BRIEF REPORT: Brief Instrument to Assess Geriatrics Knowledge of Surgical and Medical Subspecialty House Officers

Initiatives are underway to increase geriatrics training in nonprimary care disciplines. However, no validated instrument exists to measure geriatrics knowledge of house officers in surgical specialties and medical subspecialties. METHODS : A 23-item multiple-choice test emphasizing inpatient care and common geriatric syndromes was developed through expert panels and pilot testing, and administered to 305 residents and fellows at 4 institutions in surgical disciplines (25% of respondents), emergency medicine (29%), medicine subspecialties (19%), internal medicine (12%), and other disciplines (15%). RESULTS : Three items decreased internal reliability. The remaining 20 items covered 17 topic areas. Residents averaged 62% correct on the test. Internal consistency was appropriate (Cronbach's Α coefficient=0.60). Validity was supported by the use of expert panels to develop content, and by overall differences in scores by level of training ( P <.0001) and graded improvement in test performance, with 58%, 63%, 62%, and 69% correct responses among HO1, HO2, HO3, and HO4s, respectively. CONCLUSIONS : This reliable, valid measure of clinical geriatrics knowledge can be used by a wide variety of surgical and medical graduate medical education programs to guide curriculum reform or evaluate program performance to meet certification requirements. The instrument is now available on the web.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73902/1/j.1525-1497.2006.00433.x.pd

Horizontal acquisition of multiple mitochondrial genes from a parasitic plant followed by gene conversion with host mitochondrial genes

Background: Horizontal gene transfer (HGT) is relatively common in plant mitochondrial genomes but the mechanisms, extent and consequences of transfer remain largely unknown. Previous results indicate that parasitic plants are often involved as either transfer donors or recipients, suggesting that direct contact between parasite and host facilitates genetic transfer among plants. Results: In order to uncover the mechanistic details of plant-to-plant HGT, the extent and evolutionary fate of transfer was investigated between two groups: the parasitic genus Cuscuta and a small clade of Plantago species. A broad polymerase chain reaction (PCR) survey of mitochondrial genes revealed that at least three genes (atp1, atp6 and matR) were recently transferred from Cuscuta to Plantago. Quantitative PCR assays show that these three genes have a mitochondrial location in the one species line of Plantago examined. Patterns of sequence evolution suggest that these foreign genes degraded into pseudogenes shortly after transfer and reverse transcription (RT)- PCR analyses demonstrate that none are detectably transcribed. Three cases of gene conversion were detected between native and foreign copies of the atp1 gene. The identical phylogenetic distribution of the three foreign genes within Plantago and the retention of cytidines at ancestral positions of RNA editing indicate that these genes were probably acquired via a single, DNA-mediated transfer event. However, samplings of multiple individuals from two of the three species in the recipient Plantago clade revealed complex and perplexing phylogenetic discrepancies and patterns of sequence divergence for all three of the foreign genes. Conclusions: This study reports the best evidence to date that multiple mitochondrial genes can be transferred via a single HGT event and that transfer occurred via a strictly DNA-level intermediate. The discovery of gene conversion between co-resident foreign and native mitochondrial copies suggests that transferred genes may be evolutionarily important in generating mitochondrial genetic diversity. Finally, the complex relationships within each lineage of transferred genes imply a surprisingly complicated history of these genes in Plantago subsequent to their acquisition via HGT and this history probably involves some combination of additional transfers (including intracellular transfer), gene duplication, differential loss and mutation-rate variation. Unravelling this history will probably require sequencing multiple mitochondrial and nuclear genomes from Plantago

DEVELOPMENTS: Advancing Geriatrics Education: Evaluation of a New Curricular Initiative

Background: This study describes the development of a required 1-week curricular program in geriatric medicine for 3rd-year medical students and presents 3 years of evaluation data. Description: Successful aging, heterogeneity of the aging population, and comprehensive geriatric assessment were emphasized. In addition to didactic sessions, students participated in panel discussions and small group case conferences, and performed history and physical examinations on older patients. Evaluation: Students\u27 acquisition of knowledge about geriatric medicine was assessed with pre-and posttests; posttest scores showed statistically significant improvement. Because attitudes toward older patients can impact the care provided, students\u27 completed pre- and postattitude assessment scales. Attitude measures were repeated for 2 student cohorts, 1 and 2 years after completion of the program. Independent t tests comparing mean pretest and posttest scores revealed significant improvement in students\u27 attitudes, which were maintained when attitudes were retested. Standardized mean difference scores were computed to measure the relationship between the educational intervention and students\u27 attitude measures. Conclusions: Time in the medical school curriculum is scarce, but these results indicate that significant improvements can be made in medical students\u27 attitudes toward and knowledge of older patients in 1 week

Effect of leaf‐to‐fruit

BACKGROUND: The single high‐wire system is a free canopy trellis system suitable for warm to hot climates. In a global warming scenario, it arouses as a technological solution since it prevents berry overheating and sunburn. Canopy management practices manipulate leaf‐to‐fruit ratios, affecting berry and wine composition. We aimed to evaluate the phenolic and sensory profiles of Malbec wines from single high‐wire trellised vineyards in a hot region in Mendoza (Argentina) and to assess the effect of varying leaf‐to‐fruit ratios on these attributes. We manipulated leaf‐to‐fruit ratios by varying shoot trimming (experiment 1: 0.45 m, 0.80 m, and untrimmed) and winter pruning severity (experiment 2: 16, 24, 32, and >32 countable buds per meter). We characterized wine attributes by a descriptive analysis, color by the CIELAB space, and global phenolics compounds and anthocyanins by high‐performance liquid chromatography with diode array detection. RESULTS: We found that wines where shoots were trimmed to 0.80 m or left untrimmed had similar and greater intensity of color, violet hue, astringency, and alcohol and a richer aroma profile than wines where shoots were trimmed to 0.45 m. Meanwhile, wines from 16 and >32 buds/m treatments (the latter simulating a box pruning) were similar to each other and had higher color intensity, violet hue, acidity, alcohol, and astringency and a more complex aroma profile than the other pruning treatments. CONCLUSIONS: The best quality wines were achieved by leaving 16 or >32 buds/m and by trimming shoots to 0.80 m or leaving them untrimmed. The modulation of cultural practices in sprawling canopies offers the potential to produce wines with different styles in hot regions.EEA MendozaFil: Ahumada, Gastón E. Trapiche Winery; ArgentinaFil: Catania, Anibal Alejandro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mendoza. Laboratorio de Aromas y Sustancias Naturales; ArgentinaFil: Fanzone, Martín Leandro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mendoza. Laboratorio de Aromas y Sustancias Naturales; ArgentinaFil: Belmonte, Marcelo J. Trapiche Winery; ArgentinaFil: Giordano, Carla Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Gonzalez, Carina Veronica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Biología Agrícola de Mendoza. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias. Instituto de Biología Agrícola de Mendoza; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentin

The contradiction between production and consumption as related to the study of crisis (4)

Abstract Objectives Further research into medical student attitudes towards older people is important, and requires accurate and detailed evaluative methodology. The two objectives for this paper are: (1) From the literature, to critically review instruments of measure for medical student attitudes towards older people, and (2) To recommend the most appropriate quantitative instrument for future research into medical student attitudes towards older people. Results A SCOPUS and Ovid cross search was performed using the keywords Attitude and medical student and aged or older or elderly. This search was supplemented by manual searching, guided by citations in articles identified by the initial literature search, using the SCOPUS and PubMed databases. International studies quantifying medical student attitudes have demonstrated neutral to positive attitudes towards older people, using various instruments. The most commonly used instruments are the Ageing Semantic Differential (ASD) and the University of California Los Angeles Geriatric Attitudes Scale, with several other measures occasionally used. All instruments used to date have inherent weaknesses. A reliable and valid instrument with which to quantify modern medical student attitudes towards older people has not yet been developed. Adaptation of the ASD for contemporary usage is recommended