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PubMed2026

Advancing nursing education through social and emotional learning: A systematic review guided by the Collaborative for Academic, Social, and Emotional Learning framework.

BACKGROUND: With Generation Z entering the nursing workforce in growing numbers, strengthening social and emotional learning is critical for academic success, professional adaptation, and safe practice. However, the existing evidence remains fragmented because of varied interventions and inconsistent approaches. OBJECTIVES: This systematic review examined (1) the social and emotional learning essential for nursing students and nurses within the Collaborative for Academic, Social, and Emotional Learning framework, (2) their impact on educational and clinical outcomes, and (3) implications for advancing nursing education and practice. METHODS: Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five international (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane) and three Korean (RISS, KoreaMed, KMBASE) databases were searched up to June 2025. Eighteen studies involving 2,952 participants met the inclusion criteria, including quasi-experimental quantitative studies, descriptive quantitative studies, qualitative studies, and mixed-methods studies. The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS: Within the Collaborative for Academic, Social, and Emotional Learning framework, relationship skills and self-management were the most frequently studied competencies, emphasizing teamwork, communication, and stress regulation. Self-awareness and social awareness were underexplored, despite their importance in empathy, resilience, and reflective practice. Responsible decision-making was the least studied competency, despite its importance in ethical reasoning. Social and emotional learning was consistently associated with enhanced adaptation, communication, leadership, relationships, and clinical performance. Effective strategies included blended learning, simulation, reflective activities, and mentorship, which are aligned with Generation Z's learning preferences. CONCLUSION: Although social and emotional learning integration is associated with improvements in educational and clinical outcomes in nursing, current research has largely centered on relational and stress-related competencies while underrepresenting responsible decision-making. To cultivate reflective, empathetic, and ethically grounded nurses, curricula should integrate social and emotional learning through a balanced and structured approach. REGISTRATION: This study was registered on PROSPERO (ID: CRD420251005683).

Humans↗
PubMed1997

Feminism: a path to clinical knowledge development.

Nurses are under increasing pressure to defend the efficacy, value and cost benefits of professional nursing care. Now more than ever, there is a need for nurses to undertake quality clinical research, through which practice may be shaped and guided. Feminist theory can provide a lens through which nurses may explore clinical issues. It also provides a framework by which socially constructed differences, such as gender and culture, may be incorporated into the design of clinical research projects. Because feminism is an openly political and transformative process, feminist concepts are suitable for use where the aim of the research is to catalyse practice change. This paper explores the use of feminism as a theoretical framework for nursing research.

Clinical Competence↗
PubMed1981

Hemispheres as independent resource systems: limited-capacity processing and cerebral specialization.

In this article, we develop as framework for understanding how cerebral specialization of function contributes to the flexibility of human information processing. We propose that the left and right hemispheres together form a system of two mutually inaccessible and finite pools of resources. Further, we propose that these two types of resources cannot be made available in different amounts at any given time. This framework is essentially a special case of a multiple-resources model of limited-capacity information processing. It accounts for a broad range of data from experiments involving perceptual and cognitive information processing, control of motor performance, and changes in electrical activity of the brain. It also provides insights into why the cerebral specialization literature has been plagued with problems that have made theorizing so difficult. In addition, the theory provides insights into mechanisms that might be responsible for patterns of task interference that are not easily handled by an information-processing model in which processes compete for supplies from a single pool of undifferentiated resources. Thus, the framework we are proposing has important theoretical and methodological implications for researchers in both divided attention and cerebral specialization.

Attention↗
PubMed1979

Voluntary dental laboratory certification program. Council on Prosthetic Services and Dental Laboratory Relations.

Laboratory certification does not offer concrete guarantees of consistent high quality of products or services. It does, however, identify, for the dental profession, a competency and acceptability factor on which to base a predication of performance by the laboratory. Also, laboratory certification establishes a framework within which the dental laboratory industry can work to continue upgrading its facilities and personnel, demonstrates the concern of certified laboratories for continuing competence, and indicates to government and third-party payers a willingness to develop standards endorsed by the industry.

Certification↗
PubMed1990

Critical features of a curriculum in health care quality and resource management.

In response to mounting demands for quality and accountability in health care, a science of health care quality and resource management (QRM) has evolved, but too slowly and without the academic base needed to prepare practitioners to assume new roles and fulfill requirements to regulate their practice. To develop such a base, The University of Houston and The University of Texas Health Science Center sponsored a needs assessment survey to identify areas of knowledge and skills to be included in a master's degree curriculum in QRM. The study used a three-cycle Focus Delphi technique to secure experts' refinement of the survey instrument and consensus among participants, who included practitioner-members of the National Association of Quality Assurance Professionals (NAQAP), of health care administration educational program directors, and hospital administrators. Starting with a listing based on a competency outline obtained from NAQAP, the study identified critical learning needs and elaborated a framework with 12 broad categories and 108 specific knowledge and skill areas.

Curriculum↗
PubMed1995

Two structures of the catalytic domain of phosphorylase kinase: an active protein kinase complexed with substrate analogue and product.

BACKGROUND: Control of intracellular events by protein phosphorylation is promoted by specific protein kinases. All the known protein kinase possess a common structure that defines a catalytically competent entity termed the 'kinase catalytic core'. Within this common structural framework each kinase displays its own unique substrate specificity, and a regulatory mechanism that may be modulated by association with other proteins. Structural studies of phosphorylase kinase (Phk), the major substrate of which is glycogen phosphorylase, may be expected to shed light on its regulation. RESULTS: We report two crystal structures of the catalytic core (residues 1-298; Phk gamma trnc) of the gamma-subunit of rabbit muscle phosphorylase kinase: the binary complex with Mn2+/beta-gamma-imidoadenosine 5'-triphosphate (AMPPNP) to a resolution of 2.6 A and the binary complex with Mg2+/ADP to a resolution of 3.0 A. The structures were solved by molecular replacement using the cAMP-dependent protein kinase (cAPK) as a model. CONCLUSIONS: The overall structure of Phk gamma trnc is similar to that of the catalytic core of other protein kinases. It consists of two domians joined on one edge by a 'hinge', with the catalytic site located in the cleft between the domains. Phk gamma trnc is constitutively active, and lacks the need for an activatory phosphorylation event that is essential for many kinases. The structure exhibits an essentially 'closed' conformation of the domains which is similar to that of cAPK complexed with substrates. The phosphorylated residue that is located at the domain interface in many protein kinases and that is believed to stabilize an active conformation is substituted by a glutamate in Phk gamma trnc. The glutamate, in a similar manner to the phosphorylated residue in other protein kinases, interacts with an arginine adjacent to the catalytic aspartate but does not participate in interdomain contacts. The interactions between the enzyme and the nucleotide product of its activity, Mg2+/ADP, explain the inhibitory properties of the nucleotides that are observed in kinetic studies.

Adenosine Diphosphate↗
PubMed1998

Towards a conceptualization of language and cognitive impairment in closed-head injury: use of clinical measures.

Language deficits following closed-head injury (CHI) are widely considered as impairments secondary to the cognitive disruptions common to closed-head injury. In addition, the use of standardized measures to assess the functioning of the language system in closed-head injury has mostly been limited to aphasia test batteries which examine primary language functions only. This has resulted in generalizations as to the integrity of the language system following closed-head injury, and as a consequence, consideration of the contribution of the language system to the achievement of communicative competence in this population has been minimized. This paper presents a framework in which the functional language system is identified as a hierarchical system containing primary and higher-order language processes involved in reciprocal relationships with cognitive functions at each level. A group of 25 closed-head injury subjects and 23 demographically matched control subjects were examined for linguistic proficiency using a battery of standardized tests which investigated the language system across a hierarchy of complexity, structure and predictability. In addition, 23 of the closed-head subjects were administered a comprehensive neuropsychological test battery in order to determine the nature and extent of concomitant impairments in cognitive processes and their relationship with impairments in the language system. The language battery was found to consistently discriminate between the control and clinical groups indicating that the linguistic system is significantly impaired following CHI, with the lexical-semantic system being the most vulnerable to disruption. A strong influential relationship between language and cognitive processes was statistically confirmed and the nature of the relationship between aspects of language and cognition further delineated.

Adolescent↗
PubMed1985

Toward greater specificity in defining nursing's metaparadigm.

The thesis presented is that nursing in its disciplinary context cannot appropriately be considered a concept in the metaparadigm of nursing science. Nursing as a discipline is guided by theories and prescriptions that emanate from puzzles solved in the domain of nursing science. Failure to distinguish between the science of nursing and its disciplinary aspects in building conceptual frameworks will retard the growth of science. The merits of three competing paradigms--normal science, historical facts, and social facts-are discussed. None of these paradigms is adequate for discovery in nursing science. Efforts to develop knowledge around the phenomena of central concern to nursing may advance more rapidly if theory building follows a set of rules, as yet undefined, that incorporates the methods of both normal science and historical tradition.

Holistic Health↗
PubMed1986

Important parameters in plasma fractionation.

Important parameters in plasma fractionation are derived from the needs of providing assured quality and the operational requirements of good manufacturing practice. There are many inputs to quality assurance, collectively described as the quality design of the manufacturing process. Quality design is an all-embracing concept depending on selection of source plasma, proper production facilities and equipment systems and highest pharmaceutical operational standards. The scientific process must meet the requirements of safety and efficacy of product and balance the competing parameters of purity, potency and yield within an acceptable economic framework. The paper illustrates problems within the theory of quality design through current experience in the production of immunoglobulin and factor VIII fractions.

Blood Proteins↗
PubMedDate not supplied

The patient care process: a framework for change.

Healthcare organizations across the United States recognize that they must change the way in which they deliver case. As organizations reengineer to reduce costs and change the way in which services are delivered, it is critical that decisions about reengineering be communicated throughout the entire service-delivery enterprise. There must be a framework to provide a common ground for change. The process approach to delivering service provides the greatest opportunity for organizations to achieve their goals to facilitate care, achieve the best patient outcomes, and deliver services on time and at the right price. Processes that are built around core competencies and that address customer needs are the most successful. Organizations that adopt a common framework built around the delivery of patient care and the patient care process can establish a common frame of reference for the entire organization and therefore can enhance the delivery of service for their patients and achieve organization-wide commitment to common goals.

Case Management↗
PubMed1995

Using knowledge maintenance for preference assessment.

Most real-life decisions require the decision maker to make trade-offs in order to fulfill multiple conflicting objectives. This is especially true in medical decision making while selecting the optimal therapy plan from among competing therapy plans for a patient. Multi-attribute utility theory provides a framework to specify these trade-offs for optimal decision making based on the preferences of the decision maker. However traditional preference-assessment techniques are difficult to implement and rarely elicit the true preferences of the decision maker. We describe a new preference-assessment method based on the concept of knowledge maintenance where the preference model is changed each time it makes an incorrect recommendation. The method is implemented in a decision-theoretic system to evaluate competing three-dimensional radiation treatment plans. The preference-assessment method leads to preference models which perform better than preference models elicited using traditional assessment techniques.

Abdominal Neoplasms↗
PubMed1991

Court-ordered treatment in obstetrics: the ethical views and legal framework.

Four main ethical views have been put forward concerning court-ordered treatment of mentally competent pregnant women for fetal indications: 1) Such treatment is never justifiable; 2) it is justifiable provided it poses no health risks for the woman, minimally invades her bodily integrity, and would clearly prevent substantial harm to the fetus; 3) it is justifiable provided the maternal risks are low, there is a substantial likelihood that the fetus will suffer irrevocable harm without the intervention, and the treatment will likely be effective; and 4) it is justifiable provided the risks to the woman are ones she should reasonably accept, the fetal risks of treatment are minimal, and the potential fetal benefit is substantial. However, the first two views are too rigid to adequately handle the variety of clinical situations in which maternal treatment refusal can occur, and recent legal decisions have ruled out the other views. The ethics of court-ordered treatment are often discussed as though the only interests involved are those of the pregnant woman and fetus, but other important interests may be relevant. An ethical view that avoids these difficulties and takes better account of the complexity of the issues is as follows: Such treatment is justifiable in rare, exceptional circumstances provided it poses insignificant or no health risks to the woman or would promote her interests in life or health and there are compelling reasons to override her autonomy.

Ethics, Medical↗
PubMed1999

Incidence and duration of hospitalizations among persons with AIDS: an event history approach.

OBJECTIVE: To analyze hospitalization patterns of persons with AIDS (PWAs) in a multi-state/multi-episode continuous time duration framework. DATA SOURCES: PWAs on Medicaid identified through a match between the state's AIDS Registry and Medicaid eligibility files; hospital admission and discharge dates identified through Medicaid claims. STUDY DESIGN: Using a Weibull event history framework, we model the hazard of transition between hospitalized and community spells, incorporating the competing risk of death in each of these states. Simulations are used to translate these parameters into readily interpretable estimates of length of stay, the probability that a hospitalization will end in death, and the probability that a nonhospitalized person will be hospitalized within 90 days. PRINCIPAL FINDINGS: In multivariate analyses, participation in a Medicaid waiver program offering case management and home care was associated with hospital stays 1.3 days shorter than for nonparticipants. African American race and Hispanic ethnicity were associated with hospital stays 1.2 days and 1.0 day longer than for non-Hispanic whites; African Americans also experienced more frequent hospital admissions. Residents of the high-HIV-prevalence area of the state had more frequent admissions and stays two days longer than those residing elsewhere in the state. Older PWAs experienced less frequent hospital admissions but longer stays, with hospitalizations of 55-year-olds lasting 8.25 days longer than those of 25-year-olds. CONCLUSIONS: Much socioeconomic and geographic variability exists both in the incidence and in the duration of hospitalization among persons with AIDS in New Jersey. Event history analysis provides a useful statistical framework for analysis of these variations, deals appropriately with data in which duration of observation varies from individual to individual, and permits the competing risk of death to be incorporated into the model. Transition models of this type have broad applicability in modeling the risk and duration of hospitalization in chronic illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed2026

Identifying General Practitioners, Nurses, and Pharmacists Training Needs in Precision Medicine: A Survey Study.

INTRODUCTION: The clinical advances of precision medicine, elevating clinical decision-making through use of genetic and genomic data, lifestyle, and environment factors, is improving patient outcomes. Health care professionals report they are not competent or confident to deliver precision medicine to patients. To design continuing education for advanced practice nurses, general practitioners, and pharmacists, this research investigates perceived knowledge, importance, and self-efficacy in precision medicine. METHODS: Items were informed from results of a literature review and focus group study. A one-sample t test was used to compare differences for each item toward the theoretical neutral value (indifferent in our case, to number 3). To analyze differences between professions, parametric analyses of variance (ANOVA) was used. RESULTS: A lack of time, further complicated by a lack of knowledge about precision medicine services, and how to safely share patient data, with a perceived limited network of professionals in precision medicine were reported. Respondents demonstrated low confidence in precision medicine topics while indicating a willingness to pursue training aimed at improving their genetic and genomic competencies. Participants rated topics as only slightly important to their current professional roles. No significant differences were found across professional groups. DISCUSSION: Flexible formats for continuing education aligned to needs are required to target the knowledge and skills gap in precision medicine. Improved knowledge on topics including ethics, legal frameworks, and precision services is needed. Effective educational interventions aimed at enhancing the confidence and competence of health care professionals are essential to making precision care a reality for patients.

CPD↗
PubMedDate not supplied

Aging in mammalian cell population: a review.

Research on in vitro aging and development is reviewed within a framework provided by three aspects of population growth--birth, canalization and death. Although there are periodic changes in the birth rate coupled to periodic changes in the in vitro environment, there do not appear to be any age-related changes in the birth rate of dividing cells. There appear to be distinct subpopulations of dividing and nondividing cells, each with its own characteristic morphological and functional properties; thus, Weiss-Kavanaugh theory may be applicable to the growth, maturation and senescence of mammalian cell populations. Substantial cell losses occur during subcultivation and transfer; correction for these losses requires substantial reinterpretation of existing experimental findings. The various measures of age are poorly correlated with one another; there is wide variation from population to population. A uniform measure of age has been found in the cell generation, the number of ancestors of a given cell. Studies of intrinsic variation in development can provide additional insight into the developmental process. The framework of birth, canalization and death permits reduction in the number of competing hypotheses of aging in mammalian cell populations. Additional experimental evidence is needed to discriminate among the remaining hypotheses.

Aging↗
PubMed1989

Reviving the superorganism.

Individuals become functionally organized to survive and reproduce in their environments by the process of natural selection. The question of whether larger units such as groups and communities can possess similar properties of functional organization, and therefore be regarded as "superorganisms", has a long history in biological thought. Modern evolutionary biology has rejected the concept of superorganisms, explaining virtually all adaptations at the individual or gene level. We criticize the modern literature on three counts. First, individual selection in its strong form is founded on a logical contradiction, in which genes-in-individuals are treated differently than individuals-in-groups or species-in-communities. Imposing consistency clearly shows that groups and communities can be organisms in the same sense that individuals are. Furthermore, superorganisms are more than just a theoretical possibility and actually exist in nature. Second, the view that genes are the "ultimate" unit of selection is irrelevant to the question of functional organization. Third, modern evolutionary biology includes numerous conceptual frameworks for analyzing evolution in structured populations. These frameworks should be regarded as different ways of analyzing a common process which, to be correct, must converge on the same conclusions. Unfortunately, evolutionists frequently regard them as competing theories that invoke different mechanisms, such that if one is "right" the others must be "wrong". The problem of multiple frameworks is aggravated by the fact that major terms, such as "units of selection", are defined differently within each framework, yet many evolutionists who use one framework to argue against another assume shared meanings. We suggest that focusing on the concept of organism will help dispell this fog of semantic confusion, allowing all frameworks to converge on the same conclusions regarding units of functional organization.

Animals↗