Australian rural medical students' perceived readiness for work as a junior doctor: A cross-sectional national survey.

OBJECTIVE: To report self-perceived readiness for work as a junior doctor in a national cohort of rural clinical school students. DESIGN: Cross-sectional study using a self-report questionnaire. Independent variables included 14 individual readiness items related to clinical and professional tasks, sociodemographic data and reported experience of rural clinical school (RCS) training. Participants were 668 medical students (55.3% females) completing a full academic year in rural Australia. Multivariable analysis explored factors associated with overall readiness for work as a junior doctor. FINDINGS: 86% agreed that RCS experience prepared them to undertake the roles and responsibilities of a junior doctor. Self-ratings for specific clinical and professional tasks varied from a mean score of 5.9-8.0 out of 10, and 13 of the 14 items were associated with the outcome (p-value <0.001, except for performing spirometry). Lowest readiness scores were seen for some aspects including raising concerns about a colleague (mean score 6.1) or responding to workplace bullying (mean score 6.0). Aspects of the RCS experience that were strongly associated with overall readiness included: feeling a valued team-member (OR 9.28, 95%CI 2.43-35.39), feeling well-supported academically (OR 6.64, 95%CI 3.39-13.00), having opportunity for unsupervised but supported clinical practice (OR 4.67, 95%CI 1.45-15.00), having a rural mentor (OR 3.38, 95%CI 1.89-6.06) and having a previous health professional qualification (OR 2.7, 95%CI 1.32-5.54). DISCUSSION: Most RCS students felt ready for work as a junior doctor. Important aspects of RCS experience are likely to include students feeling integrated within the clinical team and having opportunities for authentic clinical roles. There remains a significant challenge for medical school curricula to address professional areas where graduates felt less prepared.

The effects of temperature and salinity on the blood chemistry and survival of juvenile Atlantic tarpon Megalops atlanticus.

Atlantic tarpon Megalops atlanticus are highly migratory sportfish that support recreational fisheries throughout their range. In US waters, juveniles can be found in coastal and estuarine habitats along the Gulf of Mexico and Atlantic seaboard, with temperature limiting their northern latitudinal distribution. Juveniles may overwinter in these areas during the first several years of life. Low temperatures are known to cause mortality in adults, but the challenges of temperature are less understood for juveniles. Furthermore, salinity, which can change dramatically in these habitats, may have a synergistic effect with temperature. To examine the physiological effects of temperature and salinity on juvenile tarpon, wild fish were acclimated to a range of conditions that potentially occur in the northern range of their estuarine habitats. The haematology of juvenile tarpon was examined in two salinity (≤2 and ≥30 ppt) and temperature (15 and 25°C) treatments, followed by a low-temperature tolerance test. After 2 weeks in treatment conditions, blood samples were analysed for haematocrit, pH, red blood cell concentration, haemoglobin content and plasma osmolality. Increased plasma osmolality was observed in fish at low temperature (15°C compared to 25°C) and at high salinity (≥30 ppt compared to ≤2 ppt). Blood pH was increased at 15°C compared to 25°C, with the highest pH at 15°C and low salinity. Haemoglobin, haematocrit and red blood cell concentration were higher at 25°C than 15°C, with haemoglobin lowest at 15°C and low salinity. For the low-temperature tolerance test, all fish were acclimated to 15°C for 2 weeks, then transferred to separate tanks where temperature was gradually decreased at 0.9 ± 0.1°C/h until fish lost equilibrium. Fish at low salinity lost equilibrium more rapidly (1 ppt, 12.65 ± 0.46°C) than fish at high salinity (30 ppt, 11.26 ± 0.14°C). The results indicate juvenile tarpon are susceptible to low temperature, which is exacerbated by low salinity, findings useful in the assessment of juvenile tarpon overwintering habitat.

Finding Vygotsky in Early Childhood Deaf Education: Sociocultural Bodies and Conversations.

Children, including those who are deaf, become aware of and learn about their environments through playing and social and cultural interactions. For most deaf children, preschool classrooms are optimal spaces for these interactions to occur, but only if they can fully engage with this environment. We discuss the need for and constituent aspects of full access to learning in these environments for deaf children. Vygotsky's sociocultural theory is employed chiefly as the basis for exploring and analyzing useful strategies for educators and families of deaf children. Our analysis focuses on processes in which individuals create knowledge through interacting with other people and the environment, a core emphasis of our work. We also discuss that, concomitant with full access to linguistic and social opportunities, deaf preschoolers develop a stronger sense of self, which leads to the development of cultures and languages in and out of their families.

The Abrupt Transition to Online Learning: Multiple Perspectives.

Transitioning to virtual learning environments during the COVID-19 pandemic made the numerous obstacles faced by deaf and hard of hearing students more apparent, and created new challenges for all involved. From this experience, much knowledge was gained that can continue to be implemented and researched to provide better access and accommodations for ongoing online education. In the present article, we introduce an American Annals of the Deaf Special Issue whose contributing authors offer a response to the challenges experienced by deaf education researchers, administrators, policymakers, faculty, and other educators in areas ranging from early childhood to higher education, as well as students and families, because of the abrupt transition to virtual learning. This Special Issue provides perspectives, strategies, and scenarios that can enhance deaf education across age and grade ranges and augment the research and literature base of online learning in deaf education.

Deaf Education Teachers and Online Instruction: Ensuring Equity in Instructional Activities and Collaboration.

The changes brought about by the COVID-19 pandemic resulted in more virtual instruction in schools. Teachers experienced multiple new challenges while moving online. As Fleming (2020) notes, "Unlike developing a whole-class lesson plan online, special education teachers are now tasked with developing unique plans for every student that align with their IEPs [individualized education programs], as required by federal mandate" (p. 1). In the present article, we consider how to best incorporate active learning, engagement, and critical thinking into an online learning environment while supporting language and social development for all students. Alexander (2020) notes the importance of socialization, observing that the loss of face-to-face interactions decreases students' confidence and affects their mental health. We also consider how to meaningfully incorporate social interaction, engagement, and active learning to support deaf and hard of hearing students in developing a sense of classroom and school community.

Reflections From the Pandemic: Lessons Learned.

During the COVID-19 pandemic, many children experienced multiple challenges while transitioning from traditional to online schooling. Teachers, administrators, and parents were expected to work together to provide students an optimal educational experience through those turbulent times. This experience generated new insights into how to teach deaf and hard of hearing (DHH) students and assess their knowledge. New tools were invented and used during the pandemic, and though teachers and students are slowly returning to traditional learning environments, educators now know that alternative forms of teaching and learning exist. We acknowledge the ways teachers, administrators, and parents can innovate and bring new knowledge to the table. The present article introduces an American Annals of the Deaf Special Issue that offers further research and discussion in the event that another, comparable challenge occurs. Multiple issues must be considered in DHH education, from academic rigor to social-emotional wellness.

Age and growth of early-life-stage Atlantic tarpon (Megalops atlanticus) from the northcentral Gulf of Mexico.

Age and growth of early-life-stage Atlantic tarpon Megalops atlanticus collected from Mississippi coastal waters in the northcentral Gulf of Mexico (GOM) are described using otolith microstructure analysis. Tarpon leptocephali (n = 95, 16.0-27.8 mm standard length, LS ) collected from June throughOctober 2013-2018, ranged in age from 22 to 43 days (mean = 30.9 ± 0.5 days). Leptocephalus somatic growth rates ranged 0.46-1.24 mm day-1 (mean = 0.76 ± 0.02 mm day-1 ), and leptocephalus otolith growth rates ranged 1.78-3.97 µm day-1 (mean = 2.58 ± 0.04 µm day-1 ). Growth rates were inversely correlated to leptocephalus age, indicating the shrinkage phase associated with leptocephalus metamorphosis. Juvenile tarpon (n = 358, 50-359 mm fork length, LF ) were collected from August through December 2007-2018. Juveniles exhibited a positive allometric relationship (adjusted R2  = 0.99, P < 0.001) between length and mass. The age of 100 juveniles (71-277 mm LF ) ranged from 76 to 174 days. Juvenile growth rate was estimated as 1.56 ± 0.11 mm day-1 . Significant (P < 0.001) linear relationships were found between juvenile age and otolith metrics, including otolith mass (R2  = 0.81) and radius (R2  = 0.68). Evaluation of the backcalculated hatch dates suggests that specimens in the collection hatched from late May through mid-September with slight peaks during July and August. A Rao's Spacing Test of Uniformity indicates the presence of significant lunar periodicity in leptocephalus hatch dates (n = 95, U = 250.1, P < 0.05), with 50% of the leptocephali hatched within 5 days (before or after) of the full moon. This study fills critical gaps in the scientific knowledge of tarpon and provides estimates of early-life-history metrics for an iconic game fish at the northernmost extent of its GOM range.