Mapping Public Health Nursing competencies: A comparative document analysis of competency frameworks and practice standards in the USA and Ireland.

The Public Health Nursing discipline plays a crucial role in promoting sustainable health services. The establishment of competency frameworks and practice standards pertaining to Public Health Nursing has emerged as a cornerstone for guiding practice, education, and research. This study aimed to identify contemporary Public Health Nursing competency frameworks and practice standards and establish a robust list of competency domains. This will inform a subsequent phase of this project that will conduct a review of recent scholarly literature to discern prevailing research trends and delineate strategic directives and research priorities for the discipline. A systematic search of three databases and a grey literature search was undertaken by incorporating keywords to identify existing Public Health Nursing-specific competency frameworks and practice standards. Through screening and selection based on our inclusion criteria, three documents were analyzed. A comprehensive document analysis was conducted to generate a unified domain list and associated descriptors. Three competency-based frameworks and practice standards emanating from two countries, the United States of America and the Republic of Ireland met the inclusion criteria. The document analysis identified 16 individual domains. There was consistent evidence of similarity across the three documents. There were minimal divergences featured within the frameworks which are discussed and compelling justifications for inclusion as universal domains are provided. This document analysis has generated a list of 16 common Public Health Nursing competency domains which will be utilized in phase two of this project as a foundational framework for the purpose of analyzing research trends, influencing research priorities, and enhancing the focal areas for future research agendas within the discipline.

Extending the TOP Framework with an Ontology-Based Text Search Component.

INTRODUCTION: Constructing search queries that deal with complex concepts is a challenging task without proficiency in the underlying query language - which holds true for either structured or unstructured data. Medical data might encompass both types, with valuable information present in one type but not the other. METHOD: The TOP Framework provides clinical practitioners as well as researchers with a unified framework for querying diverse data types and, furthermore, facilitates an easier and intuitive approach. Additionally, it supports collaboration on query modeling and sharing. RESULTS: Having demonstrated its effectiveness with structured data, we introduce the integration of a component for unstructured data, specifically medical documents. CONCLUSION: Our proof-of-concept shows a query language agnostic framework to model search queries for unstructured and structured data.

APAQ at Forty: Publication Trends.

The purpose of the present study was to analyze Adapted Physical Activity Quarterly (APAQ) publications over the journal's fourth decade (2014-2023) and compare them with previous documentary analyses of the first 3 decades. Consistent with prior documentary analyses, publications were coded and analyzed based on the use of theory, research participants, topic, whether the study was an intervention, first-author country affiliation, and research method. The total number of published research papers increased substantially (n = 61) from the third to the fourth decade. Similar to prior documentary analyses, most of the research was quantitative (n = 140; 57.5%), followed by qualitative research (n = 96; 39.5%). There were far more qualitative-research publications in the fourth decade compared with the third decade (n = 34). This may reflect the continued acceptance and growth of qualitative research compared with 10-20 years ago. It may also reflect the value of rich in-depth exploratory research using small samples. Additional trends included more review papers and meta-analyses, possibly reflecting the increased knowledge base in particular areas requiring synthesis. The diversity of topics also increased, with papers on dignity, classification, coaching, and the Paralympics playing more prominent roles. The number of international publications also grew substantially. In brief, the current paper outlines both similarities and differences in APAQ's published research over the 4 decades of its existence.

Towards performance governance in healthcare: An analysis of Italian local health units.

PURPOSE: Bouckaert and Halligan (2008) proposed four ideal types of performance management systems, ranging from a disconnected and input-led approach (performance administration) to a model in which performance management is fully integrated with both the internal and external context of an organisation (performance governance). This article empirically analyzes performance plans issued by Italian Local Health Units (LHUs) to provide a first nationwide snapshot of the different ideal-types of performance management that each (LHUs) have reached, in a 'performance governance'-oriented perspective. DESIGN: This paper employs a qualitative methodology based on document analysis. The model orienting the analysis features six dimensions capturing the ideal-types characteristics and what the Italian performance regulations prescribe. Data was derived from the performance plans adopted by the Italian LHUs on the condition that they made the documentation necessary for the analysis public on their institutional website. FINDINGS: For a 'performance governance' oriented approach, two elements are considered relevant: familiarity with the analysis of stakeholders and context. In our sample, consisting of 63 performance plans out of 99 Italian LHUs, it was challenging to identify specific territorial clusters, due to significant heterogeneity. The role of strategic objectives, integration between cycles, and context analysis seems to positively influence the orientation towards a 'performance governance' approach. ORIGINALITY/VALUE: The application of Bouckaert and Halligan's ideal-types has only been episodically investigated in the healthcare sector, mainly at the individual health unit or Region level. This article's innovative contribution consists of conducting a qualitative analysis based on a replicable taxonomy that enables further national comparisons. Furthermore, it highlights the need for public healthcare systems to engage more with external stakeholders to improve the quality of their performance governance.

School absence legislation governing in Norway, Sweden and Denmark for children with chronic illness in compulsory education-A comparative study.

BACKGROUND: Health and education are interrelated and influence social, economic and lifestyle perspectives. Children with chronic illnesses experience barriers in the educational system regarding school attendance and social isolation. Gaining knowledge of compulsory education and how children with chronic illnesses are supported is crucial for the implications of future education policy and legislation in Scandinavia. This study compares Scandinavian legislation frameworks on compulsory education, chronic illness and school absence to form the basis of future research on education for children with chronic illness. METHODS: The study uses a comparative approach to explore the support of children with chronic illnesses in compulsory education across Norway, Sweden and Denmark. The documents included are 3 education acts and 15 secondary documents, which are notes and guidelines for the education acts. The data were analysed using a manifest content analysis. FINDINGS: We found four categories and six subcategories: (1) school obligation and rights; (2) chronic illness; (3) school absence: (a) categorisation of absence; (b) registration of absence; and (c) sanction; and (4) education support: (a) Hospital school support; (b) Home instruction support; and (c) technological support. CONCLUSION: This study's findings demonstrate the similarities and differences in the Scandinavian compulsory education legislation and guidelines regarding chronic illness and school absence. We found similarities across the countries regarding chronic illness and school absence. Still, the findings showed differences in the systematic registration of school absence and requirements for attendance with compulsory education in Norway and Denmark compared with compulsory schooling in Sweden. This knowledge will inform and enlighten future discussions and decisions in education and public health. The results can contribute to awareness of the opportunities for educational support and perspectives about education for children with chronic illnesses. Future research focusing on the experience of children with chronic illness and educational support is needed.

Using construction procurement strategy to achieve socioeconomic development objectives.

The procurement strategy for a construction project should provide the framework to achieve secondary procurement and socio-economic development objectives [2]. However, little attention has been focused on this in theory and practice. This paper addresses that gap by presenting a case study of the innovative targeting strategy developed and successfully implemented on a New Universities Project in South Africa to promote specified socioeconomic development objectives. Document analysis was used to examine how four socioeconomic development targets or key performance indicators, namely: local employment, skills development, local expenditure, and B-BBEE, were contractually integrated into the main works contracts. Four out of five framework contractors achieved the development targets, with low-performance damages applied in one case where the contractor failed to achieve all the development targets. The findings demonstrate how an appropriate construction procurement strategy that effectively integrates the packaging, targeting, and contracting strategies with effective systems for monitoring performance-based specifications, can play an essential role in promoting and realising socio-economic development objectives and social value through infrastructure projects.

[Digitalization and care relationships of people living alone in old age: a critical analysis of policy documents]. / Digitalisierung und Sorgebeziehungen von Alleinlebenden im Alter: eine kritische Analyse politischer Dokumente.

Digitalization is transforming social life and relationships. New cultural ideas of care, cooperation and reciprocity are emerging that can create challenges for older people. These are particularly poignant for older people living alone, who use digital devices less frequently and rely on support to manage the increasing number of digital tasks (appointments, bookings, financial matters). This article explores the relationship between digitalization and care relationships among older people living alone using a critical document analysis approach according to Bacchi. This approach makes it possible to look at the understanding behind the terms living alone, care relationships, and digitalization, each in relation to older people and in interaction as well as to render gaps visible. The analysis of laws and social policies as well as of political and civil society orientated documents leads to two key findings: Firstly, an individual responsibility to deal with needs arising from gaining access to and handling of digitalization is expected of older people and their social networks. This is striking as digitalization is presented as a means of dealing with the large-scale social challenges, such as demographic change and shortage of care staff. Secondly, the analysis shows that legal documents that set out the structure for policies do not focus on digitalization in later life. With older people not being a target group of policy of digitalization, fewer strategies are put into practice.

The environmental sustainability implications of contrast media supply chain disruptions during the COVID-19 pandemic: A document analysis of international practice guidelines.

INTRODUCTION: Travel restrictions implemented during the acute phases of the COVID-19 pandemic disrupted supply chain for critical radiology consumables including contrast media (CM) leading to shortages. Consequently, some departments had to restructure their clinical workflows in accordance to recommended guidelines to ensure safe continuity of patient care. This study aimed to summarise the temporary crisis-driven recommendations with implicit environmental sustainability essence and to analyse how these measures might inform the development of a more sustainable, long-term clinical guideline for safer and cost-effective CM usage without compromising diagnostic quality. METHODS: Documents were obtained through an electronic database search together with a relevant manual search in Google Scholar and relevant reference lists. The selected documents were subjected to a pre-defined eligibility criteria for inclusion. The READ approach was employed for document analysis and a thematic analysis of the obtained data was conducted. RESULTS: Of the 17 documents included, 70% (n = 12) emanate from the United States of America. The summary of the findings relate to minimising CM usage through strategic clinical approaches including optimisation of CM volumes, prioritisation of non-contrast imaging and/or alternative imaging depending on patient need without compromising diagnostic quality. CONCLUSION: Critical lessons of sustainability essence are implicitly embedded in the policy guidelines issued during the periods of acute CM shortage in the COVID-19 pandemic. These lessons were themed around CM conservation based on: type and priority of medical imaging investigation, kind of imaging modality and use of smaller vials over multi-dose vials packaging. IMPLICATIONS FOR PRACTICE: The temporary crisis-driven strategies may offer critical lessons for post-pandemic service delivery to enhance patient safety while saving cost and promoting greener practice via strategic clinical and operational monitoring of CM through policy renewal, education and training and collaboration with industry partners.

Sexual and Reproductive Health and Rights for Young Migrants in Sweden: An Ideal-Type Analysis Exploring Regional Variations of Accessible Documents.

Objectives: This study aims to map sexual and reproductive health and rights (SRHR) policies, strategies, and interventions targeting young migrants and describe the patterns of organisation, resources, and services across Sweden's 21 regions. Methods: We conducted a document analysis of accessible online documents on SRHR policies, strategies, and interventions targeting young migrants in Sweden's 21 regions. We used ideal-type analysis of the documents to create a typology, which formed the basis of a ratings system illustrating variations in organisation, resources, and services across regions. Results: Findings suggest that efforts aimed at addressing young migrants' SRHR are fragmented and unequal across regions. While SRHR policies and strategies are commonplace, they routinely lack specificity. Available resources vary depending on region and resource type. Additionally, information and interventions, although common, do not consistently meet the specific needs of migrant youths. Conclusion: This study suggests that fragmented efforts are fuelling geographic inequalities in fulfilling SRHR among young migrants. There is an urgent need to improve national coordination and collaboration between national and local actors in SRHR efforts targeting young migrants to ensure equity.

Computer vision digitization of smartphone images of anesthesia paper health records from low-middle income countries.

BACKGROUND: In low-middle income countries, healthcare providers primarily use paper health records for capturing data. Paper health records are utilized predominately due to the prohibitive cost of acquisition and maintenance of automated data capture devices and electronic medical records. Data recorded on paper health records is not easily accessible in a digital format to healthcare providers. The lack of real time accessible digital data limits healthcare providers, researchers, and quality improvement champions to leverage data to improve patient outcomes. In this project, we demonstrate the novel use of computer vision software to digitize handwritten intraoperative data elements from smartphone photographs of paper anesthesia charts from the University Teaching Hospital of Kigali. We specifically report our approach to digitize checkbox data, symbol-denoted systolic and diastolic blood pressure, and physiological data. METHODS: We implemented approaches for removing perspective distortions from smartphone photographs, removing shadows, and improving image readability through morphological operations. YOLOv8 models were used to deconstruct the anesthesia paper chart into specific data sections. Handwritten blood pressure symbols and physiological data were identified, and values were assigned using deep neural networks. Our work builds upon the contributions of previous research by improving upon their methods, updating the deep learning models to newer architectures, as well as consolidating them into a single piece of software. RESULTS: The model for extracting the sections of the anesthesia paper chart achieved an average box precision of 0.99, an average box recall of 0.99, and an mAP0.5-95 of 0.97. Our software digitizes checkbox data with greater than 99% accuracy and digitizes blood pressure data with a mean average error of 1.0 and 1.36 mmHg for systolic and diastolic blood pressure respectively. Overall accuracy for physiological data which includes oxygen saturation, inspired oxygen concentration and end tidal carbon dioxide concentration was 85.2%. CONCLUSIONS: We demonstrate that under normal photography conditions we can digitize checkbox, blood pressure and physiological data to within human accuracy when provided legible handwriting. Our contributions provide improved access to digital data to healthcare practitioners in low-middle income countries.

Sociotechnical imaginaries in academic medicine strategic planning: a document analysis.

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.

Adapting multilingual vision language transformers for low-resource Urdu optical character recognition (OCR).

In the realm of digitizing written content, the challenges posed by low-resource languages are noteworthy. These languages, often lacking in comprehensive linguistic resources, require specialized attention to develop robust systems for accurate optical character recognition (OCR). This article addresses the significance of focusing on such languages and introduces ViLanOCR, an innovative bilingual OCR system tailored for Urdu and English. Unlike existing systems, which struggle with the intricacies of low-resource languages, ViLanOCR leverages advanced multilingual transformer-based language models to achieve superior performances. The proposed approach is evaluated using the character error rate (CER) metric and achieves state-of-the-art results on the Urdu UHWR dataset, with a CER of 1.1%. The experimental results demonstrate the effectiveness of the proposed approach, surpassing state of the-art baselines in Urdu handwriting digitization.

Exploring a revised interprofessional learning curriculum in undergraduate health education programs at Linköping University.

BACKGROUND: Interprofessional education aiming at providing competencies require evaluation in order to ensure that outcomes match the needs and ambitions. Health professionals today need a broad range of skills and competencies in order to provide high quality care, including interprofessional competence. Linköping University has been a pioneer in interprofessional learning for decades and this study provides one example of how a curriculum revision can be carried out. The aim of this study was to study the intentions and outcomes of a revised interprofessional learning curriculum in health professions education programs. METHODS: This was a qualitative study, including documents (n = 143) and complementary interviews with key individuals (n = 4). Data included syllabuses, study guides, educational program plans, supervisor guides, and interview transcripts. A qualitative document analysis and a content analysis with a directed approach was used, applying a theoretical framework for curriculum development that guided the analysis. RESULTS: The analysis resulted in one overarching theme named "A planned, lived, and attended curriculum" including four main categories inspired by a theoretical framework. The findings demonstrate a variety of aspects relating to the why and how of curriculum revision. The introduction of a programme director in interprofessional learning, with a mandate equal to respective program directors, seemed to contribute to legitimacy. Further, the partnership between the university and the healthcare sector had an impact on the curriculum revision, in that healthcare had a say in the revision regarding what suggestions to implement or not. The expectations of the teachers involved were high, although clear support structures seemed to be lacking. CONCLUSIONS: This study has identified some of the important links between teachers, organizational prerequisites, and healthcare when revising an existing fully integrated curriculum in interprofessional learning for health professions education programs. The aim of this curriculum revision was to legitimize and provide education that is up to date with current healthcare needs and to provide students with competencies to collaborate in teams to ensure patient safety. When redesigning a curriculum there seems to be a fine balance between pedagogical innovation and pragmatism. This study identified that the links provided between organizational support structures and the expectations on teachers were not aligned.

A synthetic dataset of different chart types for advancements in chart identification and visualization.

We introduce a meticulously curated synthetic chart dataset designed to propel algorithm advancements in data visualization and interpretation. The dataset, tailored for training and testing purposes, encompasses a diverse array of chart types, including but not limited to Area, Bar, Box, Donut, Line, Pie, and Scatter. The data collection process involves a fully automatic low-level algorithm focused on extraction of graphical elements. The algorithm ensures efficiency by restricting input images from featuring three-dimensional representations, incorporating any 3D effects, or including multiple charts in a single image. The dataset is categorized into training and testing subsets, further subdivided based on resolutions and specific chart types. The reuse potential of this dataset is substantial. It serves as a valuable resource for driving algorithmic advancements in data visualization classification and interpretation. Researchers can leverage this dataset for training and testing deep models, enhancing the adaptability of their algorithms. Moreover, it establishes a benchmark for evaluating system performance in handling diverse chart visualizations, allowing for direct comparisons, and fostering advancements in data understanding algorithms. The versatility of the dataset, encapsulating various chart types and resolutions, provides a standardized platform for assessing and comparing the effectiveness of different systems in understanding and decomposing visualizations [1,2,3].

Historical Text Line Segmentation Using Deep Learning Algorithms: Mask-RCNN against U-Net Networks.

Text line segmentation is a necessary preliminary step before most text transcription algorithms are applied. The leading deep learning networks used in this context (ARU-Net, dhSegment, and Doc-UFCN) are based on the U-Net architecture. They are efficient, but fall under the same concept, requiring a post-processing step to perform instance (e.g., text line) segmentation. In the present work, we test the advantages of Mask-RCNN, which is designed to perform instance segmentation directly. This work is the first to directly compare Mask-RCNN- and U-Net-based networks on text segmentation of historical documents, showing the superiority of the former over the latter. Three studies were conducted, one comparing these networks on different historical databases, another comparing Mask-RCNN with Doc-UFCN on a private historical database, and a third comparing the handwritten text recognition (HTR) performance of the tested networks. The results showed that Mask-RCNN outperformed ARU-Net, dhSegment, and Doc-UFCN using relevant line segmentation metrics, that performance evaluation should not focus on the raw masks generated by the networks, that a light mask processing is an efficient and simple solution to improve evaluation, and that Mask-RCNN leads to better HTR performance.

Tanzania's and Germany's Digital Health Strategies and Their Consistency With the World Health Organization's Global Strategy on Digital Health 2020-2025: Comparative Policy Analysis.

BACKGROUND: In recent years, the fast-paced adoption of digital health (DH) technologies has transformed health care delivery. However, this rapid evolution has also led to challenges such as uncoordinated development and information silos, impeding effective health care integration. Recognizing these challenges, nations have developed digital health strategies (DHSs), aligning with their national health priorities and guidance from global frameworks. The World Health Organization (WHO)'s Global Strategy on Digital Health 2020-2025 (GSDH) guides national DHSs. OBJECTIVE: This study analyzes the DHSs of Tanzania and Germany as case studies and assesses their alignment with the GSDH and identifies strengths, shortcomings, and areas for improvement. METHODS: A comparative policy analysis was conducted, focusing on the DHSs of Tanzania and Germany as case studies, selected for their contrasting health care systems and cooperative history. The analysis involved a three-step process: (1) assessing consistency with the GSDH, (2) comparing similarities and differences, and (3) evaluating the incorporation of emergent technologies. Primary data sources included national eHealth policy documents and related legislation. RESULTS: Both Germany's and Tanzania's DHSs align significantly with the WHO's GSDH, incorporating most of its 35 elements, but each missing 5 distinct elements. Specifically, Tanzania's DHS lacks in areas such as knowledge management and capacity building for leaders, while Germany's strategy falls short in engaging health care service providers and beneficiaries in development phases and promoting health equity. Both countries, however, excel in other aspects like collaboration, knowledge transfer, and advancing national DHSs, reflecting their commitment to enhancing DH infrastructures. The high ratings of both countries on the Global Digital Health Monitor underscore their substantial progress in DH, although challenges persist in adopting the rapidly advancing technologies and in the need for more inclusive and comprehensive strategies. CONCLUSIONS: This study reveals that both Tanzania and Germany have made significant strides in aligning their DHSs with the WHO's GSDH. However, the rapid evolution of technologies like artificial intelligence and machine learning presents challenges in keeping strategies up-to-date. This study recommends the development of more comprehensive, inclusive strategies and regular revisions to align with emerging technologies and needs. The research underscores the importance of context-specific adaptations in DHSs and highlights the need for broader, strategic guidelines to direct the future development of the DH ecosystem. The WHO's GSDH serves as a crucial blueprint for national DHSs. This comparative analysis demonstrates the value and challenges of aligning national strategies with global guidelines. Both Tanzania and Germany offer valuable insights into developing and implementing effective DHSs, highlighting the importance of continuous adaptation and context-specific considerations. Future policy assessments require in-depth knowledge of the country's health care needs and structure, supplemented by stakeholder input for a comprehensive evaluation.

Perspective of radiography science - a document analysis of dissertations.

INTRODUCTION: The aim of this study was to clarify the perspective of radiography science as an academic discipline. A discipline can be studied by discovering the collective use of concepts, especially core concepts. We have previously identified the core concepts as clinical practices in radiography, radiographers' profession, safe and high-quality radiation use, and technology in radiography. The relationships between these concepts have not been studied previously. In order to clarify the perspective of radiography science we have investigated further the core concepts, their interrelationships and interdependencies. METHODS: Altogether, 53 dissertations meeting the inclusion criteria were selected for a qualitative document analysis. The data were first analysed deductively using an extraction matrix comprising four core concepts developed from previous studies, then relational statements were synthesised, and the statements were analysed semantically. RESULTS: Analysis revealed the bilateral interrelationships between the concepts and their dependencies. All the concepts were used within healthcare. The rationale for radiography science research was the clinical practice of radiography and the improvement of services in a complex environment as a part of patients' pathways. Safe and high-quality radiation use was investigated as a means to deliver optimal services. Technology was studied as being functional or a means to deliver services. The perspective of the discipline was seen as the combination of humanistic interaction with advanced technology, where safety and quality were a necessity. CONCLUSIONS: Defining core concepts and their interrelations clarifies the perspective of the discipline and gives radiography researchers a way to argue their viewpoint.

The Usage of the Term "Social" in Japanese Primary Care Literature.

INTRODUCTION: There has been a growing recognition of the importance of incorporating a "social" perspective in primary care practice. However, the specific meaning of the term "social" in the context of primary care is often not clearly defined or explained in the literature. This study aims to explore the usage and interpretation of the term "social" in primary care discourse in Japan. METHODS: We collected papers containing the term "social" ("shakai-teki" in Japanese) from 810 papers published between 2010 and 2022 in the Official Journal of the Japan Primary Care Association. Through abductive coding, we examined how the term was employed and the different meanings attributed to it. RESULTS: The instances of using the term "social" were classified into five distinct categories: (i) non-medical, (ii) emphasizing the importance of topics, (iii) public as an object, (iv) connections with people who support health and well-being, and (v) structural inequities that are detrimental to health.  Conclusion: The analysis revealed that the term "social" in the context of primary care discourse was multifaceted and characterized by ambiguity. To ensure effective communication and clarity in discussions, it is crucial for primary care professionals to have a clear understanding of the intended meaning and implications of the term "social."

[Competency-based learning objectives of primary qualifying nursing studies and intended task profiles]. / Kompetenzziele von primärqualifizierenden Pflegestudiengängen und intendierte Aufgabenprofile.

INTRODUCTION: Since 2020, it has been possible in Germany to complete a primary qualifying degree in nursing in addition to vocational training in nursing. The study presented here investigates the extent to which the intended competence goals prepare students for the future fields of activity of university-qualified nurses. METHODS: The research question was answered (1) by means of a content analysis of module manuals for primary qualifying courses, specifically the information on the intended learning outcomes in the university part of the course, and (2) by evaluating the results of the analysis in focus groups with those responsible for the course. The areas of competence were used as evaluation criteria for the analysis of the module manuals. The text elements were coded using the analysis software MAXQDA. In the further course of the analysis, the competence areas were combined into three areas with a view to the task profiles (direct care, indirect care and competence area V/research competence) and the percentage weighting of the competence goals was calculated. Using study results from the project "Investigation of the implementation of the study programs within the framework of university nursing training according to the Nursing Professions Act", the hours spent in these areas and the distribution of presence and self-learning time for direct nursing were determined. The results and the reasons for the curriculum design were then discussed in focus groups with those responsible for the degree program. RESULTS: The module manuals reveal clear differences in formal design. The analysis of the learning outcomes specified in the module manuals according to the competence areas also shows considerable differences in the distribution of the percentages for the individual competence areas. In relation to direct care, the percentages range between 55% and 71%, the hours vary between 2,022 and 3,622 hours. With indirect care, the range is 246 to 520 hours. A comparatively high number of hours is planned for competence area V/research competence (869 to 1,426 hours). Also, the analysis leads to the conclusion that within the degree program with the lowest number of hours of face-to-face teaching only 690 hours of face-to-face teaching are spent on direct care, while the degree program with the highest number of hours provides 1,968 hours for face-to-face teaching. In the focus group discussions, the persons responsible for the degree program took a critical view of the hours spent on developing skills in indirect care in the primary qualifying degree programs. Those responsible for the degree programs also regard the very small number of face-to-face hours at some university locations as insufficient to develop direct care skills. DISCUSSION: The results suggest that the primary qualifying courses in some areas and at some study locations do not adequately prepare for the task profiles intended for HQP.

How did European countries set health priorities in response to the COVID-19 threat? A comparative document analysis of 24 pandemic preparedness plans across the EURO region.

The COVID-19 pandemic has forced governments across the world to consider how to prioritise the allocation of scarce resources. There are many tools and frameworks that have been designed to assist with the challenges of priority setting in health care. The purpose of this study was to examine the extent to which formal priority setting was evident in the pandemic plans produced by countries in the World Health Organisation's EURO region, during the first wave of the COVID-19 pandemic. This compliments analysis of similar plans produced in other regions of the world. Twenty four pandemic preparedness plans were obtained that had been published between March and September 2020. For data extraction, we applied a framework for identifying and assessing the elements of good priority setting to each plan, before conducting comparative analysis across the sample. Our findings suggest that while some pre-requisites for effective priority setting were present in many cases - including political commitment and a recognition of the need for allocation decisions - many other hallmarks were less evident, such as explicit ethical criteria, decision making frameworks, and engagement processes. This study provides a unique insight into the role of priority setting in the European response to the onset of the COVID-19 pandemic.