THE PROFITABILITY OF SUSTAINABLE AGRICULTURE ON A REPRESENTATIVE GRAIN FARM IN THE MID-ATLANTIC REGION, 1981-89

A long-term whole-farm analysis compared conventional and low-input farming systems. Data from a nine-year agronomic study at the Rodale Research Farm, Kutztown, Pennsylvania, were used to analyze profitability, liquidity, solvency, and risk on a representative commercial grain farm. Conventional and low-input farms participating in government programs are the most profitable scenarios, followed by conventional and low-input farms not participating in government programs. All farms increased their net worth. The low-input approach is advantageous for risk-averse farmers using a safety-first criterion.Crop Production/Industries, Environmental Economics and Policy,

Improving Nutrition ATI Scores Via Lecture, Class Presentation, & Clinical Intevention Stategies

https://fuse.franklin.edu/ss2018/1051/thumbnail.jp

Four Puzzles in Information and Politics : Product Bans, Informed Voters, Social Insurance, & Persistent Disagreement

In four puzzling areas of information in politics, simple intuition and simple theory seem to conflict, muddling policy choices. This thesis elaborates theory to help resolve these conflicts. The puzzle of product bans is why regulators don't instead offer the equivalent information, for example through a "would have banned" label. Regulators can want to lie with labels, however, either due to regulatory capture or to correct for market imperfections. Knowing this, consumers discount regulator warnings, and so regulators can prefer bans over the choices of skeptical consumers. But all sides can prefer regulators who are unable to ban products, since then regulator warnings will be taken more seriously. The puzzle of voter information is why voters are not even more poorly informed; press coverage of politics seems out of proportion to its entertainment value. Voters can, however, want to commit to becoming informed, either by learning about issues or by subscribing to sources, to convince candidates to take favorable positions. Voters can also prefer to be in large groups, and to be ignorant in certain ways. This complicates the evaluation of institutions, like voting pools, which reduce ignorance. The puzzle of group insurance as a cure for adverse selection is why this should be less a problem for groups than individuals. The usual argument about reduced variance of types for groups doesn't work in separating equilibria; what matters is the range, not variance, of types. Democratic group choice can, however, narrow the group type range by failing to represent part of the electorate. Furthermore, random juries can completely eliminate adverse selection losses. The puzzle of persistent political disagreement is that for ideal Bayesians with common priors, the mere fact of a factual disagreement is enough of a clue to induce agreement. But what about agents like humans with severe computational limitations? If such agents agree that they are savvy in being aware of these limitations, then any factual disagreement implies disagreement about their average biases. Yet average bias can in principle be computed without any private information. Thus disagreements seem to be fundamentally about priors or computation, rather than information.</p

Colleague appraisal of Australian general practitioners in training: an analysis of multisource feedback data

Background: Multisource feedback is an evidence-based and validated tool used to provide clinicians, including those in training, feedback on their professional and interpersonal skills. Multisource feedback is mandatory for participants in the Royal Australian College of General Practitioners Practice Experience Program and for some Australian General Practice Training Registrars. Given the recency of the Practice Experience Program, there are currently no benchmarks available for comparison within the program and to other comparable cohorts including doctors in the Australian General Practice Training program. The aim of this study is to evaluate and compare colleague feedback within and across General Practice trainee cohorts. Methods: Colleague feedback, from multisource feedback of Practice Experience Program participants and Australian General Practice Training Registrars, collected between January 2018 and April 2020, was compared to identify similarities and differences. Analyses entailed descriptive statistics, between and within groups rater consistency and agreement measures, principal component analysis, t-tests, analysis of variance, and psychometric network analysis. Results: Colleague ratings of Practice Experience Program participants (overall average 88.58%) were lower than for Registrars (89.08%), although this difference was not significant. ‘Communication with patients’ was rated significantly lower for Practice Experience Program participants (2.13%) while this group was rated significantly better for their ‘Ability to say no’ (1.78%). Psychometric network analyses showed stronger linkages between items making up the behavioural component (compared to the items of the performance and self-management components, as found by principal component analysis) for Practice Experience Program participants as compared to Registrars. Practice Experience Program participants were stronger in clinical knowledge and skills as well as confidentiality, while Registrars were stronger in communicating with patients, managing their own stress, and in their management and leadership skills. Conclusions: The multisource feedback scores of doctors undertaking the Practice Experience Program suggests that, while all mean values are ‘very good’ to ‘excellent’, there are areas for improvement. The linkages between skills suggests that Practice Experience Program doctors’ skills are somewhat isolated and have yet to fully synthesise. We now have a better understanding of how different groups of General Practitioners in training compare with respect to professional and interpersonal skills. Based on the demonstrated differences, the Practice Experience Program might benefit from the addition of educational activities to target the less developed skills

A comparison of patient appraisal of professional skills for GPs in training participating in differing education programs

Background: Medical boards and healthcare providers internationally are coming under increasing pressure to attract international medical graduates (IMGs) and overseas trained doctors (OTDs) to cope with predicted general practice (GP) doctor shortages. Various pathways to registration are made available for this purpose. There is very little understanding of the effects of different training pathways to licensing and registration on the ability of IMGs and OTDs, as well as locally trained doctors, to acquire the desirable professional skills deemed necessary for working effectively in the primary care sector. Methods: Feedback from patients was collected at the end of their scheduled consultation with their doctor using a questionnaire consisting of 13 Likert scale items that asked them to rate their experience of the consultation. Feedback was obtained for doctors going through the Royal Australian College of General Practice (RACGP) Practice Experience Program (PEP) and the Australian General Practice Training Program (AGPT), with the former intended primarily for IMGs and OTDs, and the latter for local medical graduates including from New Zealand. Patient feedback was also obtained for patients visiting already Fellowed and experienced GPs for comparative purposes, resulting in data for three groups of doctors (two trainee, one already Fellowed). Rater consistency and agreement measures, analysis of variance, principal component analysis, t-tests and psychometric network analysis were undertaken between and within groups to identify similarities and differences in patient experience and professionalism of doctors. Results: There was a small but significant difference in average patient raw scores given to PEP and AGPT doctors (90.25, 90.97%), with the highest scores for ‘Respect shown’ (92.24, 93.15%) and the lowest for ‘Reassurance’ 89.38, 89.84%). Male patients gave lower scores (89.56%) than female patients (91.23%) for both groups of doctors. In comparison, patients gave experienced GPs an average 91.38% score, with male patients giving a lower average score than female patients (90.62, 91.93%). Two components were found in the patient data (interpersonal communication, caring/empathy) that account for over 80% of the variance. When patient scores were aggregated by doctor, the average PEP and AGPT doctor scores received were 90.27 and 90.99%, in comparison to the average experienced GP score of 91.43%. Network analysis revealed differences in the connectedness of items between these two groups as well as in comparison with experienced GPs, suggesting that PEP doctors’ skills are less cohesively developed in the areas of listening ability, explaining and providing reassurance. Conclusions: The small but statistically significant differences between doctor groups reported in this preliminary study are supplemented by percentile analysis, network analysis and principal component analysis to identify areas for further exploration and study. There is scope for improving the integration of interpersonal communication skills of GPs in Training with their caring and empathy skills, when compared with experienced GPs as a benchmark. Suggestions are made for enhancing professional skills from a patients’ perspective in future training programs

Training Extension Professionals from Developing Countries Through Educational Workshops Conducted in the United States

Many opportunities exist for conducting stateside professional improvement workshops to train Extension professionals from developing countries. To conduct a successful workshop it is important to understand the needs of the partner country and identify participants who can use their workshop training to address those needs. An effective workshop will have high-quality field trips, practical classroom instruction, and opportunities for cultural exchange. Pre-workshop planning and close attention to logistical issues are essential to the success of the workshop. Good evaluation of the workshop is important to measure the impacts of the workshop and provide input for improving future workshops

Prevocational integrated extended rural clinical experience (PIERCE): cutting through the barriers to prevocational rural medical education

Introduction: Despite an increase in the number of undergraduate training positions, Australia faces a critical shortage of medical practitioners in regional, rural and remote communities. Extended rural clinical placements have shown great utility in undergraduate medical curricula, increasing training capacity and providing comparable educational outcomes while promoting rural medicine as a career. The Prevocational Integrated Extended Rural Clinical Experience (PIERCE) was developed to increase the training capacity of the Queensland Rural Generalist Pathway (QRGP) and strengthen trainee commitment to rural practice by offering an authentic, extended 15-week rural term that provided an integrated experience in anaesthetics, obstetrics and gynaecology, and paediatrics, while meeting the requirements for satisfactory completion of prevocational rural generalist training. This study sought to evaluate whether trainees believed PIERCE and/or traditional regional hospital specialty placements achieved their learning objectives and to identify elements of the placements that contributed to, or were a barrier to, their realisation. Methods: This translational qualitative study explored the experiences and perceptions of QRGP trainees who undertook a PIERCE placement in three Queensland rural hospitals (Mareeba, Proserpine and Stanthorpe) in 2015, with a matched cohort of trainees who undertook regional hospital placements in anaesthetics, obstetrics and gynaecology, and paediatrics at a regional referral hospital (Cairns, Mackay and Toowoomba base hospitals). The study used a realist evaluation framework that investigates What works, for whom, in what circumstances, in what respects and why? Results: PIERCE provided an enjoyable and valued rural training experience that promoted trainee engagement with, and contribution to, a rural community of practice, reinforcing their commitment to a career in rural medicine. However, QRGP trainees did not accept that PIERCE could be a substitute for regional hospital experience in anaesthetics, obstetrics and gynaecology, and paediatrics. Rather, trainees thought PIERCE and regional hospital placements offered complementary experiences. PIERCE offered integrated, hands-on rural clinical experience in which trainees had more autonomy and responsibility. Regional hospital placements offered more traditional caseload learning experiences based on observation and the handing down of knowledge and skills by hospital-based supervisors. Conclusion: Both PIERCE and regional hospital placements provided opportunities and threats to the attainment of the curriculum objectives of the Australian Curriculum Framework for Junior Doctors, the Australian College of Rural and Remote Medicine and the Royal Australian College of General Practitioners Fellowship in Advanced Rural General Practice curricula. PIERCE trainees enjoyed the opportunity to experience rural medicine in a community setting, a broad caseload, hands-on proficiency, continuity of care and an authentic role as a valued member of the clinical team. This was reinforced by closer and more consistent clinical and educational interactions with their supervisors, and learning experiences that address key weaknesses identified in current hospital-based prevocational training. Successful achievement of prevocational curriculum objectives is contingent on strategic alignment of the curricula with supportive learning mechanisms focused by the learning context on the desired outcome, rural practice. This study adds weight to the growing consensus that rural community-based placements such as PIERCE are desirable components of prevocational training

Bovine virus diarrhea

1 online resource (PDF, 4 pages)This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu