37 research outputs found
Moments In Medicine #7: Midwifery is from Venus - Medicine is from Mars
No full textIf Henry VIII had hired better midwives would the course of history be changed? The evolution of midwifery and the tension between midwives and medical men are discussed by Jean Donnison, Historian of Social Policy and author, Lucy Reid, Head of Information Services at the Royal College of Obstetricians and Gynaecologists and Elizabeth Hurren, Medical Historian at Oxford Brookes University. The seventh in a series of History of Medicine podcasts from the Centre for Health, Medicine and Society: Past and Present
WS12: Maternal Care (06-Jun-2000)
No full textSelection of photos taken at the Witness Seminar “Maternal Care” held by the History of Twentieth Century Medicine Group, 06-Jun-2000. Participants: Mrs Janette Allotey, Miss Mary Anderson, Ms Beverley Beech, Sir Christopher Booth, Dr Michael Bull; Dr Sandy Cavenagh, Dr Iain Chalmers, Professor Geoffrey Chamberlain, Mrs Mary Cronk, Dr Ann Dally, Dr Jean Donnison, Professor James Drife (Chair), Dr Sheila Duncan, Professor Peter Dunn, Miss Friedericke Eben, Mrs Jane Evans, Ms Chloe Fisher, Mrs Caroline Flint, Dr Edmund Hey, Dr Peter Hunter, Mrs Rosemary Jenkins, Dr David Jewell, Dr Irvine Loudon, Ms Alison Macfarlane, Professor Allan Maclean, Dame Lorna Muirhead, Professor Lesley Page, Mr Roger Peel, Mr Elliot Philipp, Mr Richard Porter, Professor Jean Robinson, Mrs Wendy Savage, Dr Lindsay Smith, Dr Ian Tait, Dr Tilli Tansey, Mrs Vicky Tinsley, Dame Margaret Wheeler, Professor Charles Whitfield, and Dr Luke Zander.The History of Modern Biomedicine Research Group is funded by the Wellcome Trust, which is a registered charity (no. 210183). The creation and curation of the current photo collection has been funded by the Wellcome Trust Strategic Award entitled “Makers of modern biomedicine: testimonies and legacy” (2012-2017; awarded to Professor Tilli Tansey)
Jean Donnison, Midwives and Medical Men: A History of Inter-Professional Rivalries and Women’s Rights. New York, Schocken Books, 1977, VI, 250 pp., illus., (no price stated).
No full textBehind the medical mask : medical technology and medical power
No full textThis thesis explores the role of technology as a resource in the
structure of medical domination of birth and death, stressing
technology's pivotal position at the intersection of control and
uncertainty.
Based in Intensive Care and Obstetrics (between which the health status
of patients diverges sharply), it notes the convergence of technology
used and examines the contest for control within the labour process.
This includes using technology to facilitate a 'standardized' birth or
death; a more retrospectively defensible event. In general, the
'burden of proof' is concluded to lie with those wishing not to
intervene rather than the reverse.
Given the (cognitively male) biomedical model, mind-body dualism is an
assumption embedded in medical technology: this is especially
significant in childbirth, where it fractures the woman's ontological
experience of giving birth. Its positivistic and pathological
emphasis is associated with a reification of processes and a
commodification of their 'solution': which becomes located in
technology. It is argued that commodification in health provision will
increase with the further application of market principles to the NHS.
It is concluded that 'uncertainty', endemic to medicine and a possible
challenge to control, is proactively manipulated and pressed into the
service of medical domination. Technology is used to mask uncertainty
and aid the medical profession's control of patients/relatives, and
subordinate work groups.
A technological fix may be viewed as the opposite to re-discovering
societal dreams and myths, however, more paradoxically, it is concluded
that dreams and myths have become attached to technology. Thus, the
symbolic role of technology is: to provide hope of continued survival
(or cure), the veiling of existential uncertainty and the offer of
'absolution' - should all efforts fail (a freedom from guilt in the
assurance that "everything possible was tried"). Its 'heroic' project
is viewed as an existentially 'masculine' health provision and
'feminized' health care is posited as an alternative
Multimodal analgesia using intrathecal diamorphine, and paravertebral and rectus sheath catheters are as effective as thoracic epidural for analgesia post-open two-phase esophagectomy within an enhanced recovery program
No full text\ua9 The Author(s) 2018. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. Thoracic epidural (TE) analgesia has been the standard of care for transthoracic esophagectomy patients since the 1990s. Multimodal anesthesia using intrathecal diamorphine, local anesthetic infusion catheters (LAC) into the paravertebral space and rectus sheaths and intravenous opioid postoperatively represent an alternative option for postoperative analgesia. While TE can provide excellent pain control, it may inhibit early postoperative recovery by causing hypotension and reducing mobilization. The aim of this study is to determine whether multimodal analgesia with LAC was effective with respect to adequate pain management, and compare its impact on hypotension and mobility. Patients receiving multimodal LAC analgesia were matched using propensity score matching to patients undergoing two-phase trans-thoracic esophagectomy with a TE over a two-year period (from January 2015 to December 2016). Postoperative endpoints that had been evaluated prospectively, including pain scores on movement and at rest, inotrope or vasoconstrictor requirements, and hypotension (systolic BP < 90 mmHg), were compared between cohorts. Out of 14 patients (13 male) that received LAC were matched to a cohort of 14 patients on age, sex, and comorbidity. Mean and maximum pain scores at rest and movement on postoperative days 0 to 3 were equivalent between the groups. In both cohorts, 50% of patients had a pain score of more than 7 on at least one occasion. Fewer patients in the LAC group required vasoconstrictor infusion (LAC: 36% vs. TE: 57%, P = 0.256) to maintain blood pressure or had episodes of hypotension (LAC: 43% vs. TE: 79%, P = 0.05). The LAC group was more able to ambulate on the first postoperative day (LAC: 64% vs. TE: 43%, P = 0.14) but these differences were not statistically significant. Within the epidural cohort, three patients had interruption of epidural due to dislodgement or failure of block compared to no disruption in the multimodal local anesthesia catheters group (P = 0.05). Therefore, multimodal anesthesia using spinal diamorphine with combined paravertebral and rectus sheath local anesthetic catheters appears to provide comparable pain relief post two-phase esophagectomy and may provide more reliable and safe analgesia than the current standard of care
Characterisation of Miscanthus genetic resources: a combined analysis of plastid and nuclear microsatellites, nrDNA sequences, flow cytometry and morphology.
No full textDoctoral ThesisMiscanthus is a highly important forage and horticultural genus of perennial grasses
(Poaceae) primarily native to South East Asia. Miscanthus is under intense global
investigation as a biomass source for renewable energy production and several breeding initiatives are underway to develop new genotypes optimized for improved biomass and tolerance to a range of environmental stress conditions. A collection of 128 accessions belonging to the genus Miscanthus was established in Oak Park, Teagasc, Carlow, in 2008 and was investigated for morphological and molecular variation. Morphological traits were measured at the end of the second growing season and were compared with herbarium specimens of Miscanthus. Vegetative and inflorescence traits were scored and analysed using
basic summary statistics, tests of normality and Principal Components Analysis (PCA). A
large degree of morphological variation was recorded in the collections. The PCA of
herbarium specimens was able to separate some species from others but there was also
considerable overlap among species in the ordination, especially M. sacchariflorus, M.
sinensis, M. condensatus and M. floridulus. These are known to be closely related and can
interbreed. The PCA of the specimens from the Oak Park collection was less informative
because of missing data due to lack of inflorescences (accessions did not flower). It was clear that morphology alone is often insufficient to distinguish taxa especially when inflorescence characters and ploidy information is lacking. The ploidy level of the accessions in the collection was evaluated through flow cytometry.
The ploidy included di-, tri- and tetraploids. All individuals labelled as M. ×giganteus showed a triploid status, together with the newly bred M. sacchariflorus×M. sinensis hybrids.
Most M. sinensis were diploids. Miscanthus sinensis Tea-62 was triploid and comparable to the value of the M. ×giganteus. A different situation was found for other non-diploid M. sinensis, in particular four M. sinensis ‘Goliath’ and the M. sinensis ‘Zebrinus’ Tea-33. In these the ratio measured by the flowcytometer was in between the values of the triploid M. giganteus and tetraploid M. sacchariflorus standards. The ‘Goliath-like’ hybrid is likely an
autotriploid with three M. sinensis haploid sets, whereas M. ×giganteus is an allotriploid that is supposed to have two genomes from M. sinensis and one from M. sacchariflorus, which has a lower amount of DNA per haploid genome. DNA sequences of the internal transcribed spacer of the nrDNA were obtained for 76 genotypes in the collection and compared for polymorphism. The SNPs were particularly VI useful for differentiating M. sinensis, M. sacchariflorus and M. ×giganteus accessions and in combination with ploidy and morphology offer high potential for taxon identification. To gather more markers for population level diversity and differentiation studies, new microsatellite markers for both plastid and nuclear genomes were developed. For the development of plastid markers the chloroplast genome information of Saccharum officinarum was used. The nuclear SSRs (nSSRs) were developed from the sequences of 192
clones obtained from microsatellite enriched library. New primer pairs for the amplification of nineteen nuclear loci and six chloroplast loci were developed. Both chloroplast (cpSSR) and nSSR primers were used to characterise DNA variation, to help establish gene pools and to better understand hybridization and introgression. Huge genotypic variation was found
within the genus, mostly in the species M. sinensis. The markers showed wide utility across a large number of Miscanthus species and also some closely related genera. The analysis of the cpSSRs showed a high number of different haplotypes but with a clear bias in allele composition between M. sinensis and the two species M. sacchariflorus and M. ×giganteus,
thus confirming M. sacchariflorus as the maternal lineage of the hybrid M. xgiganteus. The nSSRs were found to be highly polymorphic across the collection and transferable to closely related genera such as Saccharum. The new markers were also used in UPGMA clustering and Bayesian structuring analysis to group individuals according to their similarity. Three major clusters of individuals were defined using the Bayesian STRUCTURE analysis with nuclear markers (nSSRs) and two with plastid markers (cpSSRs).
In conclusion, the morphological, ploidy, sequence and microsatellite results highlighted the high level of diversity still unexplored in the genus and have clarified taxon identity of many
accessions in the collection. A large set of new markers have been developed for the plant
breeding and systematics community. The newly developed markers will be useful to further explore this diversity and to select useful traits for breeding of new and improved genotypes for biomass production.Teagasc Walsh Fellowship; National Development Plan Irelan
Women, health and politics, 1919-1939 : professional and lay involvement in the women's health campaign
No full textThis thesis analyses the aspirations and achievements of
the lay women who were active in the campaign to improve women's
health, and of those women who sought entry into paid occupations
in the health services.
After an introduction, Section One is intended to place the
substantive data in context. Middle-class women's enthusiasm
for voluntary work and the terms on which women entered national
politics are discussed. These issues are used to illustrate
the effects the maintenance of rigid social-class divisions had
on the unity of the women's movement and the implications for
the future of the movement of the decision to seek entry to the
public domain on the grounds that women could make a unique contribution.
Section Two is devoted to the lay women. First, the effect
of the maintenance of rigid social-class divisions on the
women's health campaign and on women seeking a career in the
health services is discussed. Secondly, the consensus between
both middle-class and working-class women, the medical profession
and the Ministry of Health on the need to extend medical services
is analysed, revealing an eagerness to follow technical advice
which affected the strategy of the lay campaign and meant support
for women workers in the health services was often circumspect.
Thirdly, the reasons for the collapse of this consensus
in the l93Os are discussed. This section is concluded with an
assessment of the lay women's health campaign and a discussion
of the impact the campaign had on women health workers.
In Section Three, women's position as paid employees in the
health services is analysed, and three occupations, midwifery,
medicine and health visiting, have been selected. Difficulties
these women encountered establishing themselves in paid employment,
and their status and their relations with male colleagues
and with the Ministry of Health are assessed. The differences
between these three occupations, which prevented a sense of solidarity
and an identification with the goals of the women's movement,
are discussed. Their achievements during the period are
assessed, and the effects of the medicalisation of childbirth
and the increasing involvement of the state in maternity and
child welfare are investigated.
A fourth, concluding section draws these strands together.
The lay women's health campaign and the goals and tactics of the
women health workers are related to the maintenance of the existing
social-class divisions, the ideological splits within the
women's movennt and the persistence of barriers preventing women
from competing on equal terms with men in the public domain.
Although the number of women working in the health services increased
dramatically and women's place in these services was
assured, women generally remained in subordinate positions, excluded
from the prestigious and lucrative posts, while they
achieved only a statutory presence on decision-making bodies
Socialism nationalism and European integration: the development of theory and practice
No full textThe late twentieth century has seen a triple crisis on the left: a crisis of socialism in all its mainstream expressions, a crisis of the state, but also a reaffirmation of the appeals of nationalism. The thesis is an attempt to examine the relationship between these developments in the context of the process of European integration. It starts with the difficult relation between socialism and nationalism, from the founding fathers of scientific socialism, through to their followers in the so-called golden age of socialism, and the practice of the Internationals, It looks briefly at the way the German SPD and the French Socialists reacted to the process of European integration, showing the predominance of national interests, which combined with the internal party problems and socialist beliefs, resulted m a confusion manifested in their rhetoric and vocabulary. An account is offered of some socialist thinkers who paid attention to European integration in the 1970s. The French Rocardians, Ernest Mandel and Johan Galtung are shown to have failed to understand the importance of nationalism and remained preoccupied with statism. The exception is Altiero Spinelli, who, as both thinker and practitioner, developed a unique non-doctrinaire vision of socialism, coupled with an understanding of national differences. His federalism and his pro-European stance incorporated notions and ideas that were to dominate the socialist discourse of today. Finally there is an examination of issues that currently dominate the discussion about the future of socialism. These can be divided into arguments about the state, the working class and the new radicalism, and democracy and the ideas of choice, rights, autonomy and the market. Spinelli had touched upon all these issues with a particular reference to European integration and opened up for socialists the European horizon. In conclusion, it is argued that while European integration is not a socialist enterprise, it might be used to further its aims
