The objective structured public health examination (OSPHE): work-based learning for a new exam

Introduction: Postgraduate education for all healthcare professionals is shifting from traditional knowledge-based models towards competency-based training and assessment. 1 Norcini’s 2003 paper on work based assessment outline’s George Miller’s pyramid framework for assessing competence (see Figure 1) – with knowledge at the base (‘knows’), competence at the next level (‘knows how’), performance above this (‘shows how’) and action (‘does’) at the top. Action is what actually occurs in day to-day practice, while the lower levels are what are more commonly assessed in an artificial examination environment. 2 The Faculty of Public Health (FPH), the standard-setting body for specialists in public health, has addressed the move towards competency-based training in two ways. The first is the development of a new and more detailed curriculum. This links competencies, training outcomes and their assessment to specific stages in training. The second is the the introduction of the new objective structured public health examination (OSPHE), which will be discussed in this paper. The OSPHE targets the ‘shows how’ level of the pyramid – measuring performance in an examination setting

Relational-Cultural Perspectives of African American Women with Diabetes and Maintaining Multiple Roles

The growth of diabetes in the United States is viewed by some as epidemic with a particular concern as related to African American women. African American women experience diabetes disproportionately to other groups with higher risks of complications and premature death. Historically, they have led all women in labor force participation and maintained roles within and outside the home. The purpose of this study was to gain understanding and meaning of the lived experience of African American women with diabetes and maintaining multiple roles using sensitizing concepts of Relational-Cultural theory. Relational-Cultural theory was described as related to use with women and the incorporation of the influence of culture. The literature review used proxy terms for the concepts of connection, disconnection, mutuality and power over related to limited use of theory concepts in the literature. The review yielded few research studies. Interpretive phenomenology following Ricoeur in philosophy and methodology was used. Three composites of the day-to-day experiences of African American women with diabetes and maintaining multiple roles were provided. The concept of connections diverged into two types of connections with multiple themes. Mutuality themes were not a matter of age but what each brings to the other and closeness developed over time. Themes that emerged related to concepts of disconnections and power over were the will to keep negativity out, disappointment in others, shackles on, shackles off, financial stress makes life difficult. Themes of informational support in the neighborhoods, trust is necessary and need for African American nurses related to the role of nurses with enhancing connections and mutuality. Further nursing research is needed related to use of Relational-Cultural theory and African American women with diabetes and maintaining multiple roles to increase a contextual understanding of their lived experience. Incorporation of Relational-Cultural theory into practice and nursing education was also suggested based on two decades of neuroscience evidence about the importance of relationships

Blood film says it all! Rare case of congenital TTP misdiagnosed as ITP

We report a case of a 16-year-old female who presented with bleeding diathesis. Peripheral blood film examination was consistent with microangiopathic hemolytic anemia with 7% fragmented red blood cells. The ADAMTS13 level was 40 ng/ml (reference range: 630-850 ng/ml). She responded to plasma exchange therapy and methylprednisolone and was discharged in a stable condition

On the Intricacies of Facial Hyperpigmentation and the Use of Herbal Ingredients as a Boon for Its Treatment: Cosmeceutical Significance, Current Challenges and Future Perspectives

Facial hyperpigmentation is the term used to express areas on irregular pigmentation in the skin. It appears as darkened patches on the face that make the facial skin look uneven. Facial hyperpigmentation is not physically debilitating but has been associated with enhanced psychosocial complications including anger, depression and frustration. These psychosocial burdens, in turn, have inference on quality of life and self-esteem. So, the treatment of facial hyperpigmentation seems to be a growing concern to the dermatologists today and they have been practising several treatment modalities including chemical peeling, laser therapy, dermabrasion, etc. But, those are found to be associated with various after-effects. Hence, the use of plants and its products is highly recommended as they are reported with either none or fewer after-effects. The present chapter draws attention to the forms of facial hyperpigmentation with their aetiologies and available treatment options for them with associated side effects. Furthermore, we have discussed about the other side of treatment with herbal ingredients which are safe and have less or no side effects. This chapter will be of value to the dermatologists who are searching for naturally derived ingredients for treating facial hyperpigmentation, in line with consumer expectations and preferences