The medical licensing examination debate

National licensing examinations are typically large‐scale examinations taken early in a career or near the point of graduation, and, importantly, success is required to subsequently be able to practice. They are becoming increasingly popular as a method of quality assurance in the medical workforce, but debate about their contribution to patient safety and the improvement of healthcare outcomes continues. A systematic review of the national licensing examination literature demonstrates that there is disagreement between assessment experts about the strengths and challenges of licensing examinations. This is characterized by a trans‐Atlantic divide between the dominance of psychometric reliability assurance in North America and the wider interpretations of validity, to include consequences, in Europe. We conclude that the debate might benefit from refocusing to what a national licensing examination should assess: to achieve a balance between assessing a breadth of skills and the capacity for such skills in practice, and focusing less on reproducibility.     

Views of public health leaders in English local authorities – changing perspectives following the transfer of responsibilities from the National Health Service to local government

This paper reports on the findings of a research project that examined the changes to the public health system in England introduced in 2013. Drawing on case study research and two national surveys the findings explore the impact of organisational change on the composition and role of public health teams. Views and experiences were obtained from public health leaders involved in the transfer of staff and functions from the National Health Service in England to local authorities. National surveys at two points in time aimed to compare and contrast views on the evolving changes. The new organisational and managerial arrangements had enabled public health professionals to widen their work and influence, and public health skills and budgets were welcomed by those in local government. Initially, in some areas, directors of public health were less certain of the benefits of the transfer to local government compared to high levels of confidence expressed by elected members, but perspectives changed over time and moved closer together. National headline figures were found to mask high levels of turbulence and churn being experienced by individual authorities identified in the case study research, and the trend of reducing capacity through cuts to staff, budget and services was a cause for serious concern.     

Social Capital and Bystander Behavior in Bullying: Internalizing Problems as a Barrier to Prosocial Intervention

Theory and research suggests that individuals with greater social capital (i.e., resources and benefits gained from relationships, experiences, and social interactions) may be more likely to be active, prosocial bystanders in bullying situations. Therefore, the goal of the current study was to examine the association of social capital (social support and social skills) with prosocial bystander behavior, and the role of internalizing problems as a potential barrier to this relation among 299 students (45.8% girls, 95% White) in sixth, seventh, and eighth grades. Results indicate a positive relation between social capital and prosocial bystander behavior. In addition, internalizing problems were a significant risk factor that may hinder youth—particularly girls—from engaging in defending behavior. Prosocial bystanders are an essential component to prevent and reduce bullying and further research is needed to better understand how to foster prosocial behavior in bullying situations, perhaps by utilizing social capital, related to school bullying.     

Theorien als latente Quellen von Normativität und Verantwortung in der Hochschullehre: Die Bedeutung von didaktischen und fachspezifischen Theoriedebatten am Beispiel des politikwissenschaftlichen Teilgebiets „Internationale Beziehungen“

The article deals with normative aspects that are negotiated in didactic and subject-specific theoretical debates and thus gain relevance in teaching. It turns out that the didactic theories provide divergent answers to the question of what should be taught how and by whom. Similarly, the example of theoretical debates in International Relations shows that, from a subject-specific perspective, there can often be a lack of consensus on the essentials that are to be taught. Such conflicting requirements, however, demonstrate the instructors’ scope for action, which they should realize and use responsibly. Due to academic pluralism, it seems possible that the societal pluralism, which is sometimes perceived as crisis-laden, can be used productively for teaching.     

The interpretation of cocaine and benzoylecgonine concentrations in postmortem cases.

This study examined cocaine and benzoylecgonine concentrations in 100 consecutive deaths where either compound was identified in blood or urine specimens to determine whether any relationship between these concentrations and cause of death can be found. Forty-seven of the 100 cases were deaths attributed to cocaine, narcotic or combined cocaine and narcotic intoxication. There were 13 cases of cocaine intoxication where no psychoactive substance other than ethanol was detected. The mean cocaine concentration in these deaths was 908 ng/ml; three cases had cocaine concentrations greater than 2000 ng/ml, while the other ten cases had cocaine concentrations less than or equal to 700 ng/ml. The mean cocaine concentration in non-cocaine deaths where no psychoactive substance other than ethanol was detected was 146 ng/ml. This difference was not statistically significant. However, the average blood benzoylecgonine concentration in the 13 cocaine deaths was significantly higher than in the 19 non-cocaine deaths. A review of combined cocaine and narcotic deaths suggest that the narcotic is the main causative agent in these deaths.     

A Bridge Too Far? Examining Bridging Assumptions in Common-Space Estimations

While most common-space estimations rely upon members who served in both the House and Senate as “bridges” to scale the remaining members, this assumes that these “bridge members” do not change their preferences when they change chambers. Such an assumption conflicts with standard notions of representation, that is, that legislators’ votes reflect (at least to some degree) the wishes of their constituents. We examine the constancy of this common-space voting assumption by focusing on a subset of House members who move to the Senate: those who come from statewide House districts. Using these members as the bridge actors—and thus bridging by constituency explicitly—in a one-dimensional item response theory model, we find that the standard assumption of chamber switchers in common-space estimations is technically, but immaterially, false. While there are statistically distinguishable differences in House and Senate voting records for chamber switchers, they are not sufficiently large to meaningfully undermine bridging.     

Women and the Labour Party: Gender and the Writing of British Political History

This article takes stock of the state of women's political history in the twentieth century and suggests new lines of enquiry, drawing on the authors’ own work on the Labour Party. It identifies a number of key themes which have enriched histories of women and gender in the nineteenth and early twentieth century and considers how these might be developed. Firstly, it examines the significance of the local, and more particularly, the neighbourhood, in women's political lives. Secondly, it asserts the value of focussing on the membership, including the economic, social and cultural shifts that shaped their lives, the intersection of gender with factors such as age or ethnicity, and their own political identities. Finally, it stresses the importance of interrogating masculine cultures to understand how gendered dynamics played out. It concludes with a reminder that inserting women into established political narratives is insufficient: the point is to transform those narratives.     

Advice about Life Plans from Mothers,Fathers, and Siblings in Always-Married and Divorced Families during Late Adolescence

The frequency of advice about life plans that older adolescents in always-married and divorced families received from mothers, fathers, and siblings was examined. Also, a pattern-analytic approach that grouped adolescents according to the amount of advice about life plans received from each parent and a sibling was employed to explore the connections between patterns of advice and adolescents' future occupational, educational, and family plans. The sample included 544 and 95 older adolescents in always-married and divorced families, respectively. Findings suggested that while adolescents relied on mothers for advice in both always-married and divorced families, adolescents in divorced families depended on fathers and siblings for advice less often than did adolescents in always-married families. Although there was some evidence of family context differences in the connections between patterns of advice and life plans, overall, adolescents in both family contexts who received more advice from a parent and, in some cases, a sibling compared to other adolescents were the most positive about their future life plans.     

Palpable insecurity and Sen’s comparative view of justice: anthropological considerations

Amartya Sen’s comparative approach to justice makes clear that notions of justice are shaped by human agency and experience, and both his focus on the ‘internal view’ of well-being that emphasizes suffering as a central feature of illness and his recognition that social and cultural factors shape perceived injustice are critical to this approach. However, Sen questionably depicts the contributions of anthropological research to this project as limited to ‘the sensory dimension of ill-health.’ Focusing on mental health in the context of global justice, I argue that Sen’s treatise on justice can be refined through an ethnographic method that synchronizes attention to (1) cultural knowledge and social relations in ecological settings; (2) fundamental human needs; and (3) levels of analytic specificity involving situations, categories, and events. This method integrates analysis of internal phenomenology and external constraints of political economy and ideology. To demonstrate I discuss three cases involving students and violence in Rio de Janeiro, women and witchcraft in Ghana, and historical migration and war trauma among Vietnamese immigrants in which external conditions of insecurity and inequality contributed to deteriorating mental health conditions including depression, trauma, and debilitating anxiety.