Appropriate remedial action? medical students, medical schools, and smoking and health education in New York and the United States, 1964-87

The Surgeon General's 1964 report on smoking and health, which declared that cigarette smoking was a cause of lung cancer, is considered a landmark in the history of medicine and public health. This article examines the impact of the report on medical student education by reviewing how the relationship between smoking and lung cancer was presented in medical school textbooks and syllabi between 1964 and 1987, changes in hospital smoking regulations and doctors' attitudes toward smoking following the publication of the report, and medical students' smoking patterns and attitudes toward cigarette smoking in the years after 1964. Although it provided some advanced students with additional insight into mechanisms of pathogenesis related to smoking, the education that many medical students received seems to have been neither a primary influence on their smoking patterns nor an important source of their scientific understanding of the causal link between smoking and lung cancer for at least a decade following the publication of the Surgeon General's report.     

Scottish landform examples 44: the Dirc Mhòr meltwater gorge

The Dirc Mhòr gorge in the central Grampian Highlands is 1.1 km long, ～250 m wide and up to 110 m deep, and is incised in granite bedrock. It is the largest of several bedrock gorges that are incised into spurs, cols or plateau margins in the area, and its present catchment area is negligible. The floor of the gorge is covered by coarse rockfall debris, and the sides of the gorge are mantled by talus accumulations; surface water flow is absent. The gorge is inferred to have evolved over several glacial-interglacial cycles, with subglacial meltwater erosion deepening the gorge under successive ice sheets, and paraglacial rockwall collapse widening the gorge during intervening interglacial periods. Subglacial erosion may also have contributed to gorge enlargement as it widened.     

Instagram photography and the geography field course: snapshots from Berlin

Although geography has long associated itself with photography, the rapid advancement of technology has created a clear divide between the visual practices regularly used in wider society and the way photography is utilized by critical geographers in their teaching. We suggest the door is ajar for new modes of (geo)photographic thinking, and one visual tool at our disposal is social media applications that allow images to be instantly shared, analysed, and discussed. This article critically reflects on the use of Instagram to enhance student participation, engagement, and learning on a geography field course in Berlin. Based on interviews with students, their field journals, and our own critical reflections, this paper looks at some advantages of using Instagram in teaching geography, but also promotes caution and presents drawbacks to relying on instant visual digital methods.     

Moral Panics and Punctuated Equilibrium in Public Policy: An Analysis of the Criminal Justice Policy Agenda in Britain

How and when issues are elevated onto the political agenda is a perennial question in the study of public policy. This article considers how moral panics contribute to punctuated equilibrium in public policy by drawing together broader societal anxieties or fears and thereby precipitating or accelerating changes in the dominant set of issue frames. In so doing they create opportunities for policy entrepreneurs to disrupt the existing policy consensus. In a test of this theory, we assess the factors behind the rise of crime on the policy agenda in Britain between 1960 and 2010. We adopt an integrative mixed-methods approach, drawing upon a combination of qualitative and quantitative data. This enables us to analyze the rise of crime as a policy problem, the breakdown of the political-institutional consensus on crime, the moral panic that followed the murder of the toddler James Bulger in 1993, the emergence of new issue frames around crime and social/moral decay more broadly, and how—in combination—these contributed to an escalation of political rhetoric and action on crime, led by policy entrepreneurs in the Labour and Conservative parties.     

Gender disparities in child health care seeking in northern Vietnam

Vietnam recently demonstrated a skewed sex ratio at birth. Little research has examined postnatal impacts of son preference in Vietnam, such as in child health care seeking. Past research in other Asian countries with son preference has found that parents are more likely to take sons to a health facility when they are sick, to do so more promptly, and invest more resources in care, than daughters. Using data from a paediatric hospital emergency department, we analyse gender differences in illnesses, referral patterns, and outcomes among children to understand how gender disparities in paediatric hospital admissions arise. Almost twice as many boys were brought into the facility as girls. Compared to girls, boys were significantly more likely to have bypassed lower-level facilities and entered care at the tertiary facility, controlling for severity of illness and socio-demographic characteristics. This suggests parents provide preferential treatment to boys, potentially leading to excess morbidity among girls who become ill. However, we find no significant differences in delay of care seeking or evidence of provider bias. Ensuring that girls are able to access appropriate, quality care when needed, will improve equity of access to care for all children.     

The Semantics of Corruption: Political Science Perspectives on Imperial and Post-Imperial Methods of State-Building

Although imperial historians concentrate on regions and periods with abundant documentation, it is worth considering how another discipline copes with the political fate of post-colonial societies whose records are not so easily accessible. The nine works reviewed below cover problems of misgovernment in new states in several regions. This article concentrates on their methods and conclusions for states in sub-Saharan Africa and more especially West Africa. Authors and editors have made considerable use of patron-client (or clientelistic) explanations in their interpretations of the aims and performance of African leaders under post-independence constitutions. Techniques of patronage have a long history; colonial rulers applied them to find useful intermediaries between administrators and African ethnic groups; and there is ample evidence for their existence in the politics of new states under the label of ‘corruption’.

Despite accepted definitions of patronage, the terminology of clientelism contains ambiguities when employed to denote historical cases in a large number of cultural contexts with poor economic management and dictatorial governance. The collective conclusion of the books reviewed charges African civil and military leaders with corruption in appropriation of public resources for private gains. All the authors comment on that generic term; one of them supplies a detailed analysis of its ramifications. Most have drawn, too, on imperial works and records as background to their explanation for the policies of civil and military leaders in independent states in coping with debt management, risk of territorial fragmentation, use of parastatals and misuse of resources. It is concluded here, however, that input from the late colonial period has been misunderstood; second, that anthropologists’ knowledge of the institution of chieftainship, its survival or disappearance, throws light on the ‘indeterminacy’ of leadership succession in Africa, unless overcome by the mechanisms of constitutional elections; and, third, that political science has not investigated the reasons for the lack of competent judicial and civil service institutions to safeguard the working of Africa's constitutions.