Connecting urban food plans to the countryside: leveraging Denver's food vision to explore meaningful rural-urban linkages

Includes bibliographical references (pages 14-18).Cities are increasingly turning to food policy plans to support goals related to food access, food security, the environment, and economic development. This paper investigates ways that rural farmers, communities, and economies can both support and be supported by metropolitan food-focused initiatives. Specifically, our research question asked what opportunities and barriers exist to developing food policies that support urban food goals, particularly related to local procurement, as well as rural economic development. To address this question, we described and analyzed a meeting of urban stakeholders and larger-scale rural producers related to Colorado’s Denver Food Vision and Plan. We documented and explored “findings” gleaned from a supply chain diagraming and data compilation process that were then used to inform an event that brought together diverse supply chain partners. Three findings stand out. First, facilitating dialog between urban food policymakers and rural producers to understand potential tensions, mitigate such tensions, and capitalize on opportunities is essential. Second, perceptions and expectations surrounding “good food” are nuanced—a timely finding given the number of preferred procurement programs emerging across the county. Third, critical evaluation is needed across a diverse set of value chain strategies (e.g., conventional and alternative distribution) if food policy intends to support heterogeneous producers, their communities, and urban food policy goals

Protective Effects of Positive Lysosomal Modulation in Alzheimer's Disease Transgenic Mouse Models

Alzheimer's disease (AD) is an age-related neurodegenerative pathology in which defects in proteolytic clearance of amyloid β peptide (Aβ) likely contribute to the progressive nature of the disorder. Lysosomal proteases of the cathepsin family exhibit up-regulation in response to accumulating proteins including Aβ1–42. Here, the lysosomal modulator Z-Phe-Ala-diazomethylketone (PADK) was used to test whether proteolytic activity can be enhanced to reduce the accumulation events in AD mouse models expressing different levels of Aβ pathology. Systemic PADK injections in APPSwInd and APPswe/PS1ΔE9 mice caused 3- to 8-fold increases in cathepsin B protein levels and 3- to 10-fold increases in the enzyme's activity in lysosomal fractions, while neprilysin and insulin-degrading enzyme remained unchanged. Biochemical analyses indicated the modulation predominantly targeted the active mature forms of cathepsin B and markedly changed Rab proteins but not LAMP1, suggesting the involvement of enhanced trafficking. The modulated lysosomal system led to reductions in both Aβ immunostaining as well as Aβx-42 sandwich ELISA measures in APPSwInd mice of 10–11 months. More extensive Aβ deposition in 20-22-month APPswe/PS1ΔE9 mice was also reduced by PADK. Selective ELISAs found that a corresponding production of the less pathogenic Aβ1–38 occurs as Aβ1–42 levels decrease in the mouse models, indicating that PADK treatment leads to Aβ truncation. Associated with Aβ clearance was the elimination of behavioral and synaptic protein deficits evident in the two transgenic models. These findings indicate that pharmacologically-controlled lysosomal modulation reduces Aβ1–42 accumulation, possibly through intracellular truncation that also influences extracellular deposition, and in turn offsets the defects in synaptic composition and cognitive functions. The selective modulation promotes clearance at different levels of Aβ pathology and provides proof-of-principle for small molecule therapeutic development for AD and possibly other protein accumulation disorders

Innovative new manager role supports nursing projects and research

Track (TL, SE, EPP, NK): TL Purpose of Nursing Initiative (include which conference learning goals are included in your project story): Creating a novel ‘Nursing Research Program Manager (NRPM)’ position integrates quality improvement (QI), evidence-based practice (EBP), and research using the Magnet® culture to optimize performance and plan for long-term impact using transformational leadership. Describe Nursing Initiative: The Vice President/Chief Nursing Officer (VP/CNO) recognized a need to integrate and coordinate nursing projects, research, and interdisciplinary collaborative efforts. There was a need to support nurses and increase the quality and quantity of the work being done, improve efficiency, and promote positive outcomes for patients and team members. Although the NRPM is at a single site in a 26-hospital system, the position is leveraged to collaborate on system-wide initiatives, councils, and studies. Implementation Strategies: The VP/CNO and a nursing director developed the position description. The NRPM developed the position by assessing needs and developing key tactics with the VP/CNO and Director. Tactics include being a resource for nursing unit projects (QI/EBP), research studies, and IRB-related information; leading the Magnet®-based Excellence in Career Engagement and Learning (ExCEL) reward/recognition program; supporting Magnet® Ambassadors for each unit; and becoming involved with shared governance at the site and system levels. Evaluate the Impact/Effectiveness: The NRPM role is a safe, identifiable contact who creates a supportive, productive environment. In the past 2 years since starting, despite pandemic and staffing challenges, the NRPM increased the number of QI/EBP projects from 25 to over 100, has helped disseminate 8 nurse-led projects at regional and national conferences, supported 15 human studies research determinations (five for students), and has helped coordinate several IRB-approved research projects including a random control trial at the site (planned to expand to other sites in the system) and collaboration with one nation-wide study and one system-wide study. In fall 2021, one of four system-wide team project awards were awarded to the hospital (out of 75 nominations) and two of the projects won first place at the system conference out of five categories due to the support from the NRPM position. Implications for Nursing Practice: The NRPM ensures projects are designed with efficiency and longevity, reducing extraneous “one-off” projects. Designing metric-oriented projects with paper trails facilitates Magnet® document preparation and nurse professional development. Having one individual whose expertise is project design, implementation, IRB processes, and dissemination to help coordinate the complex ecology of Magnet® culture is an incredibly powerful and paradigm-changing opportunity

Emotional injury: The hidden cost of workplace violence

Background Review Workplace violence (WPV) is a common, increasing experience in healthcare. Verbal violence is the most common type and is typically considered “not that big of a deal” or “minor” (Hahn et al. 2008, Magnavita 2014). However, verbal violence and harassment are extremely destructive to team member morale and productivity, leading to burnout and aggression in the victim (Brophy et al. 2017, Miller 2008, Phillips 2016). Purpose The workplace violence committee (WPVC) at a 750+ bed, Level 1 trauma center on the south side of Chicago aimed to quantify the number of verbal incidents and their consequences to inform WPVC interventions to reduce WPV and support the health, wellbeing, and retention of team members. Sample and Setting All team members (n=6040) had the option to complete the anonymous survey via email. Methodology The survey was created, distributed, and collated using Qualtrics and exported to Excel for descriptive analysis. Results Of the total team members who completed the survey (n=1018), 67% reported experiencing verbal violence in the past 12 months and 58% of those who experienced verbal violence reported having at least one consequence. The mean reporting rate for verbal violence was 12%. Team members reported 1947 consequences total with 27 per individual at the most. Of those who experienced at least one consequence, 39% reported burnout/career fatigue/job dissatisfaction, 37% reported anxiety, 33% reported crying, and 29% reported feeling less competent or effective. These were the four most common consequences. Implications Most team members in healthcare experience verbal violence that affects their ability to do their jobs and maintain their health (physical and mental). Despite prolific and serious consequences from verbal violence, its consequences are not counted as injuries and are not systematically considered. Quantifying verbal violence and its consequences based on demographics must inform future interventions for WPV prevention, resolution, healing, and retention. References: Brophy, J.T., M.M. Keith, and M. Hurley. (2017). Assaulted and unheard: Violence against healthcare staff. New Solutions: A Journal of Environmental and Occupational Health Policy. 27(4):581-606. DOI: 10.1177/1048291117732301 Hahn, S., V. Hantikainen, I. Needham, G. Kok, T. Dassen, and R.J.G. Halfens. (2013). Patient and visitor violence in the general hospital, occurrence, staff interventions and consequences: A cross-sectional study. Journal of Advanced Nursing. 68(12):2685-2699. DOI: 10.1111/j.1365-2648.2012.05967.x. Magnavita, N. (2014). Workplace violence and occupational stress in healthcare workers: A chicken-and-egg situation – Results of a 6-year follow-up study. Journal of Nursing Scholarship 46(5):366-376. Miller, L. 2008. Workplace Violence: Practical policies and strategies for prevention, response, and recovery. International Journal of Emergency Mental Health 9(4):259-280. Phillips, J.P. (2016.) Workplace violence against health care workers in the United States. The New England Journal of Medicine. 374(17):1661-1669. DOI: 10.1056/NEJMra150199

Increasing magnetic resonance imaging (MRI) completion rates using aromatherapy

Background Patients commonly verbalize anxiety about having magnetic radiation imaging (MRI) scans. Over one quarter (25-37%) of patients having MRI scans have moderate to high anxiety levels (Delic et al., 2021; McIsaac et al., 1998). Anxiety and claustrophobia lead to approximately ten percent of aborted MRI scans annually (Sadigh et al., 2017), about 2 million exams per year, resulting in annual revenue loss of about 1 billion dollars (Davis, 2016). Local Problem At Advocate Christ Medical Center (ACMC), approximately 8500 MRI exams are performed in the Outpatient Pavilion (OPP) annually. Using the national average of cancelled cases, we estimated 800 scans/year potentially aborted due to anxiety. At a conference, the radiology manager discovered an evidence-based method for statistically significantly increasing MRI completion rates using MRI-safe aromatherapy patches (Davis, 2016). Method Our quality improvement goal was to increase MRI Completion Rates (CR) by providing aromatherapy to patients self-reporting anxiety of 6 or higher on a scale of 0 (no anxiety) to 10 (the most anxiety they have ever experienced). Results Baseline MRI CR in September 2021 was 97.0%. MRI CR increased when we started offering aromatherapy (October 98.1%, November 99.6%, December 99.3%). We estimated cost per aborted scan at about $530. Estimated aborted scan costs decreased from$7420 in September to $5300 in October,$1060 in November, and $2120 in December. We reduced costs by over 50%. Implications for Practice Using inexpensive aromatherapy patches for anxious patients increases MRI completion rates. Increasing MR CR reduces overall costs and workload for MRI-related healthcare workers. Increasing MRI completion rates also theoretically helps prevent delays in patient care and increases patient satisfaction. References Davis, M.A. (2016) Aromatherapy in MRI: Evaluating the use of elequil aromatabs to reduce aborted scans in patients with anxiety and claustrophobia (report). Beekley Medical. Delic, D., D. Babic, D. Franjic, and B. Hasanefendic. (2021). Anxiety of patients at magnetic resonance imaging screening. Psychiatria Danubina. 33(4):762-767. McIsaac, H., Thordarson, D.,Shafran,R., Rachman,S., Poole,G. (1998). Claustrophobia and the magnetic resonance imaging procedure. Journal of Behavioral Medicine, 21(3):255-268. Sadigh,G., Applegate,K., Saindane,A. (2017). Prevalence of unanticipated events associated with MRI exams: A benchmark for MRI quality, safety, and patient experience. Journal of the American College of Radiology, 14(6): 765-772

Aboveground and Belowground Carbon Pools After Fire in Mountain Big Sagebrush Steppe

Postfire succession in mountain big sagebrush (Artemisia tridentata Nutt. subsp. vaseyana [Rydb.] Beetle) ecosystems results in a gradual shift from herbaceous dominance to dominance by shrubs. Determining the quality, quantity, and distribution of carbon (C) in rangelands at all stages of succession provides critical baseline data for improving predictions about how C cycling will change at all stages of succession under altered climate conditions. This study quantified the mass and distribution of above- and belowground (to 1.8-m depth) biomass at four successional stages (2, 6, 20, and 39 yr since fire) in Wyoming to estimate rates of C pool accumulation and to quantify changes in ecosystem carbon to nitrogen (C:N) ratios of the pools during recovery after fire. We hypothesized that biomass C pools would increase over time after fire and that C:N ratios would vary more between pools than during succession. Aboveground and live coarse roots (CR) biomass increased to 310 and 17 g C m-2, but live fine roots (FR) mass was static at about 225 g C m-2. Fine litter (< 1-cm diameter) accounted for about 70% of ecosystem C accumulation rate, suggesting that sagebrush leaves decompose slowly and contribute to a substantial soil organic carbon (SOC) pool that did not change during the 40 yr studied. Total ecosystem C (not including SOC) increased 16 g m-2 yr-1 over 39 yr to a maximum of 1 100 g m-2; the fastest accumulation occurred during the first 20 yr. C:N ratios ranged from 11 for forb leaves to 110 for large sagebrush wood and from 85 for live CR to 12 for bulk soil and were constant across growth stages. These systems may be resilient to grazing after fire because of vigorous regrowth of persistent bunchgrasses and stable pools of live FR and SOC. The Rangeland Ecology & Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202

Testing sagebrush allometric relationships across three fire chronosequences in Wyoming, USA

Aboveground and coarse root allometric relationships were tested across three mountain big sagebrush (Artemisia tridentata var. vaseyana (Rydb.) chronosequences at three stages of recovery from fire (establishment, expansion, and mature) in Wyoming, USA. Big sagebrush shrubs dominate North American rangelands and are critical components of habitat for threatened species such as sage grouse. There were no differences in regression relationships estimating biomass over space and time, which reduces the need to destructively sample sagebrush for local studies and supports regional carbon modeling and biomass estimates. Crown volume (CV) explained the most variability (R2>0.75) in aboveground biomass, and crown area (CA) explained the most variability for coarse roots (R2>0.87). Analyses supported both the frac(1, 4) and frac(2, 3) power universal scaling rules between leaf and stem biomass, but did not support global models of seed plant reproductive part biomass. This study provides compelling evidence that simple field measurements may be used to estimate biomass over large regions and that universal scaling rules are valid for semiarid shrubs