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Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting rich data from archives and 44 semi-structured interviews conducted between 2015 and 2018, we employ Multiple Streams Analysis to construct a complex and dynamic picture of how the idea of QALYs emerged and was adopted within UK health policy. Through its historical and political approach, the paper illuminates the relative roles in the policy-making process of experts (especially economists) and politicians as ‘entrepreneurs’ in the development of new ideas; how these were influenced by negotiation within established and emerging institutional structures; and the role of serendipity and crisis. [ABSTRACT FROM AUTHOR]

This paper explores the close links in medical understandings of miscarriage and abortion in the first half of the twentieth century in Britain. In the absence of a clear legal framework for abortion, and the secrecy surrounding the practice, medical literature suggests contradictory and confused views about women presenting with clinical signs of pregnancy loss. On one hand, there was a lack of clarity as to whether pregnancy loss was natural or induced, with a clear tendency to assume that symptoms of miscarriage were the result of criminal interference gone wrong. On the other hand, women who did not present for treatment when miscarriage was underway were accused of neglecting their unborn children. The paper suggests that discourses around pregnancy loss were class-based, distrustful of female patients, and shaped by the wider context of fertility decline and concerns about infant mortality. The close historical connection between miscarriage and abortion offers some insight into why both the pro-life movement and miscarriage support advocates today draw on similar imagery and rhetoric about early fetal loss. [ABSTRACT FROM AUTHOR]

This paper focuses on the structural development of institution-based interest in genetics in Anglo-North American medicine after 1930 concomitantly with an analysis of the changes through which ideas about heredity and the hereditary transmission of diseases in families have passed. It maintains that the unfolding relationship between medicine and genetics can best be understood against the background of the shift in emphasis in conceptualisations of recurring patterns of disease in families from ‘biological relatedness’ to ‘related to chromosomes and genes’. The paper begins with brief considerations of the historical confluences of, first, heredity and medicine and, second, genetics and medicine which, in a third section, leads to a discussion about a uniquely ‘genetics-based approach’ to medicine in the second half of the twentieth century. [Copyright &y& Elsevier]

Multidisciplinary public health (MDPH) has been a phenomenon in the UK of the 1990s and the early 21st century. Its achievement has been seen as a victory for non medical interests. While acknowledging this, the paper questions what sort of victory this represents. Public health in its sanitary phase in the mid-19th century was, after all, what passed for multidisciplinary with its mix of engineers, doctors and statisticians. Is the present simply a return to the sanitary phase? The paper argues that it is not, and that contemporary public health badly needs dearer definition. It identifies three dimensions of recent public health. Public health can be an occupation; a discourse or movement, and also an institutional location of which public health research is part. Looked at in this frame, public health has been multidisciplinary in the post war period. The development of public health research out of social medicine in the 1950s was multidisciplinary. Public health campaigning, separate from public health professionals, has also been multidisciplinary since the 1970s. Public health as an occupation has been preoccupied with its professional positioning. Will the wider multidisciplinary impetus of public health now be lost in a preoccupation with status? [ABSTRACT FROM AUTHOR]

Garden visiting is a popular activity in Great Britain. This paper identifies the historical antecedents and accompanying development of garden visiting as a form of tourism and recreation, focusing on the management of gardens open to the public in both time and space. Such an approach reveals that many gardens have been established for some considerable time and visiting is by no means a new pastime. The paper reports on a survey of garden owners in Great Britain and uses historical reconstructions to assess the theme of continuity and change in garden management and visiting through time. [ABSTRACT FROM AUTHOR]

Objectives: High levels of excess mortality (i.e. that not explained by deprivation) have been observed for Scotland compared with England & Wales, and especially for Glasgow in comparison with similar post-industrial cities such as Liverpool and Manchester. Many potential explanations have been suggested. Based on an assessment of these, the aim was to develop an understanding of the most likely underlying causes. Note that this paper distils a larger research report, with the aim of reaching wider audiences beyond Scotland, as the important lessons learnt are relevant to other populations. Study design: Review and dialectical synthesis of evidence. Methods: Forty hypotheses were examined, including those identified from a systematic review. The relevance of each was assessed by means of Bradford Hill's criteria for causality alongside--for hypotheses deemed causally linked to mortality--comparisons of exposures between Glasgow and Liverpool/Manchester, and between Scotland and the rest of Great Britain. Where gaps in the evidence base were identified, new research was undertaken. Causal chains of relevant hypotheses were created, each tested in terms of its ability to explain the many different aspects of excess mortality. The models were further tested with key informants from public health and other disciplines. Results: In Glasgow's case, the city was made more vulnerable to important socioeconomic (deprivation, deindustrialisation) and political (detrimental economic and social policies) exposures, resulting in worse outcomes. This vulnerability was generated by a series of historical factors, processes and decisions: the lagged effects of historical overcrowding; post-war regional policy including the socially selective relocation of population to outside the city; more detrimental processes of urban change which impacted on living conditions; and differences in local government responses to UK government policy in the 1980s which both impacted in negative terms in Glasgow and also conferred protective effects on comparator cities. Further resulting protective factors were identified (e.g. greater 'social capital' in Liverpool) which placed Glasgow at a further relative disadvantage. Other contributory factors were highlighted, including the inadequate measurement of deprivation. A similar 'explanatory model' resulted for Scotland as a whole. This included: the components of the Glasgow model, given their impact on nationally measured outcomes; inadequate measurement of deprivation; the lagged effects of deprivation (in particular higher levels of overcrowding historically); and additional key vulnerabilities. Conclusions: The work has helped to further understanding of the underlying causes of Glasgow's and Scotland's high levels of excess mortality. The implications for policy include the need to address three issues simultaneously: to protect against key exposures (e.g. poverty) which impact detrimentally across all parts of the UK; to address the existing consequences of Glasgow's and Scotland's vulnerability; and to mitigate against the effects of future vulnerabilities which are likely to emerge from policy responses to contemporary problems which fail sufficiently to consider and to prevent long-term, unintended social consequences. [ABSTRACT FROM AUTHOR]

No direct evidence documents exactly how Jane Seymour gave birth on October 12, 1537. Several later commentators have raised cesarean birth as an option. This paper tries to establish the probable cause of Jane Seymour's death in accordance with present-day knowledge of obstetrics and whether or not a cesarean section could have been actually performed in sixteenth-century England. It appears almost certainly that there were no obstetrical indications that would have led the Queen's physicians to operate on her, a surgeon was not present at her delivery, cesarean section on a living woman was not regularly performed in England in 1537, puerperium events do not support surgery, and the existing pro-cesarean confirmation was politically motivated. Therefore, the most likely mode of Jane Seymour's delivery was vaginal rather than cesarean. [ABSTRACT FROM AUTHOR]

This paper takes the biological drug human Growth Hormone (hGH) as a case study to investigate processes of pharmaceuticalisation and medicalisation in configuring childhood short stature as a site for pharmaceutical intervention. Human growth hormone is considered to have legitimate applications in treating childhood growth hormone deficiency and short stature associated with other recognised conditions. It is also regarded by bioethicists and others as a form of human biomedical enhancement when applied to children with idiopathic or ‘normal’ short stature. The purpose of this study is not to evaluate whether treatment of idiopathic short stature is enhancement or not, but to evaluate how some applications of hGH in treating short stature have come to be accepted and stabilised as legitimate ‘therapies’ while others remain contested as ‘enhancements’. A comparative, historical approach is employed, drawing on approaches from medical sociology and Science and Technology Studies (STS) to set out a socio-technical history of hGH in the US and UK. Through this history the relative influence and interplay of drivers of pharmaceuticalisation, including industry marketing and networks of drug distribution, and processes of medicalisation will be employed to address this question and simultaneously query the value of enhancement as a sociological concept. [ABSTRACT FROM AUTHOR]

Abstract: John Dee’s arrangements at his Mortlake house have received some attention as an English ‘academy’ or ‘experimental household.’ His ideas for St Cross, which he requested as a suitable living in 1592, have received less detailed attention. This paper examines Mortlake and his St Cross plans in detail and argues that, at their core, they shared an aspiration to create a national research institute. These plans are related to the context of Dee’s pursuit of royal patronage and his idea of the social and intellectual role of the natural philosopher. His ideas for a research institute are also placed in the context of alternatives to traditional sites of learning, including contemporary academies, princely courts, and independent establishments, indicating that Dee’s ideas, while part of a Renaissance vogue for such alternatives, were independent of other models. Discussion includes the historiographic debate regarding openness versus secrecy in the pursuit of natural knowledge. Finally, Dee’s ideas are contrasted with Francis Bacon’s proposal for a research institute, which also originated in the 1590s and culminated in ‘Solomon’s House.’ [Copyright &y& Elsevier]

Absent as a breeding bird from Britain for at least a century, avocets (Recurvirostra avosetta) began nesting on the east coast of Britain, in Suffolk, shortly after the end of the Second World War, having homed in on two spots on Britain’s coast that had been flooded for war-related reasons. The avocets’ presence was surrounded in secrecy, while a dedicated few kept up a protective watch over them. As the Royal Society for the Protection of Birds (RSPB) took over responsibility for the flourishing colony, they claimed the episode as a symbol of success for British protection, later making the bird their logo. Counter to the RSPB’s story of protecting a British bird, I read the narratives of events in terms of making a bird British. I show how, as postwar Britain slumped economically and spiritually and tried to rebuild itself, the birds became a vehicle for formulating national identity: of Britain as a home to which to return and belong. Exploring the themes of returning servicemen and closed territories, the paper also examines the episode in terms of the naturalisation of the military and the militarisation of nature. [Copyright &y& Elsevier]

Abstract: This paper describes the application of the principles of evidence based medicine to public health. It recounts the experience of the National Institute for Health and Clinical Excellence in England (NICE) which acquired a remit to develop public health guidance in 2005. Some of the history of the origins of the evidence based approach is described in the writings of Cochrane and others, and the way that this came to be a critical part of the NICE approach to developing clinical cost effectiveness is outlined. The challenge of applying these methods to an evidence base which is social and psychological as well as biomedical is considered. Key problems are identified: the breadth of the evidence base, different analytic levels of explanation, and the length of the causal chain between interventions and outcomes in public health. [ABSTRACT FROM AUTHOR]

: In 1441, Eleanor Cobham, duchess of Gloucester, was arrested, together with three associates: Margery Jourdemayne, the ‘Witch of Eye’, Roger Bolingbroke, Oxford cleric and astrologer, and Thomas Southwell, MB, canon of St. Stephen’s, Westminster. They were accused of plotting to kill King Henry VI by necromancy, but contemporary chronicles differed on the precise nature of their crime: had they summoned demons or cast an astrological chart? This paper explores the relationship between astrology and demonic magic, focusing on feelings, rites and apparatus, and perceptions that the more the practitioner’s body was implicated in the divinatory procedure, the more likely it was to be illicit. [Copyright &y& Elsevier]

Objectives: This paper presents an examination of distinct periods in the development of nursing in order to rediscover a history of nursing management in England. The overall purpose is to demonstrate that uncritical accounts written in the past have not adequately explained the complex factors that have shaped nursing management in England. It is also suggested that the approach taken may be usefully applied to other national contexts. Design: This is a review article which first establishes the value of historical perspectives in increasing understanding of nursing and then goes on to analyse the professional, social and political forces that contributed to the development of nursing management. Data sources: A range of historical and contemporary sources is accessed to support the review. Review methods: The review is informed by an historical approach which also seeks recourse to current literature to develop a critical narrative analysis which has an international dimension. Conclusions: The history of nursing management has been ‘lost’ in celebratory and uncritical accounts of nursing as a whole. The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management has a longer and more complex history than is generally accepted. [Copyright &y& Elsevier]

At least since the late nineteenth century, toy chemistry sets have featured in standard scripts of the achievement of eminence in science, and they remain important in constructions of scientific identity. Using a selection of these toys manufactured in Britain and the United States, and with particular reference to the two dominant American brands, Gilbert and Chemcraft, this paper suggests that early twentieth-century chemistry sets were rooted in overlapping Victorian traditions of entertainment magic and scientific recreations. As chemistry set marketing copy gradually reoriented towards emphasising scientific modernity, citizenship, discipline and educational value, pre-twentieth-century traditions were subsumed within domestic—and specifically masculine—tropes. These developments in branding strategies point to transformations in both users’ engagement with their chemistry sets and the role of scientific toys in domestic play. The chemistry set serves here as a useful tool for measuring cultural change and lay engagement with chemistry. [Copyright &y& Elsevier]

An unusual silver celestial planisphere is held in the collection of the Whipple Museum of the History of Science (Wh.1762); little information about this object is recorded in the museum’s documentation. A comparison of this silver example with celestial planispheres printed on paper, coupled with the consideration of other aspects of the lives and work of the cartographers and instrument-makers involved in producing such objects, suggests some possibilities regarding its production. Through this individual case study, I aim to demonstrate that the careful examination of an individual instrument, coupled with an understanding of the class of instruments to which it belongs and the milieu in which it was produced, can result in a deeper understanding of any given artefact, its circumstances of design and manufacture, and its intended use and users. [Copyright &y& Elsevier]

This paper presents a micro-history of an object in the collection of the Whipple Museum of the History of Science (accession no. Wh.3469), with an emphasis on how Wh.3469 reflects a hybrid of two different interwar British X-ray crystallographic communities, namely those based in WL Bragg’s physics laboratory at the Victoria University of Manchester and the Crystallographic Laboratory at the University of Cambridge. It explores connections between Wh.3469’s final design and construction and the different interests each community had in X-ray crystallography. [Copyright &y& Elsevier]

Summary The paper tracks the history of the School Medical Service over 150 years. The service has changed markedly during this period, with some cyclical recurrence of practice and policy. By 2006, the health of schoolchildren is of major concern, particularly the rise in nutrition-related problems including obesity: the demise of the School Health Service may welt be a matter for serious regret to future generations. [ABSTRACT FROM AUTHOR]

The Worldwide Hospice Palliative Care Alliance (WHPCA) is an international non-governmental organization registered as a charity in England and Wales that was established in 2008 following a series of international gatherings that highlighted the important need for palliative care to be included in global policy and health planning. The vision of the WHPCA is a world with universal access to hospice and palliative care. Its mission is to foster, promote and influence the delivery of affordable, quality palliative care. This article describes the evolution of the WHPCA and what it has been able to accomplish in the eight years since its formation. These accomplishments include effective advocacy with United Nations bodies, acceptance as a non-governmental organization in official relations with the World Health Organization and the UN Economic and Social Council, publication of many position papers on critical aspects of palliative care, publication of the Global Atlas of Palliative Care at the End of Life, development of toolkits for palliative care development, publication of the international edition of ehospice, and management of World Hospice and Palliative Care Day each year. Some of the many challenges to the growth and development of palliative care globally are described along with future plans. [ABSTRACT FROM AUTHOR]