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Sample records for competing risks model

  1. Statistical models for competing risk analysis

    International Nuclear Information System (INIS)

    Sather, H.N.

    1976-08-01

    Research results on three new models for potential applications in competing risks problems. One section covers the basic statistical relationships underlying the subsequent competing risks model development. Another discusses the problem of comparing cause-specific risk structure by competing risks theory in two homogeneous populations, P1 and P2. Weibull models which allow more generality than the Berkson and Elveback models are studied for the effect of time on the hazard function. The use of concomitant information for modeling single-risk survival is extended to the multiple failure mode domain of competing risks. The model used to illustrate the use of this methodology is a life table model which has constant hazards within pre-designated intervals of the time scale. Two parametric models for bivariate dependent competing risks, which provide interesting alternatives, are proposed and examined

  2. Multilevel joint competing risk models

    Science.gov (United States)

    Karunarathna, G. H. S.; Sooriyarachchi, M. R.

    2017-09-01

    Joint modeling approaches are often encountered for different outcomes of competing risk time to event and count in many biomedical and epidemiology studies in the presence of cluster effect. Hospital length of stay (LOS) has been the widely used outcome measure in hospital utilization due to the benchmark measurement for measuring multiple terminations such as discharge, transferred, dead and patients who have not completed the event of interest at the follow up period (censored) during hospitalizations. Competing risk models provide a method of addressing such multiple destinations since classical time to event models yield biased results when there are multiple events. In this study, the concept of joint modeling has been applied to the dengue epidemiology in Sri Lanka, 2006-2008 to assess the relationship between different outcomes of LOS and platelet count of dengue patients with the district cluster effect. Two key approaches have been applied to build up the joint scenario. In the first approach, modeling each competing risk separately using the binary logistic model, treating all other events as censored under the multilevel discrete time to event model, while the platelet counts are assumed to follow a lognormal regression model. The second approach is based on the endogeneity effect in the multilevel competing risks and count model. Model parameters were estimated using maximum likelihood based on the Laplace approximation. Moreover, the study reveals that joint modeling approach yield more precise results compared to fitting two separate univariate models, in terms of AIC (Akaike Information Criterion).

  3. Competing Risks and Multistate Models with R

    CERN Document Server

    Beyersmann, Jan; Schumacher, Martin

    2012-01-01

    This book covers competing risks and multistate models, sometimes summarized as event history analysis. These models generalize the analysis of time to a single event (survival analysis) to analysing the timing of distinct terminal events (competing risks) and possible intermediate events (multistate models). Both R and multistate methods are promoted with a focus on nonparametric methods.

  4. Competing Risks Copula Models for Unemployment Duration

    DEFF Research Database (Denmark)

    Lo, Simon M. S.; Stephan, Gesine; Wilke, Ralf

    2017-01-01

    The copula graphic estimator (CGE) for competing risks models has received little attention in empirical research, despite having been developed into a comprehensive research method. In this paper, we bridge the gap between theoretical developments and applied research by considering a general...... class of competing risks copula models, which nests popular models such as the Cox proportional hazards model, the semiparametric multivariate mixed proportional hazards model (MMPHM), and the CGE as special cases. Analyzing the effects of a German Hartz reform on unemployment duration, we illustrate...

  5. Tutorial in biostatistics: competing risks and multi-state models

    NARCIS (Netherlands)

    Putter, H.; Fiocco, M.; Geskus, R. B.

    2007-01-01

    Standard survival data measure the time span from some time origin until the occurrence of one type of event. If several types of events occur, a model describing progression to each of these competing risks is needed. Multi-state models generalize competing risks models by also describing

  6. Using competing risks model and competing events in outcome of pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Mehdi Kazempour Dizaji

    2016-01-01

    Conclusions: Use of competing risks model with competing events can provide a better way to understand the associated risk factors co-related with outcome of the pulmonary TB process, especially among DR-TB patients.

  7. Discrete competing risk model with application to modeling bus-motor failure data

    International Nuclear Information System (INIS)

    Jiang, R.

    2010-01-01

    Failure data are often modeled using continuous distributions. However, a discrete distribution can be appropriate for modeling interval or grouped data. When failure data come from a complex system, a simple discrete model can be inappropriate for modeling such data. This paper presents two types of discrete distributions. One is formed by exponentiating an underlying distribution, and the other is a two-fold competing risk model. The paper focuses on two special distributions: (a) exponentiated Poisson distribution and (b) competing risk model involving a geometric distribution and an exponentiated Poisson distribution. The competing risk model has a decreasing-followed-by-unimodal mass function and a bathtub-shaped failure rate. Five classical data sets on bus-motor failures can be simultaneously and appropriately fitted by a general 5-parameter competing risk model with the parameters being functions of the number of successive failures. The lifetime and aging characteristics of the fitted distribution are analyzed.

  8. Concordance for prognostic models with competing risks

    DEFF Research Database (Denmark)

    Wolbers, Marcel; Blanche, Paul; Koller, Michael T

    2014-01-01

    The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate i...

  9. Flexible competing risks regression modeling and goodness-of-fit

    DEFF Research Database (Denmark)

    Scheike, Thomas; Zhang, Mei-Jie

    2008-01-01

    In this paper we consider different approaches for estimation and assessment of covariate effects for the cumulative incidence curve in the competing risks model. The classic approach is to model all cause-specific hazards and then estimate the cumulative incidence curve based on these cause...... models that is easy to fit and contains the Fine-Gray model as a special case. One advantage of this approach is that our regression modeling allows for non-proportional hazards. This leads to a new simple goodness-of-fit procedure for the proportional subdistribution hazards assumption that is very easy...... of the flexible regression models to analyze competing risks data when non-proportionality is present in the data....

  10. Calibration plots for risk prediction models in the presence of competing risks.

    Science.gov (United States)

    Gerds, Thomas A; Andersen, Per K; Kattan, Michael W

    2014-08-15

    A predicted risk of 17% can be called reliable if it can be expected that the event will occur to about 17 of 100 patients who all received a predicted risk of 17%. Statistical models can predict the absolute risk of an event such as cardiovascular death in the presence of competing risks such as death due to other causes. For personalized medicine and patient counseling, it is necessary to check that the model is calibrated in the sense that it provides reliable predictions for all subjects. There are three often encountered practical problems when the aim is to display or test if a risk prediction model is well calibrated. The first is lack of independent validation data, the second is right censoring, and the third is that when the risk scale is continuous, the estimation problem is as difficult as density estimation. To deal with these problems, we propose to estimate calibration curves for competing risks models based on jackknife pseudo-values that are combined with a nearest neighborhood smoother and a cross-validation approach to deal with all three problems. Copyright © 2014 John Wiley & Sons, Ltd.

  11. [Application of Competing Risks Model in Predicting Smoking Relapse Following Ischemic Stroke].

    Science.gov (United States)

    Hou, Li-Sha; Li, Ji-Jie; Du, Xu-Dong; Yan, Pei-Jing; Zhu, Cai-Rong

    2017-07-01

    To determine factors associated with smoking relapse in men who survived from their first stroke. Data were collected through face to face interviews with stroke patients in the hospital, and then repeated every three months via telephone over the period from 2010 to 2014. Kaplan-Meier method and competing risk model were adopted to estimate and predict smoking relapse rates. The Kaplan-Meier method estimated a higher relapse rate than the competing risk model. The four-year relapse rate was 43.1% after adjustment of competing risk. Exposure to environmental tobacco smoking outside of home and workplace (such as bars and restaurants) ( P =0.01), single ( P <0.01), and prior history of smoking at least 20 cigarettes per day ( P =0.02) were significant predictors of smoking relapse. When competing risks exist, competing risks model should be used in data analyses. Smoking interventions should give priorities to those without a spouse and those with a heavy smoking history. Smoking ban in public settings can reduce smoking relapse in stroke patients.

  12. Semiparametric accelerated failure time cure rate mixture models with competing risks.

    Science.gov (United States)

    Choi, Sangbum; Zhu, Liang; Huang, Xuelin

    2018-01-15

    Modern medical treatments have substantially improved survival rates for many chronic diseases and have generated considerable interest in developing cure fraction models for survival data with a non-ignorable cured proportion. Statistical analysis of such data may be further complicated by competing risks that involve multiple types of endpoints. Regression analysis of competing risks is typically undertaken via a proportional hazards model adapted on cause-specific hazard or subdistribution hazard. In this article, we propose an alternative approach that treats competing events as distinct outcomes in a mixture. We consider semiparametric accelerated failure time models for the cause-conditional survival function that are combined through a multinomial logistic model within the cure-mixture modeling framework. The cure-mixture approach to competing risks provides a means to determine the overall effect of a treatment and insights into how this treatment modifies the components of the mixture in the presence of a cure fraction. The regression and nonparametric parameters are estimated by a nonparametric kernel-based maximum likelihood estimation method. Variance estimation is achieved through resampling methods for the kernel-smoothed likelihood function. Simulation studies show that the procedures work well in practical settings. Application to a sarcoma study demonstrates the use of the proposed method for competing risk data with a cure fraction. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Modelling the joint distribution of competing risks survival times using copula functions

    OpenAIRE

    Kaishev, V. K.; Haberman, S.; Dimitrova, D. S.

    2005-01-01

    The problem of modelling the joint distribution of survival times in a competing risks model, using copula functions is considered. In order to evaluate this joint distribution and the related overall survival function, a system of non-linear differential equations is solved, which relates the crude and net survival functions of the modelled competing risks, through the copula. A similar approach to modelling dependent multiple decrements was applied by Carriere (1994) who used a Gaussian cop...

  14. Classical competing risks

    CERN Document Server

    Crowder, Martin J

    2001-01-01

    If something can fail, it can often fail in one of several ways and sometimes in more than one way at a time. There is always some cause of failure, and almost always, more than one possible cause. In one sense, then, survival analysis is a lost cause. The methods of Competing Risks have often been neglected in the survival analysis literature. Written by a leading statistician, Classical Competing Risks thoroughly examines the probability framework and statistical analysis of data of Competing Risks. The author explores both the theory of the subject and the practicalities of fitting the models to data. In a coherent, self-contained, and sequential account, the treatment moves from the bare bones of the Competing Risks setup and the associated likelihood functions through survival analysis using hazard functions. It examines discrete failure times and the difficulties of identifiability, and concludes with an introduction to the counting-process approach and the associated martingale theory.With a dearth of ...

  15. Calibration plots for risk prediction models in the presence of competing risks

    DEFF Research Database (Denmark)

    Gerds, Thomas A; Andersen, Per K; Kattan, Michael W

    2014-01-01

    A predicted risk of 17% can be called reliable if it can be expected that the event will occur to about 17 of 100 patients who all received a predicted risk of 17%. Statistical models can predict the absolute risk of an event such as cardiovascular death in the presence of competing risks...... prediction model is well calibrated. The first is lack of independent validation data, the second is right censoring, and the third is that when the risk scale is continuous, the estimation problem is as difficult as density estimation. To deal with these problems, we propose to estimate calibration curves...

  16. On pseudo-values for regression analysis in competing risks models

    DEFF Research Database (Denmark)

    Graw, F; Gerds, Thomas Alexander; Schumacher, M

    2009-01-01

    For regression on state and transition probabilities in multi-state models Andersen et al. (Biometrika 90:15-27, 2003) propose a technique based on jackknife pseudo-values. In this article we analyze the pseudo-values suggested for competing risks models and prove some conjectures regarding their...

  17. Partially linear mixed-effects joint models for skewed and missing longitudinal competing risks outcomes.

    Science.gov (United States)

    Lu, Tao; Lu, Minggen; Wang, Min; Zhang, Jun; Dong, Guang-Hui; Xu, Yong

    2017-12-18

    Longitudinal competing risks data frequently arise in clinical studies. Skewness and missingness are commonly observed for these data in practice. However, most joint models do not account for these data features. In this article, we propose partially linear mixed-effects joint models to analyze skew longitudinal competing risks data with missingness. In particular, to account for skewness, we replace the commonly assumed symmetric distributions by asymmetric distribution for model errors. To deal with missingness, we employ an informative missing data model. The joint models that couple the partially linear mixed-effects model for the longitudinal process, the cause-specific proportional hazard model for competing risks process and missing data process are developed. To estimate the parameters in the joint models, we propose a fully Bayesian approach based on the joint likelihood. To illustrate the proposed model and method, we implement them to an AIDS clinical study. Some interesting findings are reported. We also conduct simulation studies to validate the proposed method.

  18. SEMI-COMPETING RISKS ON A TRIVARIATE WEIBULL SURVIVAL MODEL

    Directory of Open Access Journals (Sweden)

    Jenq-Daw Lee

    2008-07-01

    Full Text Available A setting of a trivairate survival function using semi-competing risks concept is proposed, in which a terminal event can only occur after other events. The Stanford Heart Transplant data is reanalyzed using a trivariate Weibull distribution model with the proposed survival function.

  19. Estimation of Employee Turnover with Competing Risks Models

    Directory of Open Access Journals (Sweden)

    Grzenda Wioletta

    2015-12-01

    Full Text Available Employee turnover accompanies every business organization, regardless of the industry and size. Nowadays, many companies struggle with problems related to the lack of sufficient information about the nature of employee turnover processes. Therefore, comprehensive analysis of these processes is necessary. This article aims to examine the turnover of employees from a big manufacturing company using competing risks models with covariates and without covariates. This technique allows to incorporate the information about the type of employment contract termination. Moreover, Cox proportional hazard model enables the researcher to analyse simultaneously multiple factors that affect employment duration. One of the major observations is that employee remuneration level differentiates most strongly the risk of job resignation.

  20. [Survival analysis with competing risks: estimating failure probability].

    Science.gov (United States)

    Llorca, Javier; Delgado-Rodríguez, Miguel

    2004-01-01

    To show the impact of competing risks of death on survival analysis. We provide an example of survival time without chronic rejection after heart transplantation, where death before rejection acts as a competing risk. Using a computer simulation, we compare the Kaplan-Meier estimator and the multiple decrement model. The Kaplan-Meier method overestimated the probability of rejection. Next, we illustrate the use of the multiple decrement model to analyze secondary end points (in our example: death after rejection). Finally, we discuss Kaplan-Meier assumptions and why they fail in the presence of competing risks. Survival analysis should be adjusted for competing risks of death to avoid overestimation of the risk of rejection produced with the Kaplan-Meier method.

  1. The proportional odds cumulative incidence model for competing risks

    DEFF Research Database (Denmark)

    Eriksson, Frank; Li, Jianing; Scheike, Thomas

    2015-01-01

    We suggest an estimator for the proportional odds cumulative incidence model for competing risks data. The key advantage of this model is that the regression parameters have the simple and useful odds ratio interpretation. The model has been considered by many authors, but it is rarely used...... in practice due to the lack of reliable estimation procedures. We suggest such procedures and show that their performance improve considerably on existing methods. We also suggest a goodness-of-fit test for the proportional odds assumption. We derive the large sample properties and provide estimators...

  2. Quantifying the predictive accuracy of time-to-event models in the presence of competing risks.

    Science.gov (United States)

    Schoop, Rotraut; Beyersmann, Jan; Schumacher, Martin; Binder, Harald

    2011-02-01

    Prognostic models for time-to-event data play a prominent role in therapy assignment, risk stratification and inter-hospital quality assurance. The assessment of their prognostic value is vital not only for responsible resource allocation, but also for their widespread acceptance. The additional presence of competing risks to the event of interest requires proper handling not only on the model building side, but also during assessment. Research into methods for the evaluation of the prognostic potential of models accounting for competing risks is still needed, as most proposed methods measure either their discrimination or calibration, but do not examine both simultaneously. We adapt the prediction error proposal of Graf et al. (Statistics in Medicine 1999, 18, 2529–2545) and Gerds and Schumacher (Biometrical Journal 2006, 48, 1029–1040) to handle models with competing risks, i.e. more than one possible event type, and introduce a consistent estimator. A simulation study investigating the behaviour of the estimator in small sample size situations and for different levels of censoring together with a real data application follows.

  3. Maximum likelihood estimation of semiparametric mixture component models for competing risks data.

    Science.gov (United States)

    Choi, Sangbum; Huang, Xuelin

    2014-09-01

    In the analysis of competing risks data, the cumulative incidence function is a useful quantity to characterize the crude risk of failure from a specific event type. In this article, we consider an efficient semiparametric analysis of mixture component models on cumulative incidence functions. Under the proposed mixture model, latency survival regressions given the event type are performed through a class of semiparametric models that encompasses the proportional hazards model and the proportional odds model, allowing for time-dependent covariates. The marginal proportions of the occurrences of cause-specific events are assessed by a multinomial logistic model. Our mixture modeling approach is advantageous in that it makes a joint estimation of model parameters associated with all competing risks under consideration, satisfying the constraint that the cumulative probability of failing from any cause adds up to one given any covariates. We develop a novel maximum likelihood scheme based on semiparametric regression analysis that facilitates efficient and reliable estimation. Statistical inferences can be conveniently made from the inverse of the observed information matrix. We establish the consistency and asymptotic normality of the proposed estimators. We validate small sample properties with simulations and demonstrate the methodology with a data set from a study of follicular lymphoma. © 2014, The International Biometric Society.

  4. Reliability assessment of competing risks with generalized mixed shock models

    International Nuclear Information System (INIS)

    Rafiee, Koosha; Feng, Qianmei; Coit, David W.

    2017-01-01

    This paper investigates reliability modeling for systems subject to dependent competing risks considering the impact from a new generalized mixed shock model. Two dependent competing risks are soft failure due to a degradation process, and hard failure due to random shocks. The shock process contains fatal shocks that can cause hard failure instantaneously, and nonfatal shocks that impact the system in three different ways: 1) damaging the unit by immediately increasing the degradation level, 2) speeding up the deterioration by accelerating the degradation rate, and 3) weakening the unit strength by reducing the hard failure threshold. While the first impact from nonfatal shocks comes from each individual shock, the other two impacts are realized when the condition for a new generalized mixed shock model is satisfied. Unlike most existing mixed shock models that consider a combination of two shock patterns, our new generalized mixed shock model includes three classic shock patterns. According to the proposed generalized mixed shock model, the degradation rate and the hard failure threshold can simultaneously shift multiple times, whenever the condition for one of these three shock patterns is satisfied. An example using micro-electro-mechanical systems devices illustrates the effectiveness of the proposed approach with sensitivity analysis. - Highlights: • A rich reliability model for systems subject to dependent failures is proposed. • The degradation rate and the hard failure threshold can shift simultaneously. • The shift is triggered by a new generalized mixed shock model. • The shift can occur multiple times under the generalized mixed shock model.

  5. A Proportional Hazards Regression Model for the Subdistribution with Covariates-adjusted Censoring Weight for Competing Risks Data

    DEFF Research Database (Denmark)

    He, Peng; Eriksson, Frank; Scheike, Thomas H.

    2016-01-01

    function by fitting the Cox model for the censoring distribution and using the predictive probability for each individual. Our simulation study shows that the covariate-adjusted weight estimator is basically unbiased when the censoring time depends on the covariates, and the covariate-adjusted weight......With competing risks data, one often needs to assess the treatment and covariate effects on the cumulative incidence function. Fine and Gray proposed a proportional hazards regression model for the subdistribution of a competing risk with the assumption that the censoring distribution...... and the covariates are independent. Covariate-dependent censoring sometimes occurs in medical studies. In this paper, we study the proportional hazards regression model for the subdistribution of a competing risk with proper adjustments for covariate-dependent censoring. We consider a covariate-adjusted weight...

  6. Semi-Competing Risks Data Analysis: Accounting for Death as a Competing Risk When the Outcome of Interest Is Nonterminal.

    Science.gov (United States)

    Haneuse, Sebastien; Lee, Kyu Ha

    2016-05-01

    Hospital readmission is a key marker of quality of health care. Notwithstanding its widespread use, however, it remains controversial in part because statistical methods used to analyze readmission, primarily logistic regression and related models, may not appropriately account for patients who die before experiencing a readmission event within the time frame of interest. Toward resolving this, we describe and illustrate the semi-competing risks framework, which refers to the general setting where scientific interest lies with some nonterminal event (eg, readmission), the occurrence of which is subject to a terminal event (eg, death). Although several statistical analysis methods have been proposed for semi-competing risks data, we describe in detail the use of illness-death models primarily because of their relation to well-known methods for survival analysis and the availability of software. We also describe and consider in detail several existing approaches that could, in principle, be used to analyze semi-competing risks data, including composite end point and competing risks analyses. Throughout we illustrate the ideas and methods using data on N=49 763 Medicare beneficiaries hospitalized between 2011 and 2013 with a principle discharge diagnosis of heart failure. © 2016 American Heart Association, Inc.

  7. Accelerated failure time models for semi-competing risks data in the presence of complex censoring.

    Science.gov (United States)

    Lee, Kyu Ha; Rondeau, Virginie; Haneuse, Sebastien

    2017-12-01

    Statistical analyses that investigate risk factors for Alzheimer's disease (AD) are often subject to a number of challenges. Some of these challenges arise due to practical considerations regarding data collection such that the observation of AD events is subject to complex censoring including left-truncation and either interval or right-censoring. Additional challenges arise due to the fact that study participants under investigation are often subject to competing forces, most notably death, that may not be independent of AD. Towards resolving the latter, researchers may choose to embed the study of AD within the "semi-competing risks" framework for which the recent statistical literature has seen a number of advances including for the so-called illness-death model. To the best of our knowledge, however, the semi-competing risks literature has not fully considered analyses in contexts with complex censoring, as in studies of AD. This is particularly the case when interest lies with the accelerated failure time (AFT) model, an alternative to the traditional multiplicative Cox model that places emphasis away from the hazard function. In this article, we outline a new Bayesian framework for estimation/inference of an AFT illness-death model for semi-competing risks data subject to complex censoring. An efficient computational algorithm that gives researchers the flexibility to adopt either a fully parametric or a semi-parametric model specification is developed and implemented. The proposed methods are motivated by and illustrated with an analysis of data from the Adult Changes in Thought study, an on-going community-based prospective study of incident AD in western Washington State. © 2017, The International Biometric Society.

  8. Competing risks and time-dependent covariates

    DEFF Research Database (Denmark)

    Cortese, Giuliana; Andersen, Per K

    2010-01-01

    Time-dependent covariates are frequently encountered in regression analysis for event history data and competing risks. They are often essential predictors, which cannot be substituted by time-fixed covariates. This study briefly recalls the different types of time-dependent covariates......, as classified by Kalbfleisch and Prentice [The Statistical Analysis of Failure Time Data, Wiley, New York, 2002] with the intent of clarifying their role and emphasizing the limitations in standard survival models and in the competing risks setting. If random (internal) time-dependent covariates...

  9. Three-dimensional dose-response models of competing risks and natural life span

    International Nuclear Information System (INIS)

    Raabe, O.G.

    1987-01-01

    Three-dimensional dose-rate/time/response surfaces for chronic exposure to carcinogens, toxicants, and ionizing radiation dramatically clarify the separate and interactive roles of competing risks. The three dimensions are average dose rate, exposure time, and risk. An illustration with computer graphics shows the contributions with the passage of time of the competing risks of death from radiation pneumonitis/fibrosis, lung cancer, and natural aging consequent to the inhalation of plutonium-239 dioxide by beagles. These relationships are further evaluated by mathematical stripping with three-dimensional illustrations that graphically show the resultant separate contribution of each fatal effect. Radiation pneumonitis predominates at high dose rates and lung cancer at intermediate dose rates. Low dose rates result in spontaneous deaths from natural aging, yielding a type of practical threshold for lung cancer induction. Risk assessment is benefited by the insights that become apparent with these three-dimensional models. The improved conceptualization afforded by them contributes to the planning and evaluation of epidemiological analyses and experimental studies involving chronic exposure to toxicants

  10. Competing risk bias was common in Kaplan-Meier risk estimates published in prominent medical journals.

    Science.gov (United States)

    van Walraven, Carl; McAlister, Finlay A

    2016-01-01

    Risk estimates from Kaplan-Meier curves are well known to medical researchers, reviewers, and editors. In this study, we determined the proportion of Kaplan-Meier analyses published in prominent medical journals that are potentially biased because of competing events ("competing risk bias"). We randomly selected 100 studies that had at least one Kaplan-Meier analysis and were recently published in prominent medical journals. Susceptibility to competing risk bias was determined by examining the outcome and potential competing events. In susceptible studies, bias was quantified using a previously validated prediction model when the number of outcomes and competing events were given. Forty-six studies (46%) contained Kaplan-Meier analyses susceptible to competing risk bias. Sixteen studies (34.8%) susceptible to competing risk cited the number of outcomes and competing events; in six of these studies (6/16, 37.5%), the outcome risk from the Kaplan-Meier estimate (relative to the true risk) was biased upward by 10% or more. Almost half of Kaplan-Meier analyses published in medical journals are susceptible to competing risk bias and may overestimate event risk. This bias was found to be quantitatively important in a third of such studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Competing risk model with a non-traditional application

    Czech Academy of Sciences Publication Activity Database

    Volf, Petr

    2017-01-01

    Roč. 28, č. 1 (2017), s. 1-11 ISSN 1210-8022 Institutional support: RVO:67985556 Keywords : competing risks * survival analysis * sports statistics Subject RIV: BB - Applied Statistics, Operational Research OBOR OECD: Statistics and probability http://library.utia.cas.cz/separaty/2017/SI/volf-0477767.pdf

  12. Epidemiology of competence: a scoping review to understand the risks and supports to competence of four health professions

    Science.gov (United States)

    Glover Takahashi, Susan; Nayer, Marla

    2017-01-01

    Objectives This study examined the risks and supports to competence discussed in the literature related to occupational therapists, pharmacists, physical therapists and physicians, using epidemiology as a conceptual model. Design Articles from a scoping literature review, published from 1975 to 2014 inclusive, were included if they were about a risk or support to the professional or clinical competence of one of four health professions. Descriptive and regression analyses identified potential associations between risks and supports to competence and the location of study, type of health profession, competence life-cycle and the domain(s) of competence (organised around the CanMEDS framework). Results A total of 3572 abstracts were reviewed and 943 articles analysed. Most focused on physicians (n=810, 86.0%) and ‘practice’ (n=642, 68.0%). Fewer articles discussed risks to competence (n=418, 44.3%) than supports (n=750, 79.5%). The top four risks, each discussed in over 15% of articles, were: transitions in practice, being an international graduate, lack of clinical exposure/experience (ie, insufficient volume of procedures or patients) and age. The top two supports (over 35%) were continuing education participation and educational information/programme features. About 60% of all the articles discussed medical expert and about 25% applied to all roles. Articles focusing on residents had a greater probability of reporting on risks. Conclusions Articles about physicians were dominant. The majority of articles were written in the last decade and more discussed supports than risks to competence. An epidemiology-based conceptual model offers a helpful organising framework for exploring and explaining the competence of health professions. PMID:28864686

  13. Penalized variable selection in competing risks regression.

    Science.gov (United States)

    Fu, Zhixuan; Parikh, Chirag R; Zhou, Bingqing

    2017-07-01

    Penalized variable selection methods have been extensively studied for standard time-to-event data. Such methods cannot be directly applied when subjects are at risk of multiple mutually exclusive events, known as competing risks. The proportional subdistribution hazard (PSH) model proposed by Fine and Gray (J Am Stat Assoc 94:496-509, 1999) has become a popular semi-parametric model for time-to-event data with competing risks. It allows for direct assessment of covariate effects on the cumulative incidence function. In this paper, we propose a general penalized variable selection strategy that simultaneously handles variable selection and parameter estimation in the PSH model. We rigorously establish the asymptotic properties of the proposed penalized estimators and modify the coordinate descent algorithm for implementation. Simulation studies are conducted to demonstrate the good performance of the proposed method. Data from deceased donor kidney transplants from the United Network of Organ Sharing illustrate the utility of the proposed method.

  14. Accounting for individualized competing mortality risks in estimating postmenopausal breast cancer risk

    Science.gov (United States)

    Schonberg, Mara A.; Li, Vicky W.; Eliassen, A. Heather; Davis, Roger B.; LaCroix, Andrea Z.; McCarthy, Ellen P.; Rosner, Bernard A.; Chlebowski, Rowan T.; Hankinson, Susan E.; Marcantonio, Edward R.; Ngo, Long H.

    2016-01-01

    Purpose Accurate risk assessment is necessary for decision-making around breast cancer prevention. We aimed to develop a breast cancer prediction model for postmenopausal women that would take into account their individualized competing risk of non-breast cancer death. Methods We included 73,066 women who completed the 2004 Nurses’ Health Study (NHS) questionnaire (all ≥57 years) and followed participants until May 2014. We considered 17 breast cancer risk factors (health behaviors, demographics, family history, reproductive factors), 7 risk factors for non-breast cancer death (comorbidities, functional dependency), and mammography use. We used competing risk regression to identify factors independently associated with breast cancer. We validated the final model by examining calibration (expected-to-observed ratio of breast cancer incidence, E/O) and discrimination (c-statistic) using 74,887 subjects from the Women’s Health Initiative Extension Study (WHI-ES; all were ≥55 years and followed for 5 years). Results Within 5 years, 1.8% of NHS participants were diagnosed with breast cancer (vs. 2.0% in WHI-ES, p=0.02) and 6.6% experienced non-breast cancer death (vs. 5.2% in WHI-ES, prisk factors, 5 comorbidities, functional dependency, and mammography use. The model’s c-statistic was 0.61 (95% CI [0.60–0.63]) in NHS and 0.57 (0.55–0.58) in WHI-ES. On average our model under predicted breast cancer in WHI-ES (E/O 0.92 [0.88–0.97]). Conclusions We developed a novel prediction model that factors in postmenopausal women’s individualized competing risks of non-breast cancer death when estimating breast cancer risk. PMID:27770283

  15. Competing Risks Quantile Regression at Work

    DEFF Research Database (Denmark)

    Dlugosz, Stephan; Lo, Simon M. S.; Wilke, Ralf

    2017-01-01

    large-scale maternity duration data with multiple competing risks derived from German linked social security records to analyse how public policies are related to the length of economic inactivity of young mothers after giving birth. Our results show that the model delivers detailed insights...

  16. A competing risk model for the reliability of cylinder liners in marine Diesel engines

    Energy Technology Data Exchange (ETDEWEB)

    Bocchetti, D. [Grimaldi Group, Naples (Italy); Giorgio, M. [Department of Aerospace and Mechanical Engineering, Second University of Naples, Aversa (Italy); Guida, M. [Department of Information Engineering and Electrical Engineering, University of Salerno, Fisciano (Italy); Pulcini, G. [Istituto Motori, National Research Council-CNR, Naples (Italy)], E-mail: g.pulcini@im.cnr.it

    2009-08-15

    In this paper, a competing risk model is proposed to describe the reliability of the cylinder liners of a marine Diesel engine. Cylinder liners presents two dominant failure modes: wear degradation and thermal cracking. The wear process is described through a stochastic process, whereas the failure time due to the thermal cracking is described by the Weibull distribution. The use of the proposed model allows performing goodness-of-fit test and parameters estimation on the basis of both wear and failure data. Moreover, it enables reliability estimates of the state of the liners to be obtained and the hierarchy of the failure mechanisms to be determined for any given age and wear level of the liner. The model has been applied to a real data set: 33 cylinder liners of Sulzer RTA 58 engines, which equip twin ships of the Grimaldi Group. Estimates of the liner reliability and of other quantities of interest under the competing risk model are obtained, as well as the conditional failure probability and mean residual lifetime, given the survival age and the accumulated wear. Furthermore, the model has been used to estimate the probability that a liner fails due to one of the failure modes when both of these modes act.

  17. Multivariate survival analysis and competing risks

    CERN Document Server

    Crowder, Martin J

    2012-01-01

    Multivariate Survival Analysis and Competing Risks introduces univariate survival analysis and extends it to the multivariate case. It covers competing risks and counting processes and provides many real-world examples, exercises, and R code. The text discusses survival data, survival distributions, frailty models, parametric methods, multivariate data and distributions, copulas, continuous failure, parametric likelihood inference, and non- and semi-parametric methods. There are many books covering survival analysis, but very few that cover the multivariate case in any depth. Written for a graduate-level audience in statistics/biostatistics, this book includes practical exercises and R code for the examples. The author is renowned for his clear writing style, and this book continues that trend. It is an excellent reference for graduate students and researchers looking for grounding in this burgeoning field of research.

  18. Identification of the timing-of-events model with multiple competing exit risks from single-spell data

    DEFF Research Database (Denmark)

    Drepper, Bettina; Effraimidis, G.

    2016-01-01

    The identification result of the timing-of-events model (Abbring and Van den Berg, 2003b) is extended to a model with several competing exit risk equations. This extension allows e.g. to simultaneously identify the different effects a benefit sanction has on the rate of finding work and leaving t...

  19. Penalized estimation for competing risks regression with applications to high-dimensional covariates

    DEFF Research Database (Denmark)

    Ambrogi, Federico; Scheike, Thomas H.

    2016-01-01

    of competing events. The direct binomial regression model of Scheike and others (2008. Predicting cumulative incidence probability by direct binomial regression. Biometrika 95: (1), 205-220) is reformulated in a penalized framework to possibly fit a sparse regression model. The developed approach is easily...... Research 19: (1), 29-51), the research regarding competing risks is less developed (Binder and others, 2009. Boosting for high-dimensional time-to-event data with competing risks. Bioinformatics 25: (7), 890-896). The aim of this work is to consider how to do penalized regression in the presence...... implementable using existing high-performance software to do penalized regression. Results from simulation studies are presented together with an application to genomic data when the endpoint is progression-free survival. An R function is provided to perform regularized competing risks regression according...

  20. Joint modeling of multivariate longitudinal data and the dropout process in a competing risk setting: application to ICU data

    Directory of Open Access Journals (Sweden)

    Deslandes Emmanuelle

    2010-07-01

    Full Text Available Abstract Background Joint modeling of longitudinal and survival data has been increasingly considered in clinical trials, notably in cancer and AIDS. In critically ill patients admitted to an intensive care unit (ICU, such models also appear to be of interest in the investigation of the effect of treatment on severity scores due to the likely association between the longitudinal score and the dropout process, either caused by deaths or live discharges from the ICU. However, in this competing risk setting, only cause-specific hazard sub-models for the multiple failure types data have been used. Methods We propose a joint model that consists of a linear mixed effects submodel for the longitudinal outcome, and a proportional subdistribution hazards submodel for the competing risks survival data, linked together by latent random effects. We use Markov chain Monte Carlo technique of Gibbs sampling to estimate the joint posterior distribution of the unknown parameters of the model. The proposed method is studied and compared to joint model with cause-specific hazards submodel in simulations and applied to a data set that consisted of repeated measurements of severity score and time of discharge and death for 1,401 ICU patients. Results Time by treatment interaction was observed on the evolution of the mean SOFA score when ignoring potentially informative dropouts due to ICU deaths and live discharges from the ICU. In contrast, this was no longer significant when modeling the cause-specific hazards of informative dropouts. Such a time by treatment interaction persisted together with an evidence of treatment effect on the hazard of death when modeling dropout processes through the use of the Fine and Gray model for sub-distribution hazards. Conclusions In the joint modeling of competing risks with longitudinal response, differences in the handling of competing risk outcomes appear to translate into the estimated difference in treatment effect on the

  1. The design of reliability data bases, part II: competing risk and data compression

    International Nuclear Information System (INIS)

    Cooke, Roger M.

    1996-01-01

    Models for analyzing dependent competing risk data are presented. These models are designed to represent interactions of critical failure and maintenance mechanisms responsible for intercepting incipient and degraded failures, and they are fashioned such that the (constant) critical failure rate is identifiable from dependent competing risk data. Uncertainty bounds for the critical failure rate which take modeling uncertainty and statistical fluctuations into account are given

  2. Nonparametric predictive inference for combined competing risks data

    International Nuclear Information System (INIS)

    Coolen-Maturi, Tahani; Coolen, Frank P.A.

    2014-01-01

    The nonparametric predictive inference (NPI) approach for competing risks data has recently been presented, in particular addressing the question due to which of the competing risks the next unit will fail, and also considering the effects of unobserved, re-defined, unknown or removed competing risks. In this paper, we introduce how the NPI approach can be used to deal with situations where units are not all at risk from all competing risks. This may typically occur if one combines information from multiple samples, which can, e.g. be related to further aspects of units that define the samples or groups to which the units belong or to different applications where the circumstances under which the units operate can vary. We study the effect of combining the additional information from these multiple samples, so effectively borrowing information on specific competing risks from other units, on the inferences. Such combination of information can be relevant to competing risks scenarios in a variety of application areas, including engineering and medical studies

  3. Risk factors for deep vein thrombosis and pulmonary embolism after traumatic injury: A competing risks analysis.

    Science.gov (United States)

    Van Gent, Jan-Michael; Calvo, Richard Yee; Zander, Ashley L; Olson, Erik J; Sise, C Beth; Sise, Michael J; Shackford, Steven R

    2017-12-01

    Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different. We examined all adult trauma patients admitted to our Level I trauma center from July 2006 to December 2011 who received at least one surveillance duplex ultrasound of the lower extremities and who were at high risk or greater for DVT. Outcomes included DVT and PE events, and time-to-event from admission. We used competing risks analysis to evaluate risk factors for DVT while accounting for PE as a competing event, and vice versa. Of 2,370 patients, 265 (11.2%) had at least one venous thromboembolism event, 235 DVT only, 19 PE only, 11 DVT and PE. Within 2 days of admission, 38% of DVT cases had occurred compared with 26% of PE. Competing risks modeling of DVT as primary event identified older age, severe injury (Injury Severity Score, ≥ 15), mechanical ventilation longer than 4 days, active cancer, history of DVT or PE, major venous repair, male sex, and prophylactic enoxaparin and prophylactic heparin as associated risk factors. Modeling of PE as the primary event showed younger age, nonsevere injury (Injury Severity Score, risk factors for PE and DVT after injury were different, suggesting that they are clinically distinct events that merit independent consideration. Many DVT events occurred early despite prophylaxis, bringing into question the preventability of postinjury DVT. We recommend trauma center quality reporting program measures be revised to account for DVT and PE as unique events. Epidemiologic, level III.

  4. Proposed Core Competencies and Empirical Validation Procedure in Competency Modeling: Confirmation and Classification.

    Science.gov (United States)

    Baczyńska, Anna K; Rowiński, Tomasz; Cybis, Natalia

    2016-01-01

    Competency models provide insight into key skills which are common to many positions in an organization. Moreover, there is a range of competencies that is used by many companies. Researchers have developed core competency terminology to underline their cross-organizational value. The article presents a theoretical model of core competencies consisting of two main higher-order competencies called performance and entrepreneurship. Each of them consists of three elements: the performance competency includes cooperation, organization of work and goal orientation, while entrepreneurship includes innovativeness, calculated risk-taking and pro-activeness. However, there is lack of empirical validation of competency concepts in organizations and this would seem crucial for obtaining reliable results from organizational research. We propose a two-step empirical validation procedure: (1) confirmation factor analysis, and (2) classification of employees. The sample consisted of 636 respondents (M = 44.5; SD = 15.1). Participants were administered a questionnaire developed for the study purpose. The reliability, measured by Cronbach's alpha, ranged from 0.60 to 0.83 for six scales. Next, we tested the model using a confirmatory factor analysis. The two separate, single models of performance and entrepreneurial orientations fit quite well to the data, while a complex model based on the two single concepts needs further research. In the classification of employees based on the two higher order competencies we obtained four main groups of employees. Their profiles relate to those found in the literature, including so-called niche finders and top performers. Some proposal for organizations is discussed.

  5. Developing mathematical modelling competence

    DEFF Research Database (Denmark)

    Blomhøj, Morten; Jensen, Tomas Højgaard

    2003-01-01

    In this paper we introduce the concept of mathematical modelling competence, by which we mean being able to carry through a whole mathematical modelling process in a certain context. Analysing the structure of this process, six sub-competences are identified. Mathematical modelling competence...... cannot be reduced to these six sub-competences, but they are necessary elements in the development of mathematical modelling competence. Experience from the development of a modelling course is used to illustrate how the different nature of the sub-competences can be used as a tool for finding...... the balance between different kinds of activities in a particular educational setting. Obstacles of social, cognitive and affective nature for the students' development of mathematical modelling competence are reported and discussed in relation to the sub-competences....

  6. Developing points-based risk-scoring systems in the presence of competing risks.

    Science.gov (United States)

    Austin, Peter C; Lee, Douglas S; D'Agostino, Ralph B; Fine, Jason P

    2016-09-30

    Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points-based risk-scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points-based risk-scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points-based risk-scoring systems facilitates evidence-based clinical decision making. There is a growing interest in cause-specific mortality and in non-fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points-based risk-scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk-scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

  7. Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

    Energy Technology Data Exchange (ETDEWEB)

    Carmona, Ruben; Gulaya, Sachin; Murphy, James D. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Rose, Brent S. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts (United States); Wu, John; Noticewala, Sonal [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T. [Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California San Diego, La Jolla, California (United States); Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Vaida, Florin [Department of Family and Preventive Medicine, Biostatistics and Bioinformatics, University of California San Diego Medical Center, San Diego, California (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

    2014-07-15

    Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increased risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification.

  8. Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

    International Nuclear Information System (INIS)

    Carmona, Ruben; Gulaya, Sachin; Murphy, James D.; Rose, Brent S.; Wu, John; Noticewala, Sonal; McHale, Michael T.; Yashar, Catheryn M.; Vaida, Florin; Mell, Loren K.

    2014-01-01

    Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increased risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification

  9. A competing risks approach to "biologic" interaction

    DEFF Research Database (Denmark)

    Andersen, Per Kragh; Skrondal, Anders

    2015-01-01

    framework using competing risks and argue that sufficient cause interaction between two factors can be evaluated via the parameters in a particular statistical model, the additive hazard rate model. We present empirical conditions for presence of sufficient cause interaction and an example based on data......In epidemiology, the concepts of "biologic" and "statistical" interactions have been the subject of extensive debate. We present a new approach to biologic interaction based on Rothman's original (Am J Epidemiol, 104:587-592, 1976) discussion of sufficient causes. We do this in a probabilistic...

  10. Strategies for developing competency models.

    Science.gov (United States)

    Marrelli, Anne F; Tondora, Janis; Hoge, Michael A

    2005-01-01

    There is an emerging trend within healthcare to introduce competency-based approaches in the training, assessment, and development of the workforce. The trend is evident in various disciplines and specialty areas within the field of behavioral health. This article is designed to inform those efforts by presenting a step-by-step process for developing a competency model. An introductory overview of competencies, competency models, and the legal implications of competency development is followed by a description of the seven steps involved in creating a competency model for a specific function, role, or position. This modeling process is drawn from advanced work on competencies in business and industry.

  11. A competing risk approach for the European Heart SCORE model based on cause-specific and all-cause mortality

    DEFF Research Database (Denmark)

    Støvring, Henrik; Harmsen, Charlotte G; Wisløff, Torbjørn

    2013-01-01

    for older individuals. When non-CVD mortality was assumed unaffected by smoking status, the absolute risk reduction due to statin treatment ranged from 0.0% to 3.5%, whereas the gain in expected residual lifetime ranged from 3 to 11 months. Statin effectiveness increased for non-smokers and declined...... pressure, and total cholesterol level. The SCORE model, however, is not mathematically consistent and does not estimate all-cause mortality. Our aim is to modify the SCORE model to allow consistent estimation of both CVD-specific and all-cause mortality. Methods: Using a competing risk approach, we first...

  12. Identifying Some Risk Factors for the Time to Death of the Elderly Using the Semi-Parametric Blended Model of Survival Analysis With Competing Risks

    Directory of Open Access Journals (Sweden)

    Samane Hajiabbasi

    2018-01-01

    Conclusion In single-variable fitting, age, history of myocardial infarction, history of stroke, and kidney problems were identified to have significant effects on the time to death of the elderly. Based on one-variable semi-parametric competing risk mixture fitted models, more significant risk factors for the time to death of elderly was identified when compared with a fitted multivariate mode to the data. This implies that the role of some independent variables can be explained by other independent variables.

  13. Competing risks of cancer mortality and cardiovascular events in individuals with multimorbidity

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Bayliss

    2014-08-01

    Full Text Available Background: Cancer patients with cardiovascular and other comorbidities are at concurrent risk of multiple adverse outcomes. However, most treatment decisions are guided by evidence from single-outcome models, which may be misleading for multimorbid patients. Objective: We assessed the interacting effects of cancer, cardiovascular, and other morbidity burdens on the competing outcomes of cancer mortality, serious cardiovascular events, and other-cause mortality. Design: We analyzed a cohort of 6,500 adults with initial cancer diagnosis between 2001 and 2008, SEER 5-year survival ≥26%, and a range of cardiovascular risk factors. We estimated the cumulative incidence of cancer mortality, a serious cardiovascular event (myocardial infarction, coronary revascularization, or cardiovascular mortality, and other-cause mortality over 5 years, and identified factors associated with the competing risks of each outcome using cause-specific Cox proportional hazard models. Results: Following cancer diagnosis, there were 996 (15.3% cancer deaths, 328 (5.1% serious cardiovascular events, and 542 (8.3% deaths from other causes. In all, 4,634 (71.3% cohort members had none of these outcomes. Although cancer prognosis had the greatest effect, cardiovascular and other morbidity also independently increased the hazard of each outcome. The effect of cancer prognosis on outcome was greatest in year 1, and the effect of other morbidity was greater in individuals with better cancer prognoses. Conclusion: In multimorbid oncology populations, comorbidities interact to affect the competing risk of different outcomes. Quantifying these risks may provide persons with cancer plus cardiovascular and other comorbidities more accurate information for shared decision-making than risks calculated from single-outcome models.

  14. The application of cure models in the presence of competing risks: a tool for improved risk communication in population-based cancer patient survival.

    Science.gov (United States)

    Eloranta, Sandra; Lambert, Paul C; Andersson, Therese M-L; Björkholm, Magnus; Dickman, Paul W

    2014-09-01

    Quantifying cancer patient survival from the perspective of cure is clinically relevant. However, most cure models estimate cure assuming no competing causes of death. We use a relative survival framework to demonstrate how flexible parametric cure models can be used in combination with competing-risks theory to incorporate noncancer deaths. Under a model that incorporates statistical cure, we present the probabilities that cancer patients (1) have died from their cancer, (2) have died from other causes, (3) will eventually die from their cancer, or (4) will eventually die from other causes, all as a function of time since diagnosis. We further demonstrate how conditional probabilities can be used to update the prognosis among survivors (eg, at 1 or 5 years after diagnosis) by summarizing the proportion of patients who will not die from their cancer. The proposed method is applied to Swedish population-based data for persons diagnosed with melanoma, colon cancer, or acute myeloid leukemia between 1973 and 2007.

  15. Nonparametric predictive pairwise comparison with competing risks

    International Nuclear Information System (INIS)

    Coolen-Maturi, Tahani

    2014-01-01

    In reliability, failure data often correspond to competing risks, where several failure modes can cause a unit to fail. This paper presents nonparametric predictive inference (NPI) for pairwise comparison with competing risks data, assuming that the failure modes are independent. These failure modes could be the same or different among the two groups, and these can be both observed and unobserved failure modes. NPI is a statistical approach based on few assumptions, with inferences strongly based on data and with uncertainty quantified via lower and upper probabilities. The focus is on the lower and upper probabilities for the event that the lifetime of a future unit from one group, say Y, is greater than the lifetime of a future unit from the second group, say X. The paper also shows how the two groups can be compared based on particular failure mode(s), and the comparison of the two groups when some of the competing risks are combined is discussed

  16. Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

    Science.gov (United States)

    Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

    2017-06-04

    This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

  17. [Construction of the addiction prevention core competency model for preventing addictive behavior in adolescents].

    Science.gov (United States)

    Park, Hyun Sook; Jung, Sun Young

    2013-12-01

    This study was done to provide fundamental data for the development of competency reinforcement programs to prevent addictive behavior in adolescents through the construction and examination of an addiction prevention core competency model. In this study core competencies for preventing addictive behavior in adolescents through competency modeling were identified, and the addiction prevention core competency model was developed. It was validated methodologically. Competencies for preventing addictive behavior in adolescents as defined by the addiction prevention core competency model are as follows: positive self-worth, self-control skill, time management skill, reality perception skill, risk coping skill, and positive communication with parents and with peers or social group. After construction, concurrent cross validation of the addiction prevention core competency model showed that this model was appropriate. The study results indicate that the addiction prevention core competency model for the prevention of addictive behavior in adolescents through competency modeling can be used as a foundation for an integral approach to enhance adolescent is used as an adjective and prevent addictive behavior. This approach can be a school-centered, cost-efficient strategy which not only reduces addictive behavior in adolescents, but also improves the quality of their resources.

  18. A competence executive coaching model

    Directory of Open Access Journals (Sweden)

    Pieter Koortzen

    2010-07-01

    Research purpose: The purpose of this article is to address the training and development needs of these consulting psychologists by presenting a competence executive coaching model for the planning, implementation and evaluation of executive coaching interventions. Research design, approach and method: The study was conducted while one of the authors was involved in teaching doctoral students in consulting psychology and executive coaching, specifically in the USA. The approach involved a literature review of executive coaching models and a qualitative study using focus groups to develop and evaluate the competence executive coaching model. Main findings: The literature review provided scant evidence of competence executive coaching models and there seems to be a specific need for this in the training of coaches in South Africa. Hence the model that was developed is an attempt to provide trainers with a structured model for the training of coaches. Contribution/value-add: The uniqueness of this competence model is not only described in terms of the six distinct coaching intervention phases, but also the competencies required in each.

  19. Competence Models in Technology-enhanced Competence-based Learning

    NARCIS (Netherlands)

    Sampson, Demetrios; Fytros, Demetrios

    2008-01-01

    Please cite as: Sampson, D., & Fytros, D. (2008). Competence Models in Technology-enhanced Competence-based Learning. In H. H. Adelsberger, Kinshuk, J. M. Pawlowski & D. Sampson (Eds.), International Handbook on Information Technologies for Education and Training, 2nd Edition, Springer, June 2008

  20. Media influence on risk competence in self-medication and self-treatment.

    Science.gov (United States)

    Schweim, Harald; Ullmann, Marcela

    2015-01-01

    Media play an important role in the reception of health risks; thus, media competence is important for enhancing the risk competence of patients and consumers. In addition to life-long health education, risk competence particularly requires careful handling of health information because, at present, the key problem is not the lack of sufficient information on health topics but the quality of such information. Patients and consumers of health procedures and health products also require information which relates to their daily life and matches their life style.

  1. Family cumulative risk and at-risk kindergarteners' social competence: the mediating role of parent representations of the attachment relationship.

    Science.gov (United States)

    Sparks, Lauren A; Trentacosta, Christopher J; Owusu, Erika; McLear, Caitlin; Smith-Darden, Joanne

    2018-08-01

    Secure attachment relationships have been linked to social competence in at-risk children. In the current study, we examined the role of parent secure base scripts in predicting at-risk kindergarteners' social competence. Parent representations of secure attachment were hypothesized to mediate the relationship between lower family cumulative risk and children's social competence. Participants included 106 kindergarteners and their primary caregivers recruited from three urban charter schools serving low-income families as a part of a longitudinal study. Lower levels of cumulative risk predicted greater secure attachment representations in parents, and scores on the secure base script assessment predicted children's social competence. An indirect relationship between lower cumulative risk and kindergarteners' social competence via parent secure base script scores was also supported. Parent script-based representations of the attachment relationship appear to be an important link between lower levels of cumulative risk and low-income kindergarteners' social competence. Implications of these findings for future interventions are discussed.

  2. Media influence on risk competence in self-medication and self-treatment

    Directory of Open Access Journals (Sweden)

    Schweim, Harald

    2015-07-01

    Full Text Available Media play an important role in the reception of health risks; thus, media competence is important for enhancing the risk competence of patients and consumers. In addition to life-long health education, risk competence particularly requires careful handling of health information because, at present, the key problem is not the lack of sufficient information on health topics but the quality of such information. Patients and consumers of health procedures and health products also require information which relates to their daily life and matches their life style.

  3. Energy Auditor and Quality Control Inspector Competency Model

    Energy Technology Data Exchange (ETDEWEB)

    Head, Heather R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kurnik, Charles W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Schroeder, Derek [U.S. Department of Energy; Cutchin, Kelly [Simonson Management Services

    2018-05-02

    The Energy Auditor (EA) and Quality Control Inspector (QCI) Competency model was developed to identify the soft skills, foundational competencies and define the levels of Knowledge, Skills, and Abilities (KSAs) required to successfully perform the tasks defined in the EA and QCI Job Task Analysis (JTAs), the U.S. Department of Energy (DOE) used the U.S. Department of Labor's (DOL) Competency Model Clearinghouse resources to develop a QCI and EA Competency Model. To keep the QCI and EA competency model consistent with other construction and energy management competency models, DOE and the National Renewable Energy Laboratory used the existing 'Residential Construction Competency Model' and the 'Advanced Commercial Building Competency Model' where appropriate.

  4. Causal Bayes Model of Mathematical Competence in Kindergarten

    Directory of Open Access Journals (Sweden)

    Božidar Tepeš

    2016-06-01

    Full Text Available In this paper authors define mathematical competences in the kindergarten. The basic objective was to measure the mathematical competences or mathematical knowledge, skills and abilities in mathematical education. Mathematical competences were grouped in the following areas: Arithmetic and Geometry. Statistical set consisted of 59 children, 65 to 85 months of age, from the Kindergarten Milan Sachs from Zagreb. The authors describe 13 variables for measuring mathematical competences. Five measuring variables were described for the geometry, and eight measuring variables for the arithmetic. Measuring variables are tasks which children solved with the evaluated results. By measuring mathematical competences the authors make causal Bayes model using free software Tetrad 5.2.1-3. Software makes many causal Bayes models and authors as experts chose the model of the mathematical competences in the kindergarten. Causal Bayes model describes five levels for mathematical competences. At the end of the modeling authors use Bayes estimator. In the results, authors describe by causal Bayes model of mathematical competences, causal effect mathematical competences or how intervention on some competences cause other competences. Authors measure mathematical competences with their expectation as random variables. When expectation of competences was greater, competences improved. Mathematical competences can be improved with intervention on causal competences. Levels of mathematical competences and the result of intervention on mathematical competences can help mathematical teachers.

  5. Decision-Making Competence Predicts Domain-Specific Risk Attitudes

    Directory of Open Access Journals (Sweden)

    Joshua eWeller

    2015-05-01

    Full Text Available Decision Making Competence (DMC reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804 completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & Fischhoff, 2007. Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC  expected benefits  risk-taking than the DMC  perceived riskrisk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior.

  6. Random survival forests for competing risks

    DEFF Research Database (Denmark)

    Ishwaran, Hemant; Gerds, Thomas A; Kogalur, Udaya B

    2014-01-01

    We introduce a new approach to competing risks using random forests. Our method is fully non-parametric and can be used for selecting event-specific variables and for estimating the cumulative incidence function. We show that the method is highly effective for both prediction and variable selection...

  7. EM algorithm for one-shot device testing with competing risks under exponential distribution

    International Nuclear Information System (INIS)

    Balakrishnan, N.; So, H.Y.; Ling, M.H.

    2015-01-01

    This paper provides an extension of the work of Balakrishnan and Ling [1] by introducing a competing risks model into a one-shot device testing analysis under an accelerated life test setting. An Expectation Maximization (EM) algorithm is then developed for the estimation of the model parameters. An extensive Monte Carlo simulation study is carried out to assess the performance of the EM algorithm and then compare the obtained results with the initial estimates obtained by the Inequality Constrained Least Squares (ICLS) method of estimation. Finally, we apply the EM algorithm to a clinical data, ED01, to illustrate the method of inference developed here. - Highlights: • ALT data analysis for one-shot devices with competing risks is considered. • EM algorithm is developed for the determination of the MLEs. • The estimations of lifetime under normal operating conditions are presented. • The EM algorithm improves the convergence rate

  8. Lifelong Competence Development: On the Advantages of Formal Competence-Performance Modeling

    NARCIS (Netherlands)

    Kickmeier-Rust, Michael D.; Albert, Dietrich; Steiner, Christina

    2006-01-01

    Please, cite this publication as: Kickmeier-Rust, M.D., Albert, D., & Steiner, C. (2006). Lifelong Competence Development: On the Advantages of Formal Competence-Performance Modeling. Proceedings of International Workshop in Learning Networks for Lifelong Competence Development, TENCompetence

  9. Risky-Play at School. Facilitating Risk Perception and Competence in Young Children

    Science.gov (United States)

    Lavrysen, Ann; Bertrands, Els; Leyssen, Leene; Smets, Lieve; Vanderspikken, Anja; De Graef, Peter

    2017-01-01

    Recent research indicates that risk competence and perception can be improved through the learning environment. The project "Riscki" examined how risk perception and risk competence in young children between three and eight years of age can be observed and measured within the classroom and school context. An intensive package of…

  10. Human disease mortality kinetics are explored through a chain model embodying principles of extreme value theory and competing risks.

    Science.gov (United States)

    Juckett, D A; Rosenberg, B

    1992-04-21

    The distributions for human disease-specific mortality exhibit two striking characteristics: survivorship curves that intersect near the longevity limit; and, the clustering of best-fitting Weibull shape parameter values into groups centered on integers. Correspondingly, we have hypothesized that the distribution intersections result from either competitive processes or population partitioning and the integral clustering in the shape parameter results from the occurrence of a small number of rare, rate-limiting events in disease progression. In this report we initiate a theoretical examination of these questions by exploring serial chain model dynamics and parameteric competing risks theory. The links in our chain models are composed of more than one bond, where the number of bonds in a link are denoted the link size and are the number of events necessary to break the link and, hence, the chain. We explored chains with all links of the same size or with segments of the chain composed of different size links (competition). Simulations showed that chain breakage dynamics depended on the weakest-link principle and followed kinetics of extreme-values which were very similar to human mortality kinetics. In particular, failure distributions for simple chains were Weibull-type extreme-value distributions with shape parameter values that were identifiable with the integral link size in the limit of infinite chain length. Furthermore, for chains composed of several segments of differing link size, the survival distributions for the various segments converged at a point in the S(t) tails indistinguishable from human data. This was also predicted by parameteric competing risks theory using Weibull underlying distributions. In both the competitive chain simulations and the parametric competing risks theory, however, the shape values for the intersecting distributions deviated from the integer values typical of human data. We conclude that rare events can be the source of

  11. Semiparametric regression analysis of interval-censored competing risks data.

    Science.gov (United States)

    Mao, Lu; Lin, Dan-Yu; Zeng, Donglin

    2017-09-01

    Interval-censored competing risks data arise when each study subject may experience an event or failure from one of several causes and the failure time is not observed directly but rather is known to lie in an interval between two examinations. We formulate the effects of possibly time-varying (external) covariates on the cumulative incidence or sub-distribution function of competing risks (i.e., the marginal probability of failure from a specific cause) through a broad class of semiparametric regression models that captures both proportional and non-proportional hazards structures for the sub-distribution. We allow each subject to have an arbitrary number of examinations and accommodate missing information on the cause of failure. We consider nonparametric maximum likelihood estimation and devise a fast and stable EM-type algorithm for its computation. We then establish the consistency, asymptotic normality, and semiparametric efficiency of the resulting estimators for the regression parameters by appealing to modern empirical process theory. In addition, we show through extensive simulation studies that the proposed methods perform well in realistic situations. Finally, we provide an application to a study on HIV-1 infection with different viral subtypes. © 2017, The International Biometric Society.

  12. Quantifying and estimating the predictive accuracy for censored time-to-event data with competing risks.

    Science.gov (United States)

    Wu, Cai; Li, Liang

    2018-05-15

    This paper focuses on quantifying and estimating the predictive accuracy of prognostic models for time-to-event outcomes with competing events. We consider the time-dependent discrimination and calibration metrics, including the receiver operating characteristics curve and the Brier score, in the context of competing risks. To address censoring, we propose a unified nonparametric estimation framework for both discrimination and calibration measures, by weighting the censored subjects with the conditional probability of the event of interest given the observed data. The proposed method can be extended to time-dependent predictive accuracy metrics constructed from a general class of loss functions. We apply the methodology to a data set from the African American Study of Kidney Disease and Hypertension to evaluate the predictive accuracy of a prognostic risk score in predicting end-stage renal disease, accounting for the competing risk of pre-end-stage renal disease death, and evaluate its numerical performance in extensive simulation studies. Copyright © 2018 John Wiley & Sons, Ltd.

  13. Risks, risk assessment and risk competence in toxicology.

    Science.gov (United States)

    Stahlmann, Ralf; Horvath, Aniko

    2015-01-01

    Understanding the toxic effects of xenobiotics requires sound knowledge of physiology and biochemistry. The often described lack of understanding pharmacology/toxicology is therefore primarily caused by the general absence of the necessary fundamental knowledge. Since toxic effects depend on exposure (or dosage) assessing the risks arising from toxic substances also requires quantitative reasoning. Typically public discussions nearly always neglect quantitative aspects and laypersons tend to disregard dose-effect-relationships. One of the main reasons for such disregard is the fact that exposures often occur at extremely low concentrations that can only be perceived intellectually but not by the human senses. However, thresholds in the low exposure range are often scientifically disputed. At the same time, ignorance towards known dangers is wide-spread. Thus, enhancing the risk competence of laypersons will have to be initially restricted to increasing the awareness of existing problems.

  14. Competing risk theory and radiation risk assessment

    International Nuclear Information System (INIS)

    Groer, P.G.

    1980-01-01

    New statistical procedures are applied to estimate cumulative distribution functions (c.d.f.), force of mortality, and latent period for radiation-induced malignancies. It is demonstrated that correction for competing risks influences the shape of dose response curves, estimates of the latent period, and of the risk from ionizing radiations. The equivalence of the following concepts is demonstrated: force of mortality, hazard rate, and age or time specific incidence. This equivalence makes it possible to use procedures from reliability analysis and demography for radiation risk assessment. Two methods used by reliability analysts - hazard plotting and total time on test plots - are discussed in some detail and applied to characterize the hazard rate in radiation carcinogenesis. C.d.f.'s with increasing, decreasing, or constant hazard rate have different shapes and are shown to yield different dose-response curves for continuous irradiation. Absolute risk is shown to be a sound estimator only if the force of mortality is constant for the exposed and the control group. Dose-response relationships that use the absolute risk as a measure for the effect turn out to be special cases of dose-response relationships that measure the effect with cumulative incidence. (H.K.)

  15. Varying coefficient subdistribution regression for left-truncated semi-competing risks data.

    Science.gov (United States)

    Li, Ruosha; Peng, Limin

    2014-10-01

    Semi-competing risks data frequently arise in biomedical studies when time to a disease landmark event is subject to dependent censoring by death, the observation of which however is not precluded by the occurrence of the landmark event. In observational studies, the analysis of such data can be further complicated by left truncation. In this work, we study a varying co-efficient subdistribution regression model for left-truncated semi-competing risks data. Our method appropriately accounts for the specifical truncation and censoring features of the data, and moreover has the flexibility to accommodate potentially varying covariate effects. The proposed method can be easily implemented and the resulting estimators are shown to have nice asymptotic properties. We also present inference, such as Kolmogorov-Smirnov type and Cramér Von-Mises type hypothesis testing procedures for the covariate effects. Simulation studies and an application to the Denmark diabetes registry demonstrate good finite-sample performance and practical utility of the proposed method.

  16. Providing the meta-model of development of competency using the meta-ethnography approach: Part 2. Synthesis of the available competency development models

    Directory of Open Access Journals (Sweden)

    Shahram Yazdani

    2016-12-01

    Full Text Available Background and Purpose: ConsideringBackground and Purpose: Considering the importance and necessity of competency-based education at a global level and with respect to globalization and the requirement of minimum competencies in medical fields, medical education communities and organizations worldwide have tried to determine the competencies, present frameworks and education models to respond to be sure of the ability of all graduates. In the literature, we observed numerous competency development models that refer to the same issues with different terminologies. It seems that evaluation and synthesis of all these models can finally result in designing a comprehensive meta-model for competency development.Methods: Meta-ethnography is a useful method for synthesis of qualitative research that is used to develop models that interpret the results in several studies. Considering that the aim of this study is to ultimately provide a competency development meta-model, in the previous section of the study, the literature review was conducted to achieve competency development models. Models obtained through the search were studied in details, and the key concepts of the models and overarching concepts were extracted in this section, models’ concepts were reciprocally translated and the available competency development models were synthesized.Results: A presentation of the competency development meta-model and providing a redefinition of the Dreyfus brothers model.Conclusions: Given the importance of competency-based education at a global level and the need to review curricula and competency-based curriculum design, it is required to provide competency development as well as meta-model to be the basis for curriculum development. As there are a variety of competency development models available, in this study, it was tried to develop the curriculum using them.Keywords: Meta-ethnography, Competency development, Meta-model, Qualitative synthesis

  17. Additive gamma frailty models with applications to competing risks in related individuals

    DEFF Research Database (Denmark)

    Eriksson, Frank; Scheike, Thomas

    2015-01-01

    Epidemiological studies of related individuals are often complicated by the fact that follow-up on the event type of interest is incomplete due to the occurrence of other events. We suggest a class of frailty models with cause-specific hazards for correlated competing events in related individual...

  18. Accounting for competing risks in randomized controlled trials: a review and recommendations for improvement.

    Science.gov (United States)

    Austin, Peter C; Fine, Jason P

    2017-04-15

    In studies with survival or time-to-event outcomes, a competing risk is an event whose occurrence precludes the occurrence of the primary event of interest. Specialized statistical methods must be used to analyze survival data in the presence of competing risks. We conducted a review of randomized controlled trials with survival outcomes that were published in high-impact general medical journals. Of 40 studies that we identified, 31 (77.5%) were potentially susceptible to competing risks. However, in the majority of these studies, the potential presence of competing risks was not accounted for in the statistical analyses that were described. Of the 31 studies potentially susceptible to competing risks, 24 (77.4%) reported the results of a Kaplan-Meier survival analysis, while only five (16.1%) reported using cumulative incidence functions to estimate the incidence of the outcome over time in the presence of competing risks. The former approach will tend to result in an overestimate of the incidence of the outcome over time, while the latter approach will result in unbiased estimation of the incidence of the primary outcome over time. We provide recommendations on the analysis and reporting of randomized controlled trials with survival outcomes in the presence of competing risks. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

  19. Models of digital competence and online activity of Russian adolescents

    Directory of Open Access Journals (Sweden)

    Galina U. Soldatova

    2016-06-01

    Full Text Available Having established the conception of digital competence consisting of four components (knowledge, skills, motivation and responsibility implemented in four areas (content, communication, consumption, and the techno-sphere, we propose the idea of models of digital competence as a specific systems of adolescents’ beliefs about their abilities and desires in the online world. These models (1 may be realistic or illusory, (2 their development is mediated by the motivation and online activity and (3 they regulate further online activities as well as the further development of digital competence. On the basis of nationwide study of digital competence (N=1203 Russian adolescents of 12-17 years using latent class method we revealed 5 models of digital competence corresponding to its lowest level, the average level at high and low motivation, high specific (in the components of skill and safety and high general level. It has been shown that higher appraisal of their digital competence is related to the opportunity of a more prolonged and self-service access to the Internet as well as the history of independent development of skills online. The illusion of digital competence is associated with a wide but shallow exploration activities online. Motivational component is related to the participation and recognition of the role of others in the development of digital competence, in comparison with others’ online skills and knowledge, as well as subjectively lower «digital divide» with parents. We suggest that the motivational component of the digital competence is developed if adolescent has a successful interaction via Internet, learn from other people and also if the range of her activities and interests online activity involves and requires the development of new skills. Based on digital competence model’s analysis, we have figured out 3 main types of Internet-users: (1 beginners, (2 experienced users, (3 advanced users. All these types fall into

  20. Learning at work: competence development or competence-stress.

    Science.gov (United States)

    Paulsson, Katarina; Ivergård, Toni; Hunt, Brian

    2005-03-01

    Changes in work and the ways in which it is carried out bring a need for upgrading workplace knowledge, skills and competencies. In today's workplaces, and for a number of reasons, workloads are higher than ever and stress is a growing concern (Health Risk Soc. 2(2) (2000) 173; Educat. Psychol. Meas. 61(5) (2001) 866). Increased demand for learning brings a risk that this will be an additional stress factor and thus a risk to health. Our research study is based on the control-demand-support model of Karasek and Theorell (Health Work: Stress, Productivity and the Reconstruction of Working Life, Basic Books/Harper, New York, 1990). We have used this model for our own empirical research with the aim to evaluate the model in the modern workplace. Our research enables us to expand the model in the light of current workplace conditions-especially those relating to learning. We report empirical data from a questionnaire survey of working conditions in two different branches of industry. We are able to define differences between companies in terms of working conditions and competence development. We describe and discuss the effects these conditions have on workplace competence development. Our research results show that increased workers' control of the learning process makes competence development more stimulating, is likely to simplify the work and reduces (learning-related) stress. It is therefore important that learning at work allows employees to control their learning and also allows time for the process of learning and reflection.

  1. Risks, risk assessment and risk competence in toxicology

    Science.gov (United States)

    Stahlmann, Ralf; Horvath, Aniko

    2015-01-01

    Understanding the toxic effects of xenobiotics requires sound knowledge of physiology and biochemistry. The often described lack of understanding pharmacology/toxicology is therefore primarily caused by the general absence of the necessary fundamental knowledge. Since toxic effects depend on exposure (or dosage) assessing the risks arising from toxic substances also requires quantitative reasoning. Typically public discussions nearly always neglect quantitative aspects and laypersons tend to disregard dose-effect-relationships. One of the main reasons for such disregard is the fact that exposures often occur at extremely low concentrations that can only be perceived intellectually but not by the human senses. However, thresholds in the low exposure range are often scientifically disputed. At the same time, ignorance towards known dangers is wide-spread. Thus, enhancing the risk competence of laypersons will have to be initially restricted to increasing the awareness of existing problems. PMID:26195922

  2. Risks, risk assessment and risk competence in toxicology

    Directory of Open Access Journals (Sweden)

    Stahlmann, Ralf

    2015-07-01

    Full Text Available Understanding the toxic effects of xenobiotics requires sound knowledge of physiology and biochemistry. The often described lack of understanding pharmacology/toxicology is therefore primarily caused by the general absence of the necessary fundamental knowledge. Since toxic effects depend on exposure (or dosage assessing the risks arising from toxic substances also requires quantitative reasoning. Typically public discussions nearly always neglect quantitative aspects and laypersons tend to disregard dose-effect-relationships. One of the main reasons for such disregard is the fact that exposures often occur at extremely low concentrations that can only be perceived intellectually but not by the human senses. However, thresholds in the low exposure range are often scientifically disputed. At the same time, ignorance towards known dangers is wide-spread. Thus, enhancing the risk competence of laypersons will have to be initially restricted to increasing the awareness of existing problems.

  3. A competing risk model of first failure site after definitive (chemo) radiation therapy for locally advanced non-small cell lung cancer

    DEFF Research Database (Denmark)

    Nygård, Lotte; Vogelius, Ivan R; Fischer, Barbara M

    2018-01-01

    INTRODUCTION: The aim of the study was to build a model of first failure site and lesion specific failure probability after definitive chemo-radiotherapy for inoperable non-small cell lung cancer (NSCLC). METHODS: We retrospectively analyzed 251 patients receiving definitive chemo......-regional failure, multivariable logistic regression was applied to assess risk of each lesion being first site of failure. The two models were used in combination to predict lesion failure probability accounting for competing events. RESULTS: Adenocarcinoma had a lower hazard ratio (HR) of loco-regional (LR...

  4. Developing entrepreneurial competencies for successful business model canvas

    Science.gov (United States)

    Sundah, D. I. E.; Langi, C.; Maramis, D. R. S.; Tawalujan, L. dan

    2018-01-01

    We explore the competencies of entrepreneurship that contribute to business model canvas. This research conducted at smoked fish industries in Province of North Sulawesi, Indonesia. This research used a mixed method which integrating both quantitative and qualitative approaches in a sequential design. The technique of snowball sampling and questionnaire has been used in collecting data from 44 entrepreneurs. Structural equation modeling with SmartPLS application program has been used in analyzing this data to determine the effect of entrepreneurial competencies on business model canvas. We also investigate 3 entrepreneurs who conducted smoked fish business and analyzed their business by using business model canvas. Focus Group Discussion is used in collecting data from 2 groups of entrepreneurs from 2 different locations. The empirical results show that entrepreneurial competencies which consists of managerial competencies, technical competencies, marketing competencies, financial competencies, human relations competencies, and the specific working attitude of entrepreneur has a positive and significantly effect on business model canvas. Additionally, the empirical cases and discussion with 2 groups of entrepreneurs support the quantitative result and it found that human relations competencies have greater influence in achieving successful business model canvas.

  5. High- and Low-Risk Characteristics of Youth: The Five Cs of Competency.

    Science.gov (United States)

    McWhirter, J. Jeffries; And Others

    1994-01-01

    Identifies and discusses five basic skill strengths or skill deficits that mark critical difference between low-risk and high-risk youth. The "Five Cs of Competency" described include critical school competencies, concept of self and self-esteem, communication skills, coping ability, and control. Contends that these characteristics discriminate…

  6. A Method for Evaluating Competency in Assessment and Management of Suicide Risk

    Science.gov (United States)

    Hung, Erick K.; Binder, Renee L.; Fordwood, Samantha R.; Hall, Stephen E.; Cramer, Robert J.; McNiel, Dale E.

    2012-01-01

    Objective: Although health professionals increasingly are expected to be able to assess and manage patients' risk for suicide, few methods are available to evaluate this competency. This report describes development of a competency-assessment instrument for suicide risk-assessment (CAI-S), and evaluates its use in an objective structured clinical…

  7. A Competing Risk Model of First Failure Site after Definitive Chemoradiation Therapy for Locally Advanced Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Nygård, Lotte; Vogelius, Ivan R; Fischer, Barbara M; Kjær, Andreas; Langer, Seppo W; Aznar, Marianne C; Persson, Gitte F; Bentzen, Søren M

    2018-04-01

    The aim of the study was to build a model of first failure site- and lesion-specific failure probability after definitive chemoradiotherapy for inoperable NSCLC. We retrospectively analyzed 251 patients receiving definitive chemoradiotherapy for NSCLC at a single institution between 2009 and 2015. All patients were scanned by fludeoxyglucose positron emission tomography/computed tomography for radiotherapy planning. Clinical patient data and fludeoxyglucose positron emission tomography standardized uptake values from primary tumor and nodal lesions were analyzed by using multivariate cause-specific Cox regression. In patients experiencing locoregional failure, multivariable logistic regression was applied to assess risk of each lesion being the first site of failure. The two models were used in combination to predict probability of lesion failure accounting for competing events. Adenocarcinoma had a lower hazard ratio (HR) of locoregional failure than squamous cell carcinoma (HR = 0.45, 95% confidence interval [CI]: 0.26-0.76, p = 0.003). Distant failures were more common in the adenocarcinoma group (HR = 2.21, 95% CI: 1.41-3.48, p failure showed that primary tumors were more likely to fail than lymph nodes (OR = 12.8, 95% CI: 5.10-32.17, p failure (OR = 1.26 per unit increase, 95% CI: 1.12-1.40, p failure site-specific competing risk model based on patient- and lesion-level characteristics. Failure patterns differed between adenocarcinoma and squamous cell carcinoma, illustrating the limitation of aggregating them into NSCLC. Failure site-specific models add complementary information to conventional prognostic models. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  8. An Organization's Extended (Soft) Competencies Model

    Science.gov (United States)

    Rosas, João; Macedo, Patrícia; Camarinha-Matos, Luis M.

    One of the steps usually undertaken in partnerships formation is the assessment of organizations’ competencies. Typically considered competencies of a functional or technical nature, which provide specific outcomes can be considered as hard competencies. Yet, the very act of collaboration has its specific requirements, for which the involved organizations must be apt to exercise other type of competencies that affect their own performance and the partnership success. These competencies are more of a behavioral nature, and can be named as soft-competencies. This research aims at addressing the effects of the soft competencies on the performance of the hard ones. An extended competencies model is thus proposed, allowing the construction of adjusted competencies profiles, in which the competency levels are adjusted dynamically according to the requirements of collaboration opportunities.

  9. Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile.

    OpenAIRE

    Jordi Salas-Salvado; Barbara Lohse; Tricia Psota; Ramon Estruch; Itziar Zazpe; Jose V. Sorli; Merce Serra; Jodi Stotts Krall; Fabiola Ma´rquez; Emilio Ros; PREDIMED Study Investigators

    2010-01-01

    Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile. Eating competence (EC), a bio-psychosocial model for intrapersonal approaches to eating and food-related behaviors, is associated with less weight dissatisfaction, lower BMI, and increased HDL-cholesterol in small U.S. studies, but its relationship to nutrient quality and overall cardiovascular risk have not been examined. Prevención con Dieta Mediterránea (PRE...

  10. Quantifying and comparing dynamic predictive accuracy of joint models for longitudinal marker and time-to-event in presence of censoring and competing risks.

    Science.gov (United States)

    Blanche, Paul; Proust-Lima, Cécile; Loubère, Lucie; Berr, Claudine; Dartigues, Jean-François; Jacqmin-Gadda, Hélène

    2015-03-01

    Thanks to the growing interest in personalized medicine, joint modeling of longitudinal marker and time-to-event data has recently started to be used to derive dynamic individual risk predictions. Individual predictions are called dynamic because they are updated when information on the subject's health profile grows with time. We focus in this work on statistical methods for quantifying and comparing dynamic predictive accuracy of this kind of prognostic models, accounting for right censoring and possibly competing events. Dynamic area under the ROC curve (AUC) and Brier Score (BS) are used to quantify predictive accuracy. Nonparametric inverse probability of censoring weighting is used to estimate dynamic curves of AUC and BS as functions of the time at which predictions are made. Asymptotic results are established and both pointwise confidence intervals and simultaneous confidence bands are derived. Tests are also proposed to compare the dynamic prediction accuracy curves of two prognostic models. The finite sample behavior of the inference procedures is assessed via simulations. We apply the proposed methodology to compare various prediction models using repeated measures of two psychometric tests to predict dementia in the elderly, accounting for the competing risk of death. Models are estimated on the French Paquid cohort and predictive accuracies are evaluated and compared on the French Three-City cohort. © 2014, The International Biometric Society.

  11. Competency Maps: an Effective Model to Integrate Professional Competencies Across a STEM Curriculum

    Science.gov (United States)

    Sánchez Carracedo, Fermín; Soler, Antonia; Martín, Carme; López, David; Ageno, Alicia; Cabré, Jose; Garcia, Jordi; Aranda, Joan; Gibert, Karina

    2018-05-01

    Curricula designed in the context of the European Higher Education Area need to be based on both domain-specific and professional competencies. Whereas universities have had extensive experience in developing students' domain-specific competencies, fostering professional competencies poses a new challenge we need to face. This paper presents a model to globally develop professional competencies in a STEM (science, technology, engineering, and mathematics) degree program, and assesses the results of its implementation after 4 years. The model is based on the use of competency maps, in which each competency is defined in terms of competency units. Each competency unit is described by a set of expected learning outcomes at three domain levels. This model allows careful analysis, revision, and iteration for an effective integration of professional competencies in domain-specific subjects. A global competency map is also designed, including all the professional competency learning outcomes to be achieved throughout the degree. This map becomes a useful tool for curriculum designers and coordinators. The results were obtained from four sources: (1) students' grades (classes graduated from 2013 to 2016, the first 4 years of the new Bachelor's Degree in Informatics Engineering at the Barcelona School of Informatics); (2) students' surveys (answered by students when they finished the degree); (3) the government employment survey, where former students evaluate their satisfaction of the received training in the light of their work experience; and (4) the Everis Foundation University-Enterprise Ranking, answered by over 2000 employers evaluating their satisfaction regarding their employees' university training, where the Barcelona School of Informatics scores first in the national ranking. The results show that competency maps are a good tool for developing professional competencies in a STEM degree.

  12. Risk Competence in Dealing With Alcohol and Other Drugs in Adolescence.

    Science.gov (United States)

    Nagy, Ede; Verres, Rolf; Grevenstein, Dennis

    2017-12-06

    Adolescence is a critical phase for the development substance use patterns. We propose that individual competence in dealing with psychoactive substances is crucial for the development of healthy substance use behavior and prevention of substance misuse or addiction. We present a new concept of health related skills in dealing with alcohol and other drugs in adolescence, its operationalization and validation. Our conception of risk competence (RICO) consists of the four major factors being Reflective, Informed, Self-Controlled and Life-Oriented, and their sub-facets. Based on a sample of N = 753 adolescents we used classical test theory as well as item response theory to create a new measure of RICO. Validity was investigated in a new sample of N = 229 with regard to substance use, risk perception, and measures of personality (Big Five, sense of coherence, general self-efficacy). RICO contains 7 scales with 28 items that measure independent aspects of risk competence. Cross-sectional criterion validity for most of the scales could be shown. Conclusions/Importance: The new RICO scales are a valid measure of different aspects of risk competence in dealing with psychoactive substances. The questionnaire can be used in general research settings, but may also be applied to assess the effects of interventions.

  13. Digital Competence Model of Distance Learning Students

    Science.gov (United States)

    da Silva, Ketia Kellen A.; Behar, Patricia A.

    2017-01-01

    This article presents the development of a digital competency model of Distance Learning (DL) students in Brazil called CompDigAl_EAD. The following topics were addressed in this study: Educational Competences, Digital Competences, and Distance Learning students. The model was developed between 2015 and 2016 and is being validated in 2017. It was…

  14. Oppositionality and socioemotional competence: interacting risk factors in the development of childhood conduct disorder symptoms.

    Science.gov (United States)

    Mandy, William; Skuse, David; Steer, Colin; St Pourcain, Beate; Oliver, Bonamy R

    2013-07-01

    Oppositional behavior in childhood is a probabilistic risk factor for the subsequent development of more serious conduct problems characteristic of conduct disorder (CD). The capacity to understand the subjective states of others (socioemotional competence) helps regulate antisocial behavior in typical development. We hypothesized that socioemotional competence moderates the developmental relationship between oppositionality and CD symptoms, such that oppositional defiant disorder (ODD) symptoms pose the greatest risk for subsequent CD symptoms in children with poor socioemotional competence. Parent-report data were collected for 6,218 children at 7 and 10 years of age. Bootstrap multiple regression predicting CD symptoms at age 10 was used to test for an interaction between socioemotional competence and ODD symptoms, while also accounting for direct effects and controlling for sex, maternal education, attention-deficit/hyperactivity disorder symptoms, and CD symptoms at 7 years. We further tested whether the interaction applied to both males and females, and to both aggressive and rule-breaking CD symptoms. A significant interaction was found between ODD and socioemotional competence: the association between oppositionality at 7 years and CD traits at 10 years was strongest for children with poor socioemotional capacities. As predicted, this moderation effect was significant in a model predicting aggression, but it was not significant for rule-breaking CD symptoms. Socioemotional competence moderates the developmental relationship between mid-childhood oppositionality and more serious conduct problems in later childhood. A capacity to understand the subjective states of others may buffer the risk posed by oppositionality for later CD symptoms, including aggression. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Inverse probability of treatment-weighted competing risks analysis: an application on long-term risk of urinary adverse events after prostate cancer treatments.

    Science.gov (United States)

    Bolch, Charlotte A; Chu, Haitao; Jarosek, Stephanie; Cole, Stephen R; Elliott, Sean; Virnig, Beth

    2017-07-10

    To illustrate the 10-year risks of urinary adverse events (UAEs) among men diagnosed with prostate cancer and treated with different types of therapy, accounting for the competing risk of death. Prostate cancer is the second most common malignancy among adult males in the United States. Few studies have reported the long-term post-treatment risk of UAEs and those that have, have not appropriately accounted for competing deaths. This paper conducts an inverse probability of treatment (IPT) weighted competing risks analysis to estimate the effects of different prostate cancer treatments on the risk of UAE, using a matched-cohort of prostate cancer/non-cancer control patients from the Surveillance, Epidemiology and End Results (SEER) Medicare database. Study dataset included men age 66 years or older that are 83% white and had a median follow-up time of 4.14 years. Patients that underwent combination radical prostatectomy and external beam radiotherapy experienced the highest risk of UAE (IPT-weighted competing risks: HR 3.65 with 95% CI (3.28, 4.07); 10-yr. cumulative incidence = 36.5%). Findings suggest that IPT-weighted competing risks analysis provides an accurate estimator of the cumulative incidence of UAE taking into account the competing deaths as well as measured confounding bias.

  16. Semi-Markov models for interval censored transient cognitive states with back transitions and a competing risk.

    Science.gov (United States)

    Wei, Shaoceng; Kryscio, Richard J

    2016-12-01

    Continuous-time multi-state stochastic processes are useful for modeling the flow of subjects from intact cognition to dementia with mild cognitive impairment and global impairment as intervening transient cognitive states and death as a competing risk. Each subject's cognition is assessed periodically resulting in interval censoring for the cognitive states while death without dementia is not interval censored. Since back transitions among the transient states are possible, Markov chains are often applied to this type of panel data. In this manuscript, we apply a semi-Markov process in which we assume that the waiting times are Weibull distributed except for transitions from the baseline state, which are exponentially distributed and in which we assume no additional changes in cognition occur between two assessments. We implement a quasi-Monte Carlo (QMC) method to calculate the higher order integration needed for likelihood estimation. We apply our model to a real dataset, the Nun Study, a cohort of 461 participants. © The Author(s) 2014.

  17. Competing risk models in reliability systems, a Weibull distribution model with Bayesian analysis approach

    International Nuclear Information System (INIS)

    Iskandar, Ismed; Gondokaryono, Yudi Satria

    2016-01-01

    In reliability theory, the most important problem is to determine the reliability of a complex system from the reliability of its components. The weakness of most reliability theories is that the systems are described and explained as simply functioning or failed. In many real situations, the failures may be from many causes depending upon the age and the environment of the system and its components. Another problem in reliability theory is one of estimating the parameters of the assumed failure models. The estimation may be based on data collected over censored or uncensored life tests. In many reliability problems, the failure data are simply quantitatively inadequate, especially in engineering design and maintenance system. The Bayesian analyses are more beneficial than the classical one in such cases. The Bayesian estimation analyses allow us to combine past knowledge or experience in the form of an apriori distribution with life test data to make inferences of the parameter of interest. In this paper, we have investigated the application of the Bayesian estimation analyses to competing risk systems. The cases are limited to the models with independent causes of failure by using the Weibull distribution as our model. A simulation is conducted for this distribution with the objectives of verifying the models and the estimators and investigating the performance of the estimators for varying sample size. The simulation data are analyzed by using Bayesian and the maximum likelihood analyses. The simulation results show that the change of the true of parameter relatively to another will change the value of standard deviation in an opposite direction. For a perfect information on the prior distribution, the estimation methods of the Bayesian analyses are better than those of the maximum likelihood. The sensitivity analyses show some amount of sensitivity over the shifts of the prior locations. They also show the robustness of the Bayesian analysis within the range

  18. Risk factors for cerebrovascular disease mortality among the elderly in Beijing: a competing risk analysis.

    Directory of Open Access Journals (Sweden)

    Zhe Tang

    Full Text Available OBJECTIVE: To examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases (CBVD mortality, after accounting for competing risk events, including death from cardiovascular diseases, cancers and other diseases. METHODS: Data on 2010 subjects aged over 55 years were finally analyzed using competing risk models. All the subjects were interviewed by the Beijing Longitudinal Study of Aging (BLSA, in China, between 1 January 1992 and 30 August 2009. RESULTS: Elderly females were at a lower risk of death from CBVD than elderly males (HR = 0.639, 95% CI = 0.457-0.895. Increasing age (HR = 1.543, 95% CI = 1.013-2.349, poor self-rated health (HR = 1.652, 95% CI = 1.198-2.277, hypertension (HR = 2.201, 95% CI = 1.524-3.178 and overweight (HR = 1.473, 95% CI = 1.013-2.142 or obesity (HR = 1.711, 95% CI = 1.1754-2.490 was associated with higher CBVD mortality risk. Normal cognition function (HR = 0.650, 95% CI = 0.434-0.973 and living in urban (HR = 0.456, 95% CI = 0.286-0.727 was associated with lower CBVD mortality risk. Gray's test also confirmed the cumulative incidence (CIF of CBVD was lower in the 'married' group than those without spouse, and the mortality was lowest in the 'nutrition sufficient' group among the 'frequent consumption of meat group' and the 'medial type group' (P value<0.001. CONCLUSIONS: CBVD mortality was associated with gender, age, blood pressure, residence, BMI, cognitive function, nutrition and the result of self-rated health assessment in the elderly in Beijing, China.

  19. Criteria for use of composite end points for competing risks-a systematic survey of the literature with recommendations.

    Science.gov (United States)

    Manja, Veena; AlBashir, Siwar; Guyatt, Gordon

    2017-02-01

    Composite end points are frequently used in reports of clinical trials. One rationale for the use of composite end points is to account for competing risks. In the presence of competing risks, the event rate of a specific event depends on the rates of other competing events. One proposed solution is to include all important competing events in one composite end point. Clinical trialists require guidance regarding when this approach is appropriate. To identify publications describing criteria for use of composite end points for competing risk and to offer guidance regarding when a composite end point is appropriate on the basis of competing risks. We searched MEDLINE, CINAHL, EMBASE, The Cochrane's Central & Systematic Review databases including the Health Technology Assessment database, and the Cochrane's Methodology register from inception to April 2015, and candidate textbooks, to identify all articles providing guidance on this issue. Eligible publications explicitly addressed the issue of a composite outcome to address competing risks. Two reviewers independently screened the titles and abstracts for full-text review; independently reviewed full-text publications; and abstracted specific criteria authors offered for use of composite end points to address competing risks. Of 63,645 titles and abstracts, 166 proved potentially relevant of which 43 publications were included in the final review. Most publications note competing risks as a reason for using composite end points without further elaboration. None of the articles or textbook chapters provide specific criteria for use of composite end points for competing risk. Some advocate using composite end points to avoid bias due to competing risks and others suggest that composite end points seldom or never be used for this purpose. We recommend using composite end points for competing risks only if the competing risk is plausible and if it occurs with sufficiently high frequency to influence the interpretation

  20. Risk sharing between competing health plans and sponsors

    NARCIS (Netherlands)

    E.M. van Barneveld (Erik); W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René)

    2001-01-01

    textabstractIn many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis

  1. Refusal of Treatment by Mentally Competent Patient: The Choice of Doctor-Patient Relationship Models

    Directory of Open Access Journals (Sweden)

    Andrei M. Beliaev

    2010-01-01

    Full Text Available Introduction: In modern medicine professional relationship between the clinician and the patient is patient-centered. Patients become actively involved in the treatment decision making process and are encouraged to express their health-related preferences. Some patients may, however, refuse a favorable risk/benefit ratio treatment. This manuscript presents three cases of refusal of treatment by mentally competent surgical patients and discusses differences in their management. Conclusion: To achieve the best medical outcome for patients who possess the Actual Understanding test of mental competence clinicians use the deliberate model of medical professional relationship. For patients demonstrating the Understanding test of mental competence and wishing to utilize their health-related preferences physicians are obliged to deploy the interpretive model of doctor-patient relationship. In mentally competent patients with an illness-induced acute psychological regression the interpretive model of doctor-patient relationship as an initial strategy and cognitive behavior therapy can be useful in modifying treatment rejecting behavior and improving medical outcome.

  2. Starting Point on the Development of Environemental Risk Management Compe-tences: experiential learning

    Directory of Open Access Journals (Sweden)

    Irene Martín Rubio

    2017-06-01

    Full Text Available One of the characteristics of the European Space of Higher Education  is to consider university degrees in terms of learning outcomes, and essentially expressed in forms of competence. Competencies represent a dynamic combination of attributes such as knowledge and its application, attitudes and responsibilities that describe the learning outcomes of a particular program. Transversal competences, such as competences towards environmental  risk management, are part of the general characteristics of human action in economic and technical environments. The training, evaluation and development of professional competences can present different approaches and teaching-learning methodologies. In our study, we focus on learning from experience. With the evaluation of students' learning styles, we can begin to know how our students begin to develop their skills towards environmental risk management.

  3. Continuous Competence Development Model for Teacher Teams

    DEFF Research Database (Denmark)

    Weitze, Charlotte Lærke

    2014-01-01

    "This paper presents the development of the IT‐Pedagogical Think Tank for Teacher Teams (ITP4T), a continuous competence development model. The model was co‐designed following a design‐based research approach with teachers from VUC Storstrøm’s (VUC) Global Classroom (GC), an innovative hybrid...... to create their own continuous competence development. This article describes how and why the different components of the model were developed in response to the teachers’ challenges. Such challenges included lack of time, competence and support from the educational organisation to innovate learning design...

  4. Outcome after Reconstruction of the Proximal Tibia--Complications and Competing Risk Analysis.

    Directory of Open Access Journals (Sweden)

    Stephan E Puchner

    Full Text Available The proximal tibia (pT is a common site for bone tumors. Improvements in imaging, chemotherapy and surgical technique made limb salvage surgery the treatment of choice. Yet, reconstructions of the pT have been associated with less favorable outcome compared to other parts of the extremities. The aim of this study was to evaluate the outcome of patients with a modular endoprosthetic reconstruction of the pT.Eighty-one consecutive patients with an average age of 29 years underwent endoprosthetic reconstruction of the pT. Postoperative complications were categorized according to the ISOLS classification, and revision-free survival until first complication (any Type 1-5, soft tissue failure (Type 1, aseptic loosening (Type 2, structural failure (Type 3, infection (Type 4, and local tumor progression (Type 5 was estimated by using a Fine-Gray model for competing risk analyses for univariate and multivariable regression with Firth's bias correction.A total of 45 patients (56% had at least one complication. Cumulative incidence for complication Types 1 to 5 at 5 years with death and amputation as competing events revealed a risk of 41% for the first complication, 14% for Type 1, 16% for Type 2, 11% for Type 3, 17% for Type 4, and 1% for Type 5.Despite inclusion of amputation and death as strong competing events, pT replacements are still associated with a high risk of postoperative failures. The results suggest that infection and soft tissue failures (Type 1 and 5 seem to depend from each other. Sufficient soft tissue reconstruction and closure allow better function and reduce the risk of infection as the most prominent complication. The use of a rotating hinge design has significantly reduced structural failures over time.

  5. Core Competencies and the Prevention of High-Risk Sexual Behavior

    Science.gov (United States)

    Charles, Vignetta Eugenia; Blum, Robert Wm.

    2008-01-01

    Adolescent sexual risk-taking behavior has numerous individual, family, community, and societal consequences. In an effort to contribute to the research and propose new directions, this chapter applies the core competencies framework to the prevention of high-risk sexual behavior. It describes the magnitude of the problem, summarizes explanatory…

  6. Self-Reported Risk and Delinquent Behavior and Problem Behavioral Intention in Hong Kong Adolescents: The Role of Moral Competence and Spirituality.

    Science.gov (United States)

    Shek, Daniel T L; Zhu, Xiaoqin

    2018-01-01

    Based on the six-wave data collected from Grade 7 to Grade 12 students ( N = 3,328 at Wave 1), this pioneer study examined the development of problem behaviors (risk and delinquent behavior and problem behavioral intention) and the predictors (moral competence and spirituality) among adolescents in Hong Kong. Individual growth curve models revealed that while risk and delinquent behavior accelerated and then slowed down in the high school years, adolescent problem behavioral intention slightly accelerated over time. After controlling the background socio-demographic factors, moral competence and spirituality were negatively associated with risk and delinquent behavior as well as problem behavioral intention across all waves as predicted. Regarding the rate of change in the outcome measures, while the initial level of spirituality was positively linked to the growth rate of risk and delinquent behavior, the initial level of moral competence was negatively associated with the growth rate of problem behavioral intention. The theoretical and practical implications of the present findings are discussed with reference to the role of moral competence and spirituality in the development of adolescent problem behavior.

  7. Self-Reported Risk and Delinquent Behavior and Problem Behavioral Intention in Hong Kong Adolescents: The Role of Moral Competence and Spirituality

    Science.gov (United States)

    Shek, Daniel T. L.; Zhu, Xiaoqin

    2018-01-01

    Based on the six-wave data collected from Grade 7 to Grade 12 students (N = 3,328 at Wave 1), this pioneer study examined the development of problem behaviors (risk and delinquent behavior and problem behavioral intention) and the predictors (moral competence and spirituality) among adolescents in Hong Kong. Individual growth curve models revealed that while risk and delinquent behavior accelerated and then slowed down in the high school years, adolescent problem behavioral intention slightly accelerated over time. After controlling the background socio-demographic factors, moral competence and spirituality were negatively associated with risk and delinquent behavior as well as problem behavioral intention across all waves as predicted. Regarding the rate of change in the outcome measures, while the initial level of spirituality was positively linked to the growth rate of risk and delinquent behavior, the initial level of moral competence was negatively associated with the growth rate of problem behavioral intention. The theoretical and practical implications of the present findings are discussed with reference to the role of moral competence and spirituality in the development of adolescent problem behavior. PMID:29651269

  8. On problem of competing risks and their identification

    Czech Academy of Sciences Publication Activity Database

    Volf, Petr

    2015-01-01

    Roč. 2015, 1-2 (2015), s. 85-92 ISSN 1210-8022 R&D Projects: GA ČR GA13-14445S Institutional support: RVO:67985556 Keywords : Survival analysis * competing risks * copula Subject RIV: BB - Applied Statistics, Operational Research http://library.utia.cas.cz/separaty/2015/SI/volf-0444645.pdf

  9. Estimating twin concordance for bivariate competing risks twin data

    DEFF Research Database (Denmark)

    Scheike, Thomas; Holst, Klaus K.; Hjelmborg, Jacob B.

    2014-01-01

    For twin time-to-event data, we consider different concordance probabilities, such as the casewise concordance that are routinely computed as a measure of the lifetime dependence/correlation for specific diseases. The concordance probability here is the probability that both twins have experience...... events with the competing risk death. We thus aim to quantify the degree of dependence through the casewise concordance function and show a significant genetic component...... the event of interest. Under the assumption that both twins are censored at the same time, we show how to estimate this probability in the presence of right censoring, and as a consequence, we can then estimate the casewise twin concordance. In addition, we can model the magnitude of within pair dependence...... over time, and covariates may be further influential on the marginal risk and dependence structure. We establish the estimators large sample properties and suggest various tests, for example, for inferring familial influence. The method is demonstrated and motivated by specific twin data on cancer...

  10. Development of Instructional Competencies for Assessing and Managing Suicide Risk for Baccalaureate Nursing Education: A Modified Delphi Study.

    Science.gov (United States)

    Kotowski, Abigail; Roye, Carol

    2017-03-01

    Suicide is a major health problem and a leading cause of death throughout the world. A primary goal for suicide prevention is reforming health professional education in order to increase the competence of health professionals in assessing and managing suicide risk. Nursing leadership is involved in this reform, yet nurses frequently lack the competence to care for patients in suicidal crisis. An identified gap in baccalaureate nursing education is instructional competencies for assessing and managing suicide risk. A modified Delphi study was used. The study began with a focus group which was conducted in order to develop the Round I Survey which included forty-four competencies. After scoring these competencies, thirty-four were scored for inclusion, two were dropped and eight were revised according to panel members' comments. The Round II Survey comprised the eight revised competencies which were scored for inclusion, resulting in forty-two competencies in the final set of instructional competencies. Forty-two instructional competencies were developed: fourteen pre-assessment instructional competencies, fifteen assessment instructional competencies, and thirteen management instructional competencies. Incorporating these instructional competencies into baccalaureate nursing education might increase the competence of nursing students, and thus new nurses, in caring for patients at risk for suicide. These instructional competencies provide a first step to address the challenging task of intervening with patients at risk for suicide.

  11. Improving Representational Competence with Concrete Models

    Science.gov (United States)

    Stieff, Mike; Scopelitis, Stephanie; Lira, Matthew E.; DeSutter, Dane

    2016-01-01

    Representational competence is a primary contributor to student learning in science, technology, engineering, and math (STEM) disciplines and an optimal target for instruction at all educational levels. We describe the design and implementation of a learning activity that uses concrete models to improve students' representational competence and…

  12. Heterogeneity in risk of prostate cancer: A Swedish population-based cohort study of competing risks and type 2 diabetes mellitus.

    Science.gov (United States)

    Häggström, Christel; Van Hemelrijck, Mieke; Garmo, Hans; Robinson, David; Stattin, Pär; Rowley, Mark; Coolen, Anthony C C; Holmberg, Lars

    2018-05-09

    Most previous studies of prostate cancer have not taken into account that men in the studied populations are also at risk of competing event, and that these men may have different susceptibility to prostate cancer risk. The aim of this study was to investigate heterogeneity in risk of prostate cancer, using a recently developed latent class regression method for competing risks. We further aimed to elucidate the association between type 2 diabetes mellitus (T2DM) and prostate cancer risk, and to compare the results with conventional methods for survival analysis. We analysed the risk of prostate cancer in 126,482 men from the comparison cohort of the Prostate Cancer Data base Sweden (PCBaSe) 3.0. During a mean follow-up of 6 years 6,036 men were diagnosed with prostate cancer and 22,393 men died. We detected heterogeneity in risk of prostate cancer with two distinct latent classes in the study population. The smaller class included 9% of the study population in which men had a higher risk of prostate cancer and the risk was stronger associated with class membership than any of the covariates included in the study. Moreover, we found no association between T2DM and risk of prostate cancer after removal of the effect of informative censoring due to competing risks. The recently developed latent class for competing risks method could be used to provide new insights in precision medicine with the target to classify individuals regarding different susceptibility to a particular disease, reaction to a risk factor or response to treatment. This article is protected by copyright. All rights reserved. © 2018 UICC.

  13. Models for Evaluating and Improving Architecture Competence

    National Research Council Canada - National Science Library

    Bass, Len; Clements, Paul; Kazman, Rick; Klein, Mark

    2008-01-01

    ... producing high-quality architectures. This report lays out the basic concepts of software architecture competence and describes four models for explaining, measuring, and improving the architecture competence of an individual...

  14. Risks of Death and Stroke in Patients Undergoing Hemodialysis With New-Onset Atrial Fibrillation: A Competing-Risk Analysis of a Nationwide Cohort.

    Science.gov (United States)

    Shih, Chia-Jen; Ou, Shuo-Ming; Chao, Pei-Wen; Kuo, Shu-Chen; Lee, Yi-Jung; Yang, Chih-Yu; Tarng, Der-Cherng; Lin, Chih-Ching; Huang, Po-Hsun; Li, Szu-Yuan; Chen, Yung-Tai

    2016-01-19

    Whether oral anticoagulant use should be considered in patients undergoing hemodialysis with atrial fibrillation (AF) remains controversial because of the uncertainty regarding risk-benefit assessments. The purpose of this study was to investigate the risk of ischemic stroke in patients undergoing hemodialysis with new-onset AF, in comparison with those without arrhythmia. This nationwide, population-based, propensity score-matched cohort study used data from Taiwan's National Health Insurance Research Database during 1998 to 2011 for patients on hemodialysis with new-onset nonvalvular AF and matched subjects without arrhythmia. The clinical end points were ischemic stroke (fatal or nonfatal), all-cause death, and other serious adverse cardiovascular events. In comparison with the matched cohort, patients with AF (n=6772) had higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.27; 95% confidence interval [CI], 1.13-1.43), all-cause death (aHR, 1.59; 95% CI, 1.52-1.67), in-hospital cardiovascular death (aHR, 1.83; 95% CI, 1.71-1.94), myocardial infarction (aHR, 1.33; 95% CI, 1.17-1.51), and hospitalization for heart failure (aHR, 1.90; 95% CI, 1.76-2.05). After considering in-hospital death as a competing risk, AF significantly increased the risk of heart failure (HR, 1.56; 95% CI, 1.45-1.68), but not those of ischemic stroke and myocardial infarction. Additionally, the predictive value of the CHA2DS2-VASc score for ischemic stroke was diminished in the competing-risk model. The risk of stroke was only modestly higher in patients undergoing hemodialysis with new-onset AF than in those without AF, and it became insignificant when accounting for the competing risk of in-hospital death. © 2015 American Heart Association, Inc.

  15. Professional Competence of Prospective Teachers in Business and Economics Education: Evaluation of a Competence Model Using Structural Equation Modeling

    Science.gov (United States)

    Bouley, Franziska; Wuttke, Eveline; Schnick-Vollmer, Kathleen; Schmitz, Bernhard; Berger, Stefanie; Fritsch, Sabine; Seifried, Jürgen

    2015-01-01

    Teacher competence is crucial for quality of teaching and learner achievement. Competency models and competence measurement are prevalent in domains such as the natural sciences and lacking in others. We conducted our research in the field of business and economics education by focusing on the accounting domain because it is key to a deep…

  16. Investigating the adequacy of the Competence-Turnover Intention Model: how does nursing competence affect nurses' turnover intention?

    Science.gov (United States)

    Takase, Miyuki; Teraoka, Sachiko; Kousuke, Yabase

    2015-03-01

    The aim of this study was to test the adequacy of the Competence-Turnover Intention Model, which was developed to identify how nursing competence could affect nurses' turnover intention (nurses' intention to voluntarily leave an organisation). Recent studies have suggested that the level of nursing competence is negatively related to nurses' intention to leave their jobs, suggesting that a lack of competence threatens both the quality and quantity of the nursing workforce. However, the mechanism of how nursing competence affects nurses' turnover intention has not been explored previously. A cross-sectional survey design was used. Surveys were distributed to 1337 Japanese registered nurses/midwives in October, 2013. The adequacy of the model was analysed using structural equation modelling. In total, 766 questionnaires were returned, with a return rate of 57%. The model fitted well with the data. The results showed that the level of nursing competence was related positively to the quantity of organisational rewards they felt they had received, and negatively related to the level of exhaustion they experienced. Moreover, the perceived organisational rewards and exhaustion were correlated with nurses' turnover intention through affective commitment. The Competence-Turnover Intention Model is useful for explaining how nursing competence impacts on their turnover intention. Clinical implications derived from the findings are that: promoting nursing competence is key to improving not only the quality of care provided by nurses, but also to retaining the nursing workforce, and the model can be used to develop strategies that would mitigate their turnover intention. © 2014 John Wiley & Sons Ltd.

  17. Modeling the Development of Vocational Competence: A Psychometric Model for Economic Domains

    Science.gov (United States)

    Klotz, Viola Katharina; Winther, Esther; Festner, Dagmar

    2015-01-01

    This article discusses the development of vocational competence through economic vocational educational training (VET) from a theoretical and psychometric perspective. Most assessment and competence models tend to adopt a state perspective toward assessments of competence and carve out different structures of competence for diverse vocational…

  18. Process-Based Development of Competence Models to Computer Science Education

    Science.gov (United States)

    Zendler, Andreas; Seitz, Cornelia; Klaudt, Dieter

    2016-01-01

    A process model ("cpm.4.CSE") is introduced that allows the development of competence models in computer science education related to curricular requirements. It includes eight subprocesses: (a) determine competence concept, (b) determine competence areas, (c) identify computer science concepts, (d) assign competence dimensions to…

  19. A global central banker competency model

    Directory of Open Access Journals (Sweden)

    David W. Brits

    2014-07-01

    Full Text Available Orientation: No comprehensive, integrated competency model exists for central bankers. Due to the importance of central banks in the context of the ongoing global financial crisis, it was deemed necessary to design and validate such a model. Research purpose: To craft and validate a comprehensive, integrated global central banker competency model (GCBCM and to assess whether central banks using the GCBCM for training have a higher global influence. Motivation for the study: Limited consensus exists globally about what constitutes a ‘competent’ central banker. A quantitatively validated GCBCM would make a significant contribution to enhancing central banker effectiveness, and also provide a solid foundation for effective people management. Research approach, design and method: A blended quantitative and qualitative research approach was taken. Two sets of hypotheses were tested regarding the relationships between the GCBCM and the training offered, using the model on the one hand, and a central bank’s global influence on the other. Main findings: The GCBCM was generally accepted across all participating central banks globally, although some differences were found between central banks with higher and lower global influence. The actual training offered by central banks in terms of the model, however, is generally limited to technical-functional skills. The GCBCM is therefore at present predominantly aspirational. Significant differences were found regarding the training offered. Practical/managerial implications: By adopting the GCBCM, central banks would be able to develop organisation-specific competency models in order to enhance their organisational capabilities and play their increasingly important global role more effectively. Contribution: A generic conceptual framework for the crafting of a competency model with evaluation criteria was developed. A GCBCM was quantitatively validated.

  20. Risk factors for unplanned readmissions in older adult trauma patients in Washington State: a competing risk analysis.

    Science.gov (United States)

    Fawcett, Vanessa J; Flynn-O'Brien, Katherine T; Shorter, Zeynep; Davidson, Giana H; Bulger, Eileen; Rivara, Frederick P; Arbabi, Saman

    2015-03-01

    Hospital readmission is a significant contributor to increasing health care use related to caring for older trauma patients. This study was undertaken with the following aims: determine the proportion of older adult trauma patients who experience unplanned readmission, as well as risk factors for these readmissions and identify the most common readmission diagnoses among these patients. We conducted a retrospective cohort study of trauma patients age 55 years and older who survived their hospitalization at a statewide trauma center between 2009 and 2010. Linking 3 statewide databases, nonelective readmission rates were calculated for 30 days, 6 months, and 1 year after index discharge. Competing risk regression was used to determine risk factors for readmission and account for the competing risk of dying without first being readmitted. Subhazard ratios (SHR) are reported, indicating the relative risk of readmission by 30 days, 6 months, and 1 year. The cumulative readmission rates for the 14,536 participants were 7.9%, 18.9%, and 25.2% at 30 days, 6 months, and 1 year, respectively. In multivariable models, the strongest risk factors for readmission at 1 year (based on magnitude of SHR) were severe head injury (adjusted SHR = 1.47; 95% CI, 1.24-1.73) and disposition to a skilled nursing facility (SHR = 1.54; 95% CI, 1.39-1.71). The diagnoses most commonly associated with readmission were atrial fibrillation, anemia, and congestive heart failure. In this statewide study, unplanned readmissions after older adult trauma occurred frequently up to 1 year after discharge, particularly for patients who sustained severe head trauma and who could not be discharged home independently. Examining common readmission diagnoses might inform the development of interventions to prevent unplanned readmissions. Copyright © 2015 American College of Surgeons. All rights reserved.

  1. The validation of a human resource management professional competence model for the South African context

    Directory of Open Access Journals (Sweden)

    Nico Schutte

    2015-09-01

    Research purpose: The main objective of the present research was to validate a HRM competence measure for the assessment of professional HRM competencies in the workplace. Motivation for the study: Competency models can assist HR professionals in supporting their organisations to achieve success and sustainability. Research approach, design and method: A cross-sectional research approach was followed. The proposed HRM Professional Competence Model was administered to a diverse population of HR managers and practitioners (N = 483. Data were analysed using SPSS 22.0 for Windows. Main findings: Exploratory factor analysis resulted in three distinguishable competency dimensions for HR professionals: Professional behaviour and leadership (consisting of the factors Leadership and personal credibility, Solution creation, Interpersonal communication and Innovation, Service orientation and execution (consisting of the factors Talent management, HR risk, HR metrics and HR service delivery and Business intelligence (consisting of the factors Strategic contribution, HR business knowledge, HR business acumen and HR technology. All factors showed acceptable construct equivalence for the English and indigenous language groups. Practical/managerial implications: Managers can utilise the validated competence measure to measure the performance of HR practitioners in the organisation. Contribution/value-add: This research adds to the limited HR professional competence measures that currently exist.

  2. Competency Model 101. The Process of Developing Core Competencies.

    Science.gov (United States)

    Eichelberger, Lisa Wright; Hewlett, Peggy O'Neill

    1999-01-01

    The Mississippi Competency Model defines nurses' roles as provider (caregiver, teacher, counselor, advocate), professional (scholar, collaborator, ethicist, researcher), and manager (leader, facilitator, intrapreneur, decision maker, technology user) for four levels of nursing: licensed practical nurse, associate degree, bachelor's degree, and…

  3. Safety Cultural Competency Modeling in Nuclear Organizations

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sa Kil; Oh, Yeon Ju; Luo, Meiling; Lee, Yong Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    The nuclear safety cultural competency model should be supplemented through a bottom-up approach such as behavioral event interview. The developed model, however, is meaningful for determining what should be dealt for enhancing safety cultural competency of nuclear organizations. The more details of the developing process, results, and applications will be introduced later. Organizational culture include safety culture in terms of its organizational characteristics.

  4. Exploring Clinical Rotation Competence Improvements after Interpersonal Skills Development in At-Risk Medical Students

    Directory of Open Access Journals (Sweden)

    Sri Linuwih Menaldi

    2014-12-01

    Full Text Available AbstractPrior to admission, medical students were subject to psychological tests to measure their logical thinking skills and personality, hence predicting their ability to complete their studies. The results showed 56,45% of medical students obtained recommendation category 4 (doubtful and 5 (not recommended, two categories which are considered to be at-risk group with a very small probability of completing their studies. These results predicted that students in the mentioned groups will have difficulties in achieving the clinical competence level required by the Indonesian Doctors’ Competency Standard (IDCS. The aim of the study was to investigate clinical competency achievement by at-risk medical students in the third year, after following interpersonal skills development training program on July 2011. This research used qualitative study design through psychological examination, written self-reflection and in-depth interview after the training. Interpersonal skills development training for at-risk medical students gave positive effects to theircharacter development for the helping profession. It was concluded that interpersonal skills training could help improve medical student’s achievement of clinical competence especially for at-risk group in their clinical rotations stage.Keywords: medical students, at-risk group, interpersonal skills, clinical competence AbstrakPada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan dan 5 (tidak disarankan yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan

  5. Lifetime competing risks between coronary heart disease mortality and other causes of death during 50years of follow-up.

    Science.gov (United States)

    Puddu, Paolo Emilio; Piras, Paolo; Menotti, Alessandro

    2017-02-01

    To study coronary heart disease (CHD) death versus 11 other causes of death using the cumulative incidence function (CIF) and the competing risks procedures to disentangle the differential role of risk factors for different end-points. Standard Cox and Fine-Gray models among 1712 middle-aged men were compared during 50years of follow-up. CHD death was the primary event, while deaths from 11 selected causes, mutually exclusive from the primary end-point, were considered as secondary events. Reverse solutions were also performed. We considered 10 selected risk factors. CHD death risk was the second highest among 12 mostly specific causes of death. Some risk factors were specific: serum cholesterol for CHD death whereas, systolic blood pressure, cigarette smoking and age may have a differential role in other causes of death. Application of the Fine-Gray model based on CIF enabled to dissect, at least in part, the respective role that baseline covariates may have to segregate the probabilities of two types of death in contrast from each other. They also point to the absence of contributing significance for some of the selected risk factors and this calls for a parsimonious approach in predictions. The relative rarity of competing risk challenges when defining the risk factors role at long-term needs now be corrected since we have clearly shown, with Fine-Gray model, at direct or reverse use, that comparing different end-points heavily influences the risk factor predictive capacity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Competency Modeling in Extension Education: Integrating an Academic Extension Education Model with an Extension Human Resource Management Model

    Science.gov (United States)

    Scheer, Scott D.; Cochran, Graham R.; Harder, Amy; Place, Nick T.

    2011-01-01

    The purpose of this study was to compare and contrast an academic extension education model with an Extension human resource management model. The academic model of 19 competencies was similar across the 22 competencies of the Extension human resource management model. There were seven unique competencies for the human resource management model.…

  7. Front-line intraperitoneal versus intravenous chemotherapy in stage III-IV epithelial ovarian, tubal, and peritoneal cancer with minimal residual disease: a competing risk analysis.

    Science.gov (United States)

    Chang, Yen-Hou; Li, Wai-Hou; Chang, Yi; Peng, Chia-Wen; Cheng, Ching-Hsuan; Chang, Wei-Pin; Chuang, Chi-Mu

    2016-03-17

    In the analysis of survival data for cancer patients, the problem of competing risks is often ignored. Competing risks have been recognized as a special case of time-to-event analysis. The conventional techniques for time-to-event analysis applied in the presence of competing risks often give biased or uninterpretable results. Using a prospectively collected administrative health care database in a single institution, we identified patients diagnosed with stage III or IV primary epithelial ovarian, tubal, and peritoneal cancers with minimal residual disease after primary cytoreductive surgery between 1995 and 2012. Here, we sought to evaluate whether intraperitoneal chemotherapy outperforms intravenous chemotherapy in the presence of competing risks. Unadjusted and multivariable subdistribution hazards models were applied to this database with two types of competing risks (cancer-specific mortality and other-cause mortality) coded to measure the relative effects of intraperitoneal chemotherapy. A total of 1263 patients were recruited as the initial cohort. After propensity score matching, 381 patients in each arm entered into final competing risk analysis. Cumulative incidence estimates for cancer-specific mortality were statistically significantly lower (p = 0.017, Gray test) in patients receiving intraperitoneal chemotherapy (5-year estimates, 34.5%; 95% confidence interval [CI], 29.5-39.6%, and 10-year estimates, 60.7%; 95% CI, 52.2-68.0%) versus intravenous chemotherapy (5-year estimates, 41.3%; 95% CI, 36.2-46.3%, and 10-year estimates, 67.5%, 95% CI, 61.6-72.7%). In subdistribution hazards analysis, for cancer-specific mortality, intraperitoneal chemotherapy outperforms intravenous chemotherapy (Subdistribution hazard ratio, 0.82; 95% CI, 0.70-0.96) after correcting other covariates. In conclusion, results from this comparative effectiveness study provide supportive evidence for previous published randomized trials that intraperitoneal chemotherapy

  8. Social competence and competency model as a field of scientific and practical interest

    Directory of Open Access Journals (Sweden)

    E. G. Ksenofontova

    2014-01-01

    Full Text Available The article examines the history of the use of the term “competence” and related terms in sociology, linguistics, pedagogy and practice of human resource management to identify the area of “sociology of competence”. Discussion points of the terms interpretations of the semantic sphere of “competence/competency” are considered by experts from different countries. On this basis, we propose a Universal competence-model that enables diverse professionals to work out a “common language” to contemporary social practices for discussing the relevant issues of competence assessment and development.

  9. Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis.

    Science.gov (United States)

    Seoane-Pillado, María Teresa; Pita-Fernández, Salvador; Valdés-Cañedo, Francisco; Seijo-Bestilleiro, Rocio; Pértega-Díaz, Sonia; Fernández-Rivera, Constantino; Alonso-Hernández, Ángel; González-Martín, Cristina; Balboa-Barreiro, Vanesa

    2017-03-07

    The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed. Competing risk survival analysis methods were applied to estimate the cumulative incidence of developing cardiovascular events over time and to identify which characteristics were associated with the risk of these events. Post-transplant cardiovascular events are defined as the presence of myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances, peripheral vascular disease and cardiovascular disease and death. The cause of death was identified through the medical history and death certificate using ICD9 (390-459, except: 427.5, 435, 446, 459.0). The mean age of patients at the time of transplantation was 47.0 ± 14.2 years; 62% were male. 16.5% had suffered some cardiovascular disease prior to transplantation and 9.7% had suffered a cardiovascular event. The mean follow-up period for the patients with cardiovascular event was 3.5 ± 4.3 years. Applying competing risk methodology, it was observed that the accumulated incidence of the event was 5.0% one year after transplantation, 8.1% after five years, and 11.9% after ten years. After applying multivariate models, the variables with an independent effect for predicting cardiovascular events are: male sex, age of recipient, previous cardiovascular disorders, pre-transplant smoking and post-transplant diabetes. This study makes it possible to determine in kidney transplant patients, taking into account competitive events, the incidence of post-transplant cardiovascular events and

  10. Modeling the Competence Acquiring Process in Higher Education Institution

    DEFF Research Database (Denmark)

    Malinowska, Magdelena; Kusztina, Emma; Zaikin, Oleg

    2013-01-01

    Changes in human capital management, new requirements regarding knowledge and skills of employees compel higher education institutions to redefine their learning programmes. This requires evaluation of the didactic process realization, which should be oriented on competences. In the article authors...... presents an approach to competence modeling. New tools and collaboration mechanisms are proposed, which allow defining the structure of competence, analyzing the level of competence development, and assessing the competence process realization in relation “expected benefit-required expense”....

  11. On the Importance of Accounting for Competing Risks in Pediatric Brain Cancer: II. Regression Modeling and Sample Size

    International Nuclear Information System (INIS)

    Tai, Bee-Choo; Grundy, Richard; Machin, David

    2011-01-01

    Purpose: To accurately model the cumulative need for radiotherapy in trials designed to delay or avoid irradiation among children with malignant brain tumor, it is crucial to account for competing events and evaluate how each contributes to the timing of irradiation. An appropriate choice of statistical model is also important for adequate determination of sample size. Methods and Materials: We describe the statistical modeling of competing events (A, radiotherapy after progression; B, no radiotherapy after progression; and C, elective radiotherapy) using proportional cause-specific and subdistribution hazard functions. The procedures of sample size estimation based on each method are outlined. These are illustrated by use of data comparing children with ependymoma and other malignant brain tumors. The results from these two approaches are compared. Results: The cause-specific hazard analysis showed a reduction in hazards among infants with ependymoma for all event types, including Event A (adjusted cause-specific hazard ratio, 0.76; 95% confidence interval, 0.45-1.28). Conversely, the subdistribution hazard analysis suggested an increase in hazard for Event A (adjusted subdistribution hazard ratio, 1.35; 95% confidence interval, 0.80-2.30), but the reduction in hazards for Events B and C remained. Analysis based on subdistribution hazard requires a larger sample size than the cause-specific hazard approach. Conclusions: Notable differences in effect estimates and anticipated sample size were observed between methods when the main event showed a beneficial effect whereas the competing events showed an adverse effect on the cumulative incidence. The subdistribution hazard is the most appropriate for modeling treatment when its effects on both the main and competing events are of interest.

  12. Suicide Risk Assessment Training for Psychology Doctoral Programs: Core Competencies and a Framework for Training

    OpenAIRE

    Cramer, Robert J.; Johnson, Shara M.; McLaughlin, Jennifer; Rausch, Emilie M.; Conroy, Mary Alice

    2013-01-01

    Clinical and counseling psychology programs currently lack adequate evidence-based competency goals and training in suicide risk assessment. To begin to address this problem, this article proposes core competencies and an integrated training framework that can form the basis for training and research in this area. First, we evaluate the extent to which current training is effective in preparing trainees for suicide risk assessment. Within this discussion, sample and methodological issues are ...

  13. Ohio Financial Services and Risk Management. Technical Competency Profile (TCP).

    Science.gov (United States)

    Ray, Gayl M.; Wilson, Nick; Mangini, Rick

    This document describes the essential competencies from secondary through post-secondary associate degree programs for a career in financial services and risk management. Ohio College Tech Prep Program standards are described, and a key to profile codes is provided. Sample occupations in this career area, such as financial accountant, loan…

  14. THE COMPETENCE-CONTEXT MODEL OF TRAINING AND EDUCATION IN COMPREHENSIVE SCHOOLS

    Directory of Open Access Journals (Sweden)

    N. A. Rybakina

    2017-01-01

    Full Text Available Introduction. The article is devoted to the problem of finding models of implementation of continuing education.Aim. The article deals with the competence and context-based model of learning and education in a comprehensive school as a part of lifelong education. The structural components of the competence-context model are described. The author also presents results of the model testing.Methodology and research methods. The competence-based approach is a methodological base of the presented research. The article carries out theoretical analysis of psychological and pedagogical literature concerning with the research problem. The author also applies such methods as: modeling of teaching objects, pedagogical experiment, quantitative and qualitative analysis.Results. The author suggests an educational model of competence formation and development in the framework of the theory of context-based education, which supports continuing personal development in the system of lifelong education. The paper describes the essence of the components of the competence-context model of training and upbringing.Scientific novelty. The research justifies the need to distinguish an invariant result of the continuing education. It is shown that competence as a combination of cognitive, social and reflective experience can act as an invariant.Practical significance. The proposed results of testing of the competencecontext model of training and education in comprehensive schools of the Samara region can be in-demand among school teachers for their educational work.

  15. A holistic measurement model of movement competency in children.

    Science.gov (United States)

    Rudd, J; Butson, M L; Barnett, L; Farrow, D; Berry, J; Borkoles, E; Polman, R

    2016-01-01

    Different countries have different methods for assessing movement competence in children; however, it is unclear whether the test batteries that are used measure the same aspects of movement competence. The aim of this paper was to (1) investigate whether the Test of Gross Motor Development (TGMD-2) and Körperkoordinations Test für Kinder (KTK) measure the same aspects of children's movement competence and (2) examine the factorial structure of the TGMD-2 and KTK in a sample of Australian children. A total of 158 children participated (M age = 9.5; SD = 2.2). First, confirmatory factor analysis examined the independent factorial structure of the KTK and TGMD-2. Second, it was investigated whether locomotor, object control and body coordination loaded on the latent variable Movement Competency. Confirmatory factor analysis indicated an adequate fit for both the KTK and TGMD-2. An adequate fit was also achieved for the final model. In this model, locomotor (r = .86), object control (r = .71) and body coordination (r = .52) loaded on movement competence. Findings support our hypothesis that the TGMD-2 and KTK measure discrete aspects of movement competence. Future researchers and practitioners should consider using a wider range of test batteries to assess movement competence.

  16. Connection between competence, usability, environment and risk of falls in elderly adults

    Directory of Open Access Journals (Sweden)

    José Alex Leiva-Caro

    2015-12-01

    Full Text Available Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

  17. Model of development of manager`s leadership competences

    Directory of Open Access Journals (Sweden)

    Milena Kirilova Filipova

    2015-12-01

    Full Text Available Leadership is not what the leader does, but what is done by the leader and the team together. The leader’s competences are requisite not only to the political leaders but also to the managers of big corporations. The skills of active influence on the social reality underlie each successful business and each successful career. The main purpose of the article is to propose a model for development of the leader’s competences of the manager. The main result to be achieved is designed model of leader’s competences development by the means of which the areas in which the manager needs improvement shall be developed. The major research methods used in this work are method of comparison, intuitive and systematic approach, method of analysis and synthesis.

  18. The Use of Modeling-Based Text to Improve Students' Modeling Competencies

    Science.gov (United States)

    Jong, Jing-Ping; Chiu, Mei-Hung; Chung, Shiao-Lan

    2015-01-01

    This study investigated the effects of a modeling-based text on 10th graders' modeling competencies. Fifteen 10th graders read a researcher-developed modeling-based science text on the ideal gas law that included explicit descriptions and representations of modeling processes (i.e., model selection, model construction, model validation, model…

  19. Core competency model for the family planning public health nurse.

    Science.gov (United States)

    Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

    2014-01-01

    A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

  20. A consistent NPMLE of the joint distribution function with competing risks data under the dependent masking and right-censoring model.

    Science.gov (United States)

    Li, Jiahui; Yu, Qiqing

    2016-01-01

    Dinse (Biometrics, 38:417-431, 1982) provides a special type of right-censored and masked competing risks data and proposes a non-parametric maximum likelihood estimator (NPMLE) and a pseudo MLE of the joint distribution function [Formula: see text] with such data. However, their asymptotic properties have not been studied so far. Under the extention of either the conditional masking probability (CMP) model or the random partition masking (RPM) model (Yu and Li, J Nonparametr Stat 24:753-764, 2012), we show that (1) Dinse's estimators are consistent if [Formula: see text] takes on finitely many values and each point in the support set of [Formula: see text] can be observed; (2) if the failure time is continuous, the NPMLE is not uniquely determined, and the standard approach (which puts weights only on one element in each observed set) leads to an inconsistent NPMLE; (3) in general, Dinse's estimators are not consistent even under the discrete assumption; (4) we construct a consistent NPMLE. The consistency is given under a new model called dependent masking and right-censoring model. The CMP model and the RPM model are indeed special cases of the new model. We compare our estimator to Dinse's estimators through simulation and real data. Simulation study indicates that the consistent NPMLE is a good approximation to the underlying distribution for moderate sample sizes.

  1. A survey of risk factors for digit injuries among dogs training and competing in agility events.

    Science.gov (United States)

    Sellon, Debra C; Martucci, Katherine; Wenz, John R; Marcellin-Little, Denis J; Powers, Michelle; Cullen, Kimberley L

    2018-01-01

    OBJECTIVE To identify potential risk factors for digit injuries in dogs training and competing in agility events. DESIGN Internet-based, retrospective, cross-sectional survey. ANIMALS 1,081 dogs training or competing in agility events. PROCEDURES Data were collected for eligible animals via retrospective surveys distributed electronically to handlers of dogs participating in agility-related activities. Variables evaluated included demographic (handlers) and signalment (dogs) information, physical characteristics of dogs, and injury characteristics. A separate survey of dogs competing in similar agility-related activities but without digit injuries was also administered. Multivariable logistic regression was used to develop a model for assessment of risk factors. RESULTS Data were collected from 207 agility dogs with digit injuries and 874 agility dogs without digit injuries. Factors associated with significantly increased odds of injury included Border Collie breed (OR, 2.3; 95% confidence interval [CI], 1.5 to 3.3), long nails (OR, 2.4; 95% CI, 1.3 to 4.5), absence of front dewclaws (OR, 1.9; 95% CI, 1.3 to 2.6), and greater weight-to-height ratio (OR, 1.5; 95% CI, 1.1 to 2.0). Odds of injury decreased with increasing age of the dog (OR, 0.8; 95% CI, 0.76 to 0.86). CONCLUSIONS AND CLINICAL RELEVANCE Results should be cautiously interpreted because of potential respondent and recall bias and lack of review of medical records. Nevertheless, results suggested that retaining healthy dewclaws, maintaining lean body mass, and trimming nails short for training and competition may decrease the likelihood of digit injuries. Research to investigate training practices, obstacle construction specifcations, and surface considerations for dogs competing in agility activities is indicated.

  2. A heuristic model for risk and cost impacts of plant outage maintenance schedule

    International Nuclear Information System (INIS)

    Mohammad Hadi Hadavi, S.

    2009-01-01

    Cost and risk are two major competing criteria in maintenance optimization problems. If a plant is forced to shutdown because of accident or fear of accident happening, beside loss of revenue, it causes damage to the credibility and reputation of the business operation. In this paper a heuristic model for incorporating three compelling optimization criteria (i.e., risk, cost, and loss) into a single evaluation function is proposed. Such a model could be used in any evaluation engine of outage maintenance schedule optimizer. It is attempted to make the model realistic and to address the ongoing challenges facing a schedule planner in a simple and commonly understandable fashion. Two simple competing schedules for the NPP feedwater system are examined against the model. The results show that while the model successfully addresses the current challenges for outage maintenance optimization, it properly demonstrates the dynamics of schedule in regards to risk, cost, and losses endured by maintenance schedule, particularly when prolonged outage and lack of maintenance for equipments in need of urgent care are of concern.

  3. Análisis de supervivencia en presencia de riesgos competitivos: estimadores de la probabilidad de suceso Survival analysis with competing risks: estimating failure probability

    Directory of Open Access Journals (Sweden)

    Javier Llorca

    2004-10-01

    Full Text Available Objetivo: Mostrar el efecto de los riesgos competitivos de muerte en el análisis de supervivencia. Métodos: Se presenta un ejemplo sobre la supervivencia libre de rechazo tras un trasplante cardíaco, en el que la muerte antes de desarrollar el rechazo actúa como riesgo competitivo. Mediante una simulación se comparan el estimador de Kaplan-Meier y el modelo de decrementos múltiples. Resultados: El método de Kaplan-Meier sobrestima el riesgo de rechazo. A continuación, se expone la aplicación del modelo de decrementos múltiples para el análisis de acontecimientos secundarios (en el ejemplo, la muerte tras el rechazo. Finalmente, se discuten las asunciones propias del método de Kaplan-Meier y las razones por las que no puede ser aplicado en presencia de riesgos competitivos. Conclusiones: El análisis de supervivencia debe ajustarse por los riesgos competitivos de muerte para evitar la sobrestimación del riesgo de fallo que se produce con el método de Kaplan-Meier.Objective: To show the impact of competing risks of death on survival analysis. Method: We provide an example of survival time without chronic rejection after heart transplantation, where death before rejection acts as a competing risk. Using a computer simulation, we compare the Kaplan-Meier estimator and the multiple decrement model. Results: The Kaplan-Meier method overestimated the probability of rejection. Next, we illustrate the use of the multiple decrement model to analyze secondary end points (in our example: death after rejection. Finally, we discuss Kaplan-Meier assumptions and why they fail in the presence of competing risks. Conclusions: Survival analysis should be adjusted for competing risks of death to avoid overestimation of the risk of rejection produced with the Kaplan-Meier method.

  4. Nuclear safety and human competence

    International Nuclear Information System (INIS)

    Stefanescu, Petre

    2001-01-01

    Competence represents a very well defined ensemble of knowledge and skills, behavior modalities, standard procedures and judgement types that can be used in a given situation, without a priori learning. It is obvious that a person competence should fulfill the needs of the company he works for. For a Nuclear Power Plant operator competence is a constitutive part of his individuality. Competence includes: 1. Knowledge that can be classified in three main items: - procedural and declarative knowledge; - practical knowledge and skills; - fundamental knowledge. 2. 'Non cognitive' knowledge components, such as 'social information', team collective competence, safety education, risks perception and management. The last item presents a special interest for nuclear safety. On the other hand, competence level defines the quality of procedures applied in different operational situations. Competence - procedures relations are presented. Competence fundament results from operator activity analysis. The analyst has to take into consideration several phases of activity in which competence is highlighted like: - genesis, during formation; - transformation, during adaptation to a technical modification; - transfer, from expert to probationer. Competence is subject to a continuous transformation process due to technical and organizational evolutions and 'operator ageing'. Cognitive ageing of operators or the technical ageing of competence often appear to be superimposed. Technical progress acceleration increases the ageing effects of competence. Knowledge - skills dynamic relations are discussed. The changing of organizational form determines appearance of new competence gained from others domains or defined by multidisciplinary studies. Ergonomics can help the changing of organizational form through analysis of operators evolution activity which will generate new competence. Ergonomics can contribute to identify means of raising competence starting from learning process

  5. Critical elements of culturally competent communication in the medical encounter: a review and model.

    Science.gov (United States)

    Teal, Cayla R; Street, Richard L

    2009-02-01

    Increasing the cultural competence of physicians is one means of responding to demographic changes in the USA, as well as reducing health disparities. However, in spite of the development and implementation of cultural competence training programs, little is known about the ways cultural competence manifests itself in medical encounters. This paper will present a model of culturally competent communication that offers a framework of studying cultural competence 'in action.' First, we describe four critical elements of culturally competent communication in the medical encounter--communication repertoire, situational awareness, adaptability, and knowledge about core cultural issues. We present a model of culturally competent physician communication that integrates existing frameworks for cultural competence in patient care with models of effective patient-centered communication. The culturally competent communication model includes five communication skills that are depicted as elements of a set in which acquisition of more skills corresponds to increasing complexity and culturally competent communication. The culturally competent communication model utilizes each of the four critical elements to fully develop each skill and apply increasingly sophisticated, contextually appropriate communication behaviors to engage with culturally different patients in complex interactions. It is designed to foster maximum physician sensitivity to cultural variation in patients as the foundation of physician-communication competence in interacting with patients.

  6. Competency-based training: who benefits?

    Science.gov (United States)

    Brightwell, Alexandra; Grant, Janet

    2013-02-01

    Competency based training describes progression through training referenced to the demonstrated ability to perform certain tasks. In recent years, this has become the dominant curriculum model. We seek to examine who benefits from a competency based approach to medical education. For the regulators and service, the apparent advantage is in terms of apparent measurable accountability and flexibility. For assessors, the promise of competence based assessments in the workplace to provide a reliable and objective measurement of a trainee's performance has not been demonstrated in practice. For the doctor in training, there is very little evidence to show benefit from competency based training. Competency based training places emphasis on individual skills rather than overall learning experience thus risks diminishing the role of the trainee in the workplace. Any form of medical education that devalues workplace based learning will ultimately harm the profession and, in turn, patient care.

  7. [A competency model of rural general practitioners: theory construction and empirical study].

    Science.gov (United States)

    Yang, Xiu-Mu; Qi, Yu-Long; Shne, Zheng-Fu; Han, Bu-Xin; Meng, Bei

    2015-04-01

    To perform theory construction and empirical study of the competency model of rural general practitioners. Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis. The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance. The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.

  8. Competing risk model for reduction in life expectancy from radiogenic latent cancer

    International Nuclear Information System (INIS)

    Davis, H.T.

    1978-01-01

    Because of the large number of persons who could potentially receive low doses of radiation as a result of a nuclear reactor accident, the number of fatalities from latent cancers is generally larger than the early, or prompt, fatalities. For this reason the latent cancer fatality risk of reactor accidents is perceived as being more important than the early fatality risk. In addition, there exists the temptation to add the latent cancer fatality risk to the early fatality risk for the purpose of comparing reactor accident risks to other risks that society is exposed to, such as automobile accidents, airplane accidents, hurricanes, etc. However, the impact on the individual, and society as a whole, due to latent cancer fatalities is significantly different from the impact produced by early fatalities. Early fatalities generally result in appreciable life shortening for the affected individual while latent cancer fatalities generally result in very limited life shortening. A mathematical model was developed to express the reduction in life expectancy due to latent radiogenic cancer as a function of dose received

  9. Societal perspectives on risk awareness and risk competence.

    Science.gov (United States)

    Koller, Michael; Hoffrage, Ulrich

    2015-01-01

    Medical risks can be assessed by objectifiable therapeutic features; however, these risks are also characterised to a considerable degree by individual and social values. People tend to strive towards both freedom as well as safety; in a medical context, these two aims are taken into account by shared decision-making models and by stricter regulations in the pharmaceutical sector. Media reports on medical risks are caught between providing information and economic interests, and this conflict particularly complicates rational discussions about unexpected risks (for instance, in the field of natural medicine). Thus, it is necessary to create the type of information culture which allows differentiating between real and less pronounced risks.

  10. Three-dimensional dose-response models of risk for radiation injury carcinogenesis

    International Nuclear Information System (INIS)

    Raabe, O.G.

    1988-01-01

    The use of computer graphics in conjunction with three-dimensional models of dose-response relationships for chronic exposure to ionizing radiation dramaticly clarifies the separate and interactive roles of competing risks. The three dimensions are average dose rate, exposure time, and risk. As an example, the functionally injurious and carcinogenic responses after systemic uptake of Ra-226 by beagles, mice and people with consequent alpha particle irradiation of the bone are represented by three-dimensional dose-rate/time/response surfaces that demonstrate the contributions with the passage of time of the competing deleterious responses. These relationships are further evaluated by mathematical stripping with three-dimensional illustrations that graphically show the resultant separate contribution of each effect. Radiation bone injury predominates at high dose rates and bone cancer at intermediate dose rates. Low dose rates result in spontaneous deaths from natural aging, yielding a type of practical threshold for bone cancer induction. Risk assessment is benefited by the insights that become apparent with these three-dimensional models. The improved conceptualization afforded by them contributes to planning and evaluating epidemiological analyses and experimental studies

  11. The Role of Career Competencies in the Job Demands-Resources Model

    NARCIS (Netherlands)

    Akkermans, J.; Schaufeli, W.B.; Brenninkmeijer, V.; Blonk, R.W.B.

    2013-01-01

    This study investigated the role of career competencies as a mediator in the Job Demands - Resources model. Structural equation modeling with data from 305 young employed persons aged 16-30 years showed that career competencies are positively related to job resources and work engagement, but not to

  12. Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile.

    Science.gov (United States)

    Lohse, Barbara; Psota, Tricia; Estruch, Ramón; Zazpe, Itziar; Sorli, José V; Salas-Salvadó, Jordi; Serra, Mercè; Krall, Jodi Stotts; Márquez, Fabiola; Ros, Emilio

    2010-07-01

    Eating competence (EC), a bio-psychosocial model for intrapersonal approaches to eating and food-related behaviors, is associated with less weight dissatisfaction, lower BMI, and increased HDL-cholesterol in small U.S. studies, but its relationship to nutrient quality and overall cardiovascular risk have not been examined. Prevención con Dieta Mediterránea (PREDIMED) is a 5-y controlled clinical trial evaluating Mediterranean diet efficacy on the primary prevention of cardiovascular diseases (CVD) in Spain. In a cross-sectional study, 638 PREDIMED participants (62% women, mean age 67 y) well phenotyped for cardiovascular risk factors were assessed for food intake and EC using validated questionnaires. Overall, 45.6% were eating-competent. EC was associated with being male and energy intake (P diet (P 5.6 mmol/L (0.71; 95% CI 0.51-0.98) and HDL-cholesterol or =3.4 mmol/L were 0.1). Our findings support further examination of EC as a strategy for enhancing diet quality and CVD prevention.

  13. Competence Model and Modern Trends of Development of the Russian Institute of Technical Customer

    Directory of Open Access Journals (Sweden)

    Mishlanova Marina

    2017-01-01

    Full Text Available Article considers modern maintenance and development of the management actor by the investment-construction projects of the technical customer. Urgent problems of the formation of Institute of the technical customer establishment are allocated. Elementary competence model is presented: based competences of technical customer, model of the primary competence, example of the operational level of the model. Analysis of the development of the Institute of the technical customer was performed: compliance with current realities of investment-construction activities, improvement of contractual relations, compliance with international standards, state participation, creation of the single technical customer. Necessity of development of competence models for the urgent justification of professional standards is assessed. The possibility of modeling of the competencies and functions of technical customer in approach to the FIDIC-model was revealed. Possibility of usage of the competence model of the technical customer on the stage of building in terms of public-private partnership. Results show the direction for further researches.

  14. Predicting and Modelling of Survival Data when Cox's Regression Model does not hold

    DEFF Research Database (Denmark)

    Scheike, Thomas H.; Zhang, Mei-Jie

    2002-01-01

    Aalen model; additive risk model; counting processes; competing risk; Cox regression; flexible modeling; goodness of fit; prediction of survival; survival analysis; time-varying effects......Aalen model; additive risk model; counting processes; competing risk; Cox regression; flexible modeling; goodness of fit; prediction of survival; survival analysis; time-varying effects...

  15. The role of career competencies in the Job Demands: Resources model

    NARCIS (Netherlands)

    Akkermans, J.; Schaufeli, W.B.; Brenninkmeijer, V.; Blonk, R.W.B.

    2013-01-01

    This study investigated the role of career competencies as a mediator in the Job Demands — Resources model. Structural equation modeling with data from 305 young employed persons aged 16–30 years showed that career competencies are positively related to job resources and work engagement, but not to

  16. Modeling on the Criteria of Chinese Business English Majors’ Business Communication Competence

    Directory of Open Access Journals (Sweden)

    Liu Yonghou

    2015-01-01

    Full Text Available With increasing globalization in the business arena, the phenomenal growth of international business has created a heavy demand for intellectuals with international business communication competence. Business communication competence, as one of the paramount competences business English majors should acquire and the particular embodiment of competitiveness, is of vital significance not only in personal development, but also in enterprises management, just as Liu (2012 claims “[e]ffective business communication is the lifeblood of every organization, and a key to success in one’s career”. There is, nevertheless, no universally accepted model for what excellent business communication competence should consist of up to now. Hence, the overriding aim of the present study is to identify Chinese business English majors’ communication competence relevant to the contemporary communication environment. Identification of these skills should aid business communication educators and students in addressing practical concerns in their teaching and learning. The unified model to be put forward covers four kinds of core competence, i.e. English competence, fundamental business knowledge and skills, excellent intercultural communication competence, and luxuriant humanistic quality, together with three other skills, which are also indispensable, including scenario analysis competence, outstanding technology-mediated communication competence, and non-verbal communication competence.

  17. Competency model for dentists in China: Results of a Delphi study.

    Science.gov (United States)

    Geng, Yunxia; Zhao, Liying; Wang, Yu; Jiang, Yiyuan; Meng, Kai; Zheng, Dongxiang

    2018-01-01

    With the increasing awareness of the importance of oral health, patients have an increasing need for integrated care from dentists. In China, the dentistry examination consists of two parts: a practical skills examination and a comprehensive medical examination; to date, no assessment methods that are based on specialized dentistry competencies, unlike the United States, Canada, and other countries, have been established. Therefore, the purpose of this study was to construct a competency model for dentists in China in order to guide the development, admission, training and assessment of dentists. Using a literature review, focus group interviews and in-depth personal interviews, a dentist competency index was developed with an expert consultation questionnaire. A panel of 20 specialist experts was chosen from ten national medical universities to carry out two rounds of Delphi expert analysis, using the boundary value method to filter the indicators and the Analytic Hierarchy Process to calculate the weights of the primary indicators. Two rounds of Delphi results showed that the expert authority, enthusiasm, and coordination coefficients were high. Constructs of the competency model that included seven primary indicators and 62 secondary indicators determined the weight of each index. The seven primary indicators included the following: clinical skills and medical services, disease prevention and health promotion, interpersonal communication skills, core values and professionalism, medical knowledge and lifelong learning ability, teamwork ability and scientific research ability. In conclusion, the use of the Delphi method to construct an initial model of Chinese physician competency is scientific and feasible. The initial competency model conforms to the characteristics and quality requirements of dentists in China and has a strong scientific basis. The dentist competency model should be used in the National Dental Licensing Examination in China.

  18. Attitudes of older adults with serious competing health risks toward their implantable cardioverter-defibrillators: a pilot study.

    Science.gov (United States)

    Green, Ariel R; Boyd, Cynthia M; Rickard, John; Gomon, Robert; Leff, Bruce

    2015-12-23

    In elderly heart failure patients, the survival benefit of implantable cardioverter-defibrillators (ICDs) may be attenuated due to competing health risks, and the risk of adverse outcomes magnified. Our objective was to examine older adults' attitudes towards ICD implantation in the context of competing health risks, exploring the determinants of ICD decision-making among a group of patients who had faced the decision in the past. Telephone survey with a qualitative component. Patients were age ≥70 with single- or dual-chamber ICDs from a single academic cardiac device clinic. Health status was assessed with the Vulnerable Elders Survey (VES-13). Responses to open-ended questions were transcribed verbatim; an "editing analysis" approach was used to extract themes. Forty-four ICD recipients participated (mean age 77.5 years). Nineteen participants (43%) had VES-13 scores ≥3, indicating a 50% likelihood of death or functional decline within 2 years. Twenty-one participants (48%) had received prior ICD shocks. Forty participants (91%) said they would "definitely" choose to get an ICD again in their current health. By and large, patients revealed a strong desire to extend life, expressed complete confidence in the lifesaving capabilities of their ICDs, and did not describe consideration of competing health risks. In this pilot telephone survey with a qualitative component, nearly all older adults with ICDs would still choose to get an ICD despite high short-term risk of death or health deterioration. These findings suggest the need to partner more effectively with patients and families to decide how best to use medical technologies, particularly for older adults with competing risks.

  19. Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

    Science.gov (United States)

    Ahn, Jung-Won

    2017-03-01

    This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved. Copyright © 2017. Published by Elsevier B.V.

  20. [Assessment of risk of burden in construction: improvement interventions and contribution of the competent physician].

    Science.gov (United States)

    Martinelli, R; Tarquini, M

    2012-01-01

    Three construction companies in three years have changed the operating modes, making use of innovative carpentry, with little amount of equipment, improved usability of the site, reduced cleaning time, less manual handling and reduced risk of accidents. The Competent Doctor has participated in the review of the risk assessment of manual handling: data has been acquired on musculoskeletal disorders to compare, in terms of this innovation, the average trend and changes, with encouraging results in terms of incidence of musculoskeletal disorders, absenteeism due to illness by these causes, new cases of lumbar diseases. It remains difficult in building to assess manual handling risk, but the collaboration between the Employer, Prevention and Protection Service and Competent Doctor, thanks to the greater attention that the design subject to these issues, suggests improvements and further steps to extend to all phases of operation of building.

  1. Competence-based education to develop digital competence

    NARCIS (Netherlands)

    Wesselink, R.; Giaffredo, Silvio

    2015-01-01

    The competence approach to learning and teaching has been described by several theoretical models. These formal models are often not integrated with concrete educational activity. On the contrary, this article proposes a practical implementation of the competence approach in education. The model of

  2. Exploration of a leadership competency model for medical school faculties in Korea.

    Science.gov (United States)

    Lee, Yong Seok; Oh, Dong Keun; Kim, Myungun; Lee, Yoon Seong; Shin, Jwa Seop

    2010-12-01

    To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea. To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire. The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation. This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.

  3. The robust corrective action priority-an improved approach for selecting competing corrective actions in FMEA based on principle of robust design

    Science.gov (United States)

    Sutrisno, Agung; Gunawan, Indra; Vanany, Iwan

    2017-11-01

    In spite of being integral part in risk - based quality improvement effort, studies improving quality of selection of corrective action priority using FMEA technique are still limited in literature. If any, none is considering robustness and risk in selecting competing improvement initiatives. This study proposed a theoretical model to select risk - based competing corrective action by considering robustness and risk of competing corrective actions. We incorporated the principle of robust design in counting the preference score among corrective action candidates. Along with considering cost and benefit of competing corrective actions, we also incorporate the risk and robustness of corrective actions. An example is provided to represent the applicability of the proposed model.

  4. Model of teaching competence in teachers of medicine at UNAM

    Directory of Open Access Journals (Sweden)

    Flores-Hernández, Fernando

    2011-09-01

    Full Text Available The study presents a model of teaching competence in teachers of medicine. It was generated from an existing conceptual model: a it was referred to the opinion of experts who selected the competencies of greater impact; b a reference profile was constructed; c an instrument was generated based on student opinion, and another for self-assessment; d the instruments were validated by 18 experts in evaluation; e they were applied to 2,281 students and 107 teachers, obtaining adequate psychometric characteristics, establishing a model according to current trends in teacher performance assessment.

  5. A Competence-Based Science Learning Framework Illustrated through the Study of Natural Hazards and Disaster Risk Reduction

    Science.gov (United States)

    Oyao, Sheila G.; Holbrook, Jack; Rannikmäe, Miia; Pagunsan, Marmon M.

    2015-01-01

    This article proposes a competence-based learning framework for science teaching, applied to the study of "big ideas", in this case to the study of natural hazards and disaster risk reduction (NH&DRR). The framework focuses on new visions of competence, placing emphasis on nurturing connectedness and behavioral actions toward…

  6. Object interaction competence model v. 2.0

    DEFF Research Database (Denmark)

    Bennedsen, Jens; Schulte, C.

    2013-01-01

    Teaching and learning object oriented programming has to take into account the specific object oriented characteristics of program execution, namely the interaction of objects during runtime. Prior to the research reported in this article, we have developed a competence model for object interaction...

  7. Enterprise Networks for Competences Exchange: A Simulation Model

    Science.gov (United States)

    Remondino, Marco; Pironti, Marco; Pisano, Paola

    A business process is a set of logically related tasks performed to achieve a defined business and related to improving organizational processes. Process innovation can happen at various levels: incrementally, redesign of existing processes, new processes. The knowledge behind process innovation can be shared, acquired, changed and increased by the enterprises inside a network. An enterprise can decide to exploit innovative processes it owns, thus potentially gaining competitive advantage, but risking, in turn, that other players could reach the same technological levels. Or it could decide to share it, in exchange for other competencies or money. These activities could be the basis for a network formation and/or impact the topology of an existing network. In this work an agent based model is introduced (E3), aiming to explore how a process innovation can facilitate network formation, affect its topology, induce new players to enter the market and spread onto the network by being shared or developed by new players.

  8. The role of mathematics and modeling in a competency centered learning system

    NARCIS (Netherlands)

    Langereis, G.R.; Hu, J.; Feijs, L.M.G.

    2011-01-01

    With competency based learning in a project driven environment, we are facing a different perspective of how students perceive mathematical modelling. In this paper, a model is proposed where conventional education is seen as a process from math to design, while competency driven approaches tend to

  9. Assessment of Primary 5 Students' Mathematical Modelling Competencies

    Science.gov (United States)

    Chan, Chun Ming Eric; Ng, Kit Ee Dawn; Widjaja, Wanty; Seto, Cynthia

    2012-01-01

    Mathematical modelling is increasingly becoming part of an instructional approach deemed to develop students with competencies to function as 21st century learners and problem solvers. As mathematical modelling is a relatively new domain in the Singapore primary school mathematics curriculum, many teachers may not be aware of the learning outcomes…

  10. The Importance of Military Cultural Competence.

    Science.gov (United States)

    Meyer, Eric G; Writer, Brian W; Brim, William

    2016-03-01

    Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.

  11. Teachers’ design and use of rubrics and modeling activities for formative assessment of lower secondary school students’ modeling competence in science

    DEFF Research Database (Denmark)

    Nielsen, Sanne Schnell

    Modeling competence plays a central role in the recently revised science curriculum in Denmark. Teachers are requested to assess students learning progress targeting the modeling competence in their daily teaching. Accordingly, the teachers must understand this competence and have suitable...... assessment criteria and methods at hand. However, the curriculum descriptions of the modeling competence concept is only phrased in general terms and not based on a systematic framework....

  12. Intercultural Competence – Key Competence of Multicultural Teams

    Directory of Open Access Journals (Sweden)

    Diana Bebenova - Nikolova

    2014-08-01

    Full Text Available The article deals with intercultural competence of multicultural teams elaborating European projects. Firstly, it discusses basic theoretical aspects of the related concepts: culture and intercultural competence, then presents its impact on multicultural team effectiveness and models for improving it. The article finds ground on studies of intercultural competence as a set of strategic, personal, social and professional competences. The paper uses the project cycle management theory and proves that in multi-ethnic surroundings, the project membersř communication skills might not be sufficient to generate mutual understanding. Provisionally, the study performed a standardized Internet survey on self-assessment of intercultural competence among 50 experts on European projects. Another applied approach is field observation (attendance and note-taking of the 5- day training "To become diplomats between cultures", based on Bennettřs theoretical model for "Development of Intercultural Sensitivity". A training model for improving intercultural competence of multicultural team members. Possible approach for improvement of project management of crossborder or trans-border funding programs. Building intercultural competence in European project management is important, timely and necessity-driven, especially under the framework of the Danube Region Strategy.

  13. Students To Compete in Model Solar Car Race

    Science.gov (United States)

    cars in the 1998 Junior Solar Sprint. The race will be held at the U.S. Department of Energy's (DOE Compete in Model Solar Car Race For more information contact: e:mail: Public Affairs Golden, Colo ., May 8, 1998 — Middle school students from across Colorado will design, build and race model solar

  14. Nyala and Bushbuck I: A Competing Species Model.

    Science.gov (United States)

    Fay, Temple H.; Greeff, Johanna C.

    1999-01-01

    Introduces a model of differential equations for students--a very real overpopulation problem is occurring in the Ndumu Game Reserve in KwaZulu-Natal, South Africa, where one species of antelope, the Nyala, is crowding out another species, the Bushbuck. Constructs a competing species model to mathematically describe what is occurring in Ndumu.…

  15. Therapeutic risk management of clinical-legal dilemmas: should it be a core competency?

    Science.gov (United States)

    Simon, Robert I; Shuman, Daniel W

    2009-01-01

    Therapeutic risk management of clinical-legal dilemmas achieves an optimal alignment between clinical competence and an understanding of legal concerns applicable to psychiatric practice. Understanding how psychiatry and law interact in frequently occurring clinical situations is essential for effective patient care. Successful management of clinical-legal dilemmas also avoids unnecessary, counterproductive defensive practices.

  16. SCORING ASSESSMENT AND FORECASTING MODELS BANKRUPTCY RISK OF COMPANIES

    Directory of Open Access Journals (Sweden)

    SUSU Stefanita

    2014-07-01

    Full Text Available Bankruptcy risk made the subject of many research studies that aim at identifying the time of the bankruptcy, the factors that compete to achieve this state, the indicators that best express this orientation (the bankruptcy. The threats to enterprises require the managers knowledge of continually economic and financial situations, and vulnerable areas with development potential. Managers need to identify and properly manage the threats that would prevent achieving the targets. In terms of methods known in the literature of assessment and evaluation of bankruptcy risk they are static, functional, strategic, and scoring nonfinancial models. This article addresses Altman and Conan-Holder-known internationally as the model developed at national level by two teachers from prestigious universities in our country-the Robu-Mironiuc model. Those models are applied to data released by the profit and loss account and balance sheet Turism Covasna company over which bankruptcy risk analysis is performed. The results of the analysis are interpreted while trying to formulate solutions to the economic and financial viability of the entity.

  17. Evolution dynamics modeling and simulation of logistics enterprise's core competence based on service innovation

    Science.gov (United States)

    Yang, Bo; Tong, Yuting

    2017-04-01

    With the rapid development of economy, the development of logistics enterprises in China is also facing a huge challenge, especially the logistics enterprises generally lack of core competitiveness, and service innovation awareness is not strong. Scholars in the process of studying the core competitiveness of logistics enterprises are mainly from the perspective of static stability, not from the perspective of dynamic evolution to explore. So the author analyzes the influencing factors and the evolution process of the core competence of logistics enterprises, using the method of system dynamics to study the cause and effect of the evolution of the core competence of logistics enterprises, construct a system dynamics model of evolution of core competence logistics enterprises, which can be simulated by vensim PLE. The analysis for the effectiveness and sensitivity of simulation model indicates the model can be used as the fitting of the evolution process of the core competence of logistics enterprises and reveal the process and mechanism of the evolution of the core competence of logistics enterprises, and provide management strategies for improving the core competence of logistics enterprises. The construction and operation of computer simulation model offers a kind of effective method for studying the evolution of logistics enterprise core competence.

  18. Geometry of the q-exponential distribution with dependent competing risks and accelerated life testing

    Science.gov (United States)

    Zhang, Fode; Shi, Yimin; Wang, Ruibing

    2017-02-01

    In the information geometry suggested by Amari (1985) and Amari et al. (1987), a parametric statistical model can be regarded as a differentiable manifold with the parameter space as a coordinate system. Note that the q-exponential distribution plays an important role in Tsallis statistics (see Tsallis, 2009), this paper investigates the geometry of the q-exponential distribution with dependent competing risks and accelerated life testing (ALT). A copula function based on the q-exponential function, which can be considered as the generalized Gumbel copula, is discussed to illustrate the structure of the dependent random variable. Employing two iterative algorithms, simulation results are given to compare the performance of estimations and levels of association under different hybrid progressively censoring schemes (HPCSs).

  19. Adopsi Model Competency Based Training dalam Kewirausahaan

    OpenAIRE

    I Ketut Santra

    2009-01-01

    The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT) into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulat...

  20. riskRegression

    DEFF Research Database (Denmark)

    Ozenne, Brice; Sørensen, Anne Lyngholm; Scheike, Thomas

    2017-01-01

    In the presence of competing risks a prediction of the time-dynamic absolute risk of an event can be based on cause-specific Cox regression models for the event and the competing risks (Benichou and Gail, 1990). We present computationally fast and memory optimized C++ functions with an R interface...... for predicting the covariate specific absolute risks, their confidence intervals, and their confidence bands based on right censored time to event data. We provide explicit formulas for our implementation of the estimator of the (stratified) baseline hazard function in the presence of tied event times. As a by...... functionals. The software presented here is implemented in the riskRegression package....

  1. Competence development organizations in project management on the basis of genomic model methodologies

    OpenAIRE

    Бушуев, Сергей Дмитриевич; Рогозина, Виктория Борисовна; Ярошенко, Юрий Федерович

    2013-01-01

    The matrix technology for identification of organisational competencies in project management is presented in the article. Matrix elements are the components of organizational competence in the field of project management and project management methodology represented in the structure of the genome. The matrix model of competence in the framework of the adopted methodologies and scanning method for identifying organizational competences formalised. Proposed methods for building effective proj...

  2. Intensive Class Training Model for Developing Lecturers’English Competence at IAIN Imam Bonjol Padang

    Directory of Open Access Journals (Sweden)

    Darmayenti Darmayenti

    2016-02-01

    Full Text Available Research and Development (R&D project was used to develop lecturers’ English competence particularly on speaking and writing at State Institute of Islamic Studies of Imam Bonjol Padang.  The lecturers need to develop their competence in English in order to prepare themselves to add new information of lecturing materials and writing papers. Borg and Gall’s steps were used to develop the model. Twenty active lecturers who had s2 and s3 program, who were randomly selected, participated on this research. During the process of the research, observation, questionnaire, and TOEFL test, speaking and writing tests were used to collect the data. The experimental research type and one group pre test- post test design were used to conduct the research. The result of the research showed that 74% of respondents need intensive class training model to develop their English competence. The implementation of intensive class training model gave a significant effect toward lecturers’ English competence. It is concluded that this model is more effective to improve lecturers’ on English competences. Therefore, it is recommended that this model can be implemented at IAIN Imam Bonjol Padang in order to develop lecturers’ English competences and to enhance the quality of lecturers.

  3. Competency-based education: a new model for teaching orthopaedics.

    Science.gov (United States)

    Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K

    2013-01-01

    The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

  4. Population-based absolute risk estimation with survey data

    Science.gov (United States)

    Kovalchik, Stephanie A.; Pfeiffer, Ruth M.

    2013-01-01

    Absolute risk is the probability that a cause-specific event occurs in a given time interval in the presence of competing events. We present methods to estimate population-based absolute risk from a complex survey cohort that can accommodate multiple exposure-specific competing risks. The hazard function for each event type consists of an individualized relative risk multiplied by a baseline hazard function, which is modeled nonparametrically or parametrically with a piecewise exponential model. An influence method is used to derive a Taylor-linearized variance estimate for the absolute risk estimates. We introduce novel measures of the cause-specific influences that can guide modeling choices for the competing event components of the model. To illustrate our methodology, we build and validate cause-specific absolute risk models for cardiovascular and cancer deaths using data from the National Health and Nutrition Examination Survey. Our applications demonstrate the usefulness of survey-based risk prediction models for predicting health outcomes and quantifying the potential impact of disease prevention programs at the population level. PMID:23686614

  5. riskRegression

    DEFF Research Database (Denmark)

    Ozenne, Brice; Sørensen, Anne Lyngholm; Scheike, Thomas

    2017-01-01

    In the presence of competing risks a prediction of the time-dynamic absolute risk of an event can be based on cause-specific Cox regression models for the event and the competing risks (Benichou and Gail, 1990). We present computationally fast and memory optimized C++ functions with an R interface......-product we obtain fast access to the baseline hazards (compared to survival::basehaz()) and predictions of survival probabilities, their confidence intervals and confidence bands. Confidence intervals and confidence bands are based on point-wise asymptotic expansions of the corresponding statistical...

  6. Psychological first aid: a consensus-derived, empirically supported, competency-based training model.

    Science.gov (United States)

    McCabe, O Lee; Everly, George S; Brown, Lisa M; Wendelboe, Aaron M; Abd Hamid, Nor Hashidah; Tallchief, Vicki L; Links, Jonathan M

    2014-04-01

    Surges in demand for professional mental health services occasioned by disasters represent a major public health challenge. To build response capacity, numerous psychological first aid (PFA) training models for professional and lay audiences have been developed that, although often concurring on broad intervention aims, have not systematically addressed pedagogical elements necessary for optimal learning or teaching. We describe a competency-based model of PFA training developed under the auspices of the Centers for Disease Control and Prevention and the Association of Schools of Public Health. We explain the approach used for developing and refining the competency set and summarize the observable knowledge, skills, and attitudes underlying the 6 core competency domains. We discuss the strategies for model dissemination, validation, and adoption in professional and lay communities.

  7. Modeling of Core Competencies in the Registrar's Office

    Science.gov (United States)

    Pikowsky, Reta

    2009-01-01

    The Office of the Registrar at the Georgia Institute of Technology, in cooperation with the Office of Human Resources, has been engaged since February 2008 in a pilot project to model core competencies for the leadership team and the staff. It is the hope of the office of Human resources that this pilot will result in a model that can be used…

  8. What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa.

    Science.gov (United States)

    Olu, Olushayo; Usman, Abdulmumini; Kalambay, Kalula; Anyangwe, Stella; Voyi, Kuku; Orach, Christopher Garimoi; Azazh, Aklilu; Mapatano, Mala Ali; Nsenga, Ngoy; Manga, Lucien; Woldetsadik, Solomon; Nguessan, Francois; Benson, Angela

    2018-04-02

    As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states. We conducted a pilot research using mixed methods approaches to develop and test the applicability and feasibility of a public health disaster risk management curriculum for training the African health workforce. We identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. The pilot test of the basic course among a cohort of public health practitioners in South Africa demonstrated their relevance. These competencies compare favourably to the findings of other studies that have assessed public health DRM competencies. They could provide a framework for scaling up the capacity development of African healthcare workers in the area of public health DRM; however further validation of the competencies is required through additional pilot courses and follow up of

  9. Competing risks model in screening for preeclampsia by maternal characteristics and medical history.

    Science.gov (United States)

    Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H

    2015-07-01

    The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of

  10. Creation of a competency-based professional development program for infection preventionists guided by the APIC Competency Model: steps in the process.

    Science.gov (United States)

    Bernard, Heather; Hackbarth, Diana; Olmsted, Russell N; Murphy, Denise

    2018-06-07

    Infection Preventionists have varying levels of educational preparation. Many have no prior experience in IP. The diversity makes design of professional development programs challenging. Recent surveys suggest that only about half of practicing IPs are board certified. There is an urgent need to employ competent IP's to drive improvement in patient outcomes. This is a project that utilized the APIC Competency Model to create a professional development program characterizing three career stages. Methods included a review of literature on professional development; a survey of IP competence; an assessment of job descriptions and performance evaluations; and a crosswalk of IP competencies. The professional development program includes competency - based IP job descriptions and performance evaluations for each career stage; a professional portfolio; and a toolkit for supervisors. Participants agreed that application of the model resulted in tools which are more closely aligned with current roles for IPs; and increased satisfaction and motivation with the new program. Competent and knowledgeable IP's are crucial to optimizing efficacy of IPC programs. A professional development program has the potential to guide staff orientation, improve satisfaction and retention, improve patient outcomes and promote a positive trajectory in advancing practice. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Risk-based systems analysis for emerging technologies: Applications of a technology risk assessment model to public decision making

    International Nuclear Information System (INIS)

    Quadrel, M.J.; Fowler, K.M.; Cameron, R.; Treat, R.J.; McCormack, W.D.; Cruse, J.

    1995-01-01

    The risk-based systems analysis model was designed to establish funding priorities among competing technologies for tank waste remediation. The model addresses a gap in the Department of Energy's (DOE's) ''toolkit'' for establishing funding priorities among emerging technologies by providing disciplined risk and cost assessments of candidate technologies within the context of a complete remediation system. The model is comprised of a risk and cost assessment and a decision interface. The former assesses the potential reductions in risk and cost offered by new technology relative to the baseline risk and cost of an entire system. The latter places this critical information in context of other values articulated by decision makers and stakeholders in the DOE system. The risk assessment portion of the model is demonstrated for two candidate technologies for tank waste retrieval (arm-based mechanical retrieval -- the ''long reach arm'') and subsurface barriers (close-coupled chemical barriers). Relative changes from the base case in cost and risk are presented for these two technologies to illustrate how the model works. The model and associated software build on previous work performed for DOE's Office of Technology Development and the former Underground Storage Tank Integrated Demonstration, and complement a decision making tool presented at Waste Management 1994 for integrating technical judgements and non-technical (stakeholder) values when making technology funding decisions

  12. Theoretical Model of Development of Information Competence among Students Enrolled in Elective Courses

    Science.gov (United States)

    Zhumasheva, Anara; Zhumabaeva, Zaida; Sakenov, Janat; Vedilina, Yelena; Zhaxylykova, Nuriya; Sekenova, Balkumis

    2016-01-01

    The current study focuses on the research topic of creating a theoretical model of development of information competence among students enrolled in elective courses. In order to examine specific features of the theoretical model of development of information competence among students enrolled in elective courses, we performed an analysis of…

  13. Adopsi Model Competency Based Training dalam Kewirausahaan

    Directory of Open Access Journals (Sweden)

    I Ketut Santra

    2009-01-01

    Full Text Available The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulation the research continuing to implement the competency based training in the real class. The time consumed to implementing the CBT one semester, starting on September 2006 to early February 2007. The lesson learnt from the implementation period, the CBT could improve the student competence in Personal, Situational Strategic and Business. The three of the competencies are important for the success entrepreneur. It is a sign of application of “Kurikulum Berbasis Kompetensi”. There are many evidences to describe the achievement of the CBT in entrepreneurship subject. Firstly, physically achievement, that all of the student’s business plan could became the real business. The evidences are presented by picture of the student’s real business. Secondly theoretically achievement, that the Personal, Situational Strategic and Business competence statistically have significant relation with Business Plan even Real Business quality. The effect of the Personal, Situational Strategic and Business competence to Business Plan quality is 84.4%. and, to the Real Business quality 77.2%. The statistic’s evidence suggests that the redesign of the entrepreneurship subject is the right way. The content of the entrepreneur competence (Personal, Situational and Strategic and Business competence have impact to the student to conduct and running for own business.

  14. Applying the cube model to pediatric psychology: development of research competency skills at the doctoral level.

    Science.gov (United States)

    Madan-Swain, Avi; Hankins, Shirley L; Gilliam, Margaux Barnes; Ross, Kelly; Reynolds, Nina; Milby, Jesse; Schwebel, David C

    2012-03-01

    This article considers the development of research competencies in professional psychology and how that movement might be applied to training in pediatric psychology. The field of pediatric psychology has a short but rich history, and experts have identified critical competencies. However, pediatric psychology has not yet detailed a set of research-based competencies. This article initially reviews the competency initiative in professional psychology, including the cube model as it relates to research training. Next, we review and adapt the knowledge-based/foundational and applied/functional research competencies proposed by health psychology into a cube model for pediatric psychology. We focus especially on graduate-level training but allude to its application throughout professional development. We present the cube model as it is currently being applied to the development of a systematic research competency evaluation for graduate training at our medical/clinical psychology doctoral program at the University of Alabama at Birmingham. Based on the review and synthesis of the literature on research competency in professional psychology we propose future initiatives to develop these competencies for the field of pediatric psychology. The cube model can be successfully applied to the development of research training competencies in pediatric psychology. Future research should address the development, implementation, and assessment of the research competencies for training and career development of future pediatric psychologists.

  15. Autonomy, Competence and Non-interference.

    Science.gov (United States)

    Roberts, Joseph T F

    2017-12-30

    In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights to non-interference upon demonstration of competence. In this paper, I present a risk-sensitive account of competence as a means of grounding rights to non-interference. On a risk-sensitive account of competence individuals demonstrate their competence by exercising three capacities to the extent necessary to meet a threshold determined by the riskiness of the decision. These three capacities are the capacity to (i) acquire knowledge, (ii) use instrumental rationality, and (iii) form and revise a life plan.

  16. Androgen Deprivation Therapy Use in the Setting of High-dose Radiation Therapy and the Risk of Prostate Cancer–Specific Mortality Stratified by the Extent of Competing Mortality

    Energy Technology Data Exchange (ETDEWEB)

    Rose, Brent S., E-mail: brose44@gmail.com [Harvard Radiation Oncology Program, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Chen, Ming-Hui; Wu, Jing [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Braccioforte, Michelle H.; Moran, Brian J. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); Doseretz, Daniel E.; Katin, Michael J.; Ross, Rudolf H.; Salenius, Sharon A. [21st Century Oncology, Inc, Fort Myers, Florida (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2016-11-15

    Purpose: The addition of androgen deprivation therapy (ADT) to radiation therapy (RT) is the standard of care for men with intermediate- and high-risk prostate cancer (PC). However, whether competing mortality (CM) affects the ability of ADT to improve, survival remains unanswered. Methods and Materials: We calculated a CM risk score using a Fine-Gray semiparametric model that included age and cardiometabolic comorbidities from a cohort of 17,669 men treated with high-dose RT with or without supplemental ADT for nonmetastatic PC. Fine and Gray competing risk regression analysis was used to assess whether ADT reduced the risk of PC-specific mortality for men with a low versus a high risk of CM among the 4550 patients within the intermediate- and high-risk cohort after adjustment for established PC prognostic factors, year of treatment, site, and ADT propensity score. Results: After a median follow-up of 8.4 years, 1065 men had died, 89 (8.36%) of PC. Among the men with a low CM score, ADT use was associated with a significant reduction in the risk of PC-specific mortality (adjusted hazard ratio 0.35, 95% confidence interval 0.14-0.87, P=.02) but was not for men with high CM (adjusted hazard ratio 1.33, 95% confidence interval 0.77-2.30, P=.30). Conclusions: Adding ADT to high-dose RT appears to be associated with decreased PC-specific mortality risk in men with a low but not a high CM score. These data should serve to heighten awareness about the importance of considering competing risks when determining whether to add ADT to RT for older men with intermediate- or high-risk PC.

  17. Androgen Deprivation Therapy Use in the Setting of High-dose Radiation Therapy and the Risk of Prostate Cancer–Specific Mortality Stratified by the Extent of Competing Mortality

    International Nuclear Information System (INIS)

    Rose, Brent S.; Chen, Ming-Hui; Wu, Jing; Braccioforte, Michelle H.; Moran, Brian J.; Doseretz, Daniel E.; Katin, Michael J.; Ross, Rudolf H.; Salenius, Sharon A.; D'Amico, Anthony V.

    2016-01-01

    Purpose: The addition of androgen deprivation therapy (ADT) to radiation therapy (RT) is the standard of care for men with intermediate- and high-risk prostate cancer (PC). However, whether competing mortality (CM) affects the ability of ADT to improve, survival remains unanswered. Methods and Materials: We calculated a CM risk score using a Fine-Gray semiparametric model that included age and cardiometabolic comorbidities from a cohort of 17,669 men treated with high-dose RT with or without supplemental ADT for nonmetastatic PC. Fine and Gray competing risk regression analysis was used to assess whether ADT reduced the risk of PC-specific mortality for men with a low versus a high risk of CM among the 4550 patients within the intermediate- and high-risk cohort after adjustment for established PC prognostic factors, year of treatment, site, and ADT propensity score. Results: After a median follow-up of 8.4 years, 1065 men had died, 89 (8.36%) of PC. Among the men with a low CM score, ADT use was associated with a significant reduction in the risk of PC-specific mortality (adjusted hazard ratio 0.35, 95% confidence interval 0.14-0.87, P=.02) but was not for men with high CM (adjusted hazard ratio 1.33, 95% confidence interval 0.77-2.30, P=.30). Conclusions: Adding ADT to high-dose RT appears to be associated with decreased PC-specific mortality risk in men with a low but not a high CM score. These data should serve to heighten awareness about the importance of considering competing risks when determining whether to add ADT to RT for older men with intermediate- or high-risk PC.

  18. Accelerated reliability demonstration under competing failure modes

    International Nuclear Information System (INIS)

    Luo, Wei; Zhang, Chun-hua; Chen, Xun; Tan, Yuan-yuan

    2015-01-01

    The conventional reliability demonstration tests are difficult to apply to products with competing failure modes due to the complexity of the lifetime models. This paper develops a testing methodology based on the reliability target allocation for reliability demonstration under competing failure modes at accelerated conditions. The specified reliability at mission time and the risk caused by sampling of the reliability target for products are allocated for each failure mode. The risk caused by degradation measurement fitting of the target for a product involving performance degradation is equally allocated to each degradation failure mode. According to the allocated targets, the accelerated life reliability demonstration test (ALRDT) plans for the failure modes are designed. The accelerated degradation reliability demonstration test plans and the associated ALRDT plans for the degradation failure modes are also designed. Next, the test plan and the decision rules for the products are designed. Additionally, the effects of the discreteness of sample size and accepted number of failures for failure modes on the actual risks caused by sampling for the products are investigated. - Highlights: • Accelerated reliability demonstration under competing failure modes is studied. • The method is based on the reliability target allocation involving the risks. • The test plan for the products is based on the plans for all the failure modes. • Both failure mode and degradation failure modes are considered. • The error of actual risks caused by sampling for the products is small enough

  19. A goodness of fit and validity study of the Korean radiological technologists' core job competency model

    International Nuclear Information System (INIS)

    Lim, Chang Seon; Cho, A Ra; Hur, Yera; Choi, Seong Youl

    2017-01-01

    Radiological Technologists deals with the life of a person which means professional competency is essential for the job. Nevertheless, there have been no studies in Korea that identified the job competence of radiologists. In order to define the core job competencies of Korean radiologists and to present the factor models, 147 questionnaires on job competency of radiology were analyzed using 'PASW Statistics Version 18.0' and 'AMOS Version 18.0'. The valid model consisted of five core job competencies ('Patient management', 'Health and safety', 'Operation of equipment', 'Procedures and management') and 17 sub – competencies. As a result of the factor analysis, the RMSEA value was 0.1 and the CFI, and TLI values were close to 0.9 in the measurement model of the five core job competencies. The validity analysis showed that the mean variance extraction was 0.5 or more and the conceptual reliability value was 0.7 or more , And there was a high correlation between subordinate competencies included in each subordinate competencies. The results of this study are expected to provide specific information necessary for the training and management of human resources centered on competence by clearly showing the job competence required for radiologists in Korea's health environment

  20. Nonparametric Estimation of Cumulative Incidence Functions for Competing Risks Data with Missing Cause of Failure

    DEFF Research Database (Denmark)

    Effraimidis, Georgios; Dahl, Christian Møller

    In this paper, we develop a fully nonparametric approach for the estimation of the cumulative incidence function with Missing At Random right-censored competing risks data. We obtain results on the pointwise asymptotic normality as well as the uniform convergence rate of the proposed nonparametric...

  1. The Relation Between Adolescent Social Competence and Young Adult Delinquency and Educational Attainment Among At-Risk Youth: The Mediating Role of Peer Delinquency

    Science.gov (United States)

    Stepp, Stephanie D; Pardini, Dustin A; Loeber, Rolf; Morris, Nancy A

    2015-01-01

    Objective We examined trajectories of adolescent social competence as a resilience factor among at-risk youth. To examine potential mechanisms of this resilience process, we investigated the putative mediating effect of peer delinquency on the relation between adolescent social competence and young adult delinquency seriousness and educational attainment. Method Participants (n = 257) were screened to be at risk for antisocial behaviour at age 13 years. Data were derived from an ongoing longitudinal study of the development of antisocial and delinquent behaviour among inner-city boys, the Pittsburgh Youth Study. We used data collected from participants when aged 13 years until they were aged 25.5 years for our study. Results Results indicated that boys with high levels of social competence decreased their involvement with deviant peers throughout adolescence, which, in turn, predicted less serious forms of delinquency in early adulthood. Social competence had a direct effect on educational attainment in early adulthood, as boys who developed social competencies in adolescence went further in school irrespective of their involvement with delinquent peers. Conclusions Results suggest that promoting the development of social competencies and reducing involvement with delinquent peers will protect at-risk youth from engaging in serious delinquency in early adulthood while increasing their educational success. PMID:21878156

  2. Connecting Athletes’ Self-Perceptions and Metaperceptions of Competence: a Structural Equation Modeling Approach

    Directory of Open Access Journals (Sweden)

    Cecchini Jose A.

    2015-06-01

    Full Text Available This study explored the relationships between athletes’ competence self-perceptions and metaperceptions. Two hundred and fifty one student-athletes (14.26 ± 1.89 years, members of twenty different teams (basketball, soccer completed a questionnaire which included the Perception of Success Questionnaire, the Competence subscale of the Intrinsic Motivation Inventory, and modified versions of both questionnaires to assess athletes’ metaperceptions. Structural equation modelling analysis revealed that athletes’ task and ego metaperceptions positively predicted task and ego self-perceptions, respectively. Competence metaperceptions were strong predictors of competence selfperceptions, confirming the atypical metaperception formation in outcome-dependent contexts such as sport. Task and ego metaperceptions positively predicted athletes’ competence metaperceptions. How coaches value their athletes’ competence is more influential on what the athletes think of themselves than their own self-perceptions. Athletes’ ego and task metaperceptions influenced their competence metaperceptions (how coaches rate their competence. Therefore, athletes build their competence metaperceptions using all information available from their coaches. Finally, only taskself perfections positively predicted athletes’ competence self-perceptions.

  3. Connecting Athletes’ Self-Perceptions and Metaperceptions of Competence: a Structural Equation Modeling Approach

    Science.gov (United States)

    Cecchini, Jose A.; Fernández-Rio, Javier; Méndez-Giménez, Antonio

    2015-01-01

    This study explored the relationships between athletes’ competence self-perceptions and metaperceptions. Two hundred and fifty one student-athletes (14.26 ± 1.89 years), members of twenty different teams (basketball, soccer) completed a questionnaire which included the Perception of Success Questionnaire, the Competence subscale of the Intrinsic Motivation Inventory, and modified versions of both questionnaires to assess athletes’ metaperceptions. Structural equation modelling analysis revealed that athletes’ task and ego metaperceptions positively predicted task and ego self-perceptions, respectively. Competence metaperceptions were strong predictors of competence self-perceptions, confirming the atypical metaperception formation in outcome-dependent contexts such as sport. Task and ego metaperceptions positively predicted athletes’ competence metaperceptions. How coaches value their athletes’ competence is more influential on what the athletes think of themselves than their own self-perceptions. Athletes’ ego and task metaperceptions influenced their competence metaperceptions (how coaches rate their competence). Therefore, athletes build their competence metaperceptions using all information available from their coaches. Finally, only task-self perfections positively predicted athletes’ competence self-perceptions. PMID:26240662

  4. Extensions and Applications of the Cox-Aalen Survival Model

    DEFF Research Database (Denmark)

    Scheike, Thomas H.; Zhang, Mei-Jie

    2003-01-01

    Aalen additive risk model; competing risk; counting processes; Cox model; cumulative incidence function; goodness of fit; prediction of survival probability; time-varying effects......Aalen additive risk model; competing risk; counting processes; Cox model; cumulative incidence function; goodness of fit; prediction of survival probability; time-varying effects...

  5. Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: an examination of concurrent validity.

    Science.gov (United States)

    Parker, Andrew M; Weller, Joshua A

    2015-01-01

    Decision-making competence reflects individual differences in the susceptibility to committing decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate processes that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such process, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when EV favors those options and (b) avoiding risky options when EV favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

  6. Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: An examination of concurrent validity

    Directory of Open Access Journals (Sweden)

    Andrew M Parker

    2015-05-01

    Full Text Available Decision-making competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules. Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC and one such mechanism, the degree to which individuals make choices consistent with maximizing expected value (EV. Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a choosing risky options when expected value favors those options and (b avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

  7. Cultural competence in end-of-life care: terms, definitions, and conceptual models from the British literature.

    Science.gov (United States)

    Evans, Natalie; Meñaca, Arantza; Koffman, Jonathan; Harding, Richard; Higginson, Irene J; Pool, Robert; Gysels, Marjolein

    2012-07-01

    Cultural competency is increasingly recommended in policy and practice to improve end-of-life (EoL) care for minority ethnic groups in multicultural societies. It is imperative to critically analyze this approach to understand its underlying concepts. Our aim was to appraise cultural competency approaches described in the British literature on EoL care and minority ethnic groups. This is a critical review. Articles on cultural competency were identified from a systematic review of the literature on minority ethnic groups and EoL care in the United Kingdom. Terms, definitions, and conceptual models of cultural competency approaches were identified and situated according to purpose, components, and origin. Content analysis of definitions and models was carried out to identify key components. One-hundred thirteen articles on minority ethnic groups and EoL care in the United Kingdom were identified. Over half (n=60) contained a term, definition, or model for cultural competency. In all, 17 terms, 17 definitions, and 8 models were identified. The most frequently used term was "culturally sensitive," though "cultural competence" was defined more often. Definitions contained one or more of the components: "cognitive," "implementation," or "outcome." Models were categorized for teaching or use in patient assessment. Approaches were predominantly of American origin. The variety of terms, definitions, and models underpinning cultural competency approaches demonstrates a lack of conceptual clarity, and potentially complicates implementation. Further research is needed to compare the use of cultural competency approaches in diverse cultures and settings, and to assess the impact of such approaches on patient outcomes.

  8. Preliminary clinical nursing leadership competency model: a qualitative study from Thailand.

    Science.gov (United States)

    Supamanee, Treeyaphan; Krairiksh, Marisa; Singhakhumfu, Laddawan; Turale, Sue

    2011-12-01

    This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model. © 2011 Blackwell Publishing Asia Pty Ltd.

  9. Conceptualization and Pilot Testing of a Core Competency-Based Training Workshop in Suicide Risk Assessment and Management: Notes From the Field.

    Science.gov (United States)

    Cramer, Robert J; Bryson, Claire N; Eichorst, Morgam K; Keyes, Lee N; Ridge, Brittany E

    2017-03-01

    As professional psychology training programs and continuing education have moved toward competency based approaches, it has become equally important to develop uniform, evidence-based approaches for suicide risk assessment and management. The present article presents a workshop curriculum based on established core competencies in suicide risk assessment and management. Drawing on theories suicide risk formation, the workshop features an integration of didactic, process, and experiential components. We present pilot data from 2 small group workshops (n = 17): 1 from a clinical psychology doctoral program and 1 from a university counseling center. Workshop participation yielded increases in (a) the ability to recognize appropriate clinician responses to suicidal client statements, (b) self-perceptions of general capacity to interface with suicidal patients and mastery of the 10 core competencies, (c) factual knowledge concerning suicide risk assessment and management, and (d) the self-rated ability to assess and manage a suicidal patient. We discuss statistical and generalizability limitations as well as implications for future modification, implementation, and provision of this training method. © 2016 Wiley Periodicals, Inc.

  10. On Statistical Analysis of Competing Risks with Application to the Time of First Goal

    Czech Academy of Sciences Publication Activity Database

    Volf, Petr

    2016-01-01

    Roč. 2, č. 10 (2016), s. 606-623, č. článku 2. ISSN 2411-2518 R&D Projects: GA ČR GA13-14445S Institutional support: RVO:67985556 Keywords : survival analysis * competing risks * sports statistics Subject RIV: BB - Applied Statistics, Operational Research http://library.utia.cas.cz/separaty/2016/SI/volf-0466157.pdf

  11. Multicultural Grand Rounds: Competency-Based Training Model for Clinical Psychology Graduate Students

    Science.gov (United States)

    Stites, Shana D.; Warholic, Christina L.

    2014-01-01

    Preparing students to enter the field of psychology as competent professionals requires that multicultural practices be infused into all areas of training. This article describes how the Grand Rounds model was adapted to a graduate clinical psychology training program to foster applied learning in multicultural competence. This extension of Grand…

  12. A Model and Measure of Mobile Communication Competence

    Science.gov (United States)

    Bakke, Emil

    2010-01-01

    This article deals with two studies that develop a measure and model of mobile communication competence (MCC). The first study examines the dimensionality of the measure by conducting an exploratory factor analysis on 350 students at a large university in the midwestern United States. Results identified six constructs across 24 items: willingness…

  13. Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model.

    Science.gov (United States)

    Guenter, Peggi; Boullata, Joseph I; Ayers, Phil; Gervasio, Jane; Malone, Ainsley; Raymond, Erica; Holcombe, Beverly; Kraft, Michael; Sacks, Gordon; Seres, David

    2015-08-01

    Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff. © 2015 American Society for Parenteral and Enteral Nutrition.

  14. Statistical Analysis of Competing Risks: Overall Survival in a Group of Chronic Myeloid Leukemia Patients

    Czech Academy of Sciences Publication Activity Database

    Fürstová, Jana; Valenta, Zdeněk

    2011-01-01

    Roč. 7, č. 1 (2011), s. 2-10 ISSN 1801-5603 Institutional research plan: CEZ:AV0Z10300504 Keywords : competing risks * chronic myeloid leukemia (CML) * overall survival * cause-specific hazard * cumulative incidence function Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Furstova_en.pdf

  15. The outcome competency framework for practitioners in infection prevention and control: use of the outcome logic model for evaluation.

    Science.gov (United States)

    Burnett, E; Curran, E; Loveday, H P; Kiernan, M A; Tannahill, M

    2014-01-01

    Healthcare is delivered in a dynamic environment with frequent changes in populations, methods, equipment and settings. Infection prevention and control practitioners (IPCPs) must ensure that they are competent in addressing the challenges they face and are equipped to develop infection prevention and control (IPC) services in line with a changing world of healthcare provision. A multifaceted Framework was developed to assist IPCPs to enhance competence at an individual, team and organisational level to enable quality performance and improved quality of care. However, if these aspirations are to be met, it is vital that competency frameworks are fit for purpose or they risk being ignored. The aim of this unique study was to evaluate short and medium term outcomes as set out in the Outcome Logic Model to assist with the evaluation of the impact and success of the Framework. This study found that while the Framework is being used effectively in some areas, it is not being used as much or in the ways that were anticipated. The findings will enable future work on revision, communication and dissemination, and will provide intelligence to those initiating education and training in the utilisation of the competences.

  16. Competing events and costs of clinical trials: Analysis of a randomized trial in prostate cancer

    International Nuclear Information System (INIS)

    Zakeri, Kaveh; Rose, Brent S.; D’Amico, Anthony V.; Jeong, Jong-Hyeon; Mell, Loren K.

    2015-01-01

    Background: Clinical trial costs may be reduced by identifying enriched subpopulations of patients with favorable risk profiles for the events of interest. However, increased selectivity affects accrual rates, with uncertain impact on clinical trial cost. Methods: We conducted a secondary analysis of Southwest Oncology Group (SWOG) 8794 randomized trial of adjuvant radiotherapy for high-risk prostate cancer. The primary endpoint was metastasis-free survival (MFS), defined as time to metastasis or death from any cause (competing mortality). We used competing risks regression models to identify an enriched subgroup at high risk for metastasis and low risk for competing mortality. We applied a cost model to estimate the impact of enrichment on trial cost and duration. Results: The treatment effect on metastasis was similar in the enriched subgroup (HR, 0.42; 95% CI, 0.23–0.76) compared to the whole cohort (HR, 0.50; 95% CI, 0.30–0.81) while the effect on competing mortality was not significant in the subgroup or the whole cohort (HR 0.70; 95% CI 0.39–1.23, vs. HR 0.94; 95% CI, 0.68–1.31). Due to the higher incidence of metastasis relative to competing mortality in the enriched subgroup, the treatment effect on MFS was greater in the subgroup compared to the whole cohort (HR 0.55; 95% CI 0.36–0.82, vs. HR 0.77; 95% CI, 0.58–1.01). Trial cost was 75% less in the subgroup compared to the whole cohort ($1.7 million vs. $6.8 million), and the trial duration was 30% shorter (8.4 vs. 12.0 years). Conclusion: Competing event enrichment can reduce clinical trial cost and duration, without sacrificing generalizability

  17. The Evaluation of Modelling Competences: Difficulties and Potentials for the Learning of the Sciences

    Science.gov (United States)

    Lopes, J. Bernardino; Costa, Nilza

    2007-01-01

    Modelling is an inherent process for the construction and use of science concepts that mobilize diverse specific competences. The aims of this work are to put forward a means of evaluating modelling competences that is relevant for physics teaching and science education research and to identify the potentials and constraints in the development of…

  18. Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results.

    Science.gov (United States)

    Owiti, J A; Ajaz, A; Ascoli, M; de Jongh, B; Palinski, A; Bhui, K S

    2014-01-01

    Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes. At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown. We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals. The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation. Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner

  19. A test of the California competency-based differentiated role model.

    Science.gov (United States)

    Keating, Sarah B; Rutledge, Dana N; Sargent, Arlene; Walker, Polly

    2003-01-01

    To address the incongruence between the expectations of nursing service and education in California, the Education Industry Interface Task Force of the California Strategic Planning Committee for Nursing developed descriptions to assist employers and educators in clearly differentiating practice and educational competencies. The completion of the Competency-Based Role Differentiation Model resulted in the need to test the model for its utility in the service setting, in education, and for career planning for nurses. Three alpha demonstration sites were selected based on representative geographical regions of California. The sites were composed of tri-partnerships consisting of a medical center, an associate degree in nursing program, and a baccalaureate nursing program. Observers rated senior students and new graduates in medical-surgical units on their behaviors in teacher and leadership care provider and care coordinator roles. The alpha demonstration study results were as expected. That is, senior students practice predominantly at a novice level in teacher and management/leadership care provider functions and new graduates practice predominately at the competent level. New graduates are more likely to take on novice and competent care coordinator roles. The CBRDM may be useful for practice and education settings to evaluate student and nurse performance, to define role expectations, and to identify the preparation necessary for the roles. It is useful for all of nursing as it continues to define its levels of practice and their relationship to on-the-job performance, curriculum development, and carrier planning.

  20. Improving Intercultural Competence in the Classroom: A Reflective Development Model

    Science.gov (United States)

    Feng, Jing Betty

    2016-01-01

    To meet the increased demand for international business education that prepares college students for studying, living, or working overseas, I propose a four-stage reflective development model to be used in the traditional classroom context to enhance intercultural competence for undergraduate students. I employ the model in a personal development…

  1. DEVELOPING A MODEL OF COMPETENCY AND EXPERTISE CERTIFICATION TESTS FOR VOCATIONAL HIGH SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    Pardjono Pardjono

    2015-12-01

    Full Text Available This study aims to: (1 develop, produce, and investigate the appropriateness model of competency and expertise certification tests for vocational high school (VHS students of the Mechanical Engineering expertise competency.To attain the objectives, the researcher conducted a research and development study consisting of 10 steps. The research product was validated by experts, VHS teachers, and lecturers at Mechanical Engineering Education through Focus Group Discussion (FGD, and the field tryout conducted at SMK Warga Surakarta and SMK Bhineka Karya Simo, Boyolali, Central Java. The results of the study are. (1 The study produces a model of Competency and Expertise Certification Tests Based on the School Production Unit (CECT_SPU for VHS Students of the Mechanical Engineering Expertise Competency; (2 The CECT_SPU model satisfies the criteria for a good modelby a mean score of 3.557; (3 The mean score of the model implementation in the tryouts were 3.670 in the individual tryout and 3.730 in the small-group tryout;  (4 The CECT_SPU model satisfies the criteria for an effective modelby a mean score of 3.730; (5 The CECT_SPU model satisfies the criteria for an efficient modelby a mean score of 3.780; (6 The CECT_SPU model satisfies the criteria for a practical model; by a mean score of 3.700.

  2. A goodness of fit and validity study of the Korean radiological technologists' core job competency model

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chang Seon [Dept. of Radiological Science, Konyang University College of Medical Sciences, Daejeon (Korea, Republic of); Cho, A Ra [Dept. of Medical Education, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Hur, Yera [Dept. of Medical Education, Konyang University College of Medicine, Daejeon (Korea, Republic of); Choi, Seong Youl [Dept. of Occupational Therapy, Kwangju women’s University, Gwangju (Korea, Republic of)

    2017-09-15

    Radiological Technologists deals with the life of a person which means professional competency is essential for the job. Nevertheless, there have been no studies in Korea that identified the job competence of radiologists. In order to define the core job competencies of Korean radiologists and to present the factor models, 147 questionnaires on job competency of radiology were analyzed using 'PASW Statistics Version 18.0' and 'AMOS Version 18.0'. The valid model consisted of five core job competencies ('Patient management', 'Health and safety', 'Operation of equipment', 'Procedures and management') and 17 sub – competencies. As a result of the factor analysis, the RMSEA value was 0.1 and the CFI, and TLI values were close to 0.9 in the measurement model of the five core job competencies. The validity analysis showed that the mean variance extraction was 0.5 or more and the conceptual reliability value was 0.7 or more , And there was a high correlation between subordinate competencies included in each subordinate competencies. The results of this study are expected to provide specific information necessary for the training and management of human resources centered on competence by clearly showing the job competence required for radiologists in Korea's health environment.

  3. Competing Risk Analysis of Neurologic versus Nonneurologic Death in Patients Undergoing Radiosurgical Salvage After Whole-Brain Radiation Therapy Failure: Who Actually Dies of Their Brain Metastases?

    International Nuclear Information System (INIS)

    Lucas, John T.; Colmer, Hentry G.; White, Lance; Fitzgerald, Nora; Isom, Scott; Bourland, John D.; Laxton, Adrian W.; Tatter, Stephen B.; Chan, Michael D.

    2015-01-01

    Purpose: To estimate the hazard for neurologic (central nervous system, CNS) and nonneurologic (non-CNS) death associated with patient, treatment, and systemic disease status in patients receiving stereotactic radiosurgery after whole-brain radiation therapy (WBRT) failure, using a competing risk model. Patients and Methods: Of 757 patients, 293 experienced recurrence or new metastasis following WBRT. Univariate Cox proportional hazards regression identified covariates for consideration in the multivariate model. Competing risks multivariable regression was performed to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for both CNS and non-CNS death after adjusting for patient, disease, and treatment factors. The resultant model was converted into an online calculator for ease of clinical use. Results: The cumulative incidence of CNS and non-CNS death at 6 and 12 months was 20.6% and 21.6%, and 34.4% and 35%, respectively. Patients with melanoma histology (relative to breast) (aHR 2.7, 95% CI 1.5-5.0), brainstem location (aHR 2.1, 95% CI 1.3-3.5), and number of metastases (aHR 1.09, 95% CI 1.04-1.2) had increased aHR for CNS death. Progressive systemic disease (aHR 0.55, 95% CI 0.4-0.8) and increasing lowest margin dose (aHR 0.97, 95% CI 0.9-0.99) were protective against CNS death. Patients with lung histology (aHR 1.3, 95% CI 1.1-1.9) and progressive systemic disease (aHR 2.14, 95% CI 1.5-3.0) had increased aHR for non-CNS death. Conclusion: Our nomogram provides individual estimates of neurologic death after salvage stereotactic radiosurgery for patients who have failed prior WBRT, based on histology, neuroanatomical location, age, lowest margin dose, and number of metastases after adjusting for their competing risk of death from other causes

  4. Competing Risk Analysis of Neurologic versus Nonneurologic Death in Patients Undergoing Radiosurgical Salvage After Whole-Brain Radiation Therapy Failure: Who Actually Dies of Their Brain Metastases?

    Energy Technology Data Exchange (ETDEWEB)

    Lucas, John T., E-mail: jolucas@wakehealth.edu [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Colmer, Hentry G.; White, Lance [Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Fitzgerald, Nora; Isom, Scott [Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Bourland, John D. [Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (United States); Laxton, Adrian W. [Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (United States); Tatter, Stephen B. [Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Chan, Michael D. [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States)

    2015-08-01

    Purpose: To estimate the hazard for neurologic (central nervous system, CNS) and nonneurologic (non-CNS) death associated with patient, treatment, and systemic disease status in patients receiving stereotactic radiosurgery after whole-brain radiation therapy (WBRT) failure, using a competing risk model. Patients and Methods: Of 757 patients, 293 experienced recurrence or new metastasis following WBRT. Univariate Cox proportional hazards regression identified covariates for consideration in the multivariate model. Competing risks multivariable regression was performed to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for both CNS and non-CNS death after adjusting for patient, disease, and treatment factors. The resultant model was converted into an online calculator for ease of clinical use. Results: The cumulative incidence of CNS and non-CNS death at 6 and 12 months was 20.6% and 21.6%, and 34.4% and 35%, respectively. Patients with melanoma histology (relative to breast) (aHR 2.7, 95% CI 1.5-5.0), brainstem location (aHR 2.1, 95% CI 1.3-3.5), and number of metastases (aHR 1.09, 95% CI 1.04-1.2) had increased aHR for CNS death. Progressive systemic disease (aHR 0.55, 95% CI 0.4-0.8) and increasing lowest margin dose (aHR 0.97, 95% CI 0.9-0.99) were protective against CNS death. Patients with lung histology (aHR 1.3, 95% CI 1.1-1.9) and progressive systemic disease (aHR 2.14, 95% CI 1.5-3.0) had increased aHR for non-CNS death. Conclusion: Our nomogram provides individual estimates of neurologic death after salvage stereotactic radiosurgery for patients who have failed prior WBRT, based on histology, neuroanatomical location, age, lowest margin dose, and number of metastases after adjusting for their competing risk of death from other causes.

  5. Elementary Schoolchildren's Perceived Competence and Physical Activity Involvement: The Influence of Parents' Role Modelling Behaviours and Perceptions of their Child's Competence

    OpenAIRE

    Bois, Julien; Sarrazin, Philippe; Brustad, Robert; Trouilloud, David; Cury, François

    2005-01-01

    International audience; Objectives. To study the influence of fathers' and mothers' physical activity involvement and perceptions of their children's physical competence upon children's perceptions of competence and children's time spent in physical activity. Two forms of parental socialization influence were assessed: the direct influence of parents' actual physical activity (PA) behaviour (role modelling) on children's physical activity and the indirect influence of parents' beliefs systems...

  6. Analysis of competing risk parameters in irradiated prostate cancer patients

    International Nuclear Information System (INIS)

    Mayer, R.; Mayer, E.; Langsenlehner, U.; Hackl, A.; Pummer, K.; Quehenberger, F.; Feigl, G.

    2003-01-01

    Purpose: Retrospective competing risk analysis of prognostic factors in definitive-irradiated prostate cancer patients. Patients and Methods: Data of 652 patients were analyzed according to three age subgroups ( 75 years; Table 1). Pre-RT PSA values (median 13.4 ng/ml) were available for 340 patients. Adjuvant hormone therapy (n = 261) consisted either of orchiectomy (n = 151) or LHRH agonist with/without antiandrogen therapy or, in the early years, diethystilbestrol. Neoadjuvant hormone therapy (n = 31) using LHRH agonists was given 6 months before and during radiotherapy. Results: Biochemical failure was observed in 69/.340 patients, 5 years after biochemical failure, 64.9% of them also had failed clinically. The cumulative incidence of local failure (LF) and distant metastases (DM) was 9.4% and 37.2%, respectively; LF and DM at the same time were seen in 18.2%. On multivariate analysis (Tables 2 and 3), advanced stage (relative risk [RR] 4.54), pre-RT PSA > 20 ng/ml (RR 2.79) and poorly differentiated tumors (RR 2.96) were significant predictors of biochemical failure. Advanced stage increased the risk of LF (RR 2.18), DM (RR 3.66), and prostate cancer death (PCD; RR 4.30). Hormone therapy decreased the risk of biochemical failure (RR 0.67), DM (RR 0.59), and PCD (RR 0.60) without reaching statistical significance. Median follow-up was 7.6 years. Conclusion: Risk of biochemical failure was predicted by pre-RT PSA, stage, and grade; in patients with biochemical failure, the cumulative incidence of death from intercurrent diseases and PCD was 25.0% and 29.2% after 5 years, respectively. The risk of DM and PCD was predicted by stage and grade. Higher age (> 75 years) decreased the relative risk of LF, DM, and PCD significantly. (orig.)

  7. Cogenerating a Competency-based HRM Degree: A Model and Some Lessons from Experience.

    Science.gov (United States)

    Wooten, Kevin C.; Elden, Max

    2001-01-01

    A competency-based degree program in human resource management was co-generated by six groups of stakeholders who synthesized competency models using group decision support software. The program focuses on core human resource processes, general business management, strategic decision making and problem solving, change management, and personal…

  8. Development of affective modelling competencies in primary school learners

    Directory of Open Access Journals (Sweden)

    Piera Biccard

    2011-09-01

    Full Text Available Learner affect and beliefs about mathematics are complex and multifaceted aspects of mathematical learning. Traditional teaching and learning approaches in mathematics education often result in problematic beliefs about mathematics. Since beliefs influence what learners learn and how they deal with learning mathematics, it is essential that the roles of beliefs and affect in mathematics classrooms are carefully examined. In solving modelling problems, learners and teachers take on new roles in the classroom: learners are placed in an active, self-directing situation in which they solve real-world problems. When learners engage in modelling tasks, they display and integrate cognitive, meta-cognitive and affective competencies. A modelling approach therefore allows one to detect learner beliefs in an authentic learning environment. Will this environment lead to students having more positive and productive dispositions towards mathematics? This article presents partial results of a study documenting the development of modelling competencies in learners working in groups over a period of 12 weeks. Through a design research approach, 12 learners working in groups solved three modelling problems, and transcriptions of learner interactions, questionnaires and informal interviews revealed that learner beliefs improved over this short period when exposed to modelling tasks. The results are encouraging, and may provide mathematics education with an avenue to develop more positive learner beliefs in mathematics.

  9. Model Manipulation and Learning: Fostering Representational Competence with Virtual and Concrete Models

    Science.gov (United States)

    Stull, Andrew T.; Hegarty, Mary

    2016-01-01

    This study investigated the development of representational competence among organic chemistry students by using 3D (concrete and virtual) models as aids for teaching students to translate between multiple 2D diagrams. In 2 experiments, students translated between different diagrams of molecules and received verbal feedback in 1 of the following 3…

  10. Competency model for the project managers of technical projects

    Science.gov (United States)

    Duncan, William R.

    1992-05-01

    Traditional job description techniques were developed to support compensation decisions for hourly wage earners in a manufacturing environment. Their resultant focus on activities performed on the job works well in this environment where the ability to perform the activity adequately is objectively verifiable by testing and observation. Although many organizations have adapted these techniques for salaried employees and service environments, the focus on activities performed has never been satisfactory. For example, stating that a project manager `prepares regular project status reports' tells us little about what to look for in a potential project manager or how to determine if a practicing project manager is ready for additional responsibilities. The concept of a `competency model' has been developed within the last decade to address this shortcoming. Competency models focus on what skills are needed to perform the tasks defined by the job description. For example, a project manager must be able to communicate well both orally and in writing in order to `prepare regular project status reports.'

  11. Crude incidence in two-phase designs in the presence of competing risks

    Directory of Open Access Journals (Sweden)

    Paola Rebora

    2016-01-01

    Full Text Available Abstract Background In many studies, some information might not be available for the whole cohort, some covariates, or even the outcome, might be ascertained in selected subsamples. These studies are part of a broad category termed two-phase studies. Common examples include the nested case-control and the case-cohort designs. For two-phase studies, appropriate weighted survival estimates have been derived; however, no estimator of cumulative incidence accounting for competing events has been proposed. This is relevant in the presence of multiple types of events, where estimation of event type specific quantities are needed for evaluating outcome. Methods We develop a non parametric estimator of the cumulative incidence function of events accounting for possible competing events. It handles a general sampling design by weights derived from the sampling probabilities. The variance is derived from the influence function of the subdistribution hazard. Results The proposed method shows good performance in simulations. It is applied to estimate the crude incidence of relapse in childhood acute lymphoblastic leukemia in groups defined by a genotype not available for everyone in a cohort of nearly 2000 patients, where death due to toxicity acted as a competing event. In a second example the aim was to estimate engagement in care of a cohort of HIV patients in resource limited setting, where for some patients the outcome itself was missing due to lost to follow-up. A sampling based approach was used to identify outcome in a subsample of lost patients and to obtain a valid estimate of connection to care. Conclusions A valid estimator for cumulative incidence of events accounting for competing risks under a general sampling design from an infinite target population is derived.

  12. The Optimization of Human Resource’s Performance in Islamic Microfinance Institutions Through Job Analysis and Competency Model

    Directory of Open Access Journals (Sweden)

    verni yuliaty ismail

    2015-07-01

    Full Text Available Abstract. This study aims to develop a standard job analysis and human resource competency model for Islamic Micro Finance Institutions (Baitul Maal wat Tamwil, so it could be a reference for others, providing a standard professional human resources management on MFIs. This research is a field study designed as a survey, through the method of interviewing job holders and the supervisor with direct observation of the activities of field staffs. The data was analysed in the form of a verbal description of qualitative data. The main activity of the staff of MFIs is to encourage the low economic community through the activities of saving and financing. MFIs main characteristic is the principle of being directly in the field thus forming networks through regular meetings and maintaining a reliable service. MFIs personnel competency model consists of a cluster model based on teamwork/collaboration, customer focus, and communication competencies; technical cluster includes technical expertise and managing work competencies; and personal cluster is integrity, achievement orientation, and self-control competencies.Keywords: Baitul Mal Wattamwi, competency model, job description, job specification, micro finance institution

  13. The Optimization of Human Resource’s Performance in Islamic Microfinance Institutions Through Job Analysis and Competency Model

    Directory of Open Access Journals (Sweden)

    Verni Yuliaty Ismail

    2015-06-01

    Full Text Available Abstract. This study aims to develop a standard job analysis and human resource competency model for Islamic Micro Finance Institutions (Baitul Maal wat Tamwil, so it could be a reference for others, providing a standard professional human resources management on MFIs. This research is a field study designed as a survey, through the method of interviewing job holders and the supervisor with direct observation of the activities of field staffs. The data was analysed in the form of a verbal description of qualitative data. The main activity of the staff of MFIs is to encourage the low economic community through the activities of saving and financing. MFIs main characteristic is the principle of being directly in the field thus forming networks through regular meetings and maintaining a reliable service. MFIs personnel competency model consists of a cluster model based on teamwork/collaboration, customer focus, and communication competencies; technical cluster includes technical expertise and managing work competencies; and personal cluster is integrity, achievement orientation, and self-control competencies. Keywords: Baitul Mal Wattamwi, competency model, job description, job specification, micro finance institution

  14. Emotional competence relating to perceived stress and burnout in Spanish teachers: a mediator model

    OpenAIRE

    Lourdes Rey; Natalio Extremera; Mario Pena

    2016-01-01

    This study examined direct associations between emotional competence, perceived stress and burnout in 489 Spanish teachers. In addition, a model in which perceived stress mediated pathways linking emotional competence to teacher burnout symptoms was also examined. Results showed that emotional competence and stress were significantly correlated with teacher burnout symptoms in the expected direction. Moreover, mediational analysis indicated that perceived stress partly mediated the relationsh...

  15. Intelligence quotient discrepancy indicates levels of motor competence in preschool children at risk for developmental delays

    Directory of Open Access Journals (Sweden)

    Yu TY

    2016-02-01

    Full Text Available Tzu-Ying Yu,1 Kuan-Lin Chen,2,3 Willy Chou,4,5 Shu-Han Yang,4 Sheng-Chun Kung,4 Ya-Chen Lee,2 Li-Chen Tung4,6,7 1Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung, 2Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 3Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 4Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, 5Department of Recreation and Health Care Management, Cha Nan University of Pharmacy and Science, Tainan, 6School of Medicine, Kaohsiung Medical University, Kaohsiung, 7School of Medicine, Chung Shan Medical University, Taichung, Taiwan Purpose: This study aimed to establish 1 whether a group difference exists in the motor competence of preschool children at risk for developmental delays with intelligence quotient discrepancy (IQD; refers to difference between verbal intelligence quotient [VIQ] and performance intelligence quotient [PIQ] and 2 whether an association exists between IQD and motor competence.Methods: Children’s motor competence and IQD were determined with the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers and Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition. A total of 291 children were included in three groups: NON-IQD (n=213; IQD within 1 standard deviation [SD], VIQ>PIQ (n=39; VIQ>PIQ greater than 1 SD, and PIQ>VIQ (n=39; PIQ>VIQ greater than 1 SD.Results: The results of one-way analysis of variance indicated significant differences among the subgroups for the “Gross and fine motor” subdomains of the Comprehensive Developmental Inventory for Infants and Toddlers, especially on the subtests of “body-movement coordination” (F=3.87, P<0.05 and “visual-motor coordination” (F=6.90, P<0.05. Motor competence was significantly

  16. The validation of a human resource management professional competence model for the South African context

    OpenAIRE

    Nico Schutte; Nicolene Barkhuizen; Lidewey van der Sluis

    2015-01-01

    Orientation: The last two decades have seen a great interest in the development of human resource management (HRM) professional competence models to advance the value-add of HR practitioners in organisations. However, empirical research on competency requirements for HR practitioners in the South African context has not been forthcoming. Research purpose: The main objective of the present research was to validate a HRM competence measure for the assessment of professional HRM competencies ...

  17. An Effective Model for Improving Global Health Nursing Competence.

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.

  18. An Effective Model for Improving Global Health Nursing Competence

    Directory of Open Access Journals (Sweden)

    Sunjoo Kang

    2016-09-01

    Full Text Available This paper developed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by implementing four programs. All programs were conducted with students majoring nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, most of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre and post-program implementation. We discuss how identifying students’ needs regarding global nursing competence when developing appropriate curricula.

  19. Training Needs Assessment for Leaders in Nursing Based on Comparison of Competency Models

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    Kvas Andreja

    2014-02-01

    Full Text Available Background and Purpose: The main purpose behind the formation of leadership competency models must be the improvement of leadership. A competency model should serve as one of the tools for selecting the most suitable leaders, appraising their work, assessing training needs and preparing programmes of functional and formal education. The objective of this research is to assess the training needs of leaders in health care. A comparison of leadership competency models between different professional groups should serve as one of the tools with which to assess the training needs of various levels of leaders. Design/Methodology/Approach: A descriptive study using a survey design was conducted on 141 nurse leaders in Slovenia. Respondents indicated to what extent each of 95 different behaviours was characteristic of a person at their leadership level. Results: The most important competence dimensions (groups of behaviours for leaders in health care are (1 at the first - top leadership level: strategic thinking, openness to change and responsibility; (2 for leaders at the second - middle leadership level: relations with co-workers, animation, resistance to stress; and (3 for leaders at the third leadership level: realisation skills, execution of procedures, communication. Training needs assessments were done for three leadership levels in nursing care. Conclusions: The greatest need for training of nurse leaders can be observed at the third leadership level. Special training programmes should be organised in the competency areas of realisation skills, execution of procedures, communication, education and ethics

  20. Developing a Model for an Innovative Culinary Competency Curriculum and Examining Its Effects on Students' Performance

    Science.gov (United States)

    Hu, Meng-Lei I-Chen Monica; Horng, Jeou-Shyan; Teng, Chih-Ching

    2016-01-01

    The present study designs and develops an innovative culinary competency curriculum (ICCC) model comprising seven sections: innovative culture, aesthetics, techniques, service, product, management, and creativity. The model is formulated based on culinary concept, creativity, innovation, and competency theory. The four elements of curriculum…

  1. Structuring and self-competence: How they can make a difference in assessing and managing risk

    Directory of Open Access Journals (Sweden)

    Virtu Chongtham

    2015-01-01

    Full Text Available Background: Assessing risk is a mandatory part of standard mental health practice in the West, but is fraught with difficulties. Structuring and self-efficacy are important factors, but there is near absence of work on this aspect from India. This study aimed to determine how these two concepts can make a difference in assessing and managing risk. Methods: A prospective cross-sectional study over 2 months was conducted with 35 participants (dealing with patients with mental illnesses from Department of Psychiatry, Government Medical College and Hospital-32, Chandigarh and 30 participants in comparison group (dealing with people with intellectual disabilities from Regional Institute of Mentally Handicapped-31, Chandigarh using Risk Assessment and Management Self-efficacy Scale (RAMSES. Results : In overall sample (n = 65, only 17% reported using a screening instrument while 62% reported use of screening questions thereby making the total prevalence of use of screening instruments and/or questions as 79%. Total RAMSES score and mean score for all three domains was 7.14 and between 7 and 8 respectively for the study group; while for the comparison group, the total RAMSES score was 7.92 and the mean score for all three domains was between 7 and 9 respectively indicating above average level of reported self-efficacy. For the individual RAMSES items, a lower competency (<7 for study group and (<8 for comparison group was reported for formal or written process related to synthesis of risk assessment and risk management. The study group showed lower self-efficacy scores on majority of individual RAMSES items, 2/3 domains and overall score. Conclusions: Indian mental health professionals of different backgrounds with varying duration of experience reported reasonable degree of competence regarding risk assessment (primarily for the risk toward self and others. Hence, we recommend that they embrace the western concept of "risk assessment" by incorporating

  2. The Subject-Modeling Approach to Developing the Methodol- ogy Competence of the Future Teachers-Psychologists

    Directory of Open Access Journals (Sweden)

    S. A. Gilmanov

    2012-01-01

    Full Text Available Any practical activity of a modern specialist requires the methodology knowledge – the ability of setting and transforming goals, operating with summarized approaches and plans, creating and reconstructing them, etc. The paper deals with the role of the methodology competence in professional thinking; the subject-modeling approach to developing the professional thinking and methodology competence is considered regarding the future teachers-psychologists.The substantiation of the above approach is given concerning the content and structure of the competence in question, as well as the students’ personal characteristics. The psychological mechanism of gaining the experience and professional thinking ability is described as interaction of two models – the cognitive and dynamic emotional ones – both reflecting the professional activity. The results of experimental work, based on such methods as analysis, theoretical modeling, supervision and polling, demon- strated the main developing factors of methodology competence: the general culture level, interest to the future profession, the professional activity presentation in educational process. The research results imply the conclusion that the purposeful pedagogic activity based on the methodology competence is necessary for developing the future specialists’ professional thinking. 

  3. Racial differences in risks for first cardiovascular events and noncardiovascular death: the Atherosclerosis Risk in Communities study, the Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Feinstein, Matthew; Ning, Hongyan; Kang, Joseph; Bertoni, Alain; Carnethon, Mercedes; Lloyd-Jones, Donald M

    2012-07-03

    No studies have compared first cardiovascular disease (CVD) events and non-CVD death between races in a competing risks framework, which examines risks for numerous events simultaneously. We used competing Cox models to estimate hazards for first CVD events and non-CVD death within and between races in 3 multicenter, National Heart, Lung, and Blood Institute-sponsored cohorts. Of 14 569 Atherosclerosis Risk in Communities (ARIC) study participants aged 45 to 64 years with mean follow-up of 10.5 years, 11.6% had CVD and 5.0% had non-CVD death as first events; among 4237 Cardiovascular Health Study (CHS) study participants aged 65 to 84 years and followed for 8.5 years, these figures were 43.2% and 15.7%, respectively. Middle-aged blacks were significantly more likely than whites to experience any CVD as a first event; this disparity disappeared by older adulthood and after adjustment for CVD risk factors. The pattern of results was similar for Multi-Ethnic Study of Atherosclerosis (MESA) participants. Traditional Cox and competing risks models yielded different results for coronary heart disease risk. Black men appeared somewhat more likely than white men to experience coronary heart disease with use of a standard Cox model (hazard ratio 1.06; 95% CI 0.90, 1.26), whereas they appeared less likely than white men to have a first coronary heart disease event with use of a competing risks model (hazard ratio, 0.77; 95% CI, 0.60, 1.00). CVD affects blacks at an earlier age than whites; this may be attributable in part to elevated CVD risk factor levels among blacks. Racial disparities in first CVD incidence disappear by older adulthood. Competing risks analyses may yield somewhat different results than traditional Cox models and provide a complementary approach to examining risks for first CVD events.

  4. Estimation of the standardized risk difference and ratio in a competing risks framework: application to injection drug use and progression to AIDS after initiation of antiretroviral therapy.

    Science.gov (United States)

    Cole, Stephen R; Lau, Bryan; Eron, Joseph J; Brookhart, M Alan; Kitahata, Mari M; Martin, Jeffrey N; Mathews, William C; Mugavero, Michael J

    2015-02-15

    There are few published examples of absolute risk estimated from epidemiologic data subject to censoring and competing risks with adjustment for multiple confounders. We present an example estimating the effect of injection drug use on 6-year risk of acquired immunodeficiency syndrome (AIDS) after initiation of combination antiretroviral therapy between 1998 and 2012 in an 8-site US cohort study with death before AIDS as a competing risk. We estimate the risk standardized to the total study sample by combining inverse probability weights with the cumulative incidence function; estimates of precision are obtained by bootstrap. In 7,182 patients (83% male, 33% African American, median age of 38 years), we observed 6-year standardized AIDS risks of 16.75% among 1,143 injection drug users and 12.08% among 6,039 nonusers, yielding a standardized risk difference of 4.68 (95% confidence interval: 1.27, 8.08) and a standardized risk ratio of 1.39 (95% confidence interval: 1.12, 1.72). Results may be sensitive to the assumptions of exposure-version irrelevance, no measurement bias, and no unmeasured confounding. These limitations suggest that results be replicated with refined measurements of injection drug use. Nevertheless, estimating the standardized risk difference and ratio is straightforward, and injection drug use appears to increase the risk of AIDS. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Emotional competence relating to perceived stress and burnout in Spanish teachers: a mediator model

    Science.gov (United States)

    Extremera, Natalio

    2016-01-01

    This study examined direct associations between emotional competence, perceived stress and burnout in 489 Spanish teachers. In addition, a model in which perceived stress mediated pathways linking emotional competence to teacher burnout symptoms was also examined. Results showed that emotional competence and stress were significantly correlated with teacher burnout symptoms in the expected direction. Moreover, mediational analysis indicated that perceived stress partly mediated the relationship between emotional competence and the three dimensions of burnout even when controlling for salient background characteristics. These findings suggest an underlying process by which high emotional competence may increase the capacity to cope with symptoms of burnout, by reducing the experience of stress. Implications of these findings for future research and for working with teachers to prevent burnout are discussed. PMID:27280077

  6. Emotional competence relating to perceived stress and burnout in Spanish teachers: a mediator model.

    Science.gov (United States)

    Rey, Lourdes; Extremera, Natalio; Pena, Mario

    2016-01-01

    This study examined direct associations between emotional competence, perceived stress and burnout in 489 Spanish teachers. In addition, a model in which perceived stress mediated pathways linking emotional competence to teacher burnout symptoms was also examined. Results showed that emotional competence and stress were significantly correlated with teacher burnout symptoms in the expected direction. Moreover, mediational analysis indicated that perceived stress partly mediated the relationship between emotional competence and the three dimensions of burnout even when controlling for salient background characteristics. These findings suggest an underlying process by which high emotional competence may increase the capacity to cope with symptoms of burnout, by reducing the experience of stress. Implications of these findings for future research and for working with teachers to prevent burnout are discussed.

  7. STRUCTURAL AND FUNCTIONAL MODEL OF FORMING INFORMATIONAL COMPETENCE OF TECHNICAL UNIVERSITY STUDENTS

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    Taras Ostapchuk

    2016-11-01

    Full Text Available The article elaborates and analyses the structural and functional model of formation of information competence of technical university students. The system and mutual relationships between its elements are revealed. It is found out that the presence of the target structure of the proposed model, process and result-evaluative blocks ensure its functioning and the opportunity to optimize the learning process for technical school students’ information training. It is established that the formation of technical university students’ information competence based on components such as motivational value, as well as operational activity, cognitive, and reflexive one. These criteria (motivation, operational and activity, cognitive, reflective, indexes and levels (reproductive, technologized, constructive forming technical university students’ information competence are disclosed. Expediency of complex organizational and educational conditions in the stages of information competence is justified. The complex organizational and pedagogical conditions include: orientation in the organization and implementation of class work for technical university students’ positive value treatment; the issue of forming professionalism; informatization of educational and socio-cultural environment of higher technical educational institutions; orientation of technical university students’ training to the demands of European and international standards on information competence as a factor in the formation of competitiveness at the labor market; introducing a special course curriculum that will provide competence formation due to the use of information technology in professional activities. Forms (lecture, visualization, problem lecture, combined lecture, scientific online conference, recitals, excursions, etc., tools (computer lab, multimedia projector, interactive whiteboard, multimedia technology (audio, video, the Internet technologies; social networks, etc

  8. Establishing psychiatric registrars' competence in psychotherapy: a portfolio based model.

    Science.gov (United States)

    Naidu, T; Ramlall, S

    2008-11-01

    During most of the latter part of the last century, South Africa has followed international trends in the training of psychiatrists. Training programmes have become increasingly focused on the neurobiological aspects of psychiatric disorders with less attention being paid to psychotherapy. This is consistent with developments in psychiatric research. In the clinical arena this manifests as a focus on pharmacological and medically based interventions and a resulting relative inattention to non-pharmacological interventions, most especially psychotherapy. In an effort to address this imbalance there has been an international initiative, over the past two decades, to establish an acceptable level of competence in psychotherapy in the training of psychiatrists. A South African programme is needed that can take account of international trends and adapt them for the local context. In order to produce a programme for establishing competence in psychotherapy for psychiatric registrars at the Nelson R. Mandela School of Medicine, the authors examine directives for the development of psychotherapy skills from international regulatory bodies for graduate medical training and their application. Defining and setting preliminary standards for competence is emphasized. A programme based on five core psychotherapy components using a portfolio based model to facilitate learning and assessment of competence in psychotherapy, is proposed.

  9. Emotional competence and online game use in adolescents.

    Science.gov (United States)

    Seo, Mia; Kang, Hee Sun; Chae, Sun-Mi

    2012-12-01

    The purpose of this study was to explore the relations between emotional competence and online game use in adolescents. This study is a cross-sectional descriptive survey using a convenience sample. The participants were 2199 adolescents in South Korea. Online game use and emotional competence including positive emotion, emotional expression, and emotional intelligence were measured. The study results indicated that emotional competence was negatively correlated with excessive online game use. All variables of emotional competence were significantly lower in high-risk users compared with general users. In addition, female adolescents were rated significantly higher in emotional competence among general users, but there were no significant gender differences among high-risk users. The results of our study imply that high-risk game users have lower levels of emotional intelligence than general users do. The results of this study suggest that emotion is an important factor to which practitioners in psychomedical fields and nursing should pay attention. Therefore, nurses in schools and communities should regularly screen the emotions of adolescents who habitually play online games and develop a program to enhance emotional competence associated with online games.

  10. Spherical Model Integrating Academic Competence with Social Adjustment and Psychopathology.

    Science.gov (United States)

    Schaefer, Earl S.; And Others

    This study replicates and elaborates a three-dimensional, spherical model that integrates research findings concerning social and emotional behavior, psychopathology, and academic competence. Kindergarten teachers completed an extensive set of rating scales on 100 children, including the Classroom Behavior Inventory and the Child Adaptive Behavior…

  11. Emotional competence relating to perceived stress and burnout in Spanish teachers: a mediator model

    Directory of Open Access Journals (Sweden)

    Lourdes Rey

    2016-05-01

    Full Text Available This study examined direct associations between emotional competence, perceived stress and burnout in 489 Spanish teachers. In addition, a model in which perceived stress mediated pathways linking emotional competence to teacher burnout symptoms was also examined. Results showed that emotional competence and stress were significantly correlated with teacher burnout symptoms in the expected direction. Moreover, mediational analysis indicated that perceived stress partly mediated the relationship between emotional competence and the three dimensions of burnout even when controlling for salient background characteristics. These findings suggest an underlying process by which high emotional competence may increase the capacity to cope with symptoms of burnout, by reducing the experience of stress. Implications of these findings for future research and for working with teachers to prevent burnout are discussed.

  12. Competency remodelling and application plans for development of job competency in RI-biomics

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Woo Ho; Park, Tai Jin [Korean Association for Radiation Application, Seoul (Korea, Republic of)

    2017-03-15

    RI-Biomics technology is advanced convergence technologies that can be measured in real time and track in vivo behavior and metabolism of substances using characteristics of the radioactive isotope. Its application fields are increasing such as drug development, agriculture, development of new materials and their utilization, etc. In addition, according to domestic and international developments and changes in the RI-Biomics environment, RI-Biomics professionals are needed to train continuously. To develop systematic human resources basement and competency-based curriculum, we perform competency modeling of pedagogical perspective to targeted at high-performance on RI-Biomics. Furthermore, we redefine the competency model and verified by industry experts with focus group interviews. In the result, two general competencies and three professional competencies were extracted by interview. Each competencies are organized six sub-competencies and nine sub-competencies. In the final steps, the same procedures were repeated to obtain the consensus of experts on derived competencies and behavioral objectives. The results of the study are applicable to enhance human resource management and to develop the curriculum for RI-Biomics expert training. It is expected to be used as reference material of long term-planning for RI-Biomics professional.

  13. Competency remodelling and application plans for development of job competency in RI-biomics

    International Nuclear Information System (INIS)

    Shin, Woo Ho; Park, Tai Jin

    2017-01-01

    RI-Biomics technology is advanced convergence technologies that can be measured in real time and track in vivo behavior and metabolism of substances using characteristics of the radioactive isotope. Its application fields are increasing such as drug development, agriculture, development of new materials and their utilization, etc. In addition, according to domestic and international developments and changes in the RI-Biomics environment, RI-Biomics professionals are needed to train continuously. To develop systematic human resources basement and competency-based curriculum, we perform competency modeling of pedagogical perspective to targeted at high-performance on RI-Biomics. Furthermore, we redefine the competency model and verified by industry experts with focus group interviews. In the result, two general competencies and three professional competencies were extracted by interview. Each competencies are organized six sub-competencies and nine sub-competencies. In the final steps, the same procedures were repeated to obtain the consensus of experts on derived competencies and behavioral objectives. The results of the study are applicable to enhance human resource management and to develop the curriculum for RI-Biomics expert training. It is expected to be used as reference material of long term-planning for RI-Biomics professional

  14. Towards a Competency Model: A Review of the Literature and the Competency Standards

    Science.gov (United States)

    El Asame, Maryam; Wakrim, Mohamed

    2018-01-01

    Competency-based approaches using information and communication technologies have been the main solution of the organization's expectations in all fields (public and private) to increase the products' quality and employees' capacity. Furthermore, the concept of competency can have several different definitions, which may make it difficult to…

  15. Model of Supervision Based on Primary School Teacher Professional Competency in Tematic Learning in Curriculum 2013

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    Meilani Hartono

    2017-08-01

    Full Text Available This study aims to find the Supervision Model Based on Primary Teacher Professional Competence which effective on integrated learning. This study use research and development with qualitative approach which will be carried out in the Palmerah, West Jakarta. The techniques used to collect data are interviews, questionnaires, observation and documentation. Data v alidity is tested with credibility, transferability, dependability, and comfortability. The model developed will be validated using the Delphi technique. The result of this research is the discovery of the model and device-based supervision model of professional competence of primary teachers in integrated learning. The long-term goal of this research is to improve the teachers’ competence and the supervision quality for primary teachers in integrated learning

  16. Metaphorical Competence: A Neglected Component of Communicative Competence

    Science.gov (United States)

    Sabet, Masoud Khalili; Tavakoli, Marjaneh

    2016-01-01

    The ability to comprehend and use metaphors in L2 which is referred to as metaphorical competence is an important issue in second language acquisition. Metaphors are so pervasive in our life that we might not realize their presence and simply neglect them even in our first language. Different models of communicative competence have been suggested…

  17. Accounting for competing risks is essential in comparing surgery and radiation treatment of prostate cancer

    International Nuclear Information System (INIS)

    Hanlon, Alexandra L.; Fowble, Barbara L.; Hanks, Gerald E.

    1997-01-01

    Background: The Kaplan-Meier (KM) product-limit method is frequently used incorrectly to estimate non-survival outcome measures in the medical literature. This method is based on the assumption that all censored patients will eventually fail, and therefore overestimates the probability of failure in the presence of competing risks. The higher the percentage of patients failing from extraneous (intercurrent death) causes prior to the occurrence of interest (biochemical failure), the larger the bias in the probability of failure. Cumulative incidence (CI) estimation is an alternative method that accommodates for patients who die of intercurrent disease prior to experiencing the event of interest. Although the erroneous application of the KM method has been previously reported, statisticians and clinicians continue to use it to estimate non-survival outcome measures for comparison purposes. Comparing KM results across treatment series with differing distributions of competing risks, as is true for radiation and prostatectomy patients, could easily lead to erroneous conclusions. We illustrate this problem by comparing biochemical control rates for men treated for prostate cancer obtained by KM and CI methods in two age cohorts. Methods and Materials: We report overall biochemical control (bNED) rates for 614 men treated for localized prostate cancer with radiotherapy alone between 11/85 and 11/94. Mean and median follow-up is 46 and 43 mos (2 to 133 mos) and mean and median age is 70 years (46 to 89 years). Because older patients are more likely to die of non-prostate cancer causes prior to biochemical failure than younger patients (14% versus 8%), KM failure rates are compared to CI failure rates for younger (≤65 years) and older men (>65 years). Standard errors for the KM estimates are based on Greenwood's formula and those for CI estimates are based on the delta method. Results: Overall bNED control rates for younger men at five years are 57% using KM's method and

  18. Research on Educational Standards in German Science Education--Towards a Model of Student Competences

    Science.gov (United States)

    Kulgemeyer, Christoph; Schecker, Horst

    2014-01-01

    This paper gives an overview of research on modelling science competence in German science education. Since the first national German educational standards for physics, chemistry and biology education were released in 2004 research projects dealing with competences have become prominent strands. Most of this research is about the structure of…

  19. Modeling Market Shares of Competing (e)Care Providers

    Science.gov (United States)

    van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

    In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.

  20. Judging statistical models of individual decision making under risk using in- and out-of-sample criteria.

    Science.gov (United States)

    Drichoutis, Andreas C; Lusk, Jayson L

    2014-01-01

    Despite the fact that conceptual models of individual decision making under risk are deterministic, attempts to econometrically estimate risk preferences require some assumption about the stochastic nature of choice. Unfortunately, the consequences of making different assumptions are, at present, unclear. In this paper, we compare three popular error specifications (Fechner, contextual utility, and Luce error) for three different preference functionals (expected utility, rank-dependent utility, and a mixture of those two) using in- and out-of-sample selection criteria. We find drastically different inferences about structural risk preferences across the competing functionals and error specifications. Expected utility theory is least affected by the selection of the error specification. A mixture model combining the two conceptual models assuming contextual utility provides the best fit of the data both in- and out-of-sample.

  1. Judging statistical models of individual decision making under risk using in- and out-of-sample criteria.

    Directory of Open Access Journals (Sweden)

    Andreas C Drichoutis

    Full Text Available Despite the fact that conceptual models of individual decision making under risk are deterministic, attempts to econometrically estimate risk preferences require some assumption about the stochastic nature of choice. Unfortunately, the consequences of making different assumptions are, at present, unclear. In this paper, we compare three popular error specifications (Fechner, contextual utility, and Luce error for three different preference functionals (expected utility, rank-dependent utility, and a mixture of those two using in- and out-of-sample selection criteria. We find drastically different inferences about structural risk preferences across the competing functionals and error specifications. Expected utility theory is least affected by the selection of the error specification. A mixture model combining the two conceptual models assuming contextual utility provides the best fit of the data both in- and out-of-sample.

  2. Competing orders in the Hofstadter t -J model

    Science.gov (United States)

    Tu, Wei-Lin; Schindler, Frank; Neupert, Titus; Poilblanc, Didier

    2018-01-01

    The Hofstadter model describes noninteracting fermions on a lattice in the presence of an external magnetic field. Motivated by the plethora of solid-state phases emerging from electron interactions, we consider an interacting version of the Hofstadter model, including a Hubbard repulsion U . We investigate this model in the large-U limit corresponding to a t -J Hamiltonian with an external (orbital) magnetic field. By using renormalized mean-field theory supplemented by exact diagonalization calculations of small clusters, we find evidence for competing symmetry-breaking phases, exhibiting (possibly coexisting) charge, bond, and superconducting orders. Topological properties of the states are also investigated, and some of our results are compared to related experiments involving ultracold atoms loaded on optical lattices in the presence of a synthetic gauge field.

  3. Ethical Competencies and the Organizational Competency ‘Responsible University Social Innovation’: looking at new ways of understanding universities and the competency-based education model in the context of significant social changes in Latin America

    Directory of Open Access Journals (Sweden)

    Javier Villar Olaeta

    2017-05-01

    Full Text Available Ethical competencies are included in all competency-based education models and are considered essential for the professional preparation of students, especially in terms of their professional conduct and workplace preparedness. As such, the Tuning Academy, along with incorporating ethical competencies in its group of generic competencies, also considers the organizational competency Responsible University Social Innovation (RUSI as part of its Tuning ALFA II Latin América project. This competency, in the area of organizational character, addresses innovation in the context of social responsibility, which it assumes each university should have, in terms of ethical responsibility toward the members of a community. This concept incorporates the equal relationship between the university’s internal community and civil society. By means of interviews with experts in the areas of service-learning, social responsibility, and ethical civil and professional education from the University of Deusto and the Zerbikas Foundation, this article discusses the connection and implementation of both generic ethical competencies and the RUSI organizational competency in higher education in order to respond to the new challenges to professional training in today’s world, all of which ultimately assumes a change in universities’ understandings of themselves as institutions and the role of higher education in general.

  4. Estimating Loss to Follow-Up in HIV-Infected Patients on Antiretroviral Therapy: The Effect of the Competing Risk of Death in Zambia and Switzerland

    Science.gov (United States)

    Mwango, Albert; Stringer, Jeffrey; Ledergerber, Bruno; Mulenga, Lloyd; Bucher, Heiner C.; Westfall, Andrew O.; Calmy, Alexandra; Boulle, Andrew; Chintu, Namwinga; Egger, Matthias; Chi, Benjamin H.

    2011-01-01

    Background Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings HIV-infected patients aged ≥18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings. PMID:22205933

  5. Access to Heart Transplantation: A Proper Analysis of the Competing Risks of Death and Transplantation Is Required to Optimize Graft Allocation

    Directory of Open Access Journals (Sweden)

    Christelle Cantrelle, MS

    2017-08-01

    Conclusions. The heart allocation system strongly modifies the risk of pretransplant mortality related to heart failure severity. An in-depth competing risk analysis is therefore a more appropriate method to evaluate graft allocation systems. This knowledge should help to prioritize candidates in the context of a limited donor pool.

  6. Sensation Seeking: A Potential Factor Influencing Perceived Risk and Perceived Competence in an Introductory Scuba Diving Course

    Science.gov (United States)

    Morgan, Cass

    2009-01-01

    This study examined the relationship between the sensation-seeking personality trait to changes in perceived risk and perceived competence during an adventure experience. Participants (n = 57) were enrolled in a 14-week introductory scuba diving course offered at a university in eastern North Carolina in 2006. The data was analyzed using a…

  7. Competence Map of Regulatory Body: Personal and Interpersonal Effectiveness Competencies

    International Nuclear Information System (INIS)

    Volkov, E.

    2016-01-01

    Full text: The paper presents implementation stages and outcomes of the project “Nuclear Facility Competences” fulfilled in JSC “Rosenergoatom” and outcomes of the project “Knowledge Management, Training and Staff Retention” fulfilled for Romania regulatory authority. The goal of the project was a development of competence profiles for nuclear power plant and corporate inspectorate key job positions. The paper is focused on personal and interpersonal effectiveness competencies for inspectorate job positions which are a part of well-known 4-Quadrant Competence Model. Each competence is described by one or two behavior scales. One can consider those competencies like common ones for organizations implementing inspection activity and could be used in human resource management processes like personnel selection, job assessment, career planning, training, mentoring. (author

  8. Competing approaches to analysis of failure times with competing risks.

    Science.gov (United States)

    Farley, T M; Ali, M M; Slaymaker, E

    2001-12-15

    For the analysis of time to event data in contraceptive studies when individuals are subject to competing causes for discontinuation, some authors have recently advocated the use of the cumulative incidence rate as a more appropriate measure to summarize data than the complement of the Kaplan-Meier estimate of discontinuation. The former method estimates the rate of discontinuation in the presence of competing causes, while the latter is a hypothetical rate that would be observed if discontinuations for the other reasons could not occur. The difference between the two methods of analysis is the continuous time equivalent of a debate that took place in the contraceptive literature in the 1960s, when several authors advocated the use of net (adjusted or single decrement life table rates) rates in preference to crude rates (multiple decrement life table rates). A small simulation study illustrates the interpretation of the two types of estimate - the complement of the Kaplan-Meier estimate corresponds to a hypothetical rate where discontinuations for other reasons did not occur, while the cumulative incidence gives systematically lower estimates. The Kaplan-Meier estimates are more appropriate when estimating the effectiveness of a contraceptive method, but the cumulative incidence estimates are more appropriate when making programmatic decisions regarding contraceptive methods. Other areas of application, such as cancer studies, may prefer to use the cumulative incidence estimates, but their use should be determined according to the application. Copyright 2001 John Wiley & Sons, Ltd.

  9. Competencies required for occupational health nurses.

    Science.gov (United States)

    Kono, Keiko; Goto, Yuki; Hatanaka, Junko; Yoshikawa, Etsuko

    2017-11-25

    For occupational health (OH) nurses to perform activities effectively, not only skills and knowledge but also competencies proposed by Dr. McClelland are indispensable. This study aimed to identify competencies required for OH nurses and to show their structure diagram. Qualitative descriptive research was conducted from October 2010 to August 2011. Eight high-performing OH nurses participated, and data were collected from semi-structured interviews held for each nurse. Data were qualitatively and inductively analyzed using the KJ method. Seven competencies were identified: "self-growth competency," "OH nursing essence perpetuation competency," "strategic planning and duty fulfillment competency," "coordination competency," "client growth support competency," "team empowerment competency," and "creative competency." A structure diagram of the seven competencies was clarified. As the definitions of the competencies were different, the findings of competencies for OH nursing in the United States of America (USA) could not simply be compared with the findings of our study; however, all seven competencies were compatible with those in AAOHN model 1 and AAOHN model 2 in the USA. Our seven competencies are essential for OH nurses to perform activities that meet the expectations of employees and the employer.

  10. Theoretical models for development competence of health protection and promotion

    Directory of Open Access Journals (Sweden)

    Cesnaviciene J.

    2014-01-01

    Full Text Available The competence of health protection and promotion are mentioned in various legislative documents that regulate areas of education and health policy. The researches on health conditions of Lithuania Country's population disclosed the deteriorating health status of the society, even of the children. It has also been found that the focus on health education is not adequate. The number of National and International health programmes have been realized and educational methodological tools prepared in Lithuania, however the insufficient attention to the health promotion models is been noticed. The objectiveof this article is to discuss the theoretical models used in health education field. The questions to be answered: what theoretical models are used in order to development competence of health protection and promotion? Who does employ particular models? What are the advantages of various models? What conceptions unite and characterize theoretical models? The analysis of scientific literature revealed the number of diverse health promotion model; however none of them is dominant. Some of the models focus on intrapersonal, others on interpersonal or community level but in general they can be distinguished as cognitive – behavioural models which are characterized by three main conceptions: 1 the healthy living is determined by the perceived health related knowledge: what is known and understood would influence the behaviour; 2 the knowledge in healthy living field is essential but insufficient condition for behaviour change; 3 the great influence to healthy living life style is done by perception, motivation, skills and habits as well as social environment. These are the components that are typical to all theoretical models and that reflect the hole of the conditions influencing healthy living.

  11. Applying the welfare model to at-own-risk discharges.

    Science.gov (United States)

    Krishna, Lalit Kumar Radha; Menon, Sumytra; Kanesvaran, Ravindran

    2017-08-01

    "At-own-risk discharges" or "self-discharges" evidences an irretrievable breakdown in the patient-clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician's duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care's use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient's decision-making capacity and raises questions as to the patient's decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient's welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient's specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for

  12. A Development English Language Learning Management Strategies Model to Enhance Communicative Competence for High School Students

    Directory of Open Access Journals (Sweden)

    Thitiya Ruennakarn

    2017-09-01

    Full Text Available The objectives for this research are to 1 build a development English language learning management strategies model to enhance communicative competence for high school students 2 study the results of using the model. A target group is seven English teachers in Pibulwittayalai School and the sample for studying the results of model to students are ten English club students in Pibulwittayalai School.The research tools are focus group discussion forms, communication plans, English skills evaluation forms, communicative competence test, communicative competence evaluation forms and 21st century skills evaluation forms. This model is examined by connoisseurship.The statistics for analyzing data are frequency, percentage, mean, standard deviation and Wilcoxon test. The results of the research were as follows: 1. The development English language learning management strategies model to enhance communicative competence for high school students had4components ; 1 SWOT–Analysis, 2 strategy development, 3 strategy assessment and 4 strategy adjustment.This model had 6 strategies such as 1 genius academic strategy 2 English through AEC 3 English through World Class 4 enhancing for genius academic in communication with foreigners 5 enhancing English through world class standard and 6 enhancing for potential in English skills learning through world class standard. These were merged as only one strategy as “ Development of students’ potential for communication”. 2. The results of using the model comprised of 2.1 The results to teachers were teachers could analyze SWOT- analysis for determining strength, weakness,opportunity and threat about English language learning management, received guideline and could appropriately and efficiently construct strategies of English language learning management to enhance communicative competence. 2.2 The results to students: The students had 4 English skills, such as listening,speaking, reading and writing. It was

  13. The Challenge of Cultural Competency in the Multicultural 21st Century: A Conceptual Model to Guide Occupational Therapy Practice

    Directory of Open Access Journals (Sweden)

    Wesam Darawsheh

    2015-04-01

    Full Text Available bstract Background: Occupational therapists increasingly encounter clients from diverse cultural backgrounds and need to meet their professional obligation of delivering culturally competent practice. Yet the process of cultural competency is poorly understood in occupational therapy practice. There is a need for a clear understanding of the meaning and process of cultural competency as it is enacted in practice with a wide range of individuals from culturally diverse backgrounds. Aim: To investigate the process, stages, characteristics, and requirements of cultural competency as practiced by experienced occupational therapists. Method: Semi-structured interviews were carried out with 13 community occupational therapists experienced in delivering occupational therapy services in clients’ homes in a culturally diverse area in London, England. Findings: Interview data were analyzed and ordered into the format of a conceptual process model where cultural competency formed the core concept. The model of cultural competency that emerged from this study comprised six stages: cultural awareness, cultural preparedness, a cultural picture of the person, cultural responsiveness, cultural readiness, and cultural competence. Conclusion: Cultural competency is a complex process that needs to be based on underpinning occupational theory and actualized at the level of practice. Further research is needed to test out the model and illuminate the process of cultural competency in different areas of occupational therapy practice.

  14. Modeling Mathematical Ideas: Developing Strategic Competence in Elementary and Middle School

    Science.gov (United States)

    Suh, Jennifer M.; Seshaiyer, Padmanabhan

    2016-01-01

    "Modeling Mathematical Ideas" combining current research and practical strategies to build teachers and students strategic competence in problem solving.This must-have book supports teachers in understanding learning progressions that addresses conceptual guiding posts as well as students' common misconceptions in investigating and…

  15. Evaluating Adult’s Competency: Application of the Competency Assessment Process

    Directory of Open Access Journals (Sweden)

    Dominique Giroux

    2015-01-01

    Full Text Available Competency assessment of adults with cognitive impairment or mental illness is a complex process that can have significant consequences for their rights. Some models put forth in the scientific literature have been proposed to guide health and social service professionals with this assessment process, but none of these appear to be complete. A new model, the Competency Assessment Process (CAP, was presented and validated in other studies. This paper adds to this corpus by presenting both the CAP model and the results of a survey given to health and social service professionals on its practical application in their clinical practice. The survey was administered to 35 participants trained in assessing competency following the CAP model. The results show that 40% of participants use the CAP to guide their assessment and the majority of those who do not yet use it plan to do so in the future. A large majority of participants consider this to be a relevant model and believe that all interdisciplinary teams should use it. These results support the relevance of the CAP model. Further research is planned to continue the study of the application of CAP in healthcare facilities.

  16. Importance of competing risks in the analysis of anti-epileptic drug failure

    Directory of Open Access Journals (Sweden)

    Sander Josemir W

    2007-03-01

    Full Text Available Abstract Background Retention time (time to treatment failure is a commonly used outcome in antiepileptic drug (AED studies. Methods Two datasets are used to demonstrate the issues in a competing risks analysis of AEDs. First, data collection and follow-up considerations are discussed with reference to information from 15 monotherapy trials. Recommendations for improved data collection and cumulative incidence analysis are then illustrated using the SANAD trial dataset. The results are compared to the more common approach using standard survival analysis methods. Results A non-significant difference in overall treatment failure time between gabapentin and topiramate (logrank test statistic = 0.01, 1 degree of freedom, p-value = 0.91 masked highly significant differences in opposite directions with gabapentin resulting in fewer withdrawals due to side effects (Gray's test statistic = 11.60, 1 degree of freedom, p = 0.0007 but more due to poor seizure control (Gray's test statistic = 14.47, 1 degree of freedom, p-value = 0.0001. The significant difference in overall treatment failure time between lamotrigine and carbamazepine (logrank test statistic = 5.6, 1 degree of freedom, p-value = 0.018 was due entirely to a significant benefit of lamotrigine in terms of side effects (Gray's test statistic = 10.27, 1 degree of freedom, p = 0.001. Conclusion Treatment failure time can be measured reliably but care is needed to collect sufficient information on reasons for drug withdrawal to allow a competing risks analysis. Important differences between the profiles of AEDs may be missed unless appropriate statistical methods are used to fully investigate treatment failure time. Cumulative incidence analysis allows comparison of the probability of failure between two AEDs and is likely to be a more powerful approach than logrank analysis for most comparisons of standard and new anti-epileptic drugs.

  17. An Effective Model for Improving Global Health Nursing Competence

    OpenAIRE

    Sunjoo Kang

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The co...

  18. Intrapreneurial competencies: development and validation of a measurement scale

    Directory of Open Access Journals (Sweden)

    Tomás Vargas-Halabí

    2017-07-01

    Full Text Available Purpose - Few models have attempted to explain intrapreneurial behavior from the perspective of competencies. Therefore, the purpose of this paper is to contribute along this line by developing and validating a scale to measure intrapreneurial competencies for a Costa Rican organizational context. Design/methodology/approach - A three stage process was followed. The first stage considered literature review, expert judgment, cognitive interviews, and back-translation. In the second stage, the questionnaire was administered to a sample of 543 university professionals who worked mainly in private organizations in Costa Rica. The third stage led to evaluate of the proposed scale’s psychometric properties, including, exploratory factor analysis procedure performing by SPSS 19; confirmatory factor analysis procedures by means of structural equation modeling using EQS 6.2 version and finally, a linear regression model to obtain evidence of external criterion-related validity, performed by SPSS 19. Findings - This study provides evidence of five sub-dimensions of employee attributes, i.e., “opportunity promoter”, “proactivity”, “flexibility”, “drive”, and “risk taking” that constitute a higher-level construct called intrapreneurial competencies. The scale provided evidence of convergent, discriminant, and criterion-related validity – the latter, using an employee innovative behavior scale. Originality/value - The model offers a first step to continue studies that aim at developing a robust model of intrapreneurial competencies. This potential predictive capacity of an instrument of this nature would be useful for the business sector, particularly as a diagnostic instrument to strengthen processes of staff development in areas that promote the development of innovation and the creation of new businesses for the company.

  19. Repeated testing improves achievement in a blended learning approach for risk competence training of medical students: results of a randomized controlled trial.

    Science.gov (United States)

    Spreckelsen, C; Juenger, J

    2017-09-26

    Adequate estimation and communication of risks is a critical competence of physicians. Due to an evident lack of these competences, effective training addressing risk competence during medical education is needed. Test-enhanced learning has been shown to produce marked effects on achievements. This study aimed to investigate the effect of repeated tests implemented on top of a blended learning program for risk competence. We introduced a blended-learning curriculum for risk estimation and risk communication based on a set of operationalized learning objectives, which was integrated into a mandatory course "Evidence-based Medicine" for third-year students. A randomized controlled trial addressed the effect of repeated testing on achievement as measured by the students' pre- and post-training score (nine multiple-choice items). Basic numeracy and statistical literacy were assessed at baseline. Analysis relied on descriptive statistics (histograms, box plots, scatter plots, and summary of descriptive measures), bootstrapped confidence intervals, analysis of covariance (ANCOVA), and effect sizes (Cohen's d, r) based on adjusted means and standard deviations. All of the 114 students enrolled in the course consented to take part in the study and were assigned to either the intervention or control group (both: n = 57) by balanced randomization. Five participants dropped out due to non-compliance (control: 4, intervention: 1). Both groups profited considerably from the program in general (Cohen's d for overall pre vs. post scores: 2.61). Repeated testing yielded an additional positive effect: while the covariate (baseline score) exhibits no relation to the post-intervention score, F(1, 106) = 2.88, p > .05, there was a significant effect of the intervention (repeated tests scenario) on learning achievement, F(1106) = 12.72, p blended learning approach can be improved significantly by implementing a test-enhanced learning design, namely repeated testing. As

  20. Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

    Science.gov (United States)

    Epstein, J A; Griffin, K W; Botvin, G J

    2001-09-01

    Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

  1. Competence is Competence

    DEFF Research Database (Denmark)

    Bramming, Pia

    2004-01-01

    The article will address competence, its' diffusion, application, and the consequence of this application within the field of Human Resource Management (HRM). The concept competence-in-practice will be presented and in conclusion the article will consider implications and possibilities...... of competence-in-practice as an alternative approach to Competence Development within Human Resource Management....

  2. Development of a nursing practice based competency model for the Flemish master of nursing and obstetrics degree.

    Science.gov (United States)

    De Clercq, Gerlinde; Goelen, Guido; Danschutter, Dirk; Vermeulen, Joeri; Huyghens, Luc

    2011-01-01

    The aim was to identify a set of competences for the Flemish academic Master of Nursing and Obstetrics degree that answer perceived needs in health care. The competency model was to demonstrate a degree of consensus among key nurses. The study was conducted in all Flemish hospitals registered to have 400 beds or more. Head nurses of surgery, geriatrics and intensive care units were eligible to participate, as well as one nurse from administration per hospital. A two round Delphi process allowed participants to comment on items identified in an analysis of existing international competency profiles of master level nurses and adapted to the Flemish context. Competences agreed to by 90% of the respondents were considered to have consensus. Fifteen out of 19 eligible hospitals were recruited in the study, 45 nurses participated in the Delphi panel. Consensus was reached on 31 competences that can be assigned to 5 nurse's roles: nursing expert, innovator, researcher, educator and manager. The resulting competency profile is in accordance with published profiles for similar programs. The reported study demonstrates a practical method to develop a consensus competency model for an academic master program based on the input of key individuals in mainstream nursing. 2010 Elsevier Ltd. All rights reserved.

  3. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  4. Impact of emotional competence on supportive care needs, anxiety and depression symptoms of cancer patients: a multiple mediation model.

    Science.gov (United States)

    Baudry, A-S; Lelorain, S; Mahieuxe, M; Christophe, V

    2018-01-01

    The aim of this study was to test the effect of intrapersonal and interpersonal emotional competence on cancer patients' supportive care needs, as mediated by anxiety and depression symptoms. Cross-sectional design: 137 cancer patients (42% breast or ovarian cancer, 58% gastrointestinal cancer) in 4 French hospitals completed the Profile of Emotional Competence (PEC), the Hospital Anxiety and Depression Scale (HADS), and the Supportive Care Needs Survey Short Form (SCNS-SF). Bootstrap methods with PROCESS Macro were used to test multiple mediation models. Emotional competence presented a direct or indirect beneficial effect on the satisfaction of supportive care needs, anxiety and depression symptoms. As expected, anxiety and depression symptoms had also strong positive correlations with unmet needs. All multiple mediation models were significant, except for physical needs: intrapersonal and interpersonal emotional competence impacted anxiety and depression symptoms, which in turn impacted psychological, sexual, care/support, and information needs. These innovative results show the important effect of patients' emotional competence on their supportive care need satisfaction, as mediated by anxiety and depression. Consequently, patients with high emotional competence may require less psychosocial input from medical clinicians. Thus, emotional competence may be integrated into health models and psychosocial interventions to improve patient adjustment. Further investigation is, however, needed to know which are the most beneficial specific emotional competences and at what point of the cancer pathway.

  5. Identification of a leadership competency model for use in the development, recruitment & retention of intermodal transportation professionals.

    Science.gov (United States)

    2010-05-31

    Competencies are thought to be underlying behavioral characteristics that are causally related to : criterion-referenced effective and/or superior performance in a job or situation (Spencer & : Spencer, 1993). A competency model, then, has been defin...

  6. Valid Competency Assessment in Higher Education

    Directory of Open Access Journals (Sweden)

    Olga Zlatkin-Troitschanskaia

    2017-01-01

    Full Text Available The aim of the 15 collaborative projects conducted during the new funding phase of the German research program Modeling and Measuring Competencies in Higher Education—Validation and Methodological Innovations (KoKoHs is to make a significant contribution to advancing the field of modeling and valid measurement of competencies acquired in higher education. The KoKoHs research teams assess generic competencies and domain-specific competencies in teacher education, social and economic sciences, and medicine based on findings from and using competency models and assessment instruments developed during the first KoKoHs funding phase. Further, they enhance, validate, and test measurement approaches for use in higher education in Germany. Results and findings are transferred at various levels to national and international research, higher education practice, and education policy.

  7. Ising model with competing axial interactions in the presence of a field

    International Nuclear Information System (INIS)

    Yokoi, C.S.O.; Salinas, S.R.A.; Coutinho Filho, M.D.

    1980-09-01

    A layered Ising model is studied with competing interactions between nearest and next-nearest layers in the presence of a magnetic field. The analysis is carried out in the mean-field approximation with one effective field for each layer. The high-temperature region is studied analytically. The low-temperature region is studied numerically. T-H phase diagrams are constructed, which exhibit a variety of modulated phases, for various values of the ratio of the strength of the competing interactions. Numerical evidence of the devil's staircase behavior is found either as a function of temperature or applied magnetic field. (Author) [pt

  8. Naturfaglig kompetence og IBSE – Model for evaluering af elevers kompetenceudvikling i undersøgelsesbaseret naturfagsundervisning Science competence and IBSE

    Directory of Open Access Journals (Sweden)

    Steffen Elmose

    2013-11-01

    Full Text Available The object of this article is to generate the theoretical and methodological foundation in order for researchers and educators to be able to evaluate teaching, which is inspired by Inquiry Based Science Education. Science teaching in subsequent developmental projects can be evaluated as to its ability to enhance the science competencies of the pupils. The foundation consists of the integration of the characteristics of IBSE-inspired teaching with learning outcomes in terms of science competence and its four sub-competencies: investigative competence, representative competence, modeling competence and perspective competence. The theory and method will be tested and evaluated in an upcoming developmental project in four University Colleges in Denmark, where there will be developmental as well as research focus on the integration of the two perspectives, a methodological – IBSE – and a goal-oriented – science competence. The complexity of the developmental project must be reflected by a complexity of the research process, wherefore this article presents and discusses a three dimensional evaluation model in order for the researcher to be able to investigate relations between IBSE-inspired teaching and learning outcomes in terms of science competencies.Results from the subsequent research process are expected to highlight the links between a teaching method and learning outcomes and give answers to critical questions about the goals of IBSE-inspired teaching, and also give answers about the relevance of a matrix described competence model for science teaching practice.

  9. The Model of Formation of Professional Competence of Future Software Engineers

    Directory of Open Access Journals (Sweden)

    Viktor Sedov

    2016-05-01

    Full Text Available The rapid technological development of modern society fundamentally changes processes of production, communication and services. There is a great demand for specialists who are competent in recently emerged industries. Moreover, the gap between scientific invention and its wide distribution and consumption has significantly reduced. Therefore, we face an urgent need for preparation of specialists in higher education that meet the requirements of modern society and labour market. Particularly relevant is the issue of training of future software engineers in the system of master’s degree, which is the level of education that trains not only professionals, but also scientists and university teachers. The article presents a developed model of formation of professional competence of future software engineers in the system of master’s degree. The model comprises units of training of future software engineers, identifies methodological approaches, a number of general didactic and methodological principles that underpin learning processes in higher education. It describes methods, forms of organization and means that are used in the system of master’s degree, and also provides pedagogical conditions of effective implementation of the model. The developed model addresses the issue of individualization, intensification and optimization of studying. While developing the model, special attention was paid to updating the content of education and searching for new organizational forms of training of future software engineers.

  10. The approach to detection and application of the company’s technological competences to form a business-model

    Science.gov (United States)

    Chursin, A. A.; Kashirin, A. I.; Strenalyuk, V. V.; Semenov, A. S.; Ostrovskaya, A. A.; Kokuytseva, T. V.

    2018-02-01

    The most important condition for increasing the competitiveness of business is the formation, retention, and development of key competences of the organization, which reflect the competitive advantage. This problem is especially urgent for high-tech industries, which are the most sensitive to all kinds of changes and innovations. The ways of applying the company’s technological competences to form a business model, the proper form of competence description and analysis on the example of the company “Teplolux” are considered. The following from is recommended to use in IT solutions for competence databases.

  11. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

    Energy Technology Data Exchange (ETDEWEB)

    Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed.

  12. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

    International Nuclear Information System (INIS)

    Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed

  13. Sixth Grade Students' Content-Specific Competencies and Challenges in Learning the Seasons Through Modeling

    Science.gov (United States)

    Sung, Ji Young; Oh, Phil Seok

    2017-06-01

    Recent science education reform initiatives suggest that learning in science should be organized on the basis of scientists' actual practices including the development and use of models. In line with this, the current study adapted three types of modeling practices to teach two Korean 6th grade science classes the causes of the Earth's seasons. Specifically, the study aimed to identify the students' content-specific competencies and challenges based on fine-grained descriptions and analyses of two target groups' cases. Data included digital recordings of modeling-based science lessons in the two classes, the teacher's and students' artifacts, and interviews with the students. These multiple types of data were analyzed complementarily and qualitatively. It was revealed that the students had a competency in constructing models to generate the desired phenomenon (i.e., seasons). They had difficulty, however, in considering the tilt of the Earth's rotation axis as a cause of the seasons and in finding a proper way of representing the Sun's meridian altitude on a globe. But, when the students were helped and guided by the teacher and peers' interventions, they were able to revise their models in alignment with the scientific understanding of the seasons. Based on these findings, the teacher's pedagogical roles, which include using student competencies as resources, asking physical questions, and explicit guidance on experimentation skills, were recommended to support successful incorporations of modeling practices in the science classroom.

  14. Resource effects of training general practitioners in risk communication skills and shared decision making competences.

    Science.gov (United States)

    Cohen, David; Longo, M F; Hood, Kerenza; Edwards, Adrian; Elwyn, Glyn

    2004-08-01

    Involving patients more in decisions about their own care requires doctors to be trained in effective ways of communicating information and in developing competences to negotiate levels of patient involvement which are most appropriate for each case. The aim of this study was to determine the cost of such training and identify which service resource variables are subsequently affected. An explanatory cluster randomized crossover trial was carried out which involved training general practitioners (GPs) in the use of risk communication (RC) tools, shared decision making (SDM) competences or both. Continuing care by GPs of patients with one of four chronic conditions (menopausal symptoms, menorrhagia, atrial fibrillation, prostatism) was reviewed before and after training. Cost of training was assessed by prospective monitoring of resources used. Data on prescribing, referrals and investigations were collected via questionnaires to participating practitioners. Data on follow-up GP consultations were extracted from medical records. Three two-level logistic models were performed to investigate the probability of training having an effect on prescribing, referrals and investigations ordered at the review consultation. Training cost pound 1218 per practitioner which increased the cost of a consultation by pound 2.89. Training in SDM or combined with RC significantly affected the probability of a prescription being issued to women with menopausal symptoms and menorrhagia (although RC on its own had no effect) but did not significantly affect prescribing for patients with prostatism or atrial fibrillation. It did not significantly affect the probability of investigations, referrals or follow-up GP visits for any of the conditions. Unless training has a major influence on consultation length, it is unlikely to have any major impacts on cost.

  15. What competencies should directors possess? Malaysia perspective

    Directory of Open Access Journals (Sweden)

    Wan Fauziah Wan Yusoff

    2011-07-01

    Full Text Available Directors’ competencies are seeing to be of importance to corporate governance. As this issue has not yet being studied extensively in Malaysia, this study determines the key competencies of Malaysian company’s directors using qualitative approach involving two stages of Delphi Technique. In the first stage all information pertaining to directors’ competences in the literature had been reviewed. In the second stage, the key competencies identified in stage one were the criteria for developing a semi structured questionnaire. Participants were asked to rank the competencies in term of their importance for directors’ performance. Based on personel interviews with 41 participants eight types of competencies were found to be essential for Malaysian companies’ directors. Financial competencies received the highest responses, followed by corporate planning, business forecasting, legal, risk management, marketing, human resource and international business. This paper provides important evidence to support the conclusions drawn from the study about the importance of relevant directors’ competencies for board and corporate effectiveness.

  16. Identification of a leadership competency model for use in the development, recruitment & retention of intermodal transportation workers.

    Science.gov (United States)

    2010-05-01

    The purpose of this research was to determine the competencies that predict highly effective : performance in intermodal transportation managers and that will pave the way for development : of a core competency model that can be used to recruit, trai...

  17. ESHOL study reanalysis: All-cause mortality considered by competing risks and time-dependent covariates for renal transplantation

    Directory of Open Access Journals (Sweden)

    Francisco Maduell

    2016-03-01

    Conclusion: The results of this analysis of the ESHOL trial confirm that post-dilution OL-HDF reduces all-cause mortality versus hemodialysis in prevalent patients. The original results of the ESHOL study, which censored patients discontinuing the study for any reason, were confirmed in the present ITT population without censures and when all-cause mortality was considered by time-dependent and competing risks for transplantation.

  18. Quantile uncertainty and value-at-risk model risk.

    Science.gov (United States)

    Alexander, Carol; Sarabia, José María

    2012-08-01

    This article develops a methodology for quantifying model risk in quantile risk estimates. The application of quantile estimates to risk assessment has become common practice in many disciplines, including hydrology, climate change, statistical process control, insurance and actuarial science, and the uncertainty surrounding these estimates has long been recognized. Our work is particularly important in finance, where quantile estimates (called Value-at-Risk) have been the cornerstone of banking risk management since the mid 1980s. A recent amendment to the Basel II Accord recommends additional market risk capital to cover all sources of "model risk" in the estimation of these quantiles. We provide a novel and elegant framework whereby quantile estimates are adjusted for model risk, relative to a benchmark which represents the state of knowledge of the authority that is responsible for model risk. A simulation experiment in which the degree of model risk is controlled illustrates how to quantify Value-at-Risk model risk and compute the required regulatory capital add-on for banks. An empirical example based on real data shows how the methodology can be put into practice, using only two time series (daily Value-at-Risk and daily profit and loss) from a large bank. We conclude with a discussion of potential applications to nonfinancial risks. © 2012 Society for Risk Analysis.

  19. Competing recombinant technologies for environmental innovation: Extending Arthur's model of lock-in

    NARCIS (Netherlands)

    Zeppini, P.; van den Bergh, J.C.J.M.

    2011-01-01

    This article presents a model of sequential decisions about investments in environmentally dirty and clean technologies, which extends the path-dependence framework of B. Arthur (1989, Competing technologies, increasing returns, and lock-in by historical events, The Economic Journal, 99, pp.

  20. Competing recombinant technologies for environmental innovation : extending Arthur's model of lock-in

    NARCIS (Netherlands)

    Zeppini, P.; Bergh, van den J.C.J.M.

    2011-01-01

    This article presents a model of sequential decisions about investments in environmentally dirty and clean technologies, which extends the path-dependence framework of B. Arthur (1989, Competing technologies, increasing returns, and lock-in by historical events, The Economic Journal, 99, pp.

  1. Future Directions for Research on Core Competencies

    Science.gov (United States)

    Bradshaw, Catherine P.; Guerra, Nancy G.

    2008-01-01

    This concluding commentary highlights common themes that emerged across the chapters in this volume. We identify strengths and limitations of the core competencies framework and discuss the importance of context, culture, and development for understanding the role of the core competencies in preventing risk behavior in adolescence. We also outline…

  2. Effect of food on metamorphic competence in the model system Crepidula fornicata.

    Science.gov (United States)

    Padilla, Dianna K; McCann, Michael J; Glenn, Mica McCarty; Hooks, Alexandra P; Shumway, Sandra E

    2014-12-01

    Food quality and quantity, as well as temperature, are all factors that are expected to affect rates of development, and are likely to be affected by expected climatic change. We tested the effect of a mixed diet versus a single-food diet on metamorphic competence in the emerging model species Crepidula fornicata. We then compared our results with other published studies on this species that examined time to metamorphic competence across a range of food concentrations and rearing temperatures. Ours was the only study to test the effects of single food versus a mixed diet on metamorphic competence for this species. Diet composition did not affect metamorphic competence or survivorship. Comparing results across studies, we found that the shortest time to metamorphic competence was typically found when the food availability per larva was the greatest, independent of rearing temperature. Unfortunately, some published studies did not include important metadata needed for comparison with other studies; these data included larval rearing density, food density, frequency of feeding, and rearing temperature. Mortality rates were not always reported and when reported were often measured in different ways, preventing comparison. Such metadata are essential for comparisons among studies as well as among taxa, and for the determination of generalizable patterns and evolutionary trends. Increased reporting of all such metadata is essential if we are to use scientific studies performed to their fullest potential. © 2014 Marine Biological Laboratory.

  3. Breast Density and Benign Breast Disease: Risk Assessment to Identify Women at High Risk of Breast Cancer.

    Science.gov (United States)

    Tice, Jeffrey A; Miglioretti, Diana L; Li, Chin-Shang; Vachon, Celine M; Gard, Charlotte C; Kerlikowske, Karla

    2015-10-01

    Women with proliferative breast lesions are candidates for primary prevention, but few risk models incorporate benign findings to assess breast cancer risk. We incorporated benign breast disease (BBD) diagnoses into the Breast Cancer Surveillance Consortium (BCSC) risk model, the only breast cancer risk assessment tool that uses breast density. We developed and validated a competing-risk model using 2000 to 2010 SEER data for breast cancer incidence and 2010 vital statistics to adjust for the competing risk of death. We used Cox proportional hazards regression to estimate the relative hazards for age, race/ethnicity, family history of breast cancer, history of breast biopsy, BBD diagnoses, and breast density in the BCSC. We included 1,135,977 women age 35 to 74 years undergoing mammography with no history of breast cancer; 17% of the women had a prior breast biopsy. During a mean follow-up of 6.9 years, 17,908 women were diagnosed with invasive breast cancer. The BCSC BBD model slightly overpredicted risk (expected-to-observed ratio, 1.04; 95% CI, 1.03 to 1.06) and had modest discriminatory accuracy (area under the receiver operator characteristic curve, 0.665). Among women with proliferative findings, adding BBD to the model increased the proportion of women with an estimated 5-year risk of 3% or higher from 9.3% to 27.8% (P<.001). The BCSC BBD model accurately estimates women's risk for breast cancer using breast density and BBD diagnoses. Greater numbers of high-risk women eligible for primary prevention after BBD diagnosis are identified using the BCSC BBD model. © 2015 by American Society of Clinical Oncology.

  4. DEFORMATION FIELD OF COMPETENCE IN INNOVATIVE PROJECTS

    Directory of Open Access Journals (Sweden)

    Сергей Дмитриевич БУШУЕВ

    2017-03-01

    Full Text Available The use of a competence-based approach in the programs of innovative development organizations is considered. An analysis of the latest achievements in the world and Ukraine in the field of application of the competency approach in the programs of organizational development is done. The principles of Bloom's taxonomy to generate fields of competence and expertise are given. The principle of the curvature of field of competencies in innovative projects and programs is formulated. Application of the model taking into account the deformation of the competencies of the field allows to increase the accuracy of the model and to determine the trajectory of development of competence of project managers, teams, and organizations. An example of an organization competency assessment based on IPMA Delta model is given. The successful implementation of innovative projects and programs provided by the creative use of competency approach. This approach can be used as a common language of communication, which brings together the organization and employees, tasks and performers. Thus the development of the organization and development of personnel takes place at the same time.

  5. Market analysis and risk management of EU emissions trading

    International Nuclear Information System (INIS)

    Ollikainen, M.; Ollikka, K.; Aatola, P.; Ahonen, H.M.; Pohjola, T.; Kumpulainen, A.; Lappalainen, E.

    2006-01-01

    The first EU emissions trading period commenced on 1 January 2005. It implies new challenges to companies included in the scheme. A central challenge is the uncertainty related to the markets. In order to manage risks and profitability companies need to be able to estimate future price developments of emission allowances. University of Helsinki is conducting a research project in cooperation with Helsinki University of Technology that will provide necessary information for analyzing emission allowance markets and create risk management competence. The objectives of the research project are 1) to develop a price estimation model for EU emission allowances and 2) to develop risk management competence related to EU emission allowances. With the price estimation model the short-term price developments of EU emission allowances can be estimated. By utilizing the model companies can reduce uncertainties related to the markets. The project will also deliver a general risk management model for emission allowances that aims at improving competitiveness of companies. (orig.)

  6. Observations on risk analysis

    International Nuclear Information System (INIS)

    Thompson, W.A. Jr.

    1979-11-01

    This paper briefly describes WASH 1400 and the Lewis report. It attempts to define basic concepts such as risk and risk analysis, common mode failure, and rare event. Several probabilistic models which go beyond the WASH 1400 methodology are introduced; the common characteristic of these models is that they recognize explicitly that risk analysis is time dependent whereas WASH 1400 takes a per demand failure rate approach which obscures the important fact that accidents are time related. Further, the presentation of a realistic risk analysis should recognize that there are various risks which compete with one another for the lives of the individuals at risk. A way of doing this is suggested

  7. Motor Skill Competence and Perceived Motor Competence: Which Best Predicts Physical Activity among Girls?

    Science.gov (United States)

    Khodaverdi, Zeinab; Bahram, Abbas; Khalaji, Hassan; Kazemnejad, Anoshirvan

    2013-10-01

    The main purpose of this study was to determine which correlate, perceived motor competence or motor skill competence, best predicts girls' physical activity behavior. A sample of 352 girls (mean age=8.7, SD=0.3 yr) participated in this study. To assess motor skill competence and perceived motor competence, each child completed the Test of Gross Motor Development-2 and Physical Ability sub-scale of Marsh's Self-Description Questionnaire. Children's physical activity was assessed by the Physical Activity Questionnaire for Older Children. Multiple linear regression model was used to determine whether perceived motor competence or motor skill competence best predicts moderate-to-vigorous self-report physical activity. Multiple regression analysis indicated that motor skill competence and perceived motor competence predicted 21% variance in physical activity (R(2)=0.21, F=48.9, P=0.001), and motor skill competence (R(2)=0.15, ᵝ=0.33, P= 0.001) resulted in more variance than perceived motor competence (R(2)=0.06, ᵝ=0.25, P=0.001) in physical activity. Results revealed motor skill competence had more influence in comparison with perceived motor competence on physical activity level. We suggest interventional programs based on motor skill competence and perceived motor competence should be administered or implemented to promote physical activity in young girls.

  8. You Just Want to Be Like that Teacher: Modelling and Intercultural Competence in Young Language Learners

    Science.gov (United States)

    Moloney, Robyn

    2008-01-01

    Language teachers are called upon to understand both the nature of students' intercultural competence and their own role in its development. Limited research attention has been paid to the relationship between the types of behaviour that language teachers model and the intercultural competence their students acquire. This article reports on a case…

  9. Conceptualizations of professional competencies in school health promotion

    DEFF Research Database (Denmark)

    Carlsson, Monica Susanne

    2016-01-01

    Purpose: The purpose of the paper is to contribute to the conceptualization and discussion of professional competencies needed for supporting the development of the whole-school approach in school health promotion (SHP). Design: The paper is based a conceptual synthesis of literature, guided...... delineates an overall professional competency model for SHP, discusses the specific demands on professional competencies within this field in relation to this model, and addresses three critical gaps in the conceptualizations of competency. Keywords: Professionals, competence, school health promotion Paper...... by a theoretical perspective on health promotion agency and professional competencies to identify core competency domains and elements. This is followed by a discussion of focus, gaps, and links in conceptualizations of competency domains and elements. Findings: The synthesis identifies five core competency...

  10. Conceptualizations of professional competencies in school health promotion

    DEFF Research Database (Denmark)

    Carlsson, Monica Susanne

    2016-01-01

    by a theoretical perspective on health promotion agency and professional competencies to identify core competency domains and elements. This is followed by a discussion of focus, gaps, and links in conceptualizations of competency domains and elements. Findings: The synthesis identifies five core competency...... delineates an overall professional competency model for SHP, discusses the specific demands on professional competencies within this field in relation to this model, and addresses three critical gaps in the conceptualizations of competency. Keywords: Professionals, competence, school health promotion Paper......Purpose: The purpose of the paper is to contribute to the conceptualization and discussion of professional competencies needed for supporting the development of the whole-school approach in school health promotion (SHP). Design: The paper is based a conceptual synthesis of literature, guided...

  11. The Design Model of Multilevel Estimation Means for Students’ Competence Assessment at Technical Higher School

    Directory of Open Access Journals (Sweden)

    O. F. Shikhova

    2012-01-01

    Full Text Available The paper considers the research findings aimed at the developing the new quality testing technique for students assessment at Technical Higher School. The model of multilevel estimation means is provided for diagnosing the level of general cultural and professional competences of students doing a bachelor degree in technological fields. The model implies the integrative character of specialists training - the combination of both the psycho-pedagogic (invariable and engineering (variable components, as well as the qualimetric approach substantiating the system of students competence estimation and providing the most adequate assessment means. The principles of designing the multilevel estimation means are defined along with the methodology approaches to their implementation. For the reasonable selection of estimation means, the system of quality criteria is proposed by the authors, being based on the group expert assessment. The research findings can be used for designing the competence-oriented estimation means. 

  12. Toward the Development and Validation of a Career Coach Competency Model

    Science.gov (United States)

    Hatala, John-Paul; Hisey, Lee

    2011-01-01

    The career coaching profession is a dynamic field that has grown over the last decade. However, there exists a limitation to this field's development, as there is no universally accepted definition or empirically based competencies. There were three phases to the study. In the first phase, a conceptual model was developed that highlights four…

  13. Competency-Based University Undergraduate Teaching Management: Proposal for a Conceptual Model

    Directory of Open Access Journals (Sweden)

    Rodolfo Schmal

    2005-12-01

    Full Text Available The human resources societies and their organizations can count on are more and more relevant. In that sense, a major challenge faced by universities is to give students the appropriate background to be professionals with the profile the current scenario requires. This article focuses the management of university careers. Historically, many careers have emphasized knowledge, especially abstract knowledge. Today, the trend is to address aspects that reach beyond cognition, and focus the attention in effective competencies that include procedures and attitudes. Such approach allows the opportunity of defining a holistic management of careers, reaching beyond the sheer teaching of disciplines. Concurrently, the availability of information methods and tools will contribute for the definition and implementation of a design process that can work with explicit criteria and transformations. The article proposes a conceptual model to represent the objects, and their attributes and associations that are considered of interest for the management of university teaching under a competency focus. A second stage should implement such model through the construction of an information system that supports the management of corresponding careers.

  14. Competence and competency of high school teacher as the components of his innovative development

    Directory of Open Access Journals (Sweden)

    I. K. Yarmola

    2013-10-01

    Full Text Available Priority direction of state policy concerning the development of higher education inUkraineis to prepare qualified and competitive staff in the labor market. The high level of competence and scientific competence along with pedagogical craftsmanship and psychological culture of teachers is condition for improving the efficiency of the educational process in higher education. Aim of research was theoretical justification importance of competence and competency of high school teacher for the establishment his innovation potential. In the article the analysis of interpretation of the terms competence and competency in various scientific sources and scientific works of individual authors were presented. Moreover important are ability to creativity, solving of problem’s tasks, ingenuity, flexibility and criticality mind, intuition, originality and self-confidence; ability to formulate and solve non-standard tasks; ability to analyse, synthesis and combination, to share experiences, predictions, etc.. Emotionally-shaped quality represented by the following components as spirituality, the emotional upsurge in creative situations; associativity, imagination, sense of novelty, sensitivity to contradictions, empathy; insight, ability to see the familiar in an unfamiliar; overcome the stereotypes; risk appetite, desire for freedom. The general regularities of formation of research competence have been detected. In particular, the formation carried out through the development of competencies invariant character and increasing of specialized skills. It is proved that scientific and research competence is determined primarily by the system of teacher's professional education and self-education. The most important objective characteristics that reflect the competence of teachers in the field R & D is the total number of publications, number of scientific articles, monographs, and also won grants, competitions, etc. Moreover the level of competence in the

  15. The Impact of Competencies, Risk Management and Auditors Interactions on Internal Audit Effectiveness in Libyan Commercial Banks

    OpenAIRE

    Ashour, Mohamad Salah R; Sukoharsono, Eko Ganis; Ghofar, Abdul

    2015-01-01

    Internal audit (IA) has become an important and integral function of organizations in achieving their objectives and protecting their assets. Nonetheless, IA effectiveness has received scant attention in the literature, especially in the context of developing countries such as Libya. The research aimed To analyze the impact of competencies of the internal audit team, risk management and interaction between internal auditors and audit committees on internal audit effectiveness in Libyan commer...

  16. Parenting Styles, Motivational Orientations, and Self-Perceived Academic Competence: A Mediational Model.

    Science.gov (United States)

    Leung, Patrick W. L.; Kwan, Kim S. F.

    1998-01-01

    Surveyed Hong Kong high schoolers to test model stipulating motivational orientations as mediators between parenting styles and self-perceived academic competence: authoritarian parenting leading to extrinsic motivation, authoritative parenting to intrinsic motivation, and neglectful parenting to amotivation, and each motivation in turn related to…

  17. Probabilistic risk assessment for a loss of coolant accident in McMaster Nuclear Reactor and application of reliability physics model for modeling human reliability

    Science.gov (United States)

    Ha, Taesung

    A probabilistic risk assessment (PRA) was conducted for a loss of coolant accident, (LOCA) in the McMaster Nuclear Reactor (MNR). A level 1 PRA was completed including event sequence modeling, system modeling, and quantification. To support the quantification of the accident sequence identified, data analysis using the Bayesian method and human reliability analysis (HRA) using the accident sequence evaluation procedure (ASEP) approach were performed. Since human performance in research reactors is significantly different from that in power reactors, a time-oriented HRA model (reliability physics model) was applied for the human error probability (HEP) estimation of the core relocation. This model is based on two competing random variables: phenomenological time and performance time. The response surface and direct Monte Carlo simulation with Latin Hypercube sampling were applied for estimating the phenomenological time, whereas the performance time was obtained from interviews with operators. An appropriate probability distribution for the phenomenological time was assigned by statistical goodness-of-fit tests. The human error probability (HEP) for the core relocation was estimated from these two competing quantities: phenomenological time and operators' performance time. The sensitivity of each probability distribution in human reliability estimation was investigated. In order to quantify the uncertainty in the predicted HEPs, a Bayesian approach was selected due to its capability of incorporating uncertainties in model itself and the parameters in that model. The HEP from the current time-oriented model was compared with that from the ASEP approach. Both results were used to evaluate the sensitivity of alternative huinan reliability modeling for the manual core relocation in the LOCA risk model. This exercise demonstrated the applicability of a reliability physics model supplemented with a. Bayesian approach for modeling human reliability and its potential

  18. Competency-based continuing professional development.

    Science.gov (United States)

    Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Cate, Olle Ten; Holmboe, Eric S

    2010-01-01

    Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence" toward the attainment of expertise. A competency-based continuing professional development (CPD) model is premised on a set of learning competencies that include the ability to (a) use practice information to identify learning priorities and to develop and monitor CPD plans; (b) access information sources for innovations in development and new evidence that may potentially be integrated into practice; (c) establish a personal knowledge management system to store and retrieve evidence and to select and manage learning projects; (d) construct questions, search for evidence, and record and track conclusions for practice; and (e) use tools and processes to measure competence and performance and develop action plans to enhance practice. Competency-based CPD emphasizes self-directed learning processes and promotes the role of assessment as a professional expectation and obligation. Various approaches to defining general competencies for practice require the creation of specific performance metrics to be meaningful and relevant to the lifelong learning strategies of physicians. This paper describes the assumptions, advantages, and challenges of establishing a CPD system focused on competencies that improve physician performance and the quality and safety of patient care. Implications for competency-based CPD are discussed from an individual and organizational perspective, and a model to bridge the transition from residency to practice is explored.

  19. Competencies and Their Assessment

    Science.gov (United States)

    Drisko, James W.

    2014-01-01

    This article explores competencies and methods for their assessment in higher education and in social work's accreditation standards. Many contemporary policy and educational accreditation efforts employ the model of competency assessment. The current emphasis on accountability in higher education, including the Council on Social Work…

  20. Breast cancer risks and risk prediction models.

    Science.gov (United States)

    Engel, Christoph; Fischer, Christine

    2015-02-01

    BRCA1/2 mutation carriers have a considerably increased risk to develop breast and ovarian cancer. The personalized clinical management of carriers and other at-risk individuals depends on precise knowledge of the cancer risks. In this report, we give an overview of the present literature on empirical cancer risks, and we describe risk prediction models that are currently used for individual risk assessment in clinical practice. Cancer risks show large variability between studies. Breast cancer risks are at 40-87% for BRCA1 mutation carriers and 18-88% for BRCA2 mutation carriers. For ovarian cancer, the risk estimates are in the range of 22-65% for BRCA1 and 10-35% for BRCA2. The contralateral breast cancer risk is high (10-year risk after first cancer 27% for BRCA1 and 19% for BRCA2). Risk prediction models have been proposed to provide more individualized risk prediction, using additional knowledge on family history, mode of inheritance of major genes, and other genetic and non-genetic risk factors. User-friendly software tools have been developed that serve as basis for decision-making in family counseling units. In conclusion, further assessment of cancer risks and model validation is needed, ideally based on prospective cohort studies. To obtain such data, clinical management of carriers and other at-risk individuals should always be accompanied by standardized scientific documentation.

  1. Familial Risk and Child Competence.

    Science.gov (United States)

    Sameroff, Arnold J.; Seifer, Ronald

    1983-01-01

    Examines components of familial risk in the context of a four-year longitudinal study of children with mentally ill mothers. Risk factors examined were parental mental health, social status, parental perspectives, and family stress. Interactions among risk factors were found to be complex and different for cognitive and social-emotional…

  2. The Effect of Teacher Beliefs on Student Competence in Mathematical Modeling--An Intervention Study

    Science.gov (United States)

    Mischo, Christoph; Maaß, Katja

    2013-01-01

    This paper presents an intervention study whose aim was to promote teacher beliefs about mathematics and learning mathematics and student competences in mathematical modeling. In the intervention, teachers received written curriculum materials about mathematical modeling. The concept underlying the materials was based on constructivist ideas and…

  3. Experiential Learning Model in Enhancing Prospective English Teachers` Teaching Competence

    Directory of Open Access Journals (Sweden)

    Heri Mudra

    2017-09-01

    Full Text Available This study aimed to describe the effectiveness of Experiential Learning (EL model in improving prospective EFL teachers’ (PETs teaching competence. The method of this study was Classroom Action Research (CAR consisting of planning, observing, acting, and reflecting phases. There were two cycles needed in implementing EL to the twenty one EFL learners as the participants. The results revealed that each subcompetence in cycle I and cycle II was achieved in the following score: planning & preparation for learning (Mean in cycle I=2,8; Mean in cycle II=3,38, classroom management (Mean in cycle I=2,5; Mean in cycle II=2,95, delivery of instruction (Mean in cycle I=2,6; Mean in cycle II=2,90, and monitoring, assessment, and follow-up (Mean in cycle I=2,4; Mean in cycle II=2,95. It can be concluded that EL is effective in improving PETs’ teaching competence.

  4. On the Importance of Accounting for Competing Risks in Pediatric Cancer Trials Designed to Delay or Avoid Radiotherapy: I. Basic Concepts and First Analyses

    International Nuclear Information System (INIS)

    Tai, Bee-Choo; Grundy, Richard G.; Machin, David

    2010-01-01

    Purpose: In trials designed to delay or avoid irradiation among children with malignant brain tumor, although irradiation after disease progression is an important event, patients who have disease progression may decline radiotherapy (RT), or those without disease progression may opt for elective RT. To accurately describe the cumulative need for RT in such instances, it is crucial to account for these distinct events and to evaluate how each contributes to the delay or advancement of irradiation via a competing risks analysis. Methods and Materials: We describe the summary of competing events in such trials using competing risks methods based on cumulative incidence functions and Gray's test. The results obtained are contrasted with standard survival methods based on Kaplan-Meier curves, cause-specific hazard functions and log-rank test. Results: The Kaplan-Meier method overestimates all event-specific rates. The cause-specific hazard analysis showed reduction in hazards for all events (A: RT after progression; B: no RT after progression; C: elective RT) among children with ependymoma. For event A, a higher cumulative incidence was reported for ependymoma. Although Gray's test failed to detect any difference (p = 0.331) between histologic subtypes, the log-rank test suggested marginal evidence (p = 0.057). Similarly, for event C, the log-rank test found stronger evidence of reduction in hazard among those with ependymoma (p = 0.005) as compared with Gray's test (p = 0.086). Conclusions: To evaluate treatment differences, failing to account for competing risks using appropriate methodology may lead to incorrect interpretations.

  5. LGBT-Competence in Social Work Education: The Relationship of School Contexts to Student Sexual Minority Competence.

    Science.gov (United States)

    McCarty-Caplan, David

    2018-01-01

    This study examined the relationship between master of social work programs' (MSW) support of lesbian, gay, bisexual, and transgender people (LGBT-competence) and the sexual minority competence (LGB-competence) of social work students. Data were gathered from a sample of MSW program directors, faculty members, and students (N = 1385) within 34 MSW programs in the United States. A series of hierarchical linear models tested if a MSW program's LGBT-competence was associated with the LGB-competence of its students. Results showed a significant relationship between organizational LGBT-competence and individual LGB-competence within schools of social work, and that programs with greater LGBT-competence also had students who felt more competent to work with sexual minorities. These findings suggest schools of social work can take substantive action at an organizational level to improve the professional LGB-competence of future social workers. Implications for social work education are discussed.

  6. Modelo de competencias del profesor de medicina Competencies model of medical teacher

    Directory of Open Access Journals (Sweden)

    A. Martínez-González

    2008-09-01

    Full Text Available Objetivo. Generar el modelo de competencias del profesor para ejercer la docencia de alto nivel en Medicina. Materiales y métodos. Para generar el modelo se analizó la bibliografía, el propósito del plan de estudio por competencias y se utilizó el método Developing a Curriculum (DACUM, con la participación de 35 expertos que integraron mediante consenso el trabajo que debe realizar un docente de medicina para cumplir con éxito el propósito del plan de estudio. Resultados. Se identificaron las funciones básicas de los profesores de medicina, así como las actividades para su cumplimiento. Se conformó el modelo con seis competencias: disciplinaria, de investigación, psicopedagógica, de comunicación, académico-administrativa y humanística. Conclusiones. El modelo pretende guiar las acciones de los profesores que actualmente participan en el programa y aquellos que aspiran a formar parte del proceso educativo; elaborar programas para la formación de profesores que favorezcan el desarrollo de competencias académicas; identificar elementos que se deben considerar para la evaluación del desempeño docente; orientar el diseño de indicadores útiles para otorgar reconocimientos y estímulos a los profesores cuyo desempeño académico sea excepcional; orientar al estudiante, en la relación profesor-alumno, sobre las funciones y actividades que puede esperar del profesor.Aim. To create a competency model for the medical professor in order to exert teaching at its highest level. Materials and methods. To create such model, we analyzed current literature on teaching, the aim of the curricula for competencies and we used the DACUM method whose letters stand for Developing a Curriculum. 35 experts who participated in this project reached a consensus regarding the duties that have to be carried out by a medical professor in order to successfully fulfill the aim of the curricula. Results. We identified the basic functions of medical

  7. Application of air traffic control competence reference models as a mean of air navigation services provider’s charge optimization

    Directory of Open Access Journals (Sweden)

    В.П. Харченко

    2010-01-01

    Full Text Available  The issue of application of Air Traffic Control (ATC competence reference models as a mean of air navigation services provider’s charge optimization is described in the article, and this issue is interpretated as an optimization task. The data relating to the significant growth of aviation traffic, especially using the airspace of Ukraine, given by authors, and the statement of fact that Air Traffic Management (ATM system’s technical component reliability increasement takes place on the basis of practically invariable psychophysiological abilities of aviation controller, make the substantiation of ANSP provision with the most trained ATC controllers for the work on the working places of ATC Unit actual. The ‘mechanism’ of ATC controllers competence reference model creation is defined step-by step. There is an example of candidate’s for the working place competence quantitative individual model forming as a common criteria of competence, which, in its turn, is the compressed format of all parameters of its working activity, received at the stage of control. The approach, according to which the individual parameters of graduating student’s output model’s professional characteristics, which he received after the examination of his work as Tower controller (ATM Unit of aerodrome control service, approach controller or area control service controller, are compared with the predetermined specialist’s competence reference model, relating to the special working place in ATM system, is supposed here. Notably, the conception, relating to the correspondence of the graduating student’s competence output level to the defined reference model of ATC controller, relating to the special working place of ATM Unit, is realised.

  8. Competing Risk Approach (CRA) for Estimation of Disability Adjusted Life Years (DALY's) for Female Breast Cancer in India.

    Science.gov (United States)

    Kunnavil, Radhika; Thirthahalli, Chethana; Nooyi, Shalini Chandrashekar; Shivaraj, N S; Murthy, Nandagudi Srinivasa

    2015-10-01

    Competing Risk Approach (CRA) has been used to compute burden of disease in terms of Disability Adjusted Life Years (DALYs) based on a life table for an initially disease-free cohort over time. To compute Years of Life Lost (YLL) due to premature mortality, Years of life lost due to Disability (YLD), DALYs and loss in expectation of life (LEL) using competing risk approach for female breast cancer patients for the year 2008 in India. The published data on breast cancer by age & sex, incidence & mortality for the year 2006-2008 relating to six population based cancer registries (PBCR) under Indian Council of Medical Research (ICMR), general mortality rates of 2007 in India, published in national health profile 2010; based on Sample Registration System (SRS) were utilized for computations. Three life tables were constructed by applying attrition of factors: (i) risk of death from all causes ('a'; where a is the general death rate); (ii) risk of incidence and that of death from causes other than breast cancer ('b-a+c'; where 'b' is the incidence of breast cancer and 'c' is the mortality of breast cancer); and (iii) risk of death from all other causes after excluding cancer mortality ('a-c'). Taking the differences in Total Person Years Lived (TPYL), YLD and YLL were derived along with LEL. CRA revealed that the DALYs were 40209 per 100,000 females in the life time of 0-70+ years with a LEL of 0.11 years per person. Percentage of YLL to DALYs was 28.20% in the cohort. The method of calculation of DALYs based on the CRA is simple and this will help to identify the burden of diseases using minimal information in terms of YLL, YLD, DALYs and LEL.

  9. The assessment of knowledge and learning in competence spaces: The gain-loss model for dependent skills.

    Science.gov (United States)

    Anselmi, Pasquale; Stefanutti, Luca; de Chiusole, Debora; Robusto, Egidio

    2017-11-01

    The gain-loss model (GaLoM) is a formal model for assessing knowledge and learning. In its original formulation, the GaLoM assumes independence among the skills. Such an assumption is not reasonable in several domains, in which some preliminary knowledge is the foundation for other knowledge. This paper presents an extension of the GaLoM to the case in which the skills are not independent, and the dependence relation among them is described by a well-graded competence space. The probability of mastering skill s at the pretest is conditional on the presence of all skills on which s depends. The probabilities of gaining or losing skill s when moving from pretest to posttest are conditional on the mastery of s at the pretest, and on the presence at the posttest of all skills on which s depends. Two formulations of the model are presented, in which the learning path is allowed to change from pretest to posttest or not. A simulation study shows that models based on the true competence space obtain a better fit than models based on false competence spaces, and are also characterized by a higher assessment accuracy. An empirical application shows that models based on pedagogically sound assumptions about the dependencies among the skills obtain a better fit than models assuming independence among the skills. © 2017 The British Psychological Society.

  10. Proposing a Model to present Factors which Affect e-SCM Risk and their Impacts on Organizational Performance

    Directory of Open Access Journals (Sweden)

    ali rajabzadeh ghatari

    2010-03-01

    Full Text Available Companies strive to improve market share, grow corporate profit, and gain strategic advantage. In order to achieve these goals, supply chain competency must be placed at the heart of a company’s business model. Using e-Commerce and information and communication technologies (ICT in today’s changing demands of business has made organizations more responsive and flexible. E-Commerce and Internet have changed the nature of supply chains and re-defined how customers obtain wisdom of products, services, selection, purchasing and using them. Advent of ICT and new business environment has caused emerge of electronic supply chains. This research has proposed a model for presenting factors which affect electronic supply chain’s risk; besides the influence of the risk on financial and non-financial organization’s performance indicators. Studying the influence of the risk on organization’s performance is conducted in a sample of electronic and telecommunication companies. In order to measure these relationships, using correlation and structural equation modeling (SEM techniques proposed that electronic supply chain risk identification and management have significant impact on organization’s performance improvement.

  11. A Comparison of Competing Models for Understanding Industrial Organization’s Acceptance of Cloud Services

    Directory of Open Access Journals (Sweden)

    Shui-Lien Chen

    2018-03-01

    Full Text Available Cloud computing is the next generation in computing, and the next natural step in the evolution of on-demand information technology services and products. However, only a few studies have addressed the adoption of cloud computing from an organizational perspective, which have not proven whether the research model is the best-fitting model. The purpose of this paper is to construct research competing models (RCMs and determine the best-fitting model for understanding industrial organization’s acceptance of cloud services. This research integrated the technology acceptance model and the principle of model parsimony to develop four cloud service adoption RCMs with enterprise usage intention being used as a proxy for actual behavior, and then compared the RCMs using structural equation modeling (SEM. Data derived from a questionnaire-based survey of 227 firms in Taiwan were tested against the relationships through SEM. Based on the empirical study, the results indicated that, although all four RCMs had a high goodness of fit, in both nested and non-nested structure comparisons, research competing model A (Model A demonstrated superior performance and was the best-fitting model. This study introduced a model development strategy that can most accurately explain and predict the behavioral intention of organizations to adopt cloud services.

  12. A fuzzy TOPSIS model to evaluate the Business Intelligence competencies of Port Community Systems

    Directory of Open Access Journals (Sweden)

    Ghazanfari Mehdi

    2014-04-01

    Full Text Available Evaluation of the Business Intelligence (BI competencies of port community systems before they are bought and deployed is a vital importance for establishment of a decision-support environment for managers. This study proposes a new model which provides a simple approach to the assessment of the BI competencies of port community systems in organization. This approach helps decision-makers to select an enterprise system with appropriate intelligence requirements to support the managers’ decision-making tasks. Thirtyfour criteria for BI specifications are determined from a thorough review of the literature. The proposed model uses the fuzzy TOPSIS technique, which employs fuzzy weights of the criteria and fuzzy judgments of port community systems to compute the evaluation scores and rankings. The application of the model is realized in the evaluation, ranking and selecting of the needed port community systems in a port and maritime organization, in order to validate the proposed model with a real application. With utilizing the proposed model organizations can assess, select, and purchase port community systems which will provide a better decision-support environment for their business systems.

  13. Risk in Science Instruction. The Realist and Constructivist Paradigms of Risk

    Science.gov (United States)

    Hansen, Julia; Hammann, Marcus

    2017-11-01

    Risk is always present in people's lives: diseases, new technologies, socio-scientific issues (SSIs) such as climate change, and advances in medicine—to name just a few examples—all carry risks. To be able to navigate risks in everyday life, as well as to participate in social debate on risk-related issues, students need to develop risk competence. Science education can be a powerful tool in supporting students' risk competence, which is an important component of scientific literacy. As there are different definitions of risk within the scientific community, the aims of this article are (1) to review the literature on two major theoretical frameworks for conceptualising risk, the realist, and the constructivist paradigms of risk and (2) to connect both in order to suggest a working definition of what can be understood as risk competence in science instruction.

  14. Competency profile of PR professional in sport

    OpenAIRE

    Gazdíková, Lenka

    2013-01-01

    Title: Competency profile of PR professional in sport Objective: The objective is to identify competencies required to a position of PR professional in sport. The aim of a survey is to verify the level of competencies which follows compiling competency profile and comparison with existing profile of PR specialist. Methods: The objective is achieved using survey, interview and analysis of competency models database. Results: The result of this paper is competency profile of PR professional in ...

  15. Enhancing Social Competence for Disadvantaged Youth in Pre-Vocational Education: Model Development Through Design-Based Research

    Directory of Open Access Journals (Sweden)

    Ida Kristina Kühn

    2017-12-01

    Full Text Available This study investigates the enhancement of social competence for disadvantaged young people based on the example of the "Werkschule Bremen" educational course. Theoretical approaches to social competence as a learning outcome are mainly based on the model of social information processing, although the meaning of both practical and experience-oriented approaches is constantly evolving. Taking the specific contextual conditions into account, this study combines qualitative and quantitative methods within the design-based research methodology in order to determine how a location-independent didactical concept to enhance social competence could be created as well as which comparable impacts on the participants' social competence can be verified. The results show that a basic didactical concept is feasible, while the teaching and learning environment has a huge impact on the comparability. It is also clear that the students' motivation to participate depends on both their own and their teachers' interest as well as the teachers' capacity to facilitate safe relationships. As a core result, this study delivers a didactic model that is based on target-controlled experience-oriented learning environments on the practical side and the social information processing approach on the theoretical side.

  16. Model of competence: a conceptual framework for understanding the person-environment interaction for persons with motor disabilities.

    Science.gov (United States)

    Rousseau, Jacqueline; Potvin, Louise; Dutil, Elisabeth; Falta, Patricia

    2002-01-01

    The "Model of Competence" has been recently elaborated to help expand our understanding relating to a person's interaction with the environment. Specifically, it seeks to deal with the issues related to the home adaptation (the home layout and equipment) for a person living with motor disabilities. This theoretical model takes into account various characteristics of the person as well as of the environment, by re-grouping six concepts: person, environment, activity, role, competence and handicap situation. The "Model of Competence" is distinct because it includes: (1) both the human and the nonhuman dimension of the environment; (2) personal characteristics other than the strictly physical ones; (3) a clear identification of the interaction between the person and the environment; and (4) a means of operationalizing it via an assessment instrument. This model proposes an innovative approach to the person-environment relation in terms of personalizing accessibility, and thereby offers a new approach to understanding the concept of universal access. It has been developed for research and application, and addresses several disciplines.

  17. Examining Factors Predicting Students’ Digital Competence

    Directory of Open Access Journals (Sweden)

    Ove Edvard Hatlevik

    2015-02-01

    Full Text Available The purpose of this study was to examine factors predicting lower secondary school students’ digital competence and to explore differences between students when it comes to digital competence. Results from a digital competence test and survey in lower secondary school will be presented. It is important to learn more about and investigate what characterizes students’ digital competence. A sample of 852 ninth-grade Norwegian students from 38 schools participated in the study. The students answered a 26 item multiple-choice digital competence test and a self-report questionnaire about family background, motivation, and previous grades. Structural equation modeling was used to test a model of the hypothesised relationship between family background, mastery orientation, previous achievements, and digital competence. The results indicate variation in digital competence among the ninth-graders. Further, analyses showed that students’ conditions at home, i.e., language integration and cultural capital, together with mastery orientation and academic achievements predict students digital competence. This study indicates that that there is evidence of digital diversity between lower secondary students. It does not seem like the development of digital competence among the students happens automatically. Students’ family background and school performance are the most important factors. Therefore, as this study shows, it is necessary to further investigate how schools can identify students’ level of competence and to develop plans and actions for how schools can help to try to equalize differences.

  18. A constitutive model of nanocrystalline metals based on competing grain boundary and grain interior deformation mechanisms

    KAUST Repository

    Gurses, Ercan; El Sayed, Tamer S.

    2011-01-01

    In this work, a viscoplastic constitutive model for nanocrystalline metals is presented. The model is based on competing grain boundary and grain interior deformation mechanisms. In particular, inelastic deformations caused by grain boundary

  19. A conceptual model of individual competency components as one of the predictors of success in mergers and acquisitions

    Directory of Open Access Journals (Sweden)

    Darko Kovač

    2008-12-01

    Full Text Available The increasing challenge of how to balance “soft” human factors with “hard” financial factors in mergers and acquisitions (M&A to be successful is not new. However, the real challenge lies in the question of how, and with which yardstick, to measure and compare the human factor in both the acquiring and the acquired companies in all phases of M&A. In this study, a model for measuring and comparing the human factor with competencies is presented. The model enables the measuring of soft factors with quantitative criteria. A tripartite individual competency components construct is conceived: cognitive, affective and conative, to which the personal value system is added. The model discussed is based on empirical findings and the cases of two companies and literature. The model enables companies to compare differences in competencies and thus to plan activities how to overcome those differences and achieve a higher success rate in M&A.

  20. A model of professional competences in mathematics to update mathematical and didactic knowledge of teachers

    Science.gov (United States)

    Díaz, Verónica; Poblete, Alvaro

    2017-07-01

    This paper describes part of a research and development project carried out in public elementary schools. Its objective was to update the mathematical and didactic knowledge of teachers in two consecutive levels in urban and rural public schools of Region de Los Lagos and Region de Los Rios of southern Chile. To that effect, and by means of an advanced training project based on a professional competences model, didactic interventions based on types of problems and types of mathematical competences with analysis of contents and learning assessment were designed. The teachers' competence regarding the didactic strategy used and its results, as well as the students' learning achievements are specified. The project made possible to validate a strategy of lifelong improvement in mathematics, based on the professional competences of teachers and their didactic transposition in the classroom, as an alternative to consolidate learning in areas considered vulnerable in two regions of the country.

  1. On Modeling Risk Shocks

    OpenAIRE

    Dorofeenko, Victor; Lee, Gabriel; Salyer, Kevin; Strobel, Johannes

    2016-01-01

    Within the context of a financial accelerator model, we model time-varying uncertainty (i.e. risk shocks) through the use of a mixture Normal model with time variation in the weights applied to the underlying distributions characterizing entrepreneur productivity. Specifically, we model capital producers (i.e. the entrepreneurs) as either low-risk (relatively small second moment for productivity) and high-risk (relatively large second moment for productivity) and the fraction of both types is...

  2. Competencies Framework for Climate Services.

    Science.gov (United States)

    Aguilar, Enric

    2016-04-01

    The World Climate Conference-3 (Geneva, 2009) established the Global Framework for Climate Services (GFCS) to enable better management of the risks of climate variability and change and adaptation to climate change at all levels, through development and incorporation of science-based climate information and prediction into planning, policy and practice. The GFCS defines Climate Services as the result of transforming climate data into climate information in a way that responds to user needs and assists decision-making by individuals and organizations. Capacity Development is a cross-cutting pillar of the GFCS to ensure that services are provided by institutions with professionals whom achieved the adequate set of competencies recommended by WMO, which are yet to be fully defined. The WMO-Commission for Climatology Expert Team on Education and Training, ET-ETR, has been working to define a Competencies Framework for Climate Services to help the institutions to deliver high quality climate services in compliance with WMO standards and regulations, specifically those defined by WMO's Commission for Climatology and the GFCS. This framework is based in 5 areas or competence, closely associated to the areas of work of climate services providers: create and manage climate data sets; derive products from climate data; create and/or interpret climate forecasts and model output; ensure the quality of climate information and services; communicate climatological information with users. With this contribution, we intend to introduce to a wider audience the rationale behind these 5 top-level competency statements and the performance criteria associated with them, as well as the plans of the ET-ETR for further developing them into an instrument to support education and training within the WMO members, specially the National Meteorological and Hydrological Services.

  3. A competing risks approach for time estimation of household WEEE disposal

    International Nuclear Information System (INIS)

    Gutierrez, E.; Adenso-Diaz, B.; Lozano, S.; Gonzalez-Torre, P.

    2010-01-01

    The recent growth in the number of electrical and electronic devices is viewed as one the priority waste streams in European Union waste management policy. This paper presents the findings of a survey to study domestic habits with respect to Waste Electrical and Electronic Equipment (WEEE) in Spain. A specific problem when performing this estimation arises from the fact that consumers quite often store old appliances at home when they are no longer used. Focusing on four different types of appliance, survival analysis (SA) is used to study both the usage span and the reasons for no longer using each device. The time that the discarded products were kept at home before being disposed of was studied using competing risks (CR) analysis. The results of the analysis provide information on the distribution of the studied variables for the different outcomes as well as the influence exerted by the socio-demographic variables considered. Relations between these characteristics and the storage time of the appliances before disposal emerge based on survey data. For instance, the CR model finds that the storage time of the some appliances (i.e. refrigerator) is related to these social-demographics factors. However, other appliances (i.e. microwave oven) are less influenced by these factors. The attitude and motivation of the respondents to the survey as regards the End-of-Life of appliances were also analysed. A majority of respondents do not store discarded appliances at home. The first reason for storing appliances at home is the possibility of it being useful in the future and the second that the respondents did not know what to do with them.

  4. Construction of Site Risk Model using Individual Unit Risk Model in a NPP Site

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ho Gon; Han, Sang Hoon [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    Since Fukushima accident, strong needs to estimate site risk has been increased to identify the possibility of re-occurrence of such a tremendous disaster and prevent such a disaster. Especially, in a site which has large fleet of nuclear power plants, reliable site risk assessment is very emergent to confirm the safety. In Korea, there are several nuclear power plant site which have more than 6 NPPs. In general, risk model of a NPP in terms of PSA is very complicated and furthermore, it is expected that the site risk model is more complex than that. In this paper, the method for constructing site risk model is proposed by using individual unit risk model. Procedure for the development of site damage (risk) model was proposed in the present paper. Since the site damage model is complicated in the sense of the scale of the system and dependency of the components of the system, conventional method may not be applicable in many side of the problem.

  5. Competency-based models of learning for engineers: a comparison

    Science.gov (United States)

    Lunev, Alexander; Petrova, Irina; Zaripova, Viktoria

    2013-10-01

    One of the goals of higher professional education is to develop generic student competencies across a variety of disciplines that play a crucial role in education and that provide wider opportunities for graduates in finding good jobs and more chance of promotion. In this article a list of generic competencies developed in Russian universities is compared with a similar list developed by a consortium of Russian and European universities (project TUNING-RUSSIA). Then there is a second comparison with a list of competencies taken from the CDIO Syllabus. This comparison indicates the degree of similarity among the lists and the possible convergence among universities all over the world. The results are taken from a survey carried out among Russian employers, academics, and graduates. The survey asked to rate each listed competence by its importance and the degree of achieving goals in the process of the education.

  6. Performance and competence in usage-based construction grammar

    DEFF Research Database (Denmark)

    Jensen, Kim Ebensgaard

    2014-01-01

    While formalist approaches in the Chomskian tradition to language distinguish sharply between performance and competence in their modeling of language competence, performance and competence are considered to be in a mutually influential relation in usage-based models of language. Language...... competence, in the latter approach, is, much like in Dell Hymes’ notion of communicative competence, held to be experientially based in the sense that speakers establish their competence through inductive social-cognitive processes of schematization and conventionalization. Making a case for the usage......-based definition of the language system, his paper explores the interplay between performance and competence in a construction grammar perspective in which grammatical constructions are considered meaningful symbolic units on par with lexemes, in relation to the [V until ADJ]-construction, based on a study...

  7. Standardized Competencies for Parenteral Nutrition Order Review and Parenteral Nutrition Preparation, Including Compounding: The ASPEN Model.

    Science.gov (United States)

    Boullata, Joseph I; Holcombe, Beverly; Sacks, Gordon; Gervasio, Jane; Adams, Stephen C; Christensen, Michael; Durfee, Sharon; Ayers, Phil; Marshall, Neil; Guenter, Peggi

    2016-08-01

    Parenteral nutrition (PN) is a high-alert medication with a complex drug use process. Key steps in the process include the review of each PN prescription followed by the preparation of the formulation. The preparation step includes compounding the PN or activating a standardized commercially available PN product. The verification and review, as well as preparation of this complex therapy, require competency that may be determined by using a standardized process for pharmacists and for pharmacy technicians involved with PN. An American Society for Parenteral and Enteral Nutrition (ASPEN) standardized model for PN order review and PN preparation competencies is proposed based on a competency framework, the ASPEN-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines, and is intended for institutions and agencies to use with their staff. © 2016 American Society for Parenteral and Enteral Nutrition.

  8. Access to Heart Transplantation: A Proper Analysis of the Competing Risks of Death and Transplantation Is Required to Optimize Graft Allocation.

    Science.gov (United States)

    Cantrelle, Christelle; Legeai, Camille; Latouche, Aurélien; Tuppin, Philippe; Jasseron, Carine; Sebbag, Laurent; Bastien, Olivier; Dorent, Richard

    2017-08-01

    Heart allocation systems are usually urgency-based, offering grafts to candidates at high risk of waitlist mortality. In the context of a revision of the heart allocation rules, we determined observed predictors of 1-year waitlist mortality in France, considering the competing risk of transplantation, to determine which candidate subgroups are favored or disadvantaged by the current allocation system. Patients registered on the French heart waitlist between 2010 and 2013 were included. Cox cause-specific hazards and Fine and Gray subdistribution hazards were used to determine candidate characteristics associated with waitlist mortality and access to transplantation. Of the 2053 candidates, 7 variables were associated with 1-year waitlist mortality by the Fine and Gray method including 4 candidate characteristics related to heart failure severity (hospitalization at listing, serum natriuretic peptide level, systolic pulmonary artery pressure, and glomerular filtration rate) and 3 characteristics not associated with heart failure severity but with lower access to transplantation (blood type, age, and body mass index). Observed waitlist mortality for candidates on mechanical circulatory support was like that of others. The heart allocation system strongly modifies the risk of pretransplant mortality related to heart failure severity. An in-depth competing risk analysis is therefore a more appropriate method to evaluate graft allocation systems. This knowledge should help to prioritize candidates in the context of a limited donor pool.

  9. Model of urban poverty alleviation through the development of entrepreneurial spirit and business competence

    Science.gov (United States)

    Aryaningsih, NN; Irianto, Kt; Marsa Arsana, Md; Juli Suarbawa, Kt

    2018-01-01

    The rapid increased of urban population can not be controlled by the city government. This will have an impact on the emergence of new poverty in urban areas, due to inadequate of the job opportunities and skills. Government programs for poverty alleviation can reduce some rural poverty, but have not been able to overcome poverty in urban areas. The diversity of urban issues and needs is greater than in rural areas. Therefore, it is necessary to conduct the research with the aim to build urban poverty reduction model through the development of entrepreneurship spirit and business competence. This research was conducted by investigation method, and questionnaire. Questionnaires are arranged with rating scale measurements. The validity and reliability of the questionnaire were tested by factor analysis. Model construction is constructed from various informant analyzes and descriptive statistical analysis. The results show that poverty alleviation model is very effective done by developing spirit of entrepreneurship and business competence.

  10. THREE-DIMENSIONAL MODELING TOOLS IN THE PROCESS OF FORMATION OF GRAPHIC COMPETENCE OF THE FUTURE BACHELOR OF COMPUTER SCIENCE

    Directory of Open Access Journals (Sweden)

    Kateryna P. Osadcha

    2017-12-01

    Full Text Available The article is devoted to some aspects of the formation of future bachelor's graphic competence in computer sciences while teaching the fundamentals for working with three-dimensional modelling means. The analysis, classification and systematization of three-dimensional modelling means are given. The aim of research consists in investigating the set of instruments and classification of three-dimensional modelling means and correlation of skills, which are being formed, concerning inquired ones at the labour market in order to use them further in the process of forming graphic competence during training future bachelors in computer sciences. The peculiarities of the process of forming future bachelor's graphic competence in computer sciences by means of revealing, analyzing and systematizing three-dimensional modelling means and types of three-dimensional graphics at present stage of the development of informational technologies are traced a line round. The result of the research is a soft-ware choice in three-dimensional modelling for the process of training future bachelors in computer sciences.

  11. Custom v. Standardized Risk Models

    Directory of Open Access Journals (Sweden)

    Zura Kakushadze

    2015-05-01

    Full Text Available We discuss when and why custom multi-factor risk models are warranted and give source code for computing some risk factors. Pension/mutual funds do not require customization but standardization. However, using standardized risk models in quant trading with much shorter holding horizons is suboptimal: (1 longer horizon risk factors (value, growth, etc. increase noise trades and trading costs; (2 arbitrary risk factors can neutralize alpha; (3 “standardized” industries are artificial and insufficiently granular; (4 normalization of style risk factors is lost for the trading universe; (5 diversifying risk models lowers P&L correlations, reduces turnover and market impact, and increases capacity. We discuss various aspects of custom risk model building.

  12. Conceptual framework for performance assessment: competency, competence and performance in the context of assessments in healthcare--deciphering the terminology.

    Science.gov (United States)

    Khan, Kamran; Ramachandran, Sankaranarayanan

    2012-01-01

    The definitions of performance, competence and competency are not very clear in the literature. The assessment of performance and the selection of tools for this purpose depend upon a deep understanding of each of the above terms and the factors influencing performance. In this article, we distinguish between competence and competency and explain the relationship of competence and performance in the light of the Dreyfus model of skills acquisition. We briefly critique the application of the principles described by Miller to the modern assessment tools and distinguish between assessment of actual performance in workplace settings and the observed performance, demonstrated by the candidates in the workplace or simulated settings. We describe a modification of the Dreyfus model applicable to assessments in healthcare and propose a new model for the assessment of performance and performance rating scale (PRS) based on this model. We propose that the use of adapted versions of this PRS will result in benchmarking of performance and allowing the candidates to track their progression of skills in various areas of clinical practice.

  13. Trust and risk: a model for medical education.

    Science.gov (United States)

    Damodaran, Arvin; Shulruf, Boaz; Jones, Philip

    2017-09-01

    Health care delivery, and therefore medical education, is an inherently risky business. Although control mechanisms, such as external audit and accreditation, are designed to manage risk in clinical settings, another approach is 'trust'. The use of entrustable professional activities (EPAs) represents a deliberate way in which this is operationalised as a workplace-based assessment. Once engaged with the concept, clinical teachers and medical educators may have further questions about trust. This narrative overview of the trust literature explores how risk, trust and control intersect with current thinking in medical education, and makes suggestions for potential directions of enquiry. Beyond EPAs, the importance of trust in health care and medical education is reviewed, followed by a brief history of trust research in the wider literature. Interpersonal and organisational levels of trust and a model of trust from the management literature are used to provide the framework with which to decipher trust decisions in health care and medical education, in which risk and vulnerability are inherent. In workplace learning and assessment, the language of 'trust' may offer a more authentic and practical vocabulary than that of 'competency' because clinical and professional risks are explicitly considered. There are many other trust relationships in health care and medical education. At the most basic level, it is helpful to clearly delineate who is the trustor, the trustee, and for what task. Each relationship has interpersonal and organisational elements. Understanding and considered utilisation of trust and control mechanisms in health care and medical education may lead to systems that maturely manage risk while actively encouraging trust and empowerment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  14. Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups.

    Science.gov (United States)

    Marschollek, Michael; Gövercin, Mehmet; Rust, Stefan; Gietzelt, Matthias; Schulze, Mareike; Wolf, Klaus-Hendrik; Steinhagen-Thiessen, Elisabeth

    2012-03-14

    Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2). A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances. The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity. Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified

  15. Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups

    Directory of Open Access Journals (Sweden)

    Marschollek Michael

    2012-03-01

    Full Text Available Abstract Background Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1, and to identify high-risk subgroups from the data (aim#2. Methods A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493. A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances. Results The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity. Conclusions Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack

  16. Communication competence, social support, and depression among college students: a model of facebook and face-to-face support network influence.

    Science.gov (United States)

    Wright, Kevin B; Rosenberg, Jenny; Egbert, Nicole; Ploeger, Nicole A; Bernard, Daniel R; King, Shawn

    2013-01-01

    This study examined the influence of the social networking site Facebook and face-to-face support networks on depression among (N = 361) college students. The authors used the Relational Health Communication Competence Model as a framework for examining the influence of communication competence on social support network satisfaction and depression. Moreover, they examined the influence of interpersonal and social integrative motives as exogenous variables. On the basis of previous work, the authors propose and test a theoretical model using structural equation modeling. The results indicated empirical support for the model, with interpersonal motives predicting increased face-to-face and computer-mediated competence, increased social support satisfaction with face-to-face and Facebook support, and lower depression scores. The implications of the findings for theory, key limitations, and directions for future research are discussed.

  17. Sustainable Transformation & Effective Competency Management Practices in Nuclear Organizations

    International Nuclear Information System (INIS)

    Gardelliano, S.

    2016-01-01

    Full text: Managing essential knowledge as a strategic organizational asset is a factor of upmost relevance in today’s nuclear organizations. The author considers evident that competencies are critical carriers of knowledge. As such the use of an appropriate competency model could be the most effective way to capture the present reservoir of explicit and tacit Knowledge of specific functions or organizational areas. Besides, we could use them for new or other redesigned functions or determine the needs of specific competencies for future positions. Therefore, appropriate competency models or systems have to be developed or updated in each nuclear organization since these are fundamental for managing more effectively and efficiently the present nuclear human capital and to forecast the evolving competence required in management, technical, scientific and safety areas to continuously ensure a highly competent nuclear workforce. On the other hand, competency based management models or systems would not achieve the expected results if they are not fully designed and integrated within the strategic organizational infrastructure of the related nuclear organization. This paper is expected to provide a wider view and practical reflections on organizational transformation issues and the benefits of using an integrative competency model in the nuclear industry. Particularly, the paper give an insight of an empiric model for strategic organizational transformation processes and integrative management practices, and on how to realign strategic issues with top management processes and build organizational capacity through effective competency based management for the sustainable transformation of nuclear organizations. (author

  18. Competing risks and the development of adaptive management plans for water resources: Field reconnaissance investigation of risks to fishes and other aquatic biota exposed to endocrine disrupting chemicals (edcs) in lake mead, Nevada USA

    Science.gov (United States)

    Linder, G.; Little, E.E.

    2009-01-01

    The analysis and characterization of competing risks for water resources rely on a wide spectrum of tools to evaluate hazards and risks associated with their management. For example, waters of the lower Colorado River stored in reservoirs such as Lake Mead present a wide range of competing risks related to water quantity and water quality. These risks are often interdependent and complicated by competing uses of source waters for sustaining biological resources and for supporting a range of agricultural, municipal, recreational, and industrial uses. USGS is currently conducting a series of interdisciplinary case-studies on water quality of Lake Mead and its source waters. In this case-study we examine selected constituents potentially entering the Lake Mead system, particularly endocrine disrupting chemicals (EDCs). Worldwide, a number of environmental EDCs have been identified that affect reproduction, development, and adaptive behaviors in a wide range of organisms. Many EDCs are minimally affected by current treatment technologies and occur in treated sewage effluents. Several EDCs have been detected in Lake Mead, and several substances have been identified that are of concern because of potential impacts to the aquatic biota, including the sport fishery of Lake Mead and endangered razorback suckers (Xyrauchen texanus) that occur in the Colorado River system. For example, altered biomarkers relevant to reproduction and thyroid function in fishes have been observed and may be predictive of impaired metabolism and development. Few studies, however, have addressed whether such EDC-induced responses observed in the field have an ecologically significant effect on the reproductive success of fishes. To identify potential linkages between EDCs and species of management concern, the risk analysis and characterization in this reconnaissance study focused on effects (and attendant uncertainties) that might be expressed by exposed populations. In addition, risk reduction

  19. Market Analysis and Risk Management of EU Emissions Trading - MARMET

    International Nuclear Information System (INIS)

    Ollikainen, M.; Aatola, P.; Ollikka, K.; Kumpulainen, A.; Pohjola, T.; Lappalainen, E.

    2007-01-01

    The first period of the EU Emissions Trading Scheme (EU ETS) commenced on January 1st 2005. It implies new challenges to companies included in the scheme. A central challenge is the uncertainty related to the markets. In order to manage their risks and profitability companies need to be able to estimate future price developments of emission allowances. The University of Helsinki is conducting a research project in cooperation with the Helsinki University of Technology that will provide necessary information for analyzing European Union emission allowance (EUA) markets and create risk management competence. The objectives of the research project are (1) to develop a price estimation model for EU emission allowances and (2) to develop risk management competence related to EU ETS. With the price estimation model the short-term price developments of EUAs can be estimated. By utilizing the model companies can reduce uncertainties related to the markets. The project also delivers a general risk management model for EU ETS that aims at improving competitiveness of companies. (orig.)

  20. Stochastic resonance and noise delayed extinction in a model of two competing species

    Science.gov (United States)

    Valenti, D.; Fiasconaro, A.; Spagnolo, B.

    2004-01-01

    We study the role of the noise in the dynamics of two competing species. We consider generalized Lotka-Volterra equations in the presence of a multiplicative noise, which models the interaction between the species and the environment. The interaction parameter between the species is a random process which obeys a stochastic differential equation with a generalized bistable potential in the presence of a periodic driving term, which accounts for the environment temperature variation. We find noise-induced periodic oscillations of the species concentrations and stochastic resonance phenomenon. We find also a nonmonotonic behavior of the mean extinction time of one of the two competing species as a function of the additive noise intensity.

  1. Influence of a health-related physical fitness model on students' physical activity, perceived competence, and enjoyment.

    Science.gov (United States)

    Fu, You; Gao, Zan; Hannon, James; Shultz, Barry; Newton, Maria; Sibthorp, Jim

    2013-12-01

    This study was designed to explore the effects of a health-related physical fitness physical education model on students' physical activity, perceived competence, and enjoyment. 61 students (25 boys, 36 girls; M age = 12.6 yr., SD = 0.6) were assigned to two groups (health-related physical fitness physical education group, and traditional physical education group), and participated in one 50-min. weekly basketball class for 6 wk. Students' in-class physical activity was assessed using NL-1000 pedometers. The physical subscale of the Perceived Competence Scale for Children was employed to assess perceived competence, and children's enjoyment was measured using the Sport Enjoyment Scale. The findings suggest that students in the intervention group increased their perceived competence, enjoyment, and physical activity over a 6-wk. intervention, while the comparison group simply increased physical activity over time. Children in the intervention group had significantly greater enjoyment.

  2. New Hybrid Multiple Attribute Decision-Making Model for Improving Competence Sets: Enhancing a Company’s Core Competitiveness

    Directory of Open Access Journals (Sweden)

    Kuan-Wei Huang

    2016-02-01

    Full Text Available A company’s core competitiveness depends on the strategic allocation of its human resources in alignment with employee capabilities. Competency models can identify the range of capabilities at a company’s disposal, and this information can be used to develop internal or external education training policies for sustainable development. Such models can ensure the importation of a strategic orientation reflecting the growth of its employee competence set and enhancing human resource sustainably. This approach ensures that the most appropriate people are assigned to the most appropriate positions. In this study, we proposed a new hybrid multiple attributed decision-making model by using the Decision-making trial and Evaluation Laboratory Technique (DEMATEL to construct an influential network relation map (INRM and determined the influential weights by using the basic concept of the analytic network process (called DEMATEL-based ANP, DANP; the influential weights were then adopted with a modified Vise Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR method. A simple forecasting technique as an iteration function was also proposed. The proposed model was effective. We expect that the proposed model can facilitate making timely revisions, reflecting the growth of employee competence sets, reducing the performance gap toward the aspiration level, and ensuring the sustainability of a company.

  3. Shyness, Masculine Ideology, Physical Attractiveness, and Emotional Inexpressiveness: Testing a Mediational Model of Men's Interpersonal Competence.

    Science.gov (United States)

    Bruch, Monroe A.; Berko, Eric H.; Haase, Richard F.

    1998-01-01

    A model was tested in which emotional inexpressiveness fully mediates the relationship of shyness, gender identity, and physical attractiveness with men's interpersonal competence. In a second study, a partially mediated model explained the data better. Implications for further modifications and testing of the model and for counseling practice are…

  4. Competencies - a roadmap for CERN Staff

    CERN Multimedia

    CERN Bulletin

    2011-01-01

    Back in November, the new CERN Competency Model (CCM), a framework defining the competencies that “ drive performance and lead to excellence”, was introduced by Anne-Sylvie Catherin, Head of the Human Resources (HR) Department, in a special edition of the "Spotlight on CERN" interviews.   What are competencies? Competencies are the characteristics that allow you to do the job you have been assigned. In more precise terms, competencies may be described as the knowledge, skills and types of behaviour that individuals demonstrate in carrying out a given task. Listing all the competencies that make CERN work is an impossible task but one can identify the two main types: technical and behavioural. Both are needed to work effectively in this Organization. While technical competencies are simply the domains of expertise that CERN needs – examples include physics, mechanical engineering and information technology – behavioural competencies are th...

  5. Exact solution of an Ising model with competing interactions on a Cayley tree

    CERN Document Server

    Ganikhodjaev, N N; Wahiddin, M R B

    2003-01-01

    The exact solution of an Ising model with competing restricted interactions on the Cayley tree, and in the absence of an external field is presented. A critical curve is defined where it is possible to get phase transitions above it, and a single Gibbs state is obtained elsewhere.

  6. THE MODEL OF LINGUISTIC TEACHERS’ COMPETENCY DEVELOPMENT ON DESIGNING MULTIMEDIA ELECTRONIC EDUCATIONAL RESOURCES IN THE MOODLE SYSTEM

    Directory of Open Access Journals (Sweden)

    Anton M. Avramchuk

    2017-10-01

    Full Text Available The article is devoted to the problem of developing the competency of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system. The concept of "the competence of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system" is justified and defined. Identified and characterized the components by which the levels of the competency development of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system should be assessed. Developed a model for the development of the competency of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system, which is based on the main scientific approaches, used in adult education, and consists of five blocks: target, informative, technological, diagnostic and effective.

  7. The Relationship between entrepreneurial orientation, entrepreneurial competencies, entrepreneurial leadership, and firm performance: A proposed model

    Directory of Open Access Journals (Sweden)

    Chijioke Nwachukwu

    2017-06-01

    Full Text Available This study develops a conceptual model and propositions for researchers to explore the direct and indirect relationship between entrepreneurial orientation, entrepreneurial competencies, entrepreneurial leadership and firm performance. Authors searched various databases including ProQuest, EBSCOhost databases, Scopus for peer reviewed Journals, books, and other relevant publications on the subject. A conceptual review provides direction for researchers to empirically examine the direct relationships between entrepreneurial orientation (EO, entrepreneurial competencies (EC, and firm performance and the mediating effect of entrepreneurial leadership (EL in the relationship between EO, EC, and firm performance. We suggest the use of entrepreneurial orientation scale (EOS, The entrecomp framework (2016, Renko et al., 2015 entrepreneurial leadership styles scale (ENTRELEAD, and Santos & Brito (2012 subjective measurement model for firm performance for measurement of the constructs of EO, EC, EL and performance. For researchers and academics, the model provides a basis for further research by testing empirically the validity of the model. Testing of this model could provide a better understanding of the EO, EC constructs that better predicts strategic and financial performance.

  8. Students' Competencies in Working with Functions in Secondary Mathematics Education-Empirical Examination of a Competence Structure Model

    Science.gov (United States)

    Nitsch, Renate; Fredebohm, Anneke; Bruder, Regina; Kelava, Augustin; Naccarella, Dominik; Leuders, Timo; Wirtz, Markus

    2015-01-01

    In the subject matter of functional relationships, a student's ability to translate from one form of representation to another is seen as a central competence. In the course of the HEUREKO project (heuristic work with representations of functional relationships and the diagnosis of mathematical competencies of students), a theoretical competence…

  9. Identifying context-specific competencies required by community Australian Football sports trainers.

    Science.gov (United States)

    Donaldson, Alex; Finch, Caroline F

    2012-08-01

    First-aid is a recommended injury prevention and risk management strategy in community sport; however, little is known about the sport-specific competencies required by first-aid providers. To achieve expert consensus on the competencies required by community Australian Football (community-AF) sports trainers. A three-round online Delphi process. Community-AF. 16 Australian sports first-aid and community-AF experts. Rating of competencies as either 'essential', 'expected', 'ideal' or 'not required'. Results After Round 3, 47 of the 77 (61%) competencies were endorsed as 'essential' or 'expected' for a sports trainer to effectively perform the activities required to the standards expected at a community-AF club by ≥75% of experts. These competencies covered: the role of the sports trainer; the responsibilities of the sports trainer; emergency management; injury and illness assessment and immediate management; taping; and injury prevention and risk management. Four competencies (5%) were endorsed as 'ideal' or 'not required' by ≥85% of experts and were excluded from further consideration. The 26 competencies where consensus was not reached were retained as second-tier, optional competencies. Sports trainers are important members of on-field first-aid teams, providing support to both injured players and other sports medicine professionals. The competencies identified in this study provide the basis of a proposed two-tiered community-AF-specific sports trainer education structure that can be implemented by the peak sports body. This includes six mandatory modules, relating to the 'required' competencies, and a further six optional modules covering competencies on which consensus was not reached.

  10. TEACHER‘S COMMUNICATIVE COMPETENCE OF ENGLISH FOR MATHS

    Directory of Open Access Journals (Sweden)

    Ima Isnaini Taufiqur Rohmah

    2017-12-01

    Full Text Available The aim of this study is to describe the communicative competence possessed by ―English for Math‖ teacher in handling the teaching and learning. Considered under the qualitative case study, observation conducted to get the data of the teacher‘s communicative competence based on Celcemurcia‘s model of communicative competence (2007 which is consist of discourse, linguistics, socio-cultural, strategic, interactional, and formulaic competence. Interview also conducted to support the data from observation. This study conducted at Mathematics Study Program IKIP PGRI Bojonegoro and the teacher as the respondent. The result of the study reveals that teacher‘s sociocultural, discourse and linguistics competence were not good but she has good formulaic, interactional, and strategic competences. Developing sociocultural, discourse and linguistics competence are needed to be able to give a good model for the students, since as a teacher, we much influence our students.

  11. Long-Term Survival in Young Women: Hazards and Competing Risks after Thyroid Cancer

    International Nuclear Information System (INIS)

    Stroup, A. M.; Harrell, C. J.; Herget, K. A.

    2012-01-01

    Differentiated thyroid cancers (DTCs) are one of the most common and survivable cancers diagnosed in women. We examine factors associated with long-term survival and competing risks of death in women diagnosed with DTC under the age of 40 (<40) and aged 40 and older (40+). Methods. SEER data was used to identify DTCs diagnosed in women from 1975 to 2009. We examined overall (OS), disease-specific (DSS), other cancer (OCS), and non-cancer-related (NCS) survival using multivariate Cox proportional hazards modeling. Results. Observed survival was 97.2% for <40 (n=14,540) and 82.5% for 40+ (n=20,513). Distant stage (HR=1.96, 95% CI 1.23-3.07), non-Hispanic Black (HR=2.04, 95% CI 1.45-2.87), being unmarried (HR=1.26, 95% 1.03-1.54), and subsequent primary cancers (HR=4.63, 95% CI 3.76-5.71) were significant for OS in women <40. Age was an effect modifier for all survival outcomes. Racial disparities in NCS were most pronounced for young non-Hispanic black women (HR=3.36, 95% CI 2.17-5.22). Women in both age groups were more likely to die from other causes. Conclusions. Age at diagnosis remains one of the strongest prognostic factors for thyroid cancer survival. More directed efforts to ensure effective care for co morbid conditions are needed to reduce mortality from other causes.

  12. A model parent group for enhancing aggressive children's social competence in Taiwan.

    Science.gov (United States)

    Li, Ming-Hui

    2009-07-01

    This paper presents a semi-structured psychoeducational model of group work for parents of aggressive children based on concepts of co-parenting and bidirectionality. The group was developed for enhancing five Taiwanese aggressive children's social competence by promoting positive interactions within family. Topics covered in the group included identifying parenting styles, forming parental alliances, fostering parent-child mutual initiations/mutual compliances, establishing parent-child co-regulation, and responding to aggressive children's negative emotions. Pre- and post-group comparisons suggested the effectiveness of the group model.

  13. Teachers’ individual action theories about competence-based education: the value of the cognitive apprenticeship model

    NARCIS (Netherlands)

    Seezink, Audrey; Poell, Rob; Kirschner, Paul A.

    2009-01-01

    Seezink, A., Poell, R. F., & Kirschner, P. A. (2009). Teachers' individual action theories about competence-based education: The value of the cognitive apprenticeship model. Journal of Vocational Education & Training, 61, 203-215.

  14. Comparison of additive (absolute) risk projection models and multiplicative (relative) risk projection models in estimating radiation-induced lifetime cancer risk

    International Nuclear Information System (INIS)

    Kai, Michiaki; Kusama, Tomoko

    1990-01-01

    Lifetime cancer risk estimates depend on risk projection models. While the increasing lengths of follow-up observation periods of atomic bomb survivors in Hiroshima and Nagasaki bring about changes in cancer risk estimates, the validity of the two risk projection models, the additive risk projection model (AR) and multiplicative risk projection model (MR), comes into question. This paper compares the lifetime risk or loss of life-expectancy between the two projection models on the basis of BEIR-III report or recently published RERF report. With Japanese cancer statistics the estimates of MR were greater than those of AR, but a reversal of these results was seen when the cancer hazard function for India was used. When we investigated the validity of the two projection models using epidemiological human data and animal data, the results suggested that MR was superior to AR with respect to temporal change, but there was little evidence to support its validity. (author)

  15. Models for Evaluating and Improving Architecture Competence

    National Research Council Canada - National Science Library

    Bass, Len; Clements, Paul; Kazman, Rick; Klein, Mark

    2008-01-01

    Software architecture competence is the ability of an individual or organization to acquire, use, and sustain the skills and knowledge necessary to carry out software architecture-centric practices...

  16. Understanding cultural competence in a multicultural nursing workforce: registered nurses' experience in Saudi Arabia.

    Science.gov (United States)

    Almutairi, Adel F; McCarthy, Alexandra; Gardner, Glenn E

    2015-01-01

    In Saudi Arabia, the health system is mainly staffed by expatriate nurses from different cultural and linguistic backgrounds. Given the potential risks this situation poses for patient care, it is important to understand how cultural diversity can be effectively managed in this multicultural environment. The purpose of this study was to explore notions of cultural competence with non-Saudi Arabian nurses working in a major hospital in Saudi Arabia. Face-to-face, audio-recorded, semistructured interviews were conducted with 24 non-Saudi Arabian nurses. Deductive data collection and analysis were undertaken drawing on Campinha-Bacote's cultural competence model. The data that could not be explained by this model were coded and analyzed inductively. Nurses within this culturally diverse environment struggled with the notion of cultural competence in terms of each other's cultural expectations and those of the dominant Saudi culture. The study also addressed the limitations of Campinha-Bacote's model, which did not account for all of the nurses' experiences. Subsequent inductive analysis yielded important themes that more fully explained the nurses' experiences in this environment. The findings can inform policy, professional education, and practice in the multicultural Saudi setting. © The Author(s) 2014.

  17. Competency-Based Evaluation in Higher Education--Design and Use of Competence Rubrics by University Educators

    Science.gov (United States)

    Velasco-Martínez, Leticia-Concepción; Tójar-Hurtado, Juan-Carlos

    2018-01-01

    Competency-based learning requires making changes in the higher education model in response to current socio-educational demands. Rubrics are an innovative educational tool for competence evaluation, for both students and educators. Ever since arriving at the university systems, the application of rubrics in evaluation programs has grown…

  18. TRAINING OF E-LEARNING MANAGERS: COMPETENCY APPROACH

    Directory of Open Access Journals (Sweden)

    Nataliia V. Morze

    2017-09-01

    Full Text Available The article analyzes the competencies necessary for the successful professional activity of e-learning managers. The content of the professional qualification "e-learning manager" is revealed. The model of competency system of the e-learning manager is offered. The model, which defines the content, forms, methods and means of training, tools and indicators for assessing the results of training e-learning managers by levels, is substantiated. Examples of competency tasks for forming of professional competencies in innovative teaching methods and technologies, Web 2.0 services, e-learning expertise, e-environment design, IT infrastructure management, and the development of Soft skills are presented. It is proposed to solve the problem of training specialists who will be able not only to use ICT in educational activities, but also to master the competencies of e-learning management.

  19. Integrating Research Competencies in Massage Therapy Education.

    Science.gov (United States)

    Hymel, Glenn M.

    The massage therapy profession is currently engaged in a competency-based education movement that includes an emphasis on promoting massage therapy research competencies (MTRCs). A systems-based model for integrating MTRCs into massage therapy education was therefore proposed. The model and an accompanying checklist describe an approach to…

  20. Decorated Ising models with competing interactions and modulated structures

    International Nuclear Information System (INIS)

    Tragtenberg, M.H.R.; Yokoi, C.S.O.; Salinas, S.R.A.

    1988-01-01

    The phase diagrams of a variety of decorated Ising lattices are calculated. The competing interactions among the decorating spins may induce different types of modulated orderings. In particular, the effect of an applied field on the phase diagram of the two-dimensional mock ANNNI model is considered, where only the original horizontal bonds on a square lattice are decorated. Some Bravais lattices and Cayley trees where all bonds are equally decorated are then studied. The Bravais lattices display a few stable modulated structures. The Cayley trees, on the other hand, display a large number of modulated phases, which increases with the lattice coordination number. (authors) [pt

  1. A new vision of management competencies built in Business Simulations

    Directory of Open Access Journals (Sweden)

    Gabriel Vianna Schlatter

    2015-09-01

    Full Text Available This paper presents a survey conducted on users of an online business simulation for an undergraduate Business Administration course. Previous research on the use of business simulations described the validity of this resource as a method for developing managerial skills, as well as the perceptions of students about the experience. However, few studies sought to directly assess which management competencies are built through the use of simulators. In this study, students expressed their perception of the management competencies developed by participating in the simulation. The survey was structured according to the macro-competencies proposed by the Tuning Latin America Project and identified those with higher and lower perceived development.  It was found that the simulation was useful in building up competencies related to the use of information to support decision-making, management of company resources at the operational level and the identification and management of business risks. Moreover, it was possible to determine through factor analysis that the construction of various competencies occurred simultaneously, creating more elaborate assemblies. Five sets, composed of several competencies, have been identified and described as: carrying out undertakings based on data and facts; managing organization´s processes and projects; developing their own planning process; acting primarily with social responsibility; and, managing change risks through teamwork.

  2. Medical Writing Competency Model - Section 1: Functions, Tasks, and Activities.

    Science.gov (United States)

    Clemow, David B; Wagner, Bertil; Marshallsay, Christopher; Benau, Dan; L'Heureux, Darryl; Brown, David H; Dasgupta, Devjani Ghosh; Girten, Eileen; Hubbard, Frank; Gawrylewski, Helle-Mai; Ebina, Hiroko; Stoltenborg, Janet; York, J P; Green, Kim; Wood, Linda Fossati; Toth, Lisa; Mihm, Michael; Katz, Nancy R; Vasconcelos, Nina-Maria; Sakiyama, Norihisa; Whitsell, Robin; Gopalakrishnan, Shobha; Bairnsfather, Susan; Wanderer, Tatyana; Schindler, Thomas M; Mikyas, Yeshi; Aoyama, Yumiko

    2018-01-01

    This article provides Section 1 of the 2017 Edition 2 Medical Writing Competency Model that describes the core work functions and associated tasks and activities related to professional medical writing within the life sciences industry. The functions in the Model are scientific communication strategy; document preparation, development, and finalization; document project management; document template, standard, format, and style development and maintenance; outsourcing, alliance partner, and client management; knowledge, skill, ability, and behavior development and sharing; and process improvement. The full Model also includes Section 2, which covers the knowledge, skills, abilities, and behaviors needed for medical writers to be effective in their roles; Section 2 is presented in a companion article. Regulatory, publication, and other scientific writing as well as management of writing activities are covered. The Model was developed to aid medical writers and managers within the life sciences industry regarding medical writing hiring, training, expectation and goal setting, performance evaluation, career development, retention, and role value sharing to cross-functional partners.

  3. Credit Risk Modeling

    DEFF Research Database (Denmark)

    Lando, David

    Credit risk is today one of the most intensely studied topics in quantitative finance. This book provides an introduction and overview for readers who seek an up-to-date reference to the central problems of the field and to the tools currently used to analyze them. The book is aimed at researchers...... and students in finance, at quantitative analysts in banks and other financial institutions, and at regulators interested in the modeling aspects of credit risk. David Lando considers the two broad approaches to credit risk analysis: that based on classical option pricing models on the one hand...

  4. Childhood Predictors of Adolescent Competence and Self-Worth in Rural Youth

    Science.gov (United States)

    Rew, Lynn; Grady, Matthew W.; Spoden, Micajah

    2012-01-01

    Problem Urban children who become competent adults despite circumstances that place their development and mental health at risk are considered to be resilient. Less is known about the risk and protective factors that characterize resilience among Hispanic/Latinos living in rural areas. Methods Data for regression analyses were collected when children (N = 603; 54% Hispanic/Latino) enrolled in the study in fifth grade, (M=10.4 years of age) and again five years later when they were in high school (M=15 years of age). Findings Statistically significant predictors of competence and self-worth in high schoolers included gender, ethnicity, and mother’s education, as well as stress, temperament (task persistence), and competences measured in grade school. Conclusions Parents’ perceptions of child’s temperament is a significant predictor of future competence and self-worth among rural adolescents. PMID:23121139

  5. Childhood predictors of adolescent competence and self-worth in rural youth.

    Science.gov (United States)

    Rew, Lynn; Grady, Matthew W; Spoden, Micajah

    2012-11-01

    Urban children who become competent adults despite circumstances that place their development and mental health at risk are considered to be resilient. Less is known about the risk and protective factors that characterize resilience among Hispanic/Latinos living in rural areas. Data for regression analyses were collected when children (n = 603; 54% Hispanic/Latino) enrolled in the study in fifth grade (M = 10.4 years of age), and again 5 years later when they were in high school (M = 15 years of age). Statistically significant predictors of competence and self-worth in high schoolers included gender, ethnicity, and mother's education, as well as stress, temperament (task persistence), and competences measured in grade school. Parents' perception of child's temperament is a significant predictor of future competence and self-worth among rural adolescents. © 2012 Wiley Periodicals, Inc.

  6. Implementation of the human talent management through competencies model in a university in Metropolitan Lima

    Directory of Open Access Journals (Sweden)

    Juan C. Rodríguez

    2015-12-01

    Full Text Available This article is a work proposal that aims to describe the methodology proposed by the Management of Personnel Management from a university in Lima, to implement a management model based on competencies which traceability involves various technical HR processes practiced in the organization and is aligned to institutional outcomes defined in the balance score card. In order to do it, various literature sources were consulted, and the websites of the top ten universities worldwide to identify benchmarks were visited. Generic skills, competencies level, specific skills, competencies dictionary and graduation for each of the managements, occupational categories and administrative headquarters of the University: as a result, the following definitions and elements were obtained. In this way, the institution develops a tool to guide how and to what extent human resources should have and develop skills to achieve specific organizational results

  7. Theoretical Model of Professional Competence Development in Dual-Specialty Students (On the Example of the "History, Religious Studies" Specialty)

    Science.gov (United States)

    Karimova, A. E.; Amanova, A. S.; Sadykova, A. M.; Kuzembaev, N. E.; Makisheva, A. T.; Kurmangazina, G. Zh.; Sakenov, Janat

    2016-01-01

    The article explores the significant problem of developing a theoretical model of professional competence development in dual-specialty students (on the example of the "History, Religious studies" specialty). In order to validate the specifics of the professional competence development in dual-specialty students (on the example of the…

  8. Gamma ray induced sensitization in CaSO4:Dy and competing trap model

    International Nuclear Information System (INIS)

    Nagpal, J.S.; Kher, R.K.; Gangadharan, P.

    1979-01-01

    Gamma ray induced sensitization in CaSO 4 :Dy has been compared (by measurement of TL glow curves) for different temperatures during irradiation (25 0 , 120 0 and 250 0 C). Enhanced sensitization at elevated temperatures seems to support the competing trap model for supralinearity and sensitization in CaSO 4 :Dy. (author)

  9. The ways of police cadets’ social competence evaluation

    Directory of Open Access Journals (Sweden)

    V. M. Kiikov

    2016-10-01

    Full Text Available In the article analysis of general theoretic approaches towards competent and motivated behavior definitions, the model of police officer social competence was proposed along with the ways of its study. Based on development theory conception the initial validation of social competence logical system as a mean of cadets’ social competence evaluation was considered in the article. Additionally, the determination of personality development level as possibility for definition and evaluation of cadets’ social competence based on social behavior theory perspectives was considered. As well the social features of social competence of law­enforcement officers were discussed and the theoretical construction for schematized representation of police cadets’ social competence structure is presented. The model includes: social norms related to police activity; motivation to socially­oriented activity; social intelligence, as integrative characteristic of cognitive and operational processes; emotional steadiness and communication skills. It was stated that the main characteristic of police cadets’ social competence is efficiency of interaction between police and community. The other important factor influencing social competence is professional activity and in our case it is law­enforcement. The social environment of departmental educational institution was explored as a main factor contributing to development of police cadets’ social competence components.

  10. Peran Marketing Competency dalam Meningkatkan Keunggulan Bersaing

    OpenAIRE

    Rahayu, Fatik

    2006-01-01

    Functional area competencies are considered as sources of competitive advantage (Porter, 1994; Heene & Stanches, 1997; Cravens, 1996; Vickery el AI, 1993; Vickery et. Al, 1994), and marketing competency is one of them. Marketing competency construct is defined as the sum of the performed on 31 competitive items, weighted by importance and extent of marketing responsibility (Vickery et al., 1994).This study examines a model of relationships between marketing competency and business perform...

  11. The Influence of Supervisor Multicultural Competence on the Supervisory Working Alliance, Supervisee Counseling Self-efficacy, and Supervisee Satisfaction with Supervision: A Mediation Model

    Science.gov (United States)

    Crockett, Stephanie; Hays, Danica G.

    2015-01-01

    We developed and tested a mediation model depicting relationships among supervisor multicultural competence, the supervisory working alliance, supervisee counseling self-efficacy, and supervisee satisfaction with supervision. Results of structural equation modeling showed that supervisor multicultural competence was related to the supervisory…

  12. Risk factors for competing noncancer mortality after definitive treatment for advanced-stage head and neck cancer.

    Science.gov (United States)

    Kim, Yong Han; Roh, Jong-Lyel; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

    2018-05-27

    Patients with head and neck cancer (HNC) can die of index tumor progression and second tumor or noncancer causes. Here, we investigated the risk factors for competing noncancer mortality (NCM) in a prospective cohort of patients with advanced-stage HNC. A prospective observational study was conducted with 604 patients who underwent definitive treatment for advanced-stage HNC between 2010 and 2015. Main outcomes were NCM and cancer mortality (CM) defined as death from noncancer causes and HNC or second cancers, respectively. Cumulative incidence and cause-specific hazard functions were used to analyze the risk factors of NCM and CM. Age, smoking, Charlson comorbidity index (CCI), performance status, body mass index, rural residence, education and hemoglobin level at diagnosis, and chemotherapy were significantly associated with NCM (all Padvanced-stage HNC. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Core competency requirements among extension workers in peninsular Malaysia: Use of Borich's needs assessment model.

    Science.gov (United States)

    Umar, Sulaiman; Man, Norsida; Nawi, Nolila Mohd; Latif, Ismail Abd; Samah, Bahaman Abu

    2017-06-01

    The study described the perceived importance of, and proficiency in core agricultural extension competencies among extension workers in Peninsular Malaysia; and evaluating the resultant deficits in the competencies. The Borich's Needs Assessment Model was used to achieve the objectives of the study. A sample of 298 respondents was randomly selected and interviewed using a pre-tested structured questionnaire. Thirty-three core competency items were assessed. Instrument validity and reliability were ensured. The cross-sectional data obtained was analysed using SPSS for descriptive statistics including mean weighted discrepancy score (MWDS). Results of the study showed that on a scale of 5, the most important core extension competency items according to respondents' perception were: "Making good use of information and communication technologies/access and use of web-based resources" (M=4.86, SD=0.23); "Conducting needs assessments" (M=4.84, SD=0.16); "organizing extension campaigns" (M=4.82, SD=0.47) and "Managing groups and teamwork" (M=4.81, SD=0.76). In terms of proficiency, the highest competency identified by the respondents was "Conducting farm and home visits (M=3.62, SD=0.82) followed by 'conducting meetings effectively' (M=3.19, SD=0.72); "Conducting focus group discussions" (M=3.16, SD=0.32) and "conducting community forums" (M=3.13, SD=0.64). The discrepancies implying competency deficits were widest in "Acquiring and allocating resources" (MWDS=12.67); use of information and communication technologies (ICTs) and web-based resources in agricultural extension (MWDS=12.59); and report writing and sharing the results and impacts (MWDS=11.92). It is recommended that any intervention aimed at developing the capacity of extension workers in Peninsular Malaysia should prioritize these core competency items in accordance with the deficits established in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Blending toward Competency. Early Patterns of Blended Learning and Competency-Based Education in New Hampshire

    Science.gov (United States)

    Freeland, Julia

    2014-01-01

    As the education field strives to differentiate and personalize learning to cater to each student, two related movements are gaining attention: competency-based education and blended learning. In competency-based models, students advance on the basis of mastery, rather than according to the traditional methods of counting progress in terms of time…

  15. Improving Clinical Risk Stratification at Diagnosis in Primary Prostate Cancer: A Prognostic Modelling Study.

    Directory of Open Access Journals (Sweden)

    Vincent J Gnanapragasam

    2016-08-01

    new five-stratum risk stratification system was produced, and its prognostic power was compared against the current system, with PCSM as the outcome. The results were analysed using a Cox hazards model, the log-rank test, Kaplan-Meier curves, competing-risks regression, and concordance indices. In the training set, the new risk stratification system identified distinct subgroups with different risks of PCSM in pair-wise comparison (p < 0.0001. Specifically, the new classification identified a very low-risk group (Group 1, a subgroup of intermediate-risk cancers with a low PCSM risk (Group 2, hazard ratio [HR] 1.62 [95% CI 0.96-2.75], and a subgroup of intermediate-risk cancers with an increased PCSM risk (Group 3, HR 3.35 [95% CI 2.04-5.49] (p < 0.0001. High-risk cancers were also sub-classified by the new system into subgroups with lower and higher PCSM risk: Group 4 (HR 5.03 [95% CI 3.25-7.80] and Group 5 (HR 17.28 [95% CI 11.2-26.67] (p < 0.0001, respectively. These results were recapitulated in the testing set and remained robust after inclusion of competing risks. In comparison to the current risk stratification system, the new system demonstrated improved prognostic performance, with a concordance index of 0.75 (95% CI 0.72-0.77 versus 0.69 (95% CI 0.66-0.71 (p < 0.0001. In an external cohort, the new system achieved a concordance index of 0.79 (95% CI 0.75-0.84 for predicting PCSM versus 0.66 (95% CI 0.63-0.69 (p < 0.0001 for the current NICE risk stratification system. The main limitations of the study were that it was registry based and that follow-up was relatively short.A novel and simple five-stratum risk stratification system outperforms the standard three-stratum risk stratification system in predicting the risk of PCSM at diagnosis in men with primary non-metastatic prostate cancer, even when accounting for competing risks. This model also allows delineation of new clinically relevant subgroups of men who might potentially receive more appropriate

  16. The Influence of E-learning Characteristics and Basic Ict Competencies to Actual USAge of E-learning: a Path Diagram Model

    OpenAIRE

    Suarta, I Made; Suwintana, I Ketut

    2015-01-01

    In this paper, the Technology Acceptance Model (TAM) is extent with two external stimulus namely e-learning characteristics and basic ICT (Information and Communication Technology) competencies. The purpose of this study are (1) finding relationship between e-learning characteristics and lecturers' basic ICT competencies with the perceived ease of use and perceived usefulness of e-learning; and (2) determining the effect of e-learning characteristics and lecturer basic ICT competencies to the...

  17. Core competencies in clinical neuropsychology training across the world.

    Science.gov (United States)

    Hessen, Erik; Hokkanen, Laura; Ponsford, Jennie; van Zandvoort, Martine; Watts, Ann; Evans, Jonathan; Haaland, Kathleen Y

    2018-05-01

    This work aimed to review main competency requirements from training models in countries with well-established specialties in clinical neuropsychology and to extract core competencies that likely will apply to clinical neuropsychologists regardless of regional and cultural context. We reviewed standards for post-graduate training in clinical neuropsychology from countries in Europe, Australia, and North America based on existing literature, presentations at international conferences, and from description of the training models from national psychological or neuropsychological associations. Despite differences, the reviewed models share similar core competencies considered necessary for a specialty in clinical neuropsychology: (1) In-depth knowledge of general psychology including clinical psychology (post-graduate level), ethical, and legal standards. (2) Expert knowledge about clinically relevant brain-behavioral relationships. (3) Comprehensive knowledge about, and skills in, related clinical disciplines. (4) In-depth knowledge about and skills in neuropsychological assessment, including decision-making and diagnostic competency according to current classification of diseases. (5) Competencies in the area of diversity and culture in relation to clinical neuropsychology. (6) Communication competency of neuropsychological findings and test results to relevant and diverse audiences. (7) Knowledge about and skills in psychological and neuropsychological intervention, including treatment and rehabilitation. All the models have undergone years of development in accordance with requirements of national health care systems in different parts of the world. Despite differences, the common core competency requirements across different regions of the world suggest generalizability of these competencies. We hope this summary can be useful as countries with less established neuropsychology training programs develop their models.

  18. Trustworthy patient decision aids: a qualitative analysis addressing the risk of competing interests

    NARCIS (Netherlands)

    Elwyn, G.; Dannenberg, M.; Blaine, A.; Poddar, U.; Durand, M.A.

    2016-01-01

    OBJECTIVE: Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. DESIGN: Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing

  19. On the representability of complete genomes by multiple competing finite-context (Markov models.

    Directory of Open Access Journals (Sweden)

    Armando J Pinho

    Full Text Available A finite-context (Markov model of order k yields the probability distribution of the next symbol in a sequence of symbols, given the recent past up to depth k. Markov modeling has long been applied to DNA sequences, for example to find gene-coding regions. With the first studies came the discovery that DNA sequences are non-stationary: distinct regions require distinct model orders. Since then, Markov and hidden Markov models have been extensively used to describe the gene structure of prokaryotes and eukaryotes. However, to our knowledge, a comprehensive study about the potential of Markov models to describe complete genomes is still lacking. We address this gap in this paper. Our approach relies on (i multiple competing Markov models of different orders (ii careful programming techniques that allow orders as large as sixteen (iii adequate inverted repeat handling (iv probability estimates suited to the wide range of context depths used. To measure how well a model fits the data at a particular position in the sequence we use the negative logarithm of the probability estimate at that position. The measure yields information profiles of the sequence, which are of independent interest. The average over the entire sequence, which amounts to the average number of bits per base needed to describe the sequence, is used as a global performance measure. Our main conclusion is that, from the probabilistic or information theoretic point of view and according to this performance measure, multiple competing Markov models explain entire genomes almost as well or even better than state-of-the-art DNA compression methods, such as XM, which rely on very different statistical models. This is surprising, because Markov models are local (short-range, contrasting with the statistical models underlying other methods, where the extensive data repetitions in DNA sequences is explored, and therefore have a non-local character.

  20. Model risk analysis for risk management and option pricing

    NARCIS (Netherlands)

    Kerkhof, F.L.J.

    2003-01-01

    Due to the growing complexity of products in financial markets, market participants rely more and more on quantitative models for trading and risk management decisions. This introduces a fairly new type of risk, namely, model risk. In the first part of this thesis we investigate the quantitative

  1. Children's selective trust decisions: rational competence and limiting performance factors.

    Science.gov (United States)

    Hermes, Jonas; Behne, Tanya; Bich, Anna Elisa; Thielert, Christa; Rakoczy, Hannes

    2018-03-01

    Recent research has amply documented that even preschoolers learn selectively from others, preferring, for example, reliable over unreliable and competent over incompetent models. It remains unclear, however, what the cognitive foundations of such selective learning are, in particular, whether it builds on rational inferences or on less sophisticated processes. The current study, therefore, was designed to test directly the possibility that children are in principle capable of selective learning based on rational inference, yet revert to simpler strategies such as global impression formation under certain circumstances. Preschoolers (N = 75) were shown pairs of models that either differed in their degree of competence within one domain (strong vs. weak or knowledgeable vs. ignorant) or were both highly competent, but in different domains (e.g., strong vs. knowledgeable model). In the test trials, children chose between the models for strength- or knowledge-related tasks. The results suggest that, in fact, children are capable of rational inference-based selective trust: when both models were highly competent, children preferred the model with the competence most predictive and relevant for a given task. However, when choosing between two models that differed in competence on one dimension, children reverted to halo-style wide generalizations and preferred the competent models for both relevant and irrelevant tasks. These findings suggest that the rational strategies for selective learning, that children master in principle, can get masked by various performance factors. © 2017 John Wiley & Sons Ltd.

  2. Testing a Model of Undergraduate Competence in Employability Skills and Its Implications for Stakeholders

    Science.gov (United States)

    Jackson, Denise

    2014-01-01

    Despite the development of employability skills being firmly entrenched in higher education's strategic agenda worldwide; recent graduates' standards in certain skills are not meeting industry expectations. This paper presents and tests a model of undergraduate competence in employability skills. It highlights those factors which impact on…

  3. Students' Environmental Competence Formation as a Pedagogical Problem

    Science.gov (United States)

    Ponomarenko, Yelena V.; Yessaliev, Aidarbek A.; Kenzhebekova, Rabiga I.; Moldabek, Kulahmet; Larchekova, Liudmila A.; Dairbekov, Serik S.; Asambaeva, Lazzat

    2016-01-01

    Environmentally conscious and preparation of competent professionals' in higher education system in Kazakhstan is a priority. The need for more effective environmental competence formation for students actualizes the problem of development and scientific substantiation of the theoretical model of students' environmental competence, methods of…

  4. The social competence of Latino kindergartners and growth in mathematical understanding.

    Science.gov (United States)

    Galindo, Claudia; Fuller, Bruce

    2010-05-01

    We know that social competence contributes to young children's adaptation to, and cognitive learning within, classroom settings. Yet initial evidence is mixed on the social competencies that Latino children bring to kindergarten and the extent to which these skills advance cognitive growth. Building from ecocultural and developmental-risk theory, this paper shows children's social competence to be adaptive to the normative expectations and cognitive requirements of culturally bounded settings in both the home and classroom. Latino socialization in the home may yield social competencies that teachers value rather than reflect "risk factors" that constrain children's school readiness. We draw on the Early Childhood Longitudinal Study, kindergarten cohort (N = 19,590) to detail 5 social competencies at entry to school--self-control, interpersonal skills, approaches to learning, internalizing and externalizing problem behaviors--and to examine variability among Latino subgroups. We then test the extent to which baseline variation in social competence accounts for children's cognitive growth during the kindergarten year. We find that Latino children from poor, but not middle-class, families display weaker social competencies vis-à-vis White children (all relationships p cognitive growth, which is shaped most strongly by positive approaches to learning. The disparities in competencies observed for Latino children from poor families, relative to White children, are significant yet much smaller than gaps in baseline levels of mathematical understanding. We discuss how the consonance or mismatch between competencies acquired at home and those valued by teachers must consider cultural differences, social-class position, and variation among diverse Latino subgroups. 2010 APA, all rights reserved

  5. RISK LOAN PORTFOLIO OPTIMIZATION MODEL BASED ON CVAR RISK MEASURE

    Directory of Open Access Journals (Sweden)

    Ming-Chang LEE

    2015-07-01

    Full Text Available In order to achieve commercial banks liquidity, safety and profitability objective requirements, loan portfolio risk analysis based optimization decisions are rational allocation of assets.  The risk analysis and asset allocation are the key technology of banking and risk management.  The aim of this paper, build a loan portfolio optimization model based on risk analysis.  Loan portfolio rate of return by using Value-at-Risk (VaR and Conditional Value-at-Risk (CVaR constraint optimization decision model reflects the bank's risk tolerance, and the potential loss of direct control of the bank.  In this paper, it analyze a general risk management model applied to portfolio problems with VaR and CVaR risk measures by using Using the Lagrangian Algorithm.  This paper solves the highly difficult problem by matrix operation method.  Therefore, the combination of this paper is easy understanding the portfolio problems with VaR and CVaR risk model is a hyperbola in mean-standard deviation space.  It is easy calculation in proposed method.

  6. Effectuality of Cleaning Workers' Training and Cleaning Enterprises' Chemical Health Hazard Risk Profiling.

    Science.gov (United States)

    Suleiman, Abdulqadir M; Svendsen, Kristin V H

    2015-12-01

    Goal-oriented communication of risk of hazards is necessary in order to reduce risk of workers' exposure to chemicals. Adequate training of workers and enterprise priority setting are essential elements. Cleaning enterprises have many challenges and the existing paradigms influence the risk levels of these enterprises. Information on organization and enterprises' prioritization in training programs was gathered from cleaning enterprises. A measure of enterprises' conceptual level of importance of chemical health hazards and a model for working out the risk index (RI) indicating enterprises' conceptual risk level was established and used to categorize the enterprises. In 72.3% of cases, training takes place concurrently with task performances and in 67.4% experienced workers conduct the trainings. There is disparity between employers' opinion on competence level of the workers and reality. Lower conceptual level of importance was observed for cleaning enterprises of different sizes compared with regional safety delegates and occupational hygienists. Risk index values show no difference in risk level between small and large enterprises. Training of cleaning workers lacks the prerequisite for suitability and effectiveness to counter risks of chemical health hazards. There is dereliction of duty by management in the sector resulting in a lack of competence among the cleaning workers. Instituting acceptable easily attainable safety competence level for cleaners will conduce to risk reduction, and enforcement of attainment of the competence level would be a positive step.

  7. Utility of Risk Models in Decision Making After Radical Prostatectomy: Lessons from a Natural History Cohort of Intermediate- and High-Risk Men.

    Science.gov (United States)

    Ross, Ashley E; Yousefi, Kasra; Davicioni, Elai; Ghadessi, Mercedeh; Johnson, Michael H; Sundi, Debasish; Tosoian, Jeffery J; Han, Misop; Humphreys, Elizabeth B; Partin, Alan W; Walsh, Patrick C; Trock, Bruce J; Schaeffer, Edward M

    2016-03-01

    Current guidelines suggest adjuvant radiation therapy for men with adverse pathologic features (APFs) at radical prostatectomy (RP). We examine at-risk men treated only with RP until the time of metastasis. To evaluate whether clinicopathologic risk models can help guide postoperative therapeutic decision making. Men with National Comprehensive Cancer Network intermediate- or high-risk localized prostate cancer undergoing RP in the prostate-specific antigen (PSA) era were identified (n=3089). Only men with initial undetectable PSA after surgery and who received no therapy prior to metastasis were included. APFs were defined as pT3 disease or positive surgical margins. Area under the receiver operating characteristic curve (AUC) for time to event data was used to measure the discrimination performance of the risk factors. Cumulative incidence curves were constructed using Fine and Gray competing risks analysis to estimate the risk of biochemical recurrence (BCR) or metastasis, taking censoring and death due to other causes into consideration. Overall, 43% of the cohort (n=1327) had APFs at RP. Median follow-up for censored patients was 5 yr. Cumulative incidence of metastasis was 6% at 10 yr after RP for all patients. Cumulative incidence of metastasis among men with APFs was 7.5% at 10 yr after RP. Among men with BCR, the incidence of metastasis was 38% 5 yr after BCR. At 10 yr after RP, time-dependent AUC for predicting metastasis by Cancer of the Prostate Risk Assessment Postsurgical or Eggener risk models was 0.81 (95% confidence interval [CI], 0.72-0.97) and 0.78 (95% CI, 0.67-0.97) in the APF population, respectively. At 5 yr after BCR, these values were lower (0.58 [95% CI, 0.50-0.66] and 0.70 [95% CI, 0.63-0.76]) among those who developed BCR. Use of risk model cut points could substantially reduce overtreatment while minimally increasing undertreatment (ie, use of an Eggener cut point of 2.5% for treatment of men with APFs would spare 46% from treatment

  8. Job competencies for the malaysian consultant project managers

    Directory of Open Access Journals (Sweden)

    Dr. Ilias Said

    2009-12-01

    Full Text Available Architects, engineers and quantity surveyors are among the main players in construction.Coming from different background and professional background, these professionals bring in their own respective styles and methods of project management practices. There is now a body of opinion among industry people and academics alike that the industry needs to establish competency standard especially for project managers. Irrespective of their professional background, competent project managers should hypothetically deliver high quality services to the clients. A study was conducted at the School of Housing, Building and Planning, University of Science Malaysia (USM, to develop a job competence model for Consultant Project Managers (CPMs. It attempts to determine a set of minimum standards of skills and competencies for CPMs. This paper reports the findings of the study. It provides an insight into the type of competencies needed by CPMs based on the “Job Competence Model for Consultant Project Managers” developed from the study.

  9. An Empirical Competence-Capability Model of Supply Chain Innovation

    OpenAIRE

    Mandal, Santanu

    2016-01-01

    Supply chain innovation has become the new pre-requisite for the survival of firms in developing capabilities and strategies for sustaining their operations and performance in the market. This study investigates the influence of supply and demand competence on supply chain innovation and its influence on a firm’s operational and relational performance. While the former competence refers to production and supply management related activities, the latter refers to distribution and demand manage...

  10. Ecological models and pesticide risk assessment: current modeling practice.

    Science.gov (United States)

    Schmolke, Amelie; Thorbek, Pernille; Chapman, Peter; Grimm, Volker

    2010-04-01

    Ecological risk assessments of pesticides usually focus on risk at the level of individuals, and are carried out by comparing exposure and toxicological endpoints. However, in most cases the protection goal is populations rather than individuals. On the population level, effects of pesticides depend not only on exposure and toxicity, but also on factors such as life history characteristics, population structure, timing of application, presence of refuges in time and space, and landscape structure. Ecological models can integrate such factors and have the potential to become important tools for the prediction of population-level effects of exposure to pesticides, thus allowing extrapolations, for example, from laboratory to field. Indeed, a broad range of ecological models have been applied to chemical risk assessment in the scientific literature, but so far such models have only rarely been used to support regulatory risk assessments of pesticides. To better understand the reasons for this situation, the current modeling practice in this field was assessed in the present study. The scientific literature was searched for relevant models and assessed according to nine characteristics: model type, model complexity, toxicity measure, exposure pattern, other factors, taxonomic group, risk assessment endpoint, parameterization, and model evaluation. The present study found that, although most models were of a high scientific standard, many of them would need modification before they are suitable for regulatory risk assessments. The main shortcomings of currently available models in the context of regulatory pesticide risk assessments were identified. When ecological models are applied to regulatory risk assessments, we recommend reviewing these models according to the nine characteristics evaluated here. (c) 2010 SETAC.

  11. Model Risk in Portfolio Optimization

    Directory of Open Access Journals (Sweden)

    David Stefanovits

    2014-08-01

    Full Text Available We consider a one-period portfolio optimization problem under model uncertainty. For this purpose, we introduce a measure of model risk. We derive analytical results for this measure of model risk in the mean-variance problem assuming we have observations drawn from a normal variance mixture model. This model allows for heavy tails, tail dependence and leptokurtosis of marginals. The results show that mean-variance optimization is seriously compromised by model uncertainty, in particular, for non-Gaussian data and small sample sizes. To mitigate these shortcomings, we propose a method to adjust the sample covariance matrix in order to reduce model risk.

  12. Criterion of Semi-Markov Dependent Risk Model

    Institute of Scientific and Technical Information of China (English)

    Xiao Yun MO; Xiang Qun YANG

    2014-01-01

    A rigorous definition of semi-Markov dependent risk model is given. This model is a generalization of the Markov dependent risk model. A criterion and necessary conditions of semi-Markov dependent risk model are obtained. The results clarify relations between elements among semi-Markov dependent risk model more clear and are applicable for Markov dependent risk model.

  13. Deflation Risk and Implications for Life Insurers

    Directory of Open Access Journals (Sweden)

    Jean-François Bégin

    2016-12-01

    Full Text Available Life insurers are exposed to deflation risk: falling prices could lead to insufficient investment returns, and inflation-indexed protections could make insurers vulnerable to deflation. In this spirit, this paper proposes a market-based methodology for measuring deflation risk based on a discrete framework: the latter accounts for the real interest rate, the inflation index level, its conditional variance, and the expected inflation rate. US inflation data are then used to estimate the model and show the importance of deflation risk. Specifically, the distribution of a fictitious life insurer’s future payments is investigated. We find that the proposed inflation model yields higher risk measures than the ones obtained using competing models, stressing the need for dynamic and market-consistent inflation modelling in the life insurance industry.

  14. A Case Study on the Implementation of Reflective Development Model in Improving Intercultural Competence among Business Student in Stamford College

    Science.gov (United States)

    Gowindasamy, Maniyarasi

    2017-01-01

    This study was conducted to evaluate the implementation of reflective development model in improving the intercultural competence among business student in Stamford College. This study will be focus on the local and international students in terms of their cultural competencies through the globalization subjects. An embedded design of mixed…

  15. Constructivism in cultural competence education.

    Science.gov (United States)

    Hunter, Jennifer L; Krantz, Steven

    2010-04-01

    A graduate course on cultural diversity, based in constructivist theory and structured on the Process of Cultural Competence in the Delivery of Healthcare Services model, was developed and taught through classroom and online methods. The following research questions were explored: 1) Can an educational experience, built on constructivist learning theory tenets, change students' perceptions, attitudes, knowledge, and skills in the area of cultural competence? 2) Does the delivery method, online or traditional classroom, influence the degree of change? The study used a quasi-experimental, pretest-posttest control group design using the Inventory for Assessing the Process of Cultural Competence Among healthcare Professionals Revised. Findings showed significant changes (p<0.001) in cultural competence scores and subscores for all learners with both teaching modalities based on interval scale and in categories of cultural knowledge, skills, desire, and overall competence based on a nominal scale. The untaught construct of cultural desire showed the most significant improvement.

  16. [The role of "competent physician" for prevention of accidents at work].

    Science.gov (United States)

    Ramistella, E; Bergamaschi, A; Mosconi, G; Rossi, O; Sallese, D

    2008-01-01

    Using at best the professional and legal tools at his/her disposal, the "competent physician" can have a relevant role in reducing accidents in the workplace. In assessing the worker's suitability to specific tasks, the competent physician checks the presence of pathologies or functional impairments of organs or apparatuses that can be an additional risk for the occurrence of accidents at work. The activity aimed to preventing accidents at work translates also in taking part in the planning and implementation of information activities and workers' training within the company. The various risk factors inherent in the workplace and so-called "human factors" can interact in a negative way to the point of becoming a cause of accidents. The human variables of accident risk at the industrial, occupational and even individual level, may be numerous. In this paper we shall review these important aspects and attempt to clarify the role that can be played by the competent physician in the prevention of accidents at work.

  17. Uncertainty and sensitivity analysis of flood risk management decisions based on stationary and nonstationary model choices

    Directory of Open Access Journals (Sweden)

    Rehan Balqis M.

    2016-01-01

    Full Text Available Current practice in flood frequency analysis assumes that the stochastic properties of extreme floods follow that of stationary conditions. As human intervention and anthropogenic climate change influences in hydrometeorological variables are becoming evident in some places, there have been suggestions that nonstationary statistics would be better to represent the stochastic properties of the extreme floods. The probabilistic estimation of non-stationary models, however, is surrounded with uncertainty related to scarcity of observations and modelling complexities hence the difficulty to project the future condition. In the face of uncertain future and the subjectivity of model choices, this study attempts to demonstrate the practical implications of applying a nonstationary model and compares it with a stationary model in flood risk assessment. A fully integrated framework to simulate decision makers’ behaviour in flood frequency analysis is thereby developed. The framework is applied to hypothetical flood risk management decisions and the outcomes are compared with those of known underlying future conditions. Uncertainty of the economic performance of the risk-based decisions is assessed through Monte Carlo simulations. Sensitivity of the results is also tested by varying the possible magnitude of future changes. The application provides quantitative and qualitative comparative results that satisfy a preliminary analysis of whether the nonstationary model complexity should be applied to improve the economic performance of decisions. Results obtained from the case study shows that the relative differences of competing models for all considered possible future changes are small, suggesting that stationary assumptions are preferred to a shift to nonstationary statistics for practical application of flood risk management. Nevertheless, nonstationary assumption should also be considered during a planning stage in addition to stationary assumption

  18. Foundational workplace safety and health competencies for the emerging workforce☆

    Science.gov (United States)

    Okun, Andrea H.; Guerin, Rebecca J.; Schulte, Paul A.

    2016-01-01

    Introduction Young workers (aged 15–24) suffer disproportionately from workplace injuries, with a nonfatal injury rate estimated to be two times higher than among workers age 25 or over. These workers make up approximately 9% of the U.S. workforce and studies have shown that nearly 80% of high school students work at some point during high school. Although young worker injuries are a pressing public health problem, the critical knowledge and skills needed to prepare youth for safe and healthy work are missing from most frameworks used to prepare the emerging U.S. workforce. Methods A framework of foundational workplace safety and health knowledge and skills (the NIOSH 8 Core Competencies)was developed based on the Health Belief Model (HBM). Results The proposed NIOSH Core Competencies utilize the HBM to provide a framework for foundational workplace safety and health knowledge and skills. An examination of how these competencies and the HBM apply to actions that workers take to protect themselves is provided. The social and physical environments that influence these actions are also discussed. Conclusions The NIOSH 8 Core Competencies, grounded in one of the most widely used health behavior theories, fill a critical gap in preparing the emerging U.S. workforce to be cognizant of workplace risks. Practical applications Integration of the NIOSH 8 Core Competencies into school curricula is one way to ensure that every young person has the foundational workplace safety and health knowledge and skills to participate in, and benefit from, safe and healthy work. National Safety Council and Elsevier Ltd. All rights reserved. PMID:27846998

  19. What's all the fuss about competencies?

    DEFF Research Database (Denmark)

    Blomhøj, Morten; Jensen, Tomas Højgaard

    2007-01-01

    This paper deals with applying a description of a set of mathematical competencies with the aim of developing mathematics education in general and in particular the work with mathematical modelling. Hence it offers a presentation of the general idea of working with mathemati­cal competencies as w...

  20. Unleashing Natural Competence in Lactococcus lactis by Induction of the Competence Regulator ComX

    Science.gov (United States)

    Mulder, Joyce; Wels, Michiel; Kuipers, Oscar P.; Bron, Peter A.

    2017-01-01

    ABSTRACT In biotechnological workhorses like Streptococcus thermophilus and Bacillus subtilis, natural competence can be induced, which facilitates genetic manipulation of these microbes. However, in strains of the important dairy starter Lactococcus lactis, natural competence has not been established to date. However, in silico analysis of the complete genome sequences of 43 L. lactis strains revealed complete late competence gene sets in 2 L. lactis subsp. cremoris strains (KW2 and KW10) and at least 10 L. lactis subsp. lactis strains, including the model strain IL1403 and the plant-derived strain KF147. The remainder of the strains, including all dairy isolates, displayed genomic decay in one or more of the late competence genes. Nisin-controlled expression of the competence regulator comX in L. lactis subsp. lactis KF147 resulted in the induction of expression of the canonical competence regulon and elicited a state of natural competence in this strain. In contrast, comX expression in L. lactis NZ9000, which was predicted to encode an incomplete competence gene set, failed to induce natural competence. Moreover, mutagenesis of the comEA-EC operon in strain KF147 abolished the comX-driven natural competence, underlining the involvement of the competence machinery. Finally, introduction of nisin-inducible comX expression into nisRK-harboring derivatives of strains IL1403 and KW2 allowed the induction of natural competence in these strains also, expanding this phenotype to other L. lactis strains of both subspecies. IMPORTANCE Specific bacterial species are able to enter a state of natural competence in which DNA is taken up from the environment, allowing the introduction of novel traits. Strains of the species Lactococcus lactis are very important starter cultures for the fermentation of milk in the cheese production process, where these bacteria contribute to the flavor and texture of the end product. The activation of natural competence in this industrially

  1. The Success Of Stock Selection Strategies In Emerging Markets: Is It Risk Or Behavioral Bias?

    NARCIS (Netherlands)

    J. van der Hart; G.J. de Zwart (Gerben); D.J.C. van Dijk (Dick)

    2005-01-01

    textabstractWe examine competing explanations, based on risk and behavioral models, for the profitability of stock selection strategies in emerging markets. We document that both emerging market risk and global risk factors cannot account for the significant excess returns of selection strategies

  2. Kaplan-Meier survival analysis overestimates cumulative incidence of health-related events in competing risk settings: a meta-analysis.

    Science.gov (United States)

    Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter; Ghali, William A; Marshall, Deborah A

    2018-01-01

    Kaplan-Meier survival analysis overestimates cumulative incidence in competing risks (CRs) settings. The extent of overestimation (or its clinical significance) has been questioned, and CRs methods are infrequently used. This meta-analysis compares the Kaplan-Meier method to the cumulative incidence function (CIF), a CRs method. We searched MEDLINE, EMBASE, BIOSIS Previews, Web of Science (1992-2016), and article bibliographies for studies estimating cumulative incidence using the Kaplan-Meier method and CIF. For studies with sufficient data, we calculated pooled risk ratios (RRs) comparing Kaplan-Meier and CIF estimates using DerSimonian and Laird random effects models. We performed stratified meta-analyses by clinical area, rate of CRs (CRs/events of interest), and follow-up time. Of 2,192 identified abstracts, we included 77 studies in the systematic review and meta-analyzed 55. The pooled RR demonstrated the Kaplan-Meier estimate was 1.41 [95% confidence interval (CI): 1.36, 1.47] times higher than the CIF. Overestimation was highest among studies with high rates of CRs [RR = 2.36 (95% CI: 1.79, 3.12)], studies related to hepatology [RR = 2.60 (95% CI: 2.12, 3.19)], and obstetrics and gynecology [RR = 1.84 (95% CI: 1.52, 2.23)]. The Kaplan-Meier method overestimated the cumulative incidence across 10 clinical areas. Using CRs methods will ensure accurate results inform clinical and policy decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Core competencies for shared decision making training programs: insights from an international, interdisciplinary working group.

    Science.gov (United States)

    Légaré, France; Moumjid-Ferdjaoui, Nora; Drolet, Renée; Stacey, Dawn; Härter, Martin; Bastian, Hilda; Beaulieu, Marie-Dominique; Borduas, Francine; Charles, Cathy; Coulter, Angela; Desroches, Sophie; Friedrich, Gwendolyn; Gafni, Amiram; Graham, Ian D; Labrecque, Michel; LeBlanc, Annie; Légaré, Jean; Politi, Mary; Sargeant, Joan; Thomson, Richard

    2013-01-01

    Shared decision making is now making inroads in health care professionals' continuing education curriculum, but there is no consensus on what core competencies are required by clinicians for effectively involving patients in health-related decisions. Ready-made programs for training clinicians in shared decision making are in high demand, but existing programs vary widely in their theoretical foundations, length, and content. An international, interdisciplinary group of 25 individuals met in 2012 to discuss theoretical approaches to making health-related decisions, compare notes on existing programs, take stock of stakeholders concerns, and deliberate on core competencies. This article summarizes the results of those discussions. Some participants believed that existing models already provide a sufficient conceptual basis for developing and implementing shared decision making competency-based training programs on a wide scale. Others argued that this would be premature as there is still no consensus on the definition of shared decision making or sufficient evidence to recommend specific competencies for implementing shared decision making. However, all participants agreed that there were 2 broad types of competencies that clinicians need for implementing shared decision making: relational competencies and risk communication competencies. Further multidisciplinary research could broaden and deepen our understanding of core competencies for shared decision making training. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  4. Competency-based training model for human resource management and development in public sector

    Science.gov (United States)

    Prabawati, I.; Meirinawati; AOktariyanda, T.

    2018-01-01

    Human Resources (HR) is a very important factor in an organization so that human resources are required to have the ability, skill or competence in order to be able to carry out the vision and mission of the organization. Competence includes a number of attributes attached to the individual which is a combination of knowledge, skills, and behaviors that can be used as a mean to improve performance. Concerned to the demands of human resources that should have the knowledge, skills or abilities, it is necessary to the development of human resources in public organizations. One form of human resource development is Competency-Based Training (CBT). CBT focuses on three issues, namely skills, competencies, and competency standard. There are 5 (five) strategies in the implementation of CBT, namely: organizational scanning, strategic planning, competency profiling, competency gap analysis, and competency development. Finally, through CBT the employees within the organization can reduce or eliminate the differences between existing performance with a potential performance that can improve the knowledge, expertise, and skills that are very supportive in achieving the vision and mission of the organization.

  5. Overweight Without Central Obesity, Cardiovascular Risk, and All-Cause Mortality.

    Science.gov (United States)

    He, Xin; Liu, Chen; Chen, Yili; He, Jiangui; Dong, Yugang

    2018-04-12

    To assess the association of overweight without central obesity with risks of mortality. We included 14,299 participants in the Third National Health and Nutrition Examination Survey (from October 18, 1988, through October 15, 1994). According to their body mass index and waist circumference, participants were categorized into 7 anthropometric groups. Logistic regression models were used to assess the relation of cardiovascular risk factors (hypertension, diabetes, or hypercholesterolemia) and 10-year cardiovascular risk to anthropometric groups. Cox proportional hazards models were used to assess the risk of all-cause mortality, and competing-risks regression models were used for calculating cardiovascular and noncardiovascular mortality. Compared with those with normal body mass index and waist circumference, overweight men without central obesity were more likely to have all 3 cardiovascular risk factors and a high cardiovascular risk, whereas women in this anthropometric group were more likely to have hypercholesterolemia. In proportional hazards models, overweight without central obesity was associated with lower all-cause mortality among men in the population with cardiovascular risk factors (hazard ratio, 0.71; 95% CI, 0.56-0.89; P=.004) and the general population (hazard ratio, 0.72; 95% CI, 0.60-0.87; P=.001), whereas results of these comparisons among women were not significant (P>.05). In competing risk analyses, overweight men without central obesity had a lower risk of noncardiovascular mortality, but not cardiovascular mortality. Although overweight without central obesity was associated with cardiovascular risk factors and a high cardiovascular risk among men, men in this anthropometric group had a lower mortality risk. Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  6. Events per variable for risk differences and relative risks using pseudo-observations

    DEFF Research Database (Denmark)

    Hansen, Stefan Nygaard; Andersen, Per Kragh; Parner, Erik Thorlund

    2014-01-01

    A method based on pseudo-observations has been proposed for direct regression modeling of functionals of interest with right-censored data, including the survival function, the restricted mean and the cumulative incidence function in competing risks. The models, once the pseudo-observations have...... been computed, can be fitted using standard generalized estimating equation software. Regression models can however yield problematic results if the number of covariates is large in relation to the number of events observed. Guidelines of events per variable are often used in practice. These rules...

  7. Korean risk assessment model for breast cancer risk prediction.

    Science.gov (United States)

    Park, Boyoung; Ma, Seung Hyun; Shin, Aesun; Chang, Myung-Chul; Choi, Ji-Yeob; Kim, Sungwan; Han, Wonshik; Noh, Dong-Young; Ahn, Sei-Hyun; Kang, Daehee; Yoo, Keun-Young; Park, Sue K

    2013-01-01

    We evaluated the performance of the Gail model for a Korean population and developed a Korean breast cancer risk assessment tool (KoBCRAT) based upon equations developed for the Gail model for predicting breast cancer risk. Using 3,789 sets of cases and controls, risk factors for breast cancer among Koreans were identified. Individual probabilities were projected using Gail's equations and Korean hazard data. We compared the 5-year and lifetime risk produced using the modified Gail model which applied Korean incidence and mortality data and the parameter estimators from the original Gail model with those produced using the KoBCRAT. We validated the KoBCRAT based on the expected/observed breast cancer incidence and area under the curve (AUC) using two Korean cohorts: the Korean Multicenter Cancer Cohort (KMCC) and National Cancer Center (NCC) cohort. The major risk factors under the age of 50 were family history, age at menarche, age at first full-term pregnancy, menopausal status, breastfeeding duration, oral contraceptive usage, and exercise, while those at and over the age of 50 were family history, age at menarche, age at menopause, pregnancy experience, body mass index, oral contraceptive usage, and exercise. The modified Gail model produced lower 5-year risk for the cases than for the controls (p = 0.017), while the KoBCRAT produced higher 5-year and lifetime risk for the cases than for the controls (pKorean women, especially urban women.

  8. COMPETENCE-BASED APPROACH TO MODELLING STRUCTURES OF THE MAIN EDUCATIONAL PROGRAM

    Directory of Open Access Journals (Sweden)

    V. A. Gerasimova

    2015-01-01

    Full Text Available By the analysis results of scientific works in the field of competence-based approach in education authors proved need of computer support of the planning and development stage of the main educational program, they developed the main educational program structure automatic formation model on the graphs basis, offered the integrated criterion of an discipline assessment and developed a strategic map of a discipline complex assessment. The executed theoretical researches are a basis for creation of the main educational program planning and development support automated system.

  9. Numerical transfer-matrix study of a model with competing metastable states

    DEFF Research Database (Denmark)

    Fiig, T.; Gorman, B.M.; Rikvold, P.A.

    1994-01-01

    transition. A recently developed transfer-matrix formalism is applied to the model to obtain complex-valued ''constrained'' free-energy densities f(alpha). For particular eigenvectors of the transfer matrix, the f(alpha) exhibit finite-rangescaling behavior in agreement with the analytically continued...... 'metastable free-energy density This transfer-matrix approach gives a free-energy cost of nucleation that supports the proportionality relation for the decay rate of the metastable phase T proportional to\\Imf alpha\\, even in cases where two metastable states compete. The picture that emerges from this study...

  10. Model of MSD Risk Assessment at Workplace

    OpenAIRE

    K. Sekulová; M. Šimon

    2015-01-01

    This article focuses on upper-extremity musculoskeletal disorders risk assessment model at workplace. In this model are used risk factors that are responsible for musculoskeletal system damage. Based on statistic calculations the model is able to define what risk of MSD threatens workers who are under risk factors. The model is also able to say how MSD risk would decrease if these risk factors are eliminated.

  11. Cognitive simulation of incident risks in the structure of loading and transport enterprise

    Science.gov (United States)

    Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.

    2017-09-01

    Organizational and technical system of a manufacturing enterprise was identified, which includes three subsystems: main production, industrial and social infrastructure. Based on the results of cognitive modeling, significant system concepts were identified that reduce the risks of incidents. The internal control influences formed in accordance with level of competence of heads of services, departments, sections, dispatchers, acting on the basis of regulations, job profiles. The second concept influencing the enterprise management system is personnel, which is assessed by the compliance of competencies of crane operators, loader operators, slingers, loaders, and acceptance/delivery agents to job responsibilities and labor functions. At a low level of professional competencies, the personnel does not fully comply with job duties and labor functions, the risk of an incident is maximal. The application of cognitive modeling allows us to identify the essential elements that ensure stable functioning of the system as a whole.

  12. Autonomy and Firefighting: Perceived Competence and Stress.

    Science.gov (United States)

    Chiang, Evelyn S; Baley, John; Ponder, Joy; Padilla, Miguel A

    2016-12-01

    In workplace settings, autonomy is implicated in employee motivation as well as supervisor autonomy support. As a profession of risk, firefighters may experience greater levels of stress. A self-determination paradigm was applied to the firefighter workplace. Of particular interest were perceived competence (to perform job duties) and the experience of stress. Firefighters' levels of autonomous and controlled regulation were surveyed, along with their perceptions of the autonomy support of their immediate supervisor. Autonomous regulation was positively related to perceived competence, whereas controlled regulation was negatively related. Higher levels of controlled regulation were also connected with greater stress. In contrast, greater perceived autonomy support was associated with decreased stress. Both perceived competence and stress are related to firefighter motivation and autonomy support. Recommendations are offered to increase autonomy support by chief officers.

  13. Discharge competence and pattern formation in peatlands: a meta-ecosystem model of the Everglades ridge-slough landscape.

    Directory of Open Access Journals (Sweden)

    James B Heffernan

    Full Text Available Regular landscape patterning arises from spatially-dependent feedbacks, and can undergo catastrophic loss in response to changing landscape drivers. The central Everglades (Florida, USA historically exhibited regular, linear, flow-parallel orientation of high-elevation sawgrass ridges and low-elevation sloughs that has degraded due to hydrologic modification. In this study, we use a meta-ecosystem approach to model a mechanism for the establishment, persistence, and loss of this landscape. The discharge competence (or self-organizing canal hypothesis assumes non-linear relationships between peat accretion and water depth, and describes flow-dependent feedbacks of microtopography on water depth. Closed-form model solutions demonstrate that 1 this mechanism can produce spontaneous divergence of local elevation; 2 divergent and homogenous states can exhibit global bi-stability; and 3 feedbacks that produce divergence act anisotropically. Thus, discharge competence and non-linear peat accretion dynamics may explain the establishment, persistence, and loss of landscape pattern, even in the absence of other spatial feedbacks. Our model provides specific, testable predictions that may allow discrimination between the self-organizing canal hypotheses and competing explanations. The potential for global bi-stability suggested by our model suggests that hydrologic restoration may not re-initiate spontaneous pattern establishment, particularly where distinct soil elevation modes have been lost. As a result, we recommend that management efforts should prioritize maintenance of historic hydroperiods in areas of conserved pattern over restoration of hydrologic regimes in degraded regions. This study illustrates the value of simple meta-ecosystem models for investigation of spatial processes.

  14. Analysis of uncertainty in modeling perceived risks

    International Nuclear Information System (INIS)

    Melnyk, R.; Sandquist, G.M.

    2005-01-01

    Expanding on a mathematical model developed for quantifying and assessing perceived risks, the distribution functions, variances, and uncertainties associated with estimating the model parameters are quantified. The analytical model permits the identification and assignment of any number of quantifiable risk perception factors that can be incorporated within standard risk methodology. Those risk perception factors associated with major technical issues are modeled using lognormal probability density functions to span the potentially large uncertainty variations associated with these risk perceptions. The model quantifies the logic of public risk perception and provides an effective means for measuring and responding to perceived risks. (authors)

  15. Integrating Theory, Content, and Method to Foster Critical Consciousness in Medical Students: A Comprehensive Model for Cultural Competence Training.

    Science.gov (United States)

    Dao, Diane K; Goss, Adeline L; Hoekzema, Andrew S; Kelly, Lauren A; Logan, Alexander A; Mehta, Sanjiv D; Sandesara, Utpal N; Munyikwa, Michelle R; DeLisser, Horace M

    2017-03-01

    Many efforts to design introductory "cultural competence" courses for medical students rely on an information delivery (competence) paradigm, which can exoticize patients while obscuring social context, medical culture, and power structures. Other approaches foster a general open-minded orientation, which can remain nebulous without clear grounding principles. Medical educators are increasingly recognizing the limitations of both approaches and calling for strategies that reenvision cultural competence training. Successfully realizing such alternative strategies requires the development of comprehensive models that specify and integrate theoretical frameworks, content, and teaching principles.In this article, the authors present one such model: Introduction to Medicine and Society (IMS), a required cultural competence course launched in 2013 for first-year medical students at the Perelman School of Medicine at the University of Pennsylvania. Building on critical pedagogy, IMS is centered on a novel specification of "critical consciousness" in clinical practice as an orientation to understanding and pragmatic action in three relational domains: internal, interpersonal, and structural. Instead of transmitting discrete "facts" about patient "types," IMS content provokes students to engage with complex questions bridging the three domains. Learning takes place in a small-group space specifically designed to spur transformation toward critical consciousness. After discussing the three key components of the course design and describing a representative session, the authors discuss the IMS model's implications, reception by students and faculty, and potential for expansion. Their early experience suggests the IMS model successfully engages students and prepares future physicians to critically examine experiences, manage interpersonal dynamics, and structurally contextualize patient encounters.

  16. Substantiation of the necessity to develop a competency model of training specialist in pharmacy on the basis of intellectual educational system

    Directory of Open Access Journals (Sweden)

    V. O. Demchenko

    2014-08-01

    Full Text Available The pharmaceutical market of Ukraine, in which various subjects of drug turnover operate, is gradually moving to basically new level. The development is taking place due tothe fundamental factors such as competence and the quality of pharmaceutical activities. The changes on the pharmaceutical market, tough competitive conditions, transforming of the managerial culture intensity, the problems of not always appropriate competence of specialists and require fundamental changes in the system of pharmaceutical education. The purpose. To conduct research of the links in social and economic relations between higher educational institutions and employers in the labor market through the analysis of future graduates`professional competence for the pharmaceutical industry and substantiate the necessity for the development of competency-based training model on the basis of adaptive intellectual computer system of training. Materials and methods. The study was conducted using the methods of semantic evaluation of legal and scientific documents, comparison, systemic and structural logical analysis. Results and discussion. Competence approach has been implemented in most European countries at the level of national educational standards. The current system of pharmaceutical education in Ukraine is normative and it is based on the branch standards of higher education-educational qualification characteristics and educational and vocational program. Market conditions encourage employers to determine and order specialists with a definite set of professional competencies, constantly updating and upgrading knowledge who fully meet the requirements of the position defined independent on the subjects of the system of drug provision. Therefore, it is necessary to synchronize "production" of the education system and "demand" of the labor market. It`s obvious, the solution of this problem is possible only with the introduction of new educational technologies to create a

  17. Development of a Systems Engineering Competency Model Tool for the Aviation and Missile Research, Development, And Engineering Center (AMRDEC)

    Science.gov (United States)

    2017-06-01

    grade level (GS-7 to GS-15). This foundational model is structured to support the individual needs of any Department of Defense organization and is... organizational level with traceability to the approved OPM competencies. The Redstone SECCM Tool will allow documentation of system engineering competencies and...assessment of individual and organizational development and training needs. This report documents the requirements analysis, system design, and system

  18. Fieldwork Using the Professional Development Schools Model: Developing a Social Justice Orientation and Multicultural Competency

    Science.gov (United States)

    Cook, Amy L.; Krell, Megan M.; Hayden, Laura A.; Gracia, Robert; Denitzio, Kari

    2016-01-01

    Practicum fieldwork was conducted in an urban high school setting using a Professional Development Schools (PDS) model, with a focus on multicultural and social justice counseling competencies (MSJCC). Interpretative phenomenological analysis was used to analyze the journal responses of 16 counseling students to ascertain MSJCC development during…

  19. Special Issue: Competencies from the Individual's Viewpoint.

    Science.gov (United States)

    Career Planning and Adult Development Journal, 2003

    2003-01-01

    Ten articles in this special issue deal with competencies and how their use is revolutionizing human resource management and the work of career practitioners. Topics include competency technology, models, and mapping; behavioral interviewing; talent management; emotional intelligence; succession planning; and lifelong learning. (JOW)

  20. Risk modelling in portfolio optimization

    Science.gov (United States)

    Lam, W. H.; Jaaman, Saiful Hafizah Hj.; Isa, Zaidi

    2013-09-01

    Risk management is very important in portfolio optimization. The mean-variance model has been used in portfolio optimization to minimize the investment risk. The objective of the mean-variance model is to minimize the portfolio risk and achieve the target rate of return. Variance is used as risk measure in the mean-variance model. The purpose of this study is to compare the portfolio composition as well as performance between the optimal portfolio of mean-variance model and equally weighted portfolio. Equally weighted portfolio means the proportions that are invested in each asset are equal. The results show that the portfolio composition of the mean-variance optimal portfolio and equally weighted portfolio are different. Besides that, the mean-variance optimal portfolio gives better performance because it gives higher performance ratio than the equally weighted portfolio.

  1. Conceptualizing a Dynamic Fall Risk Model Including Intrinsic Risks and Exposures.

    Science.gov (United States)

    Klenk, Jochen; Becker, Clemens; Palumbo, Pierpaolo; Schwickert, Lars; Rapp, Kilan; Helbostad, Jorunn L; Todd, Chris; Lord, Stephen R; Kerse, Ngaire

    2017-11-01

    Falls are a major cause of injury and disability in older people, leading to serious health and social consequences including fractures, poor quality of life, loss of independence, and institutionalization. To design and provide adequate prevention measures, accurate understanding and identification of person's individual fall risk is important. However, to date, the performance of fall risk models is weak compared with models estimating, for example, cardiovascular risk. This deficiency may result from 2 factors. First, current models consider risk factors to be stable for each person and not change over time, an assumption that does not reflect real-life experience. Second, current models do not consider the interplay of individual exposure including type of activity (eg, walking, undertaking transfers) and environmental risks (eg, lighting, floor conditions) in which activity is performed. Therefore, we posit a dynamic fall risk model consisting of intrinsic risk factors that vary over time and exposure (activity in context). eHealth sensor technology (eg, smartphones) begins to enable the continuous measurement of both the above factors. We illustrate our model with examples of real-world falls from the FARSEEING database. This dynamic framework for fall risk adds important aspects that may improve understanding of fall mechanisms, fall risk models, and the development of fall prevention interventions. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  2. Assessment and self-assessment of the pharmacists' competencies using the global competency framework (GbCF) in Serbia.

    Science.gov (United States)

    Stojkov, Svetlana; Tadić, Ivana; Crnjanski, Tatjana; Krajnović, Dušanka

    2016-09-01

    Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients’ health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF). The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. The assessment and self-assessment of pharmacists’ competencies were performed during the period 2012−13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. A total of 123 pharmacists were evaluated. Pharmacists’ Professional Competency Cluster (KK1) had the lowest score (average value 2.98), while the cluster Management and Organizational Competency (KK2) had the highest score (average value 3.15). The competence Recognition of the Diagnosis and Patient Counseling (K8), which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively) among the all evaluated competencies. GbCF might be considered as an instrument for the competencies' evaluation/selfevaluation and their improvement, accordingly.

  3. Competence for Contract and Competence to Consent to Treatment

    OpenAIRE

    前田, 泰

    2008-01-01

    This paper analyzes assessing competence to consent to treatment. It focuses on problems of competence for contract and competence to consent to treatment. Finally, it discusses the degree of assessing competence to consent to treatment.

  4. Extreme Levels of HbA1c Increase Incident ESRD Risk in Chinese Patients with Type 2 Diabetes: Competing Risk Analysis in National Cohort of Taiwan Diabetes Study

    Science.gov (United States)

    Liu, Chiu-Shong; Huang, Chiu-Ching; Lin, Wen-Yuan; Chiang, Jen-Huai; Lin, Cheng-Chieh; Li, Tsai-Chung

    2015-01-01

    Background Whether HbA1c is a predictor of end-stage renal disease (ESRD) in type 2 diabetes patients remains unclear. This study evaluated relationship between HbA1c and ESRD in Chinese patients with type 2 diabetes. Methods Patients aged ≥ 30 years who were free of ESRD (n = 51 681) were included from National Diabetes Care Management Program from 2002–2003. Extended Cox proportional hazard model with competing risk of death served to evaluate association between HbA1c level and ESRD. Results A total of 2613 (5.06%) people developed ESRD during a follow-up period of 8.1 years. Overall incidence rate of ESRD was 6.26 per 1000 person-years. Patients with high levels of HbA1c had a high incidence rate of ESRD, from 4.29 for HbA1c of  6.0%–6.9% to 10.33 for HbA1c ≥ 10.0% per 1000 person-years. Patients with HbA1c HbA1c  of 6.0%–6.9%. A J-shaped relationship between HbA1c level and ESRD risk was observed. After adjustment, patients with HbA1c HbA1c of 6.0%–6.9%. Conclusions Diabetes care has focused on preventing hyperglycemia, but not hypoglycemia. Our study revealed that HbA1c level ≥ 7.0% was linked with increased ESRD risk in type 2 diabetes patients, and that HbA1c HbA1c targets and improve outcomes without increasing the risk to this population. Clinicians need to pay attention to HbA1c results on diabetic nephropathy. PMID:26098901

  5. T-shaped competency profile for water professionals of the future

    Directory of Open Access Journals (Sweden)

    S. Uhlenbrook

    2012-10-01

    Full Text Available Global environmental changes introduce new challenges and expose future university graduates in hydrology and related fields to problems of unprecedented complexity and magnitude. The T-shape model is proposed as a generic competency profile guiding the design of university curricula. This model differentiates between cognitive competencies in a certain field (i.e. hydrology; vertical leg of the T, and other cognitive/knowledge competencies in neighboring fields (e.g. hydraulics, aquatic ecology, land use management etc. and functional, personal and values competencies and meta-competencies (all summarized in the horizontal bar of the T. It is based on the holistic model of professional competencies by Cheetham and Chivers (1996 and related studies (Oskam, 2009. The T-shape profile should apply to all levels of higher education (1st degree till doctorate level in hydrology and related fields. For the effectiveness of hydrologists as professionals, a variable mix of competencies is required and further discussed. Key aspects are an open attitude for learning, continuous professional development (lifelong learning, and integrative and team working skills. Furthermore, a stimulating learning environment that promotes active learning is essential. As examples that substantiate the proposed T-shape model, the post-graduate education programmes of UNESCO-IHE and the main outcomes from a university curriculum workshop to promote education for sustainable development are introduced.

  6. Environmental modeling and health risk analysis (ACTS/RISK)

    National Research Council Canada - National Science Library

    Aral, M. M

    2010-01-01

    ... presents a review of the topics of exposure and health risk analysis. The Analytical Contaminant Transport Analysis System (ACTS) and Health RISK Analysis (RISK) software tools are an integral part of the book and provide computational platforms for all the models discussed herein. The most recent versions of these two softwa...

  7. Pretest-Posttest-Posttest Multilevel IRT Modeling of Competence Growth of Students in Higher Education in Germany

    NARCIS (Netherlands)

    Schmidt, Susanne; Zlatkin-Troitschanskaia, Olga; Fox, Gerardus J.A.

    2016-01-01

    Longitudinal research in higher education faces several challenges. Appropriate methods of analyzing competence growth of students are needed to deal with those challenges and thereby obtain valid results. In this article, a pretest-posttest-posttest multivariate multilevel IRT model for repeated

  8. [New approach for managing microbial risks in food].

    Science.gov (United States)

    Augustin, Jean-Christophe

    2015-01-01

    The aim of the food legislation is to ensure the protection of human health. Traditionally, the food legislation requires food business operators to apply good hygiene practices and specific procedures to control foodborne pathogens. These regulations allowed reaching a high level of health protection. The improvement of the system will require risk-based approaches. Firstly, risk assessment should allow the identification of high-risk situations where resources should be allocated for a better targeting of risk management. Then, management measures should be adapted to the health objective. In this approach, the appropriate level of protection is converted intofood safety and performance objectives on the food chain, i.e., maximum microbial contamination to fulfil the acceptable risk level. When objectives are defined, the food business operators and competent authorities can identify control options to comply with the objectives and establish microbiological criteria to verify compliance with these objectives. This approach, described for approximately 10 years, operative thanks to the development of quantitative risk assessment techniques, is still difficult to use in practical terms since it requires a commitment of competent authorities to define the acceptable risk and needs also the implementation of sometimes complex risk models.

  9. Ten-Competence: Life-Long Competence Development and Learning

    NARCIS (Netherlands)

    Koper, Rob; Specht, Marcus

    2006-01-01

    Koper, R., & Specht, M. (2008). Ten-Competence: Life-Long Competence Development and Learning. In M-A. Cicilia (Ed.), Competencies in Organizational e-learning: concepts and tools (pp. 234-252). Hershey: IGI-Global.

  10. Individual cognitions as antecedents of emotional competence and job satisfaction

    OpenAIRE

    Spörrle, Matthias; Welpe, Isabell

    2005-01-01

    A model linking cognitions to emotional competence is presented and tested. The model is based on the four domains of Emotional Intelligence (Goleman, 2002) and on the theoretical framework of Rational-Emotive-Behavior Therapy (Ellis, 1962, 1994). In this respect, we expect irrational beliefs to be negatively associated with both emotional competence and job satisfaction. Furthermore, we expect emotional competence to be positively associated with job satisfaction. Additionally, it is propose...

  11. Logistics Systems Engineer – Interdisciplinary Competence Model for Modern Education

    OpenAIRE

    Tarvo Niine; Ott Koppel

    2015-01-01

    Logistics is an interdisciplinary field of study. Modern logisticians need to integrate business management and administration skills with technology design, IT systems and other engineering fields. However, based on research of university curricula and competence standards in logistics, the engineering aspect is not represented to full potential. There are some treatments of logistician competences which relate to engineering, but not a modernized one with wide-spread recognition. This paper...

  12. A proposal for generic competence assessment in a serious game

    Directory of Open Access Journals (Sweden)

    María José Bezanilla

    2014-01-01

    Full Text Available This paper focuses on the design of a serious game for the teaching and assessment of generic competences, placing particular emphasis on the competences assessment aspect. Taking into account important aspects of competence assessment such as context, feedback and transparency, among other aspects, and using the University of Deusto's Generic Competences Assessment Model based on the defining of levels, indicators and descriptors as a reference point, a serious game has been designed for the development and evaluation of two Generic Competences: Problem Solving and Entrepreneurship, aimed at final-year undergraduate and first-year postgraduate students. The design process shows that having a Competence Assessment Model based on levels, indicators and descriptors is of great help in defining the game's scenarios and learning and assessment activities. Serious games can also be excellent resources to help in the development and assessment of generic competences, but not as a unique tool, since the concept of competence in itself is highly complex (integrating knowledge, skills, attitudes and values and some elements might require other methods and techniques for its development. It also reveals the difficulties of evaluating competences in general and through serious games in particular.

  13. Pennsylvania State Core Competencies for Education on Opioids and Addiction.

    Science.gov (United States)

    Ashburn, Michael A; Levine, Rachel L

    2017-10-01

    The objective of this project was to develop core competencies for education on opioids and addiction to be used in all Pennsylvania medical schools. The Pennsylvania Physician General created a task force that was responsible for the creation of the core competencies. A literature review was completed, and a survey of graduating medical students was conducted. The task force then developed, reviewed, and approved the core competencies. The competencies were grouped into nine domains: understanding core aspects of addiction; patient screening for substance use disorder; proper referral for specialty evaluation and treatment of substance use disorder; proper patient assessment when treating pain; proper use of multimodal treatment options when treating acute pain; proper use of opioids for the treatment of acute pain (after consideration of alternatives); the role of opioids in the treatment of chronic noncancer pain; patient risk assessment related to the use of opioids to treat chronic noncancer pain, including the assessment for substance use disorder or increased risk for aberrant drug-related behavior; and the process for patient education, initiation of treatment, careful patient monitoring, and discontinuation of therapy when using opioids to treat chronic noncancer pain. Specific competencies were developed for each domain. These competencies will be incorporated into the educational process at all Pennsylvania medical schools. It is hoped that these curriculum changes will improve student knowledge and attitudes in these areas, thus improving patient outcomes. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. Social trust, risk perceptions and public acceptance of recycled water: testing a social-psychological model.

    Science.gov (United States)

    Ross, Victoria L; Fielding, Kelly S; Louis, Winnifred R

    2014-05-01

    Faced with a severe drought, the residents of the regional city of Toowoomba, in South East Queensland, Australia were asked to consider a potable wastewater reuse scheme to supplement drinking water supplies. As public risk perceptions and trust have been shown to be key factors in acceptance of potable reuse projects, this research developed and tested a social-psychological model of trust, risk perceptions and acceptance. Participants (N = 380) were surveyed a few weeks before a referendum was held in which residents voted against the controversial scheme. Analysis using structural equation modelling showed that the more community members perceived that the water authority used fair procedures (e.g., consulting with the community and providing accurate information), the greater their sense of shared identity with the water authority. Shared social identity in turn influenced trust via increased source credibility, that is, perceptions that the water authority is competent and has the community's interest at heart. The findings also support past research showing that higher levels of trust in the water authority were associated with lower perceptions of risk, which in turn were associated with higher levels of acceptance, and vice versa. The findings have a practical application for improving public acceptance of potable recycled water schemes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Integrating Quality and Safety Competencies to Improve Outcomes: Application in Infusion Therapy Practice.

    Science.gov (United States)

    Sherwood, Gwen; Nickel, Barbara

    Despite intense scrutiny and process improvement initiatives, patient harm continues to occur in health care with alarming frequency. The Quality and Safety Education for Nursing (QSEN) project provides a roadmap to transform nursing by integrating 6 competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As front-line caregivers, nurses encounter inherent risks in their daily work. Infusion therapy is high risk with multiple potential risks for patient harm. This study examines individual and system application of the QSEN competencies and the Infusion Nurses Society's 2016 Infusion Therapy Standards of Practice in the improvement of patient outcomes.

  16. Development of a risk prediction model for lung cancer: The Japan Public Health Center-based Prospective Study.

    Science.gov (United States)

    Charvat, Hadrien; Sasazuki, Shizuka; Shimazu, Taichi; Budhathoki, Sanjeev; Inoue, Manami; Iwasaki, Motoki; Sawada, Norie; Yamaji, Taiki; Tsugane, Shoichiro

    2018-03-01

    Although the impact of tobacco consumption on the occurrence of lung cancer is well-established, risk estimation could be improved by risk prediction models that consider various smoking habits, such as quantity, duration, and time since quitting. We constructed a risk prediction model using a population of 59 161 individuals from the Japan Public Health Center (JPHC) Study Cohort II. A parametric survival model was used to assess the impact of age, gender, and smoking-related factors (cumulative smoking intensity measured in pack-years, age at initiation, and time since cessation). Ten-year cumulative probability of lung cancer occurrence estimates were calculated with consideration of the competing risk of death from other causes. Finally, the model was externally validated using 47 501 individuals from JPHC Study Cohort I. A total of 1210 cases of lung cancer occurred during 986 408 person-years of follow-up. We found a dose-dependent effect of tobacco consumption with hazard ratios for current smokers ranging from 3.78 (2.00-7.16) for cumulative consumption ≤15 pack-years to 15.80 (9.67-25.79) for >75 pack-years. Risk decreased with time since cessation. Ten-year cumulative probability of lung cancer occurrence estimates ranged from 0.04% to 11.14% in men and 0.07% to 6.55% in women. The model showed good predictive performance regarding discrimination (cross-validated c-index = 0.793) and calibration (cross-validated χ 2 = 6.60; P-value = .58). The model still showed good discrimination in the external validation population (c-index = 0.772). In conclusion, we developed a prediction model to estimate the probability of developing lung cancer based on age, gender, and tobacco consumption. This model appears useful in encouraging high-risk individuals to quit smoking and undergo increased surveillance. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  17. Markov Transition Model to Dementia with Death as a Competing Event.

    Science.gov (United States)

    Wei, Shaoceng; Xu, Liou; Kryscio, Richard J

    2014-12-01

    This study evaluates the effect of death as a competing event to the development of dementia in a longitudinal study of the cognitive status of elderly subjects. A multi-state Markov model with three transient states: intact cognition, mild cognitive impairment (M.C.I.) and global impairment (G.I.) and one absorbing state: dementia is used to model the cognitive panel data; transitions among states depend on four covariates age, education, prior state (intact cognition, or M.C.I., or G.I.) and the presence/absence of an apolipoprotein E-4 allele (APOE4). A Weibull model and a Cox proportional hazards (Cox PH) model are used to fit the survival from death based on age at entry and the APOE4 status. A shared random effect correlates this survival time with the transition model. Simulation studies determine the sensitivity of the maximum likelihood estimates to the violations of the Weibull and Cox PH model assumptions. Results are illustrated with an application to the Nun Study, a longitudinal cohort of 672 participants 75+ years of age at baseline and followed longitudinally with up to ten cognitive assessments per nun.

  18. Risk communication as a core public health competence in infectious disease management: Development of the ECDC training curriculum and programme.

    Science.gov (United States)

    Dickmann, Petra; Abraham, Thomas; Sarkar, Satyajit; Wysocki, Piotr; Cecconi, Sabrina; Apfel, Franklin; Nurm, Ülla-Karin

    2016-01-01

    Risk communication has been identified as a core competence for guiding public health responses to infectious disease threats. The International Health Regulations (2005) call for all countries to build capacity and a comprehensive understanding of health risks before a public health emergency to allow systematic and coherent communication, response and management. Research studies indicate that while outbreak and crisis communication concepts and tools have long been on the agenda of public health officials, there is still a need to clarify and integrate risk communication concepts into more standardised practices and improve risk communication and health, particularly among disadvantaged populations. To address these challenges, the European Centre for Disease Prevention and Control (ECDC) convened a group of risk communication experts to review and integrate existing approaches and emerging concepts in the development of a training curriculum. This curriculum articulates a new approach in risk communication moving beyond information conveyance to knowledge- and relationship-building. In a pilot training this approach was reflected both in the topics addressed and in the methods applied. This article introduces the new conceptual approach to risk communication capacity building that emerged from this process, presents the pilot training approach developed, and shares the results of the course evaluation.

  19. Do we need a threshold conception of competence?

    Science.gov (United States)

    den Hartogh, Govert

    2016-03-01

    On the standard view we assess a person's competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her ('hard paternalism'). In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or not to respect a person's decision-making authority we weigh her decision on several relevant dimensions at the same time: its harmful consequences, its importance in terms of the person's own relevant values, the infringement of her autonomy involved in overruling it, and her decision-making abilities. I argue that we should openly recognize the multi-dimensional nature of this judgment. This implies rejecting both the threshold conception of competence and the categorical distinction between hard and soft paternalism.

  20. Developing a Framework for Communication Management Competencies

    Science.gov (United States)

    Jeffrey, Lynn Maud; Brunton, Margaret Ann

    2011-01-01

    Using a hierarchical needs assessment model developed by Hunt we identified the essential competencies of communication management practitioners for the purpose of curriculum development and selection. We found that the underlying values of the profession were embodied in two superordinate goals. Six major competencies were identified, which were…

  1. Establishing the Competence of Outdoor Training Staff.

    Science.gov (United States)

    Everard, Bertie

    1997-01-01

    The United Kingdom lacks a framework of nationally recognized professional qualifications for outdoor trainers and facilitators. Various definitions of competence are examined, and suggestions are offered for improving approaches to establishing staff competence. Includes a model of personal development dimensions, and compares U.K. and U.S.…

  2. The enhancement model of ICT competence for the teachers of SMP Terbuka in Central Java to support long distance learning program

    Science.gov (United States)

    Widowati, Trisnani; Purwanti, Dwi

    2017-03-01

    ICT-based learning for SMP Terbuka is a manifestation of the first pillar of DEPDIKNAS Strategic Plan 2005-2009, about the use of ICT as the facility of long distance learning. By implementing ICT-based learning, the communication between the teacher and the students is possible to happen although both parties are in differnet places. The problem in implementing ICT-based learning for SMP Terbuka is the low competence of the teachers in ICT mastery, because this research is aimed to formulate the enhancement model of ICT competence for the teachers of SMP Terbuka in Central Java to support long distance learning program. This research shows that Supervised-Teachers and Tutor Teachers Competence in ICT is still low with the average of Supervised-Teachers competence in operating Ms.Word application of 59.6%, Ms.Excel 55.40%, Power Point 43.40% and internet mastery of 41.8%; while the competence of Tutor Teachers is lower with the average of 40.40% in operating Ms. Word, 35.20% in Ms.Excel, 28.00% in Power Point, and 29% in internet mastery. It means that Supervised-Teachers understand ICT, but they do not master it; while Tutor Teachers have just understood ICT and have a low mastery in Ms.Word. The output of this research is: The new findings of the enhancement model of ICT competence for the teachers of SMP Terbuka in Central Java to support long distance learning program.

  3. Assessment and self-assessment of the pharmacists' competencies using the global competency framework (GbCF in Serbia

    Directory of Open Access Journals (Sweden)

    Stojkov Svetlana

    2016-01-01

    Full Text Available Background/Aim. Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients’ health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF. The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. Methods. The assessment and self-assessment of pharmacists’ competencies were performed during the period 2012−13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. Results. A total of 123 pharmacists were evaluated. Pharmacists’ Professional Competency Cluster (KK1 had the lowest score (average value 2.98, while the cluster Management and Organizational Competency (KK2 had the highest score (average value 3.15. The competence Recognition of the Diagnosis and Patient Counseling (K8, which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively among the all evaluated competencies. Conclusion. GbCF might be considered as an instrument for the competencies' evaluation/selfevaluation and their improvement, accordingly.

  4. The Intercultural Marketing Competence of Software Subcontractors: Toward a Conceptual Framework

    DEFF Research Database (Denmark)

    Skaates, Maria Anne

    2002-01-01

    As part of a research project on cooperation between Nordic software development subcontractors and their foreign customers, the dynamics of intercultural marketing competence are being examined. This paper builds a conceptual bridge by developing a definition of a software subcontracting firm......'s intercultural marketing competence on the basis of (a) socio-psychological and human resource management definitions of intercultural competence at the level of individuals and (b) definitions of organizational competence from the resource-based perspective. Furthermore a model of the dynamics...... of this competence is presented. In connection with the model, key economic aspects of the competence from the viewpoints of both the subcontractor and its customer firm - including strategic importance, heterogeneity, imperfect mobility, ex ante limits to competition, dynamic transaction costs, time compression...

  5. Urgency Competence of Media Literacy for Archivist

    Directory of Open Access Journals (Sweden)

    Agus Santoso

    2016-07-01

    Full Text Available The study of media literacy has been conducted by the earlier scientists. That research uses population that have different characteristics to each other. So this studies of media literacy have various models or patterns. This models or patterns of media literacies will be used as basic data to the next study that generated will usually be the basis for the further research. Basically, the model of media literacy generated by some researchers only can be applied in the population which become objects of research. To day, the archives faced many challenges due to the presence of information technology, so that the competence of media literacy as one of the important competencies to have. Through this competency, archivist are expected to manage archives organization effectively and efficiently. This paper uses a descriptive method to describe how media literacy becomes important for archives.

  6. Implementation of the Human Talent Management through Competencies Model in a University in Metropolitan Lima

    Science.gov (United States)

    Rodríguez, Juan C.

    2015-01-01

    This article is a work proposal that aims to describe the methodology proposed by the Management of Personnel Management from a university in Lima, to implement a management model based on competencies which traceability involves various technical HR processes practiced in the organization and is aligned to institutional outcomes defined in the…

  7. Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.

    Science.gov (United States)

    Bachmann, Justin M; Goggins, Kathryn M; Nwosu, Samuel K; Schildcrout, Jonathan S; Kripalani, Sunil; Wallston, Kenneth A

    2016-12-01

    Evaluate the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on health behavior and health-related quality of life. We analyzed 2063 patients hospitalized with acute coronary syndrome and/or congestive heart failure at a large academic hospital in the United States. Multivariable linear regression models investigated associations between the two-item perceived health competence scale (PHCS-2) and positive health behaviors such as medication adherence and exercise (Health Behavior Index) as well as health-related quality of life (5-item Patient Reported Outcome Information Measurement System Global Health Scale). After multivariable adjustment, perceived health competence was highly associated with health behaviors (pperceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90days after discharge (pPerceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge. Patients with low perceived health competence may be at risk for a decline in health-related quality of life after hospitalization and thus a potential target for counseling and other behavioral interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Time from first detectable PSA following radical prostatectomy to biochemical recurrence: A competing risk analysis

    Science.gov (United States)

    de Boo, Leonora; Pintilie, Melania; Yip, Paul; Baniel, Jack; Fleshner, Neil; Margel, David

    2015-01-01

    Introduction: In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR. Methods: We identified subjects who underwent a RP and had an undetectable PSA after surgery followed by at least 1 detectable PSA between 2000 and 2011. The primary outcome was time to BCR (PSA ≥0.2 and successive PSA ≥0.2) and prediction of the rate of PSA rise. Outcomes were calculated using a competing risk analysis, with univariable and multivariable Fine and Grey models. We employed a mixed effect model to test clinical predictors that are associated with the rate of PSA rise. Results: The cohort included 376 patients. The median follow-up from surgery was 60.5 months (interquartile range [IQR] 40.8–91.5) and from detectable PSA was 18 months (IQR 11–32). Only 45.74% (n = 172) had PSA values ≥0.2 ng/mL, while 15.16% (n = 57) reached the PSA level of ≥0.4 ng/mL and rising. On multivariable analysis, the values of the first detectable PSA and pathologic Gleason grade 8 or higher were consistently independent predictors of time to BCR. In the mixed effect model rate, the PSA rise was associated with time from surgery to first detectable PSA, Gleason score, and prostate volume. The main limitation of this study is the large proportion of patients that received treatment without reaching BCR. It is plausible that shorter estimated median times would occur at a centre that does not use salvage therapy at such an early state. Conclusion: The time from first detectable PSA to BCR may be lengthy. Our analyses of the predictors of the rate of PSA rise can help determine a personalized approach for patients with a detectable PSA after surgery. PMID:25624961

  9. Development Of Entrepreneur Learning Model Based On Problem Based Learning To Increase Competency Independence And Creativity Students Of Industrial Engineering

    Directory of Open Access Journals (Sweden)

    Leola Dewiyani

    2017-10-01

    Full Text Available Currently it is undeniable that the competition to get a job is very tight and of course universities have an important role in printing human resources that can compete globally not least with the Department of Industrial Engineering Faculty of Engineering Muhammadiyah University of Jakarta FT UMJ. Problems that occur is based on the analysis obtained from the track record of graduates researchers found that 60 percent of students of Industrial Engineering FT UMJ work not in accordance with the level of education owned so financially their income is still below the standard. This study aims to improve the competence of students of Industrial Engineering Department FT UMJ in entrepreneurship courses especially through the development of Problem Based Learning based learning model. Specific targets of this research were conducted with the aim to identify and analyze the need to implement learning model based on Problem Based Learning Entrepreneurship and to design and develop the model of entrepreneurship based on Problem Based Learning to improve the competence independence and creativity of Industrial Engineering students of FT UMJ in Entrepreneurship course. To achieve the above objectives this research uses research and development R amp D method. The product produced in this research is the detail of learning model of entrepreneurial model based on Problem Based Learning entrepreneurship model based on Problem Based Learning and international journals

  10. An empirical test of competing theories of hazard-related trust: the case of GM food.

    Science.gov (United States)

    Allum, Nick

    2007-08-01

    Few scholars doubt the importance of trust in explaining variation in public perception of technological risk. Relatively little, however, is known about the particular types of judgments that people use in granting or withholding trust. This article presents findings from an empirical study that explores several dimensions of trust relevant for citizens' judgments of scientists involved in the development of GM food. The relationship between particular dimensions of trust and perceptions of GM food risk is also explored, using structural equation modeling. Results suggest that trust judgments based on the perception of shared values are most important in relation to GM food risk, but that judgments about scientists' technical competence are also important.

  11. Factoring consumers' perspectives into policy decisions for nursing competence.

    Science.gov (United States)

    Lazarus, Jean B; Lee, N Genell

    2006-08-01

    Health care delivery competence and accountability have typically been defined from providers' perspectives, rather than those of consumers as purchasers of services. In 1999, in the face of broad public concern about nursing competence the Alabama Board of Nursing developed an accountability model that established consumers at the center of the model and placed accountability for competent nursing practice at all levels of providers including regulatory agencies, health care organizations, educators, and licensees. The Board then authorized two research projects involving first, consumers perceptions on nursing competence and regulation, and second, comparing their perceptions with those of licensees, nurse educators, and organizational leaders (N = 1,127). Comparative data evidenced significant differences between consumers' and other participants' perceptions. This article highlights how policy implications derived from research resulted in regulatory changes for nursing competence. Five years of progress in policy changes made in the interest of public safety are summarized.

  12. Competing-Risks Mortality After Radiotherapy vs. Observation for Localized Prostate Cancer: A Population-based Study

    Energy Technology Data Exchange (ETDEWEB)

    Abdollah, Firas, E-mail: firas.abdollah@gmail.com [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Department of Urology, Vita Salute San Raffaele University, Milan (Italy); Sun, Maxine [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Schmitges, Jan [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg (Germany); Thuret, Rodolphe [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Department of Urology, University of Montpellier Health Centre, Montpellier (France); Tian, Zhe [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Shariat, Shahrokh F. [Department of Urology, Weill Medical College of Cornell University, New York, NY (United States); Briganti, Alberto [Department of Urology, Vita Salute San Raffaele University, Milan (Italy); Jeldres, Claudio; Perrotte, Paul [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Department of Urology, University of Montreal Health Centre, Montreal (Canada); Montorsi, Francesco [Department of Urology, Vita Salute San Raffaele University, Milan (Italy); Karakiewicz, Pierre I. [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal (Canada); Department of Urology, University of Montreal Health Centre, Montreal (Canada)

    2012-09-01

    Purpose: Contemporary patients with localized prostate cancer (PCa) are more frequently treated with radiotherapy. However, there are limited data on the effect of this treatment on cancer-specific mortality (CSM). Our objective was to test the relationship between radiotherapy and survival in men with localized PCa and compare it with those treated with observation. Methods: A population-based cohort identified 68,797 men with cT1-T2 PCa treated with radiotherapy or observation between the years 1992 and 2005. Propensity-score matching was used to minimize potential bias related to treatment assignment. Competing-risks analyses tested the effect of treatment type (radiotherapy vs. observation) on CSM, after accounting to other-cause mortality. All analyses were carried out within PCa risk, baseline comorbidity status, and age groups. Results: Radiotherapy was associated with more favorable 10-year CSM rates than observation in patients with high-risk PCa (8.8 vs. 14.4%, hazard ratio [HR]: 0.59, 95% confidence interval [CI]: 0.50-0.68). Conversely, the beneficial effect of radiotherapy on CSM was not evident in patients with low-intermediate risk PCa (3.7 vs. 4.1%, HR: 0.91, 95% CI: 0.80-1.04). Radiotherapy was beneficial in elderly patients (5.6 vs. 7.3%, HR: 0.70, 95% CI: 0.59-0.80). Moreover, it was associated with improved CSM rates among patients with no comorbidities (5.7 vs. 6.5%, HR: 0.81, 95% CI: 0.67-0.98), one comorbidity (4.6 vs. 6.0%, HR: 0.87, 95% CI: 0.75-0.99), and more than two comorbidities (4.2 vs. 5.0%, HR: 0.79, 95% CI: 0.65-0.96). Conclusions: Radiotherapy substantially improves CSM in patients with high-risk PCa, with little or no benefit in patients with low-/intermediate-risk PCa relative to observation. These findings must be interpreted within the context of the limitations of observational data.

  13. Models of Credit Risk Measurement

    OpenAIRE

    Hagiu Alina

    2011-01-01

    Credit risk is defined as that risk of financial loss caused by failure by the counterparty. According to statistics, for financial institutions, credit risk is much important than market risk, reduced diversification of the credit risk is the main cause of bank failures. Just recently, the banking industry began to measure credit risk in the context of a portfolio along with the development of risk management started with models value at risk (VAR). Once measured, credit risk can be diversif...

  14. Models for assessing and managing credit risk

    Directory of Open Access Journals (Sweden)

    Neogradi Slađana

    2014-01-01

    Full Text Available This essay deals with the definition of a model for assessing and managing credit risk. Risk is an inseparable component of any average and normal credit transaction. Looking at the different aspects of the identification and classification of risk in the banking industry as well as representation of the key components of modern risk management. In the first part of the essay will analyze how the impact of credit risk on bank and empirical models for determining the financial difficulties in which the company can be found. Bank on the basis of these models can reduce number of approved risk assets. In the second part, we consider models for improving credit risk with emphasis on Basel I, II and III, and the third part, we conclude that the most appropriate model and gives the best effect for measuring credit risk in domestic banks.

  15. Ethical media competence as a protective factor against cyberbullying and cybervictimization among german school students.

    Science.gov (United States)

    Müller, Christin R; Pfetsch, Jan; Ittel, Angela

    2014-10-01

    The use of digital information and communication technologies is an integral part of adolescents' everyday life. Besides various opportunities for information, entertainment, and communication, media use is associated with risks such as cyberbullying. Cyberbullying refers to aggressive behavior in the context of computer-mediated communication, characterized by repetition, an intention to harm, and power imbalance. Previous studies have shown that increased media use is a major risk factor for cyberbullying and cybervictimization. Given that restricting media use is not a practical way to reduce the negative effects inherent in media use, the present study examines the relevance of ethical media competence. We expected ethical media competence to buffer the effect of increased media use on cyberbullying and cybervictimization. A survey was conducted with 934 students (53% female) aged 10-17 years (M=13.26, SD=1.63). As expected, hierarchical regression analyses showed a positive main effect of media use, a negative main effect of ethical media competence, and a negative interaction effect of media use and media competence on cyberbullying and cybervictimization. Simple slope analyses revealed that at high levels of ethical media competence, media use has almost no effect on cybervictimization and a significant negative effect on cyberbullying. Consequently, promoting ethical media competence constitutes a potential measure to prevent the risks of increased media use for cyberbullying and cybervictimization.

  16. Integrated product development: Competencies meet and products arise

    DEFF Research Database (Denmark)

    Jensen, Birger Boutrup; Stacey, Julia

    2000-01-01

    and process competencies throughout the whole development process. Of course, this is easier said than done but integrating various competencies into the product development prepares the ground for a better balance and consequently more products. Databases, for instance are a good example of a tool that can...... the development process and diminish the risk of inventing sliced bread once again. Furthermore the databases may be used as a foundation for a more effective and frictionless communication across departments. The project has its starting point in case studies of three Danish food companies. A research group...

  17. Kaplan-Meier Survival Analysis Overestimates the Risk of Revision Arthroplasty: A Meta-analysis.

    Science.gov (United States)

    Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter D; Ghali, William A; Marshall, Deborah A

    2015-11-01

    Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the risk of revision in the presence of competing risks (such as death). Because the magnitude of overestimation is not well documented, the potential associated impact on clinical and policy decision-making remains unknown. We performed a meta-analysis to answer the following questions: (1) To what extent does the Kaplan-Meier method overestimate the cumulative incidence of revision after joint replacement compared with alternative competing-risks methods? (2) Is the extent of overestimation influenced by followup time or rate of competing risks? We searched Ovid MEDLINE, EMBASE, BIOSIS Previews, and Web of Science (1946, 1980, 1980, and 1899, respectively, to October 26, 2013) and included article bibliographies for studies comparing estimated cumulative incidence of revision after hip or knee arthroplasty obtained using both Kaplan-Meier and competing-risks methods. We excluded conference abstracts, unpublished studies, or studies using simulated data sets. Two reviewers independently extracted data and evaluated the quality of reporting of the included studies. Among 1160 abstracts identified, six studies were included in our meta-analysis. The principal reason for the steep attrition (1160 to six) was that the initial search was for studies in any clinical area that compared the cumulative incidence estimated using the Kaplan-Meier versus competing-risks methods for any event (not just the cumulative incidence of hip or knee revision); we did this to minimize the likelihood of missing any relevant studies. We calculated risk ratios (RRs) comparing the cumulative incidence estimated using the Kaplan-Meier method with the competing-risks method for each study and used DerSimonian and Laird random effects models to pool these RRs. Heterogeneity was explored using stratified meta-analyses and

  18. On the Empirical Importance of the Conditional Skewness Assumption in Modelling the Relationship between Risk and Return

    Science.gov (United States)

    Pipień, M.

    2008-09-01

    We present the results of an application of Bayesian inference in testing the relation between risk and return on the financial instruments. On the basis of the Intertemporal Capital Asset Pricing Model, proposed by Merton we built a general sampling distribution suitable in analysing this relationship. The most important feature of our assumptions is that the skewness of the conditional distribution of returns is used as an alternative source of relation between risk and return. This general specification relates to Skewed Generalized Autoregressive Conditionally Heteroscedastic-in-Mean model. In order to make conditional distribution of financial returns skewed we considered the unified approach based on the inverse probability integral transformation. In particular, we applied hidden truncation mechanism, inverse scale factors, order statistics concept, Beta and Bernstein distribution transformations and also a constructive method. Based on the daily excess returns on the Warsaw Stock Exchange Index we checked the empirical importance of the conditional skewness assumption on the relation between risk and return on the Warsaw Stock Market. We present posterior probabilities of all competing specifications as well as the posterior analysis of the positive sign of the tested relationship.

  19. Rates and risk factors of injury in CrossFitTM: a prospective cohort study.

    Science.gov (United States)

    Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean

    2017-09-01

    CrossFitTM is a strength and conditioning program that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement ScreenTM (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was to evaluate the level of injury risk associated with CrossFit training, and examine the influence of a number of potential risk factors (including movement competency). A cohort of 117 CrossFit participants were followed prospectively for 12 weeks. Participants' characteristics, previous injury history and training experience were recorded at baseline, and an FMS assessment was conducted. The overall injury incidence rate was 2.10 per 1000 training hours (90% confidence limits: 1.32-3.33). A multivariate Poisson regression model identified males (rate ratio [RR]: 4.44 ×/÷ 3.30, very likely harmful) and those with previous injuries (RR: 2.35 ×/÷ 2.37, likely harmful) as having a higher injury risk. Inferences relating to FMS variables were unclear in the multivariate model, although number of asymmetries was a clear risk factor in a univariate model (RR per two additional asymmetries: 2.62 ×/÷ 1.53, likely harmful). The injury incidence rate associated with CrossFit training was low, and comparable to other forms of recreational fitness activities. Previous injury and gender were identified as risk factors for injury, whilst the role of movement competency in this setting warrants further investigation.

  20. On assessing surrogacy in a single trial setting using a semi-competing risks paradigm

    Science.gov (United States)

    Ghosh, Debashis

    2009-01-01

    Summary There has been a recent emphasis on the identification of biomarkers and other biologic measures that may be potentially used as surrogate endpoints in clinical trials. We focus on the setting of data from a single clinical trial. In this paper, we consider a framework in which the surrogate must occur before the true endpoint. This suggests viewing the surrogate and true endpoints as semi-competing risks data; this approach is new to the literature on surrogate endpoints and leads to an asymmetrical treatment of the surrogate and true endpoints. However, such a data structure also conceptually complicates many of the previously considered measures of surrogacy in the literature. We propose novel estimation and inferential procedures for the relative effect and adjusted association quantities proposed by Buyse and Molenberghs (1998, Biometrics, 1014 – 1029). The proposed methodology is illustrated with application to simulated data, as well as to data from a leukemia study. PMID:18759839

  1. Assuring future competence in nuclear safety in Finland

    International Nuclear Information System (INIS)

    Koskinen, K.

    2004-01-01

    To improve competence management at the regulatory body a competence analysis was carried out and a human resource plan for nuclear safety area for the near future was made. STUK studied carefully the models used in other public sector organisations and adjusted the method to its own purposes. The model used has four competence categories: substance related, management skills, common working skills and STUK related working skills. Substance related competences were defined and described at working unit level. Descriptions for the rest three categories were made at STUK level and those were common for all departments. Results of competence analysis are encouraging. Most competence areas are covered at proper level, some will need to be improved but none was totally missing. For the future challenges extra attention should be paid to knowledge management. Two separate plans were made on the basis of these results: plan for training regulatory personnel and HR-plan (at the first stage recruiting plan for next five years). It is STUK's experience that the competence analysis is worth the trouble. It gives the organisation and employees a common conception on its competences and on future needs. It also makes it easier to motivate all staff members to use their working hours on training and capability building. On the other hand it must be admitted that it takes resources and all employees have not been very anxious to do this. The results of competence analysis should lead to some improvement projects. The progress of improvement actions should be followed-up on regularly basis. It is important not to forget to communicate the results to employees

  2. Integration of Intercultural Competence in the Processes of Enterprise Internationalization: Possibilities of the Adaptation of the Model in the Operation of Small and Medium Enterprises

    Directory of Open Access Journals (Sweden)

    Jolita Vveinhardt

    2015-05-01

    Full Text Available The article briefly presents the problems identified during the studies carried out by the authors previously, i.e. the problems of intercultural competence and its integration in the processes of internationalization are disclosed. On the basis of the researches carried out the model of integration of intercultural competence in the internationalization processes is adapted, preparing the plan of development of intercultural competence in enterprises. At the end of the article the guidelines for the application of the model for development of internationalization of small and medium enterprises is presented.

  3. Pedagogical Catalysts of Civic Competence: The Development of a Critical Epistemological Model for Community-Based Learning

    Science.gov (United States)

    Stokamer, Stephanie

    2013-01-01

    Democratic problem-solving necessitates an active and informed citizenry, but existing research on service-learning has shed little light on the relationship between pedagogical practices and civic competence outcomes. This study developed and tested a model to represent that relationship and identified pedagogical catalysts of civic competence…

  4. Enhancing Key Competencies of Health Professionals in the Assessment and Care of Adults at Risk of Suicide Through Education and Technology.

    Science.gov (United States)

    Ryan, Kathryn; Tindall, Claudia; Strudwick, Gillian

    This article describes efforts undertaken to improve the clinical competencies of health professionals in the area of suicide risk assessment, documentation, and care planning. Best practices that fit the mental health and addictions setting were identified from the Registered Nurses' Association of Ontario Best Practice Guideline on Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. A variety of methods were used to implement the guidelines at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada. These included 3 in-person educational modules, an e-learning module, and the creation of an electronic health record suicide risk assessment documentation form. Results showed that interprofessional team members improved their suicide awareness and increased their confidence and knowledge in suicide risk assessment and the identification of interventions for clients at risk. Organizational level performance and quality improvement activities after implementation of the education and the electronic suicide risk assessment documentation form are being implemented through a collaboration between performance improvement, clinical education and informatics, and professional practice. The success of an interprofessional educational program of this nature is dependent on the collaboration of a number of stakeholders from a variety of areas of the organization.

  5. The Family Resemblance Model and Communicative Competence. Lektos: Interdisciplinary Working Papers in Language Sciences, Vol. 1, No. 2.

    Science.gov (United States)

    St. Clair, Robert

    The concept of a speech community is investigated within the theoretical frameworks of sociology and linguistics, and it is concluded that the collective competence models of Ferdinand de Saussure and Noam Chomsky are inadequate. They fail in that they are limited as linguistic models which have consistently overlooked the sociological importance…

  6. Melanoma Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing melanoma cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  7. Analysis Influence of Managerial Competence, Technical Competence, and Strategic Competence on Firm Performance in Electrical Engineering Company in Bandung

    Science.gov (United States)

    Wijaya, E. R.; Irianto, D.

    2018-03-01

    The industry sectors that have an important role in the era of globalization is the electro engineering sector. The era of globalization led to intense competition. One of the negative effects of the intense competition is declining profits. Drop in profits caused many firms reduces their employees without seeking the root cause of declining profits in detail. Whereas, employee is the important resources to maintain competitive advantage. Competitive advantage can be measured by the performance of which is owned by the firm. The firm's performance can be formed of competencies that is unique, rare, irreplaceable, and difficult to imitate within the firm, one of them is the competence of the individual. According to a competency-based approach and the resource- based approach, individual competence that affect the performance of the firm is managerial competence, technical competence, and strategic competence. Questionnaire is built based on the dimensions of the firm's performance, managerial competence, technical competence, and strategic competence, are processed using partial least squares application. The results indicate that managerial competence negatively impact firm’s performance with weak ties. The technical competence and strategic competence positively affect firm’s performance with moderate ties.

  8. An analysis of the concept of competence in individuals and social systems.

    Science.gov (United States)

    Adler, P T

    1982-01-01

    This paper has attempted to present a unified conceptual model of positive mental health or competence from the perspective of individuals and from the perspective of social systems of varying degrees of complexity, such as families, organizations, and entire communities. It has provided a taxonomy of the elements of competence which allows the application of a common framework to the analysis of competence and to the planning and evaluation of competence building interventions at any level of social organization. Community Mental Health Centers can apply the model which has been presented in a number of different ways. At whatever level(s) the CMHCs' efforts are directed, the competence model presents a framework for analysis, intervention, and evaluation which enriches and expands upon more typical disorder-based formulations. By providing a framework which encompasses all levels of social organization, the model provides the conceptual tools for going beyond the individual and microsystem levels which have often constituted the boundaries of CMHC concern, and allows the CMHC to approach the organizational and community levels which must be encompassed by a competently comprehensive center. Application of the concept of competence to social organizations and to communities allows the CMHC to analyze and intervene at these levels. Finally, the concept of organizational competence separated into its various elements provides the CMHC with a tool for analyzing and evaluating its own environment and the competence of various aspects of its own functioning within that environment.

  9. Calculating excess lifetime risk in relative risk models

    International Nuclear Information System (INIS)

    Vaeth, M.; Pierce, D.A.

    1990-01-01

    When assessing the impact of radiation exposure it is common practice to present the final conclusions in terms of excess lifetime cancer risk in a population exposed to a given dose. The present investigation is mainly a methodological study focusing on some of the major issues and uncertainties involved in calculating such excess lifetime risks and related risk projection methods. The age-constant relative risk model used in the recent analyses of the cancer mortality that was observed in the follow-up of the cohort of A-bomb survivors in Hiroshima and Nagasaki is used to describe the effect of the exposure on the cancer mortality. In this type of model the excess relative risk is constant in age-at-risk, but depends on the age-at-exposure. Calculation of excess lifetime risks usually requires rather complicated life-table computations. In this paper we propose a simple approximation to the excess lifetime risk; the validity of the approximation for low levels of exposure is justified empirically as well as theoretically. This approximation provides important guidance in understanding the influence of the various factors involved in risk projections. Among the further topics considered are the influence of a latent period, the additional problems involved in calculations of site-specific excess lifetime cancer risks, the consequences of a leveling off or a plateau in the excess relative risk, and the uncertainties involved in transferring results from one population to another. The main part of this study relates to the situation with a single, instantaneous exposure, but a brief discussion is also given of the problem with a continuous exposure at a low-dose rate

  10. Teaching and clinical educator competency: bringing two worlds together.

    Science.gov (United States)

    Robinson, Cathy P

    2009-01-01

    More sessional clinical educators are being employed in educational institutions today than ever before. Also identified in the literature are issues affecting sessional clinical educators' ability to develop and maintain educator competency. Using the definition of educator competency by the National League for Nursing (NLN 2005a), explored in this paper are ways of increasing sessional clinical educator competency, such as orientation and mentorship programs to support student learning in clinical environments. Approaches in the form of theoretical models designed to evaluate clinical educator competency are examined. A new Sessional Clinical Educator Competency (SCEC) Framework is offered to provide direction for implementing strategies to develop and evaluate sessional clinical educator competency. Suggested is that the SCEC framework could be useful for educational administrators and sessional clinical educators to assess clinical educator competency.

  11. CORPORATE STANDARD OF ICT COMPETENCE OF MASTERS

    Directory of Open Access Journals (Sweden)

    N. Morze

    2014-06-01

    Full Text Available Current labor market demand determines the modification of the system of higher education, including the transfer of emphasis on the educational process in its final qualitative result, a paradigm shift from knowledge education to competency. Student should must possess ICT competence that today has become a part of professional competence of professionals of any type. The purpose of the study is to develop standards in the ICT competence of all members of the educational process to ensure the quality of university education and the creation and subsequent implementation of educational policies of the University. The paper highlights the need to develop a corporate standard of ICT competence of masters based on UNESCO scientific approaches. It describes model, the level of ICT competence and tools for monitoring its formation in the future for today's professionals. For each of the selected three levels of ICT competence (basic, advanced and professional determined necessary knowledge and skills, talents and ideas to master. The necessary and sufficient conditions are determined for the formation of the ICT competence of masters in modern university, proffered examples of tasks and competency requirements for the personal educational electronic space for student and educational electronic space of university. Developed and approved corporate standard provides appropriate expertise contemporary specialist who meets the requirements of the labor market and will allow the graduate to be successful in today's information society.

  12. Competency Analytics Tool: Analyzing Curriculum Using Course Competencies

    Science.gov (United States)

    Gottipati, Swapna; Shankararaman, Venky

    2018-01-01

    The applications of learning outcomes and competency frameworks have brought better clarity to engineering programs in many universities. Several frameworks have been proposed to integrate outcomes and competencies into course design, delivery and assessment. However, in many cases, competencies are course-specific and their overall impact on the…

  13. A survey of engagement and competence levels in interventions and activities in a community mental health workforce in England

    Directory of Open Access Journals (Sweden)

    Lang Linda

    2011-12-01

    Full Text Available Abstract Background National Health Service (NHS mental health workforce configuration is at the heart of successful delivery, and providers are advised to produce professional development strategies. Recent policy changes in England have sharpened the focus on competency based role development. We determined levels of intervention activities, engagement and competence and their influencing factors in a community-setting mental health workforce. Methods Using a modified questionnaire based on the Yorkshire Care Pathways Model we investigated 153 mental health staff working in Coventry and Warwickshire NHS Trust. A median score of competence was computed across 10 cluster activities. Low engagement and competence levels were examined in a logistic regression model. Results In 220 activities, Monitoring risk was the highest rate of engagement (97.6% and Group psychological therapy/Art/Drama therapy was the lowest engagement (3.6%. The median competence level based on all activities was 3.95 (proficient. There were significant differences in the competence level among professional groups; non-qualified support group (3.00 for competent, Counsellor/Psychologist/Therapist (3.38, Occupational therapists (3.76, Nurses (4.01, Medical staff (4.05, Social workers (4.25 and Psychologists (4.62 for proficient/expert. These levels varied with activity clusters; the lowest level was for Counsellor/Psychologist/Therapist in the accommodation activity (1.44 novice/advance beginner and the highest for Occupational therapists in personal activity (4.94 expert. In a multivariate analysis, low competence was significantly related to non-qualified community support professions, late time of obtaining first qualification, more frequencies of clinical training, and training of cognitive behavioural therapy. The associations were similar in the analysis for 10 activity clusters respectively. Conclusions There was a reasonable competence level in the community

  14. Development and validation of health service management competencies.

    Science.gov (United States)

    Liang, Zhanming; Howard, Peter F; Leggat, Sandra; Bartram, Timothy

    2018-04-09

    Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

  15. The APA Ethical Principles as a foundational competency: application to rehabilitation psychology.

    Science.gov (United States)

    Hanson, Stephanie L; Kerkhoff, Thomas R

    2011-08-01

    Competence is a core component of ethical conduct as reflected in its addition as an ethical standard in the 2002 APA Ethics Code. Successfully operationalizing and assessing competence provides psychologists a means to improve education and training, advance the field of practice, and create a framework for accountability to the public. Much of the recent competency discussion has been in response to a proposed Cube Model, with its three axes being foundational competencies (practice building blocks, such as scientific knowledge, ethical standards), functional competencies (attributes of providing services, such as assessment, intervention), and developmental progression (acquiring increasing competence over the course of one's education and career). Ethics is included on the foundational competency axis and has been operationalized to the extent that subcomponents and benchmarks have been promulgated. The competency model as proposed faces multiple challenges, including gaining consensus regarding its components, addressing reliable and valid assessment over time, and creating a culture of acceptance. We propose the Ethical Principles as an alternative framework for conceptualizing ethics as a foundational competency given the Ethics Code is already time tested and includes a serial review process for broad discipline input and adaptability. We apply the Ethical Principles as foundational components to rehabilitation psychology training at internship, postdoctoral, and specialty levels to illustrate the model. Rehabilitation psychology should engage in the competency movement at the predoctoral and postdoctoral level. The application of the Ethical Principles as a foundational competency to rehabilitation psychology represents a first step in this dialog.

  16. The Development Model of Knowledge Management via Web-Based Learning to Enhance Pre-Service Teacher's Competency

    Science.gov (United States)

    Rampai, Nattaphon; Sopeerak, Saroch

    2011-01-01

    This research explores that the model of knowledge management and web technology for teachers' professional development as well as its impact in the classroom on learning and teaching, especially in pre-service teacher's competency and practices that refer to knowledge creating, analyzing, nurturing, disseminating, and optimizing process as part…

  17. The competent community: toward a vital reformulation of professional ethics.

    Science.gov (United States)

    Johnson, W Brad; Barnett, Jeffrey E; Elman, Nancy S; Forrest, Linda; Kaslow, Nadine J

    2012-10-01

    Psychologists are ethically obligated to ensure their own competence. When problems of professional competence occur, psychologists must take appropriate steps to regain competence while protecting those they serve. Yet conceptualizations of the competence obligation are thoroughly intertwined with Western ideals of individualism and a model of the person as self-contained, self-controlled, and perpetually rational. Research in health care, education, and multicultural and social psychology raise serious doubts about psychologists' capacity for consistently accurate self-assessments of competence. To address this problem, the authors advocate that education, training, professional ethics standards, and credentialing criteria be infused with a robust communitarian ethos and a culturally pervasive ethic of care. The authors propose a shift in discourse about competence to incorporate both competent individuals and competent communities.

  18. Behavior problems and social competence in Brazilian children with specific language impairment

    Directory of Open Access Journals (Sweden)

    Marina Leite Puglisi

    2016-01-01

    Full Text Available Abstract This study aimed to investigate the behavior and social profile of Brazilian children with specific language impairment (SLI and explore whether the severity of language deficits was associated with behavioral problems and low social competence. Twenty-four children with SLI aged from 6 to 11 years who showed substantial expressive language problems and were receiving speech-language therapy were assessed through the Child Behavior Checklist (CBCL. Children with SLI showed high rates of behavioral problems and low levels of social competence. With the exception of two subscales (“somatic” and “rule breaker”, the percentage of children with SLI at risk of behavioral problems was significantly higher than the same proportion in the general population; and almost all children with SLI (95.2 % demonstrated problems with social competence. The severity of language deficits was associated with the risk of behavioral problems according to only one criterion. No associations were found between the severity of language problems and social competence. The study provides cross-cultural evidence to support the existence of behavior problems and reduced social competence in children with SLI. Our findings point to the need of using a combination of measures to classify the severity of language problems rather than a single dimension.

  19. Teacher competencies

    OpenAIRE

    Svatošová, Kateřina

    2012-01-01

    This diploma thesis deals with adult teacher competencies. It describes current situation in adult education and it focuses on measuring quality level of teacher competencies. There is given the main overview of adult education specifics. These are the prerequisites for defining adult teacher competencies. There is given specific adult teacher competencies and related roles which are generally based on teacher's activities during educational courses. Next part describes present conception of ...

  20. A competing risk model for reduction in life expectancy from radiogenic cancer

    International Nuclear Information System (INIS)

    Davis, H.T.

    1978-01-01

    Latent radiogenic cancer fatalities from reactor accidents are considered to be more important than early fatalities. However, early fatalities generally result in appreciable life shortening for the affected individual whereas latent cancer fatalities generally result in limited life shortening. In this report a mathematical model is developed to express the reduction in life expectancy from radiogenic cancer as a function of dose received. The model is then used to compare the linear model of latent radiogenic cancer incidence with several nonlinear models that have appeared in the literature. (author)