General Inquiries Research Articles

Health Topics of Medical Online Inquiries at the University Hospital of Zurich: Experiences of the Last 12 Years

Digitization in the healthcare sector leads to new requirements and challenges in the doctor-patient relationship. Since 1999, the UniversitätsSpital Zürich has been offering a web-based medical online consultation service for laymen. The aim of the retrospective study was to analyze which health topics are of special interest for the inquirers. All questions and answers between 2005 and 2016 were included. The calculation of the frequencies included the ICD-10 chapters, the age and gender of the inquirers, the number of recommended visits to the doctor, as well as the rating of the service. Changes in the frequencies were examined by regression analysis. The mean age of the 23 131 inquirers was 37.9 ± 16.63 years. The age as well as the proportion of male inquirers increased significantly with yearly 1.22 years respectively 1.6 % male proportion. The most common health issues according to the ICD-10 classification included symptom-oriented or general inquiries about complaints without a particular disease (chapter XVIII:13.8 % and XXI: 11.6 %), followed by inquiries about the skin (XII: 8.8 %), about the musculoskeletal system (XIII:7.5 %) and to the genitourinary system (XIV:7.4 %). The inquiries to Chapters XVIII and II (new formations) increased significantly. With "good" to "very good" 80.2 % of the users rated the benefit and with 96.7 % the comprehensibleness of the online answers. A web-based online consultation service can strengthen patient empowerment and the health literacy of medical laymen through the individual provision of health information. This included, in particular, unclear symptoms and findings without diagnosis. The advantages of an anonymous online consultation were used especially regarding intimate questions and progressively by men. The increase in inquiries concerning new formation may be due to the complex treatment strategies in the field of oncology.

Senior Chemists Committee: Making progress

The Senior Chemists Committee’s mission is to address and support the needs and ambitions of senior chemists and to use their experience and knowledge. As the newest ACS national committee, we are keenly interested in measuring our progress as we proceed. We have made strides in the past year. For example, to facilitate better communication with our constituents, we have replaced our e-mail address with seniorchemists@acs.org. This easily recognizable e-mail address will be the point of contact for both outgoing messages, such as the Newsletter for Senior Chemists, and incoming feedback, such as responses on our Senior Chemists Group on the ACS Network, as well as general inquiries. This modification to the e-mail address has increased our newsletter open rate by 25%, a substantial increase considering that our e-mails are distributed to 45,000 recipients. We have also expanded our recognition efforts. ACS has long honored 50- and 60-year members. During

Coaching in the United States: High School Coaches’ Knowledge and Confidence Regarding Athlete Safety and Injury Management

The purpose of this original research was to survey high school coaches in four states in the Midwest region of the United States regarding their knowledge of first aid, cardiopulmonary resuscitation (CPR), and use of an Automated External Defibrillator (AED) as well as confidence in managing/treating emergency situations. Responses to general knowledge inquiries revealed that coaches were able to accurately answer questions related to return to play, level of consciousness, external bleeding, and cardiac arrest. However, coaches were unable to correctly answer questions specific to rest, ice, compression, and elevation (RICE) and also misidentified information related to pediatric AED use. Because sudden cardiac death is the leading cause of death and has been linked to lack of bystander intervention, the results of this project should be considered by coaches and administrators to implement certification and continuing education for high school coaches. Finally, coaches who were certified in first aid, CPR, and AED were more confident in treating an individual who required care compared with coaches not certified. Therefore, individuals who coach at all levels of sport and recreational activities should consider formal training and certification.

Life without parole for juvenile offenders: Public sentiments.

The United States Supreme Court recently abolished mandatory life in prison without parole (LWOP) for juvenile offenders, holding that the practice is inconsistent with the eighth amendment’s cruel and unusual punishment clause, and its “evolving standards of decency” jurisprudence. The Court explicitly left open the question of whether nonmandatory LWOP is consistent with these constitutional standards. This article examines the public’s sentiment concerning juvenile LWOP. An online sample (n = 599) weighted to be representative of the U.S. population was queried about juvenile LWOP as a general policy and in response to a specific case in which they had to impose a prison sentence on a juvenile convicted of murder. The age of the juvenile was experimentally manipulated as either 12 or 16. Overall, 31% of participants favored juvenile LWOP as a general policy while 55% were willing to impose juvenile LWOP in a specific case. The age of the juvenile moderated this effect, such that participants were more willing to impose LWOP on a 16-year-old than a 12-year-old both as a general policy matter and in the specific case. A majority of participants were consistent in their preferred punishment across both the general and specific inquiries, including 30% who selected LWOP. Political affiliation was the only demographic variable that predicted consistency in preferred punishment. Additionally, participants who consistently endorsed juvenile LWOP placed greater emphasis on retribution and deterrence as goals of punishment while individuals who evidenced inconsistent punishment preferences placed a greater emphasis on rehabilitation.

WPA Secretariat: the global link to Member Societies.

The WPA Secretariat is located at the Geneva University Psychiatric Hospital, in splendid surroundings, in a campus full of beautiful trees and open spaces with lush greenery. It is the headquarters of the WPA. Ever since the establishment of the Association, the WPA Secretariat used to move with the incumbent office bearers. As the size of our office grew, the need for a permanent secretariat became increasingly evident. Besides administering the WPA, we needed a place to keep our valuable documents in safe custody. There were several reasons for which Geneva was chosen as the location of the Secretariat. It was the town where the headquarters of the World Health Organization (WHO) were situated, and working in physical proximity and in collaboration with the WHO on mental health matters was an obvious advantage. But the most important factor was the offer from the Geneva University Hospital to provide free space and facilities to WPA for its Secretariat in their campus. In many ways, this can be considered as a gift to the psychiatrists of the world by that university. The permanent secretariat of WPA at Geneva came into being when an “accord of collaboration” between the WPA and the Geneva University Hospital was signed by M.B. Gruson (Director General of the hospital) and A. Okasha (WPA President) on September 6, 2004. This accord is valid for an initial period of 20 years and is subject to renewal thereafter. The WPA Secretariat provides the global link to 135 Member Societies and more than 200,000 members. Member Societies are the most important components of the WPA, and the Secretariat keeps them informed about the discussions and decisions of the Executive Committee, other Committees and the WPA General Assembly. Similarly, the Secretary General relates the opinions and concerns of the Member Societies to these bodies and conveys decisions and actions back to them. The Secretariat makes every effort to keep in constant touch with the Member Societies and provide information sought by them. It co-ordinates the admission process of Member Societies, Affiliated Associations and individual affiliated members. It gives logistical support to the WPA President and its leadership and makes arrangements for its business meetings. The WPA Secretary General is in charge of the WPA Secretariat and is responsible for the administrative tasks of the WPA. We have 18 Zonal Representatives who constitute the WPA Board. The Board advises the Executive Committee and the General Assembly on the work of the WPA and helps to strengthen collaboration between Member Societies and in the implementation of the WPA Action Plan. Through the Secretariat, the Secretary General co-ordinates the work of the Zonal Representatives and serves as a liaison between them and the WPA governing bodies. The WPA Secretary General is the head of the Secretariat and is ably assisted by the Administrator and the Deputy Administrator. The Administrator is in charge of handling all activities related to staff, contacts with the Swiss authorities, attending WPA Executive Committee meetings and WPA General Assembly, liaison with the Geneva University Hospital, maintaining financial records, monitoring budgets for all Standing and Operational Committees, etc.. The Deputy Administrator handles correspondence with WPA components and replies to general inquiries and requests under the guidance of the Secretary General, updates the mailing lists, manages mass mailings of the WPA News, WPA Directory, etc.. Some tasks, such as electronic and hard copy filing and archiving, progressive organization of the materials in the archives room, are jointly performed by them. The Secretariat works towards achieving the aims, objectives and mission of the WPA and ensuring success of the Action Plan 2014-2017 1. We are obliged to President D. Bhugra, President-Elect H. Herrman, the members of the Executive Committee, the Zonal Representatives and the Member Societies for their constant help and support. Making the Secretariat a global link for the psychiatrists of the world, responsive to their needs and aspirations, is our goal. We hope to work committedly towards this end!

Public Health Responses to Reemergence of Animal Rabies, Taiwan, July 16-December 28, 2013.

Taiwan had been free of indigenous human and animal rabies case since canine rabies was eliminated in 1961. In July 2013, rabies was confirmed among three wild ferret-badgers, prompting public health response to prevent human rabies cases. This descriptive study reports the immediate response to the reemergence of rabies in Taiwan. Response included enhanced surveillance for human rabies cases by testing stored cerebrospinal fluids (CSF) from patients with encephalitides of unknown cause by RT-PCR, prioritizing vaccine use for postexposure prophylaxis (PEP) during periods of vaccine shortage and subsequent expansion of PEP, surveillance of animal bites using information obtained from vaccine application, roll out of preexposure prophylaxis (PrEP) with vaccine stock restoration, surveillance for adverse events following immunization (AEFI), and ensuring surge capacity to respond to general public inquiries by phone and training for healthcare professionals. Enhanced surveillance for human rabies found no cases after testing 205 stored CSF specimens collected during January 2010–July 2013. During July 16 to December 28, 2013, we received 8,241 rabies PEP application; 6,634 (80.5%) were consistent with recommendations. Among the 6,501persons who received at least one dose of rabies vaccine postexposure, 4,953 (76.2%) persons who were bitten by dogs; only 59 (0.9%) persons were bitten by ferret-badgers. During the study period, 6,247 persons received preexposure prophylaxis. There were 23 reports of AEFI; but no anaphylaxis, Guillain-Barré syndrome, or acute disseminated encephalomyelitis were found. During the study period, there were 40,312 calls to the Taiwan Centers for Disease Control hotline, of which, 8,692 (22%) were related to rabies. Recent identification of rabies among ferret-badgers in a previously rabies-free country prompted rapid response. To date, no human rabies has been identified. Continued multifaceted surveillance and interministerial collaboration are crucial to achieve the goal of rabies-free status in Taiwan.

Phone Number Extraction and Area Code Mining in Mobile Web Browsing for Smart Phones

The phone numbers listed on a Web page displayed on a mobile phone can be useful information for instant reservations or general inquiries. Although current software technology for smart phones can recognize and highlight phone numbers on a page and auto-dial them when clicked, the extraction accuracy often drops significantly due to many cases of data that are falsely recognized as phone numbers. Furthermore, there are many situations in which the area code is missing, preventing the mobile phone from auto-dialing correctly. To resolve these problems, this paper proposes an intelligent phone number extraction and area code mining technique for smart phones in a mobile environment. A series of experiments performed using Android smart phones showed that our method greatly improved the accuracy of phone number mining and the speed of auto-dialing in a mobile Web environment.

The Sexy Issue: Visual Expressions of Heteronormativity and Gender Identities in Cosmopolitan Magazine

The current study used a qualitative image analysis to explore observed interactional behaviors communicated through images printed in Cosmopolitan magazine during the calendar year of 2009 as a means to infer social values . Two general inquiries were used to guide the manner with which behavior was observed: is a heteronormative bias present and what values regarding the expressions of sexual orientation and gender identities can be inferred from these images. The sample consisted of 722 individual images depicting groups of two or more persons. Images were coded for group gender composition, activities engaged in, and physical touch . Results indicated a strong bias favoring heterosexual romantic/sexual intimacy and disfavoring homosexual romantic/sexual intimacy. The differences found between groups of womyn and groups of men suggest the expression of traditional hegemonic gender stereotypes in these image selections. Together, these findings suggest that traditional gender identities and heteronormative ideas were the dominant values communicated in these media image selections.

Announcing Discovery and Research on Chinese Arbitration Awards

We have discovered what appears to be a comprehensive collection of over 4,000 full-text Chinese arbitration awards for international disputes for the decade 1990-2000. This is an extremely rare find because arbitrations are presumptively private and confidential, and Chinese arbitrations are considered particularly opaque. The research team is conducting a detailed empirical study of these CIETAC awards. We are analyzing the arbitrators’ decision-making process and making both general and specific inquiries about what makes a difference in how disputes were resolved. This was a formative period for Chinese trade relations and the Chinese arbitration process. The patterns uncovered by this research should provide insights into both present and future Chinese arbitration practices.

The Role of Canadian Public Librarians in Promoting Health Literacy: Potential Programs and Partnerships

This paper seeks to explore health literacies with a focus on public libraries and their patrons. The authors’ aim is to extract major themes, challenges, and recommendations for further research and collaboration between health professionals and information professionals in promoting health literacy skills to the public. Major issues will be discussed on the subjects of public service, education, and collaboration between health specialists and information specialists. A major focus of the paper is Canadian health literacy issues, as well as Canadian health information dissemination. Time constraints and budget cuts in the health care system have caused a major strain on health professionals. Within the system, there is a shortage of doctors, nurses, and time devoted to health literacy. As a result, patients often seek answers to their health concerns on their own and supplement their understanding of individual health issues by searching for information via the Internet. While consumers often seek answers to their health questions online, the lack of quality control on the Internet is problematic. Public librarians should therefore turn their attention to promoting and providing reliable online information. Meeting the needs of any group can be a challenge for information professionals in public libraries, especially when it comes to health literacy. Public libraries tend to be one of the first places of contact for general public inquiries on infectious diseases and emerging illnesses. Public librarians play an important role in their communities in all aspects of information research and therefore should be advocates for promoting proper health information.

Heuristics diagrams as a tool to formatively assess teachers’ research

Many teacher education programs include different forms of teachers doing research. Be it in the form of action research or general inquiries about their practice, it has been argued that when teachers do research on their own practice, they are able to take a more reflective stance towards their work which is necessary to bring about educational change. However, it is hard to find tools that can be used to provide clear feedback in developing such research. In this paper, we present the results of using a heuristic tool called ‘heuristic diagram’ (HD), previously designed by the authors and based on Gowin’s heuristic Vee, to formatively assess in-service teachers’ research skills. Two different groups of science and mathematics in-service teachers in a Research Methods Course completed four different HD about their research project throughout the semester. We performed a general analysis based on a scoring rubric of these HD in order to show how teachers’ research skills were developed throughout the course. Teachers also evaluated their experience of using the HD through a semantic differential analysis and answered an open questionnaire about the advantages and difficulties of using such tool. Overall, the HD seems to be useful to formatively assess research skills because it allows teachers to make their theoretical framework explicit, relate it to the research question and to the methods used to answer it in an integrated and short way.

Volker Roelcke , Paul J. Weindling and Louise Westwood (eds), International Relations in Psychiatry: Britain, Germany, and the United States to World War II (Rochester: University of Rochester Press, 2010), pp. vi + 254, £50.00/$85.00, hardback, ISBN: 978-1-58046-339-3

Over the last decade, the international dimensions of medicine and science have become topics of great interest among a wide community of historians, geographers, sociologists and anthropologists. From studies of the cultural and economic transmission of drugs, information, and materia medica through to more general inquiries into the similarities and differences between Chinese and Western medicine, scholars have increasingly sought and crafted narratives that explained and compared the ways that movements, circulations, exchanges, networks, and transfers between locales, regions, nations and systems encouraged the creation, proliferation and hegemony of some cultures (or civilisations) over others. Others, no less ambitious in their aims, became concerned to show through the same methods and analytical devices the ways that different languages, practices and power, even within relatively homogeneous cultures, could reinforce prevailing attitudes about progress or offer examples for alternative paths to shared problems. And it is in this latter category that we can locate International Relations in Psychiatry: Britain, Germany, and the United States to World War II, an extremely well-edited, coherent and informative collection of essays by renowned authors.

Development and evaluation of an inquiry scale for diagnosis of heart system syndromes in traditional Chinese medicine

To develop an inquiry scale for diagnosis of heart system syndromes, and to discuss the provisional standardization of the inquiry method in traditional Chinese medicine (TCM). Based on scale-making method, Chinese medicine theory and literature searching, an inquiry scale for diagnosis of heart system syndromes in TCM was developed. Statistics method, frequency counting and Delphi method were used for analysis. The inquiry scale was revised and tested repeatedly to check the test reliability, internal consistency reliability, and content validity, etc. The inquiry scale for diagnosis of heart system syndromes mainly covered basic data, chief complaint, history of present illness (accompanying symptoms) and past history, with appendix of inspection and palpation information as well as diagnosis made according to traditional Chinese and Western medicine. Among them, general inquiries covered fever and chills, sweating, head-body and chest-belly symptoms, taste and diet, stool and urine, sleep, mood, and gynecologic symptoms, which were scaled in 8 dimensions. And 66 symptom variables were screened finally. The scale had a good content validity and its coefficient alpha was 0.82. For the results of test-retest reliability, the Kappa values of using the scale for diagnosis of heart-qi deficiency, heart-yang deficiency, turbid phlegm, and cold coagulation twice by the same doctor ranged from 0.74 to 1, showing that the consistency of the scale was relatively high. The Kappa values of evaluation of scorer reliability in diagnosis of heart-qi deficiency, heart-yang deficiency, and heart-yin deficiency were also high, which were 0.63, 0.72, 1 and 0.48 respectively. Other results of diagnosis had low-consistency or even no diagnostic agreement. The research on the scale for inquiry in TCM indicates that it is feasible for the standardization of inquiry scale for diagnosis of heart system syndromes in TCM, offering a reference for research on the inquiry scales for other systems.

The Price of Assimilation: Felix Mendelssohn and the Nineteenth-Century Anti-Semitic Tradition (review)

NINETEENTH-CENTURY STUDIES The Price of Assimilation: Felix Mendelssohn and the Nineteenth- Century Anti-Semitic Tradition. By Jeffrey S. Sposato. Oxford: Oxford University Press, 2006. [xi, 228 p. ISBN-10: 0-19514-974-2; ISBN-13: 978- 0-19514-974-6. $39.95.] Bibliographic references, index, illustrations. The latter-day flourishing of scholarly and general interest in the music and life of Felix Mendelssohn Bartholdy gained its initial impulse after World War II, as the musical world began to recognize the injustices propagated on grounds of politics but in the name of art during the century's volatile early decades. Building on momentum that emerged at the 1959 sesquicentennial of the composer's birth, the early 1960s witnessed the publication of Eric Werner's Mendelssohn: A New Image of the Composer and His Age (London: Free Press of Glencoe, 1963), the first booklength biography to acknowledge the cultural import of the composer's Jewish heritage substantively rather than polemically, and to portray his career and output as having been crucially informed by that heritage. Having adduced many unpublished documents and offering an overall perspective largely consistent with postwar sympathies and interests, Werner's biography and its revised and expanded German edition (Mendelssohn: Leben und Werk in neuer Sicht [Zurich: Atlantis, 1980]) remained for the rest of the twentieth century the essential starting-points for scholars and general readers alike in surveys, biographical inquiries, musical analysis, and documentary and reception-historical studies. Unfortunately, a great deal of the scholarly effort expended in building on Werner's studies had to be corrective in nature, for Mendelssohn specialists quickly began to realize that many of the documents and musical sources that underlay his new image were either misrepresented or untraceable; some were demonstrably fabricated or falsified. The result, unfortunately, was widespread confusion. On the one hand, Mendelssohn scholarship gained many insights through indirect follow-ups on Werner's research-either corrections of points made in his contributions, or more detailed explorations of issues that were of necessity dealt with briefly in them. But in the meantime general studies continued to cite Werner's work chapter and verse, perpetuating his errors as well as his insights. Some headway toward raising awareness of the risks attendant to using Werner's scholarship was made by a spirited debate in the Musical Quarterly in 1998-99, launched by an article by Jeffrey Sposato and continued with further contributions from Leon Botstein, Michael P. Steinberg, and Peter Ward Jones. Only with the publication of R. Larry Todd's authoritative Mendelssohn biography, however, did a resource become widely available that promised to provide a foundation for general and specialized inquiries alike (Mendelssohn: A Life in Music [Oxford: Oxford University Press, 2003]). Sposato's The Price of Assimilation is the latest milestone in this world of Mendelssohn scholarship-one that in many ways typifies the powerful cross-currents that have been unleashed by the richness of Mendelssohn's life and works, the complexity of his posthumous reception, and the problematical brilliance of Werner's new image. Most immediately, Sposato's inquiry is about Mendelssohn's career-long engagement with the genre of the oratorio, specifically with the crafting, selection, and revision of the texts that articulate those works' dramatic and theological content. More broadly, it is about how that series of projects functioned as public creative proclamations of theological identity from a staunchly Lutheran composer whose family name immediately announced his descent from late eighteenth-century Europe's most eloquent and influential philosophical advocate of Jewish/Christian assimilation. Sposato draws on a wide range of unpublished and otherwise obscure documents as well as familiar ones, transcribes and translates the obscure ones meticulously, and interprets all with unflinching sensitivity to nuance and general accuracy. …

Our International Connections

The American Journal of Pharmaceutical Education has been at the forefront of pharmacy education in the United States for almost 70 years. During that time the Journal has grown from a communication vehicle primarily among deans to an internationally recognized medium with readership among pharmacy faculty members, students, and other health disciplines. It is important that we have a realistic view of our international status and assess the opportunities that are open to us. Four years ago, when the Journal was only distributed in printed version, there were approximately 3000 subscribers, which included a few hundred international subscribers. The number of pharmacy faculty members in the United States at that time was approximately 4,000, indicating that our readership hardly reached all faculty members and represented minimal visibility among international readers. It is likely that print copies were passed from one faculty member to another, but this was not an efficient method of information dissemination and our overall visibility was limited. In January 2003, we began open-access, online publishing. As you know, the Journal is accessible by all without a password. While open-access publication changes the model for financial support of journals, it can greatly expand journal visibility. Over the past 6 months our readership has exceeded 20,000 unique individuals. Given the number of US pharmacy faculty (now about 4,200), this level of usage indicates a large contingent of international readers. At the Journal office, we are also seeing a large increase in international manuscript submissions and general inquiries. What is it about international readership that is important? It greatly expands the influence of our authors. By publishing in AJPE, our authors' work not only commands the attention of the US pharmacy academy but is also viewed throughout the world. As in the United States, many countries are struggling with issues related to medications and are looking to pharmacists to play a greater role in solving these problems. Through international exposure, much of what we are doing in the United States to upgrade pharmacy education becomes available to the world, including research articles, descriptions of new instructional methods, the best practices of our Teacher of the Year honorees, and abstracts from our meetings, as well as AACP council and committee proceedings. Given the great expense of medical publications and limited resources in most countries, an open-access journal such as AJPE is viewed as a unique opportunity for communication and advancement. There is no limit to the influence that our authors can have on pharmacy education throughout the world. Also, by opening channels to international authors, we learn about the best practices that are going on throughout the world and can use them to improve pharmacy education in the United States. Countries with health care delivery models quite different from our own have developed advanced roles for pharmacists, and corresponding instructional models that we would like to have here in the United States. We have already learned much from our Canadian colleagues over many years. Last year our Rufus Lyman Award winners for the best paper published in AJPE in 2004 were from the United Kingdom. Many of our individual colleges have recognized the benefits of international collaboration and have established shared programs and faculty member or student exchanges with colleges of pharmacy outside of the United States. For the Journal, we view the experience of the past few years as just the beginning of our international efforts. We would like to create a forum for more international contributions; most importantly, those that are of general interest and have the potential of influencing pharmacy education in many countries. As we continue to push pharmacy education forward and seek to identify innovation and improvements we should expand our international connections and identify the opportunities for progress.

The Structure of Patients' Presenting Concerns: Physicians' Opening Questions

This article uses conversation analysis to develop a typology of questions that physicians use to solicit patients' problems and then tests question–format effects on patients' subsequent problem presentations. Data are videotapes of 302 primary-, acute-, and outpatient-care visits involving 77 physicians in 41 urban and rural clinics, as well as pre- and postvisit questionnaires. The most frequent question formats were general inquiries (62%; e.g., "What can I do for you today?") and requests for confirmation (27%; e.g., "I understand you're having some sinus problems today?"). Compared to confirmatory questions, general inquiries were associated with significantly longer problem presentations (p <. 0001) that included more discrete symptoms (p <. 0001). Physicians were more likely to use confirmatory questions in the urban setting (p =. 003).

Physicians’ opening questions and patients’ satisfaction

Objective To determine the association between the format of physicians’ opening questions that solicit patients’ presenting concerns and patients’ post-visit evaluations of (i.e., satisfaction with) the affective-relational dimension of physicians’ communication. Methods Videotape and questionnaire data were collected from visits between 28 primary-care physicians and 142 adult patients with acute problems. Factor analysis resulted in three dependent variables derived from the 9-item Socioemotional Behavior subscale of the Medical Interview Satisfaction Scale. Results Question format was significantly, positively associated with patients’ evaluations of physicians’ listening ( p = .028) and positive affective-relational communication ( p = .046). Conclusion Patients desire opportunities to present concerns in their own time and terms regardless of how extensively they act on this opportunity. Practice implications Visits should be opened with general inquiries (e.g., What can I do for you today?) versus closed-ended requests for confirmation (e.g., Sore throat, huh?).

The place of public inquiries in shaping New Zealand's national mental health policy 1858–1996

BackgroundThis paper discusses the role of public inquiries as an instrument of public policy-making in New Zealand, using mental health as a case study. The main part of the paper analyses the processes and outcomes of five general inquiries into the state of New Zealand's mental health services that were held between 1858 and 1996.ResultsThe membership, form, style and processes used by public inquiries have all changed over time in line with constitutional and social trends. So has the extent of public participation. The records of five inquiries provide periodic snapshots of a system bedevilled by long-standing problems such as unacceptable standards, under-resourcing, and poor co-ordination. Demands for an investigation no less than the reports and recommendations of public inquiries have been the catalyst of some important policy changes, if not immediately, then by creating a climate of opinion that supported later change. Inquiries played a significant role in establishing lunatic asylums, in shaping the structure of mental health legislation, establishing and maintaining a national mental health bureaucracy within the machinery of government, and in paving the way for deinstitutionalisation. Ministers and their departmental advisers have mediated this contribution.ConclusionPublic inquiries have helped shape New Zealand's mental health policy, both directly and indirectly, at different stages of evolution. In both its advisory and investigative forms, the public inquiry remains an important tool of public administration. The inquiry/cause and policy/effect relationship is not necessarily immediate but may facilitate changes in public opinion with corresponding policy outcomes long after any direct causal link could be determined. When considered from that long-term perspective, the five inquiries can be linked to several significant and long-term contributions to mental health policy in New Zealand.

Vygotsky on imagination: Why an understanding of the imagination is an important issue for schoolteachers

Lev Vygotsky was an educational theorist and psychologist of extraordinarily wide knowledge whose major writings deal with the entire learning‐teaching‐development enterprise. Despite wide‐ranging interests towards Vygotskian theory, the issue of imagination remains outside of the main line of the general inquiries. Thus there is a gap in that list of “Vygotskiana” topics that are studied in North America: Vygotsky’s writings about the imagination and its development have only recently became a topic of the discussion. This article attempts to fill the gap.

Teaching Children to Care: Their Views of War in Bosnia

36 students in Grades 5 and 6 were exposed to moralistic teaching about the rights of children during war and the meaning of International Humanitarian Law. They were also given guided tours of 44 color drawings by children in Bosnia which were on display for 12 school days. Three weeks later the children were asked to write to a pen-pal in Bosnia and answer two general inquiries about the project for a total of 40 minutes of writing. Analysis of their written responses indicated the absence of knowledge about the central concepts of the rights of children and the purpose of International Humanitarian Law. There was ample evidence that empathic responses were developed in relation to people suffering in Bosnia, although a minority were apparently frightened and retreated into a self-reassurance of their own safety.