A cohort analysis of men with a family history of BRCA1/2 and Lynch mutations for prostate cancer.

BACKGROUND: Prostate cancer (PC) is a major health concern for men worldwide, with an estimated lifetime risk of ~14 %. A recent comprehensive analysis of mutational processes revealed ageing and mismatch repair as the only altered processes in PC. We wish to test if a cohort of men with inherited risk of mismatch repair defect through BRCA1/2 or Lynch Syndrome mutations represents a target population for prostate cancer testing. METHODS: Fifty-eight men (aged 40-69 years) from families with a history of BRCA1/2 or HNPCC/Lynch mutations were invited to take part. Men with PSA >3.0 ng/ml were recommended to have transrectal ultrasound-guided prostatic biopsies. RESULTS: Overall 1 of 7 (14 %) and 1 of 20 (5 %) men with BRCA1/2 mutations were positive for a diagnosis of prostate cancer. In men with Lynch syndrome, 1 of 4 (25 %) was diagnosed to have prostate cancer. The index case with Lynch syndrome harbours a heterozygous mutation in the mismatch repair MSH6 gene. Near to complete loss of MSH6 immunoreactivity in the prostate tumour supports silencing of the remaining MSH6 allele during prostate carcinogenesis. CONCLUSION: The finding of near-to-complete loss of MSH6 expression in affected men with a family history of Lynch Syndrome supports its mechanistic involvement during prostate carcinogenesis. This work therefore contributes to the argument that, in certain male populations, Lynch Syndrome mutations are biologically implicated in men with prostate cancer.

A literature review and database of how the primary KIT/PDGFRA variant of a gastrointestinal stromal tumour predicts for sensitivity to imatinib.

It is well recognized that the primary KIT or PDGFRA variant of a gastrointestinal stromal tumour (GIST) can predict sensitivity to imatinib. However, these data are currently spread across a wide range of publications and have not been collated as one reference. A broad-ranging literature search was therefore performed to assemble such a database which should help optimize imatinib-based management of GIST patients henceforth. Having excluded wild type GISTs and results for imatinib used as adjuvant therapy, 79 publications (dated August 2001 to March 2022) underwent data extraction. These data on imatinib sensitivity were either derived from in vitro studies, predicted by in silico analysis or based on in vivo clinical patient response. Data interpretation carried some caveats: there was a potential for replication of patient-derived data between older and new publications; only predicted protein sequences were presented; the criteria used to record clinical response were not uniform across all publications; and imatinib dosage could vary between different clinical publications. However, these data showed broad agreement of imatinib sensitivity amongst similar subtypes of KIT or PDGFRA variant. There was also agreement between in vivo versus in vitro/in silico derived sensitivity data for most variants when both data types were available.

Building on Wenger: communities of practice in nursing.

Communities of practice (CoPS) provide a potentially useful practice based framework for constructing work based collaborative learning and promoting engagement with local and professional groups and communities. In nursing, we have, increasingly, to manage and deploy new and existing knowledge, although CoPs are currently not widely used to do this. This paper debates the framework created by Wenger and reviews the role of the CoP as an innovative way for educators and practitioners to collaborate to develop and manage new knowledge and emerging practice.

'Constructing communities for learning in nursing'.

Working in communities is increasingly a feature of UK (United Kingdom) higher education. Within the last decade communities of practice (CoPs) have migrated from organisational development departments and evolved to become tools for practice based learning in educational settings. More recently, in nursing, the literature reports that CoPs have the potential to blend the skills of both academics and clinicians to transform and create new knowledge that is both scholarly and applicable to practice.

Promotion of a community culture in nursing research.

This article focuses on local practice-based research and development. It uses examples from both nursing practice and education to explore some factors that prevent, promote and influence the establishment of a research culture in clinical nursing. The article presents potential approaches for successful practitioner-led and clinical/academic research initiatives, explored through practice development and communities of practice. It also highlights the challenges of these approaches.

Clinical imprinting: the impact of early clinical learning on career long professional development in nursing.

The literature recognises a relationship between clinical experience and a successful undergraduate experience in nursing; however what constitutes an effective approach remains the subject of debate, particularly in relation to first year of learning. There is evidence from a biological standpoint that early experience impacts on the behavioural development of animals, described by Konrad Lorenz (1903-1989) as 'imprinting'. The concept of imprinting has resonance for nursing. In this article the importance of 'getting it right at the beginning' is explored and what, if anything, Lorenz's theory tells us about the impact of early clinical learning on subsequent professional development.

Professional identity in nursing: are we there yet?

Nursing in the United Kingdom (UK) has been part of higher education for more than a decade and is now moving towards graduate status as a profession. Increasingly, through adherence to good practice guidelines and professional body regulation, the profession is incrementally involving communities of reference to help shape current and future identity. The desire to articulate the impact of nursing practice underscores the new undergraduate programmes and propels professional preparation beyond an existence at the fuzzy fringes of medicine towards a unique and fully fledged contemporary identity.

The duality of professional practice in nursing: academics for the 21st century.

Although pre-registration nursing in the United Kingdom (UK) is moving towards a graduate exit, the vocational/professional debate is still live and continues to be played out in both popular and professional literature. This study considers the nature of contemporary academic communities and the challenge of duality in professional nursing life. More than a decade after the move into higher education (HE) however the role of the academic is still controversial, with much of the debate focussed on the nature of clinical credibility. This article considers the dimensions of academic nursing, reports the views of academics and clinicians and introduces a model of working that could potentially harness and blend the skills of academics and clinicians, nurturing a culture of applied scholarship throughout the professional/academic journey.

'Show us you know us': using the Senses Framework to support the professional development of undergraduate nursing students.

As students, fledgling nurses need to feel they belong to a community of academics, peers and mentors who value their contribution to learning and knowledge. Creating a sense of community allows students to experience academic and practice integration at the beginning of their professional journey, recognising that positive learning experiences at an early stage of professional maturation can shape lifelong attitudes to learning and discovery. The Senses Framework has been used to develop supportive working in relation to older adults; it also has resonance for the development of undergraduate nurses. This article focuses on the student experience, exploring the potential for the Senses Framework to underpin a learning community, promoting collaboration and acknowledging the emotional, academic and professional work that is now essential for the preparation of registered nurse in the 21st Century.

Greater than the sum of its parts: transition into the first year of undergraduate nursing.

In 2006 the School of Nursing, Midwifery and Community Health, Glasgow Caledonian University, introduced an action research initiative: The Enhance Project. Originally designed to provide academic support for first year undergraduate nursing students, this project has evolved to encompass a second spiral of activity, investigating how prepared students are, both professionally and socially for year one of an undergraduate nursing programme, with particular reference to the first clinical placement. Initial findings indicate that, while the majority of students appear to understand their role as nursing students, their understanding of what is expected of in the first placement is less clear. There is also a lack of clarity regarding their role and that of the mentor in the achievement of clinical placement learning outcomes. This paper discusses the importance of getting it right at the start of the journey and comments on the development of professional identity in nursing.

Developing professional identity in nursing academics: the role of communities of practice.

This paper analyses the current standing of nursing within the wider United Kingdom (UK) higher education (HE) environment and considers the development of academic identity within the sector, introducing a technology mediated approach to professional learning and development. A community of practice (CoP) is a way of learning based on collaboration among peers. Individuals come together virtually or physically, with a common purpose, defined by knowledge rather than task [Wenger, E., 1998. Communities of Practice: Learning, Meaning and Identity, sixth ed. Cambridge University Press, Cambridge]. In 2008, a small team of academics at Glasgow Caledonian University, School of Nursing, Midwifery and Community Health created and implemented iCoP, a project undertaken to pilot an international CoP, where novices and expert academics collaborated to debate and discuss the complex transition from clinician to academic. Although not intended as a conventional research project, the developmental journey and emerging online discussion provide an insight into the collective thoughts and opinions of a multi-national group of novice academics. The article also highlights the key challenges, problems and limitations of working in an international online arena with professionals who traditionally work and thrive in a face to face, real time environment.