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Results for “Competency framework”

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PubMed1997

A comprehensive Afrocentric rites of passage program for black male adolescents.

The health consequences for African American male teenagers of living in high-risk environments are devastating. Given the existence of cultural barriers to health services use, culturally proficient programs that can engage African American male youths in preventive interventions and primary care are urgently needed. This article reviews the health status of African American male adolescents, noting that the leading health problems are preventable. The article then discusses two frameworks that are of value in social work practice with African American populations, cultural competence and empowerment; reviews of Afrocentric theory and Afrocentric social work; and describes a culturally proficient, Afrocentric program for African American male adolescents. Health social workers can take steps to increase their own cultural competence and that of the health care organizations in which they work.

Adolescent↗
PubMed2026

Transient YAP activation uncovers the neurogenic potential of proliferative mammalian Müller glia.

The Hippo pathway effector YAP promotes spontaneous proliferation of Müller glia (MG), suggesting that bypassing Hippo signaling and activating YAP could enhance retinal regeneration. However, whether proliferative adult MGs retain meaningful neurogenic competence remains unclear. Here, using viral delivery of a Hippo-resistant YAP variant to wild-type adult MGs, we achieved transient YAP activation in adult MGs, inducing proliferation followed by cell-cycle withdrawal and differentiation. Intersectional genetic lineage tracing and EdU labeling, combined with transcriptomic analyses, revealed that YAP-activated MGs predominantly regenerate MGs, whereas only a subset gives rise to bipolar cell-like neurons. These results indicate that proliferative MGs acquire a state resembling that of late-stage retinal progenitors, with limited neurogenic lineage potential. We conclude that YAP-activated cell-cycle reentry inefficiently reprograms adult MGs toward photoreceptor or ganglion cell fates. These findings define the limited competence of proliferative adult MGs to contribute to neurogenic fates and provide a rigorous framework for assessing in vivo glial reprogramming strategies.

AAV↗
PubMed2002

Clinical nurse specialist practice: addressing populations with HIV/AIDS.

Clinical nurse specialists (CNSs) in public health and human immunodeficiency virus/acquired immune deficiency syndrome are needed to eliminate healthcare disparities, especially with African American women, ages 25-44. This population of women accounts for 64% of acquired immunodeficiency syndrome cases reported among women, and most of these women need nursing care in community settings. Epidemiologic data and nursing research findings demonstrate an urgent need for nurses with advanced practice competencies in human immunodeficiency virus/acquired immune deficiency syndrome. The competencies identified by the National Association of Clinical Nurses Specialists in 3 spheres of influence-direct care, nursing personnel, and organizations/networks-are used to describe clinical nurse specialist competencies as they relate to this population. Leininger's Sunrise Model serves as a framework to help this population preserve, accommodate, and repattern behaviors for the prevention and treatment of human immunodeficiency virus/acquired immune deficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Effectiveness of a geriatric medical student scholars program: a qualitative assessment.

In 2003, the University of Cincinnati College of Medicine initiated a 4-year Geriatric Medical Student Scholars (GMSS) program in which a selected group of 14 medical students participated in a variety of extracurricular geriatrics-related activities such as one-on-one mentoring and discussion groups. These students were also required to compose journal entries describing GMSS program-related activities using a semistructured on-line computer program designed specifically for this purpose. The reflective journals, in combination with the American Geriatrics Society (AGS) competencies, were used to evaluate the degree to which the GMSS program achieved its goal of enhancing students' understanding of the complex health and social challenges facing older adults. Using a confirmatory qualitative analysis strategy, the AGS competencies served as an a priori codebook to evaluate the student journal entries. Of the original 53 AGS competencies identified as being relevant for a first- or second-year medical student, 74% were used at least one time, and only 26% were never used. These findings strongly suggest that the GMSS program successfully moved this group of first- and second-year medical students closer to at least understanding the content of many of the AGS competencies by providing them with geriatrics-related experiences and a geriatrics-related framework they could draw on when participating in curricular and extracurricular activities. The findings also point to the potential value of using reflective journaling as a tool for conducting process evaluation of medical education interventions.

Education, Medical↗
PubMed2004

The crossroads of culture and health among the Roma (Gypsies).

PURPOSE: To alert health care providers to commonly encountered cross-cultural impediments to optimal health care delivery for the Roma (also known as Gypsies) and to offer suggestions for avoiding culturally based problems in treating this subculture. ORGANIZING FRAMEWORK: Understanding of sociocultural bases of health-related behaviors is necessary for culturally competent and effective health care. METHODS: Review of literature and personal interviews. FINDINGS: Cultural factors that can affect health care delivery include: concepts of pollution, cleanliness, ideal weight, death, and views of medical procedures such as immunizations and surgery. Responsiveness of health care providers to expectations of Roma about their involvement of family and the hierarchy of age and sex also can enhance patient-provider relationships that in turn can improve compliance and satisfaction with health care regimens. CONCLUSION: The Roma have some culturally distinct beliefs and behaviors related to their health and health care. Knowledge of these characteristics and accommodations to cultural differences are important in their health care.

Age Factors↗
PubMed2003

Toward an understanding of developmental coordination disorder: terminological and diagnostic issues.

Awareness of children who experience unexpected difficulty in the acquisition of motor skills has increased dramatically over the last twenty years. Although the positing of a distinct syndrome has proven seminal in provoking further questions, several basic terminological problems remain unresolved. In this paper, we conduct a component analysis of the three, principal competing labels for this disorder, two of them being elements derived from systematic diagnostic frameworks. Our preference for the DSM IV term Developmental Coordination Disorder (DCD) is stated and justified. Problems in diagnosis are discussed, especially in relation to the etiology-dominated medical model. We argue that an attempt should be made to identify (pathological) positive signs that can reliably be detected rather than relying entirely on normative evidence of a lack of skills exhibited by other children of the same age. The high degree of overlap between DCD and other developmental disorders suggests that DCD might not constitute a distinct syndrome. In this context, we emphasize the need to determine whether incoordination takes a different form when it occurs alone or whether it is combined with general developmental delay or with other specific disorders in children of normal intelligence.

Child↗
PubMed2004

A health informatics educational framework.

There is a need to be able to define a Health Informatician by their graduate attributes. Futhermore global health informatics education that facilitates student mobility requires a common understanding of educational outcomes. An internationally agreed health informatics education framework will facilitate us to meet these needs. This chapter provides an overview of a considerable amount of work undertaken in a number of countries and by IMIA's health and medical informatics education working group. We need to make good use of these foundations as they clarify the various health informatics roles and functions together with their associated health informatics competency requirements. We are now in a good position to progress this work by developing a health informatics qualifications and educational framework. This is expected to assist educational providers with curriculum development.

Computer User Training↗
PubMed2004

Categorization, deductive reasoning, and self-awareness: association with everyday competence in persons with acute brain injury.

The present study examined the relationship between executive function, self-awareness and everyday functional competence in individuals with brain injuries. Executive function was assessed using measures of categorization and deductive reasoning ability, both of which were shown by multiple regression analysis to make significant contributions to the performance of Instrumental Activities of Daily Living (IADL), suggesting that both measures can serve as predictors of everyday functioning in persons with brain injuries. Self-awareness contributed significantly to functional competence, but its contribution was mediated through categorization ability. Executive function was correlated significantly with posttest performance estimation (self-evaluation of own performance), but not with self-prediction of test performance prior to testing. The results are discussed within the framework of a conceptual model illustrating the multifaceted nature of executive function and its relationship to self-awareness and everyday functional competence. The results of this study indicate that categorization, deductive reasoning, and self-awareness of individuals with brain injury are good predictors of IADL functional performance, and can help in planning better treatment interventions.

Activities of Daily Living↗
PubMed2002

Portfolios: possibilities for addressing emergency medicine resident competencies.

Portfolios are an innovative approach to evaluate the competency of emergency medicine residents. Three key characteristics add to their attractiveness. First, portfolios draw from the resident's actual work. Second, they require self-reflection on the part of the resident. Third, they are inherently practice-based learning since residents must review and consider their practice in order to begin the portfolio. This paper illustrates five different applications of portfolios. First, portfolios are applied to evaluating specific competencies as part of the training of emergency physicians. While evaluating specific competencies, the portfolio captures aspects of the general competencies. Second, the article illustrates using portfolios as a way to address a specific residency review committee (RRC) requirement such as follow-ups. Third is a description of how portfolios can be used to evaluate resident conferences capturing the competency of practice-based learning and possibly other competencies such as medical knowledge and patient care. Fourth, the authors of the article designed a portfolio as a way to demonstrate clinical competence. Fifth, they elaborate as to how a continuous quality improvement project could be cast within the portfolio framework. They provide some guidance concerning issues to address when designing the portfolios. Portfolios are carefully structured and not haphazard collections of materials. Following criteria is important in maintaining the validity of the portfolio as well as contributing to reliability. The portfolios can enhance the relationship between faculty and residents since faculty will suggest cases, discuss anomalies, and interact with the residents around the portfolio. The authors believe that in general portfolios can cover many of the general competencies specified by the ACGME while still focusing on issues important to emergency medicine. The authors believe that portfolios provide an approach to evaluation commensurate with the self-evaluation skills they would like to develop in their residents.

Clinical Competence↗
PubMed2002

The Purnell Model for Cultural Competence.

This article provides an overview of the Purnell Model for Cultural Competence and the assumptions on which the model is based. The 12 domains comprising the organizing framework are briefly described along with the primary and secondary characteristics of culture, which determine variations in values, beliefs, and practices of an individual's cultural heritage. All health care providers in any practice setting can use the model, which makes it especially desirable in today's team-oriented health care environment. The model has been used by nurses, physicians, and physical and occupational therapists in practice, education, administration, and research in Australia, Belgium, Canada, Central America, Great Britain, Korea, South America, and Sweden. The model has also been translated into Flemish, French, Korean, and Spanish. Although the model is only 4 years old, it shows promise for becoming a major contribution to transcultural nursing and health care.

Attitude to Health↗
PubMed2006

Guidelines for resident training in veterinary clinical pathology. II. Hematology.

BACKGROUND: The Education Committee of the American Society for Veterinary Clinical Pathology (ASVCP) identified a need for improved structure and guidance in training residents in clinical pathology. To begin to meet this need, guidelines for training in clinical chemistry were published in 2003. OBJECTIVE: The goal of this report is to define learning objectives and competencies in hematology, including coagulation and immunohematology. METHODS: These guidelines were developed and written with the input of ASVCP Education Committee members and peer experts. RESULTS: The primary objectives of training in hematology are: 1) to accrue a thorough, extensive, and relevant knowledge base of the types, principles, and properties of hematology tests and concepts of pathophysiology in animals; 2) to develop abilities to reason, think critically, communicate effectively, and exercise judgment in hematologic data interpretation and investigative problem-solving; and 3) to acquire technical and statistical skills important in hematology and laboratory operations. We also provide options and ideas for training activities and identify hematology resources useful for clinical pathology faculty and staff, training program coordinators, and residents. CONCLUSIONS: The guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary hematology and provide a useful framework for didactic and clinical activities in resident-training programs. The learning objectives can readily be adapted to institutional and individual needs, interests, goals, and resources.

Animals↗
PubMed1988

An ethical framework for nursing service administration.

Nurses as administrators are responsible for creating an ethical work environment in which nurses' human welfare is promoted. Bureaucratic organizations can dehumanize people, wherein human welfare suffers in the midst of institutional constraints. Amid these conditions nurses' ethical competence cannot develop nor can nurses maintain a sense of personal integrity. Applying concepts from nursing and general ethics to administrative practice provides a basis for developing an ethical framework for management. The proposed framework involves ethical awareness, principled reasoning, moral commitment to the profession and to one another, and primary consideration for human welfare with strategies to promote it. Use of these components when making decisions in daily practice and on a policy level enhances the well-being of nurses working in organizations.

Administrative Personnel↗
PubMedDate not supplied

Culturally competent health care: a challenge for nurses in Saudi Arabia.

An emerging global reality is the presence of a culturally diverse workforce in health care environments. Not only are nurses delivering care to culturally diverse clients, the nurses themselves may come from different cultural and educational backgrounds. In order to provide culturally competent health care, such diversity must be molded into professional collaboration and respect. To date, health care to the citizens of Saudi Arabia has been provided largely by a foreign labor force, the vast majority of whom are non-Arabic speaking. This paper explores a number of strategies aimed at educating expatriate non-Saudi health professionals in the provision of culturally competent and culturally congruent health care. Leininger's transcultural health care theory is identified as the framework for achieving this goal. The theory has proved to be of great relevance in a hospital setting where some 40 different nationalities are represented among the work force. In such a setting, the potential for cultural conflict and stress is very real. Health professionals new to the Kingdom are introduced to the cultural dimensions of health care as it relates to patient care modes, as well as living and working together in a transcultural environment. Transcultural nursing is a major component of a professional nurse practice model which provides a visionary perspective for nursing care. Within the practice model, transcultural care principles are used to guide education, clinical practice and nursing research. Furthermore, Leininger's theory serves to grasp a comprehensive view of generic (folk) and professional health systems and to identify ethical issues confronted by nurses in the transcultural setting.

Clinical Competence↗
PubMed1999

Nutrition-parasite interaction.

The interactions between host nutrition and parasitism in ruminants are viewed within a framework that accounts for the allocation of scarce nutrient resources, such as energy and protein, between the various competing body functions of the host. These include functions that are the direct result of parasitism. Since it is proposed that the host gives priority to the reversal of the pathophysiological consequences of parasitism over other body functions, it is to be expected that improved nutrition will always lead to improved resilience. On the other hand, it is proposed that the function of growth, pregnancy and lactation are prioritised over the expression of immunity. Thus, improved nutrition may affect the degree of expression of immunity during these phases. The framework is useful at highlighting areas of future research on host/parasite/nutrition interactions. Its suggestions can account for the observations of the periparturient relaxation of immunity in reproducing females, as well as the reduction in worm burden in small ruminants supplemented with additional protein. Although developed for gastrointestinal nematodes in ruminants, the concepts of the framework should be applicable to the interactions of nutrition in other parasitic diseases.

Animal Nutritional Physiological Phenomena↗
PubMed1986

Corpses, lepers, and menstruating women: tradition, transition, and the sociology of knowledge.

A study of 1148 middle-aged women in 5 Israeli subcultures ranging from modern Central European immigrants to traditional Moslem Arab villagers is the point of departure for this essay on tradition, transition, and the sociology of knowledge. The study is shown as having evolved through the competing hypotheses of the investigators, which in turn reflect the biases born of the experiential framework: 2 men and 1 young woman design a study that assumes an overvaluation of fertility and childbearing. When the findings reveal that middle-aged women do not regret the loss of fertility, regardless of tradition or modernity (and thus of childbearing history), the investigators discover their own assumptions to be erroneous. Further, the meaning of modernity is reconsidered as tradition is shown to incorporate a recognition of the strength of women despite formal status subordination; it is proposed that the dilemma of middle age is inevitably cultural transition. Finally, it is suggested that the broader social context of which the investigators were a part legitimates the study of women as "other" and as objects, while denying opportunity to study men in the same framework--a social context in which men shape decisions that grant or deny research funds, and thus shape the evolution of knowledge of gender.

Age Factors↗