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

Method of lines transpose: High order L-stable O(N) schemes for parabolic equations using successive convolution

We present a new solver for nonlinear parabolic problems that is L-stable and achieves high order accuracy in space and time. The solver is built by first constructing a single-dimensional heat equation solver that uses fast O(N) convolution. This fundamental solver has arbitrary order of accuracy in space, and is based on the use of the Green's function to invert a modified Helmholtz equation. Higher orders of accuracy in time are then constructed through a novel technique known as successive convolution (or resolvent expansions). These resolvent expansions facilitate our proofs of stability and convergence, and permit us to construct schemes that have provable stiff decay. The multi-dimensional solver is built by repeated application of dimensionally split independent fundamental solvers. Finally, we solve nonlinear parabolic problems by using the integrating factor method, where we apply the basic scheme to invert linear terms (that look like a heat equation), and make use of Hermite-Birkhoff interpolants to integrate the remaining nonlinear terms. Our solver is applied to several linear and nonlinear equations including heat, Allen-Cahn, and the Fitzhugh-Nagumo system of equations in one and two dimensions

Sources of total, non-milk extrinsic, and intrinsic and milk sugars in the diets of older adults living in sheltered accommodation

The WHO recommends limiting non-milk extrinsic sugars (NMES) consumption to ≤ 10 % energy to reduce the risk of unhealthy weight gain and dental caries, and to restrict frequency of intake to ≤ 4 times/d to reduce risk of dental caries. Older adults, especially those from low-income backgrounds, are at increased risk of dental caries, yet there is little information on sugars intake (frequency of intake and food sources) in this age group. The aim of this report is to present baseline data from a community-based dietary intervention study of older adults from socially deprived areas of North East England, on the quantity and sources of total sugars, NMES, and intrinsic and milk sugars, and on frequency of NMES intake. Dietary intake was assessed using two 3-d estimated food diaries, completed by 201 participants (170 female, thirty-one male) aged 65–85 years (mean 76·7 (sd 5·5) years) recruited from sheltered housing schemes. Total sugars represented 19·6 %, NMES 9·3 %, and intrinsic and milk sugars 10·3 % of daily energy intake. Eighty-one (40·3 %) exceeded the NMES intake recommendation. Mean frequency of NMES intake was 3·4 times/d. The fifty-three participants (26·4 %) who exceeded the frequency recommendation ( ≤ 4 times/d) obtained a significantly greater percentage of energy from NMES compared with those participants who met the recommendation. The food groups ‘biscuits and cakes’ (18·9 %), ‘soft drinks’ (13·1 %) and ‘table sugar’ (11·1 %) made the greatest contributions to intakes of NMES. Interventions to reduce NMES intake should focus on limiting quantity and frequency of intake of these food groups

Orthopedic surgeons\u27 attitudes to osteoporosis investigation and management after minimal trauma fracture

Background: The investigation and treatment of osteoporosis after minimal trauma fracture (MTF) is regarded as sub-optimal. There is strong evidence of the benefit of identifying and treating osteoporosis after MTF and there has been discussion of the possible role that orthopaedic surgeons might play in the management of osteoporosis after MTF. Questions/purposes: The study surveyed orthopaedic surgeons in rural and regional south east Australia to determine their attitudes to investigation and management of osteoporosis, the role health professionals should play, and the communication and co-ordination of follow-up care. Methods: A survey was developed and piloted prior to being posted to 69 orthopaedic surgeons asking for their opinions about the general management of osteoporosis, and the roles and responsibilities of health professionals in dealing with osteoporosis following a MTF. Results: Responses were received from 42 participants (60.8 %) with the majority of respondents agreeing that it is important to treat osteoporosis following MTF. Less than 15 % of respondents felt that it was their responsibility to initiate discussion or treatment or investigation after MTF. No respondent felt that the co-ordination of osteoporosis care was good and 45% stated it was poor. Communication after discharge is mostly left to the hospital (30%) while 20% stated they did not follow up at all. Conclusions: This study shows that many rural orthopaedic surgeons believe that follow-up in regard to osteoporosis after MTF is important, that responsibility for follow-up diagnosis and management of osteoporosis lies with primary health care and the current communication systems are poor

Studies on a fusarium disease of corn and sorghum (Preliminary)

A new fusarium disease of corn made its appearance in Iowa, during the season of 1914, seriously injuring the corn crop 01\u27 the state and causing a loss estimated at more than $15,000,000. It was not confined to Iowa, for reports of a similar disease were sent to the Iowa Agricultural Experiment station by H. B. Clark of Blair, Neb., who found an abundance of it there and elsewhere in that state. One of the authors observed the fusarium that same season in western I Illinois and northern Missouri and Dr. E. C. Stakman reported that it occurred in Minnesota. In the following year, 1915, the disease was again abundant, tho not as severe as in 1914

Statistical Photocalibration of Photodetectors for Radiometry without Calibrated Light Sources

Calibration of CCD arrays for identifying bad pixels and achieving nonuniformity correction is commonly accomplished using dark frames. This kind of calibration technique does not achieve radiometric calibration of the array since only the relative response of the detectors is computed. For this, a second calibration is sometimes utilized by looking at sources with known radiances. This process can be used to calibrate photodetectors as long as a calibration source is available and is well-characterized. A previous attempt at creating a procedure for calibrating a photodetector using the underlying Poisson nature of the photodetection required calculations of the skewness of the photodetector measurements. Reliance on the third moment of measurement meant that thousands of samples would be required in some cases to compute that moment. A photocalibration procedure is defined that requires only first and second moments of the measurements. The technique is applied to image data containing a known light source so that the accuracy of the technique can be surmised. It is shown that the algorithm can achieve accuracy of nearly 2.7% of the predicted number of photons using only 100 frames of image data