_____________________________________This state-of-knowledge review about the effects of fire on flora and fuels can assist land managers with ecosystem and fire management planning and in their efforts to inform others about the ecological role of fire. Chapter topics include fire regime classification, autecological effects of fire, fire regime characteristics and postfire plant community developments in ecosystems throughout the United States and Canada, global climate change, ecological principles of fire regimes, and practical considerations for managing fire in an ecosytem context.
_____________________________________Fires affect animals mainly through effects on their habitat. Fires often cause short-term increases in wildlife foods that contribute to increases in populations of some animals. These increases are moderated by the animals' ability to thrive in the altered, often simplified, structure of the postfire environment. The extent of fire effects on animal communities generally depends on the extent of change in habitat structure and species composition caused by fire. Stand-replacement fires usually cause greater changes in the faunal communities of forests than in those of grasslands. Within forests, standreplacement fires usually alter the animal community more dramatically than understory fires. Animal species are adapted to survive the pattern of fire frequency, season, size, severity, and uniformity that characterized their habitat in presettlement times. When fire frequency increases or decreases substantially or fire severity changes from presettlement patterns, habitat for many animal species declines.
Background
Delays in postoperative radiotherapy (PORT) for head and neck cancer (HNC) increase the risk for recurrence and mortality. The multifactorial nature of delays calls for an in‐depth understanding of potential contributors from the patient's and provider's perspectives. We sought to identify causes of delays in adjuvant radiotherapy initiation for HNC.
Methods
We performed a mixed‐methods study including patients with HNC care team members. Forty in‐depth interviews were performed (26 patients; 14 care team members). Timing and demographic data were collected from medical records.
Results
Median time from surgery to radiotherapy initiation was 45 days; 15 participants began after 42 days. Process delays and failure to communicate the urgency and significance of PORT initiation contributes to delays. Patients with a strong social support system experience less delays.
Conclusions
Achieving reductions in PORT initiation requires efficient care coordination, improved communication between interdisciplinary teams, and strengthening social support systems for patients with HNC.
Background
While quality of life (QOL), psychosocial health, and adverse treatment outcomes have been studied in head and neck cancer (HNC) patients, decision regret is an important and understudied complication that can negatively impact future health care decision making.
Methods
Data collected using a HNC patient registry with questionnaires administered at initial consultation visits plus 3 and 6 months after treatment completion was retrospectively analyzed. A visual analog anxiety scale and the University of Washington Quality of Life were given at clinic visits. Decision regret was determined using a validated scale. Demographic and clinical variables were collected retrospectively and at baseline.
Results
Patients with higher anxiety and lower self‐reported QOL had higher concurrent regret at 3‐month (n = 140) and at 6‐month (n = 82) post‐treatment. Later disease stage at presentation, nonprimary surgical treatment, and lower health literacy were associated with greater regret.
Conclusions
Decision regret was highest in HNC patients with high anxiety, low QOL, and more advanced disease.
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