General practice registrars’ intentions for future practice: Implications for rural medical workforce planning

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91) = 3.528, P = 0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88) = –4.280, P \u3c 0.001) and women ranked the ability to work part-time higher (t(94) = 3.697, P \u3c 0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ2(1) = 8.498, P = 0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice

High fidelity imaging and high performance computing in nonlinear EIT

We show that nonlinear EIT provides images with well defined characteristics when smoothness of the image is used as a constraint in the reconstruction process. We use the gradient of the logarithm of resistivity as an effective measure of image smoothness, which has the advantage that resistivity and conductivity are treated with equal weight. We suggest that a measure of the fidelity of the image to the object requires the explicit definition and application of such a constraint. The algorithm is applied to the simulation of intra-ventricular haemorrhaging (IVH) in a simple head model. The results indicate that a 5% increase in the blood content of the ventricles would be easily detectable with the noise performance of contemporary instrumentation. The possible implementation of the algorithm in real time via high performance computing is discussed

Phase and coherence analysis of VHF scintillation over Christmas Island

This short paper presents phase and coherence data from the cross-wavelet transform applied on longitudinally separated very high frequency (VHF) equatorial ionospheric scintillation observations over Christmas Island. The phase and coherence analyses were employed on a pair of scintillation observations, namely, the east-looking and west-looking VHF scintillation monitors at Christmas Island. Our analysis includes 3 years of peak season scintillation data from 2008, 2009 (low solar activity), and 2011 (moderate solar activity). In statistically significant and high spectral coherence regions of the cross-wavelet transform, scintillation observations from the east-looking monitor lead those from the west-looking monitor by about 20 to 60 (40 ± 20) min (most frequent lead times). Using several years (seasons and solar cycle) of lead (or lag) and coherence information of the cross-wavelet transform, we envisage construction of a probability model for forecasting scintillation in the nighttime equatorial ionosphere

The Burden of Motherhood: The Effect of Reproductive Load on Female Lizard Locomotor, Foraging, and Social Behavior

The costs of reproduction, involving demands associated with both current and future reproductive efforts, may place a substantial burden on females. However, animals may minimize these costs by modifying their behavior across the reproductive cycle. We examined the effects of reproductive load on three types of behavior (locomotion, foraging, and social displays) in green anole lizards (Anolis carolinensis) by comparing egg, follicle, and oviduct mass and volume with field observational data. We found that female locomotor and social display behaviors decreased as reproductive load increased, suggesting behavioral modification in these traits, but we detected no relationship between foraging and reproductive load. We also examined these relationships across eight Anolis species using a phylogenetically informed analysis and found no associations between the evolution of reproductive load and any of the three behaviors. These results suggest that the evolution of increased reproductive load is not associated with the interspecific variation in behavior across the anoles and may result from varying life history traits or selective ecological pressures across species

Scaling and root planing with and without periodontal flap surgery

. Complete removal of calculus is a primary part of achieving a “biologically acceptable” tooth surface in the treatment of periodontitis. Rabbani et al. reported that a single episode of scaling did not completely remove subgingival calculus and that the deeper the periodontal pocket, the less complete the calculus removal. The purpose of the present study was to evaluate the effectiveness of scaling relative to calculus removal following reflection of a periodontal flap. Each of 21 patients who required multiple extractions had 2 teeth scaled, 2 teeth scaled following the reflection of a periodontal flap, and 2 teeth serve as controls. Local anesthesia was used. Following extraction, the % of subgingival tooth surfaces free of calculus was determined using the method described by Rabbani with a stereomicroscope. Results showed that while scaling only (SO) and scaling with a flap (SF) increased the % of root surface without calculus, scaling following the reflection of a flap aided calculus removal in pockets 4 mm and deeper. Comparison of SO versus SF at various pocket depths for % of tooth surfaces completely free of calculus showed 1 to 3 mm pockets to be 86% versus 86%, 4 to 6 mm pockets to be 43% versus 76% and >6 mm pockets to be 32% versus 50%. The extent of residual calculus was directly related to pocket depth, was greater following scaling only, and was greatest at the CEJ or in association with grooves, fossae or furcations. No differences were noted between anterior and posterior teeth or between different tooth surfaces.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73823/1/j.1600-051X.1986.tb01461.x.pd

Signatures of the disk-jet coupling in the Broad-line Radio Quasar 4C+74.26

Here we explore the disk-jet connection in the broad-line radio quasar 4C+74.26, utilizing the results of the multiwavelength monitoring of the source. The target is unique in that its radiative output at radio wavelengths is dominated by a moderately-beamed nuclear jet, at optical frequencies by the accretion disk, and in the hard X-ray range by the disk corona. Our analysis reveals a correlation (local and global significance of 96\% and 98\%, respectively) between the optical and radio bands, with the disk lagging behind the jet by $250 \pm 42$ days. We discuss the possible explanation for this, speculating that the observed disk and the jet flux changes are generated by magnetic fluctuations originating within the innermost parts of a truncated disk, and that the lag is related to a delayed radiative response of the disk when compared with the propagation timescale of magnetic perturbations along relativistic outflow. This scenario is supported by the re-analysis of the NuSTAR data, modelled in terms of a relativistic reflection from the disk illuminated by the coronal emission, which returns the inner disk radius $R_{\rm in}/R_{\rm ISCO} =35^{+40}_{-16}$. We discuss the global energetics in the system, arguing that while the accretion proceeds at the Eddington rate, with the accretion-related bolometric luminosity $L_{\rm bol} \sim 9 \times 10^{46}$ erg s$^{-1}$ $\sim 0.2 L_{\rm Edd}$, the jet total kinetic energy $L_\textrm{j} \sim 4 \times 10^{44}$ erg s$^{-1}$, inferred from the dynamical modelling of the giant radio lobes in the source, constitutes only a small fraction of the available accretion power.Comment: 9 pages and 6 figures, ApJ accepte

Impacts of maternal nutritional plane on umbilical artery hemodynamics, fetal and placentome growth in sheep

Abstract The present study aimed to examine the impact of maternal nutritional plane on umbilical hemodynamics. Ewes (n = 15) were assigned to 1 of 3 dietary treatments [control (CON; 100% of NRC requirements), restricted (RES; 60% of CON) or overfed (OVR; 140% of CON)] beginning on day 40 of gestation. Umbilical artery hemodynamics, fetal growth and placentome growth were measured on days 40, 45, 52, 80, 94 and 108 of gestation by Doppler ultrasonography. The percentage change in umbilical artery pulsatility and resistance indices remained steady through day 80 of gestation, and then decreased (P < 0.03) by day 108 of gestation. Moreover, plane of nutrition affected (P < 0.03) the percentage change in pulsatility index from day 40, with RES ewes having a greater (P < 0.03) change compared to CON (16.7 ± 7.5 vs. -15.6 ± 7.5%), with OVR being intermediate (3.2 ± 7.5%). Fetal biparietal and abdominal diameters increased (P < 0.01) throughout gestation, and fetal heart rate decreased (P < 0.01) from day 52 to 108 of gestation. Placentome diameter increased (P < 0.01) through day 80 of gestation, was similar (P > 0.05) on days 80 and 94 of gestation, and then decreased (P < 0.01) by day 108 of gestation. Maternal plane of nutrition can impact umbilical resistance indices, and ultimately may impact blood flow to the fetus

The feasibility and acceptability of two methods ofsnack portion control in United Kingdom (UK) preschool children: reduction and replacement.

Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22⁻56 months (36.6 ± 9.5 m, 48% female) completed a three-week intervention. In week 1 (baseline) no changes were made to the child's diet; week 2 (acclimation) children received a standardised selection of HED snacks, and in week 3 (intervention) participants were randomly assigned to snack replacement (n = 24) or snack reduction (n = 22). Snack replacement involved swapping HED snacks for fruits and vegetables, whilst snack reduction involved reducing the size of HED snacks by 50%. Food and energy intake were measured using a weighed food diary for four consecutive days. Snack replacement resulted in more positive changes to children's diets; vegetable intake increased (p < 0.01), and total daily energy intake decreased when compared to snack reduction (p < 0.05). Mothers expressed a more favourable attitude to snack replacement, although snack reduction was also well received by mothers. Despite increased preliminary efficacy of snack replacement on dietary intake, both strategies were feasible and acceptable. The current pilot study provides the necessary information to inform the design of future interventions