Repositioning the patient: patient organizations, consumerism, and autonomy in Britain during the 1960s and 1970s.

This article explores how and why the patient came to be repositioned as a political actor within British health care during the 1960s and 1970s. Focusing on the role played by patient organizations, it is suggested that the repositioning of the patient needs to be seen in the light of growing demands for greater patient autonomy and the application of consumerist principles to health. Examining the activities of two patient groups-the National Association for the Welfare of Children in Hospital (NAWCH) and the Patients Association (PA)-indicates that while such groups undoubtedly placed more emphasis on individual autonomy, collective concerns did not entirely fall away. The voices of patients, as well as the patient, continued to matter within British health care.

Beyond terminology: the policy impact of a grassroots movement.

This article discusses the history of the grassroots movement led by self-advocates and their families to replace the stigmatizing term "mental retardation" with "intellectual disability" in federal statute. It also describes recent and pending changes in federal regulations and policy to adopt the new terminology for Social Security and Medicaid.

Unpacking stored and storied knowledge: elicited biographies of activismin mental health.

In this paper we consider the potential of autobiographical narratives for accessing "storied knowledge" in research around geographies of health voluntarism. We firstly consider what is meant by elicited autobiography and how the narrative approach has been used in research more broadly. Drawing on fieldwork undertaken in Manchester, UK and Auckland, New Zealand we then demonstrate how this approach has helped us to map out and unpack the career journeys of mental health activists working within and across the voluntary and statutory sectors. Through our autobiographical narratives we illustrate how this approach has enabled us to elicit important insights into the triggers and trajectories underpinning mental health activism and how events and moments in time have provided critical junctures in these trajectories. We consider places as sites of significance in activist career paths; and as central to the researcher-participant gestalt within which the autobiography is elicited and recounted. The autobiographical process, we suggest, offers reflective insights into mental health activism that might not otherwise be gained using more conventional methodologies.

Henry Ingersoll Bowditch (1808-82): American physician, public health advocate and social reformer.

Henry Ingersoll Bowditch, a Bostonian physician from the mid-19th century, lived a passionate life full of commitment and devotion to various noble causes--he was a champion of public health, an advocate for inclusion of women in medicine and a staunch abolitionist, all unpopular social perspectives at that time in medical and political history. Seemingly difficult personality traits including his stubbornness and moralistic outlook were likely 'adaptive' as he confronted the political reality of major institutional change. His interest in statistical trends and environmental influences and his inductive reasoning led to a deeper understanding of consumption (tuberculosis), the widespread diagnostic use of the stethoscope and thoracocentesis.

Activist emotions: gay radicalism and melancholic attachments.

It has been argued recently that Australian historians have overlooked histories of emotion. In this article, through the life-history analysis of two long-standing Sydney gay activists, I trace the emotional currents of radical gay activism and suggest these histories point to a wider story of Left melancholy in the closing decades of the twentieth century. I argue that their melancholia is not a trauma-like despair but surprisingly is tinged with a sustaining hope.

Building alliances in unlikely places: progressive allies and the Tobacco Institute's coalition strategy on cigarette excise taxes.

The tobacco industry often utilizes third parties to advance its policy agenda. One such utilization occurred when the industry identified organized labor and progressive groups as potential allies whose advocacy could undermine public support for excise tax increases. To attract such collaboration, the industry framed the issue as one of tax fairness, creating a labor management committee to provide distance from tobacco companies and furthering progressive allies' interests through financial and logistical support. Internal industry documents indicate that this strategic use of ideas, institutions, and interests facilitated the recruitment of leading progressive organizations as allies. By placing excise taxes within a strategic policy nexus that promotes mutual public interest goals, public health advocates may use a similar strategy in forging their own excise tax coalitions.

Diversity in academic medicine no. 3 struggle for survival among leading diversity programs.

Since efforts to increase the diversity of academic medicine began shortly after the Civil War, the efforts have been characterized by a ceaseless struggle of old and new programs to survive. In the 40 years after the Civil War, the number of minority-serving institutions grew from 2 to 9, and then the number fell again to 2 in response to an adverse evaluation by the Carnegie Foundation for the Advancement of Teaching. For 50 years, the programs grew slowly, picking up speed only after the passage of landmark civil rights legislation in the 1960s. From 1987 through 2005, they expanded rapidly, fueled by such new federal programs as the Centers of Excellence and Health Careers Opportunity Programs. Encompassing majority-white institutions as well as minority-serving institutions, the number of Centers of Excellence grew to 34, and the number of Health Careers Opportunity Programs grew to 74. Then, in 2006, the federal government cut its funding abruptly and drastically, reducing the number of Centers of Excellence and Health Careers Opportunity Programs to 4 each. Several advocacy groups, supported by think tanks, have striven to restore federal funding to previous levels, so far to no avail. Meanwhile, the struggle to increase the representation of underrepresented minorities in the health professions is carried on by the surviving programs, including the remaining Centers of Excellence and Health Careers Opportunity Programs and new programs that, funded by state, local, and private agencies, have arisen from the ashes.

The Texas Dental Association and advocacy: a TDA president's perspective.

The TDA can take pride in the joint efforts of its leadership, its grassroots members, and its elected representatives in the middle of the decade of the 1990's. When asked about his legacy for the leadership of our organization, Dr. Eggleston emphatically states, "You have to act. You have to do the right thing even when you have critics and detractors." More recently, during his campaign for ADA President-elect, he constantly stressed the importance of our relationship with each other. Our relationship, in Dr. Eggleston's words now and during his TDA presidency, "is more important than all issues put together". As this brief retrospective illustrates, the issues faced by dentists and the TDA are never trivial and are always tied to the legislative process. Political advocacy by our association is, therefore, our first priority now, no less so than it was in the mid-1990's. As described in the recent "TDA Report Card" on our legislative agenda for the 80th Texas Legislature, our challenges continue unabated, but these challenges are answered, and in many cases, successfully overcome as a result of our advocacy efforts. Our need for constant involvement in the legislative process is perhaps best summarized by advice given to Dr. Eggleston by Senator (and oral surgeon) David Sibley at the 1995 TDA Annual Session. Senator Sibley complimented TDA on its achievements during the 1995 Texas legislative session, and added "but you've got to keep your garden weeded."

"The horizon opened up very greatly": Leland O. Howard and the transition to chemical insecticides in the United States, 1894-1927.

The transition to synthetic chemicals as a popular method of insect control in the United States was one of the most critical developments in the history of American agriculture. Historians of agriculture have effectively identified the rise and charted the dominance of early chemical insecticides as they came to define commercial agriculture between the emergence of Paris green in the 1870s and the popularity of DDT in the 1940s and beyond. Less understood, however, are the underlying mechanics of this transition. this article thus takes up the basic question of how farmers and entomologists who were once dedicated to an impressively wide range of insect control options ultimately settled on the promise of a chemically driven approach to managing destructive insects. Central to this investigation is an emphasis on the bureaucratic maneuverings of Leland O. Howard, who headed the Bureau of Entomology from 1894 to 1927. Like most entomologists of his era, Howard was theoretically interested in pursuing a wide variety of control methods--biological, chemical, and cultural included. In the end, however, he employed several tactics to streamline the government's efforts to almost exclusively support arsenic and lead-based chemical insecticides as the most commercially viable form of insect control. While Howard in no way "caused" the national turn to chemicals, this article charts the pivotal role he played in fostering that outcome.