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PubMed1998

Bioethics and humanities: what makes us one field?

Bioethics and humanities (inclusive of medical ethics, health care ethics, environmental ethics, research ethics, philosophy and medicine, literature and medicine, and so on) seems like one field; yet colleagues come from different academic disciplines with distinct languages, methods, traditions, core curriculum and competency examinations. The author marks six related "framework" features that unite and make it one distinct field. It is a commitment to (1) work systematically on some of the momentous and well-defined sets of problems about the human condition that drive our field (such as death and dying, disability, confidentiality, professionalism, informed consent, abortion, euthanasia, assisted suicide, personhood, health-care resource allocation and environmental ethics, as well as the impact of new technologies, including genetic and reproductive); (2) use interdisciplinary approaches to unravel them; (3) employ cases and practical reasoning to understand problems and solve answers; (4) apply teaching methods and goals associated with John Dewey to make students better problem-solvers; (5) find morally justifiable solutions to the problems driving our field; and (6) seek interdisciplinary and collaborative scholarship, service or teaching.

Bioethical Issues↗
PubMedDate not supplied

Creating and using staff development standards.

This article is an overview of the development of the revised Scope and Standards of Practice for Nursing Professional Development, published by the American Nurses Association in 2000. It provides some background information about the standards, and discusses implications for staff development educators. The framework for these revised standards is continuing competence, which is essential to promote evidence-based practice.

American Nurses' Association↗
PubMed1998

Recognizing abuse in culturally diverse clients.

Abuse is a major problem in American society. The problem of abuse among ethnically diverse persons is an area about which most health care professionals know little. This article describes the Giger-Davidhizar Model of Transcultural Assessment as a tool of assessment of the client who is abused. Use of a framework for assessment can enable more culturally competent care to be delivered.

Adolescent↗
PubMed2000

Quality management in German health care--the EFQM Excellence Model.

A brief insight into the issues affecting German health care is given. Namely, upward pressure on costs leads to increasing expenditure within health care and downward pressure from economic recession and political unwillingness to increase taxes and budget spending. In the case of competing key stakeholder perspectives, a quality management framework is seen as a potential approach for addressing these issues. The framework is the European Foundation for Quality Management (EFQM) Excellence Model. The article briefly explains the pilot phase for utilising the EFQM Excellence Model within German health care organisations and the various implementation approaches recommended by EFQM. Specific details of an approach used by a health care organisation within Germany (providing social medicine, geriatric and elderly services) are described in detail. The benefits achieved from using the Model are a clear picture of where the gaps are in the organisation and a clear vision for concentrating future efforts towards total quality management.

Aged↗
PubMed1995

Machine technologies and caring in nursing.

Machine technologies and caring in nursing can be harmonious aspects of clinical nursing practice. The perception of technology and caring as dichotomous is so pervasive that one who is technologically proficient may often be assumed to be incapable of expressing caring. Within a framework of nursing as caring, true technologic competence in clinical nursing practice can be understood as an expression of caring. As such, technological competence assumes an indispensable place in contemporary clinical nursing practice. Nowhere is the link between machine technologies and caring demonstrated more clearly than in the practice of nursing in critical care. A model is presented to illustrate this concurrence.

Clinical Competence↗
PubMed2003

EMEA and Gene Therapy Medicinal Products Development in the European Union.

The evaluation of quality, safety, and efficacy of medicinal products by the European Medicines Evaluation Agency (EMEA) via the centralized procedure is the only available regulatory procedure for obtaining marketing authorization for gene therapy (GT) medicinal products in the European Union. The responsibility for the authorization of clinical trials remains with the national competent authorities (NCA) acting in a harmonized framework from the scientific viewpoint. With the entry into force of a new directive on good clinical practice implementation in clinical trials as of 1 May 2004, procedural aspects will also be harmonized at EU level. Scientifically sound development of medicinal products is the key for the successful registration of dossiers and for contributing to the promotion and protection of public health. The objective of this paper is to introduce the EMEA regulatory processes and scientific activities relevant to GT medicinal products.

Journal Article↗
PubMed2002

Spectrally resolved microscopy of GFP trafficking.

Folding and chromophore cyclization-oxidation processes of green and cyan fluorescent fusion proteins (GFP and CFP) in subcellular microenvironments of transfected C6 glioma cells were studied by multipixel spectrally resolved microscopy (SRM). Discrete time-dependent spectral transitions were characterized during protein folding and chromophore maturation in the cytosol, nucleus, mitochondria, endoplasmic reticulum (ER), and Golgi. Spectral similarity mapping of fluorophore transition phases demarcated spatio-temporal fluorescence correlation at a subcellular level. Folding stages were characterized by a transition from red-shifted spectral populations in the time interval of 7-10 hr after transfection to a fully matured fluorophore emitting typical GFP or CFP fluorescence after 10-15 hr. The nascent protein revealed an initial focal accumulation in cytosol emitting in the range of 580-680 nm. After 10 hr, mixed pixel population spectra were measured and at 15 hr GFP was visualized in the cytoplasm by its specific spectral fingerprints with maxima at 545 nm. For nucleus- and mitochondrion-targeted CFPs, the mature conformer was discovered only in its final destination, whereas intermediate steps of fluorophore synthesis (at 10 hr) were found in the cytoplasm. Enhanced fluorescence maturation was manifested only by the ER-Golgi-targeted CFP after 10 hr post transfection by spectral imaging. Moreover, only remnants of initial intermediate fluorescent pixels were localized externally to the Golgi framework at 15 hr. SRM assessed the competence of ER-Golgi to maintain efficient CFP folding in comparison to the rest of the cellular compartments.

Animals↗
PubMedDate not supplied

The national standards for culturally and linguistically appropriate services in health care.

In December 2000, the Office of Minority Health published the National Standards on Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards). These standards provide a framework for building the cultural and linguistic competence of home health care agencies. This article describes each of the 14 standards and suggests strategies for meeting the cultural and linguistic needs of home health care patients.

Communication Barriers↗
PubMed1996

The determinants of the duration of contraceptive use in China: a multilevel multinomial discrete-hazards modeling approach.

Often in demography, individuals may change state over time for a variety of reasons. Competing-risks hazards models have been developed to model such situations. This paper describes the extension of the discrete-time competing-risks hazards model to a multilevel framework that allows for data at different levels of aggregation. The model is illustrated with data from the 1988 Chinese National Survey of Fertility and Contraceptive Prevalence, which collected complete contraceptive histories. Women may stop using a method of contraception for a number of reasons; this paper describes how one can control for correlations between the outcomes of repeated spells of contraceptive use.

Adolescent↗
PubMed1994

Identifying and comparing competencies for social work management: a practice driven approach.

The study explicates a competency-based model of contemporary social work management practice and compares this model with frameworks derived from earlier studies. Using a purposive sample of 184 social work managers throughout the country, an exploratory factor analysis yielded twelve sets of competencies required of today's social work manager. A comparison of the present model to earlier management frameworks reveals that substantive changes in the nature, scope, complexity, and priorities assigned to management competencies and skills have transformed the role of the social work manager over the last decade. Implications for social work manager education are reviewed and future research directions are proposed.

Administrative Personnel↗
PubMed1995

Neural mechanisms for stimulus selection in cortical areas of the macaque subserving object vision.

The present article reviews some recent work on the neuronal mechanisms underlying space-based and feature-based stimulus selection in the primate occipito-temporal pathway of cortical visual processing. Clear evidence demonstrates that activity in areas V4 and IT is high for a stimulus which is selected either for its position in space or for its features, while it is considerably suppressed for other, irrelevant stimuli. Data are discussed within a conceptual framework whereby objects in the visual field always compete for focal resources. According to task demands, any kind of input (objects of a certain category, objects with a certain form, color or motion, objects at a certain location) can be behaviorally relevant. A short-term description (working memory) of the currently relevant object properties controls competitive bias in the visual system, such that inputs matching that description are favored to the disadvantage of task-irrelevant inputs. This framework emphasizes a tight, causal link between memory signals and mechanisms for stimulus selection in visual cortex. In all cases gating of neural activity was constrained by spatial factors. In area V4, responses to an ignored stimulus in the receptive field of the recorded neuron were maximally suppressed when the monkey attended to a second stimulus located within the boundary of the same receptive field, while suppression was virtually absent when attention was directed to a second stimulus well outside the receptive field border. In IT cortex, suppressed responses depended on both the selected and ignored stimuli being within the hemifield contralateral to the recorded hemisphere, while suppression was much reduced when the stimuli were presented across the vertical midline. These spatial constraints on the occurrence of modulation of visual responses may reflect limitations imposed by the local pattern of reciprocal inhibitory connections, which are supposed to underlie competitive interactions among objects in the field, that is among object representations in cortex.

Animals↗
PubMed1985

Crystallographic structure of an active, sequence-engineered ribonuclease.

X-ray diffraction methods were used to test a synthetic-modeling approach to the sequence engineering of bovine pancreatic ribonuclease. A model of RNase S-peptide (residues 1-20), having a simplified amino acid sequence but retaining elements deduced to be essential for conformation and function, was previously synthesized and found to form a catalytically active and stable complex with native S-protein (residues 21-24). We have now obtained a 3-A-resolution electron density map of this semisynthetic complex which reveals that the conformation of model peptide closely mimics that of native S-peptide, as intended by sequence design. Some small differences from the native structure are observed: Glu-2 and Arg-10 of the model complex are not close enough to form a salt bridge, the position of the His-12 imidazole ring is slightly shifted in the active site, and the peptide's amino terminus is reoriented. Nonetheless, the major structural features predicted to be essential by computer-aided peptide-design analysis are preserved in the model peptide portion of the complex. These include (i) the alpha-helical framework involving residues 3-13, (ii) the catalytically competent orientation of His-12, and (iii) complex-stabilizing non-bonding interactions involving Phe-8 and Met-13 of S-peptide and hydrophobic residues in the cleft region of S-protein. Further, sequence simplification has not introduced any non-native, potentially stabilizing contacts between the model peptide and S-protein. The results emphasize the usefulness, in redesigning native proteins, of categorizing sequence into residues providing conformational framework and those determining intra-and intermolecular surface recognition.

Amino Acid Sequence↗
PubMedDate not supplied

Embracing global similarities: a framework for cross-cultural obstetric care.

In this era of consistent global migration, cultural competency is necessary in all aspects of the care nurses provide to families. Cultural competency is particularly significant in maternal-newborn nursing because childbirth, as one of life's most significant events, is culturally shaped and socially constructed. In this article, a framework is provided to enable nurses to focus on several global phenomena and thus provide care that is more culturally sensitive, congruent with the client's needs, and competent. Suggestions for integrating cultural issues into nursing curricula are offered.

Cultural Characteristics↗
PubMed2000

Mastering the new public health.

The dramatic changes in the field of public health are reverberating in schools of public health in a number of ways, not the least of which is action by the deans of the Association of Schools of Public Health (ASPH) to ensure that graduates with master's of public health degrees are competent to meet the current challenges of practice. The conceptual framework at the center of this activity describes 3 domains--skills, perspectives, and applications--in which alumni of schools of public health may be required to demonstrate competency. ASPH work in this area is grounded in previous national and professional competency definitions and school- and department-specific competency development; it is distinct from earlier work, however, because its focus is on competency at the master's level across the graduate schools of public health.

Curriculum↗
PubMed1992

Effect of pregraduate preceptorship experience on development of adaptive competencies of baccalaureate nursing students.

Kolb's (1984) theory of experiential learning was used as a framework to study 50 baccalaureate nursing students' perceptions of the contributions of a senior preceptorship experience to the development of adaptive competencies. Nursing learning environments were thought to contribute most to divergent and convergent competencies, reflecting the importance of both people-oriented and scientific skills in nursing. The preceptorship had a significant impact on most learning competencies. Significant increases occurred in competencies considered not important for nursing by students prior to the experience, e.g., assimilative competencies such as testing theories and ideas, and accommodative competencies such as leading and influencing others. These results support the notion of further research of nursing learning environments from the experiential learning perspective.

Adaptation, Psychological↗
PubMedDate not supplied

Promotion of the good life by public health nurses.

The question of what is the good life has been discussed by philosophers since antiquity. The good of an individual and of a community is complicated. Communities influence an individual's experiences and world views, which are always individual. Public health nurses promoting the good life need multidisciplinary knowledge, as well as other skills such as personal competence and qualifications. The focus of the theoretical framework of promotion of the good life is based on models of health promotion and sustainable development. Working with different clients requires nursing theories, other theories, and multidisciplinary models in practice. Continual quality improvement is needed in order to increase customer satisfaction. This article discusses a doctoral thesis that consists of three empirical studies. The theoretical framework for promotion of the good life as the work of public health nurses is outlined, and the outcomes of the first study, the qualifications concerning health, and the environment are described. In the other parts of the study, curriculum building using future methodology and evaluation with concept maps is reported.

Consumer Behavior↗
PubMedDate not supplied

Impact of nursing learning environments on adaptive competency development in baccalaureate nursing students.

Kolb's experiential learning theory (ELT) was used as a framework to study 179 generic baccalaureate students' perceptions of the contributions of different types of nursing learning environments to development of adaptive competencies described in the theory. In addition, students in each of the 4 years of the program were asked to describe their perceptions of the importance of Kolb's adaptive competencies for successful functioning in nursing settings as well as to rate their personal levels of skill on each competency. Nursing learning environments were thought to contribute most to divergent and convergent competencies, reflecting the importance of both people-oriented and scientific skills in nursing. Clinical experiences and the senior preceptorship experience contributed significantly more to the development of these competencies than typical nursing classes and nonnursing classes. Students considered assimilative competencies--such as testing theories--and ideas and accommodative competencies--such as leading and influencing others--relatively unimportant to successful functioning in nursing learning environments. Implications for nursing education are discussed.

Adaptation, Psychological↗