Promoting Scholarship and Faculty Development through Faculty Learning Communities

Faculty learning communities (FLCs), whether they are topic or cohort-based, are a form of professional development that promote scholarship and collegiality among faculty members. This article describes how a number of FLCs were initiated in a Faculty of Nursing (FoN). Members who participated described the FLCs as scholarly, creative and morale enhancing. One of the most significant impacts in the topic-based FLCs was having members create a scholarly product such as articles, letters, theatrical performances, books, faculty modules, briefs and paintings. For the cohort-based FLC the product was preparing pre tenure faculty for tenure. It is recommended FLCs be voluntary, include meals, ask members to commit to attending each session and have expert facilitation. This article describes several examples of FLC’s and best practices around development and facilitation for effective FLC’s. Résumé : Les communautés apprenantes, qu’elles soient thématiques ou fondées sur une cohorte, sont une forme de développement professionnel qui encourage l’avancement des connaissances et la collégialité entre des membres du corps professoral. Cet article présente comment des communautés apprenantes ont été mises en place au sein d’une faculté de sciences infirmières. Les membres impliqués ont décrit l’expérience comme étant scholarly, créative et renforçant le moral. L’un des impacts les plus importants des communautés apprenantes thématiques est la création par les membres de « produits » scientifiques tels qu’articles, lettres, spectacles de théâtre, livres, modules de formation, résumés ou peintures. Quant à la communauté apprenante fondée sur une cohorte, elle visait la préparation de membres du corps professoral à l’obtention de leur permanence. Il est recommandé que l’inscription à une communauté apprenante se fasse sur une base volontaire, que les repas soient fournis, que les participants s’engagent à participer à toutes les séances et que les séances soient animées par un expert. Cet article décrit plusieurs exemples de communautés apprenantes et souligne les pratiques exemplaires en matière de mise sur pied et d’animation afin d’obtenir des communautés apprenantes efficaces

Knowledge and Attitudes of Pharmacogenetics Among Canadian Nurses: Implications for Nursing Education

Pharmacogenetic testing is used to tailor medication recommendations based on an individual\u27s genetic makeup. Increased precision in prescribing medication through the use of genetics leads to a reduction in adverse drug reactions resulting in decreased morbidity and mortality. Due to the noted benefits to patient health outcomes and reduction in healthcare costs, a growing number of Canadian health centers and community pharmacies are beginning to offer pharmacogenetic testing. Previous studies indicate that Canadian nurses have minimal education in genomics; however, there has been an increase in attention to nursing roles in the implementation of genomic health practices in recent years. As the use of pharmacogenetics increases, nurses will be expected to be knowledgeable about pharmacogenetic testing and will play a key role in patient education. Results of previous studies show a low level of knowledge about pharmacogenetic testing among physicians and pharmacists; however, this area of knowledge has not been systematically assessed for nurses. To address this gap, a cross-sectional study was conducted to assess knowledge and attitudes about pharmacogenetics of nurses across Canada. An anonymous online survey was completed by 236 participants, including nursing students (n = 84), registered nurses (n = 144), and nurse practitioners/nurse clinicians (n = 9). Participants represented 9/10 provinces and 2/3 territories across Canada. The majority of the participants (65.9%) lacked formal education in genetics and indicated a fair or poor level of understanding of pharmacogenetic testing in the clinical setting (93%). The mean score for pharmacogenetic knowledge questions was 34.5%, while the mean score for genetics knowledge questions was 61.1%. Despite their self-reported lack of knowledge and understanding, most participants had positive attitudes towards pharmacogenetic testing and recognized its ability to decrease adverse drug reactions and improve clinical efficacy (81.3%). Most participants (73.7%) were interested in educational offerings related to pharmacogenetic testing, particularly web-based courses and seminars/lectures. The results of this study indicate that nurses across Canada may not have the necessary knowledge to support the implementation of pharmacogenetic testing into clinical practice. However, positive attitudes and interest in learning about pharmacogenetics indicate opportunities for the development of educational activities to ensure that Canadian nurses are prepared for upcoming changes that will impact nursing practice. Résumé Les tests pharmacogénétiques sont utilisés pour adapter les recommandations de médicaments en fonction de la constitution génétique d’un individu. Une précision accrue dans la prescription de médicaments grâce à l’utilisation de la génétique conduit à une réduction des effets indésirables des médicaments, ce qui entraîne une diminution de la morbidité et de la mortalité. En raison des avantages constatés pour la santé des patients et de la réduction des coûts des soins de santé, un nombre croissant de centres de santé et de pharmacies communautaires au Canada commencent à offrir des tests pharmacogénétiques. Des études antérieures indiquent que les infirmières au Canada n’ont qu’une formation minimale en génomique; cependant, une attention accrue a été portée aux rôles infirmiers dans la mise en œuvre des pratiques de santé génomique au cours des dernières années. Avec l’augmentation de l’utilisation de la pharmacogénétique, les infirmières devront être bien informées sur les tests pharmacogénétiques et qu’elles jouent un rôle clé dans l’éducation des patients. Les résultats d’études antérieures montrent un faible niveau de connaissances sur les tests pharmacogénétiques chez les médecins et les pharmaciens; cependant, ce domaine de connaissances n’a pas été systématiquement évalué pour les infirmières. Pour combler cette lacune, une étude transversale a été menée pour évaluer les connaissances et les attitudes des infirmières et infirmiers du Canada au sujet de la pharmacogénétique. Un sondage anonyme en ligne a été mené auprès de 236 participantes, incluant des étudiantes en sciences infirmières (n = 84), des infirmières (n = 144) et des infirmières praticiennes/cliniciennes (n = 9). Ces participantes provenaient de neuf des dix provinces et deux des trois territoires. La majorité des participantes (65,9 %) manquaient de formation officielle en génétique et ont indiqué un niveau de compréhension passable ou faible des tests pharmacogénétiques en milieu clinique (93 %). Le résultat moyen aux questions sur les connaissances pharmacogénétiques était de 34,5 %, tandis que le résultat moyen aux questions sur les connaissances en génétique était de 61,1 %. Malgré leur manque de connaissances et de compréhension autodéclaré, la plupart des participantes avaient une attitude positive envers les tests pharmacogénétiques et reconnaissaient leur capacité à réduire les effets indésirables des médicaments et à améliorer l’efficacité clinique (81,3 %). La plupart des participantes (73,7 %) étaient intéressées par les formations offertes liée aux tests pharmacogénétiques, en particulier les cours en ligne et les séminaires/conférences. Les résultats de cette étude indiquent que les infirmières à travers le Canada n’ont peut-être pas les connaissances nécessaires pour soutenir la mise en œuvre de tests pharmacogénétiques dans la pratique clinique. Cependant, les attitudes positives et l’intérêt pour l’apprentissage de la pharmacogénétique indiquent des possibilités d’élaboration d’activités éducatives pour s’assurer que les infirmières canadiennes soient préparées aux changements à venir qui auront une incidence sur leur pratique

Staying Ahead of the Digital Technological Curve Using Survey Methods

In the early twentieth century, surveys were an innovative and neoteric methodology. Collected in-person or by mail, researchers could ascertain the thoughts and opinions of a small sample, which could then be applied to the general population. Almost one hundred years later, the use of surveys has become pervasive in society due to digital technological advancement. However, while the digital evolution has not only altered the possibilities of how, when, and where surveys may be administered, the threats to this methodology has also evolved. While issues related to previously known errors (i.e. sampling error, non-response error, etc.) remain and have also evolved, new threats regarding confidentiality and privacy, design issues, and others, have emerged in response to this digital advancement. Novice and experienced researchers alike should be cognizant of the impact digital technologies have had on survey data collection to ensure high quality research findings. This paper explores the threats to survey methodology due to digital technological changes and discusses how novice researchers and students can mitigate these challenges. Au début du vingtième siècle, les sondages constituaient une méthodologie novatrice et moderne. Les chercheurs pouvaient, à partir d’un petit échantillon, cerner des idées et opinions recueillies en personne ou par courrier, pour ensuite les appliquer à la population générale. Près de 100 ans plus tard, grâce aux avancées de la technologie numérique, les sondages sont omniprésents dans la société. Or, l’évolution numérique a non seulement modifié les paramètres spatiotemporels et les techniques d’administration des sondages, mais aussi les risques liés à cette méthodologie. Alors que les problèmes liés aux erreurs déjà connues (erreurs d’échantillonnage, erreurs de non-réponse, etc.) demeurent et évoluent tout autant, de nouvelles menaces associées à la confidentialité et à la protection des renseignements personnels, aux questions de conception et à d’autres enjeux ont surgi en réaction à cette évolution technologique. Afin d’optimiser la qualité des résultats de recherche, les chercheuses débutantes et chevronnées devraient être au fait des retombées possibles des technologies numériques sur la collecte de données par sondage. Cet article porte sur les menaces à la méthodologie des sondages en raison des changements liés aux technologies numériques, et traite de stratégies permettant aux étudiantes et aux chercheuses débutantes d’éviter ces écueils

Simulated Interprofessional Team Learning with Nursing and Pharmacy Students

Simulated Interprofessional Team Learning with Nursing and Pharmacy Students. Background: Although healthcare students are exposed to simulation learning (SL) to develop profession specific education, the use of uni-professional SL is no longer adequate as students enter clinical settings where teams work together for optimal patient care1,2, As the roles of registered nurses and pharmacists frequently overlap, future practitioners need opportunities to practice interprofessional collaboration2. Research question/Hypothesis: Guided by a pilot project2 and after receiving ethical approval from the Research Ethics Board, the study examined the feasibility of integrating interprofessional SL into existing nursing and pharmacy courses and expected that SL would be well received by students, and would not require additional resources. Method: Beginning with a high-fidelity simulation (HFS) nursing scenario, nursing students led the SL while pharmacy students participated. Pharmacy students then led a standardized patient community-focused scenario while nursing students participated. During debriefing, students discussed the professionals' roles and opportunities to collaborate for optimal patient care. Students also completed the Interprofessional Attitudes Scale (IPAS)3. Results: A total of 184 students participated. Most students (n = 182; 98%) were satisfied with the SL experiences, and reported greater role clarification of the other profession. Almost all participants (n = 180; 97%) felt better prepared for collaborating with the other healthcare profession in a clinical setting. An unexpected course change was required to accommodate the scheduling for the nursing students, requiring additional resources. Conclusion: This research demonstrated that nursing and pharmacy students were receptive to the SL experiences and felt better prepared to collaborate with other professions. However, creating this opportunity was challenging given the differing schedules of the programs. Coordination of schedules is recommended to help provide future educational opportunities for students to practice interprofessional collaboration

RNA:DNA hybrids are a novel molecular pattern sensed by TLR9.

The sensing of nucleic acids by receptors of the innate immune system is a key component of antimicrobial immunity. RNA:DNA hybrids, as essential intracellular replication intermediates generated during infection, could therefore represent a class of previously uncharacterised pathogen-associated molecular patterns sensed by pattern recognition receptors. Here we establish that RNA:DNA hybrids containing viral-derived sequences efficiently induce pro-inflammatory cytokine and antiviral type I interferon production in dendritic cells. We demonstrate that MyD88-dependent signalling is essential for this cytokine response and identify TLR9 as a specific sensor of RNA:DNA hybrids. Hybrids therefore represent a novel molecular pattern sensed by the innate immune system and so could play an important role in host response to viruses and the pathogenesis of autoimmune disease

Estimating the number needed to treat from continuous outcomes in randomised controlled trials: methodological challenges and worked example using data from the UK Back Pain Exercise and Manipulation (BEAM) trial

Background Reporting numbers needed to treat (NNT) improves interpretability of trial results. It is unusual that continuous outcomes are converted to numbers of individual responders to treatment (i.e., those who reach a particular threshold of change); and deteriorations prevented are only rarely considered. We consider how numbers needed to treat can be derived from continuous outcomes; illustrated with a worked example showing the methods and challenges. Methods We used data from the UK BEAM trial (n = 1, 334) of physical treatments for back pain; originally reported as showing, at best, small to moderate benefits. Participants were randomised to receive 'best care' in general practice, the comparator treatment, or one of three manual and/or exercise treatments: 'best care' plus manipulation, exercise, or manipulation followed by exercise. We used established consensus thresholds for improvement in Roland-Morris disability questionnaire scores at three and twelve months to derive NNTs for improvements and for benefits (improvements gained+deteriorations prevented). Results At three months, NNT estimates ranged from 5.1 (95% CI 3.4 to 10.7) to 9.0 (5.0 to 45.5) for exercise, 5.0 (3.4 to 9.8) to 5.4 (3.8 to 9.9) for manipulation, and 3.3 (2.5 to 4.9) to 4.8 (3.5 to 7.8) for manipulation followed by exercise. Corresponding between-group mean differences in the Roland-Morris disability questionnaire were 1.6 (0.8 to 2.3), 1.4 (0.6 to 2.1), and 1.9 (1.2 to 2.6) points. Conclusion In contrast to small mean differences originally reported, NNTs were small and could be attractive to clinicians, patients, and purchasers. NNTs can aid the interpretation of results of trials using continuous outcomes. Where possible, these should be reported alongside mean differences. Challenges remain in calculating NNTs for some continuous outcomes

Sheep Updates 2005 - Part 3

This session covers seven papers from different authors: CUSTOMER 1. Benefits VIAscanR to producers and WAMMCO, Rob Davidson, Supply Development Manager, David Pethick, School of Veterinary and Biomedical Studies, Murdock University. 2. Healthy fats in lamb: how WA lambs compare with others, C. F. Engelke Animal Biology, University of Western Australia, bCSIRO Livestock Industries, Western Australia B.D. Siebert, Department of Animal Science, University of Adelaide, South Australia, K. Gregg, Centre for High-Throughput Agricultural Genetic Analysis, Murdoch University, Western Australia. A-D.G. Wright CSIRO Livestock Industries, Western Australia, P.E Vercoe Animal Biology, University of Western Australia 3. Shelf life of fresh lamb meat: lamb age & electrical stimulation, Dr Robin Jacob, Department of Agriculture, Western Australia 4. Pastures from space - An evaluation of adoption of by Australian woolgrowers, Russell Barnett, Australian Venture Consultants, Joanne Sneddon, University of Western Australia 5. Your clients can learn from ASHEEP\u27s example, Sandra Brown Department of Agriculture Western Australia 6. Lifetime Wool - Farmers attitudes affect their adoption of recommended ewe management, G. Rose Department of Agriculture Western Australia, C. Kabore, Kazresearch, Lower Templestowe Vic, J. Dart, Clear Horizons, Hastings Vic 7. Sustainable certification of Australian Merino, what will customers be looking for? Stuart Adams, i-merino / iZWool International Pty Lt

Prognostic Value of Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancers From Two Phase III Randomized Adjuvant Breast Cancer Trials: ECOG 2197 and ECOG 1199

Purpose Recent studies suggest that tumor-infiltrating lymphocytes (TILs) are associated with disease-free (DFS) and overall survival (OS) in operable triple-negative breast cancer (TNBC). We seek to validate the prognostic impact of TILs in primary TNBCs in two adjuvant phase III trials conducted by the Eastern Cooperative Oncology Group (ECOG). Patients and Methods Full-face hematoxylin and eosin–stained sections of 506 tumors from ECOG trials E2197 and E1199 were evaluated for density of TILs in intraepithelial (iTILs) and stromal compartments (sTILs). Patient cases of TNBC from E2197 and E1199 were randomly selected based on availability of sections. For the primary end point of DFS, association with TIL scores was determined by fitting proportional hazards models stratified on study. Secondary end points were OS and distant recurrence–free interval (DRFI). Reporting recommendations for tumor marker prognostic studies criteria were followed, and all analyses were prespecified. Results The majority of 481 evaluable cancers had TILs (sTILs, 80%; iTILs, 15%). With a median follow-up of 10.6 years, higher sTIL scores were associated with better prognosis; for every 10% increase in sTILs, a 14% reduction of risk of recurrence or death (P = .02), 18% reduction of risk of distant recurrence (P = .04), and 19% reduction of risk of death (P = .01) were observed. Multivariable analysis confirmed sTILs to be an independent prognostic marker of DFS, DRFI, and OS. Conclusion In two national randomized clinical trials using contemporary adjuvant chemotherapy, we confirm that stromal lymphocytic infiltration constitutes a robust prognostic factor in TNBCs. Studies assessing outcomes and therapeutic efficacies should consider stratification for this parameter

Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: A comprehensive review

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples’ preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly’s hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples’ experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas