Summary of Workshop Large Outdoor Fires and the Built Environment.

Large outdoor fires present a risk to the built environment. Wildfires that spread into communities, referred to as Wildland-Urban Interface (WUI) fires, have destroyed communities throughout the world, and are an emerging problem in fire safety science. Other examples are large urban fires including those that have occurred after earthquakes. Research into large outdoor fires, and how to potentially mitigate the loss of structures in such fires, lags other areas of fire safety science research. At the same time, common characteristics between fire spread in WUI fires and urban fires have not been fully exploited. In this paper, an overview of the large outdoor fire risk to the built environment from each region is presented. Critical research needs for this problem in the context offire safety science are provided. The present paper seeks to develop the foundation for an international research needs roadmap to reduce the risk of large outdoor fires to the built environment.

Role of buoyant flame dynamics in wildfire spread.

Large wildfires of increasing frequency and severity threaten local populations and natural resources and contribute carbon emissions into the earth-climate system. Although wildfires have been researched and modeled for decades, no verifiable physical theory of spread is available to form the basis for the precise predictions needed to manage fires more effectively and reduce their environmental, economic, ecological, and climate impacts. Here, we report new experiments conducted at multiple scales that appear to reveal how wildfire spread derives from the tight coupling between flame dynamics induced by buoyancy and fine-particle response to convection. Convective cooling of the fine-sized fuel particles in wildland vegetation is observed to efficiently offset heating by thermal radiation until convective heating by contact with flames and hot gasses occurs. The structure and intermittency of flames that ignite fuel particles were found to correlate with instabilities induced by the strong buoyancy of the flame zone itself. Discovery that ignition in wildfires is critically dependent on nonsteady flame convection governed by buoyant and inertial interaction advances both theory and the physical basis for practical modeling.

Medication adherence after heart transplantation: adolescents and their issues.

CONTEXT: Medication nonadherence among adolescent heart transplant recipients can have overwhelming negative consequences including rejection and mortality. Because of issues specific to adolescents such as peer pressure, risk taking, independence, self-image, and self-esteem, they are a population susceptible to nonadherence. Adherence may be associated with a supportive environment, fewer physical and cosmetic side effects, and a sufficient knowledge of therapies. Adherence also may be related to regimens with fewer medications, predominantly fewer immunosuppressive drugs. OBJECTIVE: To examine the differences in motivation between adolescents who are more adherent and those who are less adherent to their medication regimen following transplant surgery. DESIGN: A descriptive design and mixed methodology, including a modified written survey, the Frazier Noncompliance Inventory; a self-report measure of overall medication adherence; and an interview designed by the investigator. Interview questions were reviewed for content validity by nurse clinicians and researchers. SETTING: A heart transplant follow-up clinic in the southeastern United States. RESULTS: Findings for 2 participants revealed striking contrasts in adolescent issues and factors affecting adherence. These findings are presented in a case comparison. Data show that a supportive environment and knowledge of medications were significant in increasing self-responsibility and adherence in adolescent transplant recipients. Also, experiencing rejection early in treatment because of less adherence led to increased adherence for fear of further rejections or death.

"She took the time to make sure she understood": mental health patients' experiences of being understood.

The foundation of psychiatric/mental health nursing is the relationship between nurse and patient. Caring for persons with mental illness within the context of this relationship requires knowledge of the individual. To gain this knowledge, understanding the patient's perceptions and concerns is essential. Research suggests that this understanding does not always occur. The study reported here examined what it means to individuals with mental illness to be understood. In-depth phenomenological interviews revealed three predominant themes: "I was important," "it really made us connect," and "they got on my level." Nurses can use these findings to improve the care of those with mental illness.