Thinking Outside the Box: Treating Acute Heart Failure Outside the Hospital to Improve Care and Reduce Admissions.

The management of acute heart failure is shifting toward treatment approaches outside of a traditional hospital setting. Many heart failure providers are now treating patients in less familiar health care settings, such as acute care clinics, emergency departments, and skilled nursing facilities. In this review we describe the current pressures driving change in the delivery of acute heart failure and summarize the evidence regarding treatments for acute heart failure outside of the inpatient setting. We also provide considerations for the design of future treatment strategies to be implemented in alternative care settings.

Infused: Millennials and the Future of the Black Church

Deep societal trends impact the religious fervency and participation of millennials in the Black Church. Many young adults, though remaining Christian, have fallen away from their faith communities, finding them irrelevant for their daily lives. Even the most religiously committed have shown signs of waning faith, as evidenced by limited participation, and theological and ideological dissonance with the Black Church. Historically strong across all indicators, the Black Church is ideally positioned to stave off the attrition of youth and young adults, having a missional mindset toward this cohort—prioritizing them in their ministry development and programming. African American congregational leaders must develop disciples who have cohesive identities, live integrated lives, and experience an infusion of their personal vocation and the mission of the Church. Thus the future of the Black Church depends on the development of millennials who have an integrated faith life, which is distinguishable by its practices, disciplines, and virtues that are nurtured by an understanding of the Church’s mission and their role in it. Key will be establishing mentoring relationships that allow for questioning, exploration and discovery. To enact the changes necessary the church must understand the cultural worlds of young adults and engage them in holistic ministry that is reflective of the mission of God through Christ (missio dei)—activity that culminates with reaching the world with God’s redemptive plan for humanity.