Implementation and Evaluation of a Healthcare System's Approach to Surge Staffing and Training.

In response to the coronavirus pandemic, a multihospital healthcare system expanded its nursing resources to accommodate the anticipated and actual surge of patients infected with COVID-19. Nursing professional development practitioners rapidly implemented and evaluated a novel, structured orientation and training program to provide additional surge staffing. Transitioning to a team-based model using the new role of nurse extender ensured the continued deployment of safe, person-centered care. Evaluation strategies enabled iterative improvements to the program.

Opportunities and Challenges for Investigating the Environment-Migration Nexus.

Environmental change is an acknowledged factor influencing human migration. Analytical research regarding the relationship between the environment and human migration has increased in recent years yet still faces numerous hurdles, partly due to limited availability of suitable data. We review available data and methodologies for investigating the environment-migration nexus, identifying data inconsistencies resulting from the combination of different sources and illustrating the underlying reasons for them. We discuss a number of methods for investigating the environment-migration relationship, including frameworks and concepts; surveys; empirical, quantitative methods; and simulation approaches. Based on this overview, we offer recommendations for improved analyses of the environment-migration nexus including reporting data inconsistencies and uncertainties, combining approaches and data sources, and developing multiple-study approaches.

Multisectoral climate impact hotspots in a warming world.

The impacts of global climate change on different aspects of humanity's diverse life-support systems are complex and often difficult to predict. To facilitate policy decisions on mitigation and adaptation strategies, it is necessary to understand, quantify, and synthesize these climate-change impacts, taking into account their uncertainties. Crucial to these decisions is an understanding of how impacts in different sectors overlap, as overlapping impacts increase exposure, lead to interactions of impacts, and are likely to raise adaptation pressure. As a first step we develop herein a framework to study coinciding impacts and identify regional exposure hotspots. This framework can then be used as a starting point for regional case studies on vulnerability and multifaceted adaptation strategies. We consider impacts related to water, agriculture, ecosystems, and malaria at different levels of global warming. Multisectoral overlap starts to be seen robustly at a mean global warming of 3 °C above the 1980-2010 mean, with 11% of the world population subject to severe impacts in at least two of the four impact sectors at 4 °C. Despite these general conclusions, we find that uncertainty arising from the impact models is considerable, and larger than that from the climate models. In a low probability-high impact worst-case assessment, almost the whole inhabited world is at risk for multisectoral pressures. Hence, there is a pressing need for an increased research effort to develop a more comprehensive understanding of impacts, as well as for the development of policy measures under existing uncertainty.

Assessing agricultural risks of climate change in the 21st century in a global gridded crop model intercomparison.

Here we present the results from an intercomparison of multiple global gridded crop models (GGCMs) within the framework of the Agricultural Model Intercomparison and Improvement Project and the Inter-Sectoral Impacts Model Intercomparison Project. Results indicate strong negative effects of climate change, especially at higher levels of warming and at low latitudes; models that include explicit nitrogen stress project more severe impacts. Across seven GGCMs, five global climate models, and four representative concentration pathways, model agreement on direction of yield changes is found in many major agricultural regions at both low and high latitudes; however, reducing uncertainty in sign of response in mid-latitude regions remains a challenge. Uncertainties related to the representation of carbon dioxide, nitrogen, and high temperature effects demonstrated here show that further research is urgently needed to better understand effects of climate change on agricultural production and to devise targeted adaptation strategies.