Pain and pain management are a major focus for an orthopedic nurse. However, reliance upon opioid monotherapy creates adverse effects for patients and has contributed to the opioid epidemic across the United States. There have been strategies developed locally and nationally to address the epidemic. Nurses, too, have an ethical and moral obligation to balance the management of pain therapies to alleviate the suffering of their patients, all while being good stewards of opioid medications. Nurses must also take the time to properly educate their patients on good stewardship techniques including proper use and disposal of their opioid medications.
In this work, we estimate urban evaporative consumptive use (urban ECU) in three cities in a semiarid region experiencing water scarcity: El Paso, Texas, and Las Cruces, New Mexico, in the United States and Ciudad Juárez, Chihuahua, in Mexico. Urban ECU includes vegetation and bare soil evapotranspiration (ET) and evaporation from open water, water supply infrastructure losses, and building evaporative coolers. Three independent methods were used to estimate urban ECU from individual ECU components and from utility accounting data. The three methods produced urban ECU estimates that varied by an average of 24%. Most of the disagreement was attributed to potential overestimation of vegetation and bare soil ET. Vegetation and bare soil ET account for up to 90% of total urban ECU. Urban ECU accounts for up to 60% of total annual water demand. Per capita ECU from the U.S. cities is, on average, 149 m3/capita/year, compared with 51 m3/capita/year for Ciudad Juárez.
Reduced river flows and groundwater depletion as a result of climate change and population growth have increased the effort and difficulty accessing and processing water. In turn, residential water costs from municipal utilities are predicted to rise to unaffordable rates for poor residential water customers. Building on a regional conjunctive use model with future climate scenarios and 50-year future water supply plans, our study communicates the effects of climate change on poor people in El Paso, Texas, as water becomes more difficult and expensive to obtain in future years. Four scenarios for future water supply and future water costs were delineated based on expected impacts of climate change and groundwater depletion. Residential water use was calculated by census tract in El Paso, using basic needs indoor water use and evaporative cooling use as determinants of household water consumption. Based on household size and income data from the US Census, fraction of household income spent on water was determined. Results reveal that in the future, basic water supply will be a significant burden for 40% of all households in El Paso. Impacts are geographically concentrated in poor census tracts. Our study revealed that negative impacts from water resource depletion and increasing populations in El Paso will lead to costly and difficult water for El Paso water users. We provide an example of how to connect future resource scenarios, including those affected by climate change, to challenges of affordability for vulnerable consumers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.