Effectively Conducting Field Days While Responding to Unprecedented External Restrictions

Despite external influences such as societal restrictions imposed during the 2020 COVID-19 pandemic, farmers continue to work, and needs for outreach and education have not waned. Extension professionals must continue to support these needs by using media and channels not typically employed when more traditional vehicles, such as on-site consultations and field days, are not practical or safe. The Iowa Learning Farms team from Iowa State University Outreach and Extension has developed a successful Virtual Field Day program using available online tools that can be easily adopted by other Extension organizations to facilitate outreach

Virtually the Same? Understanding Virtual and F2F Farmer Audiences

Agricultural and extension educators frequently employ a variety of methods to provide farmers with information about conservation practices. The introduction of virtual programming brought on in response to the COVID-19 pandemic set the stage for analysis of farmer outreach preferences with respect to face-to-face (F2F) versus virtual outreach. Using survey data of individuals who participated in field days in Iowa, we segmented participants based on their F2F or virtual attendance. We compared the groups based on key variables such as water quality concerns, communication behaviors, outreach preferences, and demographics. Our work suggests that a broad and dynamic communication strategy, including both in-person and virtual events, offers greater opportunities for dissemination of ideas and increases access to content

Patient Perspectives on Tobacco Use Treatment in Primary Care

IntroductionEvidence-based tobacco cessation interventions increase quit rates, yet most smokers do not use them. Every primary care visit offers the potential to discuss such options, but communication can be tricky for patients and provider alike. We explored smokers’ personal interactions with health care providers to better understand what it is like to be a smoker in an increasingly smoke-free era and the resources needed to support quit attempts and to better define important patient-centered outcomes.MethodsThree 90-minute focus groups, involving 33 patients from 3 primary care clinics, were conducted. Participants were current or recent (having quit within 6 months) smokers. Topics included tobacco use, quit attempts, and interactions with providers, followed by more pointed questions exploring actions patients want from providers and outcome measures that would be meaningful to patients.ResultsFour themes were identified through inductive coding techniques: 1) the experience of being a tobacco user (inconvenience, shame, isolation, risks, and benefits), 2) the medical encounter (expectations of providers, trust and respect, and positive, targeted messaging), 3) high-value actions (consistent dialogue, the addiction model, point-of-care nicotine patches, educational materials, carbon monoxide monitoring, and infrastructure), and 4) patient-centered outcomes.ConclusionEngaged patient-centered smoking cessation counseling requires seeking the patient voice early in the process. Participants desired honest, consistent, and pro-active discussions and actions. Participants also suggested creative patient-centered outcome measures to consider in future research

Perceptive responses and familiar staff facilitate meaningful engagement of older adults and family/care partners in long-term care home implementation science research during COVID-19

A novel registered practical nurse-led video conferencing approach using PIECESTM for team-based care planning was developed to engage family/care partners in the care of older adults. The objectives were to: (a) explore the experiences of older adults and family/care partners in collaborating in implementation science research in long-term care (LTC); (b) identify facilitators and barriers to engaging older adults and family/care partners in implementation science research; and (c) share recommendations to support the engagement of older adults and family/care partners in research. A qualitative descriptive design was used. Two older adults and two family/care partners from two Canadian LTC homes were involved in the research. Data, comprised of interviews with older adults and family/care partners, and notes from research team meetings, were analyzed using thematic analysis. Older adults and family/care partners perceived they made valuable contributions to the research project. They expressed beliefs that care delivery required improvements for older adults with responsive behaviours in LTC, which served as motivation to participate in the research project. Facilitating factors included the support of familiar LTC staff for older adults to engage in research activities and understanding the value of PIECES. A barrier to engagement for older adults was research terminology and processes described during team meetings. This research highlighted taken-for-granted factors in a collaborative research endeavour with older adults and family/care partners. One-on-one interaction, follow-up \u27reporting\u27 and presence of familiar LTC staff are needed to support meaningful engagement of older adults and family/care partners in research. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Effectively Conducting Field Days While Responding to Unprecedented External Restrictions

Despite external influences such as societal restrictions imposed during the 2020 COVID-19 pandemic, farmerscontinue to work, and needs for outreach and education have not waned. Extension professionals must continueto support these needs by using media and channels not typically employed when more traditional vehicles, suchas on-site consultations and field days, are not practical or safe. The Iowa Learning Farms team from Iowa StateUniversity Outreach and Extension has developed a successful Virtual Field Day program using available onlinetools that can be easily adopted by other Extension organizations to facilitate outreach.This article is published as Comito, Jacqueline, Elizabeth Ripley, Mark A. Licht, and Adam K. Janke. "Effectively Conducting Field Days While Responding to Unprecedented External Restrictions." The Journal of Extension 58, no. 5 (2021): 5tt3. Posted with permission

Ras-GTP dimers activate the Mitogen-Activated Protein Kinase (MAPK) pathway

Rat sarcoma (Ras) GTPases regulate cell proliferation and survival through effector pathways including Raf-MAPK, and are the most frequently mutated genes in human cancer. Although it is well established that Ras activity requires binding to both GTP and the membrane, details of how Ras operates on the cell membrane to activate its effectors remain elusive. Efforts to target mutant Ras in human cancers to therapeutic benefit have also been largely unsuccessful. Here we show that Ras-GTP forms dimers to activate MAPK. We used quantitative photoactivated localization microscopy (PALM) to analyze the nanoscale spatial organization of PAmCherry1-tagged KRas 4B (hereafter referred to KRas) on the cell membrane under various signaling conditions. We found that at endogenous expression levels KRas forms dimers, and KRas(G12D), a mutant that constitutively binds GTP, activates MAPK. Overexpression of KRas leads to formation of higher order Ras nanoclusters. Conversely, at lower expression levels, KRas(G12D) is monomeric and activates MAPK only when artificially dimerized. Moreover, dimerization and signaling of KRas are both dependent on an intact CAAX (C, cysteine; A, aliphatic; X, any amino acid) motif that is also known to mediate membrane localization. These results reveal a new, dimerization-dependent signaling mechanism of Ras, and suggest Ras dimers as a potential therapeutic target in mutant Ras-driven tumors

Nurse-Led Virtual Delivery of PIECES in Canadian Long-Term Care Homes to Support the Care of Older Adults Experiencing Responsive Behaviors During COVID-19: Qualitative Descriptive Study

BackgroundWorldwide, the COVID-19 pandemic has resulted in profound loss of life among older adults living in long-term care (LTC) homes. As a pandemic response, LTC homes enforced infection control processes, including isolating older adults in their rooms, canceling therapeutic programs, and restricting family member visits. Social isolation negatively impacts older adults in LTC, which may result in increased rates of anxiety, depression, physical and cognitive decline, disorientation, fear, apathy, and premature death. Isolation of older adults can also cause an increase in responsive behaviors (eg, yelling, hitting, calling out) to express frustration, fear, restricted movement, and boredom. To respond to the challenges in LTC and support frontline staff, older adults, and family members, a novel registered practical nurse (RPN)-led delivery of the PIECES approach for addressing responsive behaviors among older adults with dementia using virtual training/mentoring was implemented in Canadian LTC homes. PIECES employs a person- and family/care partner–centered collaborative team-based approach to provide education and capacity-building for nurses; engages families as active participants in care; and embeds evidence-informed practices to provide person- and family-centered care to older adults with complex needs, including dementia. ObjectiveThe aim of this study was to describe the experiences of LTC staff, family/care partners, and older adult research partners with implementation of a novel RPN-led virtual adaptation of the PIECES care-planning approach for responsive behaviors in two Canadian LTC homes during the COVID-19 pandemic. MethodsUsing a qualitative descriptive design, two focus groups were held with three to four staff members (eg, RPNs, managers) per LTC home in Ontario. A third focus group was held with three PIECES mentors. Individual semistructured interviews were conducted with RPN champions, family/care partners, and older adult research partners. Research team meeting notes provided an additional source of data. Content analysis was performed. ResultsA total of 22 participants took part in a focus group (n=11) or an in-depth individual interview (n=11). Participant experiences suggest that implementation of RPN-led virtual PIECES fostered individualized care, included family as partners in care, increased interdisciplinary collaboration, and improved staff practices. However, virtual PIECES, as delivered, lacked opportunities for family member feedback on older adult outcomes. Implementation facilitators included the provision of mentorship and leadership at all levels of implementation and suitable technological infrastructure. Barriers were related to availability and use of virtual communication technology (family members) and older adults became upset due to lack of comprehension during virtual care conferences. ConclusionsThese findings offer promising support to adopting virtual PIECES, a team approach to gather valuable family input and engagement to address residents’ unmet needs and responsive behaviors in LTC. Future research should investigate a hybridized communication format to foster sustainable person- and family-centered care-planning practices to include active collaboration of families in individualized care plans