Quality Assurance Through a Continuous Curriculum Review (CCR) Strategy: Reflections on a Pilot Project

Institutional research can be defined as "the activity in which the research effort of an academic institution is directed at the solution of its own problems and to the enhancement of its own performance" (Woodward, 1993, p. 113). This paper describes and reflects on an attempt at the University of Queensland to address the need for course quality appraisal for improvement. The strategy, Continuous Curriculum Review (CCR) is simply an attempt to trial and promote regular comprehensive data collection for developing 'snapshot' views of whole curricula so that decisions about what to change and what to change first can be made in an empirically defensible and timely manner. The strategy and reporting protocols that were developed are described, and the costs and benefits of engaging in this kind of data gathering exercise for quality assurance and quality enhancement purposes are discussed.

Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased In Vivo P50

We investigated whether red cell 2,3-diphosphoglycerate (2,3-DPG) concentrations are reduced in critical illness, whether acidaemia, hypophosphataemia or anaemia influence 2,3-DPG, and whether there is any net effect on in vivo P50. Twenty healthy, non-smoking, male volunteers were compared with 20 male intensive care patients with APACHE 2 scores > 20 on the preceding day. Those transfused in this time were excluded. Venous red cell 2,3-DPG concentrations were measured in both groups. In the patient group, routine multichannel biochemical profile and arterial blood gas analysis were also performed and in vivo P50 calculated. The mean 2,3-DPG concentration was significantly lower in the patient group than in the controls (4.2 +/-1.3 mmoll/l vs 4.9 +/-0.5 mmol/l, P=0.016). The patients were well oxygenated (lowest arterial PO2=75 mm Hg) and showed a tendency to acidaemia (median pH 7.37, range 7.06 to 7.48) and anaemia (median haemoglobin concentration 113 g/l, range 89 to 154 g/l). By linear regression of patient data, pH had a significant effect on 2,3-DPG concentrations (r=0.6, P=0.011). Haemoglobin and phosphate concentrations did not, but there were few abnormal phosphate values. There was no correlation between 2,3-DPG concentrations and in vivo P50 (r(2) less than or equal to 0.08). We conclude that 2,3-DPG concentrations were reduced in a broad group of critically ill patients. Although this would normally reduce the P50, the reduction was primarily linked with acidaemia, which increases the P50. Overall, there was no net effect on the P50 and thus no affinity-related decrease in tissue oxygenation.

Myocardial abnormalities in hypertensive patients with normal and abnormal left ventricular filling: a study of ultrasound tissue characterization and strain

Abnormal left ventricular (LV) filling is common, but not universal, in hypertensive LV hypertrophy (LVH). We sought to elucidate the relative contributions of myocardial structural changes, loading and hypertrophy to LV dysfunction in 113 patients: 85 with hypertensive LVH and 28 controls without LVH and with normal filling. Patients with normal dobutamine stress echocardiography and no history of coronary artery disease were selected, in order to exclude a contribution from ischaemia or scar. Abnormal LV filling was identified in 65 LVH patients, based on Doppler measurement of transmitral filling and annular velocities. All patients underwent grey-scale and colour tissue Doppler imaging from three apical views, which were stored and analysed off line. Integrated backscatter (113) and strain rate imaging were used to detect changes in structure and function; average cyclic variation of 113, strain rate and peak systolic strain were calculated by averaging each segment. Calibrated 113 intensity, corrected for pericardial 113 intensity, was measured in the septum and posterior wall from the parasternal long-axis view. Patients with LVH differed significantly from controls with respect to all backscatter and strain parameters, irrespective of the presence or absence of abnormal LV filling. LVH patients with and without abnormal LV filling differed with regard to age, LV mass and incidence of diabetes mellitus, but also showed significant differences in cyclic variation (P < 0.01), calibrated 113 in the posterior wall (P < 0.05) and strain rate (P < 0.01), although blood pressure, heart rate and LV systolic function were similar. Multivariate logistic regression analysis demonstrated that age, LV mass index and calibrated IB in the posterior wall were independent determinants of abnormal LV filling in patients with LVH. Thus structural and functional abnormalities can be detected in hypertensive patients with LVH with and without abnormal LV filling. In addition to age and LVH, structural (not functional) abnormalities are likely to contribute to abnormal LV filling, and may be an early sign of LV damage. 113 is useful for the detection of myocardial abnormalities in patients with hypertensive LVH.

Cloud-point extraction and preconcentration of cyanobacterial toxins (microcystins) from natural waters using a cationic surfactant

A new cloud-point extraction and preconcentration method, using a cationic, surfactant, Aliquat-336 (tricaprylyl-methy;ammonium chloride), his-been developed for the determination of cyanobacterial toxins, microcystins, in natural waters. Sodium sulfate was used to induce phase separation at 25 degreesC. The phase behavior of Aliquat-336 with respect to concentration of Na2SO4 was studied. The cloud-point system revealed a very high phase volume ratio compared to other established systems of nonionic, anionic, and cationic surfactants: At pH 6-7, it showed an outstanding selectivity in ahalyte extraction for anionic species. Only MC-LR and MC-YR, which are known to be predominantly anionic, were extracted (with averaged recoveries of 113.9 +/- 9% and 87.1 +/- 7%, respectively). MC-RR, which is likely to be amphoteric at the above pH range, was. not cle tectable in.the extract. Coupled to HPLC/UV separation and detection, the cloud-point extraction method (with 2.5 mM Aliquat-336 and 75 mM Na2SO4 at 25 degreesC) offered detection limits of 150 +/- 7 and 470 +/- 72 pg/mL for MC-LR and MC-YR, respectively, in 25 mL of deionized water. Repeatability of the method was 7.6% for MC-LR and 7.3% for MC-YR: The cloud-point extraction process can be. completed within 10-15 min with no cleanup steps required. Applicability of the new method to the determination of microcystins in real samples was demonstrated using natural surface waters, collected from a local river and a local duck pond spiked with realistic. concentrations of microcystins. Effects of salinity and organic matter (TOC) content in the water sample on the extraction efficiency were also studied.

Links between attachment orientations and dispositional and diary-based measures of disclosure in dating couples: A study of actor and partner effects

Issues concerning the influence of attachment characteristics on own and partner's disclosure were addressed using a sample of 113 couples in medium-term dating relationships. Individual differences in attachment were assessed in terms of relationship anxiety and avoidance. Disposition to disclose was assessed using questionnaire measures of self-disclosure, relationship-focused disclosure, and the ability to elicit disclosure from the partner; in addition, structured diaries were used to assess aspects of disclosure (amount, intimacy, emotional tone, and satisfaction) in the context of couples' everyday interactions. Couple-level analyses showed that avoidance strongly predicted dispositional measures of disclosure, whereas anxiety (particularly partner's anxiety) was related to negative evaluations of everyday interactions. Interactive effects of attachment dimensions and gender were also obtained, highlighting the complexity of communication behavior. The results are discussed in terms of the goals and strategies associated with working models of attachment.

Porphyrins as early biomarkers for arsenic exposure in animals and humans

We studied the effect of arsenic exposure on the haem biosynthetic pathway in the rat and humans. Significant increases in protoporphyrin IX, coproporphyrin III, coproporphyrin I were observed in the blood, liver and kidney, and in the urine of rats after a single dose of arsenic. The level of increase was dependent on the arsenic species present. Most of porphyrin concentrations in the tissues increased within 24 hr and urinary excretion elevated within 48 hr. In the human study, we collected urine samples from 113 people who live in Xing Ren of Guizhou Province, a coal-borne arsenicosis endemic area in southwest of PR China and from 30 people who live in Xing Yi (about 80 km southwest of Xing Ren) where arsenicosis is not prevalent. We analyzed the urinary porphyrins using HPLC. Results indicate that all urinary porphyrins were higher in the arsenic exposed group than those in the control group. Women, children and older age people spend much of their time indoors, they had greater increases of urinary arsenic and porphyrins. They were the higher risk groups among the study subjects. A positive correlation between the urinary arsenic levels and porphyrin concentrations demonstrated the effect of arsenic on haem biosynthesis. Significant alteration in the porphyrin excretion profiles of the younger age (

Epidemiological significance of subterranean Aedes aegypti (Diptera : Culicidae) breeding sites to dengue virus infection in charters towers, 1993

The objective of this study was to determine the epidemiological significance of subterranean mosquito breeding sites to the 1993 outbreak of dengue fever (type 2) in the northern Queensland town of Charters Towers, Australia. In recent studies on subterranean mosquito breeding, containers such as wells and service manholes have been shown to be important breeding sites to Australia's only dengue vector, Aedes aegypti (L.). This study demonstrates a direct epidemiological association between subterranean breeding sites and dengue virus infection. The mean distance between residents seropositive for dengue 2 and the nearest subterranean container (113 m) was significantly less than for a randomly selected control (191 m), (F = 81.9; df = 1, 478; P < 0.001). Residents positive for dengue 2 antibodies was 2.47 (95% confidence interval 1.88-3.24) times higher for those living within 160 m of a well or service manhole, compared with those residing further away. These findings emphasize the importance of including subterranean water containers in Ae. aegypti surveillance and control programs.

Functional significance of a highly conserved glutamate residue of the human noradrenaline transportere

The aim of the study was to investigate the role of glutamate residue 113 in transmembrane domain 2 of the human noradrenaline transporter in determining cell surface expression and functional activity. This residue is absolutely conserved in all members of the Na+- and Cl--dependent transporter family. Mutations to alanine (hE113A), aspartate (hE113D) and glutamine (hE113Q) were achieved by site-directed mutagenesis and the mutants were expressed in transfected COS-7 or HEK-293 cells. Cell surface expression of IIE113A and hE113D, but not hE113Q, was markedly reduced compared with wild type, and functional noradrenaline uptake was detected only for the hE113Q mutant. The pharmacological properties of the hE113Q mutant showed very little change compared with wild type, except for a decrease in V-max values for noradrenaline and dopamine uptake of 2-3-fold. However, the hE113D mutant showed very marked changes in its properties, compared with wild type, with 82-260-fold decreases in the affinities of the substrates, noradrenaline, dopamine and MPP+, and increased Na+ affinity for stimulation of nisoxetine binding. The results of the study show that the size and not the charge of the 113 glutamate residue of the noradrenaline transporter seems to be the most critical factor for maintenance of transporter function and surface expression.

Sistema integrado de passagens e di??rias: SIPAD

O Sistema Integrado de Passagens e Di??rias (SIPAD), foi concebido no conceito de integra????o de dados e utiliza uma base de dados ??nica que evita o retrabalho e a inconsist??ncia de informa????es. O sistema tem por objetivo tornar mais ??gil, transparente e desburocratizado o processo de solicita????o, gerenciamento e controle de passagens e di??rias no ??mbito do Minist??rio da Sa??de. O SIPAD permite, em tempo real, o atendimento dos pedidos de viagens mediante requisi????es eletr??nicas com alto grau de confiabilidade e seguran??a. O sistema permite ainda o controle f??sico e a gest??o financeira de todos os pedidos de viagem; o c??lculo autom??tico de valores de di??rias inclusive em moeda estrangeira; o acompanhamento de trechos de viagens e conex??es internacionais com indica????o dos aeroportos; o controle e presta????o de contas de viagens; o desconto autom??tico do valor do vale refei????o por UF. A seguran??a do SIPAD ?? garantida por sistema que permite acessos escalonados por n??veis de senha , a partir de perfis previamente definidos. No SIPAD pode-se realizar consultas on line e emiss??o automatizada de relat??rios operacionais e gerenciais com interface gr??fica. Os resultados ap??s a implanta????o , em 01/07/99, j?? causam impactos significativos. A economia estimada para o ano 2000, apenas em uma unidade gestora do Minist??rio, ?? de redu????o de 113.606 folhas de papel; elimina????o de 23.346 etiquetas; elimina????o de 40.468 assinaturas de gestores e ordenadores de despesa; elimina????o de 58.369 procedimentos de carimbo em pap??is; elimina????o de 11.673 registros de controle e 58.459 tramita????es de documentos

Colet??nea planejamento e or??amento governamental: volume 1: pref??cio

Pref??cio da colet??nea, estabelece seu objetivo de fornecer material did??tico focado no desenvolvimento profissional da administra????o p??blica brasileira.

Colet??nea planejamento e or??amento governamental: volume 1: introdu????o

Esta introdu????o, al??m de apresentar e contextualizar cada tem??tica, objetiva ser um texto did??tico b??sico para os cursos da ENAP. Nesse sentido, traz, adicionalmente, uma s??ntese dos temas desenvolvidos nos respectivos textos da colet??nea.

Colet??nea planejamento e or??amento governamental: volume 1: o plano como aposta

O texto sintetiza os principais fundamentos do m??todo PES. Esse m??todo contrap??e-se ao planejamento tradicional e prop??e uma abordagem tecnopol??tica do planejamento.

Colet??nea planejamento e or??amento governamental: volume 1: o quadro l??gico - um m??todo para planejar e gerenciar mudan??as

O texto traz uma s??ntese do Enfoque do Quadro L??gico e constr??i um exemplo da matriz de planejamento do projeto, que ilustra para o leitor a estrutura do QL

Colet??nea planejamento e or??amento governamental: volume 1: a experi??ncia brasileira em planejamento econ??mico - uma s??ntese hist??rica

O texto faz uma s??ntese did??tica dos planos de desenvolvimento e de estabiliza????o econ??mica implementados no Brasil, nas ??ltimas seis d??cadas. O relato abrange desde os primeiros exerc??cios de planejamento, no imediato p??s-Segunda Guerra Mundial, at?? os ??ltimos PPAs e, ainda, faz refer??ncias ??s tentativas de planejamento de longo prazo com o ???Brasil 2020???, no governo Fernando Henrique.

Colet??nea planejamento e or??amento governamental: volume 1: a retomada do planejamento governamental no Brasil e seus desafios

O texto apresenta um cen??rio dos avan??os recentes no planejamento governamental. Em sua primeira parte, procura referenciar o debate atual acerca das possibilidades, das limita????es e dos avan??os introduzidos pelo PPA, especialmente a partir de 2000, com destaque para a integra????o ???plano-or??amento???, por meio de programas formulados com origem em problemas ou demandas da sociedade; um plano e um or??amento orientados para resultado; e o novo sistema de planejamento e or??amento como pe??a fundamental para a implanta????o da gest??o por resultados no Pa??s. A segunda parte do texto refere-se ao modelo de gest??o do plano. S??o apresentados os fundamentos do modelo de sua gest??o e os avan??os propostos para o PPA 2004-2007. Em s??ntese, a gest??o do plano ?? fundamentada no princ??pio da responsabiliza????o e nos processos de monitoramento, avalia????o e retroalimenta????o do ciclo do gasto p??blico