guidelines on diabetes management, worked on NHS Executive projects, and operated on many of the guideline committees formed and funded by the Department of Health. 104 Influential figures were also connected through training and research with other major figures in the field, such as Harry Keen, John Nabbarro, or Robert Tattersall. 105 Specific proposals and documents, in other words, emerged out of both broader political contexts and well-defined intellectual and policy communities.
Moving between different levels of the health services, and
mental health problems. The creation of the NHS and post-war welfare state brought political attention to these populations, just as new techniques for assessing mortality and morbidity drew medical interest to long-term conditions of the middle-aged. 5 Although government departments were absorbed with how the health and social services could care for ‘the chronic sick’ during the 1950s and early 1960s, epidemiologists, public health agencies, clinicians, laboratory researchers, and social medicine academics all began to consider the problems posed by ‘chronic
arrangements highlighted numerous problems. Yet innovations spread in face of such difficulties, with novel patterns of GP-led and community-based care reaching from Stirling to Poole and from Powys to King's Lynn. 2
This chapter explores how GPs became enrolled in novel diabetes management programmes, and why schemes for integrated care spread across the country. At its heart, the chapter positions the changing organisation of diabetes care within professional political projects. For hospital consultants, the attractions of co-operating with GPs were
Dietary advice and agency in North America and Britain
the number of occasions on which individuals ate outside the home – at school or the workplace, for example – became more frequent.
On both sides of the Atlantic during the middle decades of the twentieth century, there was increased medical, political and popular interest in, and concerns about, balanced diets and lifestyles, degenerative diseases, graceful ageing and optimal nutrition. Driven largely by the conditions generated by interwar economic recession and the ravages of the Second World War, providing better nutrition, fighting cancer
The focus here is on national, rather than intergovernmental, regulation. Specifically, this chapter traces how the relationship between the British state, business and individual workers shifted in regulatory terms between 1954 and 1982, a period of significant political change, with state interventionism being replaced, by the 1980s, with widespread faith in market mechanisms and a retrenchment of the state under the Conservative governments of Margaret Thatcher. The chapter argues, however, that existing historiographical assumptions need to be re
the twentieth century that spanned diverse Western socio-political contexts. Yet a common explanatory framework made them therapeutically appealing to successive populations beset by ‘neurasthenia’, ‘exhaustion’, ‘nerves’ and ‘stress’.
Notions of balance featured predominantly in relaxation and stress discourse: therapeutic strategies were framed as a means to restore and retain bodily equilibrium, and provide a counterbalance to the mental and physical stresses of modern life. A relaxed individual would supposedly
in cases. By
the end of November 2008, Nigeria had 758 confirmed cases, the most cases of
wild poliovirus in the world. 46
Yet political decisions made at the end of 2008 also
contributed to a significant improvement of polio vaccination efforts in
Nigeria the following year. In October 2008, Dr Muhammad Ali Pate, was
appointed as the new NPHCDA executive director. Not only was Dr Pate an
health authorities have dealt with outbreaks and prevention.
The historical legacy
From an early date, the state played the
key role in the formation of Japan's distinct approach to dealing with the
spread of infectious disease. In the 1630s, the Tokugawa government
(1603–1868) officially closed the country to contact with the outside
world for some 250 years. This was not simply a momentous political decision.
A national ethics committee and bioethics during the 1990s
Consolidating the ‘ethics industry’:
a national ethics committee and
bioethics during the 1990s
During the 1980s many of the individuals who were pivotal to the
making of British bioethics sought to establish what the British
Medical Journal identified as a ‘national bioethics committee’.1 Ian
Kennedy, for one, regularly called for a politically funded committee
based on the American President’s Commission, and his proposals
were often endorsed by newspapers and other bioethicists. They
were also endorsed by senior figures at the BMA, who believed a
Ian Kennedy, oversight and accountability in the 1980s
the United States, on Ivan Illich’s critique of professions and,
perhaps most significantly, on the work of American bioethicists
such as Paul Ramsey and Jay Katz.
But while there was little new in Kennedy’s calls for external
involvement, they were certainly more influential than earlier
British proposals. This owed a great deal to the changing political climate in the 1980s. Kennedy’s arguments dovetailed with a
central belief of the Conservative government that was elected in
1979, which believed that professions should be exposed to outside
scrutiny in order to