A sufficient pipeline of doctors for rural communities is vital for Australia's overall medical workforce

The shortage of doctors in remote, rural and regional Australian communities is a longstanding health policy challenge. It is the main reason why almost 3000 overseas-trained doctors enter the labour force annually1 — a similar number to the domestic graduate output of Australian medical schools.2 Most overseas-trained doctors end up practising in major cities; 75% of all registered overseas-trained doctors in clinical practice in 2021 were metropolitan based, with major cities also accounting for 76% of the growth in overseas-trained doctors over the 2015–2021 period.3 In effect, rurally targeted recruitment of overseas-trained doctors compounds the problem of geographic maldistribution that it is meant to solve. Achieving a substantial pipeline of Australian-trained graduates who will willingly pursue regional careers as general practitioners, rural generalists and non-GP specialists is therefore a first order policy priority

Prevalence in Primary School Youth of Pica and Rumination Behavior: The Understudied Feeding

Objective: Little epidemiological evidence exists on rumination disorder behavior (RB) and pica behavior (PB). We examined prevalence of RB and PB and presence of comorbid feeding/eating disorder symptoms among school-aged children. Methods: In elementary schools in Switzerland, 1,430 children (54.0% female) ages seven to 13 completed Eating Disorder Examination-Questionnaire for children (ChEDE-Q) and Eating Disturbances in Youth Questionnaire (EDY-Q). Results: EDY-Q data behavior frequency showed 9.7% reported RB only, 10.0% reported PB only, and 3.1% reported RB+PB (≥1 on 0-6 Likert scale). At a clinical cut-off score of ≥4 (at least “often true”), 1.7% had RB only, 3.8% had PB only, and 1.1% had RB+PB. Avoidant/restrictive food intake disorder symptoms were most common in those with RB+PB, and more common in those with RB or PB than those without. Degree of eating disorder symptoms (by ChEDE-Q) over the past 28 days were similar among those with RB, PB, or RB+PB, but less common in those without RB or PB. Discussion: RB and PB were commonly reported in our sample of school-aged children, even at a potential clinically significant cut-off. Our findings also suggest that degree of eating disorder symptom comorbidity is similar between those with RB and PB

Maternal plasma DHA levels increase prior to 29 days post-LH surge in women undergoing frozen embryo transfer: a prospective, observational study of human pregnancy

Context: Docosahexaenoic acid (DHA) is an important fatty acid required for neurological development but its importance during early fetal neurological organogenesis is unknown. Objective: To assess plasma fatty acid changes in early pregnancy in women undergoing natural cycle-frozen embryo transfer as a means of achieving accurately-timed periconceptual sampling. Design: Women undergoing frozen embryo transfer were recruited and serial fasting blood samples were taken pre-luteinising hormone (LH) surge, and at days 18, 29 and 45 post-LH surge and fatty acids were analysed using gas chromatography. Setting: Assisted Conception Unit, Glasgow Royal Infirmary, Scotland Main outcome measures: Plasma fatty acid concentrations, influence of twin pregnancies on DHA plasma concentration. Results: In pregnant women, there was a rapid, early increase in the maternal rate of change of plasma DHA concentration observed by 29 days post-LH surge (mean±SD, from 0.1±1.3 to 1.6±2.9 nmol DHA per mL plasma per day). This early pressure to increase plasma DHA concentration was further emphasised in twin pregnancies where the increase in DHA concentration over 45 days was two-fold higher than in singleton pregnancies (mean±SD increase, 74±39 nmol/mL versus 36±40 nmol/mL). An index of delta-6 desaturase activity increased 30% and positively correlated with the rate of change of DHA concentration between day 18 and 29-post LH surge (R-squared adjusted = 41%, P=0.0002). DHA was the only fatty acid with a continual accelerated increase in plasma concentration and a positive incremental area under the curve (mean±SD, 632±911 nmol/mL x day) over the first 45 days of gestation. Conclusions: An increase in maternal plasma DHA concentration is initiated in human pregnancy prior to neural tube closure which occurs at 28 days' gestation

The Lantern Vol. 17, No. 3, Summer 1949

• All the Silver in Taxco • The Fall • Parlor Games • Something There Is • Friday Night • Evening • Checker-Board Country • A Noise • Expected Up In Heaven Today • When Time Has Torn My Youth • Impression of Deathhttps://digitalcommons.ursinus.edu/lantern/1048/thumbnail.jp

The Iowa Homemaker vol.2, no.3-4

Table of Contents What Do You Choose in Table Service? by Clara Jordan, page 1 The Home We Had to Have – and Had It by Katherine Goeppinger, page 2 Preparing to Meet the Linen Needs of Bridedom by Helen Paschal, page 3 Canning Without Mother for a Helper by Carrie Plunkett, page 4 Summing Up the Serving of Well Planned Meals by N. Beth Bailey, page 5 Finding Brushes to Fit Special Needs by Glenna Hesse, page 6 Bridal Showers of Blessings by Harriet Schleiter, page 7 The Art of Garnishing Foods by Mildred B. Elder, page 7 Who’s There and Where by Jeanette Beyer, page 10 Seasonable Desserts of Fruits and Berries by N. Beth Bailey, page 11 Forget It All-And a Picnicking Go! by Eleanor Murray, page 1

Aktivnost Poslovnog udruženja

The authors thank the University of Strathclyde for a PhD studentship (KLW) and Merck KGaA, Darmstadt, Germany, for financial and material support.Palladium-catalyzed bond forming reactions, such as the SuzukiMiyaura and Mizoroki-Heck reactions, are some of the most broadly utilized reactions within the chemical industry. These reactions frequently employ hazardous solvents; however, to adhere to increasing sustainability pressures and restrictions regarding the use of such solvents, alternatives are highly sought after. Here we demonstrate the utility of dimethyl isosorbide (DMI) as a bio-derived solvent in several benchmark Pd-catalysed reactions: Suzuki– Miyaura (13 examples, 62–100% yield), Mizoroki–Heck (13 examples, 47– 91% yield), and Sonogashira (12 examples, 65–98% yield).PostprintPeer reviewe

Colorectal cancer risk following adenoma removal: a large prospective population-based cohort study

BACKGROUND: Randomised controlled trials have demonstrated significant reductions in colorectal cancer (CRC) incidence and mortality associated with polypectomy. However, little is known about whether polypectomy is effective at reducing CRC risk in routine clinical practice. The aim of this investigation was to quantify CRC risk following polypectomy in a large prospective population-based cohort study. METHODS: Patients with incident colorectal polyps between 2000 and 2005 in Northern Ireland (NI) were identified via electronic pathology reports received to the NI Cancer Registry (NICR). Patients were matched to the NICR to detect CRC and deaths up to 31(st) December 2010. CRC standardised incidence ratios (SIRs) were calculated and Cox proportional hazards modelling applied to determine CRC risk. RESULTS: During 44,724 person-years of follow-up, 193 CRC cases were diagnosed amongst 6,972 adenoma patients, representing an annual progression rate of 0.43%. CRC risk was significantly elevated in patients who had an adenoma removed (SIR 2.85; 95% CI: 2.61 to 3.25) compared with the general population. Male sex, older age, rectal site and villous architecture were associated with an increased CRC risk in adenoma patients. Further analysis suggested that not having a full colonoscopy performed at, or following, incident polypectomy contributed to the excess CRC risk. CONCLUSIONS: CRC risk was elevated in individuals following polypectomy for adenoma, outside of screening programmes. IMPACT: This finding emphasises the need for full colonoscopy and adenoma clearance, and appropriate surveillance, after endoscopic diagnosis of adenoma

Particulate Matter Exposures, Mortality, and Cardiovascular Disease in the Health Professionals Follow-up Study

Background: The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes

Temporal trends and forecasting of COVID-19 hospitalisations and deaths in Scotland using a national real-time patient-level data platform: a statistical modelling study

This study is part of the EAVE II project. EAVE II is funded by the MRC (MR/R008345/1) with the support of BREATHE—The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. Additional support has been provided through Public Health Scotland and Scottish Government Director General Health and Social Care. The original EAVE project was funded by the NIHR Health Technology Assessment programme (11/46/23).Background   As the COVID-19 pandemic continues, national-level surveillance platforms with real-time individual person-level data are required to monitor and predict the epidemiological and clinical profile of COVID-19 and inform public health policy. We aimed to create a national dataset of patient-level data in Scotland to identify temporal trends and COVID-19 risk factors, and to develop a novel statistical prediction model to forecast COVID-19-related deaths and hospitalisations during the second wave.  Methods   We established a surveillance platform to monitor COVID-19 temporal trends using person-level primary care data (including age, sex, socioeconomic status, urban or rural residence, care home residence, and clinical risk factors) linked to data on SARS-CoV-2 RT-PCR tests, hospitalisations, and deaths for all individuals resident in Scotland who were registered with a general practice on Feb 23, 2020. A Cox proportional hazards model was used to estimate the association between clinical risk groups and time to hospitalisation and death. A survival prediction model derived from data from March 1 to June 23, 2020, was created to forecast hospital admissions and deaths from October to December, 2020. We fitted a generalised additive spline model to daily SARS-CoV-2 cases over the previous 10 weeks and used this to create a 28-day forecast of the number of daily cases. The age and risk group pattern of cases in the previous 3 weeks was then used to select a stratified sample of individuals from our cohort who had not previously tested positive, with future cases in each group sampled from a multinomial distribution. We then used their patient characteristics (including age, sex, comorbidities, and socioeconomic status) to predict their probability of hospitalisation or death.  Findings   Our cohort included 5 384 819 people, representing 98·6% of the entire estimated population residing in Scotland during 2020. Hospitalisation and death among those testing positive for SARS-CoV-2 between March 1 and June 23, 2020, were associated with several patient characteristics, including male sex (hospitalisation hazard ratio [HR] 1·47, 95% CI 1·38–1·57; death HR 1·62, 1·49–1·76) and various comorbidities, with the highest hospitalisation HR found for transplantation (4·53, 1·87–10·98) and the highest death HR for myoneural disease (2·33, 1·46–3·71). For those testing positive, there were decreasing temporal trends in hospitalisation and death rates. The proportion of positive tests among older age groups (>40 years) and those with at-risk comorbidities increased during October, 2020. On Nov 10, 2020, the projected number of hospitalisations for Dec 8, 2020 (28 days later) was 90 per day (95% prediction interval 55–125) and the projected number of deaths was 21 per day (12–29). Interpretation The estimated incidence of SARS-CoV-2 infection based on positive tests recorded in this unique data resource has provided forecasts of hospitalisation and death rates for the whole of Scotland. These findings were used by the Scottish Government to inform their response to reduce COVID-19-related morbidity and mortality.Publisher PDFPeer reviewe

Bostonia: The Boston University Alumni Magazine. Volume 12

Founded in 1900, Bostonia magazine is Boston University’s main alumni publication