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Tuohy D, Cassidy I, Carey E, Graham M, McCarthy J, Murphy J, Morrissey K, Shanahan J, Tuohy T. 183 DEVELOPING AND FACILITATING ONLINE INTERGENERATIONAL CAFÉS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.156] [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: 11/15/2022] Open
Abstract
Abstract
Background
Many older people throughout their lives will require nursing care, consequentially most nurses will care for older people during their career. It is important that older people and student nurses are provided with shared learning opportunities so that professional caring partnerships can be nurtured and realised for mutual benefit. Intergenerational projects offer opportunities for intergenerational learning. However, few projects explore student nurse-older person dyads and how these can be integrated within undergraduate pre-registration programmes. This paper describes the development and facilitation of online older person-student nurse intergenerational cafés.
Methods
The project was managed by a design team comprising senior administration, lecturers in BSc Nursing programmes and a lecturer in Design for Health and Wellbeing. The ‘world café’ concept along with values of enablement and participation underpinned the design. The initiative was planned to align with a year three community care module. Regular online team meetings were held to agree the aims and outcomes for student nurse-older person cohorts, decide recruitment strategies, agree the process and format of facilitation. Older people were recruited through retirement, church, volunteer, social and sporting organisations, media and also using snowballing methods.
Results
Both student nurse and older person cohorts were offered support on how to access and participate in the café. Participants attended one of three online cafés hosted through Microsoft Teams. Each café followed the same format: 1) Group meeting convened with all participants; 2) Breakout small group ‘table’ discussions with student nurse-older people participants and design team facilitation; 3) The café was reconvened to whole group meeting where feedback was collated to elicit shared learning.
Conclusion
The initiative proved successful and there is merit in embedding intergenerational cafés into professionally accredited health care programmes. Through sharing life experiences and perspectives, intergenerational barriers can be reduced and new insights developed on person-centred gerontological care.
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Affiliation(s)
- D Tuohy
- University of Limerick , Limerick, Ireland
| | - I Cassidy
- University of Limerick , Limerick, Ireland
| | - E Carey
- University of Limerick , Limerick, Ireland
| | - M Graham
- University of Limerick , Limerick, Ireland
| | - J McCarthy
- University of Limerick , Limerick, Ireland
| | - J Murphy
- University of Limerick , Limerick, Ireland
| | | | - J Shanahan
- University of Limerick , Limerick, Ireland
| | - T Tuohy
- University of Limerick , Limerick, Ireland
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Slaught C, Berry EG, Bacik L, Skalet AH, Anadiotis G, Tuohy T, Leachman SA. Clinical challenges in interpreting multiple pathogenic mutations in single patients. Hered Cancer Clin Pract 2021; 19:15. [PMID: 33541411 PMCID: PMC7863461 DOI: 10.1186/s13053-021-00172-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/25/2021] [Indexed: 01/13/2023] Open
Abstract
Background In the past two decades, genetic testing for cancer risk assessment has entered mainstream clinical practice due to the availability of low-cost panels of multiple cancer-associated genes. However, the clinical value of multiple-gene panels for cancer susceptibility is not well established, especially in cases where panel testing identifies more than one pathogenic variant. The risk for specific malignancies as a result of a mutated gene is complex and likely influenced by superimposed modifier variants and/or environmental effects. Recent data suggests that the combination of multiple pathogenic variants may be fewer than reported by chance, suggesting that some mutation combinations may be detrimental. Management of patients with “incidentally” discovered mutations can be particularly challenging, especially when established guidelines call for radical procedures (e.g. total gastrectomy in CDH1) in patients and families without a classic clinical history concerning for that cancer predisposition syndrome. Case presentation We present two cases, one of an individual and one of a family, with multiple pathogenic mutations detected by multi-gene panel testing to highlight challenges practitioners face in counseling patients about pathogenic variants and determining preventive and therapeutic interventions. Conclusions Ongoing investigation is needed to improve our understanding of inherited susceptibility to disease in general and cancer predisposition syndromes, as this information has the potential to lead to the development of more precise and patient-specific counseling and surveillance strategies. The real-world adoption of new or improved technologies into clinical practice frequently requires medical decision-making in the absence of established understanding of gene-gene interactions. In the meantime, practitioners must be prepared to apply a rationale based on currently available knowledge to clinical decision-making. Current practice is evolving to rely heavily on clinical concordance with personal and family history in making specific therapeutic decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s13053-021-00172-3.
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Affiliation(s)
- Christa Slaught
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA
| | - Elizabeth G Berry
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA.
| | - Lindsay Bacik
- Department of Dermatology, Penn State Health, Hershey, USA
| | - Alison H Skalet
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA.,Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, USA.,Department of Radiation Medicine, Oregon Health & Science University, Portland, USA
| | - George Anadiotis
- Legacy Cancer Institute, Cancer Genetics Services, Legacy Health Systems, Portland, USA
| | - Therese Tuohy
- Legacy Cancer Institute, Cancer Genetics Services, Legacy Health Systems, Portland, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, USA
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Bong YS, Assefnia S, Tuohy T, Neklason DW, Burt RW, Ahn J, Bueno De Mesquita PJ, Byers SW. A role for the vitamin D pathway in non-intestinal lesions in genetic and carcinogen models of colorectal cancer and in familial adenomatous polyposis. Oncotarget 2018; 7:80508-80520. [PMID: 27768599 PMCID: PMC5348337 DOI: 10.18632/oncotarget.12768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/11/2016] [Indexed: 12/14/2022] Open
Abstract
Vitamin D is implicated in the etiology of cancers of the gastrointestinal tract, usually characterized by alteration in the APC/β-catenin/TCF tumor suppressor pathway. The vitamin D receptor (VDR) is also implicated in cardiovascular and skin diseases as well as in immunity. Activated VDR can indirectly alter β-catenin nuclear localization and directly suppress β-catenin/TCF mediated transcriptional activity. We treated VDR null mice with the carcinogen azoxymethane (AOM) and generated mice bearing a mutated APC (hypomorph) on a VDR null background (Apc1638N/+Vdr−/−). VDR null mice do not develop GI or extra-colonic tumors but loss of VDR decreased intestinal tumor latency and increased progression to adenocarcinoma in both models. AOM treatment of VDR null mice also caused squamous cell carcinoma of the anus. Although levels and distribution of total or activated β-catenin in the epithelial component of tumors were unaffected by loss of VDR, β-catenin dependent cyclin D1 expression was affected suggesting a direct VDR effect on β-catenin co-activator activity. Extra-colonic mucosa manifestations in Apc1638N/+Vdr−/− animals included increased nuclear β-catenin in submucosal stromal cells, spleno- and cardiomegaly and large epidermoid cysts characteristic of the FAP variant, Gardner's syndrome. Consistent with this, SNPs in the VDR, vitamin D binding protein and CYP24 as well as mutations in APC distal to codon 850 were strongly associated with Gardners syndrome in a cohort of 457 FAP patients, This work suggests that alterations in the vitamin D/VDR axis are important in Gardner's syndrome, as well as in the etiology of anal cancer.
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Affiliation(s)
- Yong-Sik Bong
- Georgetown-Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University School of Medicine, Washington, DC, United States of America
| | - Shahin Assefnia
- Georgetown-Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University School of Medicine, Washington, DC, United States of America
| | - Therese Tuohy
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| | - Deborah W Neklason
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| | - Randall W Burt
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University School of Medicine, Washington, DC, United States of America
| | - Paul J Bueno De Mesquita
- Georgetown-Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University School of Medicine, Washington, DC, United States of America
| | - Stephen W Byers
- Georgetown-Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University School of Medicine, Washington, DC, United States of America
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Tuohy T, Burt RW. Novel human pathological mutations. Gene symbol: APC. Disease: adenomatous polyposis coli. Hum Genet 2010; 127:477. [PMID: 21488240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- T Tuohy
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Uta 84112, USA.
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Dent KM, Dunn DM, von Niederhausern AC, Aoyagi AT, Kerr L, Bromberg MB, Hart KJ, Tuohy T, White S, den Dunnen JT, Weiss RB, Flanigan KM. Improved molecular diagnosis of dystrophinopathies in an unselected clinical cohort. Am J Med Genet A 2005; 134:295-8. [PMID: 15723292 DOI: 10.1002/ajmg.a.30617] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Mutations in the DMD gene result in Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). Readily available clinical tests detect only deletions of one exon or greater, which are found in approximately 60% of cases. Mutational analysis of other types of DMD mutations, such as premature stop codons and small frameshifting insertions or deletions, has historically been hampered by the large size of the gene. We have recently reported a method that allows the rapid and economical sequencing of the entire coding region of the DMD gene, and that is more sensitive than methods based on single-strand conformational polymorphism (SSCP) screening or other preliminary screening steps. Here we use single condition amplification/internal primer (SCAIP) sequencing analysis, in combination with multiplex amplifiable probe hybridization (MAPH) analysis of duplications, to report the frequency of mutations in a large cohort of unselected dystrophinopathy patients from a single clinic. Our results indicate that 7% of dystrophinopathy patients do not have coding region mutations, suggesting that intronic mutations are not uncommon. The availability of rapid and thorough mutation analysis from peripheral blood samples, along with an improved estimate of the percentage of non-coding region mutations, will be of benefit for improved genetic counseling and in identification of cohorts for clinical trials.
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Affiliation(s)
- K M Dent
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
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Thliveris A, Albertsen H, Tuohy T, Carlson M, Groden J, Joslyn G, Gelbert L, Samowitz W, Spirio L, White R. Long-range physical map and deletion characterization of the 1100-kb NotI restriction fragment harboring the APC gene. Genomics 1996; 34:268-70. [PMID: 8661068 DOI: 10.1006/geno.1996.0285] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A Thliveris
- Department of Human Genetics and Howard Hughes Medical Institute, University of Utah, Salt Lake City, Utah, 84112, USA
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Abstract
Suppressor mutants that cause ribosomes to shift reading frame at specific and new sequences are described. Suppressors for trpE91, the only known suppressible -1 frameshift mutant, have been isolated in Escherichia coli and in Salmonella typhimurium. E. coli hopR acts on trpE91 within the 9-base-pair sequence GGA GUG UGA, is dominant, and is located at min 52 on the chromosome. Its Salmonella homolog maps at an equivalent position and arises as a rarer class in that organism as compared with E. coli. The Salmonella suppressor, hopE, believed to be in a duplicate copy of the same gene, maps at min 17. The +1 suppressor, sufT, acts at the nonmonotonous sequence CCGU, is dominant, and maps at min 59 on the Salmonella chromosome.
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Affiliation(s)
- D Hughes
- Department of Genetics, Trinity College, Dublin, Ireland
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