Effects of geriatric clinical skills training on the attitudes of medical students.

BACKGROUND Physicians' attitudes, knowledge and skills are powerful determinants of quality of care for older patients. Previous studies found that using educational interventions to improve attitude is a difficult task. No previous study sought to determine if a skills-oriented educational intervention improved student attitudes towards elderly patients. METHODS This study evaluated the effect of a geriatric clinical skills training (CST) on attitudes of University of Bern medical students in their first year of clinical training. The geriatric CST consisted of four 2.5-hour teaching sessions that covered central domains of geriatric assessment (e.g., cognition, mobility), and a textbook used by students to self-prepare. Students' attitudes were the primary outcome, and were assessed with the 14-item University of California at Los Angeles Geriatrics Attitudes Scale (UCLA-GAS) in a quasi-randomized fashion, either before or after geriatric CST. RESULTS A total of 154 medical students participated. Students evaluated before the CST had a median UCLA-GAS overall scale of 49 (interquartile range 44-53). After the CST, the scores increased slightly, to 51 (interquartile range 47-54; median difference 2, 95% confidence interval 0-4, P = 0.062). Of the four validated UCLA-GAS subscales, only the resource distribution subscale was significantly higher in students evaluated after the geriatric CST (median difference 1, 95% confidence interval 0-2, P = 0.005). CONCLUSIONS Teaching that targets specific skills may improve the attitudes of medical students towards elderly patients, though the improvement was slight. The addition of attitude-building elements may improve the effectiveness of future skills-oriented educational interventions.

Archaeological Research at Sirkeli Höyük: Preliminary Results of the Latest Excavations (2012 & 2013) and their Implications

Sirkeli Höyük is an ancient settlement located 40 km east of Adana on the left bank of the Ceyhan River in Plain Cilicia. The main mound covers an area of approximately 300×400 m and rises to a height of ca. 30 m above the level of the surrounding plain. Due to its strategic location overlooking a road that crosses the Misis mountains, Sirkeli Höyük always played an important role within Plain Cilicia. J. Garstang’s (1936-1937), B. Hrouda’s (1992-1996) and H. Ehringhaus’ (1997) excavations have shown that the site was occupied from the 4th to late 1st millennium B.C. Since 2006, a new Swiss-Turkish team is investigating Sirkeli Höyük again. Due to modern excavation techniques and an interdisciplinary approach, the architectural and material remains that have been uncovered by the new excavations have yielded much new information. Apart from a more precise pottery sequence, the new project has discovered an extensive lower town surrounded by an elaborate double city wall. The paper will summarize the results that have been gathered since 2006, with particular focus on the campaigns 2012-2013, and aims to show how they may contribute to the understanding of the cultural developments in this region.

Adapting agricultural water governance to climate change: Experiences from Germany, Spain and California

This study describes and discusses initiatives taken by public (water) agencies in the state of Brandenburg in Germany, the state of California in the USA and the Ebro River Basin in Spain in response to the challenges which climate change poses for the agricultural water sector. The drivers and actors and the process of changing agricultural water governance are its particular focus. The assumptions discussed are: (i) the degree of planned and anticipatory top-down implementation processes decreases if actions are more decentralized and are introduced at the regional and local level; (ii) the degree of autonomous and responsive adaptation approaches seems to grow with actions at a lower administrative level. Looking at processes of institutional change, a variety of drivers and actors are at work such as changing perceptions of predicted climate impacts; international obligations which force politicians to take action; socio-economic concerns such as the cost of not taking action; the economic interests of the private sector. Drivers are manifold and often interact and, in many cases, reforms in the sector are driven by and associated with larger reform agendas. The results of the study may serve as a starting point in assisting water agencies in developing countries with the elaboration of coping strategies for tackling climate change-induced risks related to agricultural water management.

Is the Median Voter Decisive? Evidence of 'Ends Against the Middle' From Referenda Voting Patterns

This paper examines whether the voter with the median income is decisive in local spending decisions. Previous tests have relied on cross-sectional data while we make use of a pair of California referenda to estimate a first difference specification. The referenda proposed to lower the required vote share for passing local educational bonding initiatives from 67 to 50 percent and 67 to 55 percent, respectively. We find that voters rationally consider future public service decisions when deciding how to vote on voting rules, but the empirical evidence strongly suggests that an income percentile below the median is decisive for majority voting rules. This finding is consistent with high income voters with weak demand for public educational services voting with the poor against increases in public spending on education.

Panorama of the Maine, and of the adjacent country from Mayence to Frankfort

Designed from nature by F. W. Delkeskamp. Engraved By John Clark

Na 1 Nachlass Max Horkheimer, 695 - "The Collapse of German Democracy and the Expansion of National Socialism", "Cultural Aspects of National Socialism" u.a. (p. IX 169.1a - IX 170.1-4)

"The Collapse of German Democracy and the Expansion of National Socialism" (1940):; 1. Darstellung des Forschungsprojekts (15.9.1940), b. Typoskript mit handschriftlichen Korrekturen, 78 Blatt; 2. "Research work on recent trends in the history of ideas (parts of the Research project on the Collapse of German Democracy would be included)". Als Memorandum zur Eröffnung zur Eröffnung einer Zweigstelle des Instituts in Los Angeles (12.12.1940): a) Typoskript, 2 Blatt, b) Teilstück, Typoskript mit handschriftlichen Korrekturen, 1 Blatt, c) Teilstück, Typoskript mit handschriftlichen Korrekturen, 1 Blatt, d) Teilstück, Typoskript, 1 Blatt, e) Teilstück, Typoskript, 1 Blatt, f) Entwurf, Typoskript mit handschriftlichen Korrekturen und Manuskript, 3 Blatt; 3. University of California, Los Angeles: 2 Briefe (Abschrift) von Max Horkheimer, o.O., 1940, 2 Briefe (Abschrift) an Max Horkheimer, 1940, 2 Blatt; A.R.L. Gurland: "Survey of Structural Changes in the German Economy, 1933 to 1939. Technological Bases and Organizational Forms of the National Socialist Economic System". Typoskript mit handschriftlichen Korrekturen unter anderem von Theodor W. Adorno, 48 Blatt (formal nicht identisch mit "Technological Trends and Economic Structure under National Socialism", Studies in Philosophy and Social Science, Bd. IX, 1941, S. 226ff.); "Cultural Aspects of National Socialism. A Research Project" (1941):; 1. Institute of Social Research: Mitteilung über das Forschungsprojekt und das 'Supplementary Statement', Typoskript, englisch, 4 Blatt; 2. Supplementary Statement to the Research Project, a) Typoskript, 14.4.1941, 63 Blatt, b) Typoskript, 12.4.1941, mit handschriftlichen Korrekturen, 35 Blatt; 3. "Cultural Aspects of National Socialism. A Research Project" (24.2.1941), a) als Typoskript vervielfältigt, 54 Blatt, b) Typoskript mit handschriftlichen Korrekturen, 34 Blatt, c) Fassung Januar 1941, Typoskript mit handschriftlichen Korrekturen, 40 Blatt; 4. Inhaltsverzeichnisse, mit handschriftlichen Korrekturen, 3 Blatt;

Na 1 Nachlass Max Horkheimer, 591 - Korrespondenzen mit Friedrich (Frederick) Pollock (p. VI 38, 283-496)

4 Briefe zwischen Max Horkheimer und Nicholas Jory; 3 Briefe zwischen Nicholas Jory und Frederick Pollock, 1956; 1 Brief von Frederick Pollock an die First National City Bank (New York), 27.04.1956; 1 Brief von dem Grand Hotel & Kurhaus (Bad Tarasp) an den "Gast", März 1956; 1 Brief von Franz Ollig an Frederick Pollock, 31.01.1956; 1 Brief von Erna Schroeter an Emmy Henne, 14.01.1956; 1 Brief von The State Bar of California (San Francisco) an Leo Salon, 21.11.1956; 1 Brief von Frederick Pollock an Hans Moeller, 16.10.1956; 2 Briefe zwischen Frederick Pollock und Frederick J. Wild, 1956; 1 Brief von Frederick Pollock an Alice H. Maier, 19.06.1956; 1 Brief von Frederick Pollock an Leo Löwenthal, 16.06.1956; 1 Brief von dem Hotel "Zum Schützen" (München) an Frederick Pollock, 28.05.1956;

The supposed Hebraisms in the grammar of the biblical Aramaic

Berkely, Univ. of California, Diss. 1905

Exploration of genetic susceptibility to pancreatic cancer: A GWAS approach

Pancreatic cancer is the 4th most common cause for cancer death in the United States, accompanied by less than 5% five-year survival rate based on current treatments, particularly because it is usually detected at a late stage. Identifying a high-risk population to launch an effective preventive strategy and intervention to control this highly lethal disease is desperately needed. The genetic etiology of pancreatic cancer has not been well profiled. We hypothesized that unidentified genetic variants by previous genome-wide association study (GWAS) for pancreatic cancer, due to stringent statistical threshold or missing interaction analysis, may be unveiled using alternative approaches. To achieve this aim, we explored genetic susceptibility to pancreatic cancer in terms of marginal associations of pathway and genes, as well as their interactions with risk factors. We conducted pathway- and gene-based analysis using GWAS data from 3141 pancreatic cancer patients and 3367 controls with European ancestry. Using the gene set ridge regression in association studies (GRASS) method, we analyzed 197 pathways from the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Using the logistic kernel machine (LKM) test, we analyzed 17906 genes defined by University of California Santa Cruz (UCSC) database. Using the likelihood ratio test (LRT) in a logistic regression model, we analyzed 177 pathways and 17906 genes for interactions with risk factors in 2028 pancreatic cancer patients and 2109 controls with European ancestry. After adjusting for multiple comparisons, six pathways were marginally associated with risk of pancreatic cancer ( P < 0.00025): Fc epsilon RI signaling, maturity onset diabetes of the young, neuroactive ligand-receptor interaction, long-term depression (Ps < 0.0002), and the olfactory transduction and vascular smooth muscle contraction pathways (P = 0.0002; Nine genes were marginally associated with pancreatic cancer risk (P < 2.62 × 10−5), including five reported genes (ABO, HNF1A, CLPTM1L, SHH and MYC), as well as four novel genes (OR13C4, OR 13C3, KCNA6 and HNF4 G); three pathways significantly interacted with risk factors on modifying the risk of pancreatic cancer (P < 2.82 × 10−4): chemokine signaling pathway with obesity ( P < 1.43 × 10−4), calcium signaling pathway (P < 2.27 × 10−4) and MAPK signaling pathway with diabetes (P < 2.77 × 10−4). However, none of the 17906 genes tested for interactions survived the multiple comparisons corrections. In summary, our current GWAS study unveiled unidentified genetic susceptibility to pancreatic cancer using alternative methods. These novel findings provide new perspectives on genetic susceptibility to and molecular mechanisms of pancreatic cancer, once confirmed, will shed promising light on the prevention and treatment of this disease. ^