FROM PLURILINGUAL TEACHING TO PLURILINGUAL EXAMINATION

The development, support and recognition of plurilingual competence, in other words a person´s ability to perform successfully in a plurilingual setting, required school curricula to include not only the instruction of at least two foreign languages (e.g. Italian and English as foreign languages) within one course but also a corresponding exam format. We will outline the guidelines for and challenges of a plurilingual syllabus, explore the concepts of bilingualism, plurilingualism and multilingualism and give clear examples of what we believe an oral plurilingual examination should look like. Guidelines for teachers on how to develop competence-oriented plurilingual tasks will also be accompanied by the necessary test specifications. In addition, 14 possible situations for examinations are provided. An assessment grid and examples of test papers complete the document on bilingual competences and their simultaneous evaluation in two foreign languages.   Dall’insegnamento plurilingue all’esame plurilingue Lo sviluppo, il supporto e il riconoscimento della competenza plurilingue, in altre parole della capacità di una persona di muoversi con successo in un ambiente plurilingue, ha richiesto che i programmi scolastici includessero non solo l’insegnamento di almeno due lingue straniere (ad es. italiano e inglese come lingue straniere) all’interno del curricolo di studi, ma anche un corrispondente formato d’esame. In questo contributo descriveremo le linee guida e le sfide di un programma plurilingue, esploreremo i concetti di bilinguismo, plurilinguismo e multilinguismo e forniremo esempi chiari di come crediamo che dovrebbe essere un esame plurilingue orale. Le linee guida per gli insegnanti su come sviluppare compiti plurilinguistici orientati alle competenze saranno inoltre accompagnate dalle necessarie specifiche indicazioni per l’esame. Inoltre, sono previste 14 possibili situazioni per gli esami. Una griglia di valutazione ed esempi di prove d’esame completano il documento sulle competenze bilingui e la loro valutazione simultanea in due lingue straniere

Exposure at Default Modeling with Default Intensities

The paper provides an overview of the Exposure at Default (EAD) definition, requirements, and estimation methods as set by the Basel II regulation. A new methodology connected to the intensity of default modeling is proposed. The numerical examples show that various estimation techniques may lead to quite different results with intensity of default based model being recommended as the most faithful with respect to a precise probabilistic definition of the EAD parameter

Clinical Quality Indicators and Provider Financial Incentives: Does Money Matter?

"Simply put, if reimbursement can drive utilization and utilization can drive outcome, reimbursement can drive outcome." 1 I n the decades-old debate over how best to finance and deliver health care in the United States, a nearly ubiquitous complaint about most systems of physician and hospital reimbursement is that payments are made based on the services delivered regardless of the quality of care delivered, providing no incentive-some say a disincentive-for quality improvement. 2,3 Advocates of "pay-for-performance" (P4P) systems of health care reimbursement argue that the concept of paying more to those who produce better outcomes, a "bedrock principle" in efforts to "reduce error and reinforce best practices" in other industries, should become "a top national priority" in "the campaign to rally our underperforming health care system." In proposals to improve health care systems, high-level enthusiasm is not necessarily an indicator of high-quality evidence, and P4P is no exception. Editorialists George Diamond and Sanjay Kaul, both cardiologists and keen observers of quality of evidence in health care decision making, wrote in 2009 that rapid proliferation of P4P systems "is occurring despite a paucity of empirical evidence that [they] actually deliver on their promise to improve the quality and reduce the cost of health care. There are essentially no randomized controlled trials (RCTs) demonstrating the effectiveness of [P4P] programs and very few reports in the literature that analyze the existing programs." 1 The point made by Diamond and Kaul is welltaken. As we have observed previously, the health care research literature is replete with examples of schemes that were widely (sometimes wildly) supported based on weak observational evidence but refuted and ultimately abandoned after being tested with more rigorous research designs. Effects of Quality Improvement Interventions Alone and with Financial Incentives In this issue of JMCP, Brackbill et al. report the results of a quality improvement project undertaken to increase the percentage of patients receiving discharge orders for chronic aspirin therapy following a hospitalization for acute myocardial infarction (AMI) or coronary artery bypass graft (CABG). 5 Using a pre-intervention versus post-intervention study design, Brackbill et al. found that an intervention consisting of provider education coupled with the placement of a colorful "prescription" for aspirin in the inpatient chart of patients clinically eligible for aspirin therapy was associated with a change in the aspirin discharge order rate from 94.9% pre-intervention to 98.9% post-intervention (P = 0.012). When analyzed by subgroup, the relationship between the intervention and aspirin discharge order rate was statistically significant for patients hospitalized for CABG (change from 91.5% to 100.0%, P = 0.016) but not for AMI (change from 96.6% to 98.5%, P = 0.263). The efforts of Brackbill et al. in using a novel approach to improve an important quality metric are commendable. Nonetheless, their results illustrate the challenges experienced by providers and payers that try to "move the needle" of compliance with treatment guidelines, especially when baseline compliance is high. Brackbill et al. report that quality assurance audits conducted shortly after the start of the project revealed substantial implementation problems; the aspirin "prescription" had been placed in only 25% of the charts of clinically eligible patients. Education of providers that was initially conducted pre-intervention had to be repeated twice in the project's post-implementation phase

Mensaje de las CEBs de América Latina y el Caribe

En el marco de este IV Encuentro de las Comunidades Eclesiales de Base en América Latina y el Caribe, dentro del 50 Centenario y cercana ya la Conferencia de Obispos en Santo Domingo, queremos compartir nuestra vivencia con los hermanos y hermanas que están en este mismo proceso de Fe y Vida, intentando transformar, en la perspectiva del Reino, las diferentes realidades socio-políticos-económicas, culturales y religiosas de nuestro Continente. Para esta tarea, confiamos en el Dios de la Vida y la Historia, que en Jesús se hace pobre y liberador, y que continúa enviándonos su Espíritu como luz y fuerza para el camino; y recogemos, con esta tarea la herencia que nuestros mártires y profetas nos dejaron. Como Iglesia que somos, queremos vivir la eclesialidad de un modo adulto y corresponsable, en comunión y con libertad. Como Iglesia en la base, nos sentimos particularmente llamados a llevar el Evangelio a los hermanos y hermanas marginados y alejados. Como seguidores de Jesús, continuaremos en defensa de la Vida y en lucha por la Tierra Madre. Queremos estar siempre más y más enraizados en las culturas de nuestros pueblos, y, a partir de ellas, celebraremos el dolor, la alegría y esperanza. Queremos ayudar a toda la Iglesia a superar cualquier tipo de evangelización colonizadora y elitista