Lung cancer, chronic disease epidemiology, and medicine, 1948-1964

Beginning in the early 1950s, a series of epidemiological, biochemical, pathological, and animal studies demonstrated a link between cigarette smoking and lung cancer. A number of reputable scientists challenged these findings, but for a variety of reasons, including the behavior of the tobacco industry, historians have assumed that these objections were insubstantial and disingenuous. Viewing these objections in scientific and medical perspective, however, suggests that there was a legitimate and reasonable scientific controversy over cigarette smoking and lung cancer in the 1950s and early 1960s. That controversy had important consequences. A new chronic disease epidemiology emerged, transforming the role and importance of epidemiology to medical research. This new epidemiology supplemented Koch's postulates, establishing a statistical method that allowed for linking environmental factors to the etiology of chronic diseases. The 1964 report to the surgeon general, Smoking and Health, represented the denouement and codification of these developments. This reexamination of the scientific controversy over smoking in the 1950s and early 1960s provides an important context for understanding the subsequent public relations battles between the tobacco industry and public health after 1964.     

Social and Spiritual Capital: Building ‘Emotional Resilience’ In Communities and Individuals

Abstract

The article examines the relationship between mental health, mental health promotion, religious communities and general issues of public health. It begins with an exploration of what is meant by mental health drawing a distinction between it, mental illness and mental health promotion, and argues that mental health can have a profound impact on physical health. The relationship between religious communities and the mentally ill is analysed next. Despite the attitudes of many in mental health provision, religious communities can offer a supportive environment for the mentally ill. The article avoids a ‘faith communities—good’, ‘mental health services—bad’ dichotomy, recognizing that religious communities can be excluding and discriminatory. The ambiguity of some experiences is recognized: are they forms of religious experience or symptoms of psychosis? The article highlights the inceasing advocacy of the user/survivor movement. In the final section, the relationship between mental health and public health is explored. It is suggested that religious communities can be places for the promotion of mental health. Mental health promotion is understood as aiming to strengthen both individuals and communities; its value is explored in relation to public health issues. It is suggested that those who are socially excluded are at a greater risk of some form of mental illness and that this may well impact on their physical health. Related to this are the beneficial effects of opportunities for participation in decision making, be it in the workplace or the local community. The article ends by arguing that service providers and service users need to be involved in decisions and planning. Further, some elements of mental health promotion will need to involve those outside the statutory sector.     

Sanctions,Smuggling, and the Cigarette: The Granting of Iran OFAC Licenses to Big Tobacco

This paper seeks to understand the political economy implications of nicotine addiction in Iran, focusing on the US Office of Foreign Asset Control's granting of Iran operations licenses to American tobacco companies. Presuming that tobacco taxes, levied both as import duties and ad valorem, would financially benefit the Iranian government, the introduction of a highly desired US product to the market would be antithetical to the sanctions regime currently in place. By comparing Iran's tobacco industry, and the attendant public health crisis that has arisen from high rates of nicotine addiction, to conditions in Turkey, it can be demonstrated that Iran is uniquely unable to extract revenues from the sale of tobacco products. The primary point of comparison between Iran and Turkey is smoking-attributable annual productivity losses of each country, as estimated through the use of Smoking-Attributable Mortality, Morbidity and Economic Costs Software (SAMMEC) and the available related literature. According to the calculations derived from the SAMMEC model, Iran is burdened with an astonishing economic cost due to the high prevalence of smokers. It is concluded that an awareness of this condition enables OFAC to award licenses to Big Tobacco without fear of undermining current foreign policy initiatives.     

The relative irrelevance of human rights for the care and protection of the mentally ill

This paper argues that the approach adopted by the recent Report of the National Inquiry into the Human Rights of People with Mental Illness of seeking to protect the interests of the mentally ill by following a human rights model is fundamentally flawed. The application of human rights to the care and protection of the mentally ill is at best irrelevant and at worst actually harmful to their best interests. Human rights are incapable of addressing the personal experience of mental illness and are similarly incapable of addressing the social and political issues that confront the mentally ill.     

Post-war smoking policy in the UK and the redefinition of public health

Current analyses of UK smoking policy within two frameworks--the 'heroes and villains' view of journalist accounts and a political science emphasis on rival 'producer' and 'issue' networks in policy making. It is often assumed that the US experience provides a universal historical model. This paper sees smoking policy in the UK as a case study in the relationship between 'scientific fact creation' and policy, which has also been emblematic of wider changes in public health ideology. The issue of smoking and lung cancer symbolized the post-war shift from infectious to chronic disease and the rise of a new 'lifestyle'-oriented public health. In the 1980s passive smoking brought a revival of environmentalism; in the 1990s the rediscovered concept of addiction symbolized developments in public health in which curative and preventive initiatives were entwined. Despite the rise of a militant 'healthism' within both anti-smoking and public health since the 1970s, British policy retained a dual focus, an emphasis on risk reduction as well as risk elimination in which policy networks were entwined rather than distinct. Some public health scientists worked in policy milieux, notably the expert committee, which crossed this apparent divide and which linked with industry. Connections between government and industry changed as public health 'treatment' brought the pharmaceutical industry into the picture.     

Housing Policy for Persons With Severe Mental Illness

Homelessness among persons with severe mental illness is a visible manifestation of deeply flawed public policies. This article critically assesses research to date on housing and related policies for the homeless mentally ill and recommends that future research target three strategic areas: (i) housing subsidies; (ii) landlord reluctance to rent to persons with mental illness, thereby solving one of their major problems in accessing housing; and (iii) appropriate housing and service mix for this heterogeneous population; that is, answering the longstanding threshold policy question of what housing and service mixes work best and for whom.     

Evidence of early tobacco in Northeastern North America?

While tobacco use was a widespread and important social practice among Native Americans during the Historic Period, the prehistoric origins of the practice are poorly understood. Smoking pipes significantly predate botanical evidence of tobacco in Eastern North America. A promising technique for addressing this problem is gas chromatography/mass spectroscopy (GC/MS) analysis to identify nicotine or related compounds in smoking pipe residues. GC/MS analysis of a smoking pipe dating to approximately 300 B.C. from the Boucher Site, a Middlesex-complex site from Vermont, has produced evidence of nicotine decay products. This is interpreted as evidence for an Early Woodland Period origin for tobacco use in Eastern North America. The cultural and chronological implications of this finding are discussed.     

The scientific commons in the marketplace: the industrialization of biomedical materials at the New England Enzyme Center, 1963–1980

This paper investigates the industrialization of biomedical materials at the New England Enzyme Center (NEEC) from its establishment as a federally supported biochemical resource center in 1964 through its demise and refashioning into several commercial biotech companies in the late 1970s. It sets this history within the long‐standing debate on the proper relation between science and American economic and political traditions. The NEEC sought to embody two aims that stood in tension: academic independence in knowledge production and the market‐driven interests of the biomedical industry. A clash of values ensued, but built on a particular notion of independence: scientists pragmatically accepted the primacy of the market in the age of the ‘federal research economy.’ The question became how to carve out a space for science and scientific values in the market – an intellectual position that some legal and economic scholars have referred to as a scientific commons. Even so, industry executives came to see the idea of a scientific commons and public knowledge as obstructive to industrial innovation. This paper argues that, as seen through the case of the NEEC, the ascendancy of market values and attitudes in the 1970s played a critical role in reconfiguring the science‐industry relationship and in ‘industrializing’ the life sciences. As illustration of this change, I look at a commercial firm – Genzyme – born out of NEEC’s dissolution.     

Punctuated Equilibrium in Limbo: The Tobacco Lobby and U.S. State Policymaking from 1990 to 2003

Since the mid-1980s, U.S. tobacco policy has been an intense and acrimonious issue between antitobacco advocates and the tobacco industry. In the United States, the tobacco industry has responded to heightened state antitobacco litigation, adverse public opinion, and public health advocacy by aggressively mobilizing against tobacco taxes and regulations. This article examines whether these tobacco policy trends can be generalized to punctuated equilibrium theory ideas that policy monopolies are stable over long periods and usually change because of sharp and short-term exogenous shocks to the policy system. From 1990 to 2003, there was a sharp mobilization by health advocates in all states and a significant rise in new legislation to control tobacco use. The tobacco industry, nevertheless, was able to generally keep state tobacco taxes low and counter significant regulatory threats to tobacco sales. From this, I conclude that the policy monopoly favoring the tobacco industry did not significantly change, despite the symbolic appearance of punctuation in the policy system.     

Broca and Charcot’s Research on Jacques Inaudi:The Psychological and Anthropological Study of a Mental Calculator

In the nineteenth century, French scientific institutions became interested in young “mental calculators,” arithmetical prodigies able to quickly and accurately perform complex mental calculations. The first scientists to study mental calculators were phrenologists who sought to prove the existence of a calculating organ in the frontal lobe. Paul Broca introduced one such mental calculator, Jacques Inaudi, to the Anthropological Society of Paris in 1880. Broca attributed extraordinary faculty for mental calculation to memory functioning (the psychological hypothesis) rather than physiological difference (the phrenological hypothesis). In 1892, prominent French Academy of Sciences member Jean-Martin Charcot produced a noteworthy study of Inaudi on the organization’s behalf. Charcot observed that Inaudi called upon auditory memory rather than visual memory in his mental calculations, unlike most mental calculators who preceded him. Like Broca, Charcot was skeptical of the phrenological hypothesis, though he noted that Inaudi’s skull was markedly plagiocephalic. Interestingly, anthropological examination of Inaudi is consistent with the themes of modern cognitive neuroscience. Thus, Charcot seems to have anticipated present research on the localization of mental calculation and memory for numbers.     

SEEING SPATIAL STRUCTURES: ON THE ROLE OF VISUAL MATERIAL IN THE MAKING OF THE EARLY QUANTITATIVE REVOLUTION IN GEOGRAPHY

This article examines the role that visual material played in the early years of the quantitative revolution in Anglophone geography. It is part of a larger project that attempts to write a history of geography's scopic regimes in the twentieth century and draws on post‐positivist approaches to the history of science. It is argued that there are a number of strategic as well as theoretical reasons for such a reliance on images in the quantitative revolution. Some reasons are unique to the quantitative revolution in geography, some resemble a more general way in which paradigm shifts take place in science and some are located outside of academia. This article is primarily interested in the internal view on the geography of the quantitative revolution and its rationalities. The paper departs from Christaller's hexagon, as one of the most influential and iconic. It then broadens the view to include a much wider range of visual material, arguing for some more general observations on the use of images in geography during the early quantitative revolution. It is argued that there was a significant shift of forms and functions of visual material. Overall, it is argued, visual material gained in importance and while geography was getting “thinner” and more abstract, its role in making visual arguments became stronger. From being merely an aid for seeing, visual material became a prime carrier of knowledge.     

African immigrant women’s transition and integration into Canadian society: expectations,stressors, and tensions

This article contributes to an emergent body of research that explores African immigrant women’s experiences in Western destination countries. Foregrounding these immigrant women’s voices in this research, we aim to better understand the challenges they grapple with as newcomers to Canada. Specifically, our study sought to explore the stressors they faced within and outside the family and how these stressors mediate their transition and integration into Canadian society. We conducted, audio-recorded, transcribed verbatim, and thematically analyzed two focus groups with twenty African immigrant women in Alberta, a Western province among Canada’s ten provinces. Three main themes emerged from our study: (1) Participants felt ill prepared to face the challenges of starting life anew in Canada, which included in particular navigating changes in economic wellbeing and gender roles; (2) Participants experienced a lack of community support, which was reflected in both mental/emotional health and parenting issues; and (3) Participants expressed frustration with the manner in which Canadian socio-legal systems manage immigrants’ family issues. Our findings underscore the need to actively engage African immigrant women and men in the development of policies and practices that mediate their everyday lives in Canada. Such policies and practices should consider the changing gender relations, cultural knowledge, and informal support channels within African immigrant communities.     

An overview of women's health in the U.S. since the mid-1960 s

Women's health became intertwined with the second wave of feminism in the 1960s. The process and history of the interactions among physicians, feminists, health care consumers, activists, and politicians have brought women's health into the foreground of health research and curricular agendas in several ways. It identified major gaps in research and practice and initiated a critique of the current health care system at all levels; it originated from, and remains connected with, the non-medical community; it is interdisciplinary and requires interdisciplinary teams for research and clinical practice, as well as collaboration with colleagues in non-medical academic fields; it developed new curriculum focused on women's health; it emphasizes race, class, sexual orientation, and other diversities among women. The continuing presence of activists and feminist scholars will insure that health and science include women's needs to provide better health for all.     

A Note on the Results of Recent Excavations at Camber Castle,Sussex

Abstract

A significant number of clay tobacco pipes in the style of the Ottoman ‘chibouk’ can be found in museums and private collections on the islands of Malta and Gozo. Indeed the smoking of these pipes remains a folk memory with the majority of senior citizens. It became obvious that very few of these artefacts were made locally and that the Maltese, being at the geographical centre of Mediterranean culture, might have received their imports from anywhere.

In 19th-century Tunisia (Malta’s nearest North African neighbour) three-quarters of the European population were Maltese migrants. Therefore, this study set out to discover whether Tunisia was a source of supply.

In Tunis it became obvious that although clay tobacco pipes had turned up in local excavations, little attention had been paid to them and a fuller examination was welcomed. A by-product of this examination was to establish a locally made Tunis pipe, although little evidence was found for trade to Malta in that particular commodity.     

Enforcing ‘Progress’: A Story of an MDG 5 Indicator and Maternal Health in Malawi

Considering the importance of metrics in current systems of global health accountability, this article analyses the dynamics behind a maternal health indicator. To achieve the target of Millennium Development Goal 5 (MDG 5) and increase the proportion of births attended by ‘skilled health personnel’, some districts in Malawi in 2010 introduced information campaigns to promote births in hospitals and a fine to punish mothers who delivered outside of biomedical health institutions. The study is based on ethnographic research in one Malawian village. While many mothers described the ill treatment and bad conditions in maternity wards, most women still started to publicly sanction institutional births. This apparent contradiction can be understood by looking at the positions and motivations of the various actors who participated in the performance of MDG 5 in the village and how their projects became tied to the focus on improving the indicator. Rather than expressing a demand for the existing maternal health services as such, the ethnography suggests that the actors’ practices expressed hopes and claims to wider material improvements in a context of inequality. The article highlights dynamics that are concealed if we restrict the analysis to one of biopower, and expands the purview of the study of metrics into the spaces which indicators are intended to represent.     

The reinvention of the SLAC National Accelerator Laboratory, 1992–2012

This article examines the most recent history of the SLAC National Accelerator Laboratory, with particular emphasis on how this laboratory shifted its research program from accelerator-based particle physics towards astroparticle physics, cosmology and multi-disciplinary photon science. Photon science became the central experimental research program through a series of changes in the organisational, scientific, and infrastructural set-up and in its science policy context. The article shows that SLAC’s reinvention unfolded in a science policy context in which funding priorities drifted towards the materials sciences and the life sciences at the expense of nuclear and particle physics, which had dominated science budgets during the Cold War. SLAC took a lead position in this global development by partly dismantling and also redeploying scientific and technical capabilities from its particle physics program for these new fields, thus, providing novel experimental facilities for user communities to expand across academia and industry.     

Building the nation of the future,one waiting room at a time: hospital murals in the making of modern Mexico

Abstract

Mid-twentieth century Mexican hospitals – the buildings themselves and their interior and exterior walls – became stages that depicted national hopes and aspirations. Hospitals and clinics became ideal spaces that married science and medicine with the state’s version of a triumphant social revolution. Visitors and patients to hospital waiting rooms, lobbies and auditoriums would see, indeed be surrounded by, depictions of the complicated hopes placed on science and medicine as interpreted by politicians, architects, and artists. Hospital walls became contested spaces where art depicted Mexico’s embrace of modern technology and medical practices while also showcasing, in vivid color, citizens challenging the government’s broken revolutionary promises, especially the right of all to health and social security.     

Engineering Education in Cold War Diplomacy: India,Germany, and the Establishment of IIT Madras**

The Indian Institute of Technology Madras (IIT) was set up with assistance of the Federal Republic of Germany between 1956 and 1974. It became the largest, and finally, a successful techno-scientific education project undertaken by the Federal Republic outside of Germany. In this paper, I argue that the engagement of the Federal Republic at IIT Madras has to be understood primarily as a project of Cold-War science and technology diplomacy, which on the German side was aimed at preventing an Indian recognition of the German Democratic Republic as a sovereign nation. In aiding the establishment of IIT Madras, the Federal Republic came into direct competition with the Soviet Union, which supported IIT Bombay but also with the United States of America, which supported IIT Kanpur. The assistance to establish IIT Madras and its governance followed mainly political guidelines, to which educational and scientific aspects were rendered subordinate. When the project was in a crisis after the first State Treaty to establish IIT Madras expired in 1963, the political flagship project of the Federal Republic was not allowed to fail. Instead, the cooperation was reorganized and support increased.     

Enlightenment and reform: an overview of culture and politics in Enlightenment Italy

This essay analyses the influence of the work of Franco Venturi on Italian studies of the eighteenth century over the last fifty years. Venturi's ‘model’ has certainly been of fundamental importance in stimulating new research on the connections between Enlightenment and reform in the eighteenth-century Italian states and is still an essential point of reference for all research in the field. But the direction of eighteenth-century studies in Italy has been shaped also by the contributions of many other scholars. Starting in the 1970s Italian historians became increasingly interested in new questions that were being posed by historians in France and Britain, which contributed to a more general shift away from the biographical focus on individuals characteristic of much of Venturi's work in favour of more collective topics, new types of sources and new ways of interpreting them. This article describes the different themes around which relations between culture and politics in eighteenth-century Italy have been studied, from civil, military and ecclesiastical institutions to the administrative and reform elites, the world of salons and sociability, publishing, religious beliefs, gender differences and science.     

Student activism, mental health, and English-Canadian universities in the 1960s

Student mental health services were created at many American universities during the interwar years in association with the mental hygiene movement of that era. In Canada, psychologists and psychiatrists became focused on the well-being of schoolchildren during this period, but services for university students were minimal or non-existent at most institutions until well after the Second World War. Influenced by American trends and in tune with rising public concern over the problems students were experiencing on Canada's burgeoning campuses, student organizations, in co-operation with the Canadian Mental Health Association, began a concerted campaign for improved services in the early 1960s. Through conferences, seminars, and surveys, they revealed the extent of student distress, and by 1965 their efforts were attracting increasing media attention and having a direct impact on university student health policies. Their campaign then entered a new phase, transformed by the same radicalization that infused the wider student movement in the wake of the Berkeley free speech protests. Dissatisfied with the institutional response and distrustful of the motives behind the services now provided, activists questioned the very meaning of 'mental health' in the context of their deeper critique of the university and society. By the end of the decade, the student mental health movement had run its course, but it left a lasting legacy in the ongoing reform of university health services and in attitudes towards student mental health.