why do romanian universities fail to internalize quality assurance

Despite legal provisions in place since 2005, Romanian universities are considered to perform internal quality assurance only at a formal level, on paper, and usually in anticipation of external evaluations demanded by the government or other official institutions. This paper posits five hypotheses to explain this situation. We analyze 187 interviews with people in universities in order to evaluate these hypotheses. Only two hypotheses are confirmed by the data, allowing us to construct a narrative of policy failure. First, there are top-down failures resulting from unclear and inconsistent legal provisions that focus on multilayered evaluation procedures. Second, there are bottom-up failures related to the lack of ownership over internal quality assurance systems by the actors in the universities. The existing procedures are often seen as control-tools of government, and understood as disconnected from the universities' own goals and problems. Consequently, people on the ground passively try to subvert these tools by carrying them out in a ritualistic manner—which is why quality assurance cannot become internalized

A study to derive a clinical decision rule for triage of emergency department patients with chest pain: design and methodology

<p>Abstract</p> <p>Background</p> <p>Chest pain is the second most common chief complaint in North American emergency departments. Data from the U.S. suggest that 2.1% of patients with acute myocardial infarction and 2.3% of patients with unstable angina are misdiagnosed, with slightly higher rates reported in a recent Canadian study (4.6% and 6.4%, respectively). Information obtained from the history, 12-lead ECG, and a single set of cardiac enzymes is unable to identify patients who are safe for early discharge with sufficient sensitivity. The 2007 ACC/AHA guidelines for UA/NSTEMI do not identify patients at low risk for adverse cardiac events who can be safely discharged without provocative testing. As a result large numbers of low risk patients are triaged to chest pain observation units and undergo provocative testing, at significant cost to the healthcare system. Clinical decision rules use clinical findings (history, physical exam, test results) to suggest a diagnostic or therapeutic course of action. Currently no methodologically robust clinical decision rule identifies patients safe for early discharge.</p> <p>Methods/design</p> <p>The goal of this study is to derive a clinical decision rule which will allow emergency physicians to accurately identify patients with chest pain who are safe for early discharge. The study will utilize a prospective cohort design. Standardized clinical variables will be collected on all patients at least 25 years of age complaining of chest pain prior to provocative testing. Variables strongly associated with the composite outcome acute myocardial infarction, revascularization, or death will be further analyzed with multivariable analysis to derive the clinical rule. Specific aims are to: i) apply standardized clinical assessments to patients with chest pain, incorporating results of early cardiac testing; ii) determine the inter-observer reliability of the clinical information; iii) determine the statistical association between the clinical findings and the composite outcome; and iv) use multivariable analysis to derive a highly sensitive clinical decision rule to guide triage decisions.</p> <p>Discussion</p> <p>The study will derive a highly sensitive clinical decision rule to identify low risk patients safe for early discharge. This will improve patient care, lower healthcare costs, and enhance flow in our busy and overcrowded emergency departments.</p

Successional Change in Phosphorus Stoichiometry Explains the Inverse Relationship between Herbivory and Lupin Density on Mount St. Helens

The average nitrogen-to-phosphorus ratio (N?P) of insect herbivores is less than that of leaves, suggesting that P may mediate plant-insect interactions more often than appreciated. We investigated whether succession-related heterogeneity in N and P stoichiometry influences herbivore performance on N-fixing lupin (Lupinus lepidus) colonizing primary successional volcanic surfaces, where the abundances of several specialist lepidopteran herbivores are inversely related to lupin density and are known to alter lupin colonization dynamics. We examined larval performance in response to leaf nutritional characteristics using gelechiid and pyralid leaf-tiers, and a noctuid leaf-cutter.Apple JL, Wink M, Wills SE, Bishop JG (2009) Successional Change in Phosphorus Stoichiometry Explains the Inverse Relationship between Herbivory and Lupin Density on Mount St. Helens. PLoS ONE 4(11): e7807. doi:10.1371/journal.pone.000780

An ethic of connectedness: enacting moral school leadership through people and programs

As educators, we grapple with a myriad of dilemmas and often have difficulty resolving issues that relate to curriculum and instruction, funding, facilities and supervision, to name a few. Depending on the leader(s), a variety of ethics come in to play when making decisions. The ethic of connectedness refers to community building and welfare as central to moral thought and practice (Bradley, 2007). Responsibility to community building and welfare begins in the schools and must be an acculturated practice within the schools so future generations possess the knowledge, skills and dispositions that ensure a connectedness to their society (Marzano et al., 2005; Barth 2006; Collinson et al., 2006). This article will explore the importance of an ethic of connectedness to effective school leadership and the experience of a Pennsylvania school district in nurturing and building a connectedness within the school community.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

The Oxytocin Receptor Gene (OXTR) in relation to state levels of loneliness in adolescence: Evidence for micro-level gene-environment interactions

Contains fulltext : 121851.pdf (publisher's version ) (Open Access)Previous research has shown that the rs53576 variant of the oxytocin receptor gene (OXTR) is associated with trait levels of loneliness, but results are inconsistent. The aim of the present study is to examine micro-level effects of the OXTR rs53576 variant on state levels of loneliness in early adolescents. In addition, gene-environment interactions are examined between this OXTR variant and positive and negative perceptions of company. Data were collected in 278 adolescents (58% girls), by means of the Experience Sampling Method (ESM). Sampling periods consisted of six days with nine assessments per day. A relation was found between the OXTR rs53576 variant and state loneliness, in girls only. Girls carrying an A allele had higher levels of state loneliness than girls carrying the GG genotype. In addition, adolescents with an A allele were more affected by negative perceptions of company than GG carriers, on weekend days only. No significant gene-environment interactions were found with positive company. Adolescents carrying an A allele were more susceptible to negative environments during weekend days than GG carriers. Our findings emphasize the importance of operationalizing the phenotype and the environment accurately.10 p