ABSTRACT
The 'Competing interests' statement of this Article has been updated; please see the accompanying Amendment. The original Article has not been corrected online.
ABSTRACT
Somatic mutations of ERBB2 and ERBB3 (which encode HER2 and HER3, respectively) are found in a wide range of cancers. Preclinical modelling suggests that a subset of these mutations lead to constitutive HER2 activation, but most remain biologically uncharacterized. Here we define the biological and therapeutic importance of known oncogenic HER2 and HER3 mutations and variants of unknown biological importance by conducting a multi-histology, genomically selected, 'basket' trial using the pan-HER kinase inhibitor neratinib (SUMMIT; clinicaltrials.gov identifier NCT01953926). Efficacy in HER2-mutant cancers varied as a function of both tumour type and mutant allele to a degree not predicted by preclinical models, with the greatest activity seen in breast, cervical and biliary cancers and with tumours that contain kinase domain missense mutations. This study demonstrates how a molecularly driven clinical trial can be used to refine our biological understanding of both characterized and new genomic alterations with potential broad applicability for advancing the paradigm of genome-driven oncology.
Subject(s)
Mutation , Neoplasms/drug therapy , Neoplasms/genetics , Quinolines/pharmacology , Quinolines/therapeutic use , Receptor, ErbB-2/antagonists & inhibitors , Receptor, ErbB-3/antagonists & inhibitors , Adult , Aged , Aged, 80 and over , Alleles , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Cohort Studies , Female , Humans , Male , Middle Aged , Molecular Targeted Therapy , Mutation, Missense , Neoplasms/enzymology , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , Quinolines/adverse effects , Receptor, ErbB-2/chemistry , Receptor, ErbB-2/genetics , Receptor, ErbB-3/chemistry , Receptor, ErbB-3/genetics , Treatment OutcomeABSTRACT
Interprofessional education (IPE) is vital in university clinical settings to prepare graduate students to engage in today's health care system. However, few university programs have successfully implemented IPE into existing clinical programs. The purpose of this pilot study was to evaluate the effectiveness of an interprofessional (IP) training and clinical experience on graduate students' and caregivers perceptions on quality of care in a pre-existing clinical program. Speech-language pathology (SLP) and Physical Therapy (PT) faculty, worked to coordinate and develop an IP training and clinical experience. Graduate students from both disciplines participated in the IP training and completed a pre-post training questionnaire. Students then participated in an IP clinical experience with three preschool-age children with complex sensory motor needs and completed the questionnaire again following this experience. Students' attitudes and perceptions of readiness for IP engagement following IPE training showed a positive trend but not following an IP clinical experience. Subjective feedback from students and caregivers was highly favorable. The results provide further evidence of the benefits of IP training and clinical experience. More effective qualitative and quantitative tools must be developed to capture the effectiveness of direct IP clinical collaboration.
Subject(s)
Interprofessional Relations , Learning , Physical Therapists/education , Speech-Language Pathology/education , Humans , Pilot Projects , Students, Health OccupationsABSTRACT
One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale's implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.
Subject(s)
Criminal Law , Decision Making , Elder Abuse/economics , Geriatric Assessment , Surveys and Questionnaires , Aged , Aged, 80 and over , Cognition , Elder Abuse/prevention & control , Female , Humans , Male , Middle Aged , Pilot ProjectsABSTRACT
This exploratory study evaluated the effectiveness of Apple (Cupertino, CA) iPad(®) (second generation) to deliver telepractice speech and/or language services. Five children and their parents/guardians, as well as four adult participants, received services for communication disorders in a university clinic setting over two academic semesters. The children met some of their speech goals and all of their language goals. All adult clients met some of their communication goals. Personal opinions about telepractice did not change statistically before and after therapy. The major problem identified during the study was skipping and/or freezing of images on the iPads during interactions with FaceTime(®) (Apple). Further studies are needed to investigate the feasibility of using Apple iPads in telepractice.
Subject(s)
Microcomputers , Speech Therapy , Speech-Language Pathology , Telemedicine/instrumentation , Adult , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Young AdultABSTRACT
Advanced practice nurses within acute care settings are responsible for providing healthcare to a rapidly expanding population of elderly patients. Medical advances have contributed to the longevity of the American population, resulting in an increase in age-related disease that can lead to depression. It is important for acute care nurses to become familiar with the various classes of antidepressant medications and the implications for their use.