Concept: Project management
Given the magnitude of increasing heart failure mortality, multidisciplinary approaches, in the form of disease management programs and other integrative models of care, are recommended to optimize treatment outcomes. Remote monitoring, either as structured telephone support or telemonitoring or a combination of both, is fast becoming an integral part of many disease management programs. However, studies reporting on the evaluation of real-world heart failure remote monitoring programs are scarce.
Increasing numbers of homes are being destroyed by wildfire in the wildland-urban interface. With projections of climate change and housing growth potentially exacerbating the threat of wildfire to homes and property, effective fire-risk reduction alternatives are needed as part of a comprehensive fire management plan. Land use planning represents a shift in traditional thinking from trying to eliminate wildfires, or even increasing resilience to them, toward avoiding exposure to them through the informed placement of new residential structures. For land use planning to be effective, it needs to be based on solid understanding of where and how to locate and arrange new homes. We simulated three scenarios of future residential development and projected landscape-level wildfire risk to residential structures in a rapidly urbanizing, fire-prone region in southern California. We based all future development on an econometric subdivision model, but we varied the emphasis of subdivision decision-making based on three broad and common growth types: infill, expansion, and leapfrog. Simulation results showed that decision-making based on these growth types, when applied locally for subdivision of individual parcels, produced substantial landscape-level differences in pattern, location, and extent of development. These differences in development, in turn, affected the area and proportion of structures at risk from burning in wildfires. Scenarios with lower housing density and larger numbers of small, isolated clusters of development, i.e., resulting from leapfrog development, were generally predicted to have the highest predicted fire risk to the largest proportion of structures in the study area, and infill development was predicted to have the lowest risk. These results suggest that land use planning should be considered an important component to fire risk management and that consistently applied policies based on residential pattern may provide substantial benefits for future risk reduction.
Climate change is expected to decrease heating demand and increase cooling demand for buildings and affect outdoor thermal comfort. Here, we project changes in residential heating degree-days (HDD) and cooling degree-days (CDD) for the historical (1981-2010) and future (2080-2099) periods in the United States using median results from the Climate Model Intercomparison Project phase 5 (CMIP5) simulations under the Representation Concentration Pathway 8.5 (RCP8.5) scenario. We project future HDD and CDD values by adding CMIP5 projected changes to values based on historical observations of US climate. The sum HDD + CDD is an indicator of locations that are thermally comfortable, with low heating and cooling demand. By the end of the century, station median HDD + CDD will be reduced in the contiguous US, decreasing in the North and increasing in the South. Under the unmitigated RCP8.5 scenario, by the end of this century, in terms of HDD and CDD values considered separately, future New York, NY, is anticipated to become more like present Oklahoma City, OK; Denver, CO, becomes more like Raleigh, NC, and Seattle, WA, becomes more like San Jose, CA. These results serve as an indicator of projected climate change and can help inform decision-making.
To examine the volume, relevance and quality of transnational tobacco corporations' (TTCs) evidence that standardised packaging of tobacco products ‘won’t work’, following the UK government’s decision to ‘wait and see’ until further evidence is available.
Research increasingly means that patients, caregivers, health professionals, other stakeholders, and academic investigators work in partnership. This requires effective collaboration rooted in mutual respect, involvement of all participants, and good communication. Having conducted such partnered research over multiple projects, and having recently completed a project together funded by the Patient-Centered Outcomes Research Institute, we collaboratively developed a list of 12 lessons we have learned about how to ensure effective research partnerships. To foster a culture of mutual respect, hold early in-person meetings, with introductions focused on motivation, offer appropriate orientation for everyone, and maintain awareness of individual and project goals. To actively involve all team members, it is important to ensure sufficient funding for everyone’s participation, to ask for and recognize diverse contributions, and to seek the input of quiet members. To facilitate good communication, teams should carefully consider labels, avoid jargon and acronyms, judiciously use homogeneous and heterogeneous subgroups, and keep progress visible. In offering pragmatic, actionable lessons we have learned through our separate and shared experiences, we hope to help foster more patient-centered research via productive and enjoyable research collaborations.
Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients.
Acute mesenteric ischemia (AMI) is an emergency with a high mortality rate; survivors have high rates of intestinal failure. We performed a prospective study to assess a multidisciplinary and multimodal management approach, focused on intestinal viability.
This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author explores personal resilience as an important individual characteristic that affects team functioning and thus organizational adaptability to change. The important role of resilience in strategic leadership for change is presented along with suggestions for evaluating and developing resilience.
The goal of this study was to determine whether aortic pulse wave velocity (aPWV) improves prediction of cardiovascular disease (CVD) events beyond conventional risk factors.
This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author introduces the book Lean In and presents applicable lessons for nursing leadership career development.