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New library buildings: Creighton University Bio-Information Center.

In May 1977 the newly constructed Creighton University Bio-Information Center, costing over $4 million and containing more than 57,000 square feet of space, officially began to provide services. This facility houses three educational support programs--the Health Sciences Library, the Learning Resources Center, and the Biomedical Communications Center--that primarily serve the University's health sciences schools of medicine, dentistry, pharmacy, nursing, and allied health, and the University's major teaching hospital, Saint Joseph Hospital. This article begins with a brief history of the development of the library and is chiefly concerned with the Health Sciences Library and the Learning Resources Center. Criteria formulated during the design phase of the Bio-Information Center are identified. A description of the center and its services, with an emphasis on the application of these criteria, is set forth. Finally, an assessment of the current increased utilization of library services and resources contained in the Bio-Information Center is presented.

Facility Design and Construction↗

Creighton University's Institute for Latin American Concern: a unique opportunity to provide contributed dental care.

Creighton University, a Jesuit institution of higher education, has supported a community health program in the poor and remote areas of the Dominican Republic since 1976. This program is built around multidisciplinary health teams combining undergraduate and graduate students in various health professional schools with practitioners. A permanent center in the Dominican Republic has been established for coordination and training. The program is conceived as providing participants an opportunity to reflect on their own spiritual development. The history of the program's development and its operation are described.

Academies and Institutes↗

BRCA1 and BRCA2 mutations in breast and ovarian cancer syndrome: reflection on the Creighton University historical series of high risk families.

Over the last four decades, Henry Lynch has collected pedigrees and samples from high risk breast and/or ovarian cancer families, generating a unique resource for the study of breast cancer susceptibility. These families have made a major contribution to increasing our knowledge in the cancer genetic susceptibility field, allowing the discovery of a genetic association between breast and ovarian cancer predisposition, contributing to the mapping of the BRCA1 and BRCA2 genes, advancing the idea of the existence of other breast cancer susceptibility genes, allowing the evaluation of BRCA-associated cancer risks and psychosocial aspects of BRCA testing and so on. Ten years after the cloning of BRCA1 and BRCA2, we report the current status of these families and compare the observed BRCA1/2 mutation detection rate with the estimations obtained by linkage analysis of the Breast Cancer Linkage Consortium families.

BRCA1 Protein↗

Proximal versus distal influences on underrepresented minority students pursuing health professional careers.

The Health Careers Opportunities Program (HCOP) at Creighton University provides an important illustration of the short- and long-term successes of pipeline programming. The Pipeline to Success program at Creighton University provides exposure and enrichment activities to participants beginning in middle school and continuing through a one-year postbaccalaureate component in order to ensure that they are knowledgeable about health professional careers and competitive in applying for these training programs. This study hypothesized that the enrichment activities experienced by participants would have the additional benefit of providing indirect or distal influences to motivate participants to meet their career goals. In partial support of this hypothesis, a MANOVA demonstrated that the middle-school participants demonstrated a different pattern of influence from the other program components. Results indicate that as participants progressed through the Pipeline to Success HCOP at Creighton University, the program resources impacted their desire to pursue health professional careers in addition to positively preparing them for health professional training programs. We conclude that these findings have particular importance for planning and implementing student education programs.

Achievement↗

Evaluation of the needs of male carriers of mutations in BRCA1 or BRCA2 who have undergone genetic counseling.

To date, the concerns of men at risk of inheriting a BRCA1 mutation or a BRCA2 mutation have received little attention. It had been anticipated that few men would be interested in predictive testing when a BRCA mutation was identified in their family. However, these men are often affected emotionally by diagnoses of breast cancer in their relatives and may themselves harbor fears that cancer will develop. Male carriers of BRCA1/2 mutations are at increased risk of development of cancers of several types, including those of the breast and prostate. We conducted an evaluation of the needs and experiences of 59 male carriers of BRCA1/2 mutations followed at either the University of Toronto or Creighton University. We assessed their motivations for seeking genetic counseling and testing, involvement in family discussions of breast and ovarian cancer, risk perception, changes in cancer-screening practices, and overall satisfaction with the genetic-counseling process. The principal motivation for seeking genetic counseling was concern for their daughters. The majority (88%) of men participated in family conversations about breast and ovarian cancer, and 47% participated in conversations about prophylactic surgery. Most men believed that they were at increased risk of development of cancer (prostate, breast, colorectal, and skin cancers). However, fewer than one-half (43%) of the men with no previous diagnosis of cancer stated that their prostate cancer-surveillance practices had changed after they had received genetic test results. More than one-half (55%) had intrusive thoughts about their cancer risk. Although levels of satisfaction were high, practitioners should be aware of (a) potential pressures influencing men to request predictive testing, (b) the difficulties that men encounter in establishing surveillance regimens for breast and prostate cancer, and (c) the general lack of information about men's particular experiences in the medical community.

Adult↗

State-university collaboration in Nebraska: public psychiatry residency training in a rural area.

The shortage of well-trained psychiatrists in the public sector is particularly severe in rural states, where state hospitals are often isolated from the professional resources available in cities. The combined department of psychiatry at the University of Nebraska Medical Center and Creighton University in Omaha has developed a residency training program at a rural state hospital 150 miles away. To bridge the distance, residents attend classes in Omaha once a week and faculty supervisors fly to the hospital once a week. Residents at the remote facility are subject to the same evaluation procedures used for residents at other facilities. The author describes the role of charismatic individuals in initiating the state-university collaboration, addresses the need for a structure to support the relationship in the absence of its founders, and discusses accreditation of residency training programs based in facilities that are remote from the medical school campus.

Academic Medical Centers↗

Analysis of CHEK2 gene for ovarian cancer susceptibility.

OBJECTIVES: A deletion variant in the CHEK2 gene (del1100C) has been implicated as a low-penetrance risk factor for breast cancer. We sought to determine contribution of CHEK2 mutations to the etiology of ovarian cancer (OvCa). METHODS: We used cases ascertained from the United States through Gynecologic Oncology Group (GOG) protocols 172, 182, and 144, the University of Hawaii Cancer Research Center, and Creighton University. Control women were recruited from Pittsburgh and Hawaii. Denaturing high-performance liquid chromatography, sequence analysis, and single nucleotide polymorphism genotyping by Pyrosequencing were employed to analyze the CHEK2 gene. RESULTS: Mutation screening of the CHEK2 gene in 48 cases who had a first-degree relative with OvCa uncovered only del1100C and A252G variants. Altogether, the del1100C variant was detected in none of 751 unselected cases, in 1 of 52 (1.9%) cases who had a first-degree relative with OvCa, and in 3 of 521 (0.6%) unselected controls. The frequencies of del1100C and A252G variants did not show statistically significant differences between the cases and the controls. CONCLUSIONS: These results suggest that variations in CHEK2 do not make a significant contribution to the pathogenesis of OvCa in the U.S. population.

Adult↗

Bone mineral density and biochemical markers of bone turnover in healthy elderly men and women.

BACKGROUND: Osteoporosis risk in middle-aged women is twofold greater than that in men, and the difference increases with age. Gender differences in bone mineral density, estimated rates of bone loss, and usefulness of markers of bone metabolism for predicting bone density have not been well described in healthy elders aged 65 and above. The purpose of this cross-sectional analysis was to describe associations of bone mineral density at the hip, spine, and whole body with age, serum osteocalcin, and urinary N-telopeptide crosslinks of Type I collagen in healthy elderly men and women. METHODS: A total of 1,087 healthy adults (273 men and 814 women) aged 65 to 87 years were enrolled in a collaborative study at 3 sites: Tufts University (Boston, MA), University of Connecticut Health Center (Farmington, CT), and Creighton University (Omaha, NE). Bone mineral density (BMD) at three regions of the hip, the lumbar spine, and whole body was determined by dual-energy x-ray absorptiometry. Serum osteocalcin was measured by immunoassay, and measurement of N-telopeptide crosslinks (Ntx) in urine was made using an enzyme-linked radioimmunoassay (ELISA). RESULTS: Among women, the age-related decline in BMD at all non-spine skeletal sites was significantly different from zero, with the largest decline seen at the femoral neck (-.0038 g/cm2/y, p < .001) and the smallest at the trochanter of the hip (-.0023 g/cm2/y, p = .03). Among men, the changes at all non-spine sites were not significant. In both sexes, spine BMD tended to increase with age (men, +.0045 g/cm2/y, women, +.0003 g/cm2/y). Serum osteocalcin and urinary Ntx were inversely related to BMD at all skeletal sites, but the weakest associations were observed at the spine. Individuals whose values of both osteocalcin and Ntx were in the lowest quartiles of the respective sex-specific distributions had mean femoral neck BMD that were 11% higher than individuals with marker values in the highest quartiles. CONCLUSIONS: These findings suggest that age-related decreases in BMD may vary by gender and skeletal site. Determinations of osteocalcin and N-telopeptide crosslinks at a single point in time may potentially be used as indicators of current bone status, particularly at non-spine skeletal sites.

Aged↗