National Inquiries Research Articles

The Dearing Inquiry as Process – Delegated Thinking and the Limits of Expert Advice

The Dearing Inquiry into Higher Education is assessed in terms of its contribution to a style of policy‐making which has lain dormant for two decades. The paper questions the effectiveness of national inquiries in general, and asks whether there is a case for anticipating further inquiries as proposed by the Dearing report. The Inquiry itself is examined as part of a critique of state‐sponsored delegated thinking, in which the state delegates but does not abdicate its policy‐making function. Tensions between academic experts and the elite policy‐making community are also analysed. The paper concludes that inquiries have less to do with inquiry, and more to do with the legitimation of state policy options. A way is cleared for a further paper which explores the alternatives for higher education.

Translating institutional objectives into action

In higher education, translating institutional objectives into meaningful action is a challenging task, particularly given the currency attached to analogies such as the view that managing academics is akin to herding cats, or that teaching in HE is one of the last cottage industries. Yet alignment is becoming increasingly important, as the reports of national inquiries and commissions (e.g. Dearing, West, Boyer) and the pronouncements and plans of governments indicate. The paper examines one illustration of steps that an institution has taken to translate objectives into action.

Radiation oncology in Spain: Historical notes for the radiology centennial

Cancer started to forge as a visible disease in the first third of this century (1). This means that it began to be considered as a conceivable illness by society, and above all, a concern for doctors. They were the social agents to persuade public and states of cancer curability. The lay reality was colonized by medical discourse, and individuals were assigned to be the assistants of doctors in the ideal frame of an industrial healthy society (2). This new medical mentality about cancer was a result of the professional commitment with social change, the improvement of surgery, and the perception of radioactive remedies as innovative therapeutical hopes. The process was linked to medical profession dynamics directed at the autonomization of radiotherapy as a new medical discipline. In western societies the concern about cancer and the rise of radiotherapy as a medical speciality was a process with common steps in its devolopment (3). In Spain, the therapeutic use of x-rays and radium was incorporated with a similar celerity to other countries. In the 30s the presence of radiological devices and instruments was significant in private practice medicine. According to the Spanish Medical Catalog (Anuario Medico de Espafia), from 1927 to 1931 the number of radiologists tripled (from 223 to 571) (4). This extraordinary increase did not mean a specialized type of radiological practice. Several medical specialists (surgeons, gynecologists, dermatologists) used radiological apparatus, particularly radium, due to its simple manipulation in clinics as an auxiliary therapy or, above all, as diagnostic methods. The practice of Radiotherapy as it is defined today lasted to be generalized, and for decades radiological medicine combined the practice of diagnostic and therapeutic use of this technology. In 1936, with the beginning of the Spanish Civil War, there was no regulation of the radiology practice, although in 1935 (Primer Congreso Promedico Espafiol) it was decided to name a Commission to study the legal implications and present a regulatory proposal to the health authorities. It was not until the 1930s when the health authorities of the Spanish government had a project to fight against cancer. Until then, some benefit cancer institutions, including individuals of the medical and social elite together with members of the government, were helped occasionally with financial support. These initiatives defined their objectives with the criteria of the doctors involved and in general were directed more toward the adquisition of radioactive material and its instrumentation requirements, more than to solve public education on the incurable problem. In 1909, the ComitC Central Contra el Cancer [Central Committee Against Cancer] and the Asociacion National Contra el CXncer were founded. Also the main proposals of campaigning were discussed, but following foreign experiences, difficult to carry on. The unique achievements for this period were the national enquiries (1902 and 1909) to know clinical cancer incidence, etiology, medical services available, and doctors knowledge about the disease. But the reply obtained was insignificant: 2O.ooO enquiries and 298 replies (1902) (5). The decline of international initiatives due to the war had a negative effect on Spanish institutions. In fact, except for the creation of a modest laboratory for cancer research at the Instituto Rubio (Madrid, 1909) and the discussion about radiumtherapy in the cancer campaign, nothing more was done In 1914 the Sociedad Benefica Radium-Barcelona arose, as a nonprofit institution. to provide radium to pri-

Frequency of Twin Pregnancies Following Renal Transplantation

Objective: To evaluate the incidence of twin pregnancy among renal-transplanted women.Methods: A retrospective review based on three national inquiries. A computer literature search of the Medline system was done. Only reports of series were included. For statistical analysis the probability of having a twin pregnancy was assumed to be 0.012.Main Outcome Measures: Incidence of twin pregnancy in women after renal transplantation.Results: There were 7 sets of twins among 153 pregnancies reported in the national inquiry group (4.57%). Thus, the overall incidence of twin pregnancy in these women was 1 in 22 pregnancies. The frequency of twinning in series reporting pregnancies after renal transplantation was 1.84%, a figure statistically greater than the expected number of twins (P = 0.001).Conclusions: The frequency of twin pregnancy appears to be increased among renal-transplanted women.

Pregnancy after renal transplantation: 25 years experience in Spain.

To study the outcome of pregnancy in renal transplant patients in Spain. A retrospective review based on two consecutive national inquiries. Departments of Obstetrics and Gynaecology and Renal Transplant Units in Spain. Pregnant women who had renal transplants between 1965 and 1989. From the preliminary inquiry the frequencies of miscarriage, therapeutic abortion, preterm birth, fetal malformation, twins, stillbirths, neonatal deaths and loss of maternal renal function were recorded. The subsequent, more detailed inquiry provided additional information including donor type, previous rejection episodes and interval between rejection and pregnancy, previous creatinine level, previous hypertension and development of hypertension in pregnancy, developments during labour and delivery and the occurrence of intra uterine growth retardation and low birth weight. The preliminary inquiry yielded information about 133 pregnancies. The miscarriage rate was 10% and the therapeutic abortion rate was 16%. Of the 99 pregnancies that continued, 46% ended before term and 53% progressed to term. The perinatal mortality rate was 107.8 per 1000 and 4% of the infants had minor congenital malformations. The second inquiry yielded more detailed data about 66 pregnancies. There were no therapeutic abortions and 12% of the pregnancies ended in miscarriage. Among the 58 pregnancies that reached > or = 28 weeks gestation, preterm birth occurred in 28 (48%) and intra uterine growth retardation occurred in 17 (29%). Among 48 women with normal renal function before pregnancy, the perinatal mortality rate was 68 per 1000, the miscarriage rate was 8% and in 10 of these women (21%) renal function was impaired after pregnancy. In contrast, among 18 women with impaired renal function before pregnancy, the perinatal mortality rate was 142 per 1000, the miscarriage rate was 22% and in six of these women (33%) renal function deteriorated after the pregnancy. Impairment of renal function was most common in women with hypertension during pregnancy or with rejection episodes during the year before conception. Women with a renal transplant can have a successful pregnancy, but there are definite risks for both mother and fetus. Pregnancy should be discussed with the woman and encouraged only if there is good renal graft function.

Economic Effects of Multinational Accounting Diversity

AbstractThe purpose of this paper is to whet the appetite of accounting researchers by providing a menu of research issues in accounting and auditing that merit scholarly attention and which appear suitable for publication in JIFMA. Especially needed are inquiries that examine the economic impacts of accounting differences in a world economy characterized by unconstrained capital flows, far‐flung multinational operations and financial decisions which are made within the context of organizational complexity with diverse practices and traditions of economic behavior. The research questions that need to be addressed are substantive and will soon dwarf national inquiries in importance as the trend toward a world economy continues.

Synopsis of “Cannabis: a Review of Some Important National Inquiries and Significant Research Reports”*

Synopsis of “Cannabis: a Review of Some Important National Inquiries and Significant Research Reports”*