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Pisonia grandis, now threatened, is an important source of soil organic matter on atoll islands and historically composed the dominant canopy of many atoll ecosystems across the Pacific. How the tree manages water to exist across wide precipitation gradients is poorly understood. This study tests the hypotheses that P. grandis is using organic‐rich soils that develop under their canopy and soil layering where organic soils contact carbonate sands as part of their water management strategy. We analysed the chemical and physical properties of soils from two atolls in the central Pacific Ocean, one wet (Palmyra, USA) and one dry (Nikumaroro, Kiribati). Additionally, we used HYDRUS‐1D to simulate vadose zone water dynamics under a range of organic cap thicknesses (0, 14, 30 and 50 cm), precipitation intensities (1, 5 and 10 cm/h) and average precipitation amounts (50, 100, 200 and 400 cm/yr). Laboratory results indicate organic soils are strongly, though not exclusively, associated with P. grandis. Water holding capacity increases with soil organic carbon up to about 10% but not beyond that amount. Modelling results indicate significant water retained in organic soils where they overlie coarse carbonate sediments suggesting a capillary barrier development as the plant‐mediated organic soil accumulates. Retained soil water extends modelled dry‐down times of root‐accessible soil by more than 3 weeks. This indicates that capillary barrier‐enhanced water availability can help explain how P. grandis and other soil‐building atoll species can exist across variable precipitation regimes. To our knowledge, this work is the first description of plant‐mediated capillary barrier development as a water management strategy. [ABSTRACT FROM AUTHOR]

In the mountainous regions of the Western United States, increasing wildfire activity and climate change are putting forests at risk of regeneration failure and conversion to non‐forests. During periods with unfavorable climatic conditions, locations that are suitable for post‐fire tree regeneration (regeneration refugia) may be essential for forest recovery. These refugia could provide scattered islands of recovering forest from which broader forest recovery may be facilitated. Spring ecosystems provide cool and wet microsites relative to the surrounding landscape and may act as regeneration refugia, though few studies have investigated their influence on post‐fire regeneration. To address this knowledge gap, we quantified coniferous tree regeneration adjacent to and away from springs in mixed‐conifer forests in a mountainous region of central Idaho, USA. Our research objectives were to (1) quantify post‐fire conifer density near and away from springs, (2) assess the relative importance of distance to a spring compared with other biophysical factors important to post‐fire regeneration, and (3) examine the temporal trends of post‐fire seedling establishment near and away from springs. In areas burned at high severity from fires in 1988, 2000, and 2006, we sampled transects at 27 springs for the count, age, and height of extant conifer seedlings, as well as topographic factors and distance to surviving seed source. We modeled the relative effects of distance to a spring, topographic variables (slope, heat load index, elevation), post‐fire climate, and distance to surviving seed source for the two dominant species, Douglas fir (Pseudotsuga menziesii) and lodgepole pine (Pinus contorta), using a generalized linear mixed‐effects model. Our study revealed that proximity to springs resulted in higher conifer density and earlier establishment after high‐severity wildfire when conditions for available seeds and topography were also met. Our results demonstrate that springs are important and previously undescribed regeneration refugia with landscape‐scale implications for post‐fire forest recovery in increasingly water‐limited environments. Springs are relatively abundant features of montane landscapes and may offer continued regeneration refugia for post‐fire recovery into the future, but additional springs mapping and hydroclimatic considerations are needed. [ABSTRACT FROM AUTHOR]

Introduction: Recruiting rural-practicing clinicians is a high priority. In this study, we explored burnout and contributing work conditions among rural, urban, and family practice physicians and advanced practice clinicians (APCs) in an Upper Midwestern health care system., Methods: The Mini Z burnout reduction measure was administered by anonymous electronic survey in March 2022. We conducted bivariate analyses of study variables, then assessed relationships of study variables to burnout with multivariate binary logistic regression., Results: Of 1118 clinicians (63% response rate), 589 physicians and 496 APCs were included in this study (n = 1085). Most were female (56%), physicians (54%), and White (86%), while 21% were in family practice, 46% reported burnout, and 349 practiced rurally. Rural and urban clinician burnout rates were comparable (45% vs 47%). Part-time work protected against burnout for family practice and rural clinicians, but not urban clinicians. In multivariate models for rural clinicians, stress (OR: 8.53, 95% CI: 4.09 to 17.78, P < .001 ), lack of workload control (OR: 3.06, 95% CI: 1.47-6.36, P = .003 ), busy/chaotic environments (OR: 2.53, 95% CI: 1.29-4.99, P = .007 ), and intent to leave (OR: 2.18, 95% CI: 1.06-4.45, P = .033 ) increased burnout odds. In family practice clinicians, stress (OR: 13.43 95% CI: 4.90-36.79 , P < .001 ) also significantly increased burnout odds., Conclusions: Burnout was comparable between rural and urban physicians and APCs. Part-time work was associated with decreased burnout in rural and family practice clinicians. Addressing burnout drivers (stress, workload control, chaos) may improve rural work environments, reduce turnover, and aid rural clinician recruitment. Addressing stress may be particularly impactful in family practice., Competing Interests: Conflict of interest: Dr. Linzer is supported through his employer Hennepin Healthcare for work on burnout reduction projects with large healthcare organizations including the American Medical Association, the Institute for Healthcare Improvement, the American Board of Internal Medicine, Optum, Gillette Children’s Hospital and the California Area Health Education Center System. His work on this paper was supported through his employer by Essentia Health. Ms. Poplau is supported through her employer Hennepin Healthcare Research Institute for work on burnout reduction projects with large healthcare organizations including the American Medical Association, the Institute for Healthcare Improvement, the American College of Physicians, Optum, Gillette Children’s Hospital and the California Area Health Education Center System. Her work on this paper was supported through her employer by Essentia Health. Dr. Stillman is supported through his employer, Hennepin Healthcare, for work on burnout reduction projects with healthcare organizations including the American Medical Association, Optum, Inc., and Gillette Children’s Hospital. His work on this paper was supported through his employer by Essentia Health. Dr. Sudak, Ms. Engels, and Ms. Horn are supported by their employer, Essentia Health. Their work on this paper was supported by Essentia Health., (© Copyright 2024 by the American Board of Family Medicine.)