The Swiss Schools have been Governed by Local Lay Authorities

After the introduction of the liberal-democratic constitutions in the Swiss cantons in the first half of the 1830ies the grid of existing schools has been systemized and broadly expanded. The school systems have ever since been characterized by one key element: a special local authority type called „Schulkommission“ or „Schulpflege“. They take the form of committees consisting of laymen that are appointed by democratic elections like all the other executive bodies on the different federal levels in Switzerland. When it comes to their obligations and activities these community level school committees conform very much to the school boards in the American and Canadian school systems. They are accountable for the selection and supervision of the teachers. They approve decisions about the school careers of pupils and about curricular matters like the choice of school books. Normally their members are elected by the local voters for four year terms of office (reelection remains possible) and with regard to pedagogics they normally are non-professionals. The board members are responsible for classes and teachers assigned to them and they have to go to see them periodically. These visitations and the board meetings each month together with the teachers enable the board members to attain a deep insight into what happens in their schools over the course of their term of office. But they are confronted as laymen with a professional teaching staff and with educational experts in the public administration. Nevertheless this form of executive power by non-professionals is constitutive for the state governance in the Swiss as well as in other national political environments. It corresponds to the principles of subsidiarity and militia and therefore allows for a strong accentuation of liberty and the right of self-determination, two axioms at the very base of democratic federalist ideology. This governance architecture with this strong accent on local anchorage features substantial advantages for the legitimacy and acceptability of political and administrative decisions. And this is relevant especially in the educational area because the rearing of the offspring is a project of hope and, besides, quite costly. In the public opinion such supervision bodies staffed by laymen seem to have certain credibility advances in comparison with the professional administration. They are given credit to be capable of impeding the waste of common financial resources and of warranting the protection and the fostering of the community’s children at once. Especially because of their non-professional character they are trusted to be reliably immune against organizational blindness and they seem to be able to defend the interests of the local community against the standardization and centralization aspirations originating from the administrational expertocracy. In the paper these common rationales will be underpinned by results of a comprehensive historical analysis of the Session protocols of three Bernese school commissions from 1835 to 2005.

The implementation of a tobacco dependence education curriculum in a Swiss Dental Hygiene School - an 8-year review

OBJECTIVE The aim of our investigation was to review the implementation of a comprehensive tobacco dependence education (TDE) curriculum at the Medi School of Dental Hygiene (MSDH), Bern, Switzerland, 2001-2008. METHODS In 2001, new forms to record patients' tobacco use history and willingness to quit were created for all the MSDH patients. In 2002, a new theoretically based tobacco dependence treatment protocol was implemented into the MSDH curriculum. Students received instruction on how to provide brief tobacco use dependence interventions as well as maintain detailed records of patient tobacco use and cessation interventions for every smoker at all dental hygiene visits. RESULTS In 2002, 17 lecture hours were added to the following subjects: pathology, periodontology, preventive dentistry, pharmacology and psychology. During the same time period, 2213 patients (56.9% women) have visited the MSDH. Smoking status was recorded in 85.7% of all the patients (30.2% smokers). Brief tobacco use interventions were recorded in 36.8% of all smokers while 7.6% of these have reported to quit smoking. CONCLUSIONS Overall, the new TDE curriculum was successfully implemented and accepted by the MSDH faculty. Applications in the clinical practice, however, may still be improved to better identify smokers and increase initial and follow-up interventions potentially leading to higher quit rates.

Participation in Further Education over the Life Course: a longitudinal study of three birth cohorts in the Federal Republic of Germany

In this paper we address the issue of who is most likely to participate in further training, for what reasons and at what stage of the life course. Special emphasis is given to the impact of labour-market policies to encourage further education and a person's individual or cohort possibilities to participate in further education. We apply a Cox proportional hazard model to data from the West German Life History Study, separately for women and men, within and outside the firm. Younger cohorts show not only higher proportions of participation in further education and training at early stages of the life course, they also continue to participate in higher numbers during later stages of the life course. General labour-force participation reduces and tenure with the same firm increases the propensity to participate in further education and training. Contrary to expectations, in Germany labour-market segmentation has been enhanced rather than reduced by further education and training policies, since in the firm-specific labour-market segment, i.e. skilled jobs in large firms, and in the public sector both women and men had a higher probability of participation. Particularly favourable conditions for participation in further education outside the firm prevailed during the first years of the labour promotion act (Arbeitsförderungsgesetz) between 1969 and 1974, but women did not benefit to the same extent as men. Training policies are, therefore, in need of continuous assessment based on a goal-achievement evaluation to avoid any unintended effects of such policies.

History of offending behavior in first episode psychosis patients: A marker of specific clinical needs and a call for early detection strategies among young offenders

OBJECTIVES Previous literature suggests that early psychosis (EP) patients with a history of offending behavior (HOB) have specific clinical needs. The aims of this study were to assess: (1) the prevalence of HOB in a representative sample of EP; (2) the premorbid and baseline characteristics of patients with HOB, and (3) the potential differences in short-term outcome of such patients when compared to patients without HOB. METHODS The Early Psychosis Prevention and Intervention Centre (EPPIC) admitted 786 EP patients between 1998 and 2000. Data were collected from patients' files using a standardized questionnaire. Data of 647 patients could be analyzed. RESULTS HOB patients (29% of the sample) were more likely to be male with lower level of premorbid functioning and education, have used illicit substances and have attempted suicide. They presented with a more complex clinical picture and had poorer 18-month outcome. Most importantly, they had a significantly longer duration of untreated psychosis. CONCLUSIONS On the basis of the high prevalence and specific features of EP patients with HOB, our study confirms a need for additional research in this domain and for the development of specific treatment strategies. Most importantly, it suggests a need for the promotion of early detection strategies among the populations of young offenders, considering that some of them may be going through the early phases of a psychotic disorder and that reduction of treatment delay and provision of well adapted interventions may have a significant impact at numerous levels in such patients

Comparability of Outcome Frameworks in Medical Education: Implications for framework development

Background: The demand for international harmonization in medical education increases with the growing mobility of students and health professionals. Many medical societies and governmental offices have issued outcome frameworks (OF), which describe aims and contents of medical education based on competencies. These national standards affect the development of curricula as well as assessment and licensing procedures. Comparing OF and identifying factors that limit their comparability may thus foster international harmonization of medical education. Summary of Work: We conducted a systematic search for national OF in MedLine, EmBase and the internet. We included all OF in German or English that resulted from a national consensus process and were published or endorsed by a national society or governmental body. We extracted information in five predetermined categories: history of origin, audience, formal structure, medical schooling system and key terms. Summary of Results: Out of 1816 results, 13 OF were included into further analyses. OF reference each other, often without addressing existing differences (e.g. in target audiences). The two most cited OF are “CanMEDs” and “Scottish Doctor”. OF differ especially in their level of detail as well as in the underlying educational system. Discussion and Conclusions: Based on our results we propose a two-step blueprint for OF, that may help to establish comparability for internationally aligned key features – so-called “core competencies” – while at the same time allowing for necessary regional adaptations in terms of “secondary competencies”. Take-home messages: Considerable differences in at least five categories of OF currently hinder the comparability of outcome frameworks.