Adaptability of urban grids : patterns of morphological change and persistence in Midtown Manhattan, 1884-2011

Urban grid, as an open framework and an adaptable form of spatial organisation, has a capacity to produce infinite complexity and variety through time. This research is about the morphological conditions that affect the generative capacity of urban grids. Arguing that there could be distinctive morphological settings and conditions that may hinder or facilitate further adaptation and change, the research aims to develop an analytical framework to identify possible morphological variables affecting the patterns of change and persistence in the built environment. The study focuses on the Midtown Manhattan, the central part of Manhattan's extensive grid, and traces the morphological changes and continuities between 1884 and 2011 by relying on a comprehensive spatial database. The longitudinal analysis of the site reveals that different characteristic areas in the grid (in terms of plot compositions, syntactic values of the streets, diversity of land uses) show different patterns of change and levels of adaptation to emerging disturbances through time. Identification of the reliable morphological parameters explaining the capacity of spatial change and persistence will contribute to the emerging discussions on the resilience and adaptability of urban form

Interventions to increase patient safety in long-term care facilities - umbrella review

Introduction: Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities. Method: A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2. Results: Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system. Conclusions: Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff