Granite Falls Family Medical Care Center

Core Ideas Production‐scale conservation tillage systems had few effects on crop yields. Strip till had the least costs per hectare and may be more economical for farmers. Tillage affected only fungi/bacteria ratios out of 19 soil properties. Farmers’ presumed yield losses among tillage systems did not reflect actual yields. In the US upper Midwest, the narrow growing season causes many farmers to presume yield losses when reducing tillage. The purpose of this study was to determine how four production‐scale tillage systems affected residue cover, stand populations, crop yields, and soil chemical, biological, and physical properties. Tillage systems (chisel plow, fall strip‐till with shanks, spring strip‐till with coulters, and shallow vertical till) were continued for 4 yr. Tillage effects within a site were few and mixed (0.17–0.36 Mg ha−1 difference), whereas site effects were common (0.50–3.00 Mg ha−1 difference). Among 19 soil properties, only fungal/bacteria ratios differed among strip‐till with shanks (0.078) and strip‐till with coulters (0.066) at one site. Our results suggest that many farmers’ concerns about using conservation tillage practices do not necessarily translate into yield losses when compared to standard chisel plow practices. Economics and the level of erosion control among the tillage practices compared here, rather than yield alone, should guide farmer preferences.

In her new book, award-winning principal and leadership expert Cathie West provides education leaders at all levels with the tools and guidance they need to engage teachers in the process of increasing student achievement. With authentic examples and research highlights, readers learn how to develop a motivated faculty that is truly dedicated to school improvement and student success. The "Six Keys" covered in the book are both substantive and comprehensive and offer a clear path to success: Key 1: Create a Culture of Engagement Teacher engagement definition, attributes, and steps towards attainment Key 2: Get Organizationally Engaged Exemplary organization qualities, leadership styles, and effectiveness strategies Key 3: Engineer Engagement Quality meeting characteristics, engagement activities, and leadership techniques Key 4: Zero in on Best Practice Effective teaching attributes, instructional practices, and success tips Key 5: Tap into Teacher Leaders Teacher leader selection, training, and strategic deployment Key 6: Confront Change Challengers Challenger profiles, interventions, and support suggestions BONUS! Every chapter includes a wrap-up to help readers review, apply, and retain new learning for each of the six keys to teacher engagement: Key Concepts provides a bulleted summary of each theme’s major concepts to help readers review key ideas. Best Strategies summarizes each chapter’s high impact teacher engagement strategies. Steps to Success suggests activities that will move new concepts and skills into practice. NOTEWORTHY: This book is also an excellent resource for university and college instructors who are responsible for teacher and principal preparation. The 6 Keys to Teacher Engagement substantially supports graduate level courses pertaining to educational leadership, school improvement, curriculum and assessment, and professional development.

Background: In Minnesota, stroke is the cause of 2000 deaths, 12,000 hospitalizations with 1 in 3 presenting first to a rural hospital where resources for stroke care are limited. Nationally the percent of all acute ischemic stroke (AIS) patients presenting to acute care hospitals receiving IV tPA remains low with long times to treatment (4.3% and mean DTD time 79 min - GWTG data 2003-2009). This review supports the hypothesis that a stroke system utilizing telestroke with an integrated approach to the team process and quality review will increase the percentage of AIS patients treated and foster short door-to-drug times. Methods: The HealthEast Telestroke Network began in 2006, currently there are five hospitals within the system. During the implementation, team meetings occur with spoke hospital staff to collaboratively develop the stroke code process which includes a door to drug goal of 30 minutes. Components of this process include use of aggressive triage plan for ambulatory arrivals, partnering with EMS for pre-alerts, specific team member assignments and time goals, early stroke neurology involvement and leadership of the code. This integrated team approach continues into the quarterly quality review with cooperative hub and spoke meetings to address barriers and effect continuous improvement of the process. Results: Currently, our rate of all ischemic stroke discharges treated across our telestroke network hospitals is 24%. Comparisons between each of the five network hospital’s rates of all ischemic stroke treated is 17% to 34%. Mean door to drug time across the network is 58 minutes, with a range across sites of 46 to 67 minutes and sixty percent of patients receiving IV tPA within 60 minutes or less. Conclusion: Use of telestroke combined with an integrated approach to the team process and quality review resulted in a sustained high percentage of AIS patients treated with reperfusion therapies with door- to- drug times comparing favorably to nationally reported data.