The Transatlantic Trade and Investment Partnership: Challenges and Opportunities for Consumer Protection. Paper No. 11 in the CEPS-CTR project ‘TTIP in the Balance’ and CEPS Special Report No. 115/July 2015

This paper examines options for regulatory cooperation in the Transatlantic Trade and Investment Partnership (TTIP) and assesses the challenges and opportunities posed by regulatory cooperation for consumer protection. It looks at existing approaches to regulatory cooperation by referencing a range of case studies. Based on established practice and on the European Commission’s recently published proposal on regulatory cooperation, we discuss a possible approach that could be adopted in the TTIP. Against the significant potential gains from improved regulatory cooperation, one must set the significant challenges of reconciling the different regulatory philosophies of the US and the EU as well as some differences in their respective approaches to cooperation. In broad terms, this analysis finds that regulatory powers on both sides of the Atlantic will not be significantly affected by the TTIP, but suggests that European and American legislators will need to ensure that their priorities shape the TTIP regulatory cooperation agenda and not the other way around

Foreign ant queens are accepted but produce fewer offspring

Understanding social evolution requires us to understand the processes regulating the number of breeders within social groups and how they partition reproduction. Queens in polygynous (multiple queens per colony) ants often seek adoption in established colonies instead of founding a new colony independently. This mode of dispersal leads to potential conflicts, as kin selection theory predicts that resident workers should favour nestmate queens over foreign queens. Here we compared the survival of foreign and resident queens as well as their relative reproductive share. We used the ant Formica exsecta to construct colonies consisting of one queen with workers related to this resident queen and introduced a foreign queen. We found that the survival of foreign queens did not differ from that of resident queens over a period of 136days. However, the genetic analyses revealed that resident queens produced a 1.5-fold higher number of offspring than introduced queens, and had an equal or higher share in 80% of the colonies. These data indicate that some discrimination can occur against dispersing individuals and that dispersal can thus have costs in terms of direct reproduction for dispersing queen

A simple approach to fairer hospital benchmarking using patient experience data

Objective To determine the factors contributing most to variability in patient experience in order to present approaches for fairer benchmarking of hospitals and for quality improvement. Design Secondary analysis of data from a widely used survey on patient experience. Setting Inpatients from all 24 acute hospitals in the Canton of Bern in Switzerland. Data collection followed the standardized and validated Picker Institute methodology for a period of 13 weeks in the fall/winter of 2005. Participants Inpatients age 18 years and older (n = 14 089), discharged within the sampling period. Main outcome measures ‘Patient experience', measured by the total Picker Problem Score (PPS) and by six domain scores (care, communication, respect, cooperation, organization, discharge management). Results In regression analysis, the patient factors self-reported health, age and education explained the highest proportion of variability in the PPS (4.8, 2.2 and 0.7%, respectively). Multiple linear adjustment for factors associated with patients removed between 29 and 33% of variability between hospital categories. The domain score means varied from under 5% for ‘respect towards the patient' to 34% for ‘discharge management'. Ranking of hospitals by domain scores differed from the ranking based on the total PPS. Conclusions Statistical adjustment for patient mix and additional stratification for some hospital factors make benchmarking using patient survey data fairer and more transparent. Use of our approach for presenting quality data may make interpretation easier for the different target groups and may enhance the relevance of such information for decision-makin

Genetic clusters and sex-biased gene flow in a unicolonial Formica ant

BACKGROUND: Animal societies are diverse, ranging from small family-based groups to extraordinarily large social networks in which many unrelated individuals interact. At the extreme of this continuum, some ant species form unicolonial populations in which workers and queens can move among multiple interconnected nests without eliciting aggression. Although unicoloniality has been mostly studied in invasive ants, it also occurs in some native non-invasive species. Unicoloniality is commonly associated with very high queen number, which may result in levels of relatedness among nestmates being so low as to raise the question of the maintenance of altruism by kin selection in such systems. However, the actual relatedness among cooperating individuals critically depends on effective dispersal and the ensuing pattern of genetic structuring. In order to better understand the evolution of unicoloniality in native non-invasive ants, we investigated the fine-scale population genetic structure and gene flow in three unicolonial populations of the wood ant F. paralugubris. RESULTS: The analysis of geo-referenced microsatellite genotypes and mitochondrial haplotypes revealed the presence of cryptic clusters of genetically-differentiated nests in the three populations of F. paralugubris. Because of this spatial genetic heterogeneity, members of the same clusters were moderately but significantly related. The comparison of nuclear (microsatellite) and mitochondrial differentiation indicated that effective gene flow was male-biased in all populations. CONCLUSION: The three unicolonial populations exhibited male-biased and mostly local gene flow. The high number of queens per nest, exchanges among neighbouring nests and restricted long-distance gene flow resulted in large clusters of genetically similar nests. The positive relatedness among clustermates suggests that kin selection may still contribute to the maintenance of altruism in unicolonial populations if competition occurs among clusters

Condition-dependent signaling affects male sexual attractiveness in field crickets, Gryllus campestris

The condition dependence of sexually selected traits is an important assumption of sexual selection theory. Several laboratory studies have documented a positive relationship between food availability, body condition, and sexual display. However, these studies might not reflect the resource allocation between body maintenance, reserves, and the sexually selected trait under natural conditions. Further, the effect of condition-dependent signaling on female mate choice has hardly been investigated experimentally in the field. We therefore investigated the effect of food availability on body condition, calling behavior, and sexual attractiveness of male field crickets, Gryllus campestris, under field conditions. Food availability was manipulated for individual males by supplementing food in a confined area close to the burrow. Food-supplemented males showed a significant increase in body condition, whereas the opposite was found in the control males. Males receiving extra food called more frequently, whereas the calling-song characteristics were not affected by the treatment. Further, food-supplemented males attracted more females than did control males, and their higher attractiveness was partly explained by their superior calling rate. Our study thus indicates condition-dependent signaling as an important determinant of the sexual attractiveness of males to females under natural conditio

Józef Kazimierski, Miasta i miasteczka na Podlasiu (1808-1914). Zabudowa, ludność, gospodarka, Warszawa 1994, ss. 311

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Evaluation of Ovarian Cysts

Initial evaluation of an ovarian cyst is largely determined by its characteristics on ultrasonography, in addition to the presence of symptoms, laboratory evaluation, and patient history. Women with an ovarian cyst, but with no symptoms, family or personal history of cancer (e.g., ovarian, breast, colorectal), physical or laboratory evidence suggestive of infection, pregnancy, or systemic illness, are considered at low risk of ovarian cancer and may be followed with serial ultrasonography. (Strength of Recommendation [SOR]: B, based on a prospective cohort study.) A cyst identified on transvaginal ultrasonography is usually benign if it is thin-walled, unilocular, smooth-bordered, and less than 10 cm in diameter. Cyst aspiration and treatment with combined oral contraceptives do not hasten cyst resolution. (SOR: A, based on good-quality randomized controlled trials.) A complex cyst without benign features should be aggressively evaluated for ovarian cancer. (SOR: C, based on expert opinion.

adreizehn 2012/2013

Zugleich gedruckt erschienen im Universitätsverlag der TU Berlin unter der ISBN 978-3-7983-2665-1Das Jahrbuch 'adreizehn 2012/2013' umfasst Studentenarbeiten des 3. und 4. Semesters im Bachelorstudiengang Architektur. Gegenstand der gezeigten Hochbauentwürfe sind exemplarische Vorschläge zur urbanen Nachverdichtung im Zentrum Berlins. Programme verschiedener Nutzungen werden zu Stadtimplantaten verdichtet, die privaten und öffentlichen Raum in hybriden Strukturen neu und beispielgebend verbinden können. Eine Auswahl der besten Arbeiten des Jahrgangs 2012 / 2013 wird mittels Plänen, Schnitten, Ansichten, Modellfotos und Visualisierungen dokumentiert. Ergänzt wird die Publikation durch Texte von Prof. Ute Frank und Prof. Barbara Holzer.Yearbook 2012/2013 of department adreizehn for building construction and building design, Faculty VI, Institute for Architecture, Technische Universität Berlin With students' works of the 1st and 2nd year and texts by Prof. Ute Frank and Prof. Barbara Holze

Evidence-based design recommendations for prevalence studies on multimorbidity: improving comparability of estimates

Background: In aging populations, multimorbidity causes a disease burden of growing importance and cost. However, estimates of the prevalence of multimorbidity (prevMM) vary widely across studies, impeding valid comparisons and interpretation of differences. With this study we pursued two research objectives: (1) to identify a set of study design and demographic factors related to prevMM, and (2) based on (1), to formulate design recommendations for future studies with improved comparability of prevalence estimates. Methods: Study data were obtained through systematic review of the literature. UsingPubMed/MEDLINE, Embase, CINAHL, Web of Science, BIOSIS, and Google Scholar, we looked for articles with the terms “multimorbidity,” “comorbidity,” “polymorbidity,” and variations of these published in English or German in the years 1990 to 2011. We selected quantitative studies of the prevalence of multimorbidity (two or more chronic medical conditions) with a minimum sample size of 50 and a study population with a majority of Caucasians. Our database consisted of prevalence estimates in 108 age groups taken from 45 studies. To assess the effects of study design variables, we used meta regression models. Results: In 58% of the studies, there was only one age group, i.e., no stratification by age. The number of persons per age group ranged from 136 to 5.6 million. Our analyses identified the following variables as highly significant: “mean age,” “number of age groups”, and “data reporting quality” (all p < 0.0001). “Setting,” “disease classification,” and “number of diseases in the classification” were significant (0.01 < p ≤ 0.03), and “data collection period” and “data source” were non-significant. A separate analysis showed that prevMM was significantly higher in women than men (sign test, p = 0.0015). Conclusions: Comparable prevalence estimates are urgently needed for realistic description of the magnitude of the problem of multimorbidity. Based on the results of our analyses of variables affecting prevMM, we make some design recommendations. Our suggestions were guided by a pragmatic approach and aimed at facilitating the implementation of a uniform methodology. This should aid progress towards a more uniform operationalization of multimorbidity. Keywords: Age, Gender, Study design variables, Multiple chronic conditions, Systematic revie

Motivation and personality factors of Generation Z high school students aspiring to study human medicine

Background: A new generation of medical students, Generation Z (Gen Z), is becoming the predominant population in medical schools and will join the workforce in a few years’ time. Medicine has undergone serious changes in high-income countries recently. Therefore, it is unclear how attractive the medical profession still is for high school students of Gen Z. The aim of this study was to investigate what motivation leads Gen Z students in their choice to study human medicine, and how they see their professional future. Our study was guided by motivation theory and the influence of personality traits and other personal factors on students’ choice of university major. Methods: In a cross-sectional online survey, we included third- and fourth-year high school students in Northern Switzerland. We examined the importance of criteria when choosing a university major: personality traits, career motivation, life goals, and other considerations influencing the choice of human medicine versus other fields of study. Results Of 1790 high school students, 456 (25.5%) participated in the survey (72.6% women, mean age 18.4 years); 32.7% of the respondents aspired to major in medicine at university. For all respondents, the foremost criterion for selecting a field of study was ‘interest in the field,’ followed by ‘income’ and ‘job security.’ High school students aiming to study human medicine attached high importance to ‘meaningful work’ as a criterion; supported by 36.2% of those students answering that helping and healing people was a core motivation to them. They also scored high on altruism (p < 0.001 against all groups compared) and intrinsic motivation (p < 0.001) and were highly performance- (p < 0.001) and career-minded (p < 0.001). In contrast, all the other groups except the law/economics group had higher scores on extraprofessional concerns. Conclusions: Swiss Gen Z students aspiring to study human medicine show high intrinsic motivation, altruism, and willingness to perform, sharing many values with previous generations. Adequate work-life balance and job security are important issues for Gen Z. Regarding the current working conditions, the ongoing shortage of physicians, and recent findings on physicians’ well-being, the potential for improvement and optimization is high