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Current agroecosystem management practices in tropical latitudes may not be an economically feasible and an effective long-term adaptation strategy to climate change. As such, implementing, improving and refining sustainable land management practices may be a more effective adaptation strategy. This study determined the perception and knowledge of climate change by landowners in a remote Costa Rican agricultural community, and evaluated the type of sustainable agricultural practices currently implemented and how such practices could also serve as a climate change adaptation strategy. Based on this information, recommendations for successful adaptation applicable to other communities were also discussed. This study showed that community members observed changes in local weather patterns over the past decade, which paralleled changes in the distribution patterns of vegetation and wildlife. Results also showed that community members had a good understanding of climate change and its potential impact(s) on agricultural production. Community members were continually striving to implement long-term sustainable agroecosystem management practices to maintain productivity, integrity and agroecosystem resilience while also meeting economic and socioecological needs. For example, implementing seedbanks helped to improve the quality of crops and provided a source of seeds adapted to current climate conditions. Other adaptation strategies included agroforestry for soil and water conservation and as a source of fruits, nuts and forage for people and livestock. The use of livestock nutritional supplements to offset low-quality forage during the now more intense dry season, compared to previous dry seasons, were also used as an adaptation strategy. An affiliation with social networks to help access resources and implement sustainable agriculture and climate change adaptation strategies were essential in this community. Based on surveys with community members, this study developed a 3-stage plan for developing successful adaptation programs for application in other small agricultural communities in tropical latitudes.

Complex regional pain syndrome (CRPS) is a debilitating condition characterized by specific symptoms such as intense pain and loss of function. This syndrome can be so devastating that it affects quality of life. Often, CRPS is misdiagnosed and misunderstood, which can be extremely frustrating for patients. The purpose of the survey in this study was to query actual patients living with CRPS to gain additional knowledge and suggestions to help improve their care. Respondents expressed a variety of emotions when asked about their healthcare experiences, which suggests that healthcare providers need to be better educated about CRPS so they can provide more compassionate care for patients trying to cope with this condition.

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BACKGROUND: After a stroke, urinary dysfunction and urinary tract infection are estimated to be approximately 20%. Increased postvoid residual (PVR) is a risk factor for urinary dysfunction and urinary tract infections. These complications can negatively impact recovery weeks after the initial hospitalization. Early identification of risks and patient education are important. PROJECT DESCRIPTION: This project was initiated for those patients admitted for a diagnosis of stroke on a 55-bed neuroscience unit in an acute care hospital. Patients were scanned after the initial void post stroke. Nurses followed a specific bladder scanning algorithm for subsequent scanning if the PVR volume was greater than 100 mL. RESULTS: Seventy-eight patients were scanned in the original phase of the project, and 41 (53%) had PVR volumes greater than 100 mL after the initial void/scan. Of those, 22 patients still had a volume of greater than 100 mL after the second void/scan, and 12 had PVR volumes greater than 100 mL after a third scan. IMPLICATIONS FOR PRACTICE: Patients admitted with stroke have demonstrated increased PVR volumes. Portable ultrasound bladder scanning is a safe, noninvasive method to measure residual urinary volumes. The use of a bladder scanning algorithm encourages nurses' autonomy in assessing and identifying patients at a higher risk for urinary complications. CONCLUSION: Identifying the risk for urinary complications post stroke can lead to early interventions that can improve recovery. This also allows for specific patient education related to preventative measures to reduce risk of urinary complications. The use of a specific bladder scanning protocol is recommended as standard practice for all patients admitted with stroke.