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In 2014, the Australian Government established the Teacher Education Ministerial Advisory Group (TEMAG) to advise on how teacher education programmes could ensure new teachers were adequately prepared for the classroom. Following this, the Australian Government endorsed a key recommendation of the TEMAG Action Now: Classroom Ready Teachers report, the inclusion of specialisations in primary Initial Teacher Education (ITE). This research was conducted at an Australian public university that, in 2016, had embedded specialisations in a revised primary teacher programme structure and was one of the first ITE institutions in Australia to graduate primary teachers with a specialisation. Using a mixed-methods case study design with convenience sampling, this study sought to investigate these primary graduates' perceptions of undertaking a specialisation in relation to the development of content knowledge and pedagogical knowledge in the specialist area, as well as perceived employment advantages. This research took place over 4 years with participants having completed a Bachelor of Education (Primary) at least three months prior to participating. The participants reported benefits to having completed a primary specialisation but expressed concerns about their preparedness to teach their specialisation and whether it would result in any advantages for employment. Recommendations from the participants included teaching practice in their area of specialisation, consideration of specialist skills and changing the timetabling of the specialisation in the programme. Ultimately, there is a need for ongoing research in this area to determine the extent to which primary specialisations deliver the intended outcomes and impacts at both the policy driver level and the university level.

A hybrid surgical approach was utilized to address cor triatriatum sinister in a 10-month-old castrated male domestic shorthair cat. Prior to surgery, open-mouth breathing occurred with exertion. The procedure was guided by transesophageal echocardiography and fluoroscopy. A minithoracotomy was performed, and the left atrial membrane was accessed via an introducer placed through the left ventricular apex. Sequential balloon dilations were performed, and the mean transmembrane gradient under anesthesia was reduced from 16 mmHg to 2.23 mmHg. Four months after surgery, the transmembrane mean gradient remained lower than prior to intervention. The cat tolerated surgery well and remains free of clinical signs nine months after surgery. [ABSTRACT FROM AUTHOR]

Chung-Shien Lee,1,2 Sandhya Sharma,3 Emily Miao,4 Cheryl Mensah,5 Kevin Sullivan,2 Nagashree Seetharamu2 1Department of Clinical Health Professions, St. John’s University, College of Pharmacy and Health Sciences, Queens, NY 11439, USA; 2Division of Medical Oncology and Hematology, Northwell Health Cancer Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY 11042, USA; 3Department of Hematology and Oncology, Denver Health, Denver, CO 80204, USA; 4Albert Einstein College of Medicine, Bronx, NY, USA; 5Weil Cornell School of Medicine, Department of Hematology and Oncology, Weill Cornell of Medicine, New York, NY, USACorrespondence: Nagashree SeetharamuDivision of Medical Oncology and Hematology, Northwell Health Cancer Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY 11042, USATel +1 516-734-8855Email nseetharamu@northwell.eduAbstract: Mutations in the epidermal growth factor receptor (EGFR) are common amongst those with non-small cell lung cancer and represent a major factor in treatment decisions, most notably in the advanced stages. Small molecule tyrosine kinase inhibitors (TKIs) that target the EGFR, such as erlotinib, gefitinib, icotinib, afatinib, dacomitinib and osimertinib, have all shown to be effective in this setting. Osimertinib, a third-generation EGFR TKI, is a favorable option, but almost all patients develop resistance at some time point. There are no effective treatment options for patients who progress on osimertinib, but ongoing trials will hopefully address this unmet need. The aim of this review is to provide a comprehensive review of the data with EGFR TKIs, management of the toxicities and the ongoing trials with this class of agents.Keywords: non-small cell lung cancer, epidermal growth factor receptor, tyrosine kinase inhibitor

Janet Fraser Hale,1 Jill M Terrien,1 Mark Quirk,2 Kate Sullivan,2 Mitchell Cahan3 1Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA, USA; 2Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA; 3Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA Purpose: Critical thinking underlies several Association of American Medical Colleges (AAMC)-defined core entrustable professional activities (EPAs). Critical-thinking ability affects health care quality and safety. Tested tools to teach, assess, improve, and nurture good critical-thinking skills are needed. This prospective randomized controlled pilot study evaluated the addition of deliberate reflection (DR), guidance with Web Initiative in Surgical Education (WISE-MD™) modules, to promote surgical clerks’ critical-thinking ability. The goal was to promote the application of reflective awareness principles to enhance learning outcomes and critical thinking about the module content.Participants and methods: Surgical clerkship (SC) students were recruited from two different blocks and randomly assigned to a control or intervention group. The intervention group was asked to record responses using a DR guide as they viewed two selected WISE-MD™ modules while the control group was asked to view two modules recording free thought. We hypothesized that the intervention group would show a significantly greater pre- to postintervention increase in critical-thinking ability than students in the control group.Results: Neither group showed a difference in pre- and posttest free-thought critical-thinking outcomes; however, the intervention group verbalized more thoughtful clinical reasoning during the intervention.Conclusion: Despite an unsupported hypothesis, this study provides a forum for discussion in medical education. It took a sponsored tool in surgical education (WISE-MD™) and posed the toughest evaluation criteria of an educational intervention; does it affect the way we think? and not just what we learn, but how we learn it? The answer is significant and will require more resources before we arrive at a definitive answer. Keywords: simulation, clinical reasoning, medical education strategies

Introduction To determine the association of fruit and vegetable consumption with overall sleep duration among pregnant women. Methods Data from the 2011 and 2012 Behavioral Risk Factors Surveillance System (BRFSS) were used. All women (n = 2951) of childbearing age (18-44 years) who were pregnant and responded to all fruit and vegetable consumption and sleep duration questions were included. Covariates included age, race, education level, exercise, and marital status. Data were analyzed using linear and ordinal logistic regression. Results Total daily fruit and vegetable consumption was not associated with sleep duration among pregnant women, controlling for confounders [[beta] = -0.03, (-0.07, 0.00)]. Orange and green vegetable consumption were both inversely associated with sleep duration [[beta] = -0.19, (-0.38, -0.01) and [beta] = -0.20, (-0.33, -0.08) respectively]. Ordinal logistic regression found that the odds of meeting or exceeding sleep time recommendations increased slightly with each unit increase in total fruit and vegetable consumption [OR = 1.05 (1.003, 1.092)] and for every unit increase in fruit consumption [OR = 1.12 (1.038, 1.208)]. Women who exercised within the past 30 days reported approximately 20 min of additional sleep compared to those who did not [[beta] = 0.32 (0.16, 0.49)]. Age, employment status, and marital status were also independently associated with sleep duration. Discussion Sleep duration in pregnant women was associated with exercise and other demographic factors, but only mildly associated with fruit and vegetable consumption. Future research should investigate the effects of additional factors including sleep quality, gestational age, family status and other medications as potential confounders., Author(s): C. H. Duke [sup.1] , J. A. Williamson [sup.1] , K. R. Snook [sup.1] , K. C. Finch [sup.1] , K. L. Sullivan [sup.1] Author Affiliations: (1) grid.256302.0Department of [...]

Background/Objectives: Vitamin D deficiency in children remains a global concern. Although literature exists on the vitamin D status and its risk factors among children in the Middle East, findings have yielded mixed results, and large, representative community studies are lacking. Subjects/Methods: In a nationally representative survey of 1077 Jordanian children of preschool age (12-59 months) in Spring 2010, we measured 25(OH)D.sub.3 concentrations by liquid chromatography-tandem mass spectrometry and calculated prevalence ratios for deficiency associated with various factors. Results: Results showed 19.8% (95% confidence interval (CI): 16.4-23.3%) deficiency ( Conclusions: Vitamin D deficiency and insufficiency pose significant public health problems in Jordanian children with female children disproportionately affected. Strong associations between vitamin D status in children and urban residency and maternal vitamin D status suggest that the behaviors related to sun exposure in urban mothers likely also affect the sun exposure and thus vitamin D status of their children., Author(s): E K Nichols [sup.1] , I M D Khatib [sup.2] , N J Aburto [sup.3] , M K Serdula [sup.3] , K S Scanlon [sup.3] , J P Wirth [...]

Few studies have focused on the application of the Tl isotopic system for geochemical exploration. We report ε 205Tl values of rock samples from the TL Deposit, British Columbia, Canada – a sediment-hosted massive sulfide (SHMS) deposit with characteristics of a Broken Hill-type deposit – and investigate relationships with major and trace element geochemistry. Maps generated using Tl isotope and trace element data indicate that ε 205Tl values can potentially be used to fingerprint ore mineralization at the TL Deposit. The sources of Tl and other metals (Ag, Pb, Zn) are assessed using Tl isotope data. Measured ε 205Tl values exhibit positive correlations with Pb, sedimentary exhalative metal index (Zn + 100*Pb + 100*Tl), and the redox proxy, U/Th, and negative correlations with Be, Cd, Ce, La, Ni and Th. Individual lithologies have distinct Tl isotopic compositions. Metal-rich heavily altered samples have relatively high ε 205Tl values (−5.0 to −2.5 ε -units) reflecting the euxinic conditions of the global Paleoproterozoic ocean and hydrothermal influence. Samples with lower ε 205Tl values (−15 to −7.6 ε -units) reflect a combination of their mineralogy (phyllosilicate minerals such as biotite and clinochlore), Tl from sediments reflecting the Tl isotopic composition of modern seawater, and possible low-temperature alteration processes. Samples with high Pb and Ag contents have high ε 205Tl values, indicating a hydrothermal origin of these metals, whereas Zn is highest in samples with low ε 205Tl values, indicating a low-temperature or sedimentary origin. Thallium isotopes, paired with conventional geochemical data, show promise as a useful tool for exploration of SHMS deposits with Broken Hill-type characteristics. Supplementary material: Major, minor and trace element contents of samples and reference materials, blank values, correlation coefficient values, and XRD patterns are available at https://doi.org/10.6084/m9.figshare.c.6370671 Thematic collection: This article is part of the Geochemical processes related to mined, milled, or natural metal deposits collection available at: https://www.lyellcollection.org/topic/collections/geochemical-processes-related-to-mined-milled-or-natural-metal-deposits [ABSTRACT FROM AUTHOR]