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Past and the projected future climate change in Afghanistan has been analyzed systematically and differentiated with respect to its different climate regions to gain some first quantitative insights into Afghanistan’s vulnerability to ongoing and future climate changes. For this purpose, temperature, precipitation and five additional climate indices for extremes and agriculture assessments (heavy precipitation; spring precipitation; growing season length (GSL), the Heat Wave Magnitude Index (HWMI); and the Standardized Precipitation Evapotranspiration Index (SPEI)) from the reanalysis data were examined for their consistency to identify changes in the past (data since 1950). For future changes (up to the year 2100), the same parameters were extracted from an ensemble of 12 downscaled regional climate models (RCM) of the Coordinated Regional Climate Downscaling Experiment (CORDEX)-South Asia simulations for low and high emission scenarios (Representative Concentration Pathways 4.5 and 8.5). In the past, the climatic changes were mainly characterized by a mean temperature increase above global level of 1.8 °C from 1950 to 2010; uncertainty with regard to reanalyzed rainfall data limited a thorough analysis of past changes. Climate models projected the temperature trend to accelerate in the future, depending strongly on the global carbon emissions (2006–2050 Representative Concentration Pathways 4.5/8.5: 1.7/2.3 °C; 2006–2099: 2.7/6.4 °C, respectively). Despite the high uncertainty with regard to precipitation projections, it became apparent that the increasing evapotranspiration is likely to exacerbate Afghanistan’s already existing water stress, including a very strong increase of frequency and magnitude of heat waves. Overall, the results show that in addition to the already extensive deficiency in adaptation to current climate conditions, the situation will be aggravated in the future, particularly in regard to water management and agriculture. Thus, the results of this study underline the importance of adequate adaptation to climate change in Afghanistan. This is even truer taking into account that GSL is projected to increase substantially by around 20 days on average until 2050, which might open the opportunity for extended agricultural husbandry or even additional harvests when water resources are properly managed.

Objective: To describe development, implementation, and evaluation of an evidence-based online critical care nursing education program to upskill a registered nurse workforce in response to Coronavirus disease 2019 (COVID-19) pandemic. Background: As Australian federal, and state governments prepared for the possible influx of critically ill patients associated with COVID-19, initiatives were sought to assist frontline healthcare workers meet the complex care requirements of these patients. Study design and methods: A team of experienced acute and critical care nursing, medical practitioners, and education specialists, online and mobile learning specialists, and front-line workers were assembled. This team developed 10 online educational modules for rapid delivery and upskilling of registered nurses in Victoria, Australia. Nurses undertaking these modules were invited to complete a satisfaction survey. Survey questions were answered in Likert style or free text. Quantitative data were summarised descriptively, whilst freeform answers were explored for themes. Results: An online Critical Care Essentials course was launched in May 2020. In its first month 2,875 students had accessed this course. Course evaluation (n = 395 students) found over 92% responded favourably (Strongly Agree or Agree) to all 14 Likert style questions. Qualitative course feedback revealed four core themes: applicability, accessibility, engagement, and endorsement. Discussion: This innovative project demonstrated how a university department of nursing collaborated with government and industry partners to rapidly respond to develop and implement an online educational program. This program was immediately responsive to local, national, and international urgency. Obtained student feedback was overwhelmingly positive. However, future areas for development and evaluation are presented. Conclusion: An inter-professional and interorganisational model is proposed for the development and implementation of future online programs. This focused online flexible learning, specific to care of critically unwell people with COVID-19, provides an approach to rapid upskilling of registered nurses. This approach appears favourably to its intended target audience. Furthermore, this program could be adapted for a national or international community. What is already known about the topic? - Globally, Coronavirus disease 2019 quickly overran advanced healthcare systems with vast numbers of critically ill patients requiring specialist care. - To address surging critical care numbers, healthcare staff require increased knowledge to care for higher acuity patients. - Online educational packages can be one element of fulfilling healthcare staff training needs. What this paper adds: - Description of development, implementation, and evaluation of a novel evidence-based online critical care nursing education program. - Evidence of how an online education can be made accessible to frontline healthcare workers to support the demand for a scalable resource that is responsive to emergent global health pandemic. - Using a tripartite model for knowledge translation is one potential approach for the future responses to urgent educative program development.

Societal Impact Statement The production and availability of food underpins societal stability. In Afghanistan, wheat is the major arable agricultural crop and source of dietary energy. The withdrawal of NATO allies and partner countries from Afghanistan presents numerous well‐documented societal and political challenges and has impacts on immediate and longer‐term food security. Conflict‐impacted irrigation infrastructure coupled with growing climate instability have also contributed markedly to reductions in current food, and specifically wheat, production. Here, we review the status of Afghan wheat improvement and propose a research agenda to support the regeneration of Afghanistan's wheat and agricultural sector. Summary Afghanistan is a country with diverse natural ecologies in a largely arid and mountainous region. The rural sector is still considered to drive economic potential. Current social, political and economic instability along with climatic challenges are driving food and water insecurity in the wider region. In the short term, it is likely that this and the associated challenges of displacement and unemployment can only be addressed by humanitarian intervention and agrifood and nutrition support. In the medium to long term, drought, and heat, probably linked to climate change, will pose recurrent challenges for agriculture and food security that will require a much broader set of interventions to secure the rural population's livelihoods. The genetic gap, among other major challenges, must be addressed if Afghanistan is to develop its agricultural potential leading to income and livelihood improvements for farmers and stable and accessible supplies for consumers. Only thereby will the country be enabled to reap the important and long‐sought trade and food security benefits derived from self‐sufficiency. Here, we highlight the agricultural challenges facing Afghanistan and propose forward strategies for ensuring the future stability of wheat production, the cornerstone of Afghan agriculture. The production and availability of food underpins societal stability. In Afghanistan, wheat is the major arable agricultural crop and source of dietary energy. The withdrawal of NATO allies and partner countries from Afghanistan presents numerous well‐documented societal and political challenges and has impacts on immediate and longer‐term food security. Conflict‐impacted irrigation infrastructure coupled with growing climate instability have also contributed markedly to reductions in current food, and specifically wheat, production. Here, we review the status of Afghan wheat improvement and propose a research agenda to support the regeneration of Afghanistan's wheat and agricultural sector.

Introduction Population health initiatives rely on the availability and skills of an appropriate workforce to meet required goals. One global workforce initiative with demonstrated ability to expand health care services and improve access to care is the development of Advanced Nursing Practice and Advanced Practice Nursing roles. Given the sparse published information about these roles in Low and Lower‐Middle‐Income countries, this study seeks to describe their development and application in these countries. Design The researchers developed a descriptive cross‐sectional multilingual survey for online distribution to nursing experts within the targeted countries. Survey questions addressed demographic information on the population served, Advanced Nursing Practice and Advanced Practice Nursing titles, the time frame and rationale for creating the title, and how the roles relate to the International Council of Nurses' Advanced Practice Nursing guidelines characteristics of education, practice, and regulation. Results Of the 167 responses received, only 24 participants met the inclusion criteria. This represented five low‐income countries and nineteen lower‐middle‐income countries from four World Bank regions. Seventy‐one roles were identified. Roles emerged predominantly over the last 20 years, focusing on care for underserved populations, with an almost even spread across primary and acute care settings. There were differences in education, practice, and regulation amongst the roles. Roles that required a master's education or higher with practice‐related characteristics had a broader scope of practice, which is consistent with international guidelines. Conclusion This paper describes how Advanced Nursing Practice and Advanced Practice Nursing roles from Low and Lower Middle‐Income Countries have been implemented to address gaps in service and highlights disparities in education, practice and regulation compared to international guidelines. Maintaining and increasing support from organizations and universities internationally may be required to assist in developing and expanding educational programs for advanced nursing roles in these countries. Clinical Relevance Understanding how these advanced nursing roles are operationalized in relation to education, practice, and regulation in Low and Lower‐Middle‐Income countries can provide baseline information that will inform workforce development policies to address healthcare needs in similar jurisdictions.

Objective: This paper aims to examine how the role of nurse practitioner was implemented within a public hospital Department of Neurosurgery carpal tunnel syndrome clinic. Setting: Tertiary referral centre outpatient clinic. Findings: The paper informs practice describing the process of developing, implementing and the requirements to become a nurse practitioner role within a public hospital's Department of Neurosurgery within Australia. Conclusions: The introduction of a nurse practitioner role within the Department of Neurosurgery has resulted in more timely access and cost effective care for patients referred to this specialised service. Opportunities to further expand this and similar roles in the future should be considered as demand increases.

Knowledge of the tensile Young's modulus of concrete at early ages is important for estimating the risk of cracking due to restrained shrinkage and thermal contraction. However, most often, the tensile modulus is considered equal to the compressive modulus and is estimated empirically based on the measurements of compressive strength. To evaluate the validity of this approach, the tensile Young's moduli of 6 concrete and mortar mixtures are measured using a direct tension test. The results show that the tensile moduli are approximately 1.0–1.3-times larger than the compressive moduli within the material's first week of age. To enable a direct estimation of the tensile modulus of concrete, a simple three-phase composite model is developed based on random distributions of coarse aggregate, mortar, and air void phases. The model predictions show good agreement with experimental measurements of tensile modulus at early age.

Objective: To assess the decision making process of nursing undergraduates when choosing a graduate nurse year program and to explore whether clinical school experience affects the decision making process. Design: A descriptive exploratory survey was distributed to all nursing graduates (n=166) from one cohort (single year) three months after completion of their course at a metropolitan university in Victoria, Australia. This cohort of students attended either of two metropolitan clinical schools and approximately 37.9% returned (n=62) the survey within 2 months of initial mail out. Responses from this cohort were assessed in relation to how preferences were ranked in choosing a GNY program. Setting: The setting was a metropolitan university and two metropolitan clinical schools of nursing in Victoria, Australia. Subjects: Nursing graduates (166 with 62 participating). Results: Data from respondents indicated that the overall experience at the clinical schools was positive with 59.7% (n=37) stating it was very good and another 35.5% (n=22) stating it was good. The majority of respondents (82.3% n=51) received their first preference however only 22.5% (n=14) chose to return to their original clinical school for their graduate nurse year program. Reasons for not returning to their clinical school included: nursing specialisation, support, rotations offered, past clinical experience, and ongoing career prospects. Conclusion: The high percentage of respondents receiving their first preference for GNY programs suggests the clinical school model for undergraduate nursing students is highly valued by hospitals and health care networks. In addition, undergraduate nursing students are choosing which GNY will best suit their present and future career needs, regardless of past (positive) experience in a clinical school. Choice of GNY is strongly associated with past clinical experience and nursing specialisation offered. This is of value to health care institutions or hospitals when developing or promoting their GNY program or undergraduate study programs to potential employees or students.

In 2015, the United Nations created 17 Sustainable Development Goals. Sustainable Development Goal 3, “Good Health and Wellbeing,” includes 13 health target metric goals. This short report describes how advanced practice nurses (APNs) have addressed Goal 3 around the world. Given the variation in the APN roles internationally, it is important to capture common aspects of projects conducted during the first 5 years of this initiative. This report serves as a template for further evaluations of the importance of APNs in supporting global health policies. These findings inform how the workforce can effectively pursue these goals. •Advanced practice nurses (APNs) globally are addressing most of the United Nation’s (UN’s) Sustainable Development Goal 3 (SDG3) targets.•This review highlights where and how APNs are practicing in a wide variety of contexts with exceptional outcomes globally.•Work needs to be done to ensure APNs make further contributions beyond clinical practice to meet all UN SDG 3 targets.

This article explores the applicability of the Doctor of Nursing Practice degree from the Australian nurse practitioner (NP) perspective. NPs have been endorsed to practice in Australia for more than 13 years in many diverse roles requiring education beyond that of the current master's level. However, there is little formal university training beyond this level. Current regulatory requirements, clinical practice settings, and the small number of NPs practicing do not provide the impetus to expand NP education requirements at this time.

The nurse practitioner (NP) workforce in Australia plays a vital role in helping the country meet the current demand for health care. Data from Australian NPs using the Nurse Practitioner Primary Care Organizational Climate Questionnaire demonstrated that one-seventh of the overall Australian NP population completed the study. The response was overwhelmingly positive in the area of practice; 71.6% of NPs had no restriction on their practice and felt valued by their organization. The results of this study enable a benchmark for ongoing national evaluations in addition to international comparative data.