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

Don\u27t Run Out Of STEAM! Barriers to A Transdisciplinary Learning Approach

Reform-based instruction can maximize learning and provide equitable access for students in both mathematics and science. A proposal for change by national organizations shed light on the need for programs in integrated science, technology, engineering, and mathematics (STEM) or with the inclusion of the arts (STEAM). A balanced approach to integrated STEAM education uses real issues from around the world to challenge students to be innovative, creative, and think critically about ways they can provide solutions. The purpose of this article is to highlight the potential of a transdisciplinary STEAM instructional approach, while examining the barriers that teachers face in implementation, and provide possible suggestions that allow for successful implementation of transdisciplinary STEAM instruction. With the growing interest in STEM education, it is important to better understand teacher challenges and obstacles to provide support for educators who are developing and implementing integrated STEM instruction. Integrated STEAM allows for creativity across disciplines and promotes students to become conceptual thinkers who are ready to approach future careers and education with more imagination and innovation

Communicating Hunger and Satiation in the First Two Years of Life: A Systematic Review

Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and respond to infant feeding cues. Despite this, relatively little is understood about how infants engage parental feeding responses. Therefore the aim of this systematic review was to identify what is known about infant communication of hunger and satiation and what issues impact on the expression and perception of these states. A search of Medline, CINAHL, Web of Science, PsycINFO, Science Direct and Maternal and Infant care produced 27 papers. Eligibility criteria included: peer reviewed qualitative and/or quantitative publications on feeding behaviours, hunger, satiation/satiety cues of typically developing children in the first two years of life. Papers published between 1966 and 2013 were included in the review. The review revealed that feeding cues and behaviours are shaped by numerous issues, such as infants’ physical attributes, individual psychological factors and environmental factors. Meanwhile, infant characteristics, external cues and mothers’ own characteristics affect how feeding cues are perceived. The existing literature provides insights into many aspects of hunger and satiation in infancy; however, there are significant gaps in our knowledge. There is a lack of validated tools for measuring hunger and satiation, a need to understand how different infant characteristics impact on feeding behaviour and a need to extricate the respective contributions of infant and maternal characteristics to perceptions of hunger and satiation. Further research is also recommended to differentiate between feeding driven by liking and that driven by hunger

The eyes have it: Infant gaze as an indicator of hunger and satiation

Infant gaze serves as a measure of attention to food cues in adults and children and may play a role in signalling infant hunger and satiation. Maternal responsiveness to infant satiation cues, including gaze, supports healthy appetite development and may reduce obesity risk. However, mothers often experience difficulty in interpreting feeding cues, and there have been few attempts to study cues systematically. This study aimed to develop a reliable coding scheme for categorising and tracking infant gaze behaviours during complementary feeding (CF). Twenty infants aged between six and eighteen months were filmed during typical meals on two occasions at home. The Infant Gaze at Mealtime (IGM) coding scheme was devised from the analysis of a sample of videos, a piloting and testing process, and the feeding cues and developmental psychology literature. Inter and intra-rater reliability tests of the scheme with 20% of the study videos revealed high levels of reliability. When applied to the full sample of 225 video clips, the IGM coding scheme revealed a significant decrease over time in the frequency of infants gazing at food and a significant increase in exploratory gaze behaviour within a meal. These changes were consistent across main and dessert courses, suggesting they may be indicative of changes in infant feeding state. The results suggest that infant gaze may offer a means of identifying infant hunger and satiation and, as an easily observed behaviour, an effective tool for mothers and professionals for promoting responsive feeding

Examination of dietary intake of UK preschool children by varying carers : evidence from the 2008-2016 UK National Diet and Nutrition Survey

Early years caregivers can play a key role in young children’s eating and the prevention of childhood obesity. The UK National Diet and Nutrition Survey (NDNS) is a large representative survey collecting detailed food and nutrition consumption data. Using these data, the aim of this study was to investigate the relationship between dietary intake of preschool children in the UK aged two to four years old and accompanying adult/s. Nutrition consumption data from 1,218 preschool children from years one to eight of the NDNS (2008 to 2016) were accessed. Dietary data was captured using three or four day estimated food diaries. Regression analyses were performed to explore the association between dietary intake and accompanying adult. There were significant differences in consumption when children were not accompanied by their parents. Compared to when children were with parents, children consumed significantly more energy (15kcal, 95% CI 7-23kcal) sodium (−19mg, 95% CI 6-32mg), added sugars (0.6g, 95% CI 0.1-1.1g), vegetables (3g, 95% CI 1-4g), total grams (12g, 95% CI 3-21g) and saturated fat (0.2g, 95% CI 0.1-0.4g) per eating occasion when accompanied by wider family. When children were accompanied by a formal carer they consumed significantly less added sugars (−1.6g, 95% CI −2.4-0.8g) and more fruit (12g, 95% CI 3-21g) per eating occasion than when they were with their parents. The results demonstrate that non-parental caregivers might be an important target to promote healthy eating in young children. Further research is needed to establish which caregivers would benefit most

Improving temperature‐based predictions of the timing of flowering in cotton

Key management recommendations for cotton (Gossypium hirsutum L.) management require estimates of the timing of crop phenology. Most commonly growing day degree (DD) (thermal time) approaches are used. Currently, across many cotton production regions, there is no consistent approach to predicting first square and flower timing. Day degree approaches vary considerably, with base thresholds different (12.0–15.6 °C) with no consistency using an optimum temperature threshold (i.e., temperature where development ceases to increase). As cotton is grown in variable and changing climates, and cultivars change, there is a need to ensure the accuracy of this approach for predicting timing of flowering for assisting cotton management. In this study new functions to predict first square and first flower were developed and validated using data collected in multiple seasons and regions (Australia and the United States). Earlier controlled environment studies that monitored crop development were used to assess in more detail how temperatures were affecting early cotton development. New DD functions developed predicted first square and first flower better than the existing Australian and U.S. approaches. The best performing functions had base temperatures like those of existing U.S. functions (15.6 °C) and an optimum threshold temperature of 32.0 °C. New universal DD targets for first square (343 DD [°C]) and first flower (584 DD) were developed. Controlled environment studies supported this base temperature outcome; however, it was less clear that 32.0 °C was the optimum threshold temperature from these data. Precise predictions of cotton development will facilitate accurate growth stage assessments and hence better cotton management decisions

Hydrogen Storage Needs for Early Motive Fuel Cell Markets

The National Renewable Energy Laboratory's (NREL) objective for this project is to identify performance needs for onboard energy storage of early motive fuel cell markets by working with end users, manufacturers, and experts. The performance needs analysis is combined with a hydrogen storage technology gap analysis to provide the U.S. Department of Energy (DOE) Fuel Cell Technologies Program with information about the needs and gaps that can be used to focus research and development activities that are capable of supporting market growth