We examined whether change in added sugar intake is associated with change in δ13C, a novel sugar biomarker, in thirty-nine children aged 5–10 years selected from a Colorado (USA) prospective cohort of children at increased risk for type 1 diabetes. Reported added sugar intake via FFQ and δ13C in erythrocytes were measured at two time points a median of 2 years apart. Change in added sugar intake was associated with change in the δ13C biomarker, where for every 1-g increase in added sugar intake between the two time points, there was an increase in δ13C of 0⋅0082 (P = 0⋅0053), independent of change in HbA1c and δ15N. The δ13C biomarker may be used as a measure of compliance in an intervention study of children under the age of 10 years who are at increased risk for type 1 diabetes, in which the goal was to reduce dietary sugar intake.

In June of 2016, the Collaborative Working Group (CWG) on the Future of Emergency Medicine presented its final report at the Canadian Association of Emergency Physicians (CAEP) annual meeting in Quebec City. The CWG report made a number of recommendations concerning physician Human Health Resource (HHR) shortfalls in emergency medicine, specific changes for both the Royal College of Physicians and Surgeons of Canada (FRCPC) and the College of Family Physicians of Canada (CCFP-EM) training programs, HHR needs in rural and remote hospitals, future collaboration of the CCFP-EM and FRCPC programs, and directions for future research. All recommendations were endorsed by CAEP, the Royal College of Physicians and Surgeons of Canada (RCPSC), and the College of Family Physicians of Canada (CFPC). The CWG report was published in CJEM and has served as a basis for ongoing discussion in the emergency medicine community in Canada. The CWG identified an estimated shortfall of 478 emergency physicians in Canada in 2016, rising to 1071 by 2020 and 1518 by 2025 assuming no expansion of EM residency training capacity. In 2017, the CAEP board struck a new committee, The Future of Emergency Medicine in Canada (FEMC), to advocate with appropriate stakeholders to implement the CWG recommendations and to continue with this important work. FEMC led a workshop at CAEP 2018 in Calgary to develop a regional approach to HHR advocacy, recognizing different realities in each province and region. There was wide representation at this workshop and a rich and passionate discussion among those present. This paper represents the output of the workshop and will guide subsequent deliberations by FEMC. FEMC has set the following three goals as we work toward the overarching purpose to improve timely access to high quality emergency care: (1) to define and describe categories of emergency departments (EDs) in Canada, (2) define the full time equivalents required by category of ED in Canada, and (3) recommend the ideal combination of training and certification for emergency physicians in Canada. A fourth goal supports the other three goals: (4) urge further consideration and implementation of the CWG-EM recommendations related to coordination and optimization of the current two training programs. We believe that goals 1 and 2 can largely be accomplished by the CAEP annual meeting in 2020, and goal 3 by the CAEP annual meeting in 2021. Goal 4 is ongoing with both the RCPSC and the CFPC. We urge the EM community across Canada to engage with our committee to support improved access and EM care for all Canadians.

The seventh annual Teaching and Learning Conference (TLC) was held in Philadelphia, Pennsylvania, from February 5 to 7, 2010, with 224 attendees onsite. The theme for the meeting was “Advancing Excellence in Teaching Political Science.” Using the working-group model, the TLC track format encourages in-depth discussion and debate on research dealing with the scholarship of teaching and learning.

The production of third-person /s/ on English verbs seems to be ahead of comprehension. Mainstream American English (MAE) is contrasted with African American English (AAE), in which /s/ is rarely supplied. Two studies explored what information children get solely from /s/ on the end of a verb. Sixty-five MAE- and 65 AAE-speaking four- to seven-year-olds participated in one of two experimental picture-choice comprehension studies. Neither group of four-year-olds could use the /s/ to determine if the event was generic rather than past tense on a verb (e.g. cuts/cut), or whether it was a verb or a noun compound as in The penguin dresses/The penguin dress. MAE-speakers do not use the information in third-person /s/ alone until age five, and not reliably until age six years. In keeping with AAE production, AAE-speaking children do not use the information in /s/ at all in this age range.

1. Two Shorthorn cows with rumen fistulas were used to investigate the effect of diets high in concentrates and low in hay on the physical and biochemical processes of the reticulo-rumen.

2. During the initial control period of the investigation the cows received daily 16 lb. hay and 20 lb. concentrates (flaked maize 50%, weatings 35%, decorticated ground-nut cake 15%) and during the final control period 18 lb. hay and 10 lb. concentrates. There were three intervening experimental periods, in each of which the cows received 2 lb. hay daily. In the first experimental period they received, in addition to the hay, 24 lb. concentrates; in the second, 20 lb. concentrates and 5 lb. of dried delignified straw pulp in a finely macerated form; and in the third, 20 lb. concentrates. The experiment lasted 27 weeks.

3. In the experimental periods the mean milk-fat percentage remained below 2·0 for 10 weeks, whereas the mean value for the control periods was about 3·5. Addition of the straw pulp to the diet low in hay brought about no recovery in milk-fat percentage. It is calculated that in the two cows the losses in the yield of fat were 62·2 and 51·2% in the first experimental period and 62·5 and 58·7% in the second. In the experimental periods there were increases in the milk solids-not-fat percentage amounting in the two cows to upwards of 0·75 and 0·40 respectively. The composition of the butterfat was influenced by the diets low in hay, the main changes being a marked fall in the Reichert value, and a rise in the iodine value.

4. Digestibility trials showed that in the initial control period and the first and second experimental periods the mean daily intake of digestible crudefibrewas 2·6,0·6 and 3·0 lb. respectively. A tentative estimate of the extent of digestion in the reticulo-rumen, based on the lignin-ratio method, showed that a marked depression in values for the digestibility of the cellulosic constituents of the diet given during the first experimental period took place in the reticulo-rumen. In all experimental periods, even the first, the digestion of starch in the reticulo-rumen was virtually complete, only traces passing undigested to the remainder of the gut. In these three periods the mean daily intake of ether extract remained at 0·4·0·5 lb.

1. Three comparable groups of cows were used to investigate the effect, on milk composition and yield, of diets consisting of 4 lb. hay daily and concentrates containing 35% weatings, 15% decorticated groundnut cake and 50% of either flaked maize, maize meal or dredge corn (crushed oats and barley) respectively.

2. During initial and final control periods all the cows received 16 lb. hay daily and, per 10 lb. of milk produced, they received about 4 lb. of the concentrate mixture containing flaked maize. During the experimental period of 6 weeks all the cows received 4 lb. hay, concentrates according to milk yield, and an extra 7 lb. of concentrates daily. One group of cows received the concentrate mixture containing flaked maize, a second group the mixture with maize meal and the third group that with dredge corn. The mean daily intakes of starch for the different groups were respectively 6·0, 6·4 and 5·8 lb. per cow.

3. The diet containing flaked maize caused a marked, and that containing maize meal a small fall in the fat content of the milk, but the diet containing dredge corn was without effect. In the last 2 weeks of experimental treatment the adjusted mean fat percentage for the group of cows receiving flaked maize was 0·51 and 0·71 below the percentages for the groups receiving maize meal and dredge corn respectively. The yields of milk and of milk fat were also lower in the group receiving flaked maize than in either of the other groups, but the experimental treatments produced no changes in the milk solids-not-fat percentage.

4. This experiment has shown that when diets low in hay and high in concentrates are given to lactating cows, the type of starch in the concentrates is of great importance in determining the extent of the depression in milk fat percentage. The greater depression with flaked maize than with maize meal or dredge corn is thought to be associated with the effect of the starch on the flora of the reticulo-rumen.

1. Digestibility trials were conducted, and the rate of passage of hay was measured, with five Shorthorn cows during a period of normal diet and during two experimental periods in which diets low in hay and high in concentrates were given. In the first experimental period the concentrates were cubes of the wartime type sold as National Cattle Food No. 1, and containing a variety of constituents; in the second they were a mixture offlakedmaize (50%), weatings (35%) and decorticated ground-nut cake (15%). For convenience these are referred to as concentrate ‘cubes’ and ‘mixture’ respectively.

2. During the initial and final control periods the cows consumed daily 17–21 lb. hay, and about 4·5 lb. concentrates per 10 lb. of milk produced. In the initial control period the concentrates were the concentrate cubes, and in the final they were the concentrate mixture. The hay was reduced to 4 lb. daily during the two experimental periods and the remainder of the standard requirements of the animals were met by concentrates. The concentrates were the cubes in the first experimental period and the mixture in the second experimental period.

3. Seducing the hay to 4 lb. did not affect the fat content of the milk when the other food in the diet was the concentrate cubes, but there was a striking mean fall of 1·04% fat when the cubes were replaced by the concentrate mixture. This represented a loss of over 30% in the yield of fat.

4. Digestibility trials, conducted in the initial control and first and second experimental periods, indicated that the fall in milk fat content was not the result of changes in the amounts of dry matter, crude protein, ether extract, crude fibre, cellulose, cellulosans or pentosans not in cellulose digested. The essential difference between the diet of low hay with the concentrate mixture and the other diets given in this experiment was that it provided a high intake of starch yet had little of the physical property of roughage. It is concluded that depression of milk fat content results from a combination of these two factors and probably originates from changes in the physical and biochemical processes of the reticulo-rumen.

5. The intake of starch equivalent, as calculated from the intake of digestible nutrients, was close to standard requirements in all periods of the experiments, but there was a surplus of digestible crude protein.

6. The mean solids-not-fat content of the milk rose 0·48% at the time of the fall in milk fat, and this was entirely due to an increase in milk protein. After the return to normal diets the recovery of solids-not-fat was slower, but no less complete, than the recovery in milk fat.