SEARCH · PubMed Health

Results for “Competency framework”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,117 records · Page 62Linked to original sources

PubMed1985

The role of suppression in psychophysical measures of frequency selectivity.

The neural output of the cochlea consists of a structured spectral representation of the input waveform. Psychophysical studies of frequency selectivity provide measures of the quality of this spectral representation based on the detection of a spectrally narrow signal in the presence of competing acoustic inputs. Results are often interpreted in terms of the underlying physiological processes. The present paper begins with a summary of the basic principles and data and a review of recent efforts to extend the theoretical framework to account for a wider range of phenomena. It then discusses and evaluates specific assumptions concerning the role of suppression in psychophysical measures of frequency selectivity, an area of research that has received much attention in recent years. The goal is to provide a summary of current answers to basic questions at a time of rapidly expanding knowledge about both the physiology and psychophysics of frequency selectivity.

Animals↗

PubMed2006

Evolutionary origins of leadership and followership.

Drawing upon evolutionary logic, leadership is reconceptualized in terms of the outcome of strategic interactions among individuals who are following different, yet complementary, decision rules to solve recurrent coordination problems. This article uses the vast psychological literature on leadership as a database to test several evolutionary hypotheses about the origins of leadership and followership in humans. As expected, leadership correlates with initiative taking, trait measures of intelligence, specific task competencies, and several indicators of generosity. The review finds no link between leadership and dominance. The evolutionary analysis accounts for reliable age, health, and sex differences in leadership emergence. In general, evolutionary theory provides a useful, integrative framework for studying leader-follower relationships and generates various novel research hypotheses.

Biological Evolution↗

PubMed1998

Diversity issues in the homecare setting.

As this nation becomes increasingly more culturally diverse and seeks to compete in a global health care market, it is incumbent upon the nursing profession to prepare high-tech homecare nurses who are experts in their ability to make appropriate culturologic assessments of the clients whom they provide care. The culturologically competent high-tech homecare nurse is one who is able to obtain value-free culturologic information and who utilizes that information in the development of culturally sensitive plans of care. This article has provided a framework, with supporting rationale, to assist the high-tech homecare nurse in the gathering of culture-specific data from clients whose care delivery occurs in the richly diverse home setting.

Adolescent↗

PubMed2001

Chaperonin-mediated protein folding.

Molecular chaperones are required to assist folding of a subset of proteins in Escherichia coli. We describe a conceptual framework for understanding how the GroEL-GroES system assists misfolded proteins to reach their native states. The architecture of GroEL consists of double toroids stacked back-to-back. However, most of the fundamentals of the GroEL action can be described in terms of the single ring. A key idea in our framework is that, with coordinated ATP hydrolysis and GroES binding, GroEL participates actively by repeatedly unfolding the substrate protein (SP), provided that it is trapped in one of the misfolded states. We conjecture that the unfolding of SP becomes possible because a stretching force is transmitted to the SP when the GroEL particle undergoes allosteric transitions. Force-induced unfolding of the SP puts it on a higher free-energy point in the multidimensional energy landscape from which the SP can either reach the native conformation with some probability or be trapped in one of the competing basins of attraction (i.e., the SP undergoes kinetic partitioning). The model shows, in a natural way, that the time scales in the dynamics of the allosteric transitions are intimately coupled to folding rates of the SP. Several scenarios for chaperonin-assisted folding emerge depending on the interplay of the time scales governing the cycle. Further refinement of this framework may be necessary because single molecule experiments indicate that there is a great dispersion in the time scales governing the dynamics of the chaperonin cycle.

Adenosine Triphosphate↗

PubMed2005

Developing the public health practitioner workforce in England: lessons from theory and practice.

FOCUS: The paper focuses on public health practitioners who collectively represent one of three key workforce groups identified by England's Chief Medical Officer as critical to the successful delivery of national public health policy priorities. QUESTION: We report on two areas of work which attempt to address the following two-part question: in developing the public health practitioner workforce in England, what is needed, and how do we do it? APPROACH: First, we describe a five-component conceptual framework for developing the public health workforce which is grounded in data derived from a national Open Space event hosted by the University of the West of England in March 2005. The five components are (i) strategic support and oversight; (ii) national technical and professional support; (iii) national career building; (iv) local organisational development, and (v) sub-regional skills development. Key elements of each component are described in the paper. Second, we describe in some detail a new multidisciplinary skills development programme which illustrates one of the framework components (sub-regional skills development). The programme, established in January 2005, is aimed at three key groups of public health practitioners: health visitors (specialist community public health nurse), school nurses and environmental health officers. Its main features and some initial evaluation findings are presented. CONCLUSIONS: To be effective, activities aimed at supporting the development of the public health practitioner workforce should, where possible, aim to be congruent with core public health principles of self-determination and collective responsibility. We also conclude that leadership and vision at a national level, combined with local implementation of evidence-based training programme such as the one described could help to achieve much greater and more rapid progress in skilling up the existing public health practitioner workforce than has been possible up to now. But we note that this requires sustained investment, robust sector-wide delivery frameworks, and a group of committed local public health champions.

Humans↗

PubMed2000

Cognitive therapy supervision as a framework for clinical supervision in nursing: using structure to guide discovery.

Cognitive therapy supervision as a framework for clinical supervision in nursing: using structure to guide discovery Cognitive therapy has an undisputed evidence base upon which its clinical application flourishes. This approach is now a well-recognized and widely adopted method used in the treatment of a diversity of psychological problems. More recently, prominent innovators of this psychotherapy have devised a framework to guide the clinical supervision of cognitive therapists. In keeping with its therapeutic application, the cognitive therapy framework for supervision is focused, structured, educational and collaborative. It serves to enhance the therapeutic proficiency of the cognitive therapist. In contrast, the supervision models reported in the recent nursing literature are less precise in their mission and when evaluated their contribution to nursing is shown to be dubious. Following an overview of the supervision models commonly cited in the nursing literature, a more focused comment on the evaluative research concerning Proctor's three-function interactive model will be offered. It is suggested that the unconvincing research findings may be related to the conceptual muddle surrounding clinical supervision, and the expectation for clinical supervision to deliver more than an opportunity for the progression of our therapeutic integrity. From this, a cognitive therapy supervision framework is described and suggested by the authors as a structure from which supervisors can guide discovery.

Clinical Competence↗

PubMed2002

Mental health issues in primary healthcare.

This article describes a project that was designed to explore mental health issues arising in primary care, as a basis for understanding primary care professionals' mental health training needs. Whilst recent UK government initiatives, such as the National Service Framework for Mental Health, have emphasized the need to enhance mental healthcare in the general population, the capacity to respond effectively is likely to be dependent upon primary care professionals acquiring the relevant skills. To achieve this, a thorough understanding of the issues inherent in dealing with mental health problems in primary care is required. Given that the mental health issues facing primary care professionals may differ from those that confront mainstream mental health professionals, logic dictates that primary care professionals may require a discrete set of skills and a special approach to mental health training. The principal aim of this project was, hence, to identify mental health issues arising in clinical practice, as a first step towards identifying primary care training needs. A series of focus groups and semi-structured interviews was used to gather information about mental health issues arising in primary care, based on the experiences of primary care professionals and users' representatives. The findings suggest that primary care professionals are confronted by a wide range of mental health issues, many of which lie outside of the scope of the current National Service Framework for Mental Health. The article discusses the implications for mental health training in primary care practice and future research.

Clinical Competence↗

PubMed2006

Capacity of the Golgi apparatus for cargo transport prior to complete assembly.

In yeast, particular emphasis has been given to endoplasmic reticulum (ER)-derived, cisternal maturation models of Golgi assembly while in mammalian cells more emphasis has been given to golgins as a potentially stable assembly framework. In the case of de novo Golgi formation from the ER after brefeldin A/H89 washout in HeLa cells, we found that scattered, golgin-enriched, structures formed early and contained golgins including giantin, ranging across the entire cis to trans spectrum of the Golgi apparatus. These structures were incompetent in VSV-G cargo transport. Second, we compared Golgi competence in cargo transport to the kinetics of addition of various glycosyltransferases and glycosidases into nascent, golgin-enriched structures after drug washout. Enzyme accumulation was sequential with trans and then medial glycosyltransferases/glycosidases found in the scattered, nascent Golgi. Involvement in cargo transport preceded full accumulation of enzymes or GPP130 into nascent Golgi. Third, during mitosis, we found that the formation of a golgin-positive acceptor compartment in early telophase preceded the accumulation of a Golgi glycosyltransferase in nascent Golgi structures. We conclude that during mammalian Golgi assembly components fit into a dynamic, first-formed, multigolgin-enriched framework that is initially cargo transport incompetent. Resumption of cargo transport precedes full Golgi assembly.

Biological Transport↗

PubMed2004

Empathy: towards a conceptual framework for health professionals.

Effective provider-patient communication and the relationships that it supports are located at the centre of quality health-care delivery. The patient-centred approach is increasingly seen as an effective way to provide effective patient care, being more sensitive and responsive to the needs of the individual. Empathy has been identified as a core component of "patient-centredness" but definitions often lack conceptual clarity. This paper proposes to clarify the definition of empathy keeping the discussion true to Rogers' original definitions of the concept whilst integrating the work of other writers. A major thrust is the development of an innovative conceptual model of empathy which has the potential to both integrate previous research findings and provide a framework for future research and training. The model is based in social psychological conceptions of attitude.

Attitude of Health Personnel↗

PubMed1992

How much longer must medicine's science be bound by a seventeenth century world view?

The exclusion of nonmaterial human phenomena mandated by medical science's continuing allegiance to a 17th century scientific world view has constituted a major obstacle to medicine's scientific maturation as a human discipline. But 20th century conceptual changes even in physics (not to mention the influence of the theory of evolution) now renders that exclusion untenable and in effect legitimizes efforts to devise scientific means appropriate for the human domain. Practical as well as theoretical issues involved in such an undertaking are discussed within the framework of a 20th century scientific world view as represented by the biopsychosocial model, a counterpart to the traditional biomedical model.

Clinical Competence↗

PubMed1997

Practice analysis survey: revalidation of advanced clinical practice in orthopaedic physical therapy.

The first orthopaedic physical therapy practice analysis survey was completed in 1983. Another practice analysis survey was conducted in 1993 to identify the advance practice of clinicians who practice in orthopaedic physical therapy settings. Since 10 years elapsed, a new practice analysis study was conducted to identify the practice of orthopaedic clinical specialists. The purpose of this report is to describe the results of this survey. Orthopaedic physical therapists, both specialists and nonspecialists, participated in group interviews, subject matter expert meetings, and a national practice survey to delineate important knowledges and responsibilities. The survey was.sent to a stratified convenience sample of 1,000 orthopaedic physical therapists, of which 325 were orthopaedic clinical specialists. The three-part survey contained 180 items. A total of 420 respondents, of which 241 were orthopaedic clinical specialists, rated the importance and application level for the items. The results of this study provide evidence for a core body of knowledge required by clinicians practicing with advanced skills in orthopaedic physical therapy and create the framework for the Orthopaedic Physical Therapy Specialty Exam.

Clinical Competence↗

PubMedDate not supplied

Self-evaluation for nursing students.

Self-evaluation skills are believed to promote professional development, enhance self-esteem, and develop self-awareness, but nursing students are not taught these skills in any systematic way. Collaborative evaluation techniques provide nursing educators with a framework for teaching students essential self-evaluation skills.

Education, Nursing↗

PubMed2002

When is risk stratification by race or ethnicity justified in medical care?

Issues of race and ethnicity have been controversial in both clinical care and medical education. In daily practice, many physicians struggle to be culturally competent and avoid racial stereotyping. One educational development that makes this goal more complex is the rise of clinical epidemiology and Bayesian thinking. These population-based, probabilistic approaches to medicine help guide the diagnostic and therapeutic pathways for patients, and are foundations of the evidence-based medicine movement. Can Bayesian thinking be applied effectively to issues of race and ethnicity in medical care, or are the dangers of prejudicial stereotyping too great? The authors draw upon lessons from recent cases of racial profiling, and develop a conceptual framework for thinking about ethnicity as a clinical tool. In their typology of ethnicity as a proxy, they argue that the costs of using ethnicity as a proxy for socioeconomic status and behavior are too high, but that ethnicity may appropriately be used as an initial proxy for history, language, culture, and health beliefs. They discuss their approach within the context of new curricula in cultural competence, and argue that viewing the patient within a wider cultural setting can help guide the initial clinical approach, but individualized care is mandatory. Also, physicians must remain sensitive to the changing nature of cultural norms; thus lifelong learning and flexibility are necessary.

Cultural Diversity↗

PubMed2002

A conceptual framework for understanding the process of family caregiving to frail elders in Taiwan.

This descriptive, correlational study of family caregivers (N=125) tested a conceptual framework for family caregiving to frail elders in Taiwan, using the concept of "finding a balance point" derived from a previous qualitative study. It was hypothesized that caregivers who were better able to find a balance point among competing needs would provide better-quality care to frail elders, which would lead to more positive caregiver and family outcomes. After controlling for the influence of caregiving characteristics and caregiving factors, finding a balance point significantly explained 7% of the variance in overall caregiving consequences. The findings of this study add a new perspective to the caregiving process in Taiwan.

Adaptation, Psychological↗

PubMed2005

Trust and health worker performance: exploring a conceptual framework using South African evidence.

Two relationships of particular importance to health care provision are those between patient and provider, and health worker and employer. This paper presents an analytical framework that establishes the key dimensions of trust within these relationships, and suggests how they may combine in influencing health system responsiveness. The paper then explores the relevance of the framework by using it to analyse case studies of primary care providers in South Africa. The analysis suggests that respectful treatment is the central demand of primary care service users, in terms of positive attitudes/behaviours, thoroughness, and technical competence, as well as institutions that support fair treatment. It is argued that such treatment is necessary for, and integral to, patient-provider trust. The findings also suggest that the notion of workplace trust (combining trust in colleagues, supervisor and employing organisation) has relevance to provider experiences of their workplaces, and so can provide important insights for strengthening management. Nonetheless, given the limitations of this preliminary analysis, further research is needed to develop the notion of workplace trust and to test what role it has, along with that of provider-community relations, in influencing health worker performance.

Efficiency↗

PubMed2026

Transgene sequence codon optimization and composition determines replication competence of self-amplifying RNA.

Self-amplifying RNA (saRNA) is an emerging RNA therapeutic modality that can facilitate higher magnitude and more durable protein expression at substantially lower doses than nonreplicating mRNA. Unlike conventional messenger RNA (mRNA), alphavirus-derived saRNA must support a replicase-driven RNA amplification step in addition to translation, raising the possibility that transgene coding sequences impose sequence-level constraints on replication. Here, saRNA replication was found to be dependent on the codon composition of the transgene; multiple therapeutic transgenes were replication defective despite an intact Venezuelan Equine Encephalitis Virus (VEEV)-derived saRNA backbone. Replication defects were rescued by synonymous codon re-optimization of the same transgenes, indicating that nucleotide-level features of the coding sequence, rather than the encoded protein, govern replication competence. Comparative compositional analyses identified a distinct signature associated with productive replication, characterized by elevated GC (>53%) and GC3 (>63%) content, higher codon adaptation to human (>0.75), and reduced UpA (<43/kb) and UpU (<41/kb) dinucleotide density. Moreover, deliberate compositional perturbation of an otherwise replication-competent transgene shifted these features and abolished replication, supporting a causal and combinatorial role for sequence composition in defining saRNA replication outcome. These findings define an underappreciated constraint in saRNA therapeutics and motivate saRNA-specific payload design frameworks that incorporate alphavirus-associated compositional biases during transgene sequence optimization.

Codon↗

PubMed1999

Why is the pathology of falciparum worse than that of vivax malaria?

Here, Ian Clark and Bill Cowden summarize new evidence suggesting that nitric oxide (NO) generated by inducible NO synthase (iNOS) provides a functional link between the previously competing approaches to malarial disease pathogenesis: ischaemic hypoxia and NO. When combined with the newly recognized roles of iNOS in renal and pulmonary function and glucose metabolism, synergy between inflammatory cytokines and hypoxia in iNOS induction provides a framework to help explain, at a molecular level, the differences in the pathology seen in falciparum and vivax malaria. Thus sequestration, through localized hypoxia, might contribute to pathology by enhancing cytokine-induced iNOS. Generalized hypoxia might have the same effect.

Animals↗

PubMed1999

Speechreading: illusion or window into pattern recognition.

In the Fuzzy Logical Model of Perception (FLMP) perceivers are conceptualized as forming perceptual judgments by evaluating and integrating multiple ambiguous sources of information, in an optimal manner based on relative goodness of match. This model has been tested favorably against a variety of competing theories and models. Recent extensions of the FLMP are described in this article along with empirical applications and verification, and progress in the study of speech perception by ear and eye is reviewed within this general theoretical framework. The model illuminates the differences that are observed across different languages in terms of information as opposed to information-processing. Pattern recognition of bimodal speech is representative of pattern recognition in a variety of other domains, such as emotion perception, and there are several domain-dependent reasons why multimodal presentation of audible and visible speech is particularly conducive to accurate pattern recognition. We believe that the positive outcome of this research provides a framework for the development of computer-animated agents, which can serve as language tutors and as conversational characters in other domains, easing the interaction of humans and machines.

Journal Article↗