Caring for highly infectious patients in biocontainment units is a new phenomenon, and little is known about the behavioral health of workers in this setting. This is a qualitative study exploring the unique experiences of workers involved in the care of patients with Ebola virus disease (EVD) at Nebraska Medicine during the 2014 Ebola outbreak. Twenty-one in-depth interviews were conducted focused on topics of personal memories, interpersonal experiences, stress response, and patient management. Five themes were identified: (1) positive experiences were emotional while challenges were technical; (2) a significant percentage of workers encountered interpersonal stressors, with 29% of respondents having feelings of isolation, 33% having alterations in home life, and 25% experiencing at least 1 episode of discrimination; (3) physicians and nurses had stressors primarily related to patient care; (4) mental health was an important supportive service, with 45% of respondents using behavioral health counseling; and (5) working in the biocontainment unit during activation was more stressful than everyday work for 60% of respondents. Differences were also noted based on employee occupation and leadership level: nurses, physicians, and members of the leadership team tended to focus on emotional experiences and were more likely to utilize behavioral health counseling services than support staff and nonleadership personnel. These findings provide a framework for thinking about the unique aspects of caring for highly infectious patients, and understanding these issues will improve training, enable management to better support staff, and provide insights to those establishing biocontainment units.

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Focusing on the period from 1910 to 1915, this article argues that Richard Wagner's work was crucial to the development of American cinema. Critics and artists not only advocated Wagner's composition techniques for film accompaniment, but also turned Wagner into an emblem for far broader reforms. These reforms included a greater integration of music and film, a conception of film as a high art, and a conception of film as a medium for national purification and bourgeoisification. These reforms, and their connection to Wagner, helped set the stage for the use of "The Ride of the Valkyries" in D. W. Griffith's The Birth of a Nation (1915).

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Background-Previous studies demonstrate that androgen deprivation therapy with gonodotropin-releasing hormone (GnRH) agonists and orchiectomy for prostate cancer is associated with cardiovascular disease. However, few studies have examined its effect on the peripheral vascular system.Objective-To study the risk of peripheral arterial disease and venous thromboembolism associated with androgen deprivation therapy for prostate cancer.Design, Settings and Participants-Population-based observational study of 182,757 U.S. men aged 66 years and older who were diagnosed with loco-regional prostate cancer from 1992 to 2007, of whom 47.8% received GnRH agonists and 2.2% orchiectomy.Measurements-We used Cox proportional hazards models with time-varying treatment variables to assess whether treatment with GnRH agonists or orchiectomy was associated with peripheral arterial disease and/or venous thromboembolism.Results and limitations-Overall, 47.8% of men received a GnRH agonist during follow-up and 2.2% underwent orchiectomy. GnRH agonist use was associated with an increased risk of incident peripheral arterial disease (adjusted hazard ratio [HR], 1.15, 95% confidence interval [CI] 1.11-1.19) and incident venous thromboembolism (adjusted HR, 1.1, 95% CI 1.04-1.16). In addition, orchiectomy was associated with an increased risk of peripheral arterial disease (adjusted HR, 1.14, 95% CI 1.03-1.27) and venous thromboembolism (adjusted HR, 1.22, 95% CI 1.07-1.40). Limitations include the observational study design, inability to assess the use of oral antiandrogens as monotherapy or combined androgen deprivation.Conclusions-Androgen deprivation therapy for loco-regional prostate cancer is associated with an increased risk of peripheral artery disease and venous thromboembolism. Additional research is needed to better understand the potential risks and benefits, so that these treatments can be targeted to patients where the benefits are most clear.