Search

This paper is about the clinical principle of informed choice-the hallmark feature of the midwifery model of care in Ontario, Canada. Drawing on ethnographic history interviews with midwives, I trace the origins of the idea of informed choice to its roots in the social movement of midwifery in North America in the late 1960s and 1970s. At that time informed choice was not the distinctive feature of midwifery but was deeply embedded what I call midwifery's feminist experiment in care. But as midwifery in Ontario transitioned from a social movement to a full profession within the formal health care system, informed choice was strategically foregrounded in order to make the midwifery model of care legible and acceptable to a skeptical medical profession, conservative law makers, and a mainstream clientele. As mainstream biomedicine now takes up the rhetoric of patient empowerment and informed choice, this paper is at once a nuanced history of the making of the concept and also a critique of the ascendant 'regime of choice' in contemporary health care, inspired by the reflections of the midwives in my study for whom choice is impossible without care. [ABSTRACT FROM AUTHOR]

In 1823, the Ontario House, a hotel and tavern, was built near Niagara Falls, Canada. In addition to providing a location for travelers and tourists to drink and lodge, Ontario House, like many other establishments, billeted soldiers when the need arose. The 2012 excavation of the midden and features of the Ontario House produced a large assemblage of artifacts including ceramics, buttons, numismatics, and military accoutrements. Of particular interest is an East Indian coin, found in the natural topsoil, which can be associated with the 67th Regiment of Foot's brief occupation of Ontario House in 1841. This paper addresses the significance of this coin and associated finds in regards to the global movement of the regiment and the socio-political context of Ontario House within regional history. [ABSTRACT FROM AUTHOR]

Self-organized regularities in terms of patient arrivals and wait times have been discovered in real-world healthcare services. What remains to be a challenge is how to characterize those regularities by taking into account the underlying patients' or hospitals' behaviors with respect to various impact factors. This paper presents a case study to address such a challenge. Specifically, it models and simulates the cardiac surgery services in Ontario, Canada, based on the methodology of Autonomy-Oriented Computing (AOC). The developed AOC-based cardiac surgery service model (AOC-CSS model) pays a special attention to how individuals' (e.g., patients and hospitals) behaviors and interactions with respect to some key factors (i.e., geographic accessibility to services, hospital resourcefulness, and wait times) affect the dynamics and relevant patterns of patient arrivals and wait times. By experimenting with the AOC-CSS model, we observe that certain regularities in patient arrivals and wait times emerge from the simulation, which are similar to those discovered from the real world. It reveals that patients' hospital-selection behaviors, hospitals' service-adjustment behaviors, and their interactions via wait times may potentially account for the self-organized regularities of wait times in cardiac surgery services. [ABSTRACT FROM AUTHOR]