1
|
Jeyasekharan AD, Liu Y, Hattori H, Pisupati V, Rajendra E, Jonsdottir AB, Lee M, Sundaramoorthy E, Schlachter S, Venkitaraman A. Abstract A24: A cascade of masked nuclear export signals regulates the BRCA2 tumor suppressor pathway. Cancer Res 2013. [DOI: 10.1158/1538-7445.fbcr13-a24] [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: 11/16/2022]
Abstract
Abstract
Inherited germline mutations in a single copy of the BRCA2 tumor suppressor predispose individuals to breast, ovarian, pancreatic and other cancers. BRCA2 exerts its tumor suppressive function in the cell nucleus through its role in the repair of DNA breaks by homologous recombination, where it controls the accumulation of the RAD51 recombinase enzyme at sites of DNA breakage. Cancer associated in-frame point mutations in BRCA2 have been shown to result in cytoplasmic localization of the protein, but the mechanism underlying this is unclear.
Here, we identify an unrecognized mechanism controlling the nuclear localization of BRCA2 and its cargo RAD51, which is disrupted by the common cancer-associated mis-sense mutation BRCA2D2723H. A nuclear export signal (NES) in BRCA2 is masked by its interaction with a partner protein, DSS1, such that point mutations impairing BRCA2-DSS1 binding render BRCA2 cytoplasmic. In turn, cytoplasmic mis-localization of mutant BRCA2 inhibits the nuclear retention of RAD51, by exposing a similar NES in RAD51 that is usually obscured by the BRCA2-RAD51 interaction. We demonstrate the functionality of these export sequences by cellular localization assays and in vitro binding analyses to the exportin CRM1.
We note two key implications of our work. Firstly, CRM1 mediated nuclear export is relevant to the localization of tumor suppressors such as p53 and BRCA1. However, this is the first report to our knowledge, of a ‘cascade’ of NES-masking interactions mediating nuclear localization for a tumor suppressor pathway. Our findings suggest the exploration of analogous mechanisms in other cancer-relevant cellular networks. Secondly, we also note that BRCA2D2723H decreases RAD51 nuclear retention even when wildtype BRCA2 is present. This is consistent with a transdominant effect for at least a fraction of the heterozygous disease-associated mutations noted in BRCA2. We find an increase in endogenous DNA damage in cells heterozygous for the D2723H mutation, suggesting that BRCA2D2723H heterozygosity causes a cumulative effect on genome stability in patients, which acts over years to promote carcinogenesis. Transdominance may also explain the paradox of tumorigenesis occurring in certain cases without a somatic second hit to BRCA2.
Together, our results link the nucleo-cytoplasmic translocation of the BRCA2 tumor suppressor to the cellular mechanisms of disease following its germline inactivation.
Citation Format: Anand D. Jeyasekharan, Yang Liu, Hiroyoshi Hattori, Venkat Pisupati, Eeson Rajendra, Asta Bjork Jonsdottir, Miyoung Lee, Elayanambi Sundaramoorthy, Simon Schlachter, Ashok Venkitaraman. A cascade of masked nuclear export signals regulates the BRCA2 tumor suppressor pathway. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr A24.
Collapse
Affiliation(s)
| | - Yang Liu
- 2Hutchison-MRC Research Centre, Cambridge, United Kingdom,
| | | | | | - Eeson Rajendra
- 2Hutchison-MRC Research Centre, Cambridge, United Kingdom,
| | | | - Miyoung Lee
- 2Hutchison-MRC Research Centre, Cambridge, United Kingdom,
| | | | | | | |
Collapse
|
2
|
Jeyasekharan AD, Liu Y, Hattori H, Pisupati V, Jonsdottir AB, Rajendra E, Lee M, Sundaramoorthy E, Schlachter S, Kaminski C, Ofir-Rosenfeld Y, Sato K, Savill J, Ayoub N, Venkitaraman AR. A cancer-associated BRCA2 mutation reveals masked nuclear export signals controlling localization. Nat Struct Mol Biol 2013; 20:1191-8. [PMID: 24013206 PMCID: PMC3796201 DOI: 10.1038/nsmb.2666] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [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: 05/06/2013] [Accepted: 07/25/2013] [Indexed: 02/02/2023]
Abstract
Germline missense mutations affecting a single BRCA2 allele predispose humans to cancer. Here we identify a protein-targeting mechanism that is disrupted by the cancer-associated mutation, BRCA2(D2723H), and that controls the nuclear localization of BRCA2 and its cargo, the recombination enzyme RAD51. A nuclear export signal (NES) in BRCA2 is masked by its interaction with a partner protein, DSS1, such that point mutations impairing BRCA2-DSS1 binding render BRCA2 cytoplasmic. In turn, cytoplasmic mislocalization of mutant BRCA2 inhibits the nuclear retention of RAD51 by exposing a similar NES in RAD51 that is usually obscured by the BRCA2-RAD51 interaction. Thus, a series of NES-masking interactions localizes BRCA2 and RAD51 in the nucleus. Notably, BRCA2(D2723H) decreases RAD51 nuclear retention even when wild-type BRCA2 is also present. Our findings suggest a mechanism for the regulation of the nucleocytoplasmic distribution of BRCA2 and RAD51 and its impairment by a heterozygous disease-associated mutation.
Collapse
Affiliation(s)
- Anand D Jeyasekharan
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Yang Liu
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Hiroyoshi Hattori
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Venkat Pisupati
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Asta Bjork Jonsdottir
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Eeson Rajendra
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Miyoung Lee
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | | | | | | | - Yaara Ofir-Rosenfeld
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Ko Sato
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Jane Savill
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Nabieh Ayoub
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| | - Ashok R Venkitaraman
- The Medical Research Council Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, UK
| |
Collapse
|
3
|
Schlachter S, Ahern P, Brown M. Group Gestational Diabetes Education in a Busy Maternity Focused Hospital. J Acad Nutr Diet 2013. [DOI: 10.1016/j.jand.2013.06.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
4
|
Kaminski Schierle GS, Bertoncini CW, Chan FTS, van der Goot AT, Schwedler S, Skepper J, Schlachter S, van Ham T, Esposito A, Kumita JR, Nollen EAA, Dobson CM, Kaminski CF. A FRET sensor for non-invasive imaging of amyloid formation in vivo. Chemphyschem 2011; 12:673-680. [PMID: 21308945 PMCID: PMC5402868 DOI: 10.1002/cphc.201000996] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Indexed: 11/10/2022]
Abstract
Misfolding and aggregation of amyloidogenic polypeptides lie at the root of many neurodegenerative diseases. Whilst protein aggregation can be readily studied in vitro by established biophysical techniques, direct observation of the nature and kinetics of aggregation processes taking place in vivo is much more challenging. We describe here, however, a Förster resonance energy transfer sensor that permits the aggregation kinetics of amyloidogenic proteins to be quantified in living systems by exploiting our observation that amyloid assemblies can act as energy acceptors for variants of fluorescent proteins. The observed lifetime reduction can be attributed to fluorescence energy transfer to intrinsic energy states associated with the growing amyloid species. Indeed, for a-synuclein, a protein whose aggregation is linked to Parkinson's disease, we have used this sensor to follow the kinetics of the self-association reactions taking place in vitro and in vivo and to reveal the nature of the ensuing aggregated species. Experiments were conducted in vitro, in cells in culture and in living Caenorhabditis elegans. For the latter the readout correlates directly with the appearance of a toxic phenotype. The ability to measure the appearance and development of pathogenic amyloid species in a living animal and the ability to relate such data to similar processes observed in vitro provides a powerful new tool in the study of the pathology of the family of misfolding disorders. Our study confirms the importance of the molecular environment in which aggregation reactions take place, highlighting similarities as well as differences between the processes occurring in vitro and in vivo, and their significance for defining the molecular physiology of the diseases with which they are associated.
Collapse
Affiliation(s)
- Gabriele S. Kaminski Schierle
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (U.K.)
| | - Carlos W. Bertoncini
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW (U.K.)
- Laboratory of Molecular Biophysics, Institute for Research in Biomedicine, Baldiri Reixac 10-12, 08028, Barcelona (Spain)
| | - Fiona T. S. Chan
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (U.K.)
| | - Annemieke T. van der Goot
- Department of Genetics, University Medical Centre Groningen and University of Groningen 9700 RB Groningen (The Netherlands)
| | - Stefanie Schwedler
- Physikalische Chemie I, Fakultät für Chemie Universität Bielefeld, Universitätsstr. 25, 33615, Bielefeld (Germany)
| | - Jeremy Skepper
- Department of Physiology, Development and Neuroscience University of Cambridge, Downing Street, Cambridge CB2 3DY (U.K.)
| | - Simon Schlachter
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (U.K.)
| | - Tjakko van Ham
- Department of Genetics, University Medical Centre Groningen and University of Groningen 9700 RB Groningen (The Netherlands)
| | - Alessandro Esposito
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (U.K.)
| | - Janet R. Kumita
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW (U.K.)
| | - Ellen A. A. Nollen
- Department of Genetics, University Medical Centre Groningen and University of Groningen 9700 RB Groningen (The Netherlands)
| | - Christopher M. Dobson
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW (U.K.)
| | - Clemens F. Kaminski
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (U.K.)
- Friedrich-Alexander University of Erlangen Nürnberg 91052 Erlangen (Germany)
| |
Collapse
|
5
|
Esposito A, Schlachter S, Bader AN, Pancheri L, Stoppa D, Venkitaraman AR, Kaminski C, Gerritsen HC. Multiplexed Measurement of Molecular Interactions using Hyper-Spectral Imaging and Multi-Parametric Detection. Biophys J 2010. [DOI: 10.1016/j.bpj.2009.12.4179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
6
|
Schlachter S, Schwedler S, Esposito A, Kaminski Schierle GS, Moggridge GD, Kaminski CF. A method to unmix multiple fluorophores in microscopy images with minimal a priori information. Opt Express 2009; 17:22747-22760. [PMID: 20052200 DOI: 10.1364/oe.17.022747] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The ability to quantify the fluorescence signals from multiply labeled biological samples is highly desirable in the life sciences but often difficult, because of spectral overlap between fluorescent species and the presence of autofluorescence. Several so called unmixing algorithms have been developed to address this problem. Here, we present a novel algorithm that combines measurements of lifetime and spectrum to achieve unmixing without a priori information on the spectral properties of the fluorophore labels. The only assumption made is that the lifetimes of the fluorophores differ. Our method combines global analysis for a measurement of lifetime distributions with singular value decomposition to recover individual fluorescence spectra. We demonstrate the technique on simulated datasets and subsequently by an experiment on a biological sample. The method is computationally efficient and straightforward to implement. Applications range from histopathology of complex and multiply labelled samples to functional imaging in live cells.
Collapse
Affiliation(s)
- S Schlachter
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke St, Cambridge, CB2 1RA, U.K
| | | | | | | | | | | |
Collapse
|
7
|
Schlachter S, Elder AD, Esposito A, Kaminski GS, Frank JH, van Geest LK, Kaminski CF. mhFLIM: resolution of heterogeneous fluorescence decays in widefield lifetime microscopy. Opt Express 2009; 17:1557-70. [PMID: 19188985 DOI: 10.1364/oe.17.001557] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Frequency-domain fluorescence lifetime imaging microscopy (FD-FLIM) is a fast and accurate way of measuring fluorescence lifetimes in widefield microscopy. However, the resolution of multiple exponential fluorescence decays has remained beyond the reach of most practical FD-FLIM systems. In this paper we describe the implementation of FD-FLIM using a 40 MHz pulse train derived from a supercontinuum source for excitation. The technique, which we term multi-harmonic FLIM (mhFLIM), makes it possible to accurately resolve biexponential decays of fluorophores without any a priori information. The system's performance is demonstrated using a mixture of spectrally similar dyes of known composition and also on a multiply-labeled biological sample. The results are compared to those obtained from time correlated single photon counting (TCSPC) microscopy and a good level of agreement is achieved. We also demonstrate the first practical application of an algorithm derived by G. Weber [1] for analysing mhFLIM data. Because it does not require nonlinear minimisation, it offers potential for realtime analysis during acquisition.
Collapse
Affiliation(s)
- S Schlachter
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK.
| | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
Fluorescence microscopy is a non-invasive technique that allows high resolution imaging of cytoskeletal structures. Advances in the field of fluorescent labelling (e.g., fluorescent proteins, quantum dots, tetracystein domains) and optics (e.g., super-resolution techniques and quantitative methods) not only provide better images of the cytoskeleton, but also offer an opportunity to quantify the complex of molecular events that populate this highly organised, yet dynamic, structure.For instance, fluorescence lifetime imaging microscopy and Förster resonance energy transfer imaging allow mapping of protein-protein interactions; furthermore, techniques based on the measurement of photobleaching kinetics (e.g., fluorescence recovery after photobleaching, fluorescence loss in photobleaching, and fluorescence localisation after photobleaching) permit the characterisation of axonal transport and, more generally, diffusion of relevant biomolecules.Quantitative fluorescence microscopy techniques offer powerful tools for understanding the physiological and pathological roles of molecular machineries in the living cell.
Collapse
Affiliation(s)
- Alessandro Esposito
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Esposito A, Tiffert T, Mauritz JMA, Schlachter S, Bannister LH, Kaminski CF, Lew VL. FRET imaging of hemoglobin concentration in Plasmodium falciparum-infected red cells. PLoS One 2008; 3:e3780. [PMID: 19023444 PMCID: PMC2582953 DOI: 10.1371/journal.pone.0003780] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Accepted: 10/28/2008] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND During its intraerythrocytic asexual reproduction cycle Plasmodium falciparum consumes up to 80% of the host cell hemoglobin, in large excess over its metabolic needs. A model of the homeostasis of falciparum-infected red blood cells suggested an explanation based on the need to reduce the colloid-osmotic pressure within the host cell to prevent its premature lysis. Critical for this hypothesis was that the hemoglobin concentration within the host cell be progressively reduced from the trophozoite stage onwards. METHODOLOGY/PRINCIPAL FINDINGS The experiments reported here were designed to test this hypothesis by direct measurements of the hemoglobin concentration in live, infected red cells. We developed a novel, non-invasive method to quantify the hemoglobin concentration in single cells, based on Förster resonance energy transfer between hemoglobin molecules and the fluorophore calcein. Fluorescence lifetime imaging allowed the quantitative mapping of the hemoglobin concentration within the cells. The average fluorescence lifetimes of uninfected cohorts was 270+/-30 ps (mean+/-SD; N = 45). In the cytoplasm of infected cells the fluorescence lifetime of calcein ranged from 290+/-20 ps for cells with ring stage parasites to 590+/-13 ps and 1050+/-60 ps for cells with young trophozoites and late stage trophozoite/early schizonts, respectively. This was equivalent to reductions in hemoglobin concentration spanning the range from 7.3 to 2.3 mM, in line with the model predictions. An unexpected ancillary finding was the existence of a microdomain under the host cell membrane with reduced calcein quenching by hemoglobin in cells with mature trophozoite stage parasites. CONCLUSIONS/SIGNIFICANCE The results support the predictions of the colloid-osmotic hypothesis and provide a better understanding of the homeostasis of malaria-infected red cells. In addition, they revealed the existence of a distinct peripheral microdomain in the host cell with limited access to hemoglobin molecules indicating the concentration of substantial amounts of parasite-exported material.
Collapse
Affiliation(s)
- Alessandro Esposito
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom.
| | | | | | | | | | | | | |
Collapse
|
10
|
Elder A, Schlachter S, Kaminski CF. Theoretical investigation of the photon efficiency in frequency-domain fluorescence lifetime imaging microscopy. J Opt Soc Am A Opt Image Sci Vis 2008; 25:452-62. [PMID: 18246179 DOI: 10.1364/josaa.25.000452] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We investigate the photon efficiency of frequency-domain fluorescence lifetime imaging microscopy, using both theoretical and Monte Carlo methods. Our analysis differs from previous work in that it incorporates the data fitting process used in real experiments, allows for the arbitrary choice of excitation and gain waveforms, and calculates lifetimes as well as associated F-values from higher harmonics in the data. Using our analysis, we found different photon efficiencies to those previously reported and were able to propose optimal excitation and gain waveforms. Additionally, we suggest measurement protocols that lead to further improvement in photon efficiency. We compare our results to other techniques for lifetime imaging and consider the implications of our higher-harmonic analysis for multi-exponential lifetime determination.
Collapse
Affiliation(s)
- Alan Elder
- Department of Chemical Engineering, University of Cambridge, Cambridge, UK
| | | | | |
Collapse
|
11
|
Xi C, Marks D, Schlachter S, Luo W, Boppart SA. High-resolution three-dimensional imaging of biofilm development using optical coherence tomography. J Biomed Opt 2006; 11:34001. [PMID: 16822051 DOI: 10.1117/1.2209962] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We describe the use of optical coherence tomography (OCT) for high-resolution, real-time imaging of three-dimensional structure and development of a Pseudomonas aeruginosa biofilm in a standard capillary flow-cell model. As the penetration depth of OCT can reach several millimeters in scattering samples, we are able to observe complete biofilm development on all surfaces of a 1 mm x 1 mm flow-cell. We find that biofilm growing at the bottom of the tube has more structural features including voids, outward projections, and microcolonies while the biofilm growing on the top of the tube is relatively flat and contains less structural features. Volume-rendered reconstructions of cross-sectional OCT images also reveal three-dimensional structural information. These three-dimensional OCT images are visually similar to biofilm images obtained with confocal laser scanning microscopy, but are obtained at greater depths. Based on the imaging capabilities of OCT and the biofilm imaging data obtained, OCT has potential to be used as a non-invasive, label-free, real-time, in-situ and/or in-vivo imaging modality for biofilm characterization.
Collapse
Affiliation(s)
- Chuanwu Xi
- University of Illinois at Urbana-Champaign, Department of Civil and Environmental Engineering, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 61801, USA
| | | | | | | | | |
Collapse
|
12
|
Klar R, Schlachter S, Schulz S. Health informatics world wide--a WWW service for the health informatics community. Stud Health Technol Inform 2002; 84:357-60. [PMID: 11604763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Health Informatics World Wide, a Web index of research and educational institutions in the fields of Health Informatics and Medical Informatics has been available to WWW users since 1995. In this paper we report on the original conception of this service, its subsequent modifications and address its maintenance and related problems. Access statistics are presented which demonstrate its relevance as well as the geographical focus of Health Informatics research and development.
Collapse
Affiliation(s)
- R Klar
- Department of Medical Informatics, Freiburg University Hospital, 79104 Freiburg, Germany
| | | | | |
Collapse
|
13
|
Clark SL, Schlachter S. Development of clinical education sites in an area health education system. Phys Ther 1981; 61:904-6. [PMID: 7243890 DOI: 10.1093/ptj/61.6.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In 1974 the University of Kentucky was faced with two problems: 1) overburdening of local clinical facilities by students and 2) a large exodus of graduates from the state. The advent of the Area Health Education System offered the opportunity for the clinical education program to develop nontraditional clinical sites across the state. The development and use of these nontraditional sites in predominantly rural areas has become an integral part of the clinical education program. Local facilities are no longer inundated with students. The retention rate of graduates has improved in the seven years of the program from 36 percent to 1972 to 81 percent in 1979.
Collapse
|