Developing competency - based accreditation for health promotion in Europe

RESUMO: Introdução: Em abril de 2013, a reunião inaugural do Conselho de Administração e Comitês do Sistemade Acreditação de Promoção da Saúde Europeu da União Internacional de Promoção e Educação em Saúde (UIPES) foi realizada em Paris. A reunião anunciou a implementação de um sistema inovador para a promoção da saúde na Europa, baseado em competências. O sistema tem como objetivo promover a garantiade qualidade e competência na promoção da saúde através de um sistema de acreditação a nível europeu, que foi projetado para ser flexível e sensível a diferentes contextos, mantendo critérios robustos e validados. O sistema baseia-se na literatura internacional sobre as abordagens baseadas em competências para a promoção da saúde e em iniciativas de desenvolvimento de capacidades globais, tais como a Declaração consensuada da Conferência de Galway (“Toward Domains of Core Competence for Building Global Capacity in Health Promotion”)1. O Sistema é projetado para fornecer mecanismos validados que garantam a qualidade às práticas da promoção, da educação em saúde bem como da formação e do desenvolvimento de capacidades na Europa, basedo em conceitos compartilhados e em um sistema formalizado de reconhecimento profissional. As competências e os padrões profissionais que sustentam o Sistema têm como premissa os principais conceitos e princípios da promoção da saúde definidosna Carta de Ottawa2 e sucessivas cartas e declarações(3-8) da Organização Mundial de Saúde. Atualmente, o Sistema está passando por estudos pilotos intensivos, com operacionalização plena prevista para 2014. Métodos: O Sistema baseia-se em um quadro de acreditação baseado em competências, desenvolvido como parte do Projeto CompHP. O desenvolvimento do CompHP empregou uma abordagem em etapas, com vários métodos para facilitar a construção de um consenso com as pessoas-chave da promoção da saúde em toda a Europa. O piloto para o Sistema inclui o estabelecimento e a testagem das estruturas de regulamentação, processos de aplicação, relatórios e procedimentos para garantir que eles sejam equitativos, viáveis, abertos e transparentes. Os critérios de elegibilidade e do sistema de inscrição on-line serão exaustivamentetestados na primeira rodada de inscrições de iniciativas de práticas de promoção da saúde, de educação em saúde e formação, no Outono de 2013. Resultados: as estruturas de regulamentação e os procedimentos de funcionamento do Sistema foram definidas com base nas estruturas desenvolvidas pelo Projeto CompHP. Os resultados do Projeto CompHP mostraram apoiar o desenvolvimentode um sistema de acreditação pan-europeu e isso tem sido traduzido em ação, com a criação do Conselho e das Comissões do Sistema de Acreditação de Promoção da Saúde Europeu da UIPES. Conclusões: O Sistema de Acreditação de Promoção da Saúde Europeu da UIPES dispõe de um modelo descentralizado em que as organizações nacionais de acreditação interagem com a Organização Europeia de Credenciamento para garantir a qualidade da prática de promoção da saúde, educação e formação na Europa. Embora o foco do Sistema esteja atualmente no contexto europeu, há evidências de que ele e, os quadros de competências que lhe estão subjacentes, serão recursos úteis para a capacitação para a promoção da saúde a nível mundial.Background: In April 2013, the inaugural meeting of the Board and Committees of the IUHPE European Health Promotion Accreditation System was held in Paris. The meeting heralded the implementation of an innovative competency-based accreditation system for health promotion in Europe. The System aims to promote quality assurance and competence in health promotion through a Europe-wide accreditation system which is designed to be flexible and sensitive to different contexts while maintaining robust and validated criteria. The System builds on the international literature on competency-based approaches to health promotion and on global capacity development initiatives such as the Galway Consensus Conference Statement ‘Toward Domains of Core Competency for Building Global Capacity in Health Promotion’1. The System is designed to provide validated mechanisms for assuring quality in health promotion practice, education and training and a foundation for capacity development in Europe based on shared concepts and a formalised system of professional recognition. The competencies and professional standards that underpin the System are premised on the core concepts and principles of health promotion as defined in the Ottawa Charter for Health Promotion2 and successive World Health Organisation charters and declarations3-8. The System is currently undergoing intensive piloting and will be fully operational in 2014. Methods: The System builds on a competency-based accreditation framework developed as part of the CompHP Project. The CompHP Project development processes employed a phased, multiple-method approach to facilitate consensus-building with key stakeholders in health promotion across Europe. The piloting process for the System includes establishing and testing the governance structures, application processes, reporting policies and procedures to ensure that they are equitable, feasible, open and transparent. The eligibility criteria and online application system will be thoroughly tested by processing the first round of applicants from health promotion practice and education and training in autumn 2013. Findings: The governance structures and operating procedures for the System have been established building on the frameworks developed by the CompHP Project. The findings of the CompHP Project showed support for the development of a pan-European accreditation system and this has been translated into action with the establishment of the Board and Committees of the IUHPE European Health Promotion Accreditation System. Conclusions: The IUHPE European Health Promotion Accreditation System comprises a devolved model within which National Accreditation Organisations interact with a European Accreditation Organisation to ensure quality in health promotion practice, edcuation and training in Europe. While the focus of the System is currently on the European context, there is evidence that it, and the competency frameworks which underpin it, will be useful resources for capacity building for health promotion globally

Knights in Armored Vehicles: The HALO Trust in the Caucasus

The demise of the Soviet Union and the resultant rush to establish claims over disputed areas and to assert ethnic identity led to a widespread call to arms. Nowhere was this more the case than in the Caucasus. T he former southern Caucasian soviets of Azerbaijan, Armenia and Georgia have all asserted their independence from Russia and all have witnessed bloodshed resulting from inter-ethnic fighting. In the north Caucasus there has been fighting in Dagestan, lngushetia, North Ossetia and most notably in Chechnya. The virtual abandonment of former weapons stockpiles accompanied by some very definite mischief by the departing Russian troops has led to munitions, including mines falling into the hands of almost every potential warring faction. To no one\u27s surprise the region has been troubled ever since Soviet domination ceased

Development of subjective well-being in adolescence

Despite the importance of subjective well-being (SWB) for students’ mental and physical health, there is a lack of longitudinal studies investigating the development of SWB in adolescents and what factors are associated with it over time. The present study seeks to shed further light on this question by investigating adolescents longitudinally. A sample of German academic tracks students (N = 476) from five schools were followed longitudinally over a time period of 30 months with four measurement points from Grade 11 to Grade 13. Alongside the longitudinal assessment of SWB (mood and life satisfaction), a range of other factors were also assessed at t1 including; demographic factors (sex, age, socio-economic status (HISEI)), intelligence, grades (report cards provided by the schools), personality (neuroticism, extraversion) and perceived parental expectations and support. Latent growth curve models were conducted to investigate the development of SWB and its correlates. On average, mood and life satisfaction improved at the end of mandatory schooling. However, students significantly differed in this pattern of change. Students’ life satisfaction developed more positively if students had good grades at t1. Furthermore, even though introverted students started with lower life satisfaction at t1, extraverts’ life showed greater increases over time. Changes in mood were associated with socio-economic background; the higher the HISEI the more positive the change. As social comparisons in school performance are almost inevitable, schools should intervene to buffer the influence of school grades on students’ SWB

Tusk or Bone? An Example of Ivory Substitute in the Wildlife Trade

Bone carvings (and other ivory substitutes) are common in the modern-day lucrative international ivory trade.  Souvenirs for unknowing travelers and market shoppers can be made of non-biological material (plastic "ivory" beads) or skillfully crafted natural objects made to resemble something other than their true origin.  Many of these items are received at the U. S. National Fish and Wildlife Forensics Laboratory (NFWFL) for species identification as part of law enforcement investigations.  Morphologists at the Lab often receive uniquely carved ivory items that have been imported with little or no documentation.  In recent years, analysts examined several purported ivory tusks suspected to be walrus, a protected marine mammal.  After examination, the Lab determined their origin as carved leg bones of cattle using principles and methods of zooarchaeology and ancient DNA analysis.  The naturally long and straight ungulate metapodials had been cut, carved, filled, stained, and polished to closely resemble unmodified ivory tusks.  Morphological species identification of these bones proved to be a challenge since diagnostic characters of the bones had been altered and country of origin was unknown. Genetic analysis showed that the bones originated from cattle.  While bone is commonly used as a substitute for ivory, this style of artifact was not previously documented in the wildlife trade prior to our analysis.  Archaeological ethnobiologists commonly encounter bone tools and other forms of material culture from prehistoric and historic contexts; in this case bone tools come from a modern context, thus the application of methods common in zooarchaeology are situated in wildlife forensics.  In addition, results reported here pertain to cross-cultural ivory trade and conservation science.</p

Diastolic dysfunction and left atrial volume A population-based study

ObjectivesWe examined the association between diastolic function and left atrial volume indexed to body surface area (LAVi) in a population-based study.BackgroundAtrial enlargement has been suggested as a marker of the severity and duration of diastolic dysfunction (DD). However, the association between DD and atrial enlargement and their individual prognostic implications in the population is poorly defined.MethodsA cross-sectional sample of Olmsted County, Minnesota, residents ≥45 years of age (n = 2,042) underwent comprehensive Doppler echocardiography and medical record review.ResultsThe LAVi increased with worsening DD: 23 ± 6 ml/m2(normal), 25 ± 8 ml/m2(grade I DD), 31 ± 8 ml/m2(grade II DD), 48 ± 12 ml/m2(grades III to IV DD). In bivariate analyses, age, left ventricular mass index, and DD grade were positively associated, whereas female gender and ejection fraction (EF) were inversely associated with LAVi (p < 0.001 for all). When controlling for age, gender, cardiovascular (CV) disease, EF, and left ventricular mass, grade II DD was associated with a 24%, and grade III to IV DD was associated with a 62% larger LA volume (p < 0.0001 for both). The area under the receiver-operator characteristic curve for LAVi to detect grade I, grade II, or grade III to IV DD was 0.57, 0.81, and 0.98, respectively. Both DD and LAVi were predictive of all-cause mortality, but when controlling for DD, LAVi was not an independent predictor of mortality.ConclusionsThese data suggest that DD contributes to LA remodeling. Indeed, DD is a stronger predictor of mortality; presumably it better reflects the impact of CV disease within the general population

Implementation and Long-Term Outcomes of Organisational Health Literacy Interventions in Ireland and The Netherlands:A Longitudinal Mixed-Methods Study

Organisational Health Literacy (OHL)-interventions are needed to overcome health inequality. OHL-interventions have successfully identified communication barriers at the organisational level, but evidence is limited on the extent to which this leads to sustainable organisational change. This study aims to assess the implementation fidelity, moderators (barriers and facilitators), and long-term impact of OHL-interventions in hospitals in Ireland and The Netherlands. We used a longitudinal mixed-methods approach to assess two similar OHL-interventions in one Irish and three Dutch hospitals. The OHL-interventions concerned the improvement of navigation and implementation of health literacy-friendly communication throughout organisations. Participants were 24 hospital employees and 40 older adults who use hospital services. At six, eight, and eighteen months, we assessed the level of implementation, barriers and facilitators, and impact through questionnaires and in-depth semi-structured interviews. After older adults and professionals had identified a number of communication problems, we found that professionals had successfully implemented OHL-interventions to promote navigation and comprehensible communication. Limited resources and variation in organisational structures and procedures were perceived as barriers to implementation. The participation of service users, leadership support, and a stepwise implementation of interventions were perceived to facilitate implementation. In the long term, the OHL-interventions led to system-wide improvements, as shown by better embedding of health literacy policies, enhanced patient engagement, provision of plain language training and comprehensible information. Findings were similar for the two countries. Embedded OHL-interventions resulted in sustainable and system-wide health literacy changes in all four hospitals. Following implementation, OHL-interventions have the potential to promote health equity and empowerment among health service users

We don’t do Google, we do massive attacks: Notes on creative R&D collaborations

The article presents findings from an exploratory study investigating the nature of collaborative research and development in creative industries. Participants in the study are two creative SMEs with extensive experience of participating in collaborative projects. A collective case study approach is adopted with data collected on the factors impinging on the effectiveness of such collaborations. Findings are presented at the macro and micro levels of such collaborations. The paper concludes with a summary of some of the challenges faced by small creative SMEs when collaborating with other organizations during the research and development process

Phosphoethanolamine Transferase LptA in Haemophilus ducreyi Modifies Lipid A and Contributes to Human Defensin Resistance In Vitro

Haemophilus ducreyi resists the cytotoxic effects of human antimicrobial peptides (APs), including α-defensins, β-defensins, and the cathelicidin LL-37. Resistance to LL-37, mediated by the sensitive to antimicrobial peptide (Sap) transporter, is required for H. ducreyi virulence in humans. Cationic APs are attracted to the negatively charged bacterial cell surface. In other gram-negative bacteria, modification of lipopolysaccharide or lipooligosaccharide (LOS) by the addition of positively charged moieties, such as phosphoethanolamine (PEA), confers AP resistance by means of electrostatic repulsion. H. ducreyi LOS has PEA modifications at two sites, and we identified three genes (lptA, ptdA, and ptdB) in H. ducreyi with homology to a family of bacterial PEA transferases. We generated non-polar, unmarked mutants with deletions in one, two, or all three putative PEA transferase genes. The triple mutant was significantly more susceptible to both α- and β-defensins; complementation of all three genes restored parental levels of AP resistance. Deletion of all three PEA transferase genes also resulted in a significant increase in the negativity of the mutant cell surface. Mass spectrometric analysis revealed that LptA was required for PEA modification of lipid A; PtdA and PtdB did not affect PEA modification of LOS. In human inoculation experiments, the triple mutant was as virulent as its parent strain. While this is the first identified mechanism of resistance to α-defensins in H. ducreyi, our in vivo data suggest that resistance to cathelicidin LL-37 may be more important than defensin resistance to H. ducreyi pathogenesis