Gender, Sexual Orientation, Ethnicity and Socioeconomic Factors Influence How Wildland Firefighters Communicate their Work Experiences

As Climates Change, Natural Resource Professionals Are Often Working on the Frontlines of Intensifying Environmental Disasters, Acting in Both Scientific and Emergency Response Roles. One Subset of This Group, Wildland Firefighters Often Engage in Multifaceted Careers that Incorporate Elements of Resource Planning, Conservation Management, Community Disaster Relief, and Operational Management. Despite These STEM Roles and Nearly Half (48%) of Them Having Earned at Least a bachelor\u27s degree, usually in a STEM Field, Wildland Firefighters Are Almost Exclusively Lumped with Emergency Responders in the Scientific Literature. We Surveyed 708 Wildland Firefighters with 9 Open Response Questions as Part of a Larger Survey Asking About Experiences and Attitudes in the United States Federal Workplace. from their Responses and Voluntarily Provided Demographic Data, We Extracted Information About Response Length, Use of Hedges, Tag Questions and Imperatives, Use of Personal Language, Use of Expletives and Derogatory Language, Use of Apologetic Language, and the Types of Responses Provided. We Then Analyzed Whether Certain Demographic and Socioeconomic Factors Were Statistical Predictors of Language Use in Wildland Firefighter Survey Responses with the Goal of Ultimately Providing a Framework for Differentiating and Identifying Factors that May Influence Employee Retention, Attitudes, Morale, and Experiences among Wildland Firefighter Sub-Demographics. We Found that Different Demographic Groups Varied in their Responses to Questions: Minority Groups Used Fewer Words and Were More Likely to Relate Personal Experiences Than Majority Groups

Medical Oncology Professionals’ Perceptions of Telehealth Video Visits

IMPORTANCE: Telehealth has emerged as a means of improving access and reducing cost for medical oncology care; however, use by specialists prior to the coronavirus disease 2019 (COVID-19) pandemic still remained low. Medical oncology professionals’ perceptions of telehealth for cancer care are largely unknown, but are critical to telehealth utilization and expansion efforts. OBJECTIVE: To identify medical oncology health professionals’ perceptions of the barriers to and benefits of telehealth video visits. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used interviews conducted from October 30, 2019, to March 5, 2020, of medical oncology health professionals at the Thomas Jefferson University Hospital, an urban academic health system in the US with a cancer center. All medical oncology physicians, physicians assistants, and nurse practitioners at the hospital were eligible to participate. A combination of volunteer and convenience sampling was used, resulting in the participation of 29 medical oncology health professionals, including 20 physicians and 9 advanced practice professionals, in semistructured interviews. MAIN OUTCOMES AND MEASURES: Medical oncology health professionals’ perceptions of barriers to and benefits of telehealth video visits as experienced by patients receiving cancer treatment. RESULTS: Of the 29 participants, 15 (52%) were women and 22 (76%) were White, with a mean (SD) age of 48.5 (12.0) years. Respondents’ perceptions were organized using the 4 domains of the National Quality Forum framework: clinical effectiveness, patient experience, access to care, and financial impact. Respondents disagreed on the clinical effectiveness and potential limitations of the virtual physical examination, as well as on the financial impact on patients. Respondents also largely recognized the convenience and improved access to care enabled by telehealth for patients. However, many reported concern regarding the health professional–patient relationship and their limited ability to comfort patients in a virtual setting. CONCLUSIONS AND RELEVANCE: Medical oncology health professionals shared conflicting opinions regarding the barriers to and benefits of telehealth in regard to clinical effectiveness, patient experience, access to care, and financial impact. Understanding oncologists’ perceptions of telehealth elucidates potential barriers that need to be further investigated or improved for telehealth expansion and continued utilization; further research is ongoing to assess current perceptions of health professionals and patients given the rapid expansion of telehealth during the COVID-19 pandemic

Patient and provider experiences with CBT-I administered in-person or via telemedicine: A randomized non-inferiority trial

Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment in adults. However, access to care is limited. One potential solution is telemedicine. Though synchronous video-based telemedicine CBT-I has been shown to be non-inferior to in-person treatment, there is no study to date that evaluates patient and provider experiences with video-based treatment. Our study team evaluated patient and provider perceptions of CBT-I delivered via telemedicine versus an in-person format. As part of a larger randomized control trial, we interviewed patients and providers in both arms of the study (in-person and via telemedicine). 20 minute interviews were conducted over the phone and were transcribed and coded to identify themes. While patients shared initial concerns about telemedicine CBT-I, including privacy and technological issues, they were satisfied with the approach and had similar experiences as the patients receiving in-person treatment. Providers shared concerns about challenges establishing a strong therapeutic alliance, patient engagement, and accountability in CBT-I, but felt these did not interfere with their overall ability to deliver care. Patients and providers were satisfied with CBT-I treatment delivered via telemedicine when compared to those being treated in-person. Patients in both arms noted that virtual care could increase access and provide convenience

Rapid Identification of Bio-Molecules Applied for Detection of Biosecurity Agents Using Rolling Circle Amplification

Detection and identification of pathogens in environmental samples for biosecurity applications are challenging due to the strict requirements on specificity, sensitivity and time. We have developed a concept for quick, specific and sensitive pathogen identification in environmental samples. Target identification is realized by padlock- and proximity probing, and reacted probes are amplified by RCA (rolling-circle amplification). The individual RCA products are labeled by fluorescence and enumerated by an instrument, developed for sensitive and rapid digital analysis. The concept is demonstrated by identification of simili biowarfare agents for bacteria (Escherichia coli and Pantoea agglomerans) and spores (Bacillus atrophaeus) released in field

Mental Health and Traumatic Occupational Exposure in Wildland Fire Dispatchers

Wildland fire dispatchers play a key role in wildland fire management and response organization; however, to date, wildland fire studies have largely focused on the physical hazards and, to a lesser extent, mental health hazards of wildland firefighting operational personnel, and dispatcher studies have primarily focused on 911 and police dispatchers. Studies of other dispatchers have provided some limited insight into potential strains impacting this workforce, including work-related fatigue, burnout, and traumatic exposure. However, the specific job hazards that are faced by wildland fire dispatchers are poorly understood. In 2023, we conducted a cross-sectional survey of 510 wildland fire dispatchers with questions about their occupational health, general health, and well-being. We used validated screening instruments to measure the rates of anxiety, depression, PTSD, and suicidal thoughts and ideation. Here, we also present the results of mental health and trauma exposure questions that were asked as part of a larger survey. We found that demographic factors were significant indicators of anxiety, depression, and binge/restrictive eating. Our data indicate that rates of anxiety, depression, PTSD, and suicidal thoughts and ideation are significantly higher for both the wildland fire dispatching workforce and other emergency responder populations than those of the general United States population

Telehealth Use in Oncology: Provider Perspectives on Video Visits

Telehealth is increasingly used to improve healthcare access, cost, experience, and effectiveness. These public health issues are especially challenging for patients with cancer. Despite these advantages, telehealth use in oncology is uncommon nationally and provider perceptions regarding the benefits and barriers to its uptake are not well understood. We completed a qualitative study evaluating oncology providers’ perceptions of video visits at an institution with a system-wide telehealth program. We performed semi-structured interviews with oncology providers at Thomas Jefferson University (TJU) to assess current use, perceived barriers to use, and perceptions of telehealth impact on access, cost, experience, and effectiveness. All interviews were transcribed, and coded using a team-developed codebook. Intercoder reliability was assessed by the κ coefficient. Themes and subthemes emerged via directed content analysis. 29 providers (20 oncologists and 9 advanced practice providers) were interviewed, 26 of whom utilized video visits. Most viewed video visits favorably. Key perceived benefits included increased patient convenience and interactions, and the option to have multi-person visits. Patient access to technology, patient and provider comfort with video visits, provider licensing issues, and lack of physical exam capability were key perceived barriers. Providers had starkly differing opinions on the reliability of video visit technology, integration of telehealth in their work routine, administrative assistance, and effects on patient cost. Telehealth is generally viewed favorably by oncology providers within a system with widespread telehealth. There are several perceived barriers, most pertaining to logistics and knowledge limitations, which should be addressed to support increased telehealth uptake

Telehealth Use in Oncology: Patient Perspectives on Video Visits

Telehealth is used in medical oncology to increase rural access to care and clinical trials, improve hospice communication, and has recently experienced a rapid expansion due to the COVID-19 pandemic. Despite its uses, quantitative research demonstrates conflicting reports of patient satisfaction and no qualitative studies exist examining the patient acceptability of telehealth for cancer care. This study aims to investigate the patient perceptions and factors influencing telehealth acceptability for oncologic care. To accomplish this, a semi-structured interview guide was utilized to interview 20 patients who participated in a video visit with a Thomas Jefferson University Hospital medical oncology provider between October 31, 2019 and March 30, 2020. A codebook was developed using directed content analysis and applied to the interviews by one coder. Codes were organized into themes to create a conceptual model of the factors that influence patient acceptance of video visits. For the preliminary analysis, two thematic categories were identified: (1) factors influencing the initial acceptance of a video visit and (2) the acceptability of video visit use for the delivery of serious or bad news. Participants identified convenience, the COVID-19 pandemic, and the visit type as influencing the acceptability of their initial telehealth encounter. Participants were divided in the acceptability of telehealth use for the delivery of serious or bad news, with factors considered including in-person comfort and the privacy of telehealth. This study identifies factors influencing the acceptability of telehealth for cancer care, which is a critical element of telehealth’s success in increasing access to care

Comparison between confocal microscopy and the dedicated instrument for detection of RCPs.

<p>The quantitative response of the same dilution series of EC DNA was measured using the dedicated instrument as well as the confocal setup used in Jarvius <i>et al</i> 2006. Filled symbols: dedicated instrument, open symbols: Zeiss 510 Meta confocal microscope.</p

Sequences of the oligonucleotides used in the study. Underlined nucleotides are locked nucleic acids [17].

<p>Nucleotides in italic style are 2′OMe-RNA. The NRP is furthermore labeled by biotin in the 3′end.</p

Detection scheme of the bio-monitoring system.

<p>A) Collection of environmental samples is realized using the Airborne Sample Analysis Platform (ASAP) equipment. Aerosolized particulates stick to a filter, and the content is extracted and analyzed. In contrast to protein detection, detection of nucleic acids requires preparation of the filter content prior to exposure to the molecular procedures. The molecular procedures detect the target molecules using dedicated probes and reacted probes are then amplified. The amplification products are analyzed using a dedicated prototype instrument. B) The molecular procedures of DNA (left) and protein (right) detection. Detection of nucleic acids is achieved by padlock probes that are specifically circularized if correctly hybridized to the correct target in the presence of DNA ligase. Padlock and capture probes are added to the samples along with DNA ligase (5 min). Reacted padlock probes are captured on magnetic beads and excess probes are eliminated by washing (3 min). Detection of proteins is initiated by capture of the target protein using magnetic beads equipped with antibodies. The addition of a pair of PLA probes, which are antibodies with attached oligonucleotides (3 min), forms a DNA circle guided by two connector oligonucletides, and a DNA ligase (5 min). Unreacted probes are eliminated by washing the circles, and from this step the magnetic beads are treated identically in both the genetic and PLA assays. A first RCA is initiated either by an extra primer or the target itself on the beads to replicate the DNA circles (11 min). The products are then restriction digested (2 min), and the monomers are collected. The monomers can then bind head-to-tail to the excess amount of replication oligonucleotides and formed new DNA circles. The new circles are amplified and labeled with fluorescence-tagged detection probes. The ligation, amplification and labeling are performed in one reaction (8 min). The RCPs are therefore ready for analysis in the detection instrument.</p