A new high spatial density temperature dataset in the Grenoble alpine valley (France) for urban heat island investigation and climate services dedicated to municipalities purposes.

Within the study of the urban heat island (UHI) in Echirolles and Grenoble (France, the eastern part of the alpine arc), two temperature measurement networks have been deployed. The aim is to measure the temperature gradients associated with the UHI in summer. A total of 62 measurement points has been installed in the various neighborhoods on 3-meter-high streetlights, starting in summer 2019. The preliminary classification of the different neighborhood typologies according to ``Local Climate Zone'' guided the choice of location for the temperature sensors. These urban observations respond to a dual challenge: firstly, to observe temperature located in complex topographical situations with valleys, and secondly, to observe the urban climate in neighborhoods where social considerations are important. Municipalities of Echirolles and Grenoble were involved in the investigation. The ADEME-funded (The French Agency for Ecological Transition) CASSANDRE research program analyzes and processes these observations to study the vulnerability of inhabitants to heat waves and more generally to summer heat stress.

A Focus on Relapsed Multiple Myeloma.

Multiple myeloma (MM) is a relapsing disease for many patients with multiple myeloma. At relapse, patients have many options for treatment once disease has progressed. Advanced practitioners are well suited to set expectations for ongoing therapy and underscore the importance of continued disease monitoring. Criteria for relapsed myeloma rely on biomarker and radiologic imaging, as well as physical exam and awareness of new bone pain or changes in physiologic function. The treatment of patients with relapsed MM requires a personalized approach and considers patient desires in regard to aggressiveness of therapy and willingness to participate in a clinical trial. The prognosis of patients with relapsed MM depends upon disease characteristics at baseline or throughout, as patients may acquire adverse cytogenetic abnormalities through various lines of treatment. Empowering patients to understand their diagnosis, interpret labs, and take an active role in treatment selection through shared decision-making can improve patients' quality of life and enhance adherence.

A novel intervention: Implementation of a neutropenic infection-prevention bundle and audit tool in an oncology unit.

Infectious complications are a significant cause of morbidity and mortality in patients with chemotherapy-induced neutropenia. Specific infection control practices targeting this patient population are widely endorsed, but little guidance exists on how to implement and monitor compliance with these practices. At our institution, we increased compliance with infection control measures by using a bundled neutropenic precaution (NP) audit and feedback tool.

Jehovah's Witness Patients: Interventions for Successful Stem Cell Transplantation Without Blood Product Transfusions for Hematologic Malignancies.

BACKGROUND: Jehovah's Witnesses are members of a religion that prohibits them from accepting blood product transfusions. This refusal makes them a particularly compelling population in the context of hematologic malignancies and stem cell transplantation, because blood product transfusions are a mainstay of supportive treatment. OBJECTIVES: This article presents preventive and supportive measures allowing Jehovah's Witness patients the opportunity to receive a stem cell transplantation without blood product transfusions. METHODS: A literature review was done that included evidence focusing on optimizing hematopoiesis, blood loss prevention, alterations in chemotherapy regimens, and implications for nursing practice. FINDINGS: With proper preventive and supportive care measures, Jehovah's Witness patients can receive stem cell transplantations for hematologic malignancies without blood product transfusions.

Bone Health, Pain, and Mobility: Evidence-Based Recommendations for Patients With Multiple Myeloma

BACKGROUND: About 85% of patients with multiple myeloma develop bone disease. In these patients, lytic bone lesions can cause fractures, poor circulation, blood clots, pain, poor mobility, and decreased quality of life.
. OBJECTIVES: This article presents consensus statements to guide nurses in the assessment and management of bone disease, pain, and mobility in patients with multiple myeloma at varying points in their disease trajectory.
. METHODS: Members of the International Myeloma Foundation Nurse Leadership Board reviewed previously provided recommendations, current recommendations based on literature review, and evidence-based grading.
. FINDINGS: Oncology nurses play a key role in maximizing bone health, minimizing skeletal injury, maximizing pain control, and improving quality of life in patients by enhancing patient mobility and safety. Clinician assessment accompanied by effective interventions reduces patient injury and optimizes functioning in patients with multiple myeloma.

Heart and Lung Complications: Assessment and Prevention of Venous Thromboembolism and Cardiovascular Disease in Patients With Multiple Myeloma
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BACKGROUND: Venous thromboembolism (VTE) and cardiovascular (CV) disease can occur in patients with multiple myeloma. Although VTE and CV disease are separate medical conditions, they can be serious and even life-threatening.
. OBJECTIVES: The objectives of this article are to describe risk factors for cancer-associated VTE, describe the influence of CV disease on patients with multiple myeloma, and review the approaches to VTE and CV disease identification and treatment.
. METHODS: PubMed and CINAHL® databases were used to identify literature to describe VTE and CV in patients diagnosed with multiple myeloma.
. FINDINGS: When present in patients with multiple myeloma, VTE and CV disease can limit patient tolerance for myeloma treatment and, therefore, decrease therapeutic options.

Evidence-Based Guidelines for Preventing and Managing Side Effects of Multiple Myeloma.

OBJECTIVE: To review disease-related symptoms and side effects of treatment in patients with multiple myeloma (MM). DATA SOURCES: Peer-reviewed articles, research studies, and clinical guidelines. CONCLUSION: New therapies provide patients with extended survival, but in many cases this benefit is counterbalanced by an increased incidence of side effects. Preservation of organ function, while managing side effects, is essential for the care of patients with MM. IMPLICATIONS FOR NURSING PRACTICE: Disease- and treatment-related adverse events are prevalent in patients with MM. Patient, family, and health care professional education is essential to monitor and manage these side effects.

Survivorship care guidelines for patients living with multiple myeloma: consensus statements of the International Myeloma Foundation Nurse Leadership Board.

Novel therapies approved over the past decade for the management of multiple myeloma have contributed to improved overall survival in patients with newly diagnosed and relapsed disease. Nurses play a key role in educating, advocating for, and supporting patients throughout the continuum of care. Identifying potential and actual comorbid conditions associated directly with multiple myeloma and its treatment is important, as is confirming those that are patient specific so that prompt intervention can take place; therefore, the International Myeloma Foundation Nurse Leadership Board identified the most significant needs of patients diagnosed with multiple myeloma as bone health, health maintenance, mobility and safety, sexual dysfunction, and renal health. The Nurse Leadership Board then developed a survivorship care plan to assist healthcare providers and patients with multiple myeloma, their partners, and their caregivers to identify these needs.

Mobility and safety in the multiple myeloma survivor: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board.

As in many other cancers, survivorship of multiple myeloma involves handling treatment, recovery from therapeutic interventions, the effects of the disease, and ongoing therapies. Although mobility challenges vary among survivors of multiple myeloma, these patients have an increased risk of impaired mobility because of side effects of therapy and the pathology of the disease, as well as other factors (e.g., increasing age). Health maintenance increasingly is becoming a part of the cancer control continuum, and nurses have the opportunity to help survivors of multiple myeloma optimize their functional mobility and safety, thereby preserving quality of life. The purpose of these practice recommendations is to provide the healthcare professional with information on mobility, fall risk, and planned activity as an integral part of the plan of care for patients with multiple myeloma. Tools for nurses and physicians for assessing and evaluating the newly diagnosed patient, the patient undergoing treatment, and the long-term survivor of multiple myeloma will be provided.

Current diagnosis and management of multiple myeloma.

The availability of a wide variety of treatments for multiple myeloma allows healthcare providers to tailor treatments to individual patient needs, and has enabled prolonged survival of patients with the disease. Improved understanding of the disease, its treatment options, and potential side effects of therapy has provided unique opportunities for oncology nurses to employ preventive approaches, care strategies, and patient and family education and support over time. Because therapies have been developed that prolong the survival time, people with multiple myeloma are in the position of living with the disease for many years. Additional challenges are presented as healthcare providers develop wellness and quality of life plans of care in the setting of multiple myeloma survivorship. This article will explore the diagnosis, treatment planning, and clinical management of patients with multiple myeloma.

Hematopoietic stem cell transplantation nursing: a practice variation study.

PURPOSE/OBJECTIVES: To examine practice variation in hematopoietic stem cell transplantation (HSCT) nursing and to identify the gap between recommended standards of practice and actual practice across settings. Additional practices relevant to HSCT nursing also were explored. RESEARCH APPROACH: Cross-sectional, descriptive survey. SETTING: National and international cancer centers. PARTICIPANTS: A convenience sample was obtained from the 2006 Oncology Nursing Society Blood and Marrow Stem Cell Transplant Special Interest Group membership list (N = 205). Most participants were women (94%) with a median age of 45 years. The primary role was bedside nurse (46%), with an adult-only population (78%) in an academic (84%), inpatient (68%-88%) center. 39 (94%) U.S. states and 7 (6%) non-U.S. countries were represented. METHODOLOGIC APPROACH: Survey development was guided by Dillman Mail and Internet survey design. Electronic questionnaires were conducted with Zoomerang Market Tools. MAIN RESEARCH VARIABLES: Infection control practices across bone marrow transplantation settings. FINDINGS: Descriptive statistics revealed minimal practice variation regarding infection control across transplantation types or conditioning regimens. Practices regarding implementation of restrictions on patients' hygiene, diet, and social interactions varied by phase of transplantation, with the greatest variations occurring during the post-transplantation phase. Sixty-two percent of respondents reported using published guidelines; 72% reported using organization-specific policies. CONCLUSIONS: Although published standards are under consideration, practice variation exists across transplantation centers. Whether the variation is caused by a lack of compliance with published guidelines or by the poor delineation of details for providers to translate the guidelines into practice is not known. INTERPRETATION: Identifying gaps in the literature and inconsistencies in HSCT practices is an important first step in designing evidence-based projects that can be used to standardize practice and link best practices to improved patient outcomes.

Management of side effects of novel therapies for multiple myeloma: consensus statements developed by the International Myeloma Foundation's Nurse Leadership Board.

Nurses play an essential role in managing the care of patients with multiple myeloma, who require education and support to receive and adhere to optimal therapy. The International Myeloma Foundation created a Nurse Leadership Board comprised of oncology nurses from leading cancer centers and community practices. An assessment survey identified the need for specific recommendations for managing key side effects of novel antimyeloma agents. Myelosuppression, thromboembolic events, peripheral neuropathy, steroid toxicities, and gastrointestinal side effects were selected for the first consensus statements. The board developed recommendations for healthcare providers in any medical setting, including grading of side-effect toxicity and strategies for managing the side effects in general, with specific recommendations pertaining to the novel agents.

Thromboembolic events associated with novel therapies in patients with multiple myeloma: consensus statement of the IMF Nurse Leadership Board.

Patients with myeloma are at risk for serious and life-threatening thromboembolic events because of their disease, individual risk factors, and antimyeloma or other medications. The International Myeloma Foundation's Nurse Leadership Board developed this consensus statement for assessment and prevention of thromboembolic events. Prophylactic measures are categorized as mechanical, regimen related, and antithrombotic drug, based on individual and myeloma-related risk factors. Aspirin is suggested for patients with no or one risk factor, low-molecular-weight heparin or full-dose warfarin for patients with two or more risk factors, and low-molecular-weight heparin or full-dose warfarin for all patients with therapy-related risks, including high-dose dexamethasone, doxorubicin, or multiagent chemotherapy.