No / In Autumn 2010, a multidisciplinary group of clinicians met in Manchester to discuss the issue of debridement in wound management. There are various debridement techniques available in the UK, but facilities and skills vary. This paper, resulting from the meeting, briefly outlines the differing techniques used, the levels of skill required to use them and the wound types for which they are appropriate. It is important that clinicians practising debridement are aware of the variations in method, and the limitations of their own skills and competency so that, if appropriate, the patient can be referred to receive timely and appropriate intervention.

No / Objective The number of colonoscopies required to reach competency is not well established. The primary aim of this study was to determine the number of colonoscopies trainees need to perform to attain competency, defined by a caecal intubation rate (CIR) ≥90%. As competency depends on completion, we also investigated trainee factors that were associated with colonoscopy completion. Design The Joint Advisory Group on GI Endoscopy in the UK has developed a trainee e-portfolio from which colonoscopy data were retrieved. Inclusion criteria were all trainees who had performed a total of ≥20 colonoscopies and had performed ≤50 colonoscopies prior to submission of data to the e-portfolio. The primary outcome measure was colonoscopy completion. The number of colonoscopies required to achieve CIR ≥90% was calculated by the moving average method and learning curve cumulative summation (LC-Cusum) analysis. To determine factors which determine colonoscopy completion, a mixed effect logistic regression model was developed which allowed for nesting of patients within trainees and nesting of patients within hospitals, with various patient, trainee and training factors entered as fixed effects. Results 297 trainees undertook 36 730 colonoscopies. By moving average analysis, the cohort of trainees reached a CIR of 90% at 233 procedures. By LC-Cusum analysis, 41% of trainees were competent after 200 procedures. Of the trainee factors, the number of colonoscopies, intensity of training and previous flexible sigmoidoscopy experience were significant factors associated with colonoscopy completion. Conclusions This is the largest study to date investigating the number of procedures required to achieve competency in colonoscopy. The current training certification benchmark in the UK of 200 procedures does not appear to be an inappropriate minimum requirement. The LC-Cusum chart provides real time feedback on individual learning curves for trainees. The association of training intensity and flexible sigmoidoscopy experience with colonoscopy completion could be exploited in training programmes.

This study investigated the effect of cognitive factors on competency to stand trial. Previous researchers have investigated how psychological variables --such as psychosis and intelligence--contribute to incompetency. Although several researchers have established that intelligence contributes to incompetency, very few have investigated the role of specific cognitive abilities within the realm of intelligence. This study investigated the performance of 55 defendants referred for competency restoration on neuropsychological measures. Specifically, competent defendants and incompetent defendants were compared on several measures assessing functioning in seven cognitive domains. Competent defendants performed significantly better than incompetent defendants on measures of verbal comprehension, social judgment, verbal memory, and executive functioning. Competent and incompetent defendants did not differ on attention, visual spatial skills, or nonverbal memory.

The problem of this study was to examine the current practices and evaluations of the uses of minimum competency testing as perceived by the representatives of thirty large city school districts of the nation. In order to conduct this study, a questionnaire was developed and validated by panels. Members of the two five-member panels included various level personnel. The survey instrument was mailed to the superintendent of thirty large-city school districts. Twenty-nine were returned representing 96.67 percent of the population surveyed.

This study addresses the attitudes of counselors, teachers, and administrators toward competency testing programs in their districts. ten districts from each of the four states --Arizona, California, Michigan, and Oregon-- were randomly selected to participate in the study. A total of 247 educators responded to the survey. The following conclusions were made on the basis of the findings: (1) The competency programs have the support the teachers, counselors, and administrators who work with them; (2) They are perceived as being effective in identifying students in need of remediation; (3) They are perceived as being most beneficial to the deficient student, but the setting of minimum standards had not lowered the expectations of the average and above average student; (4) They have not eliminated any programs or courses from the curriculum; (5) They have not limited the parameter of course content guides to concepts covered in the competency test; (6) They are perceived as nor being expensive to the district; (7) The competency program does add a burden of extra paperwork for the groups surveyed, especially the counselors; (8) Most competency programs involve teachers, counselors, and administrators in the planning; (9) Improvements in the quality of education and in student learning are attributable to the the competency program; and (10) The competency program is a recognizable component of the educational program in those districts surveyed.

No description available.

The globalised world of business is driven by a complex mix of communication technology, consumerism and social, economic and political change. In pursuit of the latest technologies, processes and systems, managers often tend to neglect their business’s organisational culture. Traditional assets and strategies can easily be copied. A business’s organisational culture is much more difficult to reproduce and can be a competitive differentiator. Businesses which deliberately manage their organisational cultures, outperform similar businesses that do not. The performance culture in a business depends largely on the effectiveness of managers to establish an attitude of performance among employees. To achieve high performance, managers need different competencies to engage workers’ hearts and minds, as well as take advantage (in a positive way) of their physical labour. Managers who are able to create and sustain a performance culture and react to rapid change in markets and technologies, can maintain exceptional service and product quality levels despite of unpredictable business environments. Some managerial competencies are more conducive and prone to managerial effectiveness and the subsequent enhancement of a business's performance culture. Only a few businesses worldwide are managed by the notion that a performance culture equates outstanding profits and little research exists pertaining to managerial competencies that allow managers to motivate employees, win their commitment, and ultimately enhance the business’s performance culture. The primary objective of this study is to investigate the role of managers in enhancing performance culture. Knowledge and current perceptions of first-line managers and middle-level managers regarding the business’s performance culture (in terms of the associated business practices and employee characteristics), as well as certain related managerial competencies (such as communication, planning and administration, teamwork and emotional intelligence) were obtained. With regard to research methodology, the study used descriptive research in the form of quantitative, self-administered questionnaires. Two questionnaires were developed and uploaded on the Survey Monkey website. Subsequently, all first-line managers and middle-level managers (employed at Amalgamated Beverage Industries (ABI), the soft drink division of The South African Breweries (Pty) Ltd) were informed of the survey via an e-mail containing a cover letter as well as the hyperlink to the relevant questionnaires. The target population in this study was obtained by means of a census. Of the 438 respondents identified for the census, 186 viable questionnaires, comprising of 73 middle-level manager and 113 first-line manager respondents, were used for statistical analysis. Data entry, tabulation and statistical analysis were done by the Statistical Consultation Services of the North-West University (Potchefstroom Campus). The results of this study indicate that organisational culture places considerable pressure on employee behaviour and influences businesses in several ways. Every business has a unique organisational culture and an organisational culture that is not conducive to the performance culture of the business, needs to be addressed. In their efforts to enhance performance culture, managers need to display certain managerial competencies. It is recommended that, in order to assess a business’s performance culture and the degree to which managers display the associated managerial competencies, employees’ perceptions are taken into consideration, as practically significant differences pertaining to gender, qualification, age as well as managerial levels exist between different groups of respondents. The creation of a performance culture should be viewed as a continuous effort and it is suggested that managers investigate certain best practices in this regard in order to differentiate their businesses from competitors. In addition, managers may gain from training or coaching in order to develop and/or improve managerial skills related to the communication, planning and administration, teamwork and emotional intelligence managerial competencies, and subsequently practicing these in order to enhance the business’s performance culture. / MCom (Business Management), North-West University, Potchefstroom Campus, 2014

The globalised world of business is driven by a complex mix of communication technology, consumerism and social, economic and political change. In pursuit of the latest technologies, processes and systems, managers often tend to neglect their business’s organisational culture. Traditional assets and strategies can easily be copied. A business’s organisational culture is much more difficult to reproduce and can be a competitive differentiator. Businesses which deliberately manage their organisational cultures, outperform similar businesses that do not. The performance culture in a business depends largely on the effectiveness of managers to establish an attitude of performance among employees. To achieve high performance, managers need different competencies to engage workers’ hearts and minds, as well as take advantage (in a positive way) of their physical labour. Managers who are able to create and sustain a performance culture and react to rapid change in markets and technologies, can maintain exceptional service and product quality levels despite of unpredictable business environments. Some managerial competencies are more conducive and prone to managerial effectiveness and the subsequent enhancement of a business's performance culture. Only a few businesses worldwide are managed by the notion that a performance culture equates outstanding profits and little research exists pertaining to managerial competencies that allow managers to motivate employees, win their commitment, and ultimately enhance the business’s performance culture. The primary objective of this study is to investigate the role of managers in enhancing performance culture. Knowledge and current perceptions of first-line managers and middle-level managers regarding the business’s performance culture (in terms of the associated business practices and employee characteristics), as well as certain related managerial competencies (such as communication, planning and administration, teamwork and emotional intelligence) were obtained. With regard to research methodology, the study used descriptive research in the form of quantitative, self-administered questionnaires. Two questionnaires were developed and uploaded on the Survey Monkey website. Subsequently, all first-line managers and middle-level managers (employed at Amalgamated Beverage Industries (ABI), the soft drink division of The South African Breweries (Pty) Ltd) were informed of the survey via an e-mail containing a cover letter as well as the hyperlink to the relevant questionnaires. The target population in this study was obtained by means of a census. Of the 438 respondents identified for the census, 186 viable questionnaires, comprising of 73 middle-level manager and 113 first-line manager respondents, were used for statistical analysis. Data entry, tabulation and statistical analysis were done by the Statistical Consultation Services of the North-West University (Potchefstroom Campus). The results of this study indicate that organisational culture places considerable pressure on employee behaviour and influences businesses in several ways. Every business has a unique organisational culture and an organisational culture that is not conducive to the performance culture of the business, needs to be addressed. In their efforts to enhance performance culture, managers need to display certain managerial competencies. It is recommended that, in order to assess a business’s performance culture and the degree to which managers display the associated managerial competencies, employees’ perceptions are taken into consideration, as practically significant differences pertaining to gender, qualification, age as well as managerial levels exist between different groups of respondents. The creation of a performance culture should be viewed as a continuous effort and it is suggested that managers investigate certain best practices in this regard in order to differentiate their businesses from competitors. In addition, managers may gain from training or coaching in order to develop and/or improve managerial skills related to the communication, planning and administration, teamwork and emotional intelligence managerial competencies, and subsequently practicing these in order to enhance the business’s performance culture. / MCom (Business Management), North-West University, Potchefstroom Campus, 2014

Research has shown that African-Americans are least likely to receive adequate palliative interventions leading to concerns about the quality of health care in general and palliative care in particular for this population. Acknowledging patient preferences are essential in administering quality health care especially when a patient's condition is terminal. But when African-Americans are least likely to complete living wills or durable power of attorneys for health care and more likely to continue to request life sustaining treatments when near death, conflicts between patients and medical professionals can result.<br> Recognizing patient spirituality and addressing their spiritual needs can help the patient, family or surrogate decision-maker come to terms with, if not make sense of, their life-threatening illness and eventual mortality. This may be especially salient for African-Americans because of their history of victimization of racial discrimination and ensuing overwhelming challenges with sometimes tragic consequences. Models and approaches used to assess the spirituality of African-American patients must be culturally appropriate and performed by professionals with interpersonal communications skills and an awareness of how their implicit bias can impede the integrity of the clinician-patient interaction. / McAnulty College and Graduate School of Liberal Arts; / Health Care Ethics / PhD; / Dissertation;

Enterprise Systems (ESs) are more than a collection of people, technology, processes, and capabilities. The responsibilities of post implementation management of ES lie in the unit called the Competency Center (CC). The CC has a bidirectional relationship with ESs wherein the CC influences the shaping of ESs, and the CC is affected by the dynamic interaction between people, technology, process, and capabilities within the ES. These dynamic interactions keep the CC, fluid and always in-process. The general-use definition of the term “process” as used in the Enterprise Systems literature treats the notion as “repeatable processes” or "replicable processes". However, arising from comparative case studies in four large organizations, I found that decision making, managing, and governing in the ES are not “replicable processes”, not reifications of structural variations over time when examined through the lens of the Assemblage Theory. Assemblage Theory incorporates the dynamic interplay of two continua: the first, territorialization, deterritorialization, and reterritorialization, and the second, material vs. expression. Although the notion of the terms formation, deformation, and reformation are suitable for understanding the processes these CCs encounter in a broad and general manner, they do not sufficiently describe the not-so-solid, never-quite-finished, always in-process or structuring referred to by Hopper (1996) as "emergent regularities". In contrast to the notion of stable structures, this dissertation research adopts the language of Deleuzian assemblage of Territorialization, deterritorialization, and Reterritorialization. Although the four study organizations planned and intended to develop clearly defined competency centers, which would create formalized processes and procedures to manage the post implementation phase, none of the study organizations ever achieved the anticipated stability. Instead, the CCs exhibited the signs of being ‘in-process’ and ‘structuring’. The contribution of this research to the IS field is an understanding of the CCs as processes as opposed to structures and how CCs structuring impact the ESs in organizations.