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Results for “Competency framework”

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PubMed2000

Familicide, depression and catathymic process.

A case of familicide by a 36-year-old male is reported. After years of stable marriage, exemplary military service, and steady employment, the subject developed his first episode of depression triggered, in part, by his inability to solve a problem associated with completion of a home improvement project. As the depression intensified, and dormant conflicts regarding his competency and self-esteem were rekindled, he experienced pronounced feelings of failure. After an extended period of agonizing about his problem, the idea suddenly emerged that his only recourse was to kill his family and himself, in order to spare everyone the humiliation of his perceived inadequacy. Such a fixed idea, along with a mounting pressure to act, is characteristic of the (chronic) catathymic process, in which a subject, without apparent motive, resorts to extreme violence directed at someone close to him. A detailed discussion of this case within the framework of catathymic process adds to our knowledge of family mass murder and refines the profile of potentially familicidal men.

Adult↗

PubMed2004

The medical provision of hydration and nutrition: two very different outcomes in Victoria and Florida.

Decisions to withhold or withdraw medical hydration and nutrition are amongst the most difficult that confront patients and their families, medical and other health professionals all over the world. This article discusses two cases relating to lawful withdrawal and withholding of a percutaneous endoscopic gastrostomy tube (PEG) from incompetent patients with no hope of recovery. Victoria and Florida have statutory frameworks that provide for advance directives, however in both Gardner; Re BWV and Schindler v Schiavo; Re Schiavo the respective patients did not leave documented instructions. The article analyses the two cases and their outcomes from legal, medical and ethical perspectives.

Adult↗

PubMed2005

Marking criteria for assessing practice-based portfolios at masters' level.

Whilst portfolios have increasingly been used to assess attainment and competence in nursing and other health care professions for over a decade, the assessment processes and criteria for assessing them have remained largely rudimentary and undeveloped. In fact, assessment often remains localised, impressionistic and dependent upon the interpretation and adaptation of criteria developed generically for work at this level within individual Higher Education Institutes (HEIs). This paper presents Masters' level marking criteria for portfolios from practice-based healthcare disciplines developed from the Quality Assurance Agency (QAA) descriptors of Masters level achievement and graduateness [Quality Assurance Agency for Higher Education, 2001. The Framework for Higher Education Qualifications in England, Scotland, Northern Ireland] in combination with practice-based outcomes. A six-stage methodology was devised to analyse these descriptors, develop, re-order, test and refine them in order to enhance their applicability to portfolios from practice-based disciplines. As part of this process the emerging criteria were tested against existing portfolios. Extracts from these are presented to illustrate the criteria. Two case study sites from diverse areas of England are used where Masters' courses in nursing and healthcare disciplines are offered. For portfolios to be effective in demonstrating Masters' level academic criteria, learning outcomes and advanced professional practice they need to demonstrate coherent structure, conclusions drawn from reflection on practice and a body of evidence that is coherent with, and linked to their reflective commentaries. The marking criteria presented to assess these attributes incorporate features of the structures, processes and outcomes of both practice and learning. The strategy can be used by both assessors and students, in formative and summative assessment, to identify student attainments, strengths and weaknesses.

Education, Nursing, Graduate↗

PubMed2026

BriGHT: transcriptome-regularized multimodal neuroimaging for brain disorder prediction.

MOTIVATION: Hypergraph-based models for brain disorder prediction mainly adopt imaging-derived hypergraphs as propagation backbones. However, the entanglement of topology construction and feature propagation leaves regional representations weakly constrained by underlying biological organization, making them vulnerable to subject-specific variation and noise, particularly in heterogeneous multimodal settings. RESULTS: We present BriGHT, a Brain transcriptome-reGularized Hypergraph framework for mulTimodal disorder prediction. BriGHT employs a transcriptome-derived structural reference as a soft anchoring prior to regularize neuroimaging ROI embeddings, stabilizing representation geometry while preserving disease-relevant subject-specific variation. BriGHT further incorporates a reliability-aware fusion module to estimate subject-specific modality reliability from prediction confidence, cross-modal consistency, and decision certainty, enabling adaptive integration under heterogeneous modality quality. Experiments on three neuroimaging cohorts (ADNI, ADHD-200, REST-meta-MDD) and four modalities (VBM, fMRI, FDG, AV45) demonstrate that BriGHT consistently outperforms competing graph/hypergraph learning methods across six brain disorder prediction tasks. Perturbation analyses show that BriGHT benefits from the spatial correspondence between transcriptomic modules and imaging ROIs, rather than from arbitrary hypergraph regularization alone. Ablation and meta-analytic interpretability analyses support the contribution of transcriptomic anchoring and adaptive fusion to robust and biologically meaningful brain disorder prediction. AVAILABILITY: The software is publicly available at: https://github.com/Yaolab-fantastic/BriGHT. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Journal Article↗

PubMedDate not supplied

The Black-White perception gap and health disparities research.

Reducing and eliminating racial and ethnic health disparities has become a national research priority. This research agenda requires new research frameworks that encompass the social determinants of health and the translation pathways of these social contexts into physiological morbidity. Within these sociobiological research frameworks, identity and emotions are seen as crucial links in the causal pathways from stressors to biological responses. In this country, the lived social reality of African American individuals is experienced through the color of their skin. Their identity is bound with the racial inequities of our society. It has been suggested that the emotions of anger and frustration resulting from this institutionalized racial discrimination are an emotional causative pathway to the pathophysiology contributing to the health disparities experienced by African Americans. However, as much as we espouse the concept of cultural competency in health care, until recently, there has been very little honest dialogue about how race and racism influences health. This article will explore the Black-White cultural perception gap and attempt to provide insight on the relationship to African American health and implications for health disparities research.

Black or African American↗

PubMed2006

The effect of biodiversity on the hantavirus epizootic.

We analyze a mathematical model of the epizootic of Hantavirus in mice populations, including the effect of species that compete with the host. We show that the existence of the second species has an important consequence for the prevalence of the infectious agent in the host. When the two mice species survive in the ecosystem, the competitive pressure of the second species may lead to reduction or complete elimination of the prevalence of infection. The transition between the disappearance of the infection and its presence occurs at a critical value of the competitor's population, resembling a second-order phase transition in a statistical system. The results provide a rigorous framework for the study of the impact of biodiversity in the propagation of infectious diseases, and further lends itself to future experimental verification.

Animals↗

PubMed2000

Mothers' stories about their experiences in the neonatal intensive care unit.

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant's outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

Adult↗

PubMed2005

The continued evolution of the credit system.

In its ongoing support of continuous physician professional development, the American Medical Association (AMA) for use in the AMA Physician's Recognition Award has adopted 2 new learning platforms: Performance Improvement (PI) and Internet Point of Care (PoC). This article highlights the process that led to their adoption and places these new forms of continuing and physician professional development in the framework of existing continuing medical education (CME). The article calls for new research that revisits existing data on physician learning and prepares to incorporate provider experience with "practice situated" forms of CME. The Conjoint Committee on CME may serve as an important contributor to this process by enabling valuable dialogue among stakeholder organizations.

American Medical Association↗

PubMed2005

Provision of care for older people with co-morbid mental illness in general hospitals: general nurses' perceptions of their training needs.

INTRODUCTION: There are high levels of co-morbid mental illness amongst older people in general hospitals; this study explored the training needs of general nurses to care for this group. METHOD: Focus groups with general nurses were analysed using framework analysis. FINDINGS AND CONCLUSION: Nurses wanted training, but did not believe that training alone was sufficient to improve care, expressing that more integrated working between acute and mental health services was also needed. Liaison mental health services provide a way to deliver both training and a more integrated service.

Aged↗

PubMed2002

An evaluation of the baccalaureate-nursing program within the (MOPH), Thailand.

This research study was designed to evaluate the baccalaureate-nursing curricula undertaken in the nursing colleges under the jurisdiction of the Ministry of Public Health (MOPH), Thailand. A stakeholder approach was used to incorporate mixed methods of data collection and models of evaluation within the research framework. Both qualitative and quantitative approaches were used. Newly registered nurses and their colleagues were generally positive about the course outcomes. However, qualitative data demonstrate a need to focus more on the development of abilities related to life-long learning and critical thinking. The findings suggest challenges in achieving program outcomes attributed to the feasibility of implementation strategies. Concepts in the curriculum plan are not fully translated into practice. A number of factors have a major impact on the actual program implementation or course organisation and teaching/learning processes. There is evidence of competing or conflicting ideologies about nursing practice and education. Findings suggest that the preferable educational models for contemporary and future nursing education are process rather than content-based. It is challenging to develop ways of accommodating the more desirable professional nursing and educational approaches within the context of Thailand and MOPH nursing education policies where resources are limited and the maintenance of Thai culture is of paramount importance.

Curriculum↗

PubMedDate not supplied

Disasters and development: Part 3: Assessing trade-offs in investing in vulnerability reduction.

This lesson describes how a government decides whether and how much it should spend on vulnerability reduction. There are techniques and methods by which decision-makers compare development alternatives. The differences between the risk that a potentially catastrophic event will occur and uncertainty are described, with uncertainty providing greater difficulty in economic analyses. There is a range of methods for identifying the complex mix of competing costs and benefits associated with any restructuring of investment priorities to accomplish disaster mitigation. The possibilities are described in terms of the opportunity costs and present value. Impact and consequent losses include: (1) direct monetary effects; (2) indirect monetary effects; (3) direct, non-monetary effects; (4) indirect, non-monetary effects; and (5) loss of non-renewable natural resources. The difficulties in assigning values to these effects are described, as well as the means of judging the cost-effectiveness of such interventions. An advantage of screening projects using a framework of analytical methods is that it can assist in focusing on a variety of possible outcomes and make the factors influencing these outcomes quite explicit.

Cost-Benefit Analysis↗

PubMed2006

Understanding the concept of basicity in zeolites. A DFT study of the methylation of Al-O-Si bridging oxygen atoms.

DFT calculations on a 4-ring cluster and on ONIOM models of faujasite were carried out to assess the concept of basicity in zeolites, exchanged with alkali cations. The considered reaction is the methylation of the Si-O-Al bridging oxygen by methanol and methyl iodide. The reaction involves both the dissociation of the H3C-OH or H3C-I bonds and the formation of the C-O-zeolite bond. The former involves the hardness of the alkaline cation. The latter reflects the charge density of the basic oxygen, well described by the "hard" descriptor: the molecular electrostatic potential. The harder is the alkali metal, the easier is the H3C-OH or H3C-I bond dissociation, and the lower is the basicity of the bridging oxygen, and thus the more difficult is the C-O-zeolite bond formation. The fact that these two processes compete has been established by comparing the energy profiles for the methylation with methyl iodide and methanol. For methanol the role of the alkaline metal on the bond dissociation prevails because of the larger hardness of the OH group as compared to that of the iodine atom. For methyl iodide the oxygen basicity prevails over the interaction of I with metal. This study clearly shows that in both experimental and theoretical studies the role of the Lewis acidity or hardness of the alkali metal ion and the role of the basicity of the framework oxygen have to be separated from each other for a good interpretation of zeolite basicity. Also, the hardness of the probe molecule is particularly important when considering the interaction with the alkali metal ion.

Journal Article↗

PubMed1996

A theoretical framework created from a repertory grid analysis of graduate nurses in relation to the feelings they experience in clinical practice.

This paper outlines a theoretical framework that was created as a result of an investigation into the feelings graduate nurses have towards clinical practice. The framework offers an explanation of the complexity of emotions which need to be considered when considering why it is that people react in the way they do to their environment. The study from which this framework emerged was a repertory grid analysis of six graduates from an English university in their first year of practice. From the elicited constructs six themes emerged: feelings related to connectedness; feelings related to job satisfaction; feelings related to effectiveness; feelings related to ability; feelings related to threat to self; and feelings related to pressure of work.

Burnout, Professional↗

PubMed1996

The medical device directives and their impact on the development and manufacturing of medical implants.

The introduction of a legal framework for the supply of medical implants is discussed with reference to the Active Implantable Medical Device Directive and the Medical Device Directive. The definitions of medical device and manufacturer are discussed. The application of the Directives to device/drug combinations is considered. All implants must meet certain essential requirements to ensure that they do not harm the patient, clinician or any third party. For most implants this will be indicated on the product or its packaging by CE; marking involving an independent organization called a Notified Body; the latter are appointed by the Competent Authority of the Member State. Devices are classified in proportion to the risk associated with them. The steps needed to be taken by manufacturers are outlined and the verification options discussed. The role of standards and the new approach to writing them in Europe is presented. After placing a product on the market, the manufacturer must set up a system of post-market surveillance, including a vigilance procedure, in order to monitor product performance. Individual Member States can exercise the safeguard clause when a product appears to have had the CE marking incorrectly applied.

Equipment Design↗

PubMed2000

A framework for assessing outcomes and practices in Web-based courses in nursing.

This article presents a framework to assess the dynamic interaction of technology used to offer Web-based courses, the teaching-learning practices in these courses, and the outcomes enabled by the technology. Concepts of the model include outcomes, educational practices, faculty support, learner support, and use of technology. Variables are identified for each of the concepts.

Attitude of Health Personnel↗

PubMed1999

Defining new frameworks for psychosocial intervention.

The personal experiences of individuals with schizophrenia have been neglected in the psychiatric literature. Disappointingly, ideas about the impact of the illness on the experience of "self" have either been devalued or based primarily on the impressions of theorists rarely collaborating with individuals with the illness. Rather than making assumptions about the subjective experience of mental illness, we must enter a meaningful dialogue with our clients so that they can tell us about their situations using their own voices. This study presents life-history interviews with 15 individuals diagnosed with schizophrenia and describes the explanatory models they use to give coherence to their experiences of psychosis. The struggle for control emerges as a central theme with effects on the management of symptoms, self-image, feelings of social competence, and dealing with others' expectations. Respondents speak about the possibility of recovery from illness through engaging in a process of internal and external reorganization. These individuals echo the assertions in the literature generated by consumers and other investigators of subjective experience and advocate for recovery-based models of care including therapeutic discourse with clients.

Adaptation, Psychological↗

PubMed2026

Navigating Social Media: Balancing Connectivity With Media Literacy to Combat Misinformation and Protect Mental Well-Being.

BACKGROUND: The pervasive use of social media has created a complex digital ecosystem where high connectivity coexists with significant challenges, including the rapid spread of misinformation, particularly regarding mental health, and documented negative impacts on psychological well-being. Platform architectures designed for engagement maximization have been identified as central factors in both issues. OBJECTIVE: This paper critically analyzes the interconnected relationships between social media use, misinformation dissemination, and mental health impacts, with particular attention to psychiatric misinformation across diagnostic categories (e.g., depression, anxiety, ADHD). A primary objective is to evaluate the potential of advanced critical digital literacy frameworks to serve as protective mechanisms against these dual threats. METHODS: A systematic search was conducted following PRISMA 2020 guidelines across APA PsycInfo, PubMed, JSTOR, and Google Scholar for literature published between January 2018 and March 2026 (updated from the original 2023 search). The search yielded 2672 records. After removing 624 duplicates, 2048 records underwent title and abstract screening, with 1802 excluded. The remaining 246 full-text articles were assessed for eligibility, resulting in 86 studies included in the final qualitative synthesis. Inter-rater reliability was established (Cohen's κ = 0.82). Quality assessment was conducted using the Joanna Briggs Institute Checklist, AXIS, and CASP tools, with findings weighted by methodological quality. A thematic analysis was undertaken to synthesize findings. RESULTS: The analysis reveals that core architectural features of social media platforms, algorithmic curation and engagement-based metrics, simultaneously foster environments ripe for misinformation spread and contribute to psychological distress, including anxiety, depression, and harmful social comparison. Psychiatric misinformation specifically (e.g., inaccurate claims about treatment effectiveness, diagnostic criteria, and medication side effects) represents a growing concern, particularly on image- and video-based platforms. The findings indicate that conventional media literacy approaches focused solely on fact-checking are insufficient. Instead, a critical digital literacy framework encompassing algorithmic awareness, data literacy, and emotional awareness is essential for building user resilience, with evidence from high-quality systematic reviews supporting this approach. CONCLUSIONS: Navigating the complexities of modern social media requires an integrated approach combining "pedagogies of play" for experiential skill development with advocacy for structural change (e.g., algorithmic transparency, well being by design principles). This dual strategy empowers individual users to critically engage with digital content while advocating for ethical platform design, thereby safeguarding both mental well-being and democratic discourse. Implications for educators, mental health professionals (including competencies for addressing patient encounters with psychiatric misinformation), policymakers, and platform designers are discussed.

Humans↗

PubMed1992

The family, crisis and chronic illness: an evolutionary model.

While chronic illness has a profound impact upon the individual, an immense burden is imposed upon the family. When the competing demands of an illness and the family escalate exponentially, there may be a crisis. Traditionally, crisis theory has been applied to acute care contexts such as emergency, intensive care and mental health nursing. Yet, clinical experience with families and chronic illness supports the notion of periodic crises from the prediagnostic phase to the long-haul of the illness. Moreover, the authors hypothesize that the family's perception of the event determines whether the crisis is perceived as a threat or a challenge. This paper thus addresses the perception of crisis within the framework of chronic illness from a biological and family systems nursing perspective. First, the theory of Humberto Maturana, a Chilean biologist, is explored and applied to clinical observations regarding family, crisis and chronic illness. Second, an evolutionary model for conceptualizing crisis and chronic illness is presented. Third, the role of beliefs in the family perceptions of crisis and chronic illness is discussed.

Adolescent↗