title: The Common-Health and Beyond: New Zealand Trainee Specialists in International Medical Networks, 1945-1975

authors: Armstrong, John

subjects: History

abstract: In the two to three decades that followed World War Two, approximately three-quarters of all New Zealand doctors, and up to ninety per cent of New Zealand medical specialists, travelled overseas for the purposes of obtaining post-graduate experience and qualifications. This thesis uses oral interviews, quantification techniques, and a range of textual analyses to explore the form and function of this large-scale professional migration, and to capture the experiences of those doctors who participated in it.
The central argument of this thesis is that the careers of New Zealand specialists during this period cannot be understood without making reference to a complex and mutually influential international system of cultural and professional conventions, institutional rules, interpersonal networks, health related policies, and discursive formations. While powerfully centred on British medical norms and structures, this ‘Common-health’ system facilitated the transmission of people, ideas, technologies, and policies both within and between the nations of the British Commonwealth, in multiple directions by multiple means, and in doing so, was critical to the development of medical specialisation in the twentieth century.
For New Zealand’s prospective specialists, the primary motivating force behind these migrations was the need to access populations that were large enough to facilitate specialist training. Britain’s much larger population and the existence of a range of cultural and institutional commonalities, derived from nineteenth-century colonisation, made Britain the default destination for thousands of New Zealand trainee specialists during the second half of the twentieth century. However, while the Common-health system was a powerful facilitator of medical interaction and migration, it also functioned as a mechanism of exclusion that severely curtailed the ability of women doctors and those of non-European heritage to participate in professional medicine on their own terms. This thesis examines this restrictive aspect of post-World War Two medical networks with relation to women by suggesting that traditional beliefs about the role of women in medicine, together with the strongly informal nature of many professional interactions, not only limited the overall participation of women doctors, but also conditioned their ability to access particular specialty fields. The thesis also examines the reconfiguration of these patterns of connection during the late 1960s and early 1970s, and in particular, the emergence of the United States and Australia as important venues for post-graduate training for New Zealand’s prospective specialists.

text: The Common-Health and Beyond: New Zealand Trainee Specialists in International Medical Networks, 1945-1975 In the two to three decades that followed World War Two, approximately three-quarters of all New Zealand doctors, and up to ninety per cent of New Zealand medical specialists, travelled overseas for the purposes of obtaining post-graduate experience and qualifications. This thesis uses oral interviews, quantification techniques, and a range of textual analyses to explore the form and function of this large-scale professional migration, and to capture the experiences of those doctors who participated in it.
The central argument of this thesis is that the careers of New Zealand specialists during this period cannot be understood without making reference to a complex and mutually influential international system of cultural and professional conventions, institutional rules, interpersonal networks, health related policies, and discursive formations. While powerfully centred on British medical norms and structures, this ‘Common-health’ system facilitated the transmission of people, ideas, technologies, and policies both within and between the nations of the British Commonwealth, in multiple directions by multiple means, and in doing so, was critical to the development of medical specialisation in the twentieth century.
For New Zealand’s prospective specialists, the primary motivating force behind these migrations was the need to access populations that were large enough to facilitate specialist training. Britain’s much larger population and the existence of a range of cultural and institutional commonalities, derived from nineteenth-century colonisation, made Britain the default destination for thousands of New Zealand trainee specialists during the second half of the twentieth century. However, while the Common-health system was a powerful facilitator of medical interaction and migration, it also functioned as a mechanism of exclusion that severely curtailed the ability of women doctors and those of non-European heritage to participate in professional medicine on their own terms. This thesis examines this restrictive aspect of post-World War Two medical networks with relation to women by suggesting that traditional beliefs about the role of women in medicine, together with the strongly informal nature of many professional interactions, not only limited the overall participation of women doctors, but also conditioned their ability to access particular specialty fields. The thesis also examines the reconfiguration of these patterns of connection during the late 1960s and early 1970s, and in particular, the emergence of the United States and Australia as important venues for post-graduate training for New Zealand’s prospective specialists.

year: 2013

title: Risk axis: Implementation of structured clinical guidelines for the assessment and management of risk in psychiatry

authors: Kumar, Shailesh

subjects: classification

abstract: Introduction: Mental health clinicians routinely assess risk in three domains: suicide, violence and self neglect. While the published work on the assessment of these risks has increased, concerns are often expressed that assessment alone does not lead to management of the identified risk. Not all axes of multiaxial classificatory systems are used by clinicians to the same extent, despite their proven usefulness. It is possible that a dedicated axis for risk management as a part of a multiaxial classificatory system could align risk assessment with management and increase utility of multiaxial classificatory systems.
Methods: Based on our earlier work we developed a comprehensive risk management axis (RMA), which was then further refined by conducting a pilot study and then used to collect data retrospectively from the case notes of 100 patients consecutively discharged from a general psychiatric ward.
Results: Common association between risk factors and three risk domains were as follows. Violence: active symptoms of major mental illness, employment problems, and major mental illness; Suicide: history of abuse, clinically significant depressive symptoms, and alcohol and drug use; Self neglect: neglect of home, personal safety, noncompliance with treatment, male gender, and low income. We also investigated whether the presence of a particular risk factor acted as a barrier or prompt for clinicians to address management factors in the RMA.
Discussion: It is possible to assess risk across the three domains and to derive management plans by using the proposed RMA. Minimal clinical background is necessary for collecting data retrospectively. It should be possible to apply this axis prospectively.

text: Risk axis: Implementation of structured clinical guidelines for the assessment and management of risk in psychiatry Introduction: Mental health clinicians routinely assess risk in three domains: suicide, violence and self neglect. While the published work on the assessment of these risks has increased, concerns are often expressed that assessment alone does not lead to management of the identified risk. Not all axes of multiaxial classificatory systems are used by clinicians to the same extent, despite their proven usefulness. It is possible that a dedicated axis for risk management as a part of a multiaxial classificatory system could align risk assessment with management and increase utility of multiaxial classificatory systems.
Methods: Based on our earlier work we developed a comprehensive risk management axis (RMA), which was then further refined by conducting a pilot study and then used to collect data retrospectively from the case notes of 100 patients consecutively discharged from a general psychiatric ward.
Results: Common association between risk factors and three risk domains were as follows. Violence: active symptoms of major mental illness, employment problems, and major mental illness; Suicide: history of abuse, clinically significant depressive symptoms, and alcohol and drug use; Self neglect: neglect of home, personal safety, noncompliance with treatment, male gender, and low income. We also investigated whether the presence of a particular risk factor acted as a barrier or prompt for clinicians to address management factors in the RMA.
Discussion: It is possible to assess risk across the three domains and to derive management plans by using the proposed RMA. Minimal clinical background is necessary for collecting data retrospectively. It should be possible to apply this axis prospectively.

year: 2010

title: Representations of diversity in the revised New Zealand PictureBook Collection

authors: Daly, Nicola

subjects: picturebooks

abstract: Collections of children’s literature are used for a range of reasons including preservation, record keeping, and more recently the encouragement of intercultural understanding. Both the signifi- cance of learning about other cultures and the importance of children seeing themselves reflected in the books that they read have been discussed extensively. In 2010, the New Zealand PictureBook Collection (NZPBC) was developed in order to create a resource that reflected New Zealand national identity. In 2015 the NZPBC was revised and this article presents a visual and textual analysis of the diversity present in the sixty books nomi- nated through the lens of critical multicultural analysis, using four variables. Findings indicate considerable diversity is present in the collection in terms of representations of ethnicity and family; less so for representations of disability and languages.

text: Representations of diversity in the revised New Zealand PictureBook Collection Collections of children’s literature are used for a range of reasons including preservation, record keeping, and more recently the encouragement of intercultural understanding. Both the signifi- cance of learning about other cultures and the importance of children seeing themselves reflected in the books that they read have been discussed extensively. In 2010, the New Zealand PictureBook Collection (NZPBC) was developed in order to create a resource that reflected New Zealand national identity. In 2015 the NZPBC was revised and this article presents a visual and textual analysis of the diversity present in the sixty books nomi- nated through the lens of critical multicultural analysis, using four variables. Findings indicate considerable diversity is present in the collection in terms of representations of ethnicity and family; less so for representations of disability and languages.

year: 2017