Evaluating the role of Cardiac Genetics Nurses in inherited cardiac conditions services using a Maturity Matrix

Background: Cardiovascular disease is a leading cause of death worldwide and genetic risk factors play a role in nearly all such cases. In the UK, health service capacity to meet either current or future estimated needs of people affected by inherited cardiac conditions (ICC) is inadequate. In 2008 the British Heart Foundation funded nine three-year Cardiac Genetic Nurses (CGN) posts across England and Wales to enhance ICC services. The CGNs were experienced cardiac nurses who had additional training in genetics and acted to coordinate cardiac and genetics service activities. Aim: To create and apply a framework against which progress in ICC service improvement could be measured over time following the CGN appointments. Methods: A performance grid (Maturity Matrix) articulating standards in 5 domains against stages of ICC service development was created by stakeholders through a consensus approach. The Maturity Matrix (MM) was used to guide staged self-assessments by the CGNs between 2009-2011. A 6-point scale was used to locate progress from ‘emerging’ to ‘established’, represented graphically by spider diagrams. Results: Progress in all domains was significant for new, emerging and established services. It was most notable for effective utilisation of care pathways and efficient running of clinics. Commitment to family-centred care was evident. Conclusion: The ICC-MM provided a comprehensive framework for assessing ICC services and has merit in providing guidance on development. Cardiac genetics nurses can help integrate care across specialisms, facilitating the development of effective and sustainable ICC services at new, developing, and more established ICC service locations.Full text available via open access at journal website.British Heart Foundatio

Selective migration of neuralized embryonic stem cells to stem cell factor and media conditioned by glioma cell lines

BACKGROUND: Pluripotent mouse embryonic stem (ES) cells can be induced in vitro to become neural progenitors. Upon transplantation, neural progenitors migrate toward areas of damage and inflammation in the CNS. We tested whether undifferentiated and neuralized mouse ES cells migrate toward media conditioned by glioma cell lines (C6, U87 & N1321) or Stem Cell Factor (SCF). RESULTS: Cell migration assays revealed selective migration by neuralized ES cells to conditioned media as well as to synthetic SCF. Migration of undifferentiated ES cells was extensive, but not significantly different from that of controls (Unconditioned Medium). RT-PCR analysis revealed that all the three tumor cell lines tested synthesized SCF and that both undifferentiated and neuralized ES cells expressed c-kit, the receptor for SCF. CONCLUSION: Our results demonstrate that undifferentiated ES cells are highly mobile and that neural progenitors derived from ES cells are selectively attracted toward factors produced by gliomas. Given that the glioma cell lines synthesize SCF, SCF may be one of several factors that contribute to the selective migration observed