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At least 19 recordsLinked to original sources
PubMed2026

The work of specialist nurses in the mainstreaming of germline genomic testing in cancer: an investigation.

BACKGROUND: Specialist nurses are increasingly working in the mainstreaming of germline genomic testing in cancer. AIMS: The study aimed to investigate the work of specialist nurses in the mainstreaming of germline genomic testing in cancer, with a focus on Lynch syndrome, and to consider the future of genomics in nursing. METHODS: Semi-structured interviews were conducted with a purposive sample of 12 specialist nurses and three genetic counsellors, and thematic analysis was carried out. FINDINGS: Prominent themes arising from the data were: the capability and capacity of specialty-based clinical nurse specialists, for whom genomics is an added part of their wider role, to deliver genomic testing; and whether these specialty-based nurses or specialist genomic nurses, who work only in genomics, are best placed to deliver genomic testing. CONCLUSION: When planning service provision in the mainstreaming of genetic testing, the capacity and capability of specialty-based clinical nurse specialists should be considered alongside the possible need for specialist genomic nurses.

Humans↗
PubMed2026

Climate Gradients and Habitat Discontinuity Structure Genetic Variation in a Spring-Specialist Plant.

BACKGROUND AND AIMS: Groundwater-dependent ecosystems support disproportionate biodiversity in arid regions, yet the population genetics of spring-specialist plants remains poorly understood. Here, we present the first species-wide genetic dataset for crimson monkeyflower (Mimulus verbenaceus, Phrymaceae), a spring-specialist plant distributed in seeps, springs, and associated riparian areas across desert regions of North America. We aim to relate landscape features and climate gradients to the spatial genetic structuring within this system. METHODS: Using genome-wide reduced representation sequencing data consisting of 10,760 SNPs from 175 individuals across 17 populations, we characterized the patterns of genetic differentiation and diversity. Population structure was assessed using ADMIXTURE and Principal Component Analysis. We examined the contributions of climate to range-wide genetic variation in crimson monkeyflower using redundancy analysis. KEY RESULTS: Patterns of genetic differentiation were more consistent with those of spring-specialist animal taxa than those of upland plants or generalist riparian plants. We found strong population structure at both broad regional scales and at fine local scales. While geographic and spatial structuring was a primary driver of genetic structure across all scales, riparian connectivity influenced local patterns of diversity, and adaptation to local climatic variation was more influential at regional scales, with temperature, relative humidity, and a monsoon-driven climate gradient contributing to genetic differentiation. CONCLUSIONS: Our findings highlight the distinctive association with isolated perennial groundwater sources, as well as climate gradients, with genetic variation in this spring-specialist plant. These findings suggest that spring-specialist plants deserve special consideration in ecological theory, management, and conservation.

Mimulus↗
PubMed1979

How many specialists?

The need for specialists cannot be adequately assessed on the basis of current practice and an estimated case-load (based on prevalence/population ratio). Specialists should declare which patients can or cannot be expected to benefit from their treatment, and they should consider the consequences of underprovision of specialist services. Specialists should also decide how much of what they normally do might equally well be carried out by generalists using the knowledge of specialists. Only then can the appropriate level of provision for various specialties be assessed, and effective deployment of the resources provided ensured.

Health Planning↗
PubMed1979

The contribution of specialists to the delivery of primary care.

Despite increased numbers of medical-school graduates and opportunities for "primary-care" specialty training since the mid-1960's, many believe that the shortage of physicians delivering generalist care will continue through the 1980's. Missing, however, is solid information on the role of physician specialists in providing such care. Two national studies have shown that one of every five Americans now receives continuing general medical care from a specialist physician. Our study suggests that, despite the current shortage of generalist-physician services, continuing specialist participation in primary care will lead to sufficient generalist medical services by the mid-1980's. Whether specialist participation is the most appropriate or cost-effective way to improve access to such care is unclear. However, until this question is resolved, more governmental regulation of graduate medical education may be unwise. Offering all physicains, regardless of specialty, more primary-care experience during residency training might better deal with this aspect of American medical practice.

California↗
PubMed1979

Pharmacy technician specialist: a career opportunity.

A training program for pharmacy technician specialists is described. The 200-hour pharmacy technician specialist training program consists of 20 hours of management seminars and conferences and 180 hours of on-the-job training. The program educates inhouse-trained technicians to assume more specialized tasks and supervisory roles. The behavioral objectives for the training program, and the responsibilities and job description of the technician specialist are presented. The technician specialist training program provides career opportunities which help stimulate and motivate technicians.

Job Description↗
PubMed1979

Abortion counselling by nurse specialists.

This paper describes additional training given to nurse specialists in family planning to cover abortion counselling. The primary counselling was carried out by general practitioners or family planning clinic doctors, following this the patient was referred to hospital for counselling by nurse specialists. Of the first 742 patients seen, 3.2% were not pregnant and a further 25 patients (3.4%) decided against termination, 21 after counselling, and 4 because of advanced gestation. The interval between nurse counselling and termination (TOP) was 3 to 9 days, and of 682 TOPs 566 (83%) were in the first trimester. The additional training for nurse specialists prevented the unnecessary wastage of resources as only 42 (5.1%) required a second visit to confirm blood test results, e.g. rubella titres, and only a further 44 (5.3%) required referral to medical social workers.

Abortion, Therapeutic↗
PubMed1978

Nurse specialists in family planning: the results of a 3-year study.

In the first three years of a Nurse Specialist Clinic in Family Planning, 1422 new patients were seen. Oral contraception (OCs) was dispensed for 638 patients, 548 intrauterine devices (IUDs) were fitted and 126 patients received an injectable contraceptive. The continuation rate at thirty months was, 73.2 for OCs, and 68.6 for IUDs. The additional training received by the nurse specialists allowed them to practice comprehensive family planning safely and effectively, as shown by the low "problem" rate, 9.1% for OCs and 7.2% for IUDs. Continued use effectiveness, as shown by the second choice of contraception initiated in the clinic for those who stopped using their first method, was also high, 81.5% for OCs and 90.5% for IUD closures.

Contraceptive Agents↗
PubMed1975

Training and function of a women's health-care specialist, a physician's assistant, or nurse practitioner in obstetrics and gynecology.

Serious manpower shortages exist in the United States. Proposed corrective measures indicate the need for nonphysicians to provide medical care for well or worried well patients. We have tested this proposed solution in the field of obstetrics and gynecology using allied health personnel to provide health maintenance services to well women, and feel that the experiment has been a success. Using principles of pattern recognition allied health workers recognize normal and abnormal findings. Patients with abnormalities are referred to the supervising physician for diagnosis and therapy. Allied health workers can also perform technical health-maintenance tasks such as inserting intrauterine devices and obtaining Pap smears. This article describes the historical evolution of our allied health personnel workers, called women's health-care specialists (WHCS), the selection and training of students, functions and levels of performance of the specialists, and the future role of such individuals in obstetrics and gynecology. We feel that with appropriate preparation of the physician, co-workers, and patients, the integration of the WHCS into the health-care system is both desirable and appropriate and will offer significant advantages to the patient and the practicing obstetrician-gynecologist in either the clinic or private practice setting.

Allied Health Personnel↗
PubMed2024

UDP-glycosyltransferases act as key determinants of host plant range in generalist and specialist Spodoptera species.

Phytophagous insects have evolved sophisticated detoxification systems to overcome the antiherbivore chemical defenses produced by many plants. However, how these biotransformation systems differ in generalist and specialist insect species and their role in determining insect host plant range remains an open question. Here, we show that UDP-glucosyltransferases (UGTs) play a key role in determining the host range of insect species within the Spodoptera genus. Comparative genomic analyses of Spodoptera species that differ in host plant breadth identified a relatively conserved number of UGT genes in generalist species but high levels of UGT gene pseudogenization in the specialist Spodoptera picta. CRISPR-Cas9 knockouts of the three main UGT gene clusters of Spodoptera frugiperda revealed that UGT33 genes play an important role in allowing this species to utilize the poaceous plants maize, wheat, and rice, while UGT40 genes facilitate utilization of cotton. Further functional analyses in vivo and in vitro identified the UGT SfUGT33F32 as the key mechanism that allows generalist S. frugiperda to detoxify the benzoxazinoid DIMBOA (2,4-dihydroxy-7-methoxy-2H-1,4-benzoxazin-3(4H)-one), a potent insecticidal phytotoxin produced by poaceous plants. However, while this detoxification capacity is conserved in several generalist Spodoptera species, Spodoptera picta, which specializes on Crinum plants, is unable to detoxify DIMBOA due to a nonfunctionalizing mutation in SpUGT33F34. Collectively, these findings provide insight into the role of insect UGTs in host plant adaptation, the mechanistic basis of evolutionary transitions between generalism and specialism and offer molecular targets for controlling a group of notorious insect pests.

Animals↗
PubMed1978

Evaluation and peer review of the role of specialist and general medical units in a teaching hospital.

The trend toward increasing specialization in the medical wards of teaching hospitals has important implications for future health care delivery and student teaching. A study of the likely implications of a change to a specialty oriented medical admission system at the Royal Adelaide Hospital has shown that already the general physicians are seeing little renal and endocrine disease and, that work satisfaction is greater on the specialty units than on the general medical units. Patient satisfaction marginally favoured the specialty units. A peer review audit method was introduced to try and discern whether the quality of care was significantly different on the two types of units. Most physicians cooperated in at least one or two audits which involved them in judgements about adequacy of casenotes, management decisions, follow-up arrangements, length of stay and investigations in randomly assigned specialty pairs of patients (cared for by specialist or general units). No clear-cut trend was discerned favouring specialist or generalist care amongst 17 randomly selected pairs, but this part of the study was never completed, perhaps partly because of lack of enthusiasm for it by busy clinicians. The importance of maintaining a model of generalism for medical students on the teaching hospital campus is discussed discussed in the light of the decline of the role of general physicians.

Australia↗
PubMed1979

The psychiatric clinical specialist in the general hospital.

The author describes her experience as a psychiatric clinical nurse specialist functioning independently in a general hospital in a variety of roles. Seven areas of involvement illustrate the wide range of patient, staff, and other needs which this nurse specialist can meet. The author wishes to thank Joanne Damon, R.N., Sandra Zion, R.N., Dorothy Markay, R.N., and Rachel Rotkovitch, R.N., for their advice, encouragement, and support, and Florence Williams, R.N., who provided clinical supervision.

Aftercare↗
PubMed1978

Evolution of the Gynecology Teaching Associate: an education specialist.

The traditional pelvic examination instruction methods were reviewed and found to be deficient: the student learning experience was compromised by the triangular setting of patient, student, and instructor for early pelvic examination instruction. Over the past decade, a new education specialist, the Gynecology Teaching Associate (GTA), has evolved to help improve the initial gynecology teaching experience. The evolution of the GTA is described. The qualities she brings to the instructional system include sensitivity as a woman, educational skill in pelvic examination instruction, knowledge of female pelvic anatomy and physiology, and, most important, sophisticated interpersonal skills to help medical students learnin in a nonthreatening environment. Reinforcement learning theory is the foundation of this educational system. Student acceptance of this system is documented.

Curriculum↗