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Initiation of the VAP bundle is associated with a significantly reduced incidence of VAP in patients in the SICU and with cost savings. Initiation of a VAP bundle protocol is an effective method for VAP reduction when compliance is maintained.

Poverty is widely understood to be a key factor that increases the propensity for individuals and households to be harmed by climatic shocks and stresses. This review explores recent literature at the nexus of climate change impacts, vulnerability, and poverty. Within this literature, poverty is increasingly recognized as a dynamic and multidimensional condition that is shaped by the interplay of social, economic, political, and environmental processes, individual and community characteristics, and historical circumstances. While climate change is never seen as a sole cause of poverty, research has identified numerous direct and indirect channels through which climatic variability and change may exacerbate poverty, particularly in less developed countries and regions. Recent studies have also investigated the effects of climate change on economic growth and poverty levels, formation of poverty traps, and poverty alleviation efforts. These studies demonstrate that climate change‐poverty linkages are complex, multifaceted, and context‐specific. Priority issues for future work include greater attention to factors that promote resilience of poor populations, a stronger focus on nonmonetary dimensions of poverty, investigation of the impacts of climate change on relative poverty and inequality, and exploration of the poverty impacts of extreme climate change. This article is categorized under: Climate Economics > Economics and Climate Change Climate and Development > Social Justice and the Politics of Development

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This paper examines how double exposure to economic and environmental stressors – and the interaction between the two – affect smallholder farmers in Mozambique's Limpopo River Basin. Studying two case study villages we find that people, in general, are resilient to environmental stressors. However, most households show less resilience to the socioeconomic stressors and shocks that have been introduced or intensified by economic globalisation. Our findings indicate that economic change brought about by structural adjustment policies pressures rural people to alter their approach to farming, which makes it more difficult for them to respond to environmental change. For example, smallholder farmers find it difficult to make a transition to commercial farming within the Limpopo Basin, in part because farming techniques that are well adapted to managing environmental variability in the region – such as seeding many small plots – are not well suited to the economies of scale needed for profitable commercial agriculture. People use a variety of strategies to cope with interactive environmental and economic stressors and shocks, but many face considerable constraints to profitably exploiting market‐based opportunities. We conclude that economic stressors and shocks may now be causing small‐scale agriculture to be less well adapted to ecological and climate variability, making smallholders more vulnerable to future climate change. Some local level policy interventions, including those that support and build on local environmental knowledge, could assist rural agricultural societies in adapting to future environmental change in the context of economic globalisation.