis of medical accidents is intended to discover information that explains the nature and cause of what occurred in the interest of preventing or minimizing future loss. The thorough, objective investigation of medical adverse events rarely happens due to the complexity of the environment, litigation, risk, and socio-political implications. Special concerns can undermine investigation depth, breadth, and quality. Healthcare's distinct difference from other high hazard sectors such as aviation and nuclear power requires a unique approach. Healthcare accident examination requires detailed domain knowledge and the use of diverse investigation methods. This paper describes the current state of medical accident analysis, obstacles to understanding such accidents and strategies to overcome them, as well as future investigation and analysis approaches.
Collapse
Affiliation(s)
- C. Nemeth
- Cognitive Technologies Laboratory, The University of Chicago
| | - R. I. Cook
- Cognitive Technologies Laboratory, The University of Chicago
| | | | - Y. Donchin
- Hadassah Hebrew University Medical Center, Jerusalem
| | | | | |
Collapse
|
26
|
Patterson E, Elinder LS. A practical web-based tool helps Swedish schools improve their meal quality. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw171.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
27
|
Elinder LS, Hakimi SN, Lager A, Patterson E. Increased type 2 diabetes risk in migrants to Sweden from Asia, Africa and the Middle East. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw167.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
28
|
Thummala AS, Leach JK, Patterson E, O'Rear EA. Effect of encapsulation on plasminogen activator delivery to the microcirculation and its implications for bleeding. Clin Hemorheol Microcirc 2016; 63:373-379. [PMID: 26890102 DOI: 10.3233/ch-152030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE It is known that encapsulation can alter the delivery of plasminogen activators by flow to accelerate fibrinolysis while other experimental studies suggest encapsulation may reduce the risk of hemorrhage with administration of the agent. The aim of this research is to resolve the effect of encapsulation on fibrinolysis and bleeding in the microcirculation. METHODS An established rabbit model of fibrinolytic hemorrhage was utilized to explore the potential of encapsulation to limit bleeding. Equal dosages of free or microencapsulated streptokinase (MESK) were infused to initiate thrombolysis of small vessel clots while tracking blood loss. RESULTS Compared to free streptokinase, significant improvements in bleeding were observed with MESK as demonstrated by (1) delayed onset of bleeding, (2) shortened duration, and (3) reduction in the volume of lost blood, consistent with less systemic fibrinogen degradation. CONCLUSIONS Findings demonstrate that encapsulation of streptokinase can inhibit clot lysis in small vessels. Combined with prior work on accelerated thrombolysis, results suggest a time-based regimen for avoiding bleeding complications during thrombolytic therapy with encapsulated agent.
Collapse
Affiliation(s)
- A S Thummala
- Oklahoma Bioengineering Center, University of Oklahoma, Norman, OK, USA
| | - J K Leach
- Oklahoma Bioengineering Center, University of Oklahoma, Norman, OK, USA
| | - E Patterson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - E A O'Rear
- Oklahoma Bioengineering Center, University of Oklahoma, Norman, OK, USA
| |
Collapse
|
29
|
Marques TM, Patterson E, Wall R, O'Sullivan O, Fitzgerald GF, Cotter PD, Dinan TG, Cryan JF, Ross RP, Stanton C. Influence of GABA and GABA-producing Lactobacillus brevis DPC 6108 on the development of diabetes in a streptozotocin rat model. Benef Microbes 2016; 7:409-20. [PMID: 27013462 DOI: 10.3920/bm2015.0154] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The aim of this study was to investigate if dietary administration of γ-aminobutyric acid (GABA)-producing Lactobacillus brevis DPC 6108 and pure GABA exert protective effects against the development of diabetes in streptozotocin (STZ)-induced diabetic Sprague Dawley rats. In a first experiment, healthy rats were divided in 3 groups (n=10/group) receiving placebo, 2.6 mg/kg body weight (bw) pure GABA or L. brevis DPC 6108 (~10(9)microorganisms). In a second experiment, rats (n=15/group) were randomised to five groups and four of these received an injection of STZ to induce type 1 diabetes. Diabetic and non-diabetic controls received placebo [4% (w/v) yeast extract in dH2O], while the other three diabetic groups received one of the following dietary supplements: 2.6 mg/kg bw GABA (low GABA), 200 mg/kg bw GABA (high GABA) or ~10(9) L. brevis DPC 6108. L. brevis DPC 6108 supplementation was associated with increased serum insulin levels (P<0.05), but did not alter other metabolic markers in healthy rats. Diabetes induced by STZ injection decreased body weight (P<0.05), increased intestinal length (P<0.05) and stimulated water and food intake. Insulin was decreased (P<0.05), whereas glucose was increased (P<0.001) in all diabetic groups, compared with non-diabetic controls. A decrease (P<0.01) in glucose levels was observed in diabetic rats receiving L. brevis DPC 6108, compared with diabetic-controls. Both the composition and diversity of the intestinal microbiota were affected by diabetes. Microbial diversity in diabetic rats supplemented with low GABA was not reduced (P>0.05), compared with non-diabetic controls while all other diabetic groups displayed reduced diversity (P<0.05). L. brevis DPC 6108 attenuated hyperglycaemia induced by diabetes but additional studies are needed to understand the mechanisms involved in this reduction.
Collapse
Affiliation(s)
- T M Marques
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,2 Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.,3 School of Microbiology, University College Cork, Cork, Ireland
| | - E Patterson
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,2 Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.,3 School of Microbiology, University College Cork, Cork, Ireland
| | - R Wall
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,2 Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - O O'Sullivan
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,2 Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - G F Fitzgerald
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,3 School of Microbiology, University College Cork, Cork, Ireland
| | - P D Cotter
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,2 Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - T G Dinan
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,4 Department of Psychiatry and Neurobehavioural Science, Biosciences Institute, University College Cork, Cork, Ireland
| | - J F Cryan
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland
| | - R P Ross
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland
| | - C Stanton
- 1 APC Microbiome Institute, University College Cork, Cork, Ireland.,2 Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| |
Collapse
|
30
|
Tourangeau AE, Wong M, Saari M, Patterson E. Generation-specific incentives and disincentives for nurse faculty to remain employed. J Adv Nurs 2014; 71:1019-31. [DOI: 10.1111/jan.12582] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Ann E. Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Ontario Canada
| | - Matthew Wong
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Ontario Canada
| | - Margaret Saari
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Ontario Canada
| | - Erin Patterson
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Ontario Canada
| |
Collapse
|
31
|
Tourangeau A, Saari M, Patterson E, Ferron EM, Thomson H, Widger K, MacMillan K. Work, work environments and other factors influencing nurse faculty intention to remain employed: a cross-sectional study. Nurse Educ Today 2014; 34:940-947. [PMID: 24238852 DOI: 10.1016/j.nedt.2013.10.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/19/2013] [Accepted: 10/21/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Given the role nurse faculty have in educating nurses, little is known about what influences their intention to remain employed (ITR) in academic settings. OBJECTIVES Findings from a nurse faculty survey administered to test a conceptual model of factors hypothesized as influencing nurse faculty ITR are reported. DESIGN A cross-sectional survey design was employed. SETTING We included colleges and universities in Ontario, Canada. PARTICIPANTS The population of Ontario nurse faculty who reported being employed as nurse faculty with the College of Nurses of Ontario (Canada) was included. Of the 1328 nurse faculty who were surveyed, 650 participated. METHODS Participants completed a questionnaire with measures of work, work environment, job satisfaction, burnout and ITR. Regression analyses were conducted to test the model. RESULTS Ten of 26 independent variables explained 25.4% of variance in nurse faculty ITR for five years. These variables included: proximity to retirement, quality of relationships with colleagues, being employed full time, having dependents, satisfaction with work-life balance, quality of education, satisfaction with job status, access to financial support for education from organization, access to required human resources and being unionized. CONCLUSIONS Although not all influencing factors are modifiable, academic leadership should develop strategies that encourage nurse faculty ITR. Strategies that support collegial relationships among faculty, increase the number of full time positions, promote work-life balance, engage faculty in assessing and strengthening education quality, support faculty choice between full-time and part-time work, and ensure adequate human resources required to teach effectively will lead to heightened nurse faculty ITR.
Collapse
Affiliation(s)
- Ann Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T1P8, Canada.
| | - Margaret Saari
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T1P8, Canada.
| | - Erin Patterson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T1P8, Canada.
| | - Era Mae Ferron
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T1P8, Canada.
| | - Heather Thomson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T1P8, Canada.
| | - Kimberley Widger
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario M5T1P8, Canada.
| | - Kathleen MacMillan
- Dalhousie University, 5869 University Ave., PO Box 15000, Halifax, NS B3H 4R2, Canada.
| |
Collapse
|
32
|
Tourangeau A, Patterson E, Rowe A, Saari M, Thomson H, MacDonald G, Cranley L, Squires M. Factors influencing home care nurse intention to remain employed. J Nurs Manag 2013; 22:1015-26. [PMID: 23905629 DOI: 10.1111/jonm.12104] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2013] [Indexed: 11/27/2022]
Abstract
AIM To identify factors affecting Canadian home care nurse intention to remain employed (ITR). BACKGROUND In developed nations, healthcare continues to shift into community settings. Although considerable research exists on examining nurse ITR in hospitals, similar research related to nurses employed in home care is limited. In the face of a global nursing shortage, it is important to understand the factors influencing nurse ITR across healthcare sectors. METHODS A qualitative exploratory descriptive design was used. Focus groups were conducted with home care nurses. Data were analysed using qualitative content analysis. RESULTS Six categories of influencing factors were identified by home care nurses as affecting ITR: job characteristics; work structures; relationships/communication; work environment; nurse responses to work; and employment conditions. CONCLUSION Findings suggest the following factors influence home care nurse ITR: having autonomy; flexible scheduling; reasonable and varied workloads; supportive work relationships; and receiving adequate pay and benefits. Home care nurses did not identify job satisfaction as a single concept influencing ITR. IMPLICATIONS FOR NURSING MANAGEMENT Home care nursing management should support nurse autonomy, allow flexible scheduling, promote reasonable workloads and create opportunities for team building that strengthen supportive relationships among home care nurses and other health team members.
Collapse
Affiliation(s)
- Ann Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Patterson E. Book Review: Immigration and Integration in Urban Communities. Hispanic Journal of Behavioral Sciences 2013. [DOI: 10.1177/0739986313487620e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
34
|
Patterson E, Wan YWT, Sidani S. Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. J Clin Nurs 2013; 22:2668-78. [PMID: 23654210 DOI: 10.1111/jocn.12211] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2012] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To identify and describe nonpharmacological interventions for the management of fatigue that are within the scope of nursing practice. BACKGROUND Fatigue is a complex multidimensional symptom experienced by patients with varying diagnoses. Limited details are available on the nature of nursing interventions to manage fatigue, which preclude fidelity of implementation in day-to-day practice. DESIGN Literature review. METHODS Multiple databases were searched for publications reporting on the evaluation of nurse-delivered interventions for the management of fatigue. Data were extracted on study and intervention characteristics and results pertaining to the effects of the intervention on fatigue. RESULTS The studies (n = 16) evaluated eight interventions: psycho-education, cognitive behavioural therapy, exercise, acupressure, relaxation, distraction, energy conservation and activity management, and a combination of exercise, education and support. CONCLUSION Psycho-education was evaluated in several studies and demonstrated effectiveness when delivered in both acute and community settings. RELEVANCE TO CLINICAL PRACTICE This review focused on interventions that are within the scope of nursing practice for the management of fatigue. The findings provide nurses with an overview of the effectiveness of interventions they may use in their day-to-day practice to help patients manage fatigue. A detailed description of interventions found effective is provided to assist nurses in translating evidence into practice.
Collapse
Affiliation(s)
- Erin Patterson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | | | | |
Collapse
|
35
|
Abstract
As the location of health care delivery continues to shift from inpatient settings into the community understanding the experience of the home care workforce is important. Challenges related to recruitment and retention of nurses in home care has resulted in agencies hiring new graduate nurses. While Extensive research exists exploring experiences of new graduates in hospital settings, experiences of new graduates in home care are not well understood. Given the contextual differences between hospital and home care, research exploring new graduate nurses’ experiences in the home care sector is warranted. A phenomenological approach was used. “Deciding if home care is right for me” emerged as a way of understanding new graduate nurses’ experiences in home care.
Collapse
Affiliation(s)
| | | | | | - Nancy Purdy
- Ryerson University, Toronto, Ontario, Canada
| |
Collapse
|
36
|
Chen CL, Sangiah S, Roder JD, Chen H, Berlin KD, Garrison GL, Scherlag BJ, Lazzara R, Patterson E. Pharmacokinetics and Plasma Protein Binding of BRB-I-28, a Novel Antiarrhythmic Agent, in Dogs. Clin Drug Investig 2012. [DOI: 10.1007/bf03259249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
37
|
Nguyen N, Champion JK, Ponce J, Quebbemann B, Patterson E, Pham B, Raum W, Buchwald JN, Segato G, Favretti F. A review of unmet needs in obesity management. Obes Surg 2012; 22:956-66. [PMID: 22438220 DOI: 10.1007/s11695-012-0634-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The prevalence of obesity continues to escalate in the USA; however, there is no consensus regarding the optimal therapy for obesity. For the vast majority of severely obese patients, conventional medical therapies (i.e., diet, exercise, behavioral counseling) often fail over the long term. Existing pharmacotherapy adjunctive to behavioral therapy has limited effectiveness and an imperfect safety record. In contrast, bariatric surgery has a high degree of weight loss efficacy, yet only a small fraction of the qualifying obese population undergoes these procedures because of the associated perioperative risks and potential late complications. In addition, the role of bariatric surgery is unclear in certain patient populations, such as patients with lower body mass index (BMI, 30-35 kg/m(2)), the high-risk super-super obese patients (BMI > 60), the morbidly obese adolescent, and obese patients requiring weight reduction in preparation for other procedures, such as orthopedic, transplant, or vascular surgeries. In these circumstances, there is a need for an effective but less invasive treatment to bridge the gap between medical and surgical therapy. This review examines current treatment outcomes, identifies prominent areas of unmet clinical needs, and provides an overview of two minimally invasive "temporary procedures for weight loss" that may eventually address some of the unmet needs in obesity management.
Collapse
Affiliation(s)
- N Nguyen
- Division of GI Surgery, University of California Irvine Medical Center, 333 City Bldg. West, Suite 850, Orange, CA 92868, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Anders SH, Woods DD, Schweikhart S, Ebright P, Patterson E. The effects of health information technology change over time: a study of Tele-ICU functions. Appl Clin Inform 2012; 3:239-47. [PMID: 23646073 PMCID: PMC3613018 DOI: 10.4338/aci-2011-12-ra-0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 06/02/2012] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Longitudinal studies exploring the evolution of health information technology functions provide valuable information about how technology systems are integrated and exploited in situ. This study reports changes in the distribution of functions for a specific health information technology, the tele-ICU, over time. The studied tele-ICU provided care to six remote ICUs within a local geographic region in the same state and had nursing staff around the clock. METHODS The intervention logs of tele-ICU nurses were collected during two discrete times and coded into nine emergent functional categories, who initiated the intervention and, if required, subsequent escalation. All coded functional categories were investigated for significant changes over time in the nursing logged interventions. RESULTS A total of 1927 interventions were coded into the nine emergent functional categories. Seven of the nine categories (78%) were significantly different between 2005 and 2007. The functions of the tele-ICU system continue to change and develop over time. CONCLUSION These findings suggest that the tele-ICU increased support when ICU nurses were off the unit, inter-hospital coordinating and adherence to best practices, while simultaneously decreasing real-time support for ICU nurses. This research suggests that sustaining safety features in a new technology over time have post-conditions after implementation.
Collapse
Affiliation(s)
- S H Anders
- Center for Research & Innovation in Systems Safety, Vanderbilt University Medical Center (VUMC) , Nashville, TN 37209, USA.
| | | | | | | | | |
Collapse
|
39
|
Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health implications of high dietary omega-6 polyunsaturated Fatty acids. J Nutr Metab 2012; 2012:539426. [PMID: 22570770 PMCID: PMC3335257 DOI: 10.1155/2012/539426] [Citation(s) in RCA: 489] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 11/17/2011] [Accepted: 11/20/2011] [Indexed: 12/17/2022] Open
Abstract
Omega-6 (n-6) polyunsaturated fatty acids (PUFA) (e.g., arachidonic acid (AA)) and omega-3 (n-3) PUFA (e.g., eicosapentaenoic acid (EPA)) are precursors to potent lipid mediator signalling molecules, termed "eicosanoids," which have important roles in the regulation of inflammation. In general, eicosanoids derived from n-6 PUFA are proinflammatory while eicosanoids derived from n-3 PUFA are anti-inflammatory. Dietary changes over the past few decades in the intake of n-6 and n-3 PUFA show striking increases in the (n-6) to (n-3) ratio (~15 : 1), which are associated with greater metabolism of the n-6 PUFA compared with n-3 PUFA. Coinciding with this increase in the ratio of (n-6) : (n-3) PUFA are increases in chronic inflammatory diseases such as nonalcoholic fatty liver disease (NAFLD), cardiovascular disease, obesity, inflammatory bowel disease (IBD), rheumatoid arthritis, and Alzheimer's disease (AD). By increasing the ratio of (n-3) : (n-6) PUFA in the Western diet, reductions may be achieved in the incidence of these chronic inflammatory diseases.
Collapse
Affiliation(s)
- E. Patterson
- Alimentary Pharmabiotic Centre, Biosciences Institute, County Cork, Ireland
- Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, County Cork, Ireland
| | - R. Wall
- Alimentary Pharmabiotic Centre, Biosciences Institute, County Cork, Ireland
- Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, County Cork, Ireland
| | - G. F. Fitzgerald
- Alimentary Pharmabiotic Centre, Biosciences Institute, County Cork, Ireland
- Department of Microbiology, University College Cork, County Cork, Ireland
| | - R. P. Ross
- Alimentary Pharmabiotic Centre, Biosciences Institute, County Cork, Ireland
- Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, County Cork, Ireland
| | - C. Stanton
- Alimentary Pharmabiotic Centre, Biosciences Institute, County Cork, Ireland
- Teagasc Food Research Centre, Biosciences Department, Moorepark, Fermoy, County Cork, Ireland
| |
Collapse
|
40
|
Patterson E, Webb R, Weisbrod A, Bian B, He M, Zhang L, Holloway AK, Krishna R, Nilubol N, Pacak K, Kebebew E. The microRNA expression changes associated with malignancy and SDHB mutation in pheochromocytoma. Endocr Relat Cancer 2012; 19:157-66. [PMID: 22241719 PMCID: PMC4716660 DOI: 10.1530/erc-11-0308] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Currently, the diagnosis of malignant pheochromocytoma can only be made when there is clinical evidence of metastasis or extensive local invasion. Thus, there is a need for new diagnostic marker(s) to identify tumors with malignant potential. The purpose of this study was to identify microRNAs (miRNAs) that are differentially expressed between benign and malignant pheochromocytomas and assess their diagnostic accuracy. Toward this aim, we analyzed miRNA expression in benign and malignant pheochromocytoma tumor samples using whole genome microarray profiling. Microarray analysis identified eight miRNAs that were significantly differentially expressed between benign and malignant pheochromocytomas. We measured a subset of these miRNAs directly by RT-PCR and found that miR-483-5p, miR-183, and miR-101 had significantly higher expression in malignant tumors as compared to their benign counterparts. Area under the receiver operating curve (AUC) analysis indicated that miR-483-5p, miR-101, and miR-183 could be useful diagnostic markers for distinguishing malignant from benign pheochromocytomas. In addition, these miRNAs could be detected in pheochromocytoma patient serum. Overall our data suggest that misexpression of miR-483-5p, miR-101, and miR-183 is associated with malignant pheochromocytoma.
Collapse
Affiliation(s)
- E Patterson
- Endocrine Oncology Section, NIH/NCI/Surgery Branch, National Cancer Institute, NIH, Hatfield Clinical Research Center, Bethesda, Maryland 20892, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Rahbari R, Kitano M, Zhang L, Bommareddi S, Patterson E, Jain M, Kebebew E. Reticulon 4 Interacting Protein 1 (RTN4IP1) Regulates Cancer Cell Phenotype and is Downregulated in Papillary Thyroid Cancer. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
42
|
Elinder LS, Brunosson A, Bergström H, Hagströmer M, Patterson E. Validation of personal digital photography to assess dietary quality among people with intellectual disabilities. J Intellect Disabil Res 2012; 56:221-226. [PMID: 21801265 DOI: 10.1111/j.1365-2788.2011.01459.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Dietary assessment is a challenge in general, and specifically in individuals with intellectual disabilities (ID). This study aimed to evaluate personal digital photography as a method of assessing different aspects of dietary quality in this target group. METHOD Eighteen adults with ID were recruited from community residences and activity centres in Stockholm County. Participants were instructed to photograph all foods and beverages consumed during 1 day, while observed. Photographs were coded by two raters. Observations and photographs of meal frequency, intake occasions of four specific food and beverage items, meal quality and dietary diversity were compared. Evaluation of inter-rater reliability and validity of the method was performed by intra-class correlation analysis. RESULTS With reminders from staff, 85% of all observed eating or drinking occasions were photographed. The inter-rater reliability was excellent for all assessed variables (ICC ≥ 0.88), except for meal quality where ICC was 0.66. The correlations between items assessed in photos and observations were strong to almost perfect with ICC values ranging from 0.71 to 0.92 and all were statistically significant. CONCLUSION Personal digital photography appears to be a feasible, reliable and valid method for assessing dietary quality in people with mild to moderate ID, who have daily staff support.
Collapse
Affiliation(s)
- L S Elinder
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
43
|
Stephens R, Cudnik M, Patterson E. Barriers and Facilitators to Timely Admission and Transfer of Patients from an Emergency Department to an Intensive Care Unit. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/1071181311551158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
44
|
Purnell JQ, Selzer F, Smith M, Berk P, Courcoulas A, Inabnet W, King W, Pender J, Pomp A, Raum W, Schrope B, Steffen K, Wolfe B, Patterson E. Metabolic Syndrome (MS) is Associated with Higher Prevalence of Cardiovascular Disease (CVD) and Sleep Apnea (SA), Longer Length of Hospital Stay (LOS) and Higher Re‐hospitalization Rate after Bariatric Surgery in the Longitudinal Assessment of Bariatric Surgery (LABS) Cohort. FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.212.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
45
|
Hack E, Burguete R, Siebert T, Davighi A, Mottershead J, Lampeas G, Ihle A, Patterson E, Pipino A. Validation of full-field techniques: discussion of experiences. EPJ Web of Conferences 2010. [DOI: 10.1051/epjconf/20100646004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
46
|
|
47
|
|
48
|
Collett JA, Ighodaro A, Patterson E, Osborn JL. Tissue Angiotensin II Type 1 Receptor Expression in Development of Hypertension in SHR/Brown Norway Congenic Rats. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.982.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
49
|
|
50
|
Hack E, Patterson E, Siebert T, Thalmann R. Calibration and validation of full-field techniques. EPJ Web of Conferences 2010. [DOI: 10.1051/epjconf/20100646003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|