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Results for “Competency framework”

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PubMed2000

What determines hospital sponsorship of an HMO?

Using a strategic adaptation framework, this study evaluates the underlying institutional, market, organizational, and financial factors leading to hospital sponsorship of a health maintenance organization (HMO) insurance product. Analyzing hospitals in Metropolitan Statistical Areas (MSAs) in 1995 and 1996, the study found that a hospital is more likely to sponsor an HMO in markets that see a combined interaction effect of a large number of competing HMOs and high HMO penetration. HMO sponsorship also is more likely among hospitals with relatively low market share. Only in small MSA markets do hospitals with greater liquidity sponsor an HMO. Finally, hospitals that are affiliated with a multihospital system and under public ownership are more likely to sponsor HMOs.

American Hospital Association↗

PubMed2005

Attachment and motivational strategies in adolescence: exploring links.

Within the framework of attachment theory and of motivation goal theory, this study explored the relation between quality of attachment strategies and quality of motivational strategies in a sample of young adolescents. Specifically, this study examined patterns of thoughts, behaviors, and emotions as they related to representations of attachment and motivational functioning in situations that challenge or threaten three psychological needs (emotional security, competence, and autonomy). Forty-four students, aged 11 to 14 years, responded to imagined stressful situations in order to: (a) assess attachment strategies; (b) identify and assess students' motivational strategies in stressful classroom circumstances; (c) assess motivational strategies of students with high and low control and agency beliefs; and (d) examine the relations between attachment and motivational strategies. Four distinct action patterns were identified: flexible action, rigid action, passive behavior, and disorganized behavior. Significant relations were found between control beliefs and motivational strategies, as well as a trend toward relations between attachment and motivational strategies, suggesting that secure adolescents show more constructive motivational strategies and less disorganized strategies when compared to insecure adolescents.

Adolescent↗

PubMed2006

Attitudes of nurses towards End-user Development.

The purpose of this study is to explore nurses' attitudes toward developing self-made information tools. In order to understand nurses' attitudes, we studied the factors that affect nurses' attitudes toward End-user Development (EUD). The investigation of nurses in Taiwan hospitals showed that nurses had positive attitudes toward EUD. A framework of nurses' attitudes toward EUD is presented. A gap was found between the functions provided by the nursing information system and self-assessment required by the job. The nurses were inclined to be dissatisfied with support provided by the information centers. Nursing managers were advised to enhance on-the-job training for computer applications, and to include computer competencies in the nursing ladders program. The results indicated that nurses were willing to develop their own tools. We believe that nurses with computer application skills who are provided with appropriate tools can become nursing application developers. The results encourage nurses to develop software by themselves. Further research and development is required to enhance the impact of EUD and establish a sharing environment for EUD applications.

Adult↗

PubMed1993

Catch 22: manipulative family members.

When a Medicare patient from another state, who is not deemed mentally incompetent, vehemently demands treatment but then defers all procedures and treatment to her questionably competent son who, in turn, curtails any progress toward diagnosis, what are the hospital's and attending physicians' rights to continue basic care to the tune of $90,000 and beyond? Such multifaceted and complex dilemmas are illustrated by this case study which outlines the challenges and restraints encountered in dealing with an unusual situation. Also, it offers guidelines as a framework for action when a manipulative family member or patient is encountered.

Aged↗

PubMed2005

Cognitive ability, expertise, and age differences in following air-traffic control instructions.

Differences in cognitive ability and domain-specific expertise may help explain age differences in pilot performance. Pilots heard air-traffic controller messages and then executed them while "flying" in a simulator. Messages varied in length and speech rate. Age was associated with lower accuracy, but the expected Age x Message Difficulty interactions were not obtained. Expertise, as indexed by pilot ratings, was associated with higher accuracy; yet expertise did not reduce age differences in accuracy. The effect of age on communication task accuracy was largely explainable as an age-associated decrease in working memory span, which in turn was explainable as decreases in both speed and interference control. Results are discussed within frameworks of deliberate practice and cognitive mediation of age differences.

Age Distribution↗

PubMed1997

Heuristics, servants to intuition, in clinical decision-making.

This paper explores intuitive judgements of nurses in clinical decision-making situations. The qualities of intuition are presented from both theoretical and practical perspectives and attitudes towards intuition from both nurses themselves and other health professionals are identified. An heuristic framework from cognitive psychology is applied to intuitive aspects of the clinical judgements that nurses have made. This interpretation is proposed as a partial explanation of intuition, and its use in advancing the understanding of intuition is recommended.

Clinical Competence↗

PubMed1994

Privacy and confidentiality of patient information. Challenges for nursing.

The growing interest in automating healthcare information and the emergence of the computer-based patient record-keeping have brought the issues of privacy and confidentiality to the fore-front. Nurse executives and nurse managers need to be sensitive to these issues, as never before, to guide their staffs and to prevent harm. Technology makes sensitive information more accessible to more people, with resulting benefits and dangers. The author presents a nursing ethical framework for discussing patient privacy and confidentiality issues, and highlights specific issues that reflect nursing's unique viewpoints.

Codes of Ethics↗

PubMedDate not supplied

The dynamics of curriculum design, evaluation, and revision. Quality improvement in leadership development.

The nursing shortage and specifically the shortage of new nursing leaders has fueled heightened recognition of the need for leadership development. This article considers the application of the quality improvement process to leadership curriculum development for the Center for Nursing Leadership's (CNL) Journey Toward Mastery program. Both the postmodernist approach and a commitment to scholarship are used as a framework to develop, evaluate, and revise the program. Further, the importance of symmetry between philosophical perspective and curriculum design are illustrated.

Curriculum↗

PubMedDate not supplied

Gently into the light: a call for the critical analysis of end-of-life outcomes.

This article overviews the holistic, hospice, and palliative care models as they relate to end-of-life (EOL) care outcomes. Freire's model of overcoming oppression, which builds on Hegel's philosophical approach, is used as a framework for raising nurses' awareness of end-of-life issues. Concerns that require critical dialogue, as well as questions that warrant discussion, are posited.

Attitude of Health Personnel↗

PubMed1983

Application of humanistic learning theory in an associate degree program for occupational therapy assistants.

A humanistic education model was implemented in a 2-year associate degree curriculum for occupational therapy assistants. The goal of this model was to help students to become responsible and successful with their own lives. This prepares students with higher levels of ability to cope effectively with clients in crises. The curriculum presented here supports the framework of The American Occupational Therapy Association role delineation document (Entry-Level Role Delineation for OTRs and COTAs, approved by the Representative Assembly, AOTA, March 1981).

Adult↗

PubMedDate not supplied

Agenda for Change: the knowledge and skills framework.

This article examines a range of issues associated with role redesign and pay modernisation in the light of Agenda for Change (DoH 1999a). It is argued that the Knowledge and Skills Framework is central to Agenda for Change and should not be seen in isolation, but needs to be considered alongside other changes that are being introduced as a result of GP practice and consultant contracts.

Career Mobility↗

PubMed1998

A theoretical analysis of Carper's ways of knowing using a model of social cognition.

Although Carper's model of the ways of knowing in nursing has played a critical role in delineating the body of knowledge that comprises the discipline, questions remain regarding the defining properties of the knowledge structures, how they relate to each other, and how they function in the process of knowing. In this article, we propose that the cognitive model of social knowledge developed within the field of social psychology can be used to extend our understanding of the form and function of the four types of nursing knowledge. Empirical, personal, esthetic and ethical knowledge are compared with semantic, episodic and procedural knowledge specified in the cognitive model, and the schema construct, which is defined as an organized package of these three types of knowledge, is proposed as an integrative framework for addressing the relationships among the four types of nursing knowledge and their role in the process of knowing. Implications for nursing theory development, education and practice are addressed.

Clinical Competence↗

PubMed2000

Coming to Terms with Motivation Constructs.

The field of motivation is beset with a lack of clear definition of motivational constructs and specification of their operation within larger theoretical frameworks. These problems have implications for interpretation of research results and applications to practice. The articles in this collection represent an important step in attaining greater clarity. Future research should be directed toward clarifying conditions under which motivational constructs predict achievement behavior, delineating the role of social processes in motivation, and exploring long-term motivation in the face of obstacles and competing demands. Copyright 2000 Academic Press.

Journal Article↗

PubMed2004

Coordinated school health program and dietetics professionals: partners in promoting healthful eating.

Although research indicates that school meal programs contribute to improved academic performance and healthier eating behaviors for students who participate, fewer than 60% of students choose the National School Lunch Program or School Breakfast Program. School meal programs have a difficult time competing with foods that are marketed to young people through sophisticated advertising campaigns. Youth's preferences for fast foods, soft drinks, and salty snacks; mixed messages sent by school personnel; school food preparation and serving space limitations; inadequate meal periods; and lack of education standards for school foodservice directors challenge school meal programs as well. A coordinated school health program offers a framework for meeting these challenges and provides children and adolescents with the knowledge and skills necessary for healthful eating. This article identifies challenges facing school foodservice directors in delivering healthful meals and acquaints dietetics professionals with the coordinated school health program to be used as a tool for addressing unhealthful weight gain and promoting healthful eating.

Advertising↗

PubMed2003

Combining principal component and spectral analyses with the method of moments in studies of quantal transmission.

This chapter considers methods for measurements of postsynaptic responses and simple approaches to the estimation of parameters of quantal release in synapses of the central nervous system of vertebrates. The use of these methods is illustrated by the analysis of single-fibre and "minimal" monosynaptic postsynaptic potentials (PSPs) or currents (PSCs) recorded from neurons of the frog spinal cord and rat hippocampus. First, we briefly discuss traditional methods of the response measurements using peak amplitudes or areas, further focusing on a novel method based on multivariate statistical techniques of the principal component analysis (PCA). This approach provides typically better signal-to-noise ratios and is able to separate two or more response components, which can arise due to activation of more than one presynaptic fibre, axon collaterals, receptor subtypes or spatially separated transmission sites. Second, spectral analysis is introduced as the method of choice to verify whether the amplitude fluctuations of the postsynaptic responses have a quantal nature and to obtain estimations of the "basic" quantal parameters, i.e. the quantal size (Q) and mean quantal content (m), without introducing assumptions on release statistics. Third, we show how the method of moments could be applied in the framework of the Poisson and binomial models to estimate the basic quantal parameters and parameters p and n, which reflect the release probability and maximum number of quanta released (or the number of effective release sites), respectively. Fourth, we show that the analysis of the moments can also be instrumental to reveal non-uniformity of release probabilities and compare how several competing models of neurotransmitter release fit to multiple experimental data sets.

Animals↗

PubMed2004

Dynamics and processivity of 40S ribosome scanning on mRNA in yeast.

The eukaryotic 40S ribosomal subunit locates the translation initiation codon on an mRNA via the so-called scanning process that follows 40S binding to the capped 5' end. This key step in translation is required for the expression of almost all eukaryotic genes, yet the mechanism and dynamics of scanning are unknown. We have performed quantitative studies in vivo and in vitro of the movement of yeast 40S ribosomes along 5' untranslated regions (UTRs) of different lengths. 40S subunits perform cap-dependent scanning with high processivity for more than 1700 nucleotides in cells of Saccharomyces cerevisiae. Moreover, the observed rates of expression indicate that scanning is performed by an untethered 40S subunit that has been released from the 5' cap complex. Unexpectedly, the capability to maintain scanning competence on a long 5' UTR is more dependent on the Ded1/Dbp1 type of helicase than on eIF4A or eIF4B. In a yeast cell-free extract, scanning shows reduced processivity, with an estimated net 5'-->3' rate of approximately 10 nucleotides per second at 26 degrees C. We have developed a biased bidirectional walking model of ribosomal scanning that provides a framework for understanding the above observations as well as other known quantitative and qualitative features of this process.

5' Untranslated Regions↗

PubMed2005

Geropsychology post-doctoral training in public sector service delivery: the USF/Tampa VA fellowship model.

There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care settings. Addressing the bio-psycho-social needs of frail, poor, and minority older adults within an interdisciplinary framework exposes geropsychology Fellows to the complex nature of mental health problems of older adults and the need for collaborative efforts across professional lines. The program builds on prior geropsychology training at the graduate and internship levels by providing an integrated framework to achieve clinical, didactic, program evaluation, and advocacy goals: (1) delivery of state-of-the-art evidence-based psychological services to disadvantaged older adults in geriatric public sector primary care sites; (2) mastery of the knowledge base on diversity and interdisciplinary teamwork as they relate to providing services to older adults, including those residing in rural areas; (3) gaining competence in the evaluation of services to disadvantaged older adults; and (4) experience in public health advocacy for improvement of the LTC system.

Aged↗

PubMed2004

Water governance: learning by developing adaptive capacity to incorporate climate variability and change.

There is increasing evidence that global climate variability and change is affecting the quality and availability of water supplies. Integrated water resources development, use, and management strategies, represent an effective approach to achieve sustainable development of water resources in a changing environment with competing demands. It is also a key to achieving the Millennium Development Goals. It is critical that integrated water management strategies must incorporate the impacts of climate variability and change to reduce vulnerability of the poor, strengthen sustainable livelihoods and support national sustainable development. UNDP's strategy focuses on developing adaptation in the water governance sector as an entry point within the framework of poverty reduction and national sustainable development. This strategy aims to strengthen the capacity of governments and civil society organizations to have access to early warning systems, ability to assess the impact of climate variability and change on integrated water resources management, and developing adaptation intervention through hands-on learning by undertaking pilot activities.

Climate↗