The Canadian military and veterans have a long history of dealing with psychological trauma caused by war and peacekeeping. Over the past century views about trauma among physicians, military leaders, society, and veterans’ themselves have been shaped by medical theories, predominant views about the ideal soldier and man, and the nation’s role in international affairs. Since the First World War, major conflicts and peacekeeping operations have been responsible for distinct shifts in how trauma is conceptualized, named, and experienced by Canadian soldiers and the public. Canadian historians have examined this subject by looking at particular wars, most notably the First World War, but no attempt has been made to provide a monograph-length study of military trauma over the past century. This thesis utilizes several lenses – medical, social, and cultural – to explore how conceptions of trauma changed from 1914 to 2014, how such changes affected veterans in their civilian life, and the interactions between medical and popular knowledge, military culture, and veterans’ lived experiences. With a particular emphasis on the latter, it uses oral interviews with veterans of the post-Cold War, government reports, medical literature, and national newspapers to track shifts in consciousness about trauma and its social and medical treatment. It argues that despite numerous changes in medical thought and popular understandings of trauma, stigmas about psychological illness persisted, and that masculine ideals inherent in 1914 were still present, albeit in an altered form, one-hundred years later. It also argues that the Canadian veteran’s experience demonstrates that from 1914 to 2014, trauma consistently oscillated between being a medical entity and a metaphorical representation of war, peacekeeping, veterans’ socio-economic struggles, and national identity. This thesis takes advantage of a historically unique openness in the Canadian military since the year 2000 to contribute to a growing literature about trauma in Canadian military history and society.

Submitted by Priscila Bermudes Peixoto null (pribpeixoto@hotmail.com) on 2017-12-14T18:38:58Z No. of bitstreams: 1 Priscila-Final-CapaDura.pdf: 1600815 bytes, checksum: 5357ed9f92e5048fd0732fd516af1ac0 (MD5) / Submitted by Priscila Bermudes Peixoto null (pribpeixoto@hotmail.com) on 2017-12-21T12:31:26Z No. of bitstreams: 1 Priscila-Final-CapaDura.pdf: 1600815 bytes, checksum: 5357ed9f92e5048fd0732fd516af1ac0 (MD5) / Approved for entry into archive by Laura Odette Dorta Jardim null (laura@franca.unesp.br) on 2018-01-17T19:05:55Z (GMT) No. of bitstreams: 1 Priscila-Final-CapaDura.pdf: 1600815 bytes, checksum: 5357ed9f92e5048fd0732fd516af1ac0 (MD5) / Made available in DSpace on 2018-01-17T19:05:55Z (GMT). No. of bitstreams: 1 Priscila-Final-CapaDura.pdf: 1600815 bytes, checksum: 5357ed9f92e5048fd0732fd516af1ac0 (MD5) Previous issue date: 2017-11-29 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O objetivo desse trabalho consiste em analisar o debate de cunho eugenista acerca da adoção do exame médico pré-nupcial ocorrido nos meios ligados à medicina e às práticas sanitárias no Brasil, nas primeiras décadas do século XX. A medicina social, baseada em doutrinas higienistas e eugenistas, buscou intervir mais diretamente no cotidiano da população, estabelecendo normas de conduta, sob o pretexto de prevenir moléstias e epidemias. O exame pré-nupcial foi um dos aspectos desta orientação mais ampla. Sua realização era defendida por médicos que pretendiam impedir ou adiar casamentos quando um dos nubentes apresentasse alguma doença ou fatores considerados degenerativos, sempre orientados por supostas medidas preventivas imprescindíveis ao que acreditavam ser o aprimoramento racial. Observando que discurso eugênico classificou determinados indivíduos como inferiores e pretendia impedir a reprodução destes, esta pesquisa busca compreender em que medida a questão da raça esteve presente na proposta de intervenção matrimonial. Tomando como referência a noção de discurso como um conjunto de regras adequado à sua prática, constituído por conflitos e tensões internas, procura-se demonstrar como os eugenistas tentaram impor seu saber à sociedade, ou seja, quais eram suas motivações para transformar o exame pré-nupcial em uma lei aplicável em todo o país. Analisa-se ainda as controvérsias e objeções reclamadas por seus críticos, notando como estas e a própria realidade do país contribuíram para que determinadas políticas eugênicas não fossem adotadas, a exemplo da obrigatoriedade do exame pré-nupcial. / The aim of this paper is to analyze the eugenicist medical discourse about the premarital medical examination occurred in the medical environment and the sanitary practices in Brazil, in the early decades of the twentieth century. The social medicine, based on the hygienist and eugenicist doctrines, would intervene in the daily basis of the population by establishing standards of conduct, intending to prevent diseases and epidemics. The prenuptial exam was one of the aspects of this wider orientation. The defense of its realization, gathered doctors who could prevent or postpone marriages when one of the spouses had any disease, always guided by supposed preventive and necessary measures concerning what they believed to be a racial enhancement. Noticing that the eugenic speech classified some people as inferior and it was supposed to stop their reproduction, this research aims to understand in which measure the question about race was present in the proposal of matrimonial intervention. Taking as a reference the notion of the discourse as a group of rules appropriate to its practice, constituted by conflicts and intern tensions, we are going to show how the doctors tried to impose their knowledge to society, in other words, what were their motivations to transform the premarital examination in an applicable law in all over the country. It also analyzes the controversies and objections claimed by the critics, noting how these and the reality of the country contributed to the fact that certain eugenic policies were not adopted, such as the compulsory prenuptial examination. / 15/08002-8

abstract: This is a project about medicine and the history of a condition called premenstrual syndrome (PMS), its “discovery” and conceptual development at both scientific and socio-cultural levels. Since it was first mentioned in medical literature, PMS has been explored empirically as a medical condition and conceptually as non-somatic cultural phenomenon. Many attempts have been made to produce scientific, empirical evidence to bolster the theory of PMS as a biological disease. Some non-medical perspectives argue that invoking biology as the cause of PMS medicalizes a natural function of the female reproductive system and shallowly interrogates what is actually a complex bio-psycho-social phenomenon. This thesis questions both sides of this debate in order to reveal how criteria for PMS were categorized despite disagreement surrounding its etiology. This thesis illustrates how the concept of PMS developed and was informed by the discovery of hormones and the resulting field of endocrinology that provided a framework for conceptualizing PMS. It displays how the development of the medical diagnostic category of PMS developed in tandem with the emergence of the field of endocrinology and was legitimized and effectively medicalized through this connection. The diagnosis of PMS became established though the diagnostic techniques like questionnaires in spite of persistent disagreement over its definition. The thesis shows how these medical concepts and practices legitimated the category of PMS, and how it has become ubiquitous in contemporary culture. / Dissertation/Thesis / Masters Thesis Biology 2016

The purpose of this thesis is to study and analyse collections of outsider art in two Swedish Medical History Museums, Medicinhistoriska museet in Uppsala and Mentalvårdsmuseet in Säter. The work explores how the history of the museums, how art collections were established, the outsider artist as well as how the two museums work the collections today. The empirical part of the study is based on the fieldwork that the author conducted at the Medicinhistoriska museet in Uppsala and Mentalvårdsmuseet in Säter during two separate days in the winter/spring of 2022. Both observations of the museum room were made, as well as interviews with the two curators in charge of the art collections. Attentive observations and systematic notes from constitute the basis for the description of the material and immaterial features of the museum. For the chapters on the historical and cultural context concerning outsider art, art brut, psychiatric care and how the hospitals became museums, literary sources were used.  The result of the study shows that outsider art made in a hospital is a very specific part of outsider art and art brut because of the very special conditions of an often locked psychiatric care unit. It implies that outsider art made in psychiatric care have not been seen as real art, not been viewed as interesting for the public. There has existed an authorised heritage discourse (“AHD”) in the hospitals and well as in the later museums which has led to the collections not been correctly taken care of, and research about the patients has not been made. Instead, the patients work has been stored incorrectly in attics, basements and in un-locked storage areas with only a few ”aesthetically pleasing” works showed in the museum.      Further, the study shows how the art collections in the two medical hospitals correctly used and worked with, can be a part of removing the stigma around mental disease and people living with it.  The conclusions to be drawn from this are that the complexity of the art collections of outsider art made in psychiatric care lie in the fact that mental illness, psychiatric hospitals, and outsider art have been under a stigma, as well as the fact that the patients’ stories being stories from the margin. This is a two-years master’s thesis in Museum and Cultural Heritage Studies.

This thesis contributes insight into the lives and injury experiences of the working poor of London, UK during the “long” eighteenth century. The distribution of fracture types within individual bodies and the larger experiences of those living and dying during this period are explored. Skeletal evidence, drawn from five London cemeteries, and historical evidence, in the form of contemporary hospital admission records and surgeons’ and physicians’ notebooks, speak in concert to reveal evidence of sex-based differences in fracture patterning and evidence for interpersonal violence. Sex-based differences in fracture patterning reveal that males and females suffered differing constellations of fractures and that the risk of fracture for males and females differed throughout the life course. Patterning of fractures in the male skeletal sample suggests that males’ lives were punctuated with episodes of interpersonal violence, supporting the historical data found in contemporary court records. Significant differences observed in the fracture frequencies in the skeletal and archival datasets indicate that not all fractures were being treated in a hospital setting. These results allow for examination of the intangible notion of human choice regarding health care in the past. The mixture of healed, healing, and perimortem fractures found in the skeletal sample allows for a relative timeline of fracture events to be reconstructed, contributing to a more comprehensive life course understanding of fractures in this group. Ultimately, the combined skeletal and archival datasets contribute to anthropological and historical studies of fractures and health care by placing the working poor at the centre of their own narrative. / Thesis / Doctor of Philosophy (PhD)

Submitted in fulfillment of the requirements for the Degree of Master of Technology in Nursing, Durban University of Technology, 2014. / Brief background to the study The national guidelines for maternity care in South Africa recommend that a standardised maternity case record be used by all facilities at all levels of care in order to improve the quality of care for pregnant women. According to the National Department of Health, this will facilitate continuity and quality of care for women during pregnancy, labour and post-partum. Aim of the study The aim of the study was to assess whether the implementation of the new maternity case record has improved the quality of care for pregnant women. Methodology An exploratory, descriptive study using both quantitative and qualitative design was used to conduct the study. Data was collected through a retrospective record review using a checklist for the quantitative strand, and from midwives using unstructured interviews for the qualitative strand. The quantitative data set was analysed using the Statistical Package for the Social Sciences version 21.0 and the qualitative strand was analysed using the Tesch’s method of data analysis. Results The results of the record review revealed that although the recording was done fairly well, there were a number of activities and interventions that were recorded poorly or not recorded at all in some primary health care clinic. The midwives verbalised that many mistakes and mismanagement of ante-natal care clients emanated from the structure and the design of the new maternity case record. Recommendations Recommendations include the following: communication of policies and protocols to the midwives should be done timeously, provision of in-service education and/or updates on new developments, strengthening of supportive supervision, the Nursing colleges be kept up-to-date with new developments in nursing practice and that a broader study involving other districts and provinces be conducted.

When face-to-face physical medical exams are not possible, virtual physical exams, in the form of a pictorial medical exam/history, can be substituted, and telemedicine can be the means to deliver these virtual exams. The goal of this work was to determine if presence in the form of a visual and/or pictorial medical history can be of benefit to clinicians in the diagnosis of medical conditions of individuals with developmental disabilities (DDs) and/or intellectual disabilities (IDs), in particular those who cannot, because of their cognitive and/or physical disabilities, verbally relate their illness to a clinician. Virtual exams can also be useful in cases where clinicians may need additional advice from fellow experts, especially if those experts are not physically present. A web-based telemedicine application used for treating persons with DD/IDs was developed. This application includes a visual medical history component incorporated into an electronic medical records application. The purpose is to allow the clinician to use an environment that integrates a written and visual representation of a patient’s medical history and physical findings to aid the clinician in determining a medical diagnosis. Twenty-two clinicians and five direct service aids of a New York State Developmental Disabilities Services Office facility, who deliver healthcare to DD/ID patients on a daily basis, accessed the telemedicine application instead of their traditional hardcopy/paper medical history when examining patients. A comprehensive survey was distributed to the clinicians to determine the effectiveness of the application as well as help answer the primary questions proposed by this research. The results of this study showed that presence in the form of a video medical history is preferred by clinicians rather than having just a written medical history of the patient. Clinicians felt the visual medical history component of the telemedicine application was useful and informative for delivering healthcare to individuals with DD/ID and enabled them in diagnosing a patient as well as lessened the need to transfer patients to the emergency room, resulting in a significant cost savings.

A importância dos serviços de assistência odontológica prestada pela Faculdade de Odontologia da Universidade de São Paulo reflete nos dados obtidos do Anuário Estatístico da Universidade de São Paulo. Somente na disciplina de Cirurgia, foram realizados 1075 atendimentos cirúrgicos, no ano de 2000 saltando para 5686 em 2007. A cada paciente gera-se um prontuário que contém informações de cunho pessoal, da história médica, odontológicas, e de imagens que lhe atribui alto valor legal e de pesquisa. Com a alta procura pelos serviços oferecidos pela faculdade, o número de documentos gerados por paciente cresce proporcionalmente e constata-se que o arquivamento dos prontuários de toda a faculdade é frágil e sujeito à ocorrência de eventos que poderiam danificar o material. A morosidade na busca por dados dos pacientes, a perda de informações, e a dificuldade em realizar estudos epidemiológicos levaram à motivação para o desenvolvimento e avaliação de um prontuário virtual e seu respectivo Banco de Dados da disciplina de Cirurgia da Faculdade de Odontologia da Universidade de São Paulo. Um modelo de ficha para transcrição eletrônica, com os mesmos itens da ficha clínico-cirúrgica, foi elaborado e utilizado para a transcrição das informações dos pacientes atendidos no ambulatório de Cirurgia, no curso noturno, no ano de 2008. Um protótipo de prontuário virtual foi desenvolvido e os dados coletados de 417 pacientes foram inseridos e armazenados localmente num Banco de Dados desenvolvido para WEB, visando uma nova forma de acesso à informação. A partir dos testes de uso retrospectivo e prospectivo, concluímos que o protótipo do prontuário virtual representa uma importante ferramenta baseada em tecnologias de informação, de uso epidemiológico, de pesquisa e de avaliação dos requisitos necessários para o desenvolvimento de um prontuário virtual com mais robustez e flexibilidade. / The importance of the dental aid services offered by the School of Dentistry of the University of São Paulo reflects on the data from the Statistical Yearbook of the University of São Paulo. In the discipline of Oral Surgery by itself, 1075 surgical appointments were done in 2000, which has increased greatly to 5686 in 2007. To every new patient admitted by the service, a record file is created and contains personal information, health and dental history, and images, thus setting a high legal and research value on the patient record file for the institution. With the high demand for these dental services, the number of documents by patient proportionally augments and it can be seen in the entire institution fragility of the files archiving and risk of events occurrence that could damage the material. The slowness of retrieving patient data, lack of information, and difficulties motivate the development and evaluation of an electronic health record and its respective database in the discipline of Oral Surgery of the School of Dentistry of the University of São Paulo. A sheet form for electronic transcription, with the same content of the surgical-clinical questionnaire form, was elaborated to transcript the health information of the patients admitted at the Oral Surgery Service, in the nocturnal graduation course during 2008. A prototype of an electronic health record was created and the collected data were processed and stored in a web-based local database, aiming to an innovative access mode to information. By the tests of retrospective and prospective use of the electronic health record, we concluded the prototype of the electronic health record represents an important tool based in technologies of information, useful to epidemiology, research and evaluation of required features to development of an electronic health record more robust and flexible.

Cette thèse aborde l'histoire des enfants et adultes handicapés mentaux en France et en Allemagne entre 1890 et le milieu des années 1930. Ce travail prend pour objet les personnes atteintes de déficience mentale, qualifiées à l'époque de « débiles mentaux », « imbéciles », « idiots » ou du terme plus générique d' « arriérés ». Cette étude apporte un éclairage nouveau sur plusieurs thèmes, en adoptant une perspective transnationale pour éclairer la circulation et les résistances dans les pratiques médicales et pédagogiques destinées aux arriérés. Cherchant à mettre en valeur la part de construction qui est en jeu dans l'élaboration de ces catégories nosographiques, les critères aboutissant à créer la « faiblesse d'esprit » (Schwachsinnigkeit) sont étudiés à travers de points de vue variés (famille, instituteurs, psychologues et aliénistes). On montre ainsi comment la catégorie est forgée par ceux qui les observent au quotidien. A l'échelle des institutions étudiées, l'évolution des pratiques asilaires démontre une volonté progressive de rationaliser le tri entre ceux qu'on pense « éducables » et les « incurables » par l'emploi d'outils tels que les tests psychométriques. La thèse démontre aussi comment les arriérés sont envisagés peu à peu comme une charge, voire un danger à l'échelle nationale. Après la Grande Guerre, le coût de leur prise en charge est vu comme un fardeau dans les deux pays, justifiant une rationalisation des soins qui leur sont accordés. Ils sont surtout considérés comme porteurs de tares transmissibles héréditairement, soit des individus qu'il s'agit de sélectionner voire d'éliminer en tant que danger sanitaire. La thèse explore ces deux aspects observés en France comme en Allemagne, et leur part dans la légitimation de la stérilisation forcée des arriérés comme « Malades héréditaires » mises en place par la loi adoptée dès les premiers mois de l'avènement du IIIe Reich, ainsi que les réactions du milieu psychiatrique français. / The topic of this PhD dissertation is the history of mentally deficient children and adults in both France and Germany between 1890 and 1934. This work focuses on people who suffered from mental retardation although at that time they would have been referred to as "feeble-minded," "idiots" or "imbeciles." This study provides a new focus on different subjects. The various circulations of medical models are considered in a dynamic perspective. lt also provides an original vision of the construction of the category of feeblemidness, influenced by agents like doctors [psychiatrists], families or teachers, questioning what was done in practical terms. Mentally deficient people were shaped by the gaze of the people they interacted with. They are also examined in a social and economic context to which these individuals respond. The evolution of the characterization of feeble-mindedness and the use of intelligence tests highlight various attempts to classify those individuals in a more rational way. From a more specific psychiatrie point of view, this thesis shows how the emphasis on their classification as "unproductive persans" as well as the description of feeble-mindedness as a hereditary and "racial" disease transformed them into a social issue in the context of the rise of social Darwinism and eugenics, which led fo their sterilization in Germany from 1934 on.

<p>This dissertation examines the political response of gay and lesbian organizations to the HIV/AIDS crisis through the lens of disability. When the National Gay Task Force (NGTF) formed in the 1970s, their early political efforts confronted the stigma and exclusion associated with the American Psychiatric Association’s disabling label. In the 1980s, gay and lesbian organizations faced a deadly epidemic—AIDS. The high cost of medical care left people with AIDS destitute. NGTF pressed the Social Security Administration to modify their disability criteria to recognize AIDS and ARC as qualifying disabilities. Fear and homophobia left people with AIDS vulnerable to employment, housing and medical discrimination as well as social ostracism. Gay Men’s Health Crisis and Lambda Legal Defense and Education Fund countered AIDS discrimination in New York through collaborative efforts with city and state agencies. Disability rights codes and laws offered people with AIDS some protection against discrimination. The Task Force, the Gay Rights National Lobby and the Disability Rights Defense & Education Fund joined the Leadership Conference on Civil Rights in 1982. While the Conference did not engage in the campaign for gay and lesbian rights in the 1980s, their extended legislative crusade for the Civil Rights Restoration Act would bring AIDS onto the battlefield. This study finds these various antecedents came into play during the Americans with Disabilities Act (ADA) to the extent that gay and lesbian organizations could describe the ADA as an “AIDS bill” in terms of both their political participation and the text protecting people with contagious diseases who were not a threat.<br></p>