Ego competency: a framework for formulating the nursing care plan.
The Ego Competency Model of psychiatric nursing provides a framework to guide nurses when developing or revising the nursing care or treatment plan.
SEARCH · PubMed Health
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.
The Ego Competency Model of psychiatric nursing provides a framework to guide nurses when developing or revising the nursing care or treatment plan.
Explore the source record for details and available documents.
Artificial intelligence (AI) is reshaping every stage of leukemia diagnostics, from digital morphology and multiparameter flow cytometry to next-generation sequencing, multi-omics analysis, and emerging computational frontiers such as quantum-inspired feature selection. This review outlines how contemporary AI tools can automate labor-intensive quantitation, flag diagnostically salient patterns, and standardize interpretation, while the pathologist or hematologist retains authority over validation, context-specific integration, and clinical decision-making. We present an illustrative "human-in-the-loop" workflow that embeds AI modules within current laboratory information systems, emphasizing points where expert oversight mitigates algorithmic bias and resolves discordant findings. We further map the validator-integrator role across morphology, flow cytometry, and genomic/multi-omic interpretation and provide practical training competencies and use cases for AI-assisted hematopathology. Beyond technical deployment, the article addresses the educational transformation required for sustainable adoption. Drawing on international competency frameworks, including the Digital Health Competencies in Medical Education Framework and recently proposed AI-specific Entrustable Professional Activities, we map core skills that future hematopathologists must master: data-science literacy, critical appraisal of AI outputs, and ethical governance. We highlight evaluated training models such as the Pathology Informatics Essentials for Residents curriculum, Stanford Artificial Intelligence in Machine and Imaging workshops, and College of American Pathologists bootcamps and propose integration strategies adaptable across resource settings. By pairing rigorous validation with targeted education, AI can elevate rather than eclipse the diagnostic role of the leukemia specialist, enabling more timely, reproducible, and personalized patient care.
Nursing science is progressing at such a rapid rate that it is difficult for nursing professionals to remain current with the knowledge and skills necessary to provide quality patient care. To assure that staff members demonstrate the required competencies, a framework composed of eight steps and a master plan for implementation is presented in this article. The framework offers staff development educators structure and direction in planning and conducting educational programs to achieve the goal of competency development.
BACKGROUND: The global transition toward patient-centered pharmaceutical care has exposed structural disparities in ASEAN pharmacy workforce training and deployment. This review examines four research questions: how pharmacy education systems and accreditation standards differ across Indonesia, Malaysia, Thailand, the Philippines, and Singapore (collectively, the ASEAN-5); the extent to which pre-registration education influences clinical service scope and professional confidence; how education reform and regulatory change have shaped pharmacist clinical roles; and what barriers and enablers exist for regional qualification harmonization. METHODS: A systematic literature review following PRISMA 2020 was conducted. Searches of PubMed/MEDLINE and Scopus, supplemented by grey literature, were completed in May 2026. Of 78 unique records screened, 46 studies published between 2005 and 2026 met inclusion criteria. Quality appraisal used an adapted Mixed Methods Appraisal Tool; synthesis employed narrative thematic analysis. RESULTS: The five countries represent four structurally distinct pharmacy education architectures: Thailand's standardized six-year Doctor of Pharmacy with dual specialization tracks; four-year Bachelor of Pharmacy programmes in Malaysia and the Philippines with institutional variation; Indonesia's clinically underdeveloped system despite rapid expansion; and Singapore's four-year Bachelor of Pharmacy followed by a nationally mandated one-year pre-registration pathway. Evidence links deeper clinical training to broader practice scope, higher confidence, and improved patient outcomes. Reform produced uneven results: Thailand's PharmD transition improved clinical recognition but exposed deployment paradoxes; Singapore achieved the strongest training-to-practice alignment; Indonesia's health insurance reforms were not absorbed by an underprepared workforce; the Philippines lacks a national competency framework. No binding mutual recognition arrangement was identified; divergent qualification structures, incompatible accreditation systems, and an asymmetric evidence base remain the primary barriers. DISCUSSION: These findings indicate that clinical service scope is bounded less by national policy ambition than by the depth and clinical orientation of the pre-registration education that precedes it, and that credentialing reforms which outpace a health system's capacity to absorb new clinical roles, or the reverse, do not by themselves translate into expanded practice. CONCLUSIONS: Pharmacy education across the ASEAN-5 remains nationally distinct and clinically uneven. Clinical service scope is directly bounded by pre-registration education quality. No country has fully closed the education-practice gap. Regional harmonization requires national-level educational reform as a prerequisite.
Many studies have shown that low adherence is a common problem in treatment programmes. Adherence to sports injury rehabilitation is dependent on the personality characteristics of athletes operating in conjunction with particular aspects of their rehabilitation settings and the quality of interactions developed between athletes and their therapists. Any attempt to view treatment adherence as a unitary construct is doomed to fail; a complex construct demands a multidimensional outlook. Taking into account the challenges that injured athletes face during their rehabilitation, strategies can be designed to promote adherence. Self-confidence is the key to enhanced rehabilitation adherence, and the strategies are organised within that framework. Competence strategies include education, treatment efficacy, tailoring, and relapse prevention training. Control strategies include dissociation, self-monitoring, decision-balance sheet, and pain deconditioning. Commitment strategies include shaping, contracting, threats, goal-setting, and social support. Because of the dearth of empirical data on the specific issue of adherence to sports injury rehabilitation programmes, it is necessary to extrapolate from various other areas of treatment adherence (e.g. cardiac rehabilitation). Treatment dropout does not seem to be inevitable, but is in fact preventable. The task for the sports medicine professional is to recognise and acknowledge the salient features of their clients and the rehabilitation demands on them and then to utilise various strategies to enhance the likelihood of treatment adherence.
Explore the source record for details and available documents.
Sexuality and suicidality express man being competent to shape his/her own life. From the bioethical point of view both phenomena are connected by shortening and fulfilling as well as autonomy. Considerations are provided for the physician to assist the aged being competent. Adequate framework is related to a concept of values guide living together. Thus tenderness and communication are appropriate levels of sexuality. Therefore they are to be integrated into the physician's concept of sexuality. For suicidality that means not to rescue life in a biological sense, but helping the elderly people making their life fulfilled and determining their life competent.
Thirty consecutive cases of laryngeal trauma requiring open exploration are reviewed. Eighteen injuries were the result of blunt trauma and 12 resulted from penetrating wounds. Within the blunt trauma group, eight of 18 injuries resulted in a competent airway and a good voice, six with a good airway but a fair voice, and four with airway compromise. Of 12 patients with penetrating wounds, ten sustained a good airway and a good voice, two a good airway and fair voice. Substantial granulation tissue response, though occurring in only eight of the 30 patients, was present in three of the four patients with airway stenosis. The use of a stent, in association with a soft tissue graft when mucosal loss cannot be approximated primarily, does not predispose to such a response, but rather facillitates maintenance of a competent skeletal framework and prevention of soft tissue endolaryngeal distortion.
This paper proposes a two-process log-linear model for analysis of polychotomous response data generated on study subjects assessed at successive discrete intervals. Response type at each discrete time may be either a transient response or a cause-specific failure. We view outcome of transient response as fundamentally different from outcome of failure, and, in a competing risk framework, we motivate a separate model for each: one to describe the process for transitions to transient response states and the other to describe the process for transitions to absorbing failure states. We maximize the likelihood for each model separately with use of existing software for iterative proportional fitting.
BACKGROUND: Supervision is a fundamental component of psychotherapy training, transforming theoretical knowledge into clinical skills through real-world practice. Psychotherapy training practices vary widely between countries, training programs, and over time, including supervision. Our systematic review aimed to investigate and describe the experiences of psychotherapy supervision through early-career psychiatrists' (ECPs) views. METHODS: We systematically searched PubMed/MEDLINE, Scopus, and PubPsych for survey-based studies on ECPs' experiences of psychotherapy supervision during or after their psychiatry training and reported our findings according to the PRISMA guidelines. Of 32,877 articles screened, 29 articles were included. Each article underwent quality assessment, and results were synthesized narratively. RESULTS: Included articles published between 2000 and 2025, were from Europe (N = 16, 55.1%), the Americas (N = 5, 17.2%), Western Pacific (N = 4, 13.7%), South-East Asia (N = 2, 7%), Eastern Mediterranean (N = 1, 3.5%), and Africa (N = 1, 3.5%), with a total of 4691 participants. Supervision access rates ranged from 26.2% in Nigeria to 85.5% in Russia, with significant variation across countries and psychotherapy modalities. Most ECPs received 50-100 total hours of supervision, frequently delivered in weekly sessions. While formats, individual, group, or mixed, varied by country and training scheme, supervision was generally provided by a psychiatrist-psychotherapist. Common learning techniques included oral consultations and case discussions, followed by audio recordings or transcripts. The need to self-fund psychotherapy supervision costs was identified as a prominent barrier. CONCLUSIONS: Psychotherapy supervision is inconsistent globally, with barriers including supervisor availability and cost. There is a large implementation gap between recommendations and evaluated practice. Digital tools and competency-based frameworks may improve access and quality.
Distinct problems in the analysis of failure times with competing causes of failure include the estimation of treatment or exposure effects on specific failure types, the study of interrelations among failure types, and the estimation of failure rates for some causes given the removal of certain other failure types. The usual formation of these problems is in terms of conceptual or latent failure times for each failure type. This approach is criticized on the basis of unwarranted assumptions, lack of physical interpretation and identifiability problems. An alternative approach utilizing cause-specific hazard functions for observable quantities, including time-dependent covariates, is proposed. Cause-specific hazard functions are shown to be the basic estimable quantities in the competing risks framework. A method, involving the estimation of parameters that relate time-dependent risk indicators for some causes to cause-specific hazard functions for other causes, is proposed for the study of interrelations among failure types. Further, it is argued that the problem of estimation of failure rates under the removal of certain causes is not well posed until a mechanism for cause removal is specified. Following such a specification, one will sometimes be in a position to make sensible extrapolations from available data to situations involving cause removal. A clinical program in bone marrow transplantation for leukemia provides a setting for discussion and illustration of each of these ideas. Failure due to censoring in a survivorship study leads to further discussion.
The real strength of the competency-based education effort lies in its emphasis on the total program. No longer can we, as educators, ask ourselves merely: "What do I want students to learn in my course?" The studies and learning opportunities of students must meet specific objectives developed on assessed needs in the profession. The resulting output can then be evaluated against standards or a set of criteria. Since implementation of a competency-based education program requires "adaptation rather than adoption," both the role-competency and entry-level approaches are valuable. Few professionals are willing to accept totally a program or syllabus developed by someone else. However, effective adaptation requires understanding of the total concept of competency-based education. In fact, the search for totality is the heart of the competency-based movement. By viewing the framework of competency-based education and thoroughly understanding all of the components of the program, professionals should be able to utilize the ideas of others, even though they are presented in varying formats with constantly changing semantics.
The aim of this study is to control the effectiveness of a training in social competence within the framework of a stationary therapy by means of observable behavior and to regard the course of salivary-serum- and urine cortisol in parallel with expected changes in behavior. The behavior assessment showed, that apart from anxiety and a deficiency in social competence, lack of trust and helplessness were essential variables (symptoms). Against the theoretical background of contemporary research in trust and helplessness it was tried to find relations between these factors and to show up relevance for therapy in the case in point. Guided by hypotheses the effects of training and therapy are verified by systematic observation of behavior as well as a significant change of the salivary cortisol values. The development of the therapy and the graphic similarity between the sequence of urine cortisol and the formalized Wortman-Dintzer-Model suggest a corresponding interpretation reservedly. In parallel with Seligman's theories the process could refer to psychophysiological connections between helpless behavior and urine cortisol.
BACKGROUND: Detecting signals of polygenic adaptation remains a significant challenge in population genomics, as traditional methods often struggle to identify the associated subtle, multi-locus allele-frequency shifts. Here, we introduced and tested several novel approaches combining machine learning techniques with traditional statistical tests to detect polygenic adaptation patterns in time-series of allele frequency changes from whole genome data. We implemented a Naive Bayesian Classifier (NBC) and One-Class Support Vector Machines (OCSVM), and compared their performance against the classical Fisher's Exact Test (FET). Furthermore, we combined machine learning and statistical models (OCSVM-FET and NBC-FET), resulting in 5 competing approaches. The framework is mainly designed and validated for evolve-and-resequence (EaR) experimental designs, where defined selection pressures and temporal sampling are feasible, but might be applicable for certain natural experiments as well. RESULTS: Using a simulated dataset based on empirical C. riparius Pool-Seq data, we evaluated methods across evolutionary scenarios varying in generation, selection strength, and number of loci under selection. Our results demonstrate that the combined OCSVM-FET approach consistently outperformed competing methods, achieving the lowest false positive rate, highest area under the curve, and high accuracy. The performance peak aligned with what we term the 'late dynamic phase' of adaptation - the period after initial selection has occurred but before fixation - highlighting the method's sensitivity to ongoing selective processes. CONCLUSIONS: Furthermore, we emphasize the critical role of parameter tuning, balancing biological assumptions with methodological rigor. While broader applicability remains an important direction for future work, the present benchmarking is intentionally scoped to EaR experimental contexts.
Systematic observations were made of a small number of aid post orderlies (APOs) managing children with the common but potentially serious symptoms of cough, fever and diarrhoea. On-site performance was evaluated against recommended management guidelines set out in Dr Keith Edwards' Diagnosis and Treatment of Common Childhood Illnesses for APOs. History taking at the aid post was brief and usually non-exploratory; examination of patients was often neglected. Drug prescription was generally appropriate for the diagnosis made, but drug dosages were often incorrect and treatment principles were rarely explained to guardians. Preventive health issues were rarely tackled. Our study reaffirms the need for on-site assessment of the performance of paramedical workers, sets priority demands for continuing education of health workers, and provides a framework for competency-based problem-solving activities within this context.
Today's emergency and first-aid systems are a challenge to Public Health offices which they must meet diligently and competently within the framework of health care and defence against health hazards. Close cooperation with fire brigades and first-aid and emergency service organizations is mandatory especially in case of threatening major disasters (for example, accidents involving large amounts of toxic matter). There are gaps in the immediate care and service systems in case of emergencies. Public Health offices are called upon to close these gaps by active participation, if required, at the site of the disaster, in the management and supervision of first-aid and other measures in the fight against the sequels of major disasters or catastrophes. Innovative concepts regarding the future development of public emergency and first-aid services have been worked out.
Most attempts to measure clinical competence start by modeling the clinician's problem-solving process. The conflicting data from studies built around this approach suggest the need for rethinking the underlying concepts. Presented is a conceptual framework for clinical competence which is a natural expansion of earlier approaches. The framework is based upon defining the domain in which the clinician functions as the starting point for measuring clinical competence. There are three dimensions to the framework-problem-solving process, clinical discipline, and context of care. The intersection of the dimensions defines the clinical practice domain to be measured. For each domain specific problems can be identified and clinicians asked to demonstrate competence in resolving them.