Lessons Learned from Historical Analysis of Seven Decades of Educational Scholarship at McMaster University School of Nursing

The McMaster School of Nursing (SON) was approaching its 70th anniversary prompting a time of reflection on its contributions to nursing education. Were there lessons learned from the past that could provide a compass to navigate current day challenges and orient future strategies in the continued pursuit of excellence in nursing education? While the history of nursing education in Canada has been previously documented, there has been limited research into the evolution of different educational approaches. We decided to conduct in-depth historical analysis of the conditions that fostered educational scholarship and practice at our SON from 1946 to 2016. Using Danto’s (2009) descriptive historiography approach, we first compiled a chronological catalogue of evidences of educational scholarship and of major events that occurred within the SON through literature and archival document searches and 23 key informant interviews. We included a cultural historiography lens that uses a cultural framework to help explain influences on and of the SON activities. Several key areas of educational innovation and scholarship that have influenced nursing education nationally and internationally were identified. However, this article focuses on the historical development of three highly interrelated educational approaches in which the McMaster SON was an early leader: problem-based learning, evidence based nursing, and academic/community partnerships. The article further traces the influences on and of these approaches, set within the context of major events of the SON. Several lessons were uncovered by this historical analysis including building on existing strengths while being open to opportunities, being cognizant of the impact of organizational culture over time, using a proactive planning approach, and exploiting the exponential effect of innovations. A cautionary lesson on nursing’s voice in promoting our own knowledge was also uncovered. Applying the historical methodology taught us lessons on the preservation of nursing-specific information. This historical analysis of one school of nursing’s educational scholarship has provided insights in terms of understanding the forces that have shaped its educational approaches and how this history orients the thinking on educational changes proposed in response to ongoing challenges. Résumé À l’approche de son 70e anniversaire, l’école de sciences infirmières McMaster a pris un temps de réflexion par rapport à ses contributions à la formation en sciences infirmières. Des leçons apprises dans le passé pourraient-elles servir de guide pour gérer les défis d’aujourd’hui et orienter les futures stratégies dans la poursuite continue de l’excellence de la formation en sciences infirmières? Bien que l’histoire de la formation en sciences infirmières au Canada ait été documentée par le passé, il y a eu peu de recherche sur l’évolution des différentes approches pédagogiques. Nous avons décidé de réaliser une analyse historique en profondeur des conditions qui ont favorisé l’avancement des connaissances et la pratique à notre école de sciences infirmières de 1946 à 2016. En nous basant sur l’approche d’historiographie descriptive de Danto (2009), nous avons d’abord compilé un catalogue chronologique de faits sur les programmes pédagogiques et des évènements marquants qui ont eu lieu au sein de l’école de sciences infirmières par le biais de recherches dans la littérature et les archives et d’entrevues avec 23 informateurs clés. Nous avons inclus le point de vue de l’historiographie culturelle, qui utilise un cadre culturel pour aider à expliquer les influences sur et de l’école de sciences infirmières. Plusieurs domaines clés de l’innovation et des programmes pédagogiques qui ont influencé la formation en sciences infirmières au pays et ailleurs dans le monde ont été identifiés. Toutefois, cet article se concentre sur le développement historique de trois approches pédagogiques fortement reliées pour lesquelles l’école de sciences infirmières de McMaster était un chef de file précoce : l’apprentissage basé sur les problèmes, les sciences infirmières fondées sur des données probantes et les partenariats entre les universités et les communautés. L’article retrace également les influences de ces approches dans le contexte des évènements marquants de l’école. Plusieurs leçons ont été apprises grâce à cette analyse historique, notamment de compter sur des forces existantes tout en étant ouverts aux opportunités, reconnaître l’impact de la culture organisationnelle au fil du temps, utiliser une approche de planification proactive et exploiter les effets exponentiels de l’innovation. Une mise en garde a également été établie sur la voix des sciences infirmières pour promouvoir nos propres connaissances. L’application de la méthodologie historique nous a appris des leçons sur la conservation d’informations spécifiques aux sciences infirmières et l’analyse historique de la formation et l’avancement des connaissances d’une école de sciences infirmières a donné un aperçu des forces qui ont forgé ses approches pédagogiques et la façon dont l’histoire guide la réflexion sur les changements pédagogiques proposés en réponse aux défis perpétuels

Beyond Wellness Monitoring: Continuous Multiparameter Remote Automated Monitoring of Patients

The pursuit of more efficient patient-friendly health systems and reductions in tertiary health services use has seen enormous growth in the application and study of remote patient monitoring systems for cardiovascular patient care. While there are many consumer-grade products available to monitor patient wellness, the regulation of these technologies varies considerably, with most products having little to no evaluation data. As the science and practice of virtual care continues to evolve, clinicians and researchers can benefit from an understanding of more comprehensive solutions capable of monitoring multiple biophysical parameters (eg, oxygen saturation, heart rate) continuously and simultaneously. These devices, herein referred to as continuous multiparameter remote automated monitoring (CM-RAM) devices, have the potential to revolutionise virtual patient care. Through seamless integration of multiple biophysical signals, CM-RAM technologies can allow for the acquisition of high-volume big data for the development of algorithms to facilitate early detection of negative changes in patient health status and timely clinician response. In this article, we review key principles, architecture, and components of CM-RAM technologies. Work to date in this field and related implications are also presented, including strategic priorities for advancing the science and practice of CM-RAM. Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.publishedVersio

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Cancer care coordination in ambulatory care

Establish a BC Cancer Agency pilot project that focuses on care coordination and supportive client‐centered care.Applied Science, Faculty ofNursing, School ofUnreviewedUndergraduat

The Future of the Royal Institution of Great Britain -- striving for a more efficient environment

The Royal Institution has upheld its mission of popularizing science over the past two centuries. While it has always encouraged cutting-edge science, the Royal Institution could enhance its impact on society with a more efficient administration. Our project entailed the installation of a new, comprehensive accounting software package as a first step towards implementing a solid, scaleable management system. The Royal Institution must cherish its heritage while embracing modern technology if it is to thrive in the next millennium

93 Investigating the minimal requirements for startup procurement by healthcare institutions in Ontario, Canada

OBJECTIVES/GOALS: The primarygoal is to understand the challenges and barriers associated with the procurement of innovative technologies.Specifically, our research will answer the following question: what are the minimal requirements for a startup’s solution to beprocuredby anOntariohealthcare institution? METHODS/STUDY POPULATION: Participants will include procurement professionals at startups, healthcare institutions, and procurement facilitating agencies. Semi-structured interviews will be conducted in order to understand different procurement pathways and the possible procurement related gaps or barriers that startups face. Through qualitative ethnographic methods, participant interviews will characterize existing relationships and examine the rationale behind startup procurement decision-making. Data collection will include recordings, verbatim transcripts, and researcher field notes. Through inductive qualitative analysis, the data will be examined to build an intervention to assist in startup procurement. RESULTS/ANTICIPATED RESULTS: Our investigation will yield insight into expectations between hospital procurement requirements and startup procurement. The qualitative analysis will identify targets for engagement, and appropriate actors that can bridge gaps. Our results will identify pathways for procurement and the minimal procurement requirements to aid startup procurement planning. Our research will support innovators by delivering an intervention that will enable easier implementation of market ready solutions in a Canadian context. In line with principles from the National Center for Advancing Translational Sciences, this research can be used towards enhancing efficiency, speed of translation, and innovation. DISCUSSION/SIGNIFICANCE: We will contextualize the needs of start-ups and empower them to understand their procurement ecosystem. Facilitating better navigation of the procurement space allows for innovators to present solutions that healthcare organizations can adopt, resulting in improved clinical and patient outcomes

Synovial membrane cytokine expression is predictive of joint damage progression in rheumatoid arthritis : a two-year prospective study (the DAMAGE Study Cohort)

Objective: The primary aim of this prospective 2-year study was to explain the wide variability in joint damage progression in patients with rheumatoid arthritis (RA) from measures of pathologic changes in the synovial membrane. Methods: Patients underwent clinical measurements and joint damage assessments by magnetic resonance imaging (MRI) and radiography at enrollment and at year 2. Synovial membrane was obtained by knee biopsy and assessed histologically by hematoxylin and eosin staining. Interleukin-1β (IL-1β), IL-10, IL-16, IL-17, RANKL, tumor necrosis factor (TNF), and interferon- (IFN) messenger RNA (mRNA) expression was determined by quantitative reverse transcription–polymerase chain reaction. The relationship of synovial measurements to joint damage progression was determined by multivariate analysis. Results: Sixty patients were enrolled. Histologic features had no relationship to damage progression. Multivariate analysis by several different methods consistently demonstrated that synovial membrane mRNA levels of IL-1β, TNF, IL-17, and IL-10 were predictive of damage progression. IL-17 was synergistic with TNF. TNF and IL-17 effects were most pronounced with shorter disease duration, and IL-1β effects were most pronounced with longer disease duration. IFN was protective. These factors explained 57% of the MRI joint damage progression over 2 years. Conclusion: We have demonstrated for the first time in a prospective study that synovial membrane cytokine mRNA expression is predictive of joint damage progression in RA. The findings for IL-1β and TNF are consistent with results of previous clinical research, but the protective role of IFN, the differing effects of disease duration, and IL-17–cytokine interactions had only been demonstrated previously by animal and in vitro research. These findings explain some of the variability of joint damage in RA and identify new targets for therapy