716 resultados para Gillick competency


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The purpose of this study is to explore the mechanisms that influence decisions regarding outsourcing competencies in the operation of project management offices (PMOs). The exploratory research described here involves the use of a web-based survey for enterprises in Brazil. In 78 of the survey's valid cases, the PMO is operated using the organization's internal resources. A possible conclusion is that the PMO is unlikely to positively relate to the culture of external services used by the organization and to use outsourcing to operate the PMO.

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Language alterations in Huntington's disease (HD) are reported, but their nature and correlation with other cognitive impairments are still under investigation. This study aimed to characterize the language disturbances in HD and to correlate them to motor and cognitive aspects of the disease. We studied 23 HD patients and 23 controls, matched for age and schooling, using the Boston Diagnostic Aphasia Examination, Boston Naming Test, the Token Test, Animal fluency, Action fluency, FAS-COWA, the Symbol Digit Modalities Test, the Stroop Test and the Hooper Visual Organization Test (HVOT). HD patients performed poorer in verbal fluency (p<0.0001), oral comprehension (p<0.0001), repetition (p<0.0001), oral agility (p<0.0001), reading comprehension (p=0.034) and narrative writing (p<0.0001). There was a moderate correlation between the Expressive Component and Language Competency Indexes and the HVOT (r=0.519, p=0.011 and r=0.450, p=0.031, respectively). Language alterations in HD seem to reflect a derangement in both frontostriatal and frontotemporal regions.

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OBJECTIVE: To analyze the competency of people with diabetes mellitus to perform the insulin administration process, before and after telephone monitoring. METHODS: A quantitative, observational, longitudinal, comparative study. Participants were 26 people enrolled in the at-home capillary glycemia self-monitoring program. Data collection occurred in three phases, in January and February of 2010, for a period of 30 days for each person, by means of interview guided by a data collection instrument and an intervention manual. RESULTS: Of the 38 (100%) questions referring to the insulin administration process, telephone monitoring was demonstrated to be efficient in 30 (78.9%), but in 19 (50%) the intervention was statistically significant (p<0.05), in 11 (28.9%) there were no errors in responses to the final competency evaluation, and seven (18.4%) were not amenable to intervention. CONCLUSION: Telephone mornitoring was effective, as a nursing intervention strategy for the insulin administration process in the home.

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The use of tobacco continues to be a substantial risk factor in the development and progression of oral cancer, periodontitis, implant failure and poor wound healing. Dental and dental hygiene education providers have made great advances towards the incorporation of tobacco education into their curricula in recent years. Unfortunately, however, both medical and dental education research has consistently reported schools providing only basic knowledge-based curricula that rarely incorporate more effective, behaviourally-based components affecting long-term change. The limited training of oral healthcare students, at least in part, is reflected in practising dental professionals continuing to report offering incomplete tobacco interventions. In order to prepare the next generation of oral healthcare providers, this paper proposes a paradigm shift in how tobacco use prevention and cessation (TUPAC) may be incorporated into existing curricula. It is suggested that schools should carefully consider: to what level of competency should TUPAC be trained in dental and dental hygiene schools; the importance of establishing rapport through good communication skills; the core knowledge level for TUPAC; suggested instructional and assessment strategies; the importance of continuing professional education for the enhancement of TUPAC.

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In my thesis, I use literary criticism, knowledge of Russian, and elements of translation theory to study the seminal poet of the Russian literary tradition ¿ Aleksandr Pushkin. In his most famous work, Eugene Onegin, Pushkin explores the cultural and linguistic divide in place at the turn of the 19th century in Russia. Pushkin stands on the peripheries of several colliding worlds; never fully committing to any of them, he acts as a translator between various realms of the 19th-century Russian experience. Through his narrator, he adeptly occupies the voices, styles, and modes of expression of various characters, displaying competency in all realms of Russian life. In examining Tatiana, his heroine, the reader witnesses her development as analogous to the author¿s. At the center of the text stands the act of translation itself: as the narrator ¿translates¿ Tatiana¿s love letter from French to Russian, the author-narrator declares his function as a mediator, not only between languages, but also between cultures, literary canons, social classes, and identities. Tatiana, as both main character and the narrator¿s muse, emerges as the most complex figure in the novel, and her language manifests itself as the most direct and capable of sincerity in the novel. The elements of Russian folklore that are incorporated into her language speak to Pushkin¿s appreciation for the rich Russian folklore tradition. In his exaltation of language considered to be ¿common¿, ¿low¿ speech is juxtaposed with its lofty counterpart; along the way, he incorporates myriad foreign borrowings. An active creator of Russia¿s new literary language, Pushkin traverses linguistic boundaries to synthesize a fragmented Russia. In the process, he creates a work so thoroughly tied to language and entrenched in complex cultural traditions that many scholars have argued for its untranslatability.

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Landscapes of education are a new topic within the debate about adequate and just education and human development for everybody. In particular, children and youths from social classes affected by poverty, a lack of prospects or minimal schooling are a focal group that should be offered new approaches and opportunities of cognitive and social development by way of these landscapes of education. It has become apparent that the traditional school alone does not suffice to meet this need. There is no doubt that competency-based orientation and employability are core areas with the help of which the generation now growing up will manage the start of its professional career. In addition and by no means less important, the development involves individual, social, cultural and societal perspectives that can be combined under the term of human development. In this context, the Capability Approach elaborated by Amartya Sen and Martha Nussbaum has developed a more extensive concept of human development and related it to empirical instruments. Using the analytic concept of individual capabilities and societal opportunities they shaped a socio-political formula that should be adapted in particular to modern social work. Moreover, the Capability Approach offers a critical foil with regard to further development and revision of institutionalised approaches in education and human development.

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Die kurzen Technologiezyklen in der IT-Industrie stellen Unternehmen vor das Problem, Mitarbeiter zeit- und themenadäquat weiter zu qualifizieren. Für Bildungsanbieter erwächst damit die Herausforderung, relevante Bildungsthemen möglichst frühzeitig zu identifizieren, ökonomisch zu bewerten und ausgewählte Themen in Form geeigneter Bildungsangebote zur Marktreife zu bringen. Zur Handhabung dieser Problematik wurde an der Hochschule für Telekommunikation Leipzig (HfTL), die sich in Trägerschaft der Deutsche Telekom AG befindet, ein innovatives Analyseinstrument entwickelt. Mit diesem Instrument, dem IT-KompetenzBarometer, werden Stellenanzeigen, die in Jobportalen online publiziert werden, ausgelesen und mithilfe von Text Mining-Methoden untersucht. Auf diese Weise können Informationen gewonnen werden, die differenzierte Auskunft über die qualitativen Kompetenzanforderungen zentraler Berufsbilder des IT-Sektors liefern. Dieser Beitrag stellt Ergebnisse vor, die durch Analyse von mehr als 40.000 Stellenanzeigen für IT-Fachkräfte aus Jobportalen im Zeitraum von Juni-September 2012 gewonnen werden konnten. Diese Ergebnisse liefern eine Informationsgrundlage, um marktrelevante Bildungsthemen zu identifizieren, sodass Bildungsangebote erfolgreich gestaltet und weiterentwickelt werden können.

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Introduction: Concerns about the quality of physician education have changed current medical education practices. Learners must demonstrate competency in core areas, rather than solely participating in educational activities. Academic medical institutions are challenged with identifying leaders to direct curricular and evaluation reforms. An innovative partnership between the University of Houston College of Education and Baylor College of Medicine, the University of Texas Medical School at Houston, and the University of Texas Dental Branch at Houston offers a Masters of Education in Teaching degree with an emphasis in Health Sciences. Courses encompass fundamental areas including curriculum, instruction, technology, measurement, research design and statistics. [See PDF for complete abstract]

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In Switzerland, there are 26 systems of cantonal decentralisation because regulating municipal autonomy is an exclusively cantonal competency. Existing measures of local autonomy/cantonal decentralisation are confined to measuring the real or perceived distribution of functions. Alternatively, they weigh expenditures (Dafflon 1992) or tax revenues (Dlabac and Schaub forthcoming) of municipalities against those of the canton. Complementing these indices, this paper additionally measures the politics dimension of cantonal decentralisation. Seven aspects are measured: intra-cantonal regionalism, cumuldesmandats (double tenure of cantonal MP and mayoral office), territorial quotas for legislative and executive elections, direct local representation and lobbying, party decentralisation, the number and size of constituencies, and direct democracy (communal referendum and initiative). This results in a ranking of all 26 cantons as regards the politics of local autonomy within their political systems. The measure will help scholars to test assumptions held for decentralisation in general, be it as a dependent (explaining decentralisation) or as an independent variable (decentralisation—so what?), within but also beyond the Swiss context.

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The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities.

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The diversity of European culture is reflected in its healthcare training programs. In intensive care medicine (ICM), the differences in national training programs were so marked that it was unlikely that they could produce specialists of equivalent skills. The Competency-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) program was established in 2003 as a Europe-based worldwide collaboration of national training organizations to create core competencies for ICM using consensus methodologies to establish common ground. The group's professional and research ethos created a social identity that facilitated change. The program was easily adaptable to different training structures and incorporated the voice of patients and relatives. The CoBaTrICE program has now been adopted by 15 European countries, with another 12 countries planning to adopt the training program, and is currently available in nine languages, including English. ICM is now recognized as a primary specialty in Spain, Switzerland, and the UK. There are still wide variations in structures and processes of training in ICM across Europe, although there has been agreement on a set of common program standards. The combination of a common "product specification" for an intensivist, combined with persisting variation in the educational context in which competencies are delivered, provides a rich source of research inquiry. Pedagogic research in ICM could usefully focus on the interplay between educational interventions, healthcare systems and delivery, and patient outcomes, such as including whether competency-based program are associated with lower error rates, whether communication skills training is associated with greater patient and family satisfaction, how multisource feedback might best be used to improve reflective learning and teamworking, or whether increasing the proportion of specialists trained in acute care in the hospital at weekends results in better patient outcomes.

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Over the last 20 years, health literacy (German: Gesundheitskompetenz/health competency) has become a popular concept in research and health policy. Initially defined as an individual's ability to understand medical information, the definition has quickly expanded to describe individual-based resources for actions or conduct relevant to health, in different socio-cultural or clinical contexts. Today, researchers and practice experts can draw on a wide variety of definitions and measurements. This article provides an overview of the definitions, briefly introduces the "structure and agency" approach as an example of theorizing health literacy, and shows different types of operationalization. The article presents the strengths and shortcomings of the available concepts and measures and provides starting points for future research in public health and health promotion.

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The medical education community is working-across disciplines and across the continuum-to address the current challenges facing the medical education system and to implement strategies to improve educational outcomes. Educational technology offers the promise of addressing these important challenges in ways not previously possible. The authors propose a role for virtual patients (VPs), which they define as multimedia, screen-based interactive patient scenarios. They believe VPs offer capabilities and benefits particularly well suited to addressing the challenges facing medical education. Well-designed, interactive VP-based learning activities can promote the deep learning that is needed to handle the rapid growth in medical knowledge. Clinically oriented learning from VPs can capture intrinsic motivation and promote mastery learning. VPs can also enhance trainees' application of foundational knowledge to promote the development of clinical reasoning, the foundation of medical practice. Although not the entire solution, VPs can support competency-based education. The data created by the use of VPs can serve as the basis for multi-institutional research that will enable the medical education community both to better understand the effectiveness of educational interventions and to measure progress toward an improved system of medical education.

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This dissertation investigated perspectives on cultural competence among African-American women patients, staff, and the administrator of a dental clinic serving people living with HIV/AIDS; and evaluated the role of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) in advancing the provision of culturally competent care in the clinic. ^ The study was qualitative with data collection via focus groups and individual interviews with a sample of African-American women patients, and individual interviews with a sample of staff and the clinic administrator. Transcripts were coded and themes identified using the software program ATLAS.ti. A cultural audit template was developed and applied to evaluate cultural competency. ^ Among attitudes and behaviors that contributed to the provision of culturally competent care at the clinic were respect and empathic communication. Formal cultural competency was not featured strongly in the methods by which the staff learned to work with diverse populations. Instead cultural competence among the staff was based on thoughtful hiring practices, natural aptitude and a climate that encouraged learning through informal sharing of experiences. The staff and administrator felt that an African-American dentist would be an asset in improving culturally competent care at the clinic. Previous research and national policy also promote the provider-patient racial/ethnic concordance to improve care. In this study, however, the patients were happy with the care provided regardless of the race/ethnicity of the staff, probably reflecting the well developed cultural competence skills of clinic staff overall. ^ The clinic administrator was unaware of the CLAS standards although the clinic was implicitly operated under their mandates. This occurred because the clinic is supported by federal funding and the CLAS standards were incorporated into the requirements. Incorporation into and monitoring of the CLAS standards in federally funded programs therefore appears to be an effective means for ensuring that they are implemented. ^ This study illustrates that cultural competence, though not universally understood, can be systematically investigated to identify what constitutes appropriate care and the factors that support or inhibit it. Among important elements of culturally competent care are respect and empathic communication. ^