Who cares? The lost legacy of Archie Cochrane.

Over the last 20 years, the evidence-based medicine (EBM) movement has sought to develop standardised approaches to patient treatment by drawing on research results from randomised controlled trials (RCTs). The Cochrane Collaboration and its eponym, Archie Cochrane, have become symbols of this development, and Cochrane's book Effectiveness and Efficiency from 1972 is often referred to as the first sketch of what was to become EBM. In this article, we claim that this construction of EBM's historical roots is based on a selective reading of Cochrane's text. Through a close reading of this text, we show that the principal aim of modern EBM, namely to warrant clinical decisions based on evidence drawn from RCTs, is not part of Cochrane's original project. He had more modest ambitions for what RCTs can accomplish, and, more importantly, he was more concerned with care and equality than are his followers in the EBM movement. We try to reconstruct some of Cochrane's lost legacy and to articulate some of the important silences in Effectiveness and Efficiency From these clues it might be possible, we argue, to remodel EBM in a broader, more pluralistic, more democratic and less authoritarian manner.

Historiografia brasileira e meio ambiente: as contribuições de Sérgio Buarque de Holanda e o debate contemporâneo da história ambiental / Brazilian historiography and the environment: contributions by Sérgio Buarque de Holanda and the contemporary environmental history debate

Resumo Ao longo da segunda metade do século XX, o debate historiográfico brasileiro foi profundamente marcado por Sérgio Buarque de Holanda. Na primeira década do século XXI, os problemas da identidade nacional, da ocupação do território, da organização social do Brasil e suas matrizes civilizacionais, dos limites e trocas culturais em terras interiores, das percepções e formas de apropriação da natureza, entre outros temas do autor, ainda ecoam nos estudos históricos contemporâneos. O artigo discute as contribuições das suas principais obras para a história ambiental, sobretudo as interpretações das interferências cruzadas entre sociedades humanas e o meio natural. O papel da natureza, suas metáforas, ideias ou imagens são os vestígios de uma história da historiografia brasileira.

Abstract Throughout the second half of the twentieth century, Brazilian historigraphical debate was profoundly marked by Sérgio Buarque de Holanda. The problems of national identity, the occupation of the land, the social organization of Brazil and its civilizatory roots, the cultural exchanges and boundaries in inland parts, the perceptions and forms of appropriation of nature, and other topics covered by the author still echo in contemporary historical research. This article discusses how his main works contribute to environmental history, especially his interpretations of how human societies and the natural environment have affected one another. The role of nature, its metaphors, ideas, or images are the evidence of a history of Brazilian historiography.

Brazilian historiography and the environment: contributions by Sérgio Buarque de Holanda and the contemporary environmental history debate. / Historiografia brasileira e meio ambiente: as contribuições de Sérgio Buarque de Holanda e o debate contemporâneo da história ambiental.

Throughout the second half of the twentieth century, Brazilian historigraphical debate was profoundly marked by Sérgio Buarque de Holanda. The problems of national identity, the occupation of the land, the social organization of Brazil and its civilizatory roots, the cultural exchanges and boundaries in inland parts, the perceptions and forms of appropriation of nature, and other topics covered by the author still echo in contemporary historical research. This article discusses how his main works contribute to environmental history, especially his interpretations of how human societies and the natural environment have affected one another. The role of nature, its metaphors, ideas, or images are the evidence of a history of Brazilian historiography.

AJ Cronin and The Citadel: did a work of fiction contribute to the foundation of the NHS?

AJ Cronin (1896-1981) was a Scottish-born doctor-turned-novelist whose most famous novel is The Citadel, published in 1937. The book describes the struggles of an idealistic young doctor working in Wales and London in the 1920s and 30s. The novel was a global bestseller and its portrayal of a largely ineffective, corruption-ridden system of healthcare is thought to have directly influenced the foundation of the National Health Service in 1948. The Citadel anticipates such phenomena as evidence-based medicine and continuing medical education. This paper argues that the novel was never intended as propaganda for a state-controlled national health service. On the contrary, Cronin was against state control. Analysis of the novel is informed by recent biographical revelations about Cronin and the blurring of the margin between fact and fiction in Cronin's life and work is examined.

White girls: avant-gardism and advertising after 1860.

James McNeill Whistler's painting "The White Girl (Symphony in White, No. 1)" caused a scandal for depicting a woman dressed all in white, uncontained by any clear framing narrative. Though the painting is usually read into history of modernism for its experimental play with tones of white, in fact the painting was linked by Victorian viewers to the mass-cultural phenomenon surrounding Wilkie Collins's sensation novel "The Woman in White." By examining the two works together, this article shows that the divide between the world of fine arts and that of sensational entertainment is perhaps more entrenched in our own canons than it was for Victorian spectators and consumers.

Natural history's hypothetical moments: narratives of contingency in Victorian culture.

This essay focuses on the ways in which works by Robert Chambers, Charles Darwin, and George Eliot encouraged readers to imagine the future as contingent. But where Chambers alludes to Charles Babbage's computational engine and the period's life insurance industry to hint at the role of contingency in natural history, Darwin insists on the importance of contingently determined outcomes to speciation. The "Origin" consistently exercises the reader's speculative energies by generating conditional statements, causal hypotheses, adn diverging alternatives. "Adam Bede" constitutes its characters' interior lives around the proliferation of such contingent narratives. To reflect on the future or on the past, these works suggest, demands a temporal, moral, and narrative complexity in one's thinking.

"So long as I can read": farm women's reading experiences in Depression-era South Dakota.

During the Great Depression, with conditions grim, entertainment scarce, and educational opportunities limited, many South Dakota farm women relied on reading to fill emotional, social, and informational needs. To read to any degree, these rural women had to overcome multiple obstacles. Extensive reading (whether books, farm journals, or newspapers) was limited to those who had access to publications and could make time to read. The South Dakota Free Library Commission was valuable in circulating reading materials to the state's rural population. In the 1930s the commission collaborated with the USDA's Extension Service in a popular reading project geared toward South Dakota farm women. This "Reading in the Home" program greatly increased reading opportunities and motivations. Of particular interest to rural women were tales of pioneer life featuring strong protagonists. Through these stories, farm women found validation and encouragement to persevere. Reading also broadened horizons and challenged assumptions. For the depression-era farm woman, reading books and other materials provided recreation, instruction, and inspiration in a discouraging time.

The costs of being a restless intellect: Julian Huxley's popular and scientific career in the 1920s.

Julian Huxley's (1887-1975) contribution to twentieth-century biology and science popularisation is well documented. What has not been appreciated so far is that despite Huxley's eminence as a public scientific figure and the part that he played in the rise of experimental zoology in Britain in the 1920s, his own research was often heavily criticised in this period by his colleagues. This resulted in numerous difficulties in getting his scientific research published in the early 1920s. At this time, Huxley started his popular science career. Huxley's friends criticised him for engaging in this actively and attributed the publication difficulties to the time that he allocated to popular science. The cause might also have its roots in his self-professed inability to delve deeply into the particularities of research. This affected Huxley's standing in the scientific community and seems to have contributed to the fact that Huxley failed twice in the late 1920s to be elected to the Royal Society. This picture undermines to some extent Peter J. Bowler's recent portrayal of Huxley as a science populariser.

The image of the atomic bomb in Japan before Hiroshima.

This paper traces the roots of the image of the atomic bomb in Japan by investigating the various discourses on atomic energy and atomic weapons in Japanese literature prior to the bombing of Hiroshima in August 1945. Japan is a country that suffered an atomic attack and, at the same time, one of the countries that was engaged in atomic weapons research during the Second World War. During the war, the discourses on atomic weapons were not limited to the military or scientific communities, but included the general public, thus facilitating the creation of a shared image of the atomic bomb as an ultimate weapon. This paper examines how this image was created. This special issue deals with the comparison among different countries, but the purpose of my paper is to deepen this subject by illustrating the differences within a single country in different periods. This research aims to extend the historical perspective concerning the atomic bomb in Japan, and offers another way of looking at this both historical and contemporary issue.

Feeling like a clerk in H. G. Wells.

In three turn-of-the-century novels about clerks and scholarship boys, H. G. Wells illustrates the emotional impact of social hierarchies on individual lives. By portraying the conflicted, class-related emotions of lower-middle-class men, Wells departs from the common contemporary image of the clerk as a figure synonymous with his function. But Wells depicts other emotions--specifically, those associated with domesticity and recklessness--to push against what he sees as the classed nature of emotional lives. He rewrites Victorian domesticity as a zone of sexuality and desire for his lower-middle-class clerks, and he mobilizes an emergent cultural appreciation of recklessness to instill them with vitality. The "significant selves" that develop as a result help to offset their ultimate failure to escape their class.

[Medical discourse, the cornerstone of the gender relations in contemporary times]. / El discurso médico, Piedra Angular de la construcción de las relaciones de género en la época contemporánea.

The concept of gender establishes not only a distinction between biological sex (natural data and the object of biological and medical knowledge) and social sex (constructed within and by power relations). As a category of analysis, it also allows us to research the area of tension which governs the mutual construction of both. This construction inevitably pervades language and its capacity to establish categories of thought in cultures. This paper will demonstrate how the conceptual and linguistic category of "woman" is one of the areas where this mutual construction may be found in the 19th century.