Literature review on advance care planning of nursing home residents

Aim: Conduct a search and analytic review of literature regarding attributes of Advance Care Planning (ACP) and Advance Directive in order to identify the experiences and the best care strategies for older adults resident in nursing homes or long term institutions. Methodology: An extensive electronic search was undertaken in the following databases: Pubmed (via Ovid search), Cumulative Index of Nursing and Allied Health (CINAHL, via EBHOST), psychINFO and Cochrane. After analyzing and eliminating duplicates and professional's point of view (19), 144 titles were considered relevant: 28 opinion papers, 94 descriptive/qualitative studies or predictive studies, 17 experimental and five systematic reviews. Most of them were produced in North America and only 10 were in French. Results: With regard to European experiences, studies are scarce and further research could benefit from North American evidence. Contrary to Europe, nurses in North America play a major role in the process of care planning. The major findings were related to the poor efficacy of the completion of Advance Directives, even in presence of a substantial variety of implementation strategies. The evidence supports interventions that conceptualize ACP as a process, with an emphasis on the ascertainment of patients' values and beliefs and the necessity to include the family or loved ones from the beginning of the process in order to favor the expression and sharing of one's life perspectives and priorities in care. The most relevant findings were associated with the conceptualization of the ACP as a change in health behaviors which needs an involvement in different stages to overcome a variety of barriers. Conclusion: Rigorous research in ACP for the older adults in Swiss nursing homes that promote respect and dignity in this frail population is needed. How to best achieve patients and families goals should be the focus of nursing intervention and research in this domain.

Archaeology on the Road, July 2010

Not only are we excited that Team Archaeology is back for our third ride, we are energized to be part of a “Human and Natural History” partnership that allows us expanded opportunities to share the story of Iowa’s amazing past. Once again there will be archaeologists along for the ride, as well as at Expo and this year at roadside locations Day One, Five and Six. Don’t hesitate to ask about the history of the first people to travel this landscape as well as the stories of each generation that has contributed to what we know of ourselves today. We will also feature information about the landscape and natural resources of Iowa you will encounter along the route through our partnering colleagues specializing in geology, hydrology, and other earth sciences. Enjoy using this booklet as your guide to the week’s activities and please help yourself to free materials from our outreach booth about our shared past and the natural world we depend on. Ride smart, be safe, and when you get home, be sure to tell your friends and neighbors about Iowa archaeology!

RAGBRAI Learn about the Land; Day 4, July 2010

The University of Iowa Office of the State Archaeologist and Team Archaeology are back on RAGBRAI for our third year of Archaeology on the Road, and pleased to partner this year with the IDNR: Geological and Water Survey and the U.S. Geological Survey under the theme “Human and Natural History Partners.” Archaeology on the Road brings you the unique cultural history and prehistory of Iowa on the RAGBRAI route, pointing out interesting and significant archaeological sites and sharing Iowa’s past along the way. Look for our booth at Expo and then again on Days 1, 5 and 6 on the route, and also keep an eye out for our Team Archaeology

RAGBRAI Learn about the Land; Day 5, July 2010

The University of Iowa Office of the State Archaeologist and Team Archaeology are back on RAGBRAI for our third year of Archaeology on the Road, and pleased to partner this year with the IDNR: Geological and Water Survey and the U.S. Geological Survey under the theme “Human and Natural History Partners.” Archaeology on the Road brings you the unique cultural history and prehistory of Iowa on the RAGBRAI route, pointing out interesting and significant archaeological sites and sharing Iowa’s past along the way. Look for our booth at Expo and then again on Days 1, 5 and 6 on the route, and also keep an eye out for our Team Archaeology

RAGBRAI Learn about the Land; Day 2, July 2010

The University of Iowa Office of the State Archaeologist and Team Archaeology are back on RAGBRAI for our third year of Archaeology on the Road, and pleased to partner this year with the IDNR: Geological and Water Survey and the U.S. Geological Survey under the theme “Human and Natural History Partners.” Archaeology on the Road brings you the unique cultural history and prehistory of Iowa on the RAGBRAI route, pointing out interesting and significant archaeological sites and sharing Iowa’s past along the way. Look for our booth at Expo and then again on Days 1, 5 and 6 on the route, and also keep an eye out for our Team Archaeology

RAGBRAI Learn about the Land; Day 3, July 2010

The University of Iowa Office of the State Archaeologist and Team Archaeology are back on RAGBRAI for our third year of Archaeology on the Road, and pleased to partner this year with the IDNR: Geological and Water Survey and the U.S. Geological Survey under the theme “Human and Natural History Partners.” Archaeology on the Road brings you the unique cultural history and prehistory of Iowa on the RAGBRAI route, pointing out interesting and significant archaeological sites and sharing Iowa’s past along the way. Look for our booth at Expo and then again on Days 1, 5 and 6 on the route, and also keep an eye out for our Team Archaeology

RAGBRAI Learn about the Land; Day 6, July 2010

The University of Iowa Office of the State Archaeologist and Team Archaeology are back on RAGBRAI for our third year of Archaeology on the Road, and pleased to partner this year with the IDNR: Geological and Water Survey and the U.S. Geological Survey under the theme “Human and Natural History Partners.” Archaeology on the Road brings you the unique cultural history and prehistory of Iowa on the RAGBRAI route, pointing out interesting and significant archaeological sites and sharing Iowa’s past along the way. Look for our booth at Expo and then again on Days 1, 5 and 6 on the route, and also keep an eye out for our Team Archaeology

RAGBRAI Learn about the Land; Day 7, July 2010

The University of Iowa Office of the State Archaeologist and Team Archaeology are back on RAGBRAI for our third year of Archaeology on the Road, and pleased to partner this year with the IDNR: Geological and Water Survey and the U.S. Geological Survey under the theme “Human and Natural History Partners.” Archaeology on the Road brings you the unique cultural history and prehistory of Iowa on the RAGBRAI route, pointing out interesting and significant archaeological sites and sharing Iowa’s past along the way. Look for our booth at Expo and then again on Days 1, 5 and 6 on the route, and also keep an eye out for our Team Archaeology

A clathrin-dependent pathway leads to KRas signaling on late endosomes en route to lysosomes

Ras proteins are small guanosine triphosphatases involved in the regulation of important cellular functions such as proliferation, differentiation, and apoptosis. Understanding the intracellular trafficking of Ras proteins is crucial to identify novel Ras signaling platforms. In this study, we report that epidermal growth factor triggers Kirsten Ras (KRas) translocation onto endosomal membranes (independently of calmodulin and protein kinase C phosphorylation) through a clathrin-dependent pathway. From early endosomes, KRas but not Harvey Ras or neuroblastoma Ras is sorted and transported to late endosomes (LEs) and lysosomes. Using yellow fluorescent protein¿Raf1 and the Raichu-KRas probe, we identified for the first time in vivo¿active KRas on Rab7 LEs, eliciting a signal output through Raf1. On these LEs, we also identified the p14¿MP1 scaffolding complex and activated extracellular signal-regulated kinase 1/2. Abrogation of lysosomal function leads to a sustained late endosomal mitogen-activated protein kinase signal output. Altogether, this study reveals novel aspects about KRas intracellular trafficking and signaling, shedding new light on the mechanisms controlling Ras regulation in the cell.

Iowa Smart Planning Task Force Report

In the 2010 legislative session, the General Assembly passed and the Governor signed into law Senate File 2389 (SF 2389), which provided guidance for Smart Planning in Iowa and established the Iowa Smart Planning Task Force. This Task Force was charged with recommending policies and strategies for creating a stronger planning culture in Iowa, producing more resilient and sustainable communities. The Task Force, along with its two committees and four workgroups, met throughout the summer and fall of 2010 to identify and review best practices, consult local and national experts, and craft recommendations in the best interest of Iowans. A public input process was also implemented, resulting in improved recommendations.

The use of 3D planning in facial surgery: Preliminary observations.

Three-dimensional (3D) planning is becoming a more commonly used tool in maxillofacial surgery. At first used only virtually, 3D planning now also enables the creation of useful intraoperative aids such as cutting guides, which decrease the operative difficulty. In our center, we have used 3D planning in various domains of facial surgery and have investigated the advantages of this technique. We have also addressed the difficulties associated with its use. 3D planning increases the accuracy of reconstructive surgery, decreases operating time, whilst maintaining excellent esthetic results. However, its use is restricted to osseous reconstruction at this stage and once planning has been undertaken, it cannot be reversed or altered intraoperatively. Despite the attractive nature of this new tool, its uses and practicalities must be further evaluated. In particular, cost-effectiveness, hospital stay, and patient perceived benefits must be assessed.

Supplemental Information to the August 2008 Long Term Recovery Planning Task Force Report, August 2008

Eighty-five of 99 Iowa counties were declared Presidential Disaster Areas for Public Assistance and/orIndividual Assistance as a result of the tornadoes, storms, and floods over the incident period May 25 through August 13, 2008. Response dominated the state’s attention for weeks, with a transition to recovery as the local situations warranted. The widespread damage and severity of the impact on Iowans and their communities required a statewide effort to continue moving forward despite being surrounded by adversity. By all accounts, it will require years for the state to recover from these disasters. With an eye toward the future, recovery is underway across Iowa. As part of the Rebuild Iowa efforts, the Long Term Recovery Planning Task Force was charged with responsibilities somewhat different from other topical Task Force assignments. Rather than assess damage and report on how the state might address immediate needs, the Long Term Recovery Planning Task Force is directed to discuss and discern the best approach to the lengthy recovery process. Certainly, the Governor and Lieutenant Governor expect the task to be difficult; when planning around so many critical issues and overwhelming needs, it is challenging to think to the future, rather than to rise to the current day’s needs.