Help Wanted, Experience Preferred, Stamina a Must: A Narrative Review of the Contextual Factors Influencing Nursing Recruitment and Retention in Rural and Remote Western Canada from the Early Twentieth Century to 2023

Rural and remote communities of Western Canada have struggled to recruit and retain nursing professionals since the turn of the twentieth century. Existing literature has identified the unique challenges of rural nursing due to the shifting context of rural and remote nursing practice. The objective of this narrative review is to explore the history of rural and remote nursing to better understand the contextual influences shaping rural nursing shortages in Western Canada. This narrative review compared 27 sources of scholarly and historical evidence on the nature of rural nursing practices and recruitment and retention methods following the First World War until 2023. The findings suggest that the complex nature of rural nursing practice is a consistent challenge that has intersected with the long-standing power inequities that are inherent in rural marginalization, political influences, the nursing profession, social structures, and organizational design, to perpetuate rural nursing shortages throughout the past century. Integration and collaboration are needed to reduce systemic marginalization and develop effective and sustainable solutions to reduce nursing shortages in rural and remote areas of Western Canada.

[Practicing without a diploma, battling for a license: crossroads in the history of the professionalization of dentistry in Colombia]

This paper addresses the professionalization of dentistry in Colombia during the first half of the twentieth century. To fully comprehend such a process, we must consider the tensions between the practice of non-certified and certified dentistry. As an outcome of such tensions, dentists began to acquire professional autonomy. We analyze applications for license files to practice dentistry without a degree, some of which were of women. The findings show the informal transfer of knowledge outside formal apprenticeship and the unrestricted practice of dentistry by many non-professionals but "permitted" dentists who faced a centralized and powerful professional bureaucracy.

Introduction: Healthcare Practitioners' Emotions and the Politics of Well-Being in Twentieth Century Anglo-America

From the stress of burnout to the gratification of camaraderie, medicine is suffused with emotions that educators, administrators, and reformers have sought to shape. Yet historians of medicine have only begun to analyze how emotions have structured health care work. This introductory essay frames a special issue on health care practitioners' emotions in the twentieth-century United Kingdom and United States. We argue that the massive bureaucratic and scientific changes in medicine after the Second World War helped to reshape affective aspects of care. The articles in this issue emphasize the intersubjectivity of feelings in healthcare settings and the mutually constitutive relationship between patients' and providers' emotions. Bridging the history of medicine with the history of emotion demonstrates how emotions are instilled rather than innate, social as well as personal, and, above all else, change over time. The articles reckon with the power dynamics of healthcare. They address the policies and practices that institutions, organizations, and governments have implemented to shape, govern, or manage the affective experiences and well-being of healthcare workers. And they point to important new directions in the history of medicine.

Ways of knowing the health of livestock populations: the age of surveys, 1928-65

This article advances historical understandings of health, veterinary medicine and livestock agriculture by examining how, in mid-twentieth-century Britain, the diseases of livestock were made collectively knowable. During this period, the state extended its gaze beyond a few, highly impactful notifiable diseases to a host of other threats to livestock health. The prime mechanism through which this was achieved was the disease survey. Paralleling wider developments in survey practices, it grew from small interwar beginnings into a hugely expensive, wide-ranging state veterinary project that created a new conception of the nation's livestock as a geographical aggregation of animals in varying states of health. This article traces the disease survey's entanglements with dairy cows, farming practices, veterinary professional politics and government agendas. It shows that far from a neutral reflection of reality, surveys both represented and perpetuated specific versions of dairy cow health, varieties of farming practice and visions of the veterinary professional role. At first, their findings proved influential, but over time they found it harder to discipline their increasingly complex human, animal and disease subjects, resulting in unconvincing representations of reality that led ultimately to their marginalization.

The complex life course of mobility: Quantitative description of 300,000 residential moves in 1850-1950 Netherlands

Mobility is a major mechanism of human adaptation, both in the deep past and in the present. Decades of research in the human evolutionary sciences have elucidated how much, how and when individuals and groups move in response to their ecology. Prior research has focused on small-scale subsistence societies, often in marginal environments and yielding small samples. Yet adaptive movement is commonplace across human societies, providing an opportunity to study human mobility more broadly. We provide a detailed, life-course structured demonstration, describing the residential mobility system of a historical population living between 1850 and 1950 in the industrialising Netherlands. We focus on how moves are patterned over the lifespan, attending to individual variation and stratifying our analyses by gender. We conclude that this population was not stationary: the median total moves in a lifetime were 10, with a wide range of variation and an uneven distribution over the life course. Mobility peaks in early adulthood (age 20-30) in this population, and this peak is consistent in all the studied cohorts, and both genders. Mobile populations in sedentary settlements provide a productive avenue for research on adaptive mobility and its relationship to human life history, and historical databases are useful for addressing evolutionarily motivated questions.

Self-help for learned journals: Scientific societies and the commerce of publishing in the 1950s

In the decades after the Second World War, learned society publishers struggled to cope with the expanding output of scientific research and the increased involvement of commercial publishers in the business of publishing research journals. Could learned society journals survive economically in the postwar world, against this competition? Or was the emergence of a sales-based commercial model of publishing - in contrast to the traditional model of subsidized journal publishing - an opportunity to transform the often-fragile finances of learned societies? But there was also an existential threat: if commercial firms could successfully publish scientific journals, were learned society publishers no longer needed? This paper investigates how British learned society publishers adjusted to the new economic realities of the postwar world, through an investigation of the activities organized by the Royal Society of London and the Nuffield Foundation, culminating in the 1963 report Self-Help for Learned Journals. It reveals the postwar decades as the time when scientific research became something to be commodified and sold to libraries, rather than circulated as part of a scholarly mission. It will be essential reading for all those campaigning to transition academic publishing - including learned society publishing - away from the sales-based model once again.

Eugène-Louis Doyen and his Atlas d'Anatomie Topographique (1911): Sensationalism and gruesome theater

French surgeon and anatomist Eugène-Louis Doyen (1859-1916) was a focus of controversy and scandal throughout his career, an innovative surgeon of great technical skill whose unsurpassed abilities were offset by narcissistic and frequently unethical behavior. Doyen produced the most controversial atlas of human anatomy of the early-twentieth century, his Atlas d'Anatomie Topographique. He used a chemical process to fix whole cadavers, then used a motorized band saw with a sliding table to precisely cut sequential slices in all three anatomic planes. His intentionally arresting images of the nervous system in situ (using heliotypes in his atlas and projected images of prepared specimens in his lectures) made for gruesome theater, directed more at the public than the medical profession, which Doyen disdained and delighted in antagonizing. Although photography and photomechanical reproduction facilitated the rapid production of Doyen's atlas, many of the fine details were lost. In addition, although he developed tissue fixation techniques that preserved the natural colors of tissues, this was not evident in the monochrome images of the printed atlas. Doyen's atlas is compared with other anatomic atlases of the late-nineteenth century that included serial sections of the central nervous system, either from sections of entire cadavers, the isolated head, or the excised brain. In retrospect, Doyen's fevered activity, including his efforts to depict the topographic anatomy of the nervous system, produced only modest benefits, and often produced significant costs for his patients, his colleagues, the medical profession, and his own reputation.

Nineteenth- and twentieth-century brain maps relating to locations and constructions of brain functions

This article is an outline of the transition in "brain maps" used to illustrate locations of cortical "centers" associated with movements, sensations, and language beginning with images from Gall and Spurzheim in the nineteenth century through those of functional magnetic resonance imaging in the twenty-first century. During the intervening years, new approaches required new brain maps to illustrate them, and brain maps helped to objectify and naturalize mental processes. One approach, electrical stimulation of the cerebral cortex-exemplified by Fritsch and Hitzig in 1870, Ferrier in 1873, and Penfield by 1937-required brain maps showing functional centers with expanded and overlapping boundaries. In another approach, brain maps that linked cortical centers to account for the complex syndromes of aphasia, apraxia, alexia, and agraphia were initially constructed by Baginsky in 1871, Wernicke in 1874, and Lichtheim in 1885, then later by Lissauer in 1890, Dejerine in 1892, and Liepmann in 1920, and eventually by Geschwind in 1965 and others through the late twentieth century. Over that intervening time, brain maps changed from illustrations of points on the cerebral cortex where movements and sensations were elicited to illustrations of areas (centers) associated with recognizable functions to illustrations of connections between those areas that account for complex symptoms occurring in clinical patients. By the end of this period, advancements in physics, mathematics, and cognitive science resulted in inventions that allowed brain maps of cortical locations derived from cognitive manipulations rather than from the usual electrical or ablative manipulations. "Mental" dependent variables became "cognitive" independent variables.

The Social and Emotional World of Twentieth-Century Anglo-American Surgery: The James IV Association of Surgeons

Founded in 1957 by a group of elite British and American surgeons, the James IV Association of Surgeons is an international organization that "promotes communication among surgeons across the globe." Every year since 1961, the association has funded trips for several "surgical travellers" to encourage "exchange and camaraderie between surgical communities." This article uses the association's archive to explore the social lives, professional identities, and affective experiences of the men and women who populated the "surgical world" of Britain and North America in the mid-twentieth century. Integrating the social history of medicine with emotions history, I argue that the social lives of surgeons were crucial to the development and maintenance of their professional identities and communities by assisting in the definition of what it meant to be a surgeon. This definition was structured not just by surgical skill but by the forms of sociability available to potential participants.

Sex ratios and gender discrimination in Modern Greece

This paper argues that son preference resulted in gender-based discriminatory practices that unduly increased mortality rates for females at birth and throughout infancy and childhood in nineteenth- and early-twentieth-century Greece. The relative numbers of boys and girls at birth was extremely high and under-registration of females cannot on its own explain this result. The infanticide and/or mortal neglect of infant girls was therefore more common than previously acknowledged. Likewise, sex ratios increased as children grew older, thus suggesting that parents continued to treat boys and girls differently throughout childhood. A large body of qualitative evidence (contemporary accounts, folklore traditions, feminist newspapers, and anthropological studies) further supports the conclusion that girls were neglected due to their inferior status in society.

The Neurological Study Unit: "A Combined Attack on a Single Problem from Many Angles"

In the 1920s, neurology was a fledgling discipline. Various attempts were made to establish programs relating to neurological care and research. One such initiative was the Neurological Study Unit (NSU) at the Yale School of Medicine. My aim is to chronicle the early years of the NSU (1924-40): the motivations for establishing the unit, its structure, its challenges, and its evolution. I have studied all documents related to the NSU at Manuscripts & Archives, Yale University Library. The NSU was heralded as a "combined attack on a single problem from many angles." It was slow to develop, however, and had a number of missing elements. While some of this may have been due to a lack of funds and the absence of a dedicated neurologist, it was also the result of a failure to conceptualize a neurological unit, the slow evolution-into-existence of a nascent and fledgling medical discipline, growing pains and frictions within the leadership, a university-based rather than a hospital-based model of operation, and turf wars between neurology and allied disciplines.

The Sherrington-Cushing connection: A bench to bedside collaboration at the dawn of the twentieth century

British physiologist Charles Sherrington (1857-1952) and American neurosurgeon Harvey Cushing (1869-1939) were seminal figures in the history of neuroscience. The two came from different worlds, one laboratory-based and the other largely clinical. Their scientific intersection, beginning in July 1901, provides a glimpse into a nascent form of "bench to bedside" collaboration, which carried with it the potential to extend the arm of neurophysiological experimentation from Sherrington's laboratory to Cushing's operatory. I reviewed extensive primary source materials archived at Yale University School of Medicine Library. Sherrington viewed Cushing's bedside work as an opportunity, in humans, to extend his bench-side physiological observations on higher primates, at times almost directing Cushing in the clinic. Cushing would indeed take Sherrington's observations on apes and extend them to his patients, and the work would eventually overturn the prevailing notion that the motor and sensory cortex were intermixed across the Rolandic fissure.

Culture and psychism: the ethnopsychoanalysis of Georges Devereux

This paper introduces the significant theoretical contribution of Georges Devereux (1908-85) on the relationship between culture and psychism, which he developed in his work at the interface of anthropology, psychoanalysis and quantum epistemology during the mid-twentieth century. Devereux was one of the key early contributors to the field of transcultural psychiatry; he was in touch with its most important exponents, although he remained critical of many of the popular trends developed in this field of research in the USA, where Devereux conducted most of his research between 1932 and 1963. As a part of his critique, he founded a new epistemology: ethnopsychoanalysis, which was largely based on the concept of complementarity and countertransference.

Evaluating the Aboriginal child's mind: assimilation and cross-cultural psychology in Australia

This article examines two psychological interventions with Australian Aboriginal children in the late 1960s and early 1970s. The first involved evaluating the cognitive maturation of Aboriginal adolescents using a series of Piagetian interviews. The second, a more extensive educational intervention, used a variety of quantitative tests to measure and intervene in the intellectual performance of Aboriginal preschoolers. In both of these interventions the viability of the psychological instruments in the cross-cultural encounter created ongoing ambiguity as to the value of the research outcomes. Ultimately, the resolution of this ambiguity in favour of notions of Aboriginal 'cultural deprivation' reflected the broader political context of debates over Aboriginal self-governance during this period.

Health and hierarchy: soldiers, civilians and mental healthcare in Scotland, 1914-34

During the First World War injured servicemen were constructed as a better class of patient than civilians, and their care was prioritized in social and political discourses. For the mentally disordered servicemen themselves, however, these distinctions were permeable and transient. This article will challenge the reality of the 'privileged' service patient in civil asylums in Scotland. By examining the impact of the war on asylum structures, economies and patient health, this study will explore exactly which patients were valued in these difficult years. In so doing, this paper will also reveal how the lives of institutionalized ex-servicemen and the civilian insane inside district asylums were not quite as distinct as political and social groups would have liked.

The Sounds and Sights of Natural Childbirth: Films and Records in Antenatal Preparation Classes, 1950s-1980s

Film and sound recordings are a ubiquitous part of the antenatal preparation courses that serve as a rite of passage to parenthood in Western Europe and North America. This article analyses a sample of these didactic tools used in classes from the 1950s to the 1980s, the heyday of the natural childbirth movement. These audio-visual artefacts both reflected and conditioned expectations for women's behaviour during labour and birth through their representation of pain. They demonstrate changing norms in the role of the father, but show how physician authority-and male authority more broadly-remained largely unchallenged. Two phases are discernable in these sources. From the 1950s through the mid-1960s, natural childbirth was presented as essentially painless. From the late 1960s through the 1980s, pain and effort in labour and birth found graphic representation on the screen, reflecting a shift in what was considered a desirable birth experience and what natural childbirth preparation could accomplish.

Childbirth and Trauma, 1940s-1980s

This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history.

From mental hygiene to mental health: ideology, discourses and practices in Franco's Spain (1939-75)

Based on an analysis of the discourses, the ideological appropriation and the practical influence of mental hygiene in Spanish psychiatry during the early years of the Francoist regime, this article examines its decline and subsequent replacement by the new concept of mental health promoted by the World Health Organization and other international bodies from the mid-twentieth century. The old approach, essentially focused on the prophylaxis of insanity within the framework of a set of interventionist policies of social defence, was thus transformed from the beginning of the 1960s into a much more ambitious and comprehensive project which sought to promote the psychosocial balance and performance of individuals in the context of increasingly socialized health-related discourses and networks of care.

Henderson and Meyer in correspondence: a transatlantic history of dynamic psychiatry, 1908-29

Charting a transatlantic movement of so-called 'dynamic psychiatry' during the early twentieth century, this paper reads against the grain of established historiographies. Comparing biographical and autobiographical sources with contemporary correspondence, a history is told which considers the evolution of psychiatric knowledge and clinical practices 'from below'. Revealing a period and place when a 'dynamic' counter-culture challenged the established materialist views of Scottish psychiatry, the longevity of this challenge is considered in the concluding paragraphs.

From 'Nerve Fiber Regeneration' to 'Functional Changes' in the Human Brain-On the Paradigm-Shifting Work of the Experimental Physiologist Albrecht Bethe (1872-1954) in Frankfurt am Main

Until the beginning 1930's the traditional dogma that the human central nervous system (CNS) did not possess any abilities to adapt functionally to degenerative processes and external injuries loomed large in the field of the brain sciences (Hirnforschung). Cutting-edge neuroanatomists, such as the luminary Wilhelm Waldeyer (1836-1921) in Germany or the Nobel Prize laureate Santiago Ramón y Cajal (1852-1934) in Spain, debated any regenerative and thus "plastic" properties in the human brain. A renewed interest arose in the scientific community to investigate the pathologies and the healing processes in the human CNS after the return of the high number of brain injured war veterans from the fronts during and after the First World War (1914-1918). A leading research center in this area was the "Institute for the Scientific Study of the Effects of Brain Injuries," which the neurologist Ludwig Edinger (1855-1918) had founded shortly before the war. This article specifically deals with the physiological research on nerve fiber plasticity by Albrecht Bethe (1872-1954) at the respective institute of the University of Frankfurt am Main. Bethe conducted here his paradigmatic experimental studies on the pathophysiological and clinical phenomena of peripheral and CNS regeneration.

Objectifying "Pain" in the Modern Neurosciences: A Historical Account of the Visualization Technologies Used in the Development of an "Algesiogenic Pathology", 1850 to 2000

Particularly with the fundamental works of the Leipzig school of experimental psychophysiology (between the 1850s and 1880s), the modern neurosciences witnessed an increasing interest in attempts to objectify "pain" as a bodily signal and physiological value. This development has led to refined psychological test repertoires and new clinical measurement techniques, which became progressively paired with imaging approaches and sophisticated theories about neuropathological pain etiology. With the advent of electroencephalography since the middle of the 20th century, and through the use of brain stimulation technologies and modern neuroimaging, the chosen scientific route towards an ever more refined "objectification" of pain phenomena took firm root in Western medicine. This article provides a broad overview of landmark events and key imaging technologies, which represent the long developmental path of a field that could be called "algesiogenic pathology."

Was zählt der Preis? Dogmengeschichte und Wissensgeschichte der Ökonomie

What's in a Price? History of Economic Ideologies vs. History of Economic Ideas. This paper suggests applying the approach of a historical epistemology to the field of economics. We observe that an assumedly fundamental opposition between the market and the state dominates popular images of the history of economic ideas. Two conflicting ideologies are roughly assigned to the two opposing sides in the Cold War. To this historical narrative the paper opposes a different view. The argument is that when taking the technical practices of economic knowledge production in the twentieth century into view, similarities abound across ideological ruptures. The chief characteristic change in the recent history of economics was a radical turn towards quantification, measurement, and mathematical modelling. A historical epistemology of economics could show how deeply both, admirers of the state and of the market, share a history. The paper concludes that to-date critique of political economy should also take into consideration a critical perspective towards the unfolding of this measurement revolution in the social sciences.

Recapturing the history of surgical practice through simulation-based re-enactment

This paper introduces simulation-based re-enactment (SBR) as a novel method of documenting and studying the recent history of surgical practice. SBR aims to capture ways of surgical working that remain within living memory but have been superseded due to technical advances and changes in working patterns. Inspired by broader efforts in historical re-enactment and the use of simulation within surgical education, SBR seeks to overcome some of the weaknesses associated with text-based, surgeon-centred approaches to the history of surgery. The paper describes how we applied SBR to a previously common operation that is now rarely performed due to the introduction of keyhole surgery: open cholecystectomy or removal of the gall bladder. Key aspects of a 1980s operating theatre were recreated, and retired surgical teams (comprising surgeon, anaesthetist and theatre nurse) invited to re-enact, and educate surgical trainees in this procedure. Video recording, supplemented by pre- and post-re-enactment interviews, enabled the teams' conduct of this operation to be placed on the historical record. These recordings were then used to derive insights into the social and technical nature of surgical expertise, its distribution throughout the surgical team, and the members' tacit and frequently sub-conscious ways of working. While acknowledging some of the limitations of SBR, we argue that its utility to historians - as well as surgeons - merits its more extensive application.

Sir Peter Medawar: science, creativity and the popularization of Karl Popper

Sir Peter Medawar was respected by scientists and literati alike. It was perhaps not surprising, then, that he would choose to involve himself in the ‘two cultures’ debate of 1959 and beyond. The focus of his intervention was the philosophy of Sir Karl Popper. However, Medawar's Popper was not the guru of falsification familiar from philosophy textbooks. Medawar's distinctive interpretation of Popper treated him instead as the source of insights into the role of creativity and imagination in scientific inquiry. This paper traces the context for Medawar's adoption of Popperian philosophy, together with its application before the debate. It then examines, within the context of the debate itself, the way in which Medawar attempted to reconcile scientific inquiry with literary practice. Medawar became increasingly convinced that not only was induction epistemologically unsound, but it was also damaging to the public role of the scientist. His construction of Popperianism would, he envisaged, provide a worthy alternative for scientists’ self-image.

Early Controversies over Athetosis: I. Clinical Features, Differentiation from other Movement Disorders, Associated Conditions, and Pathology

BACKGROUND

Since the description of athetosis in 1871 by American neurologist William Alexander Hammond (1828-1900) the disorder has been a source of controversy, as were many aspects of Hammond's career.

METHODS

Primary sources have been used to review controversies in the 50-year period since the initial description of athetosis, in particular those concerning clinical features, differentiation from other movement disorders, associated conditions, and pathology. Controversies concerning treatment will be addressed in a subsequent article.

RESULTS

Hammond struggled to establish athetosis as a distinct clinical-pathological entity, and had successfully predicted the striatal pathology in his initial case (albeit somewhat serendipitously). Athetosis was, nevertheless, considered by many neurologists to be a form of post-hemiplegic chorea or part of a continuum between chorea and dystonia. European neurologists, and particularly the French, initially ignored or discounted the concept. Additional controversies arose over whether the movements persisted during sleep, whether athetosis was, or could be, associated with imbecility or insanity, and how it should be treated.

DISCUSSION

Some controversies concerning athetosis served to identify areas where knowledge was insufficient to make accurate statements, despite prior self-assured or even dogmatic statements to the contrary. Other controversies illustrated established prejudices, even if these biases were often only apparent with the greater detachment of hindsight.

Contagious rhythm: infectious diseases of 20th century musicians

Infectious diseases have led to illness and death for many famous musicians, from the classical period to the rock 'n' roll era. By the 20th century, as public health improved and orchestral composers began living more settled lives, infections among American and European musicians became less prominent. By mid-century, however, seminal jazz musicians famously pursued lifestyles characterized by drug and alcohol abuse. Among the consequences of this risky lifestyle were tuberculosis, syphilis, and chronic viral hepatitis. More contemporary rock musicians have experienced an epidemic of hepatitis C infection and HIV/AIDS related to intravenous drug use and promiscuity. Musical innovation is thus often accompanied by diseases of neglect and overindulgence, particularly infectious illnesses, although risky behavior and associated infectious illnesses tend to decrease as the style matures.

Epidemiology: A Science of Patterns

During the twentieth century disease detectives progressed by jagged leaps in understanding patterns of plant disease. With ladders, airplanes, and automatic traps they observed airborne spores, and with meteorological theory they explained takeoff, flight, and landing. They analyzed the grand, logistic rise of epidemics and the roles of horizontal versus vertical resistance. From early experiments on the details of life cycles and weather, they simulated epidemics with new computers. Early in the century they revealed genetic diversity with differential varieties and late in the century with differential fungicides and DNA. They learned the interplay of pest, photosynthesis, and supply and demand to reckon loss. Integrating observations of pest, host, losses, and weather, they placed winning short-term bets for farmer and environment on whether to spray. In the twenty-first century, their goal can be analyses so sound that the world can securely place winning long-term bets.