How using Microsoft Office 365 can benefit you

This blogpost was written by Fiona Graham, IT training at St George’s, University of London.

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Microsoft Office 365 is one of the most popular IT tools in the world, benefitting people in education, at home, and offices every day to create material, collect and share information via the internet on the go and on any device.  

Being proficient with Office will support you in your studies at university and beyond. Increased productivity and efficiency are only two of the benefits of Microsoft Office 365.

The main apps in Microsoft Office are: 

  • Word 
  • Excel 
  • PowerPoint 
  • Outlook 
  • Teams 
  • OneDrive 

Each application has a different purpose. For example, you can use Word to write assignments, create documents and put together reports, Excel you can use to store, organise, and analyse data. With PowerPoint you can create presentations and videos and Outlook is used to manage email and calendars. In Teams you can collaborate online and attend meetings. OneDrive is key to sharing documents with your colleagues and coediting them.

10 reasons why you want to use Office 365 @St George’s

  1. Office 365: Microsoft Word, PowerPoint, Excel, OneNote, Outlook, Forms and Sway.  
  1. Five installations: Install Office 365 on up to five (5) devices) for one user. 
  1. Duration: Available throughout your course with support. 
  1. Note-taking: Take notes in OneNote and keep them in the cloud and across devices.  
  1. Save to OneDrive: Save documents to OneDrive, so files are always available across devices with 1TB storage space. 
  1. Teams: use Teams to stay connected and collaborate with all St. George’s staff and students and others.  
  1. Planner: share tasks and keep up to date. 
  1. Sway: Create interactive digital presentations 
  1. Office on Demand: Use Office 365 on the go on any device. 
  1. Easily share content: to co-edit files 
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IT training

CTiE provides Microsoft Office training and support at St George’s, University, also covering Faculty of Health, Social Care and Education (joint with Kingston), and St George’s Hospital. 

We provide free: 

  • Hands-on training sessions in using Microsoft Office (in person and online).
  • Drop-ins via Microsoft Teams to give one-to-one support with specific questions or if you need help with a particular package.  
  • One-to-one support available by appointment using this booking form. 

We run a mix of online and in-person workshops throughout the year. Please see our Training and Support web page for current sessions.  

Additionally, there is a range of How to Guides available to download. We also have online tutorials available.

Welcome to St George’s Library 2021

Welcome to St George’s to all our new students and welcome back to everyone who is returning to their studies with us. After the flurry of Freshers Week and the first weeks of classes, now is a good time to start familiarising yourself with the library’s resources and the services we offer.

We are here to help you and support you in your studies.

Photo of library entrance and social learning space taken from outside.

Library help guides

We have a range of guides, called Libguides, to help you find out more and get to grips with your subject, library or research related skills. You can find all of them on the Libguides homepage. They are grouped into subjects related to each course. Under Faculty of Health, Social Care and Education, you will find, for example, guides for paramedic science or radiography. Guides for  Institute of Medicine and Biomedical Education courses include medicine or biomedical science.

Each guide includes information on which resources we recommend for your subject, including revision and e-learning resources and databases, if you are doing complex literature searches. In the guide, you can also find information on how to reference correctly and who to contact to get further help. A little tip: it’s generally a good idea to email liaison@sgul.ac.uk for help with finding information and referencing.

We also have a range of skills guides, ranging from the basic (but totally necessary) Library Essentials and printing, to more in-depth guides on literature searching and using Refworks to manage your references.

Decorative image of student looking at the medicine libguide on their laptop.

E-learning tutorials

On Canvas you can find a range of self-directed library research based tutorials that you can take at your own pace when you are ready. They each include some videos, explanations and short quizzes so you can test your knowledge as you go along.

Have you ever wondered how to Google like a librarian? Or how to select the best-quality information for your assignments? Give our Finding and Evaluating Information tutorial a go.

If you need to use Harvard referencing in your assignments (and it is very likely that you do as it is the institutional referencing style), you will find our Referencing Essentials tutorial helpful. It covers the basics of referencing, explains what in-text citations and references consist of and guides you through the reference layout of the most commonly used resources.

Once you have completed the tutorial, why don’t you take our referencing quiz to see how well you can apply Harvard referencing? A little tip: you might find our Cite Them Right video helpful to answer the questions.

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Liaison Librarians

We have a brand-new service this year! There is an expert ‘on-call’ librarian available every weekday between 10am-2pm you can talk to in person about any research or referencing concerns. All you need to do is let us know at the library helpdesk and we’ll take it from there.

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Every subject at St George’s has a specialist librarian, in fact librarians, so you are sure to get the specialist support you need for what you are studying. You can find out who your librarians are on your subject’s libguide.

You can also email us at liaison@sgul.ac.uk if you’d like any help with research, systematic literature searches, finding information in Hunter, referencing or RefWorks. For more in-depth enquiries we can make an appointment with you, either online or in person, depending on availability.

Reading for pleasure collection

Regular breaks from studying and revision are important, which is where our collection of fiction, poetry and popular non-fiction comes in. Not all our books are medical and healthcare-related textbooks. We have a range of books you might expect to find in a public library!

These books are grouped along different themes, you can find all our collections here. There are collections on science bestsellers, Black Lives Matter and Black History Month, fiction by women and women in leadership, health and mental well-being and LGBTQ+ books for example.

The Library also supports the Big Read. This is an exciting shared reading project, which is now in its third year at St George’s. We have all the shortlisted books from the last years, going back to the project’s origins at Kingston University, and of course all the winners, in the library available for you to borrow. You can find the Big Read books listed here.

Big Read logo

Academic skills

Last but not least, you might be looking for help with academic skills, such as essay writing, revision skills or note taking. You can find information on these topics and many more on the Study+ page on Canvas.

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You can also get one-to-one support by booking an appointment with the Academic Success Team. You need to book via the Study+ page on Canvas. Appointments can be in person or online.


We hope you find these resources will support you in your assignments, dissertations and learning. Don’t hesitate to email us at liaison@sgul.ac.uk with you

Focus on Figshare: using ‘collections’ and ‘projects’

This post has been written by Liz Stovold, Research Data Support Manager and Information Specialist, Cochrane Airways.

What is Figshare?

Figshare provides the infrastructure for the St George’s Research Data Repository. The repository facilitates the discovery, storage, citing and sharing of research data produced at St George’s. It is possible to store and share a range of research outputs in the repository including datasets, posters, presentations, reports, figures, and data management plans. Each item that is published via the repository receives a Digital Object Identifier (DOI) which makes it easy to cite, share and promote your work.

Screenshot of the St George's Figshare landing page.

What is a collection?

One of the features of Figshare is the ability to create a citable collection of individual related items. You can choose to publish a collection publicly, or opt to keep it private. Collections can be added to over time and republished as they are updated with new items. There are several advantages to using collections, such as the ability to group themed research outputs together in one place, and to showcase a portfolio of work.  

Here at SGUL, Cochrane Airways – a research group based in the Population Health Research Institute – decided to create a collection of the posters and presentations that they have produced over a number of years. A Figshare collection enables the Group to showcase and cite their research dissemination activities and share with funders and other stakeholders. It also provides them with one place to store these outputs instead of saving them across a variety of shared and personal drives.

What is a ‘project’?

A Figshare ‘project’ also enables researchers to group together related items, but it differs from a collection in that it allows multiple collaborators to contribute and to add notes and comments. You can choose to make your project public or keep it private. The project itself doesn’t have a DOI, but the items within a project can do. A project can contain a mix of publicly available data and private data visible only to the project collaborators.  

Cochrane Airways are piloting a Figshare project to store, share and publish reports and other documents that have been produced as part of their priority setting work. A project hosted on Figshare allows them to collate the output of their ongoing work, share documents within their group, and publish documents with a DOI as and when needed.


Could a collection or project in Figshare be useful for you or your team? Contact the SGUL RDM Service at researchdata@sgul.ac.uk to discuss your needs, or see SGUL Research Data Management for more general information and guidance.

Academic Success Centre – Getting support with your studies at St George’s

This blogpost was written by Olga Rodriguez Falcon, Lecturer in Learning Development.

Decorative image, of student sitting at a desk in front of the laptop smiling at the camera.

Whether this is your first year at St George’s or you’re now continuing your studies, there are always lots of uncertainties and worries when starting a new academic year. This year particularly so, since you’ll probably need to adapt again to new ways of learning after a long period of mostly online study. Having ambivalent feelings on this, at the same time excited and worried, is very normal. We’re all feeling them, and it definitely helps to know you’re not alone in feeling this way. These are some of the questions that might be going through your head right now:

  • Is there anything I need to be doing to make sure I’m on top of things from day one?
  • Should I change the way I usually take notes and revise this year?
  • Is my academic writing good enough for the type of assignments I’ll have this year?
  • How can I know whether I’m on the right track with my studies?

Getting together with your peers to have honest discussions on these questions will make them less daunting, and you might end up going away with some very useful tips. At St George’s, there is also a dedicated team of Learning Developers that can offer you support and advice on how to maximise your learning and explore any study issues.

First, have a look at our Canvas page: Study+. You should be automatically enrolled as a St George’s student. There you will find lots of very useful self-directed resources that will help with your studies. For example, there is a whole section dedicated to ‘Effective Study and Revision’. This section is very popular with students and can offer ideas on how to approach the material differently, so that you understand it and can apply it to different contexts – instead of just remembering it to pass exams. There are also sections on ‘Academic writing’, ‘Referencing’ and other relevant topics to university study. Try to spend some time going through some of them.

Study plus banner

Our team also offers one-to-one appointments. During these appointments, you can discuss in confidentiality any issues you’re having with your studies. We can offer support and advice on a variety of topics, including effective study strategies, writing academic assignments and English language help. And the good news is, this year we can offer both in-person and online appointments so we can accommodate the needs of your specific circumstances. You can book an appointment via Study + (Click on ‘Academic Success’) or directly using this link: https://10to8.com/book/sgul/

Finally, if you have a quick enquiry for us that might not require a one-to-one appointment, or you’re not able to find a date and time that suits you, you can contact us directly using this email address: AS@sgul.ac.uk. We check this email regularly and try to respond as soon as possible.

We look forward to meeting you!

Photos of Learning Development lecturers, Rosie and Olga.

DMPOnline for St George’s University researchers

This post has been written by Liz Stovold, Research Data Support Manager and Information Specialist, Cochrane Airways.

A data management plan (DMP) is an important part of a research project and many funders require a DMP as part of a research proposal. A DMP will typically cover issues such as data collection, format, storage, security, documentation, discoverability, reuse, sharing, retention and preservation. Thinking through these issues before embarking on your research will help to improve the organisation of your data throughout the lifecycle of your research and save you time in the long run.

To help you with writing your data management plan, St George’s subscribes to DMPonline – a tool provided by the Digital Curation Centre (DCC). To access DMPonline you simply need to log in with your St George’s credentials:

Screenshot of the DMPOnline website sign in page. Select "sign in with your institutional credentials".

From the dashboard, click on ‘create plan’ and off you go!

Screenshot of creating a plan option. From the dashboard, click on the "create plan" link.

Detailed guidance is available in the help tab, together with links to a wealth of resources on data management planning and examples of data management plans. You can also look at publicly shared DMPs from the reference tab:

Screenshot of public DMPs which can serve as guidance for your own. Select Reference from the top menu and then click on public DMPs.

Using DMPOnline to write your DMP offers a number of benefits:

  • access to funder specific templates
  • built-in guidance for each section of the plan
  • invite your collaborators to join the plan
  • add comments for your collaborators
  • option to request feedback on your plan from the SGUL Research Data Management Service
  • export your plan in a variety of formats including MS Word and PDF
  • option to keep your plan private, share with SGUL DMPOnline users, or share publicly

Further reading

Jones, S. (2011). ‘How to Develop a Data Management and Sharing Plan’. DCC How-to Guides. Edinburgh: Digital Curation Centre. Available online: https://www.dcc.ac.uk/guidance/how-guides/develop-data-plan (accessed 6 August 2021).

DCC. (2013). Checklist for a Data Management Plan.v.4.0. Edinburgh: Digital Curation Centre. Available online: http://www.dcc.ac.uk/resources/data-management-plans (accessed 6 August 2021).


If you would like further support with developing your plan then please do get in touch at: researchdata@sgul.ac.uk

Visit SGUL Research Data Management for general information and guidance about research data management.

Welcome video 2021

If you are joining us this autumn, have a look at our Welcome video.  

We give you our top five tips on making the most of the library, our services and resources while you are studying at St George’s. 

And…there might even be a bonus tip! 

Induction Quiz 

Don’t forget to do our library induction quiz on Canvas. It is part of your Getting Started module and you can also find it here

If you have any questions about using the library, don’t hesitate to get in touch by emailing liaison@sgul.ac.uk 

Introducing the Big Read 2021

For the third year, St George’s University is organising its very own Big Read. What is the Big Read? We’re so glad you asked…

Decorative logo for the Big Read at St George's, University of London.

The Big Read is a shared reading project, aimed at bringing new and returning students, academic and professional staff across the university together to foster community and belonging. Each year, we pick a book we think makes for an engaging read, with lots of interesting topics to discuss with colleagues and friends.

The Big Read webpages are now live.

This year’s pick

We are very excited about having chosen The Private Joys of Nnenna Maloney, the debut novel of Okechukwu Nzelu for this year’s Big Read. It is a coming-of-age story set in Manchester and Cambridge and it explores topics like going to university, race, class and sexuality. The author has managed to discuss complex and at times difficult themes with humour and warmth.

You can find out more about the book and watch the author’s message for everyone participating in the Big Read here on our website.

How to get your free copy

If you are a returning student or staff at St George’s, you can now pick up your copy from the library helpdesk between 8am and 6pm, Monday to Friday. But be quick – there is a limited number!

If you are new to St George’s, you will get your copy when you enrol. Our Big Read team will be on hand to give out books and answer your questions at the enrolment hub.

Book cover for The Private Joys of Nnenna Maloney by Okechukwu Nzelu.

What’s on?

We are busy preparing a range of exciting events for you including discussions with experts around themes such as transitioning to university, race and LGBTQ+ identities. There will be book clubs, creative writing workshops and the author will come to St George’s for a live event too. We will publish the schedule of events soon. In the meantime, why not sign up to our mailing list to be the first to hear about what’s on offer.

An Assassination in the Archive

Opening Up the Body’ is a Wellcome-funded project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946. Our Archive team have been cataloguing and digitising records dating from 1841-1921. This post was written by Project Archivist Natasha Shillingford.

While cataloguing the 1909 volume of post mortem case books of St George’s Hospital, we came across the post mortem examination of Cawas Lalcaca, a Medico. The cause of death was listed as ‘Bullet wound in back perforating lung, diaphragm, liver, mesentery, intestines and ilium. 2nd bullet wound in right chest.’  The medical case notes record that the ‘Patient was murdered on July 1 at the same time as Sir William Curzon Wyllie at the Imperial Institute by an Indian fanatic named Dhingra, who was subsequently executed at Pentonville.’

Photo of post mortem PM/1909/223.
PM/1909/223. Archives and Special Collections, St George’s, University of London

What happened on that fateful night to result in the murder of two men?

A reception had been given at the Imperial Institute on behalf of the National Indian Association. It was attended by Lieutenant-Colonel Sir William Hutt Curzon Wyllie, K.C.I.E, C.V.O, Political Aide-de-Camp to Viscount Morley, Secretary of State for India and his wife, Lady Wyllie.

The Globe newspaper reported on the 2nd July that “The occasion passed without incident until the close of proceedings. Sir Curzon was descending the staircase prior to leaving, Lady Wyllie having, in the meantime, descended to the cloakroom to fetch her wraps. Descending the staircase near Sir Curzon was Dr. Cawas Lalcaca.

Then suddenly, in the twinkling of an eye as it were, and to the stupefaction of those around, shots rang out, and Sir Curzon fell on his back on the stairs. An Indian student was standing in front holding a smoking revolver. One bullet had shattered Sir Curzon’s right eye; another bullet had pierced his face just below the other eye. Dr. Cawas Lalcaca fell with a bullet through his chest.”

There were a number of doctors among the guests, and they attended the victims, but “it was at once seen, however, that Sir Curzon’s fate was sealed and life was certified to be extinct. In the case of Dr. Cawas Lalcaca hopes were entertained of his ultimate recovery, and he was conveyed to St George’s Hospital, but died almost immediately.”

An eyewitness at the scene said that Dr. Lalcaca had previously been speaking to Sir Curzon Wyllie, and he was “of the opinion that he must have noticed the actions of the assassin just as he was about to fire, and thrust himself before Sir Curzon Wyllie, and thus received his death wound.”

Photo of post moretem PM/1909/223
PM/1909/223. Archives and Special Collections, St George’s, University of London

The morbid appearances in the post mortem examination at St George’s Hospital reveal the extent of Dr. Lalcaca’s injuries. The external description of the body describes the locations and entry of the bullets.

Meanwhile, the assassin was apprehended at the scene and escorted to Walton Street Police Station. The Globe newspaper reported that “the prisoner, stated to be a Parsee, is apparently about 25 years of age. Not of powerful physique, but mild-mannered, cool and self-possessed, his hair black, he was wearing gold spectacles, and a turban, which in the enactment of the tragedy fell off.” The motive of the crime was believed to be political, and in addition to the revolver which he fired, he had a further revolver, a long knife and a dagger on his person. His name was given as Madan Lal Dhingra, a student in Engineering at University College.

The Globe newspaper reported that when asked if he had anything to say, the prisoner replied, “The only thing I want to say is there was no wilful murder in the case of Dr. Lalcaca. I did not know him at all. When he advanced to take me I only fired in self-defence.”

An inquest on the body of Dr. Lalcaca was held at Westminster Coroner’s Court and was reported in the London and China Express, 9th July 1909.

It stated that Dr. Lalcaca was a native of Allahabad but resided in Bombay, later at Shanghai. He was a doctor of medicine and had been in England since June 8th. A friend described him as a “fine looking Indian, slightly over medium height, with a handsome bronze countenance, of a genial bearing, and refined appearance.”

The Coroner stated that it was a clear case of wilful murder by Dhingra or Dr. Lalcaca. He said that it was true that Dhingra stated that his intentions were not against Dr. Lalcaca and it was an act of self-defence, but that was not an excuse for murder. The Jury returned a verdict of ‘Wilful Murder’.

So, what was Dhingra’s motive for the attack on Curzon? The Christchurch Times reported on 10th July 1909 that a brother of Dhingra had written to Sir Curzon Wyllie asking if he would offer Dhingra some advice, as “the family feared he was getting into a dangerous circle.” Sir Curzon apparently did write to Dhingra, and advised him in a tactful manner, but Dhingra resented this advice and clearly indicated this in a letter sent to Sir Curzon.

It was also said that Dhingra had attempted to kill George Curzon, Viceroy of India and had planned to assassinate the ex-Governor of Bengal. Wyllie’s presence at events with Indian students, made him an easier target for assassination.

Dinghra was tried at the Old Bailey on 23rd July. He stated that “Whatever I did was an act of patriotism and justice which was justified. The only thing I have to say is in the statement which I believe you have got,” and he pleaded not guilty to the indictment. The Bicester Herald published Dhingra’s statement on 20th August 1909. He wished it to be read at the trial, but permission was refused. “I admit the other day I attempted to shed English blood as an humble revenger for the inhuman hangings and deportations of patriotic youths. In this attempt I have consulted none but my own conscience. I have conspired with none but my own duty.” He continued, “I believe that a nation held down by foreign bayonet is in a perpetual state of war, since open battle is rendered impossible to a disarmed race. I attacked by surprise; since guns were denied me I drew forth my pistol and fired…The only lesson required in India at present is to learn how to die, and the only way to teach it is by dying ourselves. Therefore I died, and glory in my martyrdom.”

For the murder of Sir Curzon Wyllie and Dr. Lalcaca, Madan Lal Dhingra was hanged at Pentonville prison on 17th August 1909.

The funeral of Dr. Cawas Lalcaca took place at Brookwood Cemetery, the only Parsee burial place within the metropolitan district. The London and China Express described the ceremony at the graveside as ‘short, simple and impressive. The coffin was covered with floral tributes. It was placed on a bier and drawn to the Fire Temple of the Parsees. When the coffin was taken into the building a fire of sandalwood and frankincense was lighted on the altar, on either side of which burned also a candle. The interment took place in a plain grace, and after the body had been taken from the temple, most of those present placed a small piece of sandalwood in the flames on the altar.”

The British Medical Journal reported that the floral tributes were particularly beautiful, and “conspicuous among them was a wreath from Lady Wyllie inscribed: ‘These flowers are sent by the wife of Sir Curzon Wyllie, in ever grateful remembrance of the brave and noble man who lost his life on the night of July 1st in trying to save her beloved husband and others, with deepest sympathy.’”


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Summer Holiday Library Update

Photo by Vicko Mozara on Unsplash

The recent weather has let us know that summer is finally upon us, and with the last of our student groups finishing exams in the next few days, we’re sure that many people’s thoughts are now turning to the summer holiday. Below we’ve highlighted a small selection of our services and resources that we hope will be helpful to you over the coming months, whether you’re studying or taking a moment to relax.

E-books

Hunter now gives access to over 5000 e-books to help with your studies, and this collection is continuing to grow. So whatever the topic of your assignment or research, it’s increasingly likely that you’ll find e-books that can help.

To find e-books, select Books and more from the dropdown box when you search in Hunter. Then choose Online Resources from the filter options on the left to limit your results to e-books only.

View our YouTube video for a quick reminder of how to access e-books (and other online resources) from off-campus using your SGUL username and password.

Resetting your SGUL password

If your SGUL password has expired, or if you’ve forgotten it, you can reset it here as long as you’ve previously registered an alternate email address. If you haven’t registered an alternate adress, contact the Student Life Centre to set one up.

If you have problems resetting you password, email ITAV@sgul.ac.uk.

Reading for Pleasure

If you’ve been in the library recently, you may have spotted our Summer Reading display filled with books from our growing collection of fiction, poetry and contemporary non-fiction. Coming soon will be another reading for pleasure display, this one using a new collection of uplifting titles chosen by NHS staff in collaboration with The Reading Agency. Find out which titles will be available at The Reading Agency’s website here.

Please help yourself to anything from the book display using the nearby self-issue machines.

For more inspiration, take a look at some of our book collections in Wakelet such as the Mood-Boosting, Black History Month, St George’s Big Read and LGBT+ collections. Each entry links to the catalogue so you can check a book’s availability and find it on the shelves.

Items in these collections are mostly print books only, so if you’re heading away from SGUL for the summer and are thinking of picking up a book or two, remember to do this before you go.

Research support in summer

Believe it or not, summer is a busy time for your liaison librarians as we are preparing for the next academic year, developing and updating training sessions, recording videos, preparing inductions and getting new resources and tools ready for all come the autumn. Nevertheless, we will be available all summer to help students, researchers and academics. We can help with searching Hunter, our library catalogue, using databases to do complexes searches and show you how to make the most of RefWorks, the reference management software at St George’s. Email us at liaison@sgul.ac.uk for help. If you require more in-depth support, we can schedule an online appointment with you.

If you want to get a head start for next year, check out our Libguide on literature searching and our video series on how to search Ovid databases, such as Medline. We have many more how-to videos on our YouTube channel.

From the archives: International students at St George’s

In this blogpost, written by Archivist Juulia Ahvensalmi, we will be looking at the international history of St George’s students.

St George’s Medical School was formally established in 1834, but the hospital, which was opened in 1733, took pupils long before that. There were also several anatomical schools closely associated with the St George’s, including John Hunter’s Great Windmill Street school (established by John’s brother William Hunter in 1745), and Samuel Lane’s School of Anatomy and Medicine adjoining St George’s Hospital; John Hunter was a surgeon at St George’s, and Lane had also studied at St George’s.

There were fees to pay, and students could study for various lengths of time. The early student records show that some students only enrolled for a three-month period, others for six or 12 months. Initially pupils were assigned to a particular surgeon or physician. To become a perpetual pupil, there was an additional fee (which in 1870 was 100 guineas), and allowed the student admission to the practice of the physicians and surgeons of the hospital and all the lectures, allowing them to compete for any prizes and to become clinical clerks and dressers. The high fees then (as now) meant that education was not available for everyone, and the majority of the students were from the upper middle classes; many had gone to public schools and Cambridge or Oxford before attending St George’s.

Photo of 1805 student register.
Student register 1805, showing students enrolled for various lengths of time under different surgeons. Register of Pupils and House Officers 1756-1837, SGHMS/4/1/16, Archives & Special Collections, St George’s, University of London; and Extract from student register, 1945, showing the schools and colleges attended by student prior to their enrolment at St George’s. Register of Pupils 1837-1946, SGHMS/4/1/18, Archives & Special Collections, St George’s, University of London.

International connections

The student records held in the archives reveal a steady trickle of international students, based on their names (which in these early records is often the only information recorded). Names, of course, can only be used as a starting point, but the records also occasionally explicitly refer to visiting students, as in the case of Michal Astrashapovitch and Stephen Koniwetsky, who paid £20 to study under Everard Home and attend the lectures ‘for an uncertain time, to be settled at their leaving England’. There is no more information about them, but they may have been Russian – there are several other Russian names which suggests some regular contact or connection.

Photo of 1808 student register, showing enrolment of Michal Astrashapovitch and Stephen Koniwetsky.
Student register 1808, showing enrolment of Michal Astrashapovitch and Stephen Koniwetsky. SGHMS/4/1/16, Archives & Special Collections, St George’s, University of London.

Another early student was Philip Syng Physick, who had graduated from the University of Pennsylvania, and travelled to England to study under John Hunter in 1785. Known as the ‘father of American surgery’, he is said to have performed the first human blood transfusion, and was particularly interested in using autopsy as a method for observation and discovery – a practice that we can time and again see in our post mortem records.

Swedish names also appear in the registers with some regularity, especially in the 1890s when it appears to have been somewhat of a trend to travel to London to study medicine. These students include Henning Grenander, who later gained fame as a figure skater, winning the world title at the National Skating Palace in London in 1898.

Image of Henning Grenander ice skating.
Henning Grenander. Image: skateguard1.blogspot.com

Henrik Kellgren’s ‘Swedish Institution for the Cure of Diseases by Manual Treatment’in Eton Square, London appears to have further encouraged Swedish students to study in London: Axel Wolter Louis Stackelberg, who was a pupil at Kellgren’s institute, for instance, is enrolled for 6 months as a student of anatomy in 1897, while both Kellgren’s sons Ernst and Jonas also studied at St George’s for a period; Jonas went on to study rheumatism, was a pioneer in the study of physiology of pain, and became a professor of rheumatology in Manchester in 1953.

The adventures of Hajji Baba of Ispahan

Hajee Baba may have been the first Muslim student at St George’s, and one of the first Iranian medical practitioners to study in Europe in this period. He came to England to study medicine alongside another young Iranian, Muhammad Kazim or Mohammed Cassim, in 1811 with the British ambassador to Iran, Sir Harford Jones. Hajee Baba was the son of an officer in the Shah’s army, and the sending of students to study in Britain was seen as a way of strengthening the diplomatic ties and connections between the countries; his brother trained as a mining engineer in Russia. Kazim was to study arts, but died shortly after their arrival in England.

Hajee Baba stayed in England for eight years. Following his studies, he returned to Iran to work as a physician in the court in Teheran, and in 1835 he is described as ‘a respectable elderly looking man’. He also worked as an interpreter for Persian missions abroad. Eventually he became the chief physician to the shah. He died in 1842 or 1843.

Composite image. From left to right: photo of 1817 student register, Cover of ‘The Adventures of Hajji Baba of Ispahan’ (1824-28) by James Justinian Morier; Poster for ‘The Adventures of Hajji Baba’ (1954).
Student register 1817, Register of Pupils and House Officers 1756-1837, SGHMS/4/1/16, Archives & Special Collections, St George’s, University of London; Cover of ‘The Adventures of Hajji Baba of Ispahan’ (1824-28) by James Justinian Morier; Poster for ‘The Adventures of Hajji Baba’ (1954), Wikipedia, ©20th Century Studios.

He may have been the inspiration for a series of best-selling novels, ‘The Adventures of Hajji Baba of Ispahan’ (1824-28) by James Justinian Morier, secretary to Sir Harford Jones; Hajee Baba was reportedly annoyed at Morier’s use of his name for this purpose (and would have been, we can imagine, even more annoyed by the American adventure film of the same name of 1954!).  Nile Green’s book ‘The Love of Strangers: What Six Muslim Students Learned in Jane Austen’s England’ (2016) recounts the story of a group of six students who travelled to Britain in 1815, based on contemporary diaries and letters of the students, in which he also mentions Hajee Baba and his unfortunate companion.

The problem of sources…

Often, the spelling of names varies considerably in different sources (this is of course particularly true when the original is in a different script), which can make tracking people difficult (but we do enjoy a bit of detective work!); there is a Wikipedia entry for Hajee Baba, for instance, but in that his name is spelled Hadji Baba Ashfar, whilst the Encyclopaedia Iranica uses the form Ḥājjī Bābā Afšār; in Persian his name is افشار، حاجی بابا.

Many students are also entered in the registers only by their first initial and surname, making identification even more problematic. A ‘foreign-sounding’ name, moreover, is of course not solid evidence either way – the somewhat exotic-sounding Peregrine Fernandez in 1799, for instance, ‘gentleman of Widcombe, Somerset’, may have had family roots elsewhere, but was born and bred in London. Where the student records are simply lists of names, as the earlier ones are, we have to turn to other sources to find out more about the people behind the names.

Image of Assaad Y. Kayat. Source: ‘A Voice from Lebanon with the Life and Travels of Assaad Y. Kayat’ (1847).
Image of Assaad Y. Kayat. Source: ‘A Voice from Lebanon with the Life and Travels of Assaad Y. Kayat’ (1847).

One student we do know more about is Assaad Kayat, who enrolled as a student at St George’s in 1843, studying alongside Henry Gray (of Gray’s Anatomy). His fascinating story is recounted in more detail in an earlier blogpost, and his autobiography tells us a lot about his childhood in Beirut, as well as his and his wife’s experiences as immigrants in London.

The archives also reveal the story of Boghos Baghdasan Tahmisian, who, according to an appeal launched in 1892 by the Turkish Mission’s Aid Society, was a ‘native of Cilicia’, in present-day Turkey; his name may suggest Armenian origins. He is in the appeal described as a diligent student, who had arrived in London in 1889 and enrolled as a medical student at St George’s. He had, however, found himself lacking adequate funds to be able to finish his studies, which is why the society decided to appeal to the public on his behalf.

Composite image. Left-hand side: ‘An appeal on behalf of Mr B.B. Tahmisian’ (1892). Right-hand side: a letter signed by Tahmisian.
‘An appeal on behalf of Mr B.B. Tahmisian’ (1892) and a letter signed by Tahmisian. Archives and Special Collections, St George’s, University of London.

Pictorial propaganda

Following the end of the First World War, the Universities Bureau of the British Empire (now Association of Commonwealth Universities), established in 1913, encouraged British universities to admit students, and the Foreign Office was eager to distribute what they called ‘pictorial propaganda’:

‘The idea is to endeavour to impress the peoples of Russia and of the East with the greatness of the educational system of the British Empire’

Photo of letters to the Medical School, preserved in the minute books of the Medical School Committee XII-XIII.
Letters to the Medical School, preserved in the minute books. Minutes of the Medical School Committee XII-XIII, SGHMS/1/1/1/15. Archives and Special Collections, St George’s, University of London.

‘This medical school is unable to admit any Ceylonese students’

(Medical School minute books, 1920)

The minute books of the medical school from that time contain frequent references to the admission (or not, as it were) of international students; the minutes refer to students by their nationalities: ‘a Pole’, ‘the Siamese doctor’, ‘a native of India’.

At times, certain nationalities were the subject of intense conversations. Following the end of the First World War and demobilisation, many ‘American and colonial’ soldiers found themselves with some time to spare, and willing to use that time to study. A letter from the Royal Society of Medicine in 1918 warns that if plans to offer brief post-graduate courses for such students are not soon put in place, ‘the chances are that the majority of them will go to Paris, where […] post-graduate courses have been arranged for all Allied Officers and are already in full swing!’. The response from St George’s was not enthusiastic due to staff shortages and bureaucratic burden on the school. In the end, however, it was decided that up to 10 American students could be admitted for a three-month course, with a fee of ten guineas.

Appeals from the Egyptian Educational Mission received an even less favourable response: despite admitting two Egyptian students for a clinical course, ‘it was decided that this School cannot bind itself to admit any definite number of Egyptians’, the dean at this time wrote, suggesting that the school is too small to admit ‘foreign students […] although I am doubtful whether they ever really amalgamate or attempt to settle down with their fellow-students’.

At the moment we’re looking forward to delving into our nursing records and learning more about the student nurses at St George’s. Our initial research suggests that in the 1950s-1960s for instance up to 70% of the nursing students were immigrants to the UK; among these are many from the Windrush generation, and students came from all over the world, including the Caribbean, Ireland, India, Nigeria, Sweden and Bermuda.

Photo showing nursing students' nationality in 1970s student records.
Records of nursing students at St George’s in the 1970s. Archives and Special Collections, St George’s, University of London.

Want to know more, or see and study the records for yourself? Just get in touch with us at archives@sgul.ac.uk – we’d be very happy to hear from you!


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Mental Health Awareness Week – Reading to support wellbeing

It is Mental Health Awareness Week from 10th to 16th May and this year the Mental Health Foundation has chosen nature as the theme.

This is our second blogpost for Mental Health Awareness Week. To find out about your library team’s thoughts on what nature means to them and their wellbeing in words and pictures, have a look at our previous blogpost. Check out the hashtag #ConnectwithNature on social media. We will be sharing posts around Mental Health Awareness Week all week on TwitterFacebook and Instagram.

Decorative image of person reading in a field.

A great way to support your mental wellbeing is through reading. Especially during busy periods such as exam and essay writing weeks, it is important that you take time away from work to just relax.

Reading a good novel or poetry can certainly help with that which is why the library has developed a whole collection around reading for pleasure. In addition to medical and healthcare textbooks, we also have books you might find in any public library: good novels, poetry and contemporary non-fiction for when you want to take a break from your studies.

Some highlights from our reading for pleasure collection around the theme of nature are listed below.

  • Step by Step: The Life in My Journeys by Simon Reeve. Find out the shelf mark here. The author talks about his own mental health struggles and how he has found wellbeing in walking some of the most remote parts of the world. Perfect for adventurers!
  • Feral: Rewilding the land, the sea and human life by George Monbiot. Find out the shelf mark here. An environmental journalist talks about the importance of rewilding in the UK and across the world, reengaging with nature and discovering a new way of life which is much more in tune with nature.
  • The sun and her flowers by Rupi Kaur. Find the shelf mark here. A beautiful collection of poems in which the natural world plays a big role.
  • Dream Work by Mary Oliver. Find the shelf mark here. One of the finest contemporary poets, Mary Oliver who won a Pulitzer Prize, writes about the natural world with reverence and playfulness. This collection focuses on the work of self-exploration.
Decorative image of person reading on a bench outside.

Reading a good novel or poetry can certainly help with that which is why the library has developed a whole collection around reading for pleasure. In addition to medical and healthcare textbooks, we also have books you might find in any public library: good novels, poetry and contemporary non-fiction for when you want to take a break from your studies.

Specific Wakelets, or lists, we have created, that you might find interesting in this regard are books for Health and Wellbeing , Mood-Boosting books and the Big Read collection.

Resources for nurses at St George’s library

To mark this year’s Nurses Day, we have compiled a brief guide to some of the resources that can help to guide and support the amazing work that nurses do each and every day.

Books

A wide range of print and electronic books are available from the library at St George’s. Below are some lists of available titles on a selection of nursing specialties or nursing-related topics:

To access any of the e-books included in the above lists, you will need an NHS OpenAthens account. If you don’t already have one, you can easily register online. This also provides access to most of the journals, databases and other useful resources noted below.

Websites and online resources

The Royal Marsden Manual of Clinical and Cancer Nursing Procedures, is available online with your OpenAthens account.

A series of training videos on a range of topics including how to carry out different assessments and procedures is available through the ProQuest Hospital Collection.

Clinical guidelines, resources to support professional and career development, and other helpful information can be found on the Royal College of Nursing website, while information relating to registration and nursing standards is available from the Nursing and Midwifery Council.

Journals

NICE provide a searchable A-Z of all journals available through OpenAthens, which can be found here: https://journals.nice.org.uk/

Available journals include: Nursing Standard, Nursing Management, and the British Journal of Nursing.

Login and search to see all available titles.

Databases

In addition to Cinahl and Emcare the larger, and international databases which provide coverage relevant to all nursing specialties and professionals, there are also some smaller UK specific databases with a focus on nursing: the British Nursing Index, and Internurse.

The Cochrane Database of Systematic Reviews, which you can find at the Cochrane Library also includes material relevant to nursing, as do more general medical databases such as Medline (and it’s free equivalent PubMed) and Embase.

Finding information

The library team at St George’s offers training on where and how to find the best quality information to support clinical practice, research, and quality improvement. You can find details on the sessions available here.

We also provide a evidence search service, CARES, which provides aims to provide recent, reliable and relevant evidence on your topic or question. Search requests can be submitted for patient care queries, service development, teaching or research projects, or for any other professional need.

Help

St George’s library has a team dedicated to providing support for all of the nurses (and other NHS staff) at St George’s trust. If you have any questions, need advice on anything related to finding, or managing information, or if there’s anything that we might be able to help with, you can get in touch at: liaison@sgul.ac.uk

Mental Health Awareness Week – what nature means to library staff

From 10th to 16th May 2021 is Mental Health Awareness Week and this year the Mental Health Foundation has chosen nature as the theme.

Check out the hashtag #connectwithnature on social media. We will be sharing posts around Mental Health Awareness Week all week on Twitter, Facebook and Instagram.

In this blogpost, your library team highlights in sentences and images what nature means to them and their mental wellbeing.

Over the last year, many of us have become more aware of our relationship with nature, be that our balcony, garden, local park, forest, the beach or mountains. More than an appreciation of the small things in life, the last year has shown that we are inextricably part of nature and that nature plays a central role in our emotional and physical wellbeing. It has also become clear that access to and time in nature is often still for the privileged few, despite the fact that we all benefit enormously. Nature is not a luxury but must be available to all of us. Perhaps our appreciation for the natural world over the last year in combination with our increasing and continued damage to our planet has given us food for thought. In this sense, access to nature for mental wellbeing is a social justice and environmental issue.

With this blogpost, we want to raise awareness of the importance of mental wellbeing and the role that nature can play in that. We want to normalise conversations around how we are doing and that at times, we might not be doing so well emotionally or mentally.

What does nature mean to us and our mental wellbeing?

Sue – Associate Director of Information Services (Library & Learning Services)

Escape from the rat race
Space to think
Inspiring awe
A step away from the mundane
Tiny miracles
Expanding our horizons

Rocks on the beach in Hastings
at the beach in Hastings

Karen – NHS and Liaison Manager

Accessing local green spaces has helped me and my children digitally detox during intensive times of home-learning and home-working this past year

Emily (Information Assistant)

During the first lock down, when you were only allowed an hour outside a day, I tried to ensure I took my kids out for some sort of walk every day to get a bit of exercise and fresh air.  Being outside helped us to stay feeling connected to the world and I think feel somehow reassured that the sun still came out, the rain still fell, the trees still stood, and the flowers grew. It was a sense of some normality in the chaos that nature still carried on. It made us appreciate every little bit of green space nearby.  We always returned from outside feeling more hopeful.

Anna – Liaison Librarian (FHSCE)

Conversations about nature tend to cheer people up, and are a vehicle for a non-stressful chat with colleagues.

Stephen – Liaison Support Librarian (NHS)

Regarding the question of nature, I suppose the first impulse is to think of the outdoors in some of its grander forms (beaches, mountains, forests, etc.) before then considering those havens of nature which may be nearby to us (parks, commons, woods) which, given that ‘more than one in five households in London has no access to a private or shared garden‘, offer invaluable resources in support of health and wellbeing. 

Even more locally than these, however, is the nature that can (should?) be brought into the home (and work) environment. For the good that plants can do in cleaning indoor air; for the connection that tending plants offers to a larger living world; and for the aesthetic contribution that plants can make to any indoor space, my shout out goes to the humble (or showy) houseplant.

Jennifer – Research Publications Librarian

White blossom; blue sky

Delicate petals fall and

Again, I will sigh.

Photo of tree blossoms
Blossom

Louise – Helpdesk supervisor

I like to be out in nature – in the outside, wandering in the woods – always nicer in the sunshine of course but I love lifting my face to the wind in early Autumn.

The main thing I think is how nature affects your senses;

Smell –  fresh rain – especially in the summer, flowers, freshly cut grass, even those ‘farmyard’ smells just make you think of nature in general.

Sight – new blossom on trees, the changing colours of leaves in the Autumn, freshly laid snow in Winter. Seeing newborns – ducklings/Goslings growing, tadpoles changing into frogs.

Touch – feeling grasses, petals even different textured tree trunks, pebbles, stones, sand beneath your bare feet.

Hearing – the most obvious is the bird call of course. Although noting beats the sea crashing on the shore if you are by the coast, or even the gentler shushing of waves.

Ros – User Experience & Operations Manager

Two children with their backs turned away from the camera, running along a forest path with bluebells on either side.

Dan – Information Assistant

It’s always good to get out of the house whether its just to the park over the road or a car trip to the beach. Its about being out in the fresh air and looking at the trees and green or being by the Sea. I always feel better after I’ve been outside even if its just for an hour or two. It certainly improves my day. The dog loves it too!

Juulia – Archivist

Here is a composite of photos I’ve taken across the year of the trees in a nearby woods. Having access to a green space has definitely been a lifeline, and doing more or less the same walk every day has made me focus on the seasonal changes, and on all the small details you might otherwise miss. And it has made me really appreciate how you can find beauty maybe in some unexpected places – my local cemetery is absolutely brimming with nature & life!

Composite of photos of trees across the seasons

James – Liaison Support Librarian (FHSCE)

When I’m outside in nature my mind becomes quiet and I have the opportunity to become aware of something bigger than myself. When I’m not so focused on me and my story, I can really begin to relax and start to let go of built-up tensions.

Georgie – Information Assistant

I’ve become a member of Kew Gardens in the last year and it’s been wonderful to be able to spend time in such a beautiful place. I had a lovely, quiet, peaceful walk there on Sunday morning.

Picture of bluebells and trees in the sunshine at Kew Gardens.
At Kew Gardens

Alex – Project Archivist

I think to me, nature reminds me that I am part of something bigger, something beautiful. It makes me feel extremely lucky and full of joy but as I have gotten older that joy tends to be tinged with a bit of sadness and frustration at how often we mistreat it and take it for granted. Over the last year I have loved seeing people, myself included, reconnect with nature and take pleasure in simply being outside, but I have also seen how much nature has become a privilege that not everyone has equal access to and that it is very easy to be cut off from in modern cities. Being surrounded by nature, I would say, is extremely good for my mental wellbeing, but it is not always an entirely positive experience and sometimes I do leave it feeling slightly weighed down by my responsibility to do more to protect what I have seen.

Anne – Liaison Support Librarian (IMBE)

A chance to connect with something beyond myself
Miracles of colours, textures, sounds
The abundance of life away from a screen
Sharing the joy of nature with others
A spiritual practice and gratitude
Watching seedlings grow

Careers Week 2021 Reflections and Survey

In March we held the second annual Careers Week at St George’s, University of London. We were delighted with the participation with over 500 views. Complete our survey for a chance to win £50 Amazon vouchers.

Careers Week 2021 – what did we do?

The theme this year was Resilience, Workplace Wellbeing and Planning your Career in a Pandemic. The programme included Q&A sessions in which alumni and students from a range of disciplines and courses shared their own careers and wellbeing insights, providing advice on how to manage your own future and job hunt successfully in these unpredictable times. There were top tips and words of encouragement for current students and those seeking work or direction as well as inspirational career stories, with common themes of perseverance, commitment, and consistent courage to find and take opportunity. The broad spectrum of careers and study routes open to SGUL graduates was showcased by alumni representing the wide range of SGUL programmes, some were most unexpected, demonstrating that studying a vocational course does not mean career choice and progression is a foregone conclusion.

The sessions were recorded and are available to watch on the St George’s YouTube channel.

Decorative image of two healthcare professionals walking and talking.

Win £50 Amazon vouchers – Careers Week Feedback Survey

We would really value your feedback! We are running a competition to win 3 x £50 Amazon vouchers to thank you for your participation. By giving your feedback you will help us improve and make sure we are providing the support you and future students value. You will get the opportunity to give your own ideas and suggestions for Careers Week 2022, comment on the online experience, as well as the Careers Week programme 2021. Complete the survey (5 minutes to complete). Deadline for completion is 21 May 2021.

If you missed the Alumni Q&A sessions then do visit here. See the full list below with key themes covered. It is worth watching a range (i.e. even those outside of your own programme) as the tips and inspiration are often interchangeable between disciplines. Don’t forgot to watch and complete our survey before 21 May 2021 for your chance to win Amazon vouchers.

Careers Week recordings on YouTube Channel

The Careers Week session recordings are on YouTube.

Programme contributors

Resilience and Adjusting to Channel Nicoletta Fossati, MBBS Alumna  

Adapting to change and looking after your wellbeing Cathy Wield, MBBS Alumna 

Work-life balance and managing stress Chris Redmond, Healthcare Science Alumnus

Looking after your wellbeing in a pandemic– Nirja Joshi, MBBS Alumna

Making a move into teaching, and taking a career break – Matthew Owen, Physiotherapy Alumnus

Non-traditional career pathways Francesca Humfrey, Biomedical Science Alumna

Changing career paths and moving into management– Jessica Brett, Healthcare Practice Alumna

Non-traditional routes into healthcare – Adrien Dansette, Paramedic Science Alumnus

Changing direction in your career, and working towards your goals – Shirley Forson, Physiotherapy Alumna

Postgraduate study and studying abroad – Rosie Dutt, Biomedical Science Alumna

Adapting to new ways of working and balancing work and family – Saira Alam, Therapeutic Radiography (contact careers@sgul.ac.uk should you wish to view this interview).

Making a difference through research – tips for those considering a PhD – Jacob Wildfire, PhD

Outpatients at St George’s Hospital, 1733-1948

This blogpost was written by Alexandra Foulds, Project Archivist at St George’s, University of London.

How did you become an outpatient at St George’s Hospital before the creation of the NHS? What was it like to be an outpatient at St George’s Hospital at this time? Well, from its establishment in 1733 until the creation of the NHS in 1948, St George’s Hospital was what was called a voluntary hospital, which meant that it was reliant on receiving donations from ‘subscribers’ for funding. The board of governors at St George’s Hospital was made up of those who made large financial contributions to the hospital and medical staff who, unlike at most voluntary hospitals, were eligible to make subscriptions to the hospital.

In order to support themselves, voluntary hospitals ‘ran continuous appeals and publicity campaigns’, and voluntary hospitals competed with each other for funding. They would organise dinners and fundraisers which played an important part in the social calendar for donors. The expanding middle class would donate to the hospitals out of philanthropy and because of the social status it brought them. Becoming a subscriber to a voluntary hospital also meant that you could refer people to the hospital to become an outpatient or inpatient, and the amount donated equated to a certain number of referrals that were allowed per year.

Voluntary hospitals were created in the eighteenth century to give free medical treatment to the ‘sick poor’, or those who could not afford to be treated by private physicians. A distinction was made between the ‘poor’ who were considered to be self-reliant and therefore believed to be deserving of charity and the ‘destitute’ who were not. As Henry Burdett, the hospital administrator who helped to establish the British Hospitals Association in 1884, stated:

‘The people who are entitled to free relief are those who are able to maintain themselves independently of all extraneous assistant until the hour of sickness, when the breadwinner, for instance, is  struck down, or the added expense of sickness in the home renders it necessary that the hospital of dispensary should step in’.

This meant that initially to be treated as an outpatient or an inpatient at a voluntary hospital like St George’s, patients needed a letter from one of the hospital governors or a hospital subscriber that said that they were ‘proper objects of charity’, and even once patients had been accepted they were subject to suspicion that they may be abusing the system.

The outpatient department functioned alongside dispensaries to provide out of hospital medical care to poor patients on a charitable basis, and it was where the majority of what we now refer to as primary care was conducted.

Patients at St George’s mostly came from Westminster and Pimlico, both of which were largely poor, working class areas and some parts of which were slums. In 1910 St George’s Hospital reported that the majority of patients came from Westminster (Pimlico), Chelsea, Fulham and Battersea, with a few coming from further South in Clapham, and Lavender Hill (King Edward). 6% of these patients were trained servants, however, only 2 1/4% were currently employed as servants, and their average annual wage was between £21 and £22.

Photo of a newspaper clipping showing a photo of people attending the unveiling of the bust of John Hunter at the St George's Hospital Medical School, Hyde Park Corner. Not Dated.

After receiving a letter from a subscriber to the hospital, outpatients would visit St George’s Hospital. They would first be seen by a Medical Officer who would decide whether a patient was an acceptable hospital case, should be an outpatient or an inpatient, or should be treated as a casualty in which case they would be seen by a doctor immediately. The term casualty could apply to anything from ‘a small cut’ to a ‘bad toothache’, as well as those who had been in an accident. Once a patient had been accepted as an outpatient an Inquiry Officer would ask for their name, age, occupation, address, their marital status, their wages, and if they were married then their number of children that were dependent on them. In the case of patients who were children they would also be asked for information about the father, and in the case of married women they would be asked for information about their husbands.

Upon their second attendance at the hospital they would be seen by a Casualty Officer and an Almoner. The almoner could then investigate to advise on whether free treatment should be ceased and patients should be referred to workhouse infirmaries, private practitioners, dispensaries, or other hospitals. In 1910, of the 48,583 outpatients 6,768 cases were investigated, with 432 considered not suitable for treatment. The almoner could also decide along with the doctor whether home visits from volunteer ‘lady health visitors’ should be organised, or whether instruments (such as trusses for hernias) or meals should be provided, generally paid for out of the Hospital’s Samaritan Fund which was principally made up of subscriptions from hospital governors. The almoner was also responsible for coordinating with charitable societies to ensure that patients would continue to receive the care they needed outside of the hospital.

At the beginning of the nineteenth century, outpatient treatment numbers were small, however, from 1835 they began to rise and continued to rise until the beginning of the twentieth century. In the years 1833-1842, St George’s Hospital treated 70,000 cases of which 44,000 were outpatients. By 1910, St George’s treated 48,583 outpatients in that year alone, of which 67% were casualties.

As a result, doctors had to treat patients incredibly quickly, with Dr Robert Bridges, a casualty physician at St Bartholomew’s Hospital and later the Poet Laureate, writing in 1878 that he had to treat over 30,000 outpatients a year at a rate of 88 seconds per patient. By 1900, St George’s Hospital introduced a limit on how many new outpatients would be treated each day with the rest being turned away. In 1910 average outpatient attendances were approximately 160 a day, with new cases limited to 15 per hospital department per day, with all patients being seen first by a superintendent who imposed the limit when they arrived at the hospital. If a patient was not one of the 15 but was considered to require treatment he was brought back the next day.

Photo of the outpatient department at St George's Hospital at Hyde Park Corner.

As outpatient departments provided free access to health care, they were viewed as being in competition with private physicians and were therefore seen as a threat to the physician’s income. This meant that in medical journals outpatient departments, and voluntary hospitals more generally, were frequently described as locations in which patients abused the medical system by getting free care when they could afford to be treated by a private doctor.

By the end of the nineteenth century several voluntary hospitals, St George’s among them, was choosing not to require a letter from a hospital subscriber for outpatients (Louden), and so physicians tried to introduce the requirement for patients to be referred to the hospital by private practitioners in order to prevent this perceived abuse of the system. A letter to the British Medical Journal in 1894 stated that:

‘The abuse of the hospitals’ outpatient departments is an evil so gigantic that the tendency is to regard it […] as necessary in the sense of being unavoidable […] The remedy lies in the hands of those who suffer most from the unfair competition of the hospitals, and it is idle to appeal to the public or to the hospital authorities. […] The remedy I would suggest (though I claim no originality) would be to admit to the outpatient department only patients whose cases are certified by some medical authority or medical man to require special consideration’.

In 1910, however, only 3-6% of outpatients at St George’s Hospital were referred by physicians.

These perceived abuses led in 1910 to an investigation into the admission of outpatients in hospitals in London by the King Edward’s Hospital Fund for London, who from 1897 gave funding to voluntary hospitals. They called on people from various medical charities and representatives from each of the voluntary hospitals to testify, asking about the suitability of the letter system, hospital procedures for dealing with outpatients, the numbers of outpatients and the kinds of cases hospitals treated, and whether they believed the system was being abused by patients. William West, the treasurer at St George’s at the time, testified, arguing that he did not believe that the system was abused at St George’s, but that there were times it was misused by patients who had paid to be treated by a physician and upon seeing no improvement wanted a second opinion and so visited the hospital.

In 1948 the NHS Acts brought voluntary hospitals under public ownership, however, researchers have argued that it is these nineteenth and early twentieth century arguments about the relationship between hospitals and private physicians that led to our current NHS health system in which patients are required to be referred to specialists in hospitals by their GP.


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Information Skills Training: April to June

In the upcoming months we will again be offering a variety of library skills training sessions. There are different sessions suitable for your level of expertise or year of study, for students, academics and NHS staff.

Below you can find out more about the different training sessions we offer and the dates for these sessions. To book, please visit LibCal and register for the session you would like to attend. These sessions are all held online, via Microsoft Teams.

Don’t forget, we also continue to run our Library Research online drop-ins, Monday to Friday 12-1pm. At our drop-ins we can help you with getting started with finding information for your assignment, doing in-depth literature searching projects and referencing enquiries.

Visit our website to find out more or email liaison@sgul.ac.uk.

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Training sessions on offer

My Learning Essentials: Hunter & Harvard

Wednesday 26th May, 1-2pm
Tuesday 22nd June, 1-2pm

This session is suitable for SGUL or FHSCE undergraduate or postgraduate students who have specific referencing or literature searching enquiries relating to their assignments.  You will be able to discuss your query with the librarian, and receive guidance on how to effectively use Hunter to find academic books and articles and how to use CiteThemRight to ensure your referencing complies with SGUL’s specific Harvard Referencing Style.

Book here.

Literature searching for your dissertation

Tuesday 18th May, 11.00-12.30pm
Tuesday 15th June, 11-12.30pm

We know databases, like Medline (aka PubMed) and CINAHL, can be daunting, but with a little help and guidance, we are short you will get to grips with them in no time. If you have a longer research project, like a dissertation, or you just want to impress in your assignments, this session is for you. You will learn how to effectively run a literature search in a database relevant to your subject. The sessions are suitable for St George’s and FHSCE staff and students.

Sign up here.

RefWorks

Thursday 13 May 1-2pm
Wednesday 16 June 12-1pm

In this session, we will introduce you to the reference management software RefWorks. We will show you up to set up an account, add references, manage them and how to use RefWorks Citation Manager (RCM), a Microsoft Word Add-in.

Book here.

Training sessions for NHS staff

NHS Library induction

Thursday 20th May, 12.30-1pm
Tuesday 15th June, 11-11.30am

Library induction for NHS staff, introducing you to the range of services and resources on offer to those working for St George’s Hospital, Queen Mary’s Hospital and other community-based sites.

Sign up here.

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Finding the Evidence

Thursday 29th April, 1-2.30pm


Monday 10th May, 12-1.30pm
Wednesday 26th May, 12.30-2pm


Friday 11th June, 11-12.30
Monday 21st June, 1-2.30pm

Finding top-quality evidence is a priority for health care practitioners. This session will introduce the high-quality resources available to you, as well as provide training in how to use them effectively to support evidence-based clinical practice or decision-making.

The session will cover: The range of evidence-based healthcare resources available, including: NICE Evidence, the Cochrane Library and BMJ Best Practice.

How to use the NHS databases effectively and identify the most appropriate database for your need. This includes how to create and plan a search strategy using subject headings and keywords and how to combine searches and apply limits to focus your results; how to access full-text articles where available or locate articles through St George’s journals page; and how to save your searches and set up alerts.

You can book your slot here.

Systematic Reviews: finding and managing the evidence

Wednesday 28th April, 1-3pm

Tuesday 25th May, 11am-1pm

Thursday 24th June, 11am-1pm

This course will focus on in-depth literature searching for systematic reviewers and how to manage your results. It will provide you with an overview of the systematic review process, the know-how of creating effective search strategies, systematic searching of the literature, managing your results and documenting the search process.

You can book this session here.

At the end of this session you will be able to:

  • plan robust search strategies for literature searches in support of systematic reviews
  • carry out systematic, advanced searches on the Ovid platform
  • save searches strategies and create alerts
  • plan how you will manage your search results and report on your search methodology.

If you have any questions about these training sessions, don’t hesitate to get in touch by emailing liaison@sgul.ac.uk.

The library working environment: study break passes and texting service

Maintaining a pleasant working environment for everyone who uses the library is one of our main concerns. To ensure that it continues to be a great place to study, we have introduced, or rather reintroduced for those of you  who have used the library for a few years, two new schemes.

Study break scheme

We are still operating at reduced capacity and we’d like to make sure everyone has access to the study space they need. A study break pass allows you to take a break of up to 30 minutes during which time you can leave your belongings unattended. While we don’t take any responsibility for unattended personal stuff, with our study break scheme you can make sure that we don’t move your things to make space for other library users during the 30 minutes. After that time or if you choose not to use a study break card and you are away from the desk, other library users or staff are able to move your belongings to the side to make space. Find out more here or email library@sgul.ac.uk with any comments you might have.

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Noise in the library

We have also introduced a texting service, so you are easily able to alert us to noise in the library or other issues affecting your study space. Text us, with your location, on 07562901543 and we will ensure you can study in peace and quiet. This service is available between 9am and 9pm Monday through to Sunday. Again, if you have any comments about this, please email library@sgul.ac.uk.

Poster for texting service.

We hope that these schemes allow us to continue keeping the library a pleasant working environment for all library users.

Tips and tricks for longer research projects

The focus of this blogpost is literature searching, specifically for longer research projects such as dissertations, and it is aimed at St George’s students.

Your expert Liaison Librarians are able to support you with every step of the way so don’t hesitate to get in touch by emailing liaison@sgul.ac.uk. We are able to advise on how to plan and carry out a complex literature search in a variety of databases. We can also recommend which databases are most suitable for your topic.

You can email us for an individual appointment or come to one of our online drop-ins. Monday to Friday between 12-1pm you can chat to a Liaison Librarian directly. Click on the relevant link on the day you want to drop by.

Here we provide tips and tricks, no matter which stage of the process you are currently at.

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If you are…

…just getting started

Do a scoping search in Hunter. Even if you already use Hunter to locate books and journal articles in our collection, our Hunter video might teach you another thing or two about how to really make the most of its search functions.

If you aren’t familiar with the planning stage of literature searching or you usually skip this bit to get stuck in straight away, now is a good time to change that. When it comes to dissertations and research projects, you need to be much more systematic in your work, including when you formulate your research question. Have a look at our Canvas unit on this topic. It gives you more information and by the end, you will have a research question ready to start searching with.

If you are worried about how to structure your dissertation or academic writing, you can make an appointment with the Academic Success Centre team. Their details are found on the Study+ section in Canvas. We also have a number of books in our collection which can help with academic writing, including how to approach a literature review, dissertation or research paper. They are listed on our Writing for Assessment Wakelet.

If you need specific software to do your research, such as SPSS, have a look at what is available to you through St George’s University and request it here.

And finally, a little tip on how to get started. If you know of a paper which covers the area you are interested in already, have a look at which articles they reference and perhaps you find some relevant papers in their reference list for your project. While this is not a systematic method, it can help you get started and add to your search strategy (e.g. which alternative terms to use).

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…ready for an in-depth literature search

If you are a little overwhelmed by the prospect of doing a complex search in multiple databases (and who can blame you), you need to start by familiarising yourself with how to build a complex search, what alternative terms are and how to include them and how to use advanced search strategies. We have a libguide that takes you through the whole literature searching process. For those of you who are working on a systematic literature review, have a look at our relevant libguide, which highlights what you need to consider to turn your literature review into a systematic literature review. Watch the following videos to find out more about identifying keywords and alternative terms.

We have introductory videos on Ovid (Medline), Ebsco (Cinahl) and Internurse to get you started. Once you have familiarised yourself with the basics, watch our detailed video tutorial on how to search in Ovid/Medline using advanced search techniques.

Have a look at our Databases A-Z list to see which databases are available to you. Your subject guide will tell you which databases are most relevant to your course.

Don’t forget – you can also ask a Liaison Librarian for help by emailing us at liaison@sgul.ac.uk or coming to one of our daily online drop-ins. We can recommend which databases are most suitable for your topic.

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…finishing up and sorting out your references

To cite correctly at St George’s, most of you need to use Harvard Cite Them Right. While we have a number of physical copies of this in the library, you will probably be using the Cite Them Right website (login required). In case you need a refresher on how to navigate Cite Them Right, we also have a detailed walkthrough video on our YouTube channel and in our Referencing Essentials unit in Canvas.

We strongly recommend you don’t use reference generators such as Cite This for Me as we find that generally the references produced by such tools are wrong. You end up spending longer correcting and double-checking your references than you would have done writing them from scratch. If you find the resource in Hunter, you will notice a “citation” option for each record. This has been formatted to match the requirements of Harvard Cite Them Right but it is not always correct. Make sure you compare it to Cite Them Right and correct it if necessary.

For a longer project, we encourage you to use reference management software as it helps you to deduplicate your search results, manage your references and create in-text citations and references. At St George’s, we support RefWorks, which is a web-based software. You need your St George’s login to access it and create an account. To get started, have a look at our RefWorks libguide. Additionally, our detailed video tutorial covers everything from how to get started to how to create references and in-text citations from within Microsoft Word.

We can also help you with your references, so if you are unsure about anything please email liaison@sgul.ac.uk or come to our drop-ins.

A Railway Mystery

Opening Up the Body’ is a Wellcome-funded project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946. Our Archive team have been cataloguing and digitising records dating from 1841-1921. This post was written by Project Archivist Natasha Shillingford.

Following on from the discovery of a post mortem case of a monkey on the railway we decided to explore other cases of railway mysteries in the post mortem collection of St George’s Hospital. We soon came across a case worthy of the great Hercule Poirot.

On 23rd September 1886 Moritz Fischer was admitted to St George’s Hospital with a compound depressed fracture of the skull, with laceration of the dura mater and brain with meningitis.

PM/1886/292. Archives and Special Collections, St George’s, University of London

The case notes said that ‘The man was found in a 1st class compartment of the Metrop[olitan] Railway with a fractured skull.’ He was conscious but did not speak. There was a scalp wound about eight inches in length which extended from the centre of the forehead. The external table of the skull was fractured and the internal table was driven through the dura mater into the brain, with the brain substance protruding. The fragments of the bone were picked out with forceps and the scalp was brought together with sutures. He went on well without any special symptoms for nine days when he passed his urine into the bed and became drowsy. His temperature slowly rose from 99 degrees to 106 degrees on the evening of the 3rd October and he died on the 4th.

The post mortem examination states that there was a wound 3 ¼ inches long over the frontal region. It started from a point 1 inch to the right of the middle line and passed obliquely forwards and to the left. The angles of the wound were infiltrated. Beneath it, part of the temporal bone was absent. Some soft greyish substance protruded which was examined microscopically and found to consist almost entirely of nerve fibres, blood and granular matter.

PM/1886/292. Archives and Special Collections, St George’s, University of London

What happened to Mr Fischer in the first-class compartment to cause such brutal and deadly injuries?

Lloyds Weekly London Newspaper reported on September 26th 1886 that on the arrival of the train at Bayswater, ‘the attention of the newspaper boy attached to the bookstall on the platform was attracted to the last compartment by one of the first-class carriage fourth from the engine, there being a stream of blood on the outside of the carriage door, the window of which was open. On looking through into the compartment the lad observed a gentleman lying prostate on the floor, alone, and with his feet towards the door, there being a small quantity of blood on the carpet, and a much larger quantity on the cushion of the seat nearest the engine.’ The acting-inspector on duty opened the door and ‘saw that the unfortunate man was quite insensible, and that blood was flowing from a terrible wound on the forehead.’ The gentleman was ‘attired in a grey overcoat, the coat underneath being of black diagonal cloth, and his trousers were light-striped. His gold watch and chain were safe, as were also his rings, but not much money was found in his possession. A few papers were discovered, and they were all in German. A visiting card was found bearing the inscription, “Mr. Moritz Fischer,” and the police, as the result of subsequent inquiries, ascertained on Friday that the injured gentleman was Mr. Moritz Fischer, head of the firm of Mr. A. Fischer and Co., general foreign agents of 35 Carter-lane, and having residence in Westbourne-terrace.’ Thus it appears that none of Mr Fischer’s belongings were stolen so theft was unlikely to be a motive for an attack. However, ‘It was reported that despite the carriage being empty, they could not be quite certain on the point, owing to the confusion which prevailed.’ Therefore it is entirely possible that another individual was in the carriage with Mr Fischer and escaped during the turmoil.

The police, however, were of the opinion that Mr Fischer sustained his injuries by accident, and the following anecdote appeared to confirm this hypothesis:

‘A friend of the injured man says that about twelve months ago Mr. Fischer met with a curiously similar but by no means so serious an accident while travelling on the railway. He had put his head out of the carriage window when he was struck by some projection in the tunnel. He was severely cut, and had to wear a bandage for some time. The injury then sustained was just over the forehead, as now, but the skull was not fractured. The old accident subsequently formed a standing joke among his friends, and he was often rallied about putting his head out of carriage window and advised not to be of so inquisitive a turn of mind. Only a few nights ago the old joke was repeated to him, along with the question whether he had lately been putting his head out of the window. This may be an explanation of the mystery, or it may be only a striking coincidence; but it is a singular fact that most of the known facts appear to lend themselves to such an explanation of what at first appeared to be a very tragic crime.’

The newspaper paper continues by saying that ‘It is conjectured that Mr. Fischer had a propensity for watching the people who occupied the adjoining compartments, and while indulging in this habit he must have placed his feet on the carriage seat, and in his endeavour to place his body as far outside the window as possible, his head must have come in contact with the projection in the spring of the arch.’

However, at the inquest into the death of Moritz Fischer (reported in the London Evening Standard 08 October 1886), a friend of the deceased, Fritz Mercier, said that despite being aware of Mr Fischer previously having injured his head during a journey from Manchester, he refuted the claim that he was well known to have put his head out a carriage window. Despite this, the inquest further confirmed that there was no sign of a struggle, there was no derangement of the carriage and ‘On the night of the accident when the traffic had ceased, Witness went in a carriage and found at the very spot where it was supposed the gentleman met with his injury, that it was quite possible by leaning about 18 to 20 inches out of the window, to meet with a similar accident. At the same spot there was a continuous trail of blood on the wall.’ Furthermore, a witness spoke to picking up a pair of spectacles about twenty yards from where the blood was found on the wall, and another witness testified that Mr Fischer had never been known to be without his spectacles.

Based on the evidence, and despite conflicting testimonies from the friends of Mr Fischer, the jury returned a verdict of Accidental Death. Foul play or a case of curiosity killed the cat, either way please refrain from putting your head outside a carriage window on a moving train.


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New Read and Publish deals for 2021

Since last year’s announcements, SGUL Library has expanded our number of “Read and Publish” deals, giving SGUL researchers even more opportunities to publish open access – this year we have new arrangements with publishers such as Oxford University Press, BMJ Publishing and Cambridge University Press, in addition to others such as Springer and Wiley.

Under these Read and Publish deals, open access fees for publishing original research in many journals from participating publishers are waived.

The deals are called read and publish because the institution has paid for SGUL staff and students to have access to read articles in the subscription journals covered, PLUS, where the SGUL researcher is the corresponding author, research articles can be published under a Creative Commons licence at no extra cost. This is visualised below:

Image shows a large green circle containing a smaller blue circle, containing an even smaller yellow circle. The largest circle is labelled 'university subscription', the middle circle is labelled 'Read articles' and the smallest 'Publish open access'.

To be eligible to publish open access, you’ll need to be the corresponding author on the paper, and either a member of St George’s, University of London staff, or a student at St George’s, University of London. You’ll be expected to use your SGUL affiliation on any articles where the fee is waived under this scheme. Guidance on acknowledging affiliation is contained in SGUL’s Research Publications Policy.

Corresponding authors who are members of St George’s University Hospitals NHS Foundation Trust staff with honorary status at SGUL won’t normally qualify for these deals, although if the paper acknowledges a UK funder and a co-author with a relevant grant is based at SGUL, the paper may still qualify – please contact us for further advice.

As well as increasing the opportunities for SGUL researchers to make their research openly available, these deals will also help researchers to comply with funder mandates to publish open access (a CC-BY licence will usually be the one to select for funded research papers).

Which publishers are included in these new deals?

  • BMJ Publishing, including titles such as Archives of Disease in Childhood, Gut, Heart and Sexually Transmitted Infections (your research must be acknowledging one or more specific UK funders to qualify). Note: This deal does not include open access waivers for publishing in the BMJ, or wholly open access titles.
  • Cambridge University Press, including titles such as British Journal of Psychiatry, Cardiology in the Young, Epidemiology & Infection and Twin Research and Human Genetics.
  • Oxford University Press, including titles such as Brain, Clinical Infectious Diseases, European Heart Journal, Human Molecular Genetics, Journal of Infectious Diseases and Virus Evolution.
  • The American Physiological Society, including titles such as American Journal of Physiology – Cell Physiology and American Journal of Physiology – Lung Cellular and Molecular Physiology. Researchers will also be eligible for a one year APS membership.

See our webpages for further information on the publishers and journals included in these deals, and information on how to apply.

Open Research Platforms

As well as these opportunities to publish open access, a growing number of funders are providing open research platforms for researchers to publish the results of their research rapidly. These include:

Are you funded by the Wellcome Trust?

If you are funded by the Wellcome Trust, remember that their open access policy has changed for journal articles submitted from 1st January 2021. All original, peer reviewed research articles funded by the Wellcome Trust and submitted from this date must be made freely available via PubMed Central (PMC) and Europe PMC by the final publication date, and must be published under a CC BY license (unless Wellcome has agreed to the use of a CC BY-ND license).

The following statement must be included on original, peer reviewed research articles funded by Wellcome and submitted from 1st January 2021:

“This research was funded in whole, or in part, by the Wellcome Trust [Grant number]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.”

This rights retention strategy, developed by cOAlition S, will allow Wellcome funded authors to publish in their choice of journal, while also complying with the Wellcome Trust’s new open access policy.

COAlition S have also produced this graphic to explain the rights retention strategy.

For more information on Wellcome’s open access policy, have a look at our Library web page setting out the key points you need to know.

Questions?

Contact us at openaccess@sgul.ac.uk

Or see our Open Access FAQs webpage

Jenni Hughes, Research Publications Assistant

Jennifer Smith, Research Publications Librarian

If you are interested receiving updates from the Library on all things open access, open data and scholarly research communications, you can subscribe to the Library Blog using the Follow button or click here for further posts from us.

Big Read 2021: ‘Airhead’ reviews by the St George’s community

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This year, Emily Maitlis’s book Airhead : the imperfect art of making news was chosen as St George’s University’s Big Read book. The Big Read is a shared reading project to foster a sense of belonging among staff and students. It is not too late to claim your free e-book copy. Visit our website to find out more.

Since the beginning of the academic year we have had a number of engaging events around the Big Read. We have met for book clubs (there’s another one on the 28th April). People from across the institution organised discussions around some of the themes covered by the book such as the environment, grief, meditation and movement. We also had the pleasure of welcoming Emily Maitlis to St George’s and hearing from her directly as she was interviewed by two St George’s students. You can find the recording of that session here.

Airhead is a collection of Emily Maitlis’s accounts of meeting world-famous people, reporting on significant world events and investigating important topics of the day. As such, the book lends itself perfectly to reviews as each of us will have chapters that resonate more than others.

Book cover for Airhead by Emily Maitlis

Below you can read a selection of chapter reviews from members across the St George’s community.

Dan Jeffcote (Information Assistant) – David Attenborough: One hour in a hot-air balloon

The interview took place just after the BBC released “Planet Earth II”.  The programme features incredible camera-work and increasingly there is a sense of urgency about the effects of climate change on the planet in his work.

In the interview he discusses issues such as the ozone layer, plastic, building in wildlife habitats and population growth. He is clearly passionate about using scientific evidence to explain climate change. He is well known for his gift for narration and as an adventurer but its his calmness, thoughtfulness and wisdom that come across in this chapter.

His message appears to be we have at this moment in time a choice to either “destroy” or “cherish” our heritage.  Emily Maitlis describes her one hour with him as an interview that calms her soul.

Alina Apostu (Student Experience Officer) – A few words on Jon Stewart and the creature of the news

I suppose one question is ‘What is it like? What is it like to meet all those people in person?’

She, Emily Maitlis, does a good job at giving you a sense of how that might be … but it’s a different feeling that she makes real for the reader …

While all the names in Airhead are big names, my first chapter to read was the one about Jon Steward. I like Jon Stewart. A lot. I like his work, his humour, his voice (both metaphorically and literally). So I echoed Maitlis’ hopes that ‘I do not want to find out he’s a complete muppet in real life. That his thoughts are all tightly scripted, his jokes pre-prepped. I am desperate, in other words, not to be disappointed.’ (p.60).

In the chapter, Maitlis moves so swiftly from mention of his film, Rosewater, and the story behind it of the incarcerated Iranian journalist Maziar Bahari, to the different implications of writing news and writing satire, to his political convictions, to the relationship to his father, to his retirement from the Daily Show, to his view of Islamism, to the effects news have on people’s actual lives, to how he thinks (or doesn’t) about the audience. Eight topics in what feels like a glimpse of a meeting.

As I read, the feeling that became real was of that rush, that rush of the news, of the need to ‘get it’, of the clock-ticking… the book doesn’t lie, it is about the imperfect art of making news, and it felt that whom I met was not so much Jon Stewart but something else … an entity, a creature of the news that takes hold of everything, that brings interviewer and interviewee together in a quick exchange, moving oh so swiftly between philosophical questions, practical implications in real life and personal, intimate histories. Not sure how I feel about that creature …

Sue David (Associate Director of Information Services (Library & Learning Services)) – Rachel Dolezal: the black human activist who turned out to be white

I have enjoyed Emily Maitlis’s book Airhead, with its broad range of issues and personalities and its insight into the frantic life of a journalist – her emotional rollercoaster and personal struggles and juggles.

I found this chapter particularly thought provoking in the context of my own journey towards an understanding of issues associated with racism which have recently been brought to the fore, but which have been part of the British narrative for centuries.

Rachel is a complicated character with a host of interwoven complexities following her abusive upbringing and the negligence and despair she suffered as a child.  That she finds solace in a role as a substitute mother to four adopted black siblings in whose culture she become immersed is a fascinating insight into someone who is looking for a sense of belonging and a need to escape from her own reality.

Emily Maitlis treats Rachel with empathy and compassion.  She does not try to sensationalise her story and has split loyalties, understanding what others will be expecting from the interview – and they are disappointed.  The vitriolic responses to Rachel and the interview are deeply upsetting and have a personal impact on Maitlis who feels an inner need to protect the person behind the story.

This is an example of a hugely complex story which cannot be tackled from a single perspective.  Here the issues “had overtaken the person at the centre”, but the focus of the interview was Rachel and Emily Maitlis treats her subject with sensitivity despite the expectations of her audience.

James Calvert (Liaison Support Librarian (Faculty of Health, Social Care and Education))

Airhead: The Imperfect Art of Making News examines the nature of broadcast news journalism, capturing a vivid snapshot of what happens in front of the camera as well as behind the scenes. As an anecdotal tale of her journalistic adventures, and seemingly fuelled on a diet of chocolate, alcohol and very little sleep, Emily Maitlis takes us swiftly from one famous encounter to the next, her book presented as a collection of compelling vignettes. The short, episodical chapters that make up this easy-reading, but not always comfortable-reading book offers an insider’s perspective on the news-making process. For myself, this never felt more real than with the chapter, ‘Meeting a Prince’, an account of the build-up of the weeks and days to that now infamous Newsnight interview, an important event that may still have the power to help Epstein’s victims later down the line.

Anne Binsfeld (Liaison Support Librarian (IMBE)) – Russell Brand: How Addiction Starts with a Penguin Bar

While I don’t necessarily like Russell Brand, his way of branding himself or even most of his opinions, I really enjoyed the chapter on Maitlis’s interview with Brand around addiction and his book Recovery. Emily Maitlis’s honesty is disarming and I am intrigued by her claim that his book is ‘a sort of AA programme without the pomposity’ considering Russell Brand comes across as pompous and over the top quite often. In this interview however, or rather in Emily’s account of this interview, he comes across as insightful and honest – perhaps because I can see the importance of acknowledging addiction as incredibly common, be it to online shopping sprees (in Maitlis’s case) or drinks, drugs and Penguin bars (in Brand’s case). I would imagine after a year of Covid-19 and three lockdowns down the line, most of us have developed unhealthy coping mechanisms to, as Brand says, supplement ‘our experience of being’. Addiction is a distraction from worries and fears that just feel too large for us to face head on. Despite Brand’s charm, Maitlis doesn’t let him off the hook easily and I have also enjoyed reading about that. Although she might not get any ‘tears of repentance’, she does know how to ask those questions that touch on something true and important in Brand’s experience. In return, Brand comes across as an engaged and engaging interviewee. The final scene highlights poignantly that the art of making news is a game of give and take, like a dance in which interviewer and interviewee are in communication with each other. Great interviews are not one-directional and as Emily Maitlis is happy to admit, put the interviewer on the spot time and time again.

Women in Leadership at St George’s

This blogpost was written by Sue David, Associate Director of Information Services (Library & Learning Services) at St George’s, for International Women’s Day 2021.

Sue David, Associate Director of Information Services (Library & Learning Services) at St George’s

St George’s is lucky to have many inspirational women leaders who act as role models to the whole institution.  Our Principal Jenny Higham, gives us an example of a woman who has made a mark in her field; a practicing clinician, leading a complex institution, with an amazing CV.  She inspires confidence and trust, but remains approachable and compassionate.  Alongside her in the Senior Leadership Team, Jane Saffell heads up Education with tireless energy, creativity and vision.  Other women leaders at St George’s are many and bring their own skills and personalities to their roles.

In the field of librarianship I can look to colleagues who have truly inspired me and have had an impact on how I fulfil my role on a day to day basis.  Liz Jolly, currently heading up the British Library is a loud advocate for services which genuinely meet users’ needs.  Stella Butler (Leeds) and Chris Banks (Imperial) are strong voices for change in accessibility and access to resources.  Within the University of London colleagues at some of the biggest institutions (King’s, City, LSE) work tirelessly to support their staff and deliver the best services they can within the budgets available to them.

What I hope I have gleaned from my encounters with these colleagues is that there is a huge range of skills and attributes that make a strong leader.  There are plenty of important texts and articles, development programmes (the Aurora leadership programme was a particular highlight for me) and training opportunities (I would point to “Manager as Coach” which I attended this year), but I believe it is my networking with inspirational colleagues both within St George’s and in the wider community that has shaped my approach.

From my experience I have come to realise that a cornerstone for me is authenticity.  I try to remain true to my values and to also encompass the St George’s CORE values (Commitment, Openness, Respect, Engagement) in how I lead my team.  People are at the heart of everything I do and my greatest inspiration is my team.  I value their enormous commitment, creativity and hard work. They inspire me to do the best job I can, represent them and our services fairly across the institution and raise the profile of our services wherever possible. 

The key skills I have tried to develop to help me do this are emotional intelligence, empathy and an ability to listen.  Enthusiasm and energy are also important to me and I hope to lead from the front, showing that I am willing to be on the front line when I am needed and not shy away from tasks which are difficult or outside my comfort zone.  My door is always open and I hope that I welcome suggestions, innovation and change from wherever in the institution it may come.

Covid has really emphasised the need to be flexible – to be willing to take on new challenges and contribute to the whole institution’s response.  This has involved engaging with colleagues I wouldn’t normally have the opportunity to work with, learning from them and collaborating in our response, keeping our students’ and staffs’ best interests at heart.

Taking a leadership role can be daunting.  Overcoming the feelings of inadequacy and developing confidence in your ability to do the best job you can in your own way takes time.  Seeking support from both inside and outside the organisation, getting involved in activities which are challenging (chairing committees, involvement in external networks) and trusting your instincts go a long way to help.  I think it is really important not to be afraid to make mistakes and to own those mistakes and learn from them.  We are none of us perfect and can only do our best. 

For me it is important that what I do enables others.  I aim to help my team grow and develop their own skills and qualities, to help our students get the service they need and to help St George’s continue to be a caring, compassionate “family” that strives to do the best it can for everyone.

Careers Week 2021: 1-6 March Careers Inspiration in Challenging Times

It has never been so important to manage your career to achieve your ambitions. The next St George’s Careers Week (our second ever!) will be taking place over the week 1-6 March, coinciding with the same national themed week.

Register here.

We hope the programme will help you make the right choices, inspire you with real life stories, re-energise your job hunt, and ultimately, boost your career.

Open to students of all year groups and pathways, as well as recent graduates, our programme of events will address themes like Resilience, Workplace Wellbeing and Planning your Career in a Pandemic. The programme will include Q&A sessions in which alumni and students from a range of disciplines and courses share their own careers and wellbeing insight, as well as advice on how to manage your own future and job hunt successfully in these unpredictable times.

We will be revealing other useful careers and well-being resources during Careers Week and beyond to help our current students and newest alumni on their career path.

Details of the virtual programme is Canvas Careers Pages, Sgul.ac.uk and other St George’s social media.

You can view profiles, stories and advice from our alumni, tips on resilience, and well-being resources.

We hope you will be able to join us! REGISTER HERE (to keep up to date with latest news and activities)

The Post Mortem Examinations and Case Books as a Source for Genealogical Research

Opening Up the Body’ is a Wellcome-funded project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946. Our Archive team have been cataloguing and digitising records dating from 1841-1921. This post was written by Project Archivist Natasha Shillingford.

Previous blog posts have highlighted the value of the Post Mortem collection for contributing to our understanding of medical education, death practices, and the history of London’s hospitals and infectious diseases. However, it is also a valuable and rich resource for genealogy and tracing your family history. The collection consists of 76 volumes, and an estimated total of 36,000 cases which is a lot of names! The majority of the patients admitted to St George’s Hospital were from the lower classes as wealthier individuals were able to pay physicians to attend to them in their homes. Therefore, the Post Mortem Examinations and Case Books provide information about working class patients who may not be represented in many other records and can provide additional or missing information about your ancestors.

PM/1890/349. Archives and Special Collections, St George’s, University of London

The right-hand page is reserved for details of the medical case before the patient’s death. It records the patient’s medical history, current symptoms which caused them to attend the hospital, a description of the patient on admission and details of the treatments prescribed and changes in condition prior to their death. On first glance the medical case history appears to be rather formulaic but on closer inspection they provide fascinating insights into the patients and provide a glimpse into their life before death.

From 1st July 1837 all births and deaths had to be reported to a local registrar, who in turn reported them to the superintendent registrar of the registration district where the birth or death occurred. Since 1874 doctors’ certificates were also required by a registrar before a death certificate could be issued. A death certificate records where and when the individual died, name and surname, sex, age, occupation, cause of death, the signature, description and residence of the informant, when the death was registered and the signature of the registrar.

The death certificate of George Danbury will undoubtedly list his death simply as Tetanus. However, the medical notes expand on this diagnosis and tell us that ‘A fortnight before his admission George Danbury ran a nail into the ball of his right great toe. He felt no pain but later felt stiffness of the jaw and pain in the back. On admission he could not open his jaw and there was stiffness and pain in the back of the neck. He began to experience spasms, had a good deal of sweating and the head became retracted and fixed.’ (PM/1870/258)

The case notes often include the medical history of other family members to determine if the patient could be suffering from an inheritable disease. This is invaluable for tracing other family members of the deceased.  Fifty-three-year-old Henry Moon died in 1889 from ‘Carcinomatous stricture of Oesophagus’. The case notes begin ‘The patient was a clerk. He gave a family history of carcinoma. One aunt had died of cancer of the throat, another of cancer of the stomach, a cousin of cancer of the eye.’ (PM/1889/285). The medical case notes will also record if they came from a phthisical (tuberculous) family, and if their parents lived to an old age. If the patient is female, it will often be noted how long they had been married, how many children they had given birth to, how many children were living at the time of her admission, and how many miscarriages the woman had suffered. The case notes for Sarah Harris records ‘Pregnancies = 9. Children = 8. Miscarriage = 1, in Dec last at 5 months. Says that during this last pregnancy had ‘fits’ when about 4 ½ months gone, from which time till she aborted she did not feel the child. A doubtful abortion in Feb last.’ (PM/1881/388). Ellen Pointon, a thirty-nine-year-old Widow ‘had been married for 9 years. She had had 1 miscarriage and four children, 3 of whom were alive when she came into the hospital.’ (PM/1888/301)

The case notes often track a patient’s travel both within the UK and abroad to determine the origin of the disease, particularly if the disease is highly infectious. Amy Bradshaw, a seven-year-old girl, was admitted to St George’s Hospital on 24th July 1883 and she later died on 10th January 1884. She was suffering from Leprosy. The medical case notes record that ‘Her mother was a native of Oxfordshire, her father of Barbados, where his family had lived for three generations since leaving Scotland.’ Amy was one of six children, one of whom died in infancy of Dysentery, and two had Leprosy. The sister next above her in age was four and a half years older, and she developed symptoms of Leprosy in 1875 (PM/1884/9). Charles Dilloway was a footman who had just returned from a foreign tour. Twenty days before his admission he was in Rome. He returned via San Remo, Cannes and Boulogne. ‘He was back in England a fortnight before he came to the hospital. After his return he lived at 35 Chesham Place Belgrave Square’ where he slept below ground. Not only is each city he travelled through recorded in the case notes, the physician has also recorded the name of each hotel that he stayed at during his travel back to England.

Furthermore, the physicians often record the address of the patient along with living conditions if they believe it is relevant to the disease, such as in the case of a four-year-old boy called Albert Pratt. His ‘Parents lived at Brighton but the child had been staying at 1A Bulmer Place Notting Hill Gate. In this house the floor of the W.C. [Water Closet] was in a very bad state, having all crumbled away. The Landlord refusing to do anything. Within the last 6 weeks 6 persons living in the house, 4 children and 2 young women had had sore throats but all recovered.’ Young Albert, was diagnosed with Diphtheria and ultimately succumbed to the illness. (PM/1889/22)

Diet is often commented on in the medical case notes, such as in this case of 15 year old John Landeg who died of Scurvy in 1882.  ‘When admitted the boy stated that he had been feeling weak and ill for four or five months previously. That he had a dislike to [non] salt meat and consequently had for the last four or five weeks been eating only salted meat. He was an office boy, in the habit of taking away from home meat for the whole day, and consequently rarely eat vegetables. Got potatoes on Sundays only.’ (PM/1882/366)

Alcohol consumption is also often recorded, such as in the case of 25 year old Alfred Balcombe who was described as ‘A coachman of intemperate habits, a beer drinker, reported to be generally in a fuddled state, refusing his food and supplying its place with beer, ’ (PM/1866/18) or Frederick Osborne, a forty five year old labourer, who had ‘always been accustomed to drink beer, avoiding the weaker kinds and drinking chiefly ‘six ale,’ and some spirits. The average quantity of beer was five or six pints daily.’ (PM/1888/95)

Occupations are listed where known, and the medical case notes often expand on simple terms such as ‘Groom’ or ‘Soldier’. Elbra Appleby died in 1881, aged fifty-one. In his work as a painter he had been exposed to so much lead that, despite precautions, he developed colic and wrist drop, losing strength in both hands and becoming irritable and depressed (PM/1881/392). John Lewicki was ‘An old soldier, formerly on Napoleon’s Polish lancers. He had fought in nearly all the wars of the empire. He had been frost-bitten at Beresina, and again at Moscow. He was wounded at Austerlitz, recovered a sabre cut at Vittoria. Altogether he shewed seven scars. He escaped from Waterloo unhurt. Latterly he enjoyed a pension for a few years, but lost it on account of his republican views. He was expelled from Paris and contrived to get his living by selling pencils about the streets of London. He attributed his illness to eating sprats.’ (PM/1860/36)

Sometimes the comments of the physicians can be extremely evocative and paint a picture of the patient on their admission. For example, the doctor Octavius Sturges (1883-1894) describes various patients as ‘an anxious, delicate girl with an anxious, sad expression’, another as a ‘dark, spare person of melancholy aspect, a needlewoman’, another as ‘stout and well-built with the countenance of a drunkard’ or ‘a miserable, emaciated old man having the withered and wrinkled face of a mummy’.

The case notes sometimes include anatomical sketches and drawings, and occasionally portraits of the patient, such as in the case of Thomas Roles, a 49-year-old Shopkeeper, who was admitted to St George’s with a tumour of the face which was removed by operation.

PM/1880/236. Archives and Special Collections, St George’s, University of London

The left-hand page, labelled ‘Morbid appearances’, is used to record the details in the post mortem examination, with each part of the body examined in depth. The morbid appearances also include a general description of the body, recording information such as height, weight and hair colour. At a time when photography was unusual for many working-class Londoners such as those attending St George’s Hospital, the general description at least provides a hint as to their appearance. Thomas Roles was described as ‘Well nourished. Obese. 5’6” high. Hair dark.’

In conclusion, the Post Mortem Examinations and Case Books are a unique and fantastic resource for tracing the lives of working-class individuals in London, and the information provided in the volumes almost serves to bring the patients back to life.


If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.

Kortext ebooks NHS collection

Health Education England (HEE) has invested in a collection of ebooks for NHS staff, now available through Kortext.

The collection of ebooks covers subject areas including key clinical topics, nursing and healthcare management, alongside titles on critical appraisal, mentoring and revision resources for medical exams.

To access the books, go directly to the Kortext website: https://app.kortext.com, select St George’s University Hospitals NHS Trust from the list of institutions and enter your OpenAthens details. You will also find a link to Kortext in ‘My Resources‘ when you log into your OpenAthens account.

On the landing page of the site, click on Collections to view the full list of ebooks. Selecting an available title will add it to Books, which is your personal bookshelf. Books that you open will remain on your bookshelf for the duration of their loan period.

Kortext offers accessiblity options which allow you to change the formatting of a book, including options for the background colour, the font and the size of the text. When reading a book, make use of the options to take notes, highlight content, bookmark pages or print – all notes, highlights and bookmarks are saved in your account.

If you wish to read offline, create a personal Kortext account and download the app; Kortext apps are available for Mac, Windows, iOS and Android.

Example titles:

Bailey & Love’s Essential Clinical Anatomy

Care of the Cancer Patient

Children and Young People’s Nursing Skills at a Glance

Essentials of Management for Healthcare Professionals

Essential knowledge and skills for healthcare assistants

Medical Statistics at a Glance

Patient-Centred Ethics and Communication at the End of Life

Research Methodologies for Beginners

Supervision in Clinical Practice : A Practitioner’s Guide

The doctor’s guide to critical appraisal

The Foundation Programme for Doctors

The textbook of non-medical prescribing

This collection is an addition to those ebooks which are already available from St George’s Library, and which can be accessed through Hunter.

If you need to create an OpenAthens account, or have forgotten your password, visit: https://openathens.nice.org.uk/. Contact liaison@sgul.ac.uk with any questions.

#MorbidAdvent: What Did We Learn?

Opening Up the Body’ is a Wellcome-funded project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946. Our Archive team have been cataloguing and digitising records dating from 1841-1921. This post was written by Project Archivist Alexandra Foulds, with contributions from Project Archivist Natasha Shillingford and Archivist Juulia Ahvensalmi.

St George’s University of London Museum and Archives Instagram post on smallpox as part of #MorbidAdvent
St George’s University of London Museum and Archives Instagram post on smallpox as part of #MorbidAdvent

In December 2020 we decided to do an advent calendar on social media in which we would use every day to highlight a disease or condition that could be found in our post mortem casebooks. Calling it #MorbidAdvent, throughout the month we covered:

When we started, we assumed that these were conditions that had been relegated to history but the morbid nature of all these diseases was brought into stark relief with the realisation that none of the diseases apart from smallpox (thanks to the efforts of Edward Jenner) have actually been eradicated.

Vaccinations are, of course, of particular interest and relevance at the moment, and there are vaccines for many of the diseases we examined, including tuberculosis, rabies, influenza, whooping cough, tetanus, diphtheria, measles and smallpox. Others, such as malaria or leprosy can be treated with various medications.

Despite this, many of the diseases remain common outside of the Western world. 10 million people were diagnosed with tuberculosis in 2019, predominantly in South-East Asia, Africa, and the Western Pacific, resulting in 1.5 million deaths. There were an estimated 229 million cases of malaria in 2019, the majority of them in sub-Saharan Africa: children are particularly vulnerable to the disease. Diphtheria, despite mass immunisations in the UK in the 1940s, is still common in Africa, India and Indonesia, with a 5-10% death rate affecting mainly children. Measles, which has an alarmingly high R number of 12 to 18, similarly caused over 140,000 deaths in 2018, mostly in children under 5 years old. Cholera outbreaks remain common in Africa, South America and Asia. In 2008-2009 an outbreak in Zimbabwe killed 4200 people and in 2010-2011 another in Haiti caused 6631 deaths. In all of these places, a lack of access to health care, poor water quality and poor sanitation allow for contagious diseases to take hold and spread.

As these diseases have not been eradicated they frequently resurface in the United Kingdom. There are still around 12 new cases of leprosy diagnosed each year in the UK and the World Health Organisation states that in 2018 there were 208, with 619 new cases of leprosy diagnosed worldwide. This is approximately one every two minutes. In 2019 the notification rate for TB in the UK was 8.4 per 100,000 of the population. Even smallpox has the potential to return, as it did in 1978, as it is retained in laboratories.

It is not only contagious diseases that can have resurgences. Rickets, for example, which is caused by a vitamin D deficiency, despite mostly disappearing in the UK in the 1950s with mass programs of cod liver oil for children, has recently experienced a comeback that has been attributed to children spending more time indoors and the use of sun creams whenever they are outside.

Photo of the post mortem record of Ethel Almond who had rickets and then contracted tubercular meningitis (PM/1888/314). Archives and Special Collections, St George’s, University of London.

The post mortem record of Ethel Almond who had rickets and then contracted tubercular meningitis (PM/1888/314). Archives and Special Collections, St George’s, University of London

Patients at St George’s Hospital

Visualisation of the causes of death found in the post mortem casebooks of St George’s Hospital 1841-1887 created using Flourish. Archives and Special Collections, St George’s, University of London.
Visualisation of the causes of death found in the post mortem casebooks of St George’s Hospital 1841-1887 created using Flourish. Archives and Special Collections, St George’s, University of London.

When we started the advent calendar we knew that the period covered by our post mortem casebooks (1841-1946) was punctuated by numerous outbreaks, epidemics and global pandemics of various contagious diseases. The most notable of these that affected the UK included:

Cholera: 1831-1832, 1838-1839, 1848-1849, 1853-1854, 1866-1867

Influenza: 1830-1831, 1833, 1836-1837, 1847-1848, 1857-1858, 1889-1890 (Russian/Asiatic Flu), 1918-1920 (Spanish Flu)

Smallpox: Large epidemics in 1837-1838 and 1870-1874 (after the Franco-Prussian War). 1901-1902 was the last outbreak in London. (England was declared rid of smallpox in 1939).

Scarlet fever: 1892-1893. Particularly common at the beginning and ends of the nineteenth century.

Diphtheria: 1850-1860

While trying to find cases of these diseases in the post mortem casebooks, however, we were struck by the fact that there were far fewer cases than we had expected, even in years when there were epidemics. This was despite many contagious diseases being more easily caught by people with malnourishment, a condition from which it is likely that many of the patients at St George’s would have suffered. St George’s Hospital’s nineteenth-century position at Hyde Park Corner meant that many of its patients came from Westminster and Pimlico, both of which were very impoverished, working-class areas of London at this time. Wealthier patients in nearby St James’s, Belgravia and Mayfair would have been more likely to have been treated by visiting physicians (some of whom would have also worked at St George’s) in their own homes. Hospitals had been created in the UK in the eighteenth century to serve the ‘deserving’ working class poor and were considered, at least until the late nineteenth century, to be dirty and sources of contagion, so people tended to stay away if they could. The extremely poor who were unable to support themselves, considered to be ‘undeserving’, would have been treated in workhouse hospitals.

Fever hospitals

Trying to account for this low number of contagious diseases in our post mortem casebooks led us to find out about fever hospitals, or hospitals set up in the nineteenth century specifically to treat contagious diseases. Prior to this only a small amount of hospitals were willing to take contagious patients. A smallpox hospital had been created in Windmill Street off Tottenham Court Road in 1746, and patients with other contagious diseases could be sent to one of the Royal Hospitals or to Guy’s Hospital. As part of the nineteenth-century public health movement, 12 fever hospitals were created in London, starting with the Institution for the Care and Prevention of Contagious Fevers (later called the London Fever Hospital) at Grays Inn Lane in 1801. While the majority of these were on land, between 1883 and the end of the nineteenth century three of them were converted ships (the wooden warships the Atlas and the Endymion, and the iron paddle steamer Castalia), which were moored on the River Thames and used to treat smallpox patients. Patients who needed to be treated in a hospital were sent to one of these fever hospitals after being referred by a doctor, and were only treated in hospitals such as St George’s if their condition was not apparent when they were admitted. Once their condition was diagnosed, we can see from the medical notes in our post mortem casebooks that they were moved to separate wards. One of the fever hospitals, however, the Grove Fever Hospital which opened in 1899, was sited where St George’s Hospital is now in Tooting. Two of the ward blocks survive to this day.

Photograph of Grove Fever Hospital. Archives and Special Collections, St George’s, University of London.
Photograph of Grove Fever Hospital. Archives and Special Collections, St George’s, University of London.

Highlights of the advent calendar

A few of the conditions covered in the advent calendar proved to be particularly interesting and unusual, such as glanders, leprosy, and malaria.

Glanders

Glanders is an unusual disease in the Morbid Advent Calendar as it is a zoonotic disease. In other words, Glanders primarily occurs in horses, mules and donkeys but can be transmitted to humans by direct contact with an infected animal’s body fluid and tissues, and can enter the body through skin abrasions. The majority of patient’s in the post mortem volumes who contracted Glanders, were stablemen, horse keepers and grooms.

Despite the fact that the last confirmed case in Great Britain was in 1928, it still remains a very real threat, particularly as a biological weapon during war and has long been a threat to armies. It is believed that Glanders may have affected the horses of Marshall Tallard’s cavalry prior to the Battle of Blenheim in 1704 which helped the Duke of Marlborough to win the battle. It is also believed that during World War I, Russian horses on the Eastern Front were deliberately infected with Glanders by German agents. More recently, the Soviet Union allegedly used the germ that causes Glanders during the Soviet-Afghan War.

Unlike many of the diseases featured in the calendar, there is currently no vaccine for Glanders. The lack of a vaccine, the fact that the disease is not widely known and is therefore difficult to diagnose, the ability for the germs to be released into the air, water or food supply, and the germ’s resistance to common antibiotics makes the bacteria a significant bioterrorism threat.

Leprosy

Photo of manuscript showing a leper. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)
Manuscript showing a leper. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

The earliest possible account of a disease which is believed to be leprosy appears in an Egyptian papyrus document written around 1500 BC. The first account of the disease in Europe occurs in the records of Ancient Greece after the army of Alexander the Great returned from India.

Leprosy had entered England by the 4th century AD and was a common feature of life by 1050. However, it seemed unusual to find a case of leprosy in London in 1884, particularly as the last case of indigenous leprosy in the United Kingdom was diagnosed in 1798.

Further research uncovered that it wasn’t until 1873 that Dr Gerhard Henrik Armauer from Norway identified the germ that causes leprosy and proved that it was not a hereditary disease or a punishment by God, but an infection caused by bacteria. It is now curable with a multidrug therapy which was developed in the early 1980s.

Malaria

The post mortem record of John Lee who is described as having ‘lived in an aguish district near Eastbourne’ (PM/1891/87). Archives and Special Collections, St George’s, University of London.
The post mortem record of John Lee who is described as having ‘lived in an aguish district near Eastbourne’ (PM/1891/87). Archives and Special Collections, St George’s, University of London.

From ‘mal’aria’, or bad air, malaria was so named as it was thought to be caused by miasma. The connection between mosquitoes and malaria was not established until the 1890s; Patrick Manson, the first lecturer in tropical diseases at St George’s Hospital Medical School and the founder of the London School of Hygiene and Tropical Medicine, was instrumental in developing the so-called mosquito-malaria theory.

Far from being confined to hot, faraway countries (though the postmortems show that the majority of the cases were contracted by soldiers, seamen and colonial officers in India, the West Indies, China or the United States), the postmortem books reveal cases in places like Deptford, Hampshire and Eastbourne: it turns out that malaria was, in fact, a significant cause of death in Britain. In these cases, the diagnosis is often given as ‘ague’ or ‘marsh fever’. Decrease of marsh wetlands and increase in cattle as well as improvements in housing, drainage and ventilation (factors which affect also many other causes of death during this period) and water chlorination led to malaria gradually disappearing as an endemic disease in Britain (the last cases occurred in Stockwell in 1953).

Quinine, derived from the bark of cinchona tree, has been used to treat malaria since the 1600s, and the origins of gin & tonic is often said to be as an anti-malarial drug, though this is not strictly true. Quinine is still used to treat malaria, although there are now various other medications too.

What did we take away?

Finding out more about these diseases put the current Covid-19 pandemic in a new light. While it is easy to think of our current situation as exceptional, what our advent calendar made clear was that it is something that humans have experienced many times before and continue to endure in many parts of the world. While it might be easy to find this thought quite bleak, it helped us to feel more positive. Like all outbreaks of contagious disease, this too shall pass, and as our history and our experience over the last year shows, we have the ability to band together to make great medical advancements when we have the drive to do so. Current technology has enabled us to experience this pandemic in a global way that has never been seen before and hopefully this unity will continue as we try to vaccinate the world’s population. Perhaps this will carry forward and enable us tackle other diseases together, giving new impetus to strategies such as the World Health Organisation’s plan to cut new cases of TB by 90% and reduce deaths by 95% by 2035.


If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.

What can you do to help your job hunt despite being in a pandemic?

This is a guest post by the Careers team at St George’s.

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Whether you are soon to graduate or perhaps you are a student considering your future, applying for placements or simply looking for part-time work, the pandemic has had an enormous impact on recruitment. Nevertheless, the global spotlight on healthcare and scientific research offers career opportunities for students studying and graduating at St George’s. The importance of what you know and do has never been so critical to all our lives. Undeniably, these are challenging times for job searching as uncertainty is the theme of the day. Rest assured that whatever struggle you are going through now, your career goals and ambitions are still attainable. There are plenty of constructive things you can do to give yourself the best chance now and for the longer term, when we hope the current situation will be part of history, gone but not forgotten.

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Here are some of our top tips on how to handle your career planning in this current situation and turn some negatives into positives.

Set a schedule – allocate time in your schedule for career management. This can be a neglected area in our lives. In fact in normal times, people spend more time planning holidays than their careers. With no concrete travel plans on the horizon, much more time can be given to this life-changing preparation. It also means that you can feel reassured that you have given thought and time to your future, and you are in control. Use the Careers pages on Canvas where I guarantee you will find something that will change your life, even in a small way! 

Take a step back and be kind to yourself – take time to Explore, Plan, Apply. At St George’s, ‘Explore, Plan and Apply’ is the approach and mantra for career planning and management. This means starting from the beginning to ‘explore’ what different possibilities exist, what do you enjoy, what are you good at? What are your values? There are lots of online tools to help you analyse yourself and the options available to direct your research –  options that inspire, and motivate you, or at least provide the stepping stone to your preferred career areas (you may have several!). 

Don’t limit yourself to local options – look more broadly than your immediate area or London. You can always return to our beautiful metropolis in future once you have some solid experience under your belt and the cost of housing can be less in other areas too.

Stand out from the Crowd…tailor your CV and application. Students have said when the pressure is on to find a job, there can be a tendency to send off as many duplicate CVs or applications as possible, some quoting 20, 50 or even more, hoping that one will stick. Time and time again, employers have said how this approach does not work. To help you stand out from the crowd, read the job description and person specification, research what the company do, their values and reflect this in your application. Every employer and job will be different so one size does not fit all. There is more advice here in the Apply section on the Careers Canvas module  and do book an appointment with the Careers Service if you want to talk through your approach or get your application checked.

Decorative image. Person sitting at a table looking at a CV.

Build your network of professionals – Your career will develop and evolve. Develop your network of people working in sectors you are interested in. Check the St George’s Alumni pages on LinkedIn or the SGUL alumni bios to find inspiration, make like-minded contacts with similar interests and gain knowledge

Develop your skills – As you explore different career paths or expand your network, you may feel there are skills that you would like to improve or develop. Perhaps there is an area that you have been curious to try. There are a large number of free (and otherwise) online courses, and what better way to show your motivation to a new employer, while developing your own confidence in yourself, really feeling like you are managing your own development – it is certainly a win/win. Don’t forget too that you can keep track of the skills you are developing through the St George’s Skills and Recognition Award.

Look after your mental health – You are not alone if you are feeling gloomy and struggling. So many are under strain in these uncertain times. Do get help. Here are some organisations you can contact to support you through this time.

Think longer term – In 2030 what will you be glad you did in 2020/21? Developed your research skills and specialisms? Improved your digital skills? Extended your network of professional and scientific contacts? Improved your health/stress management? Experimented with something different?

There are lots more tips here on making the most of this time.

For further support, refer to the Canvas Careers pages, the website or contact us careers@sgul.ac.uk.


Look out for details about St George’s Uni Careers Week 1-6 March 2021, coming soon on all St George’s social media accounts and platforms.

Introducing: RefWorks video series

Getting all your citations and bibliography right can be a daunting prospect – especially if is for a longer research project, an article or your dissertation. In moments like that, it can be helpful to make use of reference management software, which eliminates some of the stress and hassle of referencing correctly.

At St George’s, we support RefWorks, a web-based application which supports you in collecting, storing and managing your references. As part of RefWorks, you can also make use of RefWorks Citation Manager (RCM) which is a Microsoft Word Add-in. With RCM you can create citations and bibliographies within your documents.

While RefWorks is a really useful tool for students and staff at St George’s, it requires learning how to use it before tempting to get started on your references. This is where our new RefWorks video series comes in handy.

RefWorks video series

We have created 9 short videos that guide you through the process of using RefWorks. You can find the entire series on our YouTube channel and on Canvas, as part of our RefWorks unit. If you want to get a quick overview, check out this video.

RefWorks can be a big help in getting your references done quickly, but you will find that there are mistakes in your references. You are responsible for making sure that when you submit your assignment all your citations and your bibliography are correct, so do double-check each reference in line with Cite Them Right, the correct version of Harvard to use at St George’s.

If you are new to referencing, work your way through our referencing unit on Canvas before you start using RefWorks.

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Further help

Don’t hesitate to get in touch with us by emailing liaison@sgul.ac.uk with any questions about RefWorks that you might have. While RefWorks is generally straight-forward to use, at times users experiences issues for example with creating an account. We can help with you with that.

If you prefer getting a proper training session on RefWorks, please visit our website to sign up for a session that suits you. Our RefWorks training is part of a number of generic training sessions, including literature searching for your dissertation.

We also have a Libguide on RefWorks and reference management, which gives you a quick overview of what you need to know to sign up and add references to RefWorks. Our Libguide also includes helpful screenshots if you get stuck and information on Legacy RefWorks.

Access to BNF and BNFC

The BNF and BNFC are key resources for all medical and pharmacology students.

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This is particularly important for Clinical Pharmacology students and those of you in your final year studying medicine, as you will have your PSA (Prescribing Safety Assessment) coming up soon and we know you need BNF and BNFC to do well.

Recently, we have made some changes to how you access these resources, so we wanted to keep you updated.

Access to BNF and BNFC

You no longer have to go via BMJ Best Practice to access BNF and BNFC. Instead you can go straight via MedicinesComplete. We hope this will make things a little more straight-forward for you. If you go to our website, you find the Databases A-Z link on the right-hand side. From there, all you need to do is search for BNF or find it under ‘B’.

Even easier, you can access both via Hunter. Click here for the BNF and here for the BNFC.

If you have any questions or issues around accessing e-resources, please email journals@sgul.ac.uk.

Information Skills Training: January – March

We are restarting our information skills training for university and NHS library users from January. While the sessions were on hold over the past months as we shifted all our training and support services online, we are now in the position to start offering these sessions again. All our sessions are online.

We have specific training for St George’s staff and students, as well as for NHS library users. These generic training sessions are open to everyone and are available in addition to any course-specific training you might have.

Don’t forget, we also continue to run our online drop-in, Monday to Friday 12-1pm. At our drop-ins we can help you with getting started, doing in-depth literature searching projects and referencing enquiries.

Below you can find out more about the different online training sessions we offer and the dates for these sessions. To book, please visit LibCal and register for the session you would like to attend.

Visit our website to find out more or email liaison@sgul.ac.uk.

Training sessions on offer

My Learning Essentials: Hunter & Harvard

Wednesday 27 January 1-2pm
Monday 22 March 12-1pm

This session is suitable for SGUL or FHSCE undergraduate or postgraduate students who have specific referencing or literature searching enquiries relating to their assignments.  You will be able to discuss your query with the librarian, and receive guidance on how to effectively use Hunter to find academic books and articles and how to use CiteThemRight to ensure your referencing complies with SGUL’s specific Harvard Referencing Style.

Book here.

Students sitting in lecture theatre.

Literature searching for your dissertation

Thursday 14 January 11.30-1pm
Monday 15 February 11.30-1pm
Tuesday 15 March 11-12.30pm

We know databases, like Medline (aka PubMed) and CINAHL, can be daunting, but with a little help and guidance, we are short you will get to grips with them in no time. If you have a longer research project, like a dissertation, or you just want to impress in your assignments, this session is for you. You will learn how to effectively run a literature search in a database relevant to your subject. The sessions are suitable for St George’s and FHSCE staff and students.

Sign up here.

RefWorks

Thursday 28 January 12-1pm
Tuesday 23 February 12-1pm
Wednesday 24 March 1-2pm

In this session, we will introduce you to the reference management software RefWorks. We will show you up to set up an account, add references, manage them and how to use RefWorks Citation Manager (RCM), a Microsoft Word Add-in.

Book here.

Book shelf in the library.

Training sessions for NHS staff

NHS Library induction

Friday 22 January 12-1pm
Wednesday 17 February 12-1pm
Monday 22 March 1-2pm

Library induction for NHS staff, introducing you to the range of services and resources on offer to those working for St George’s Hospital, Queen Mary’s Hospital and other community-based sites.

Sign up here.

Finding the Evidence

Monday 11 January 11am-12pm
Wednesday 27 January 2pm-3pm

Tuesday 9 February 10am-11am
Thursday 25 February 3pm-4pm

Friday 12 March 1pm-2pm
Wednesday 31 March 12pm-1pm

Finding top-quality evidence is a priority for health care practitioners. This session will introduce the high-quality resources available to you, as well as provide training in how to use them effectively to support evidence-based clinical practice or decision-making.

The session will cover: The range of evidence-based healthcare resources available, including: NICE Evidence, the Cochrane Library and BMJ Best Practice.

How to use the NHS databases effectively and identify the most appropriate database for your need. This includes how to create and plan a search strategy using subject headings and keywords and how to combine searches and apply limits to focus your results; how to access full-text articles where available or locate articles through St George’s journals page; and how to save your searches and set up alerts.

You can book your slot here.

Systematic Reviews: finding and managing the evidence

This course will focus on in-depth literature searching for systematic reviewers and how to manage your results. It will provide you with an overview of the systematic review process, the know-how of creating effective search strategies, systematic searching of the literature, managing your results and documenting the search process.

You can book this session here.

At the end of this session you will be able to:

  • plan robust search strategies for literature searches in support of systematic reviews
  • carry out systematic, advanced searches on the Ovid platform
  • save searches strategies and create alerts
  • plan how you will manage your search results and report on your search methodology.

If you have any questions about these training sessions, don’t hesitate to get in touch by emailing liaison@sgul.ac.uk.

Holiday Library Update

Wherever you’re planning to spend the next few weeks, we hope you’ll have as peaceful and relaxing a time as possible. We know that lots of you will also be thinking about revision and assignments at some point over the break, and with that in mind we wanted to remind you of some of the help and resources that are always available from the library, no matter where you are.

1. Find useful tips in our How-to videos

Over the past few months, we’ve been busy adding to our collection of How-to videos. We hope these short videos will give quick, clear answers to a range of questions, so you can get help whenever you need it.

A few of our recent videos focus on referencing. If you’re new to referencing, then our How to use Cite Them Right video can get you started. Or if you’re ready to start using reference management software, we have a series of videos on RefWorks, starting with a RefWorks Overview. Other videos include:

…and lots more. See the full collection on our YouTube channel here.

2. Explore e-books in Hunter

This year we’ve also been rapidly expanding our e-book collection, which now includes over 3000 titles. This means that even if you’re not able to come into the library in person, it’s now more likely that you’ll be able to find the books you need to support your study online.

There are two ways to find e-book material in Hunter:

  • You can search for whole e-books by selecting Books and more in the dropdown menu, then choosing Online Resources from the filter options on the left.
  • You can also search for individual chapters – a useful option if your topic is a bit more specific. Search under All Resources, then choose Book Chapters from the options on the left.

Read online

When you first sign in to view an e-book, you’ll usually be offered options to read online or download the book. Opting to read online will allow more SGUL users to view the e-book simultaneously.

3. Study resources

We have many resources available to students to help you prepare for exams and do your assignments. You can find out more about what resources we recommend for your subject by checking your Libguide. Whatever your subject, we have got you covered; medicine, biomedical science, paramedic science, radiography and many more. Access all our learning resources via the Databases A-Z list. JoVE Science Education is popular among our visual learners and suitable for different subjects. Long-standing favourites are Acland’s Video Atlas of Human Anatomy and BMJ Learning. New this year are LWW Health Library, for medicine and Occupational Therapy students and AccessMedicine for medicine students. As mentioned above, we have produced a range of how-to videos on Youtube. If you have any questions about these resources or if you are looking for personalised recommendations, email us at liaison@sgul.ac.uk

4. Literature searching

If you are spending the holidays preparing an essay or another written assignment such as a dissertation, have a look at our literature searching guide and our video series on how to use Ovid (Medline). We also have a collection of books around doing systematic literature reviews, dissertations and report writing. Get in touch via liaison@sgul.ac.uk to get help from your liaison librarian.

5. Christmas closure

Decorative Merry Christmas image.

The library closes at 11pm, Tuesday 22nd December and reopens at 8am, Monday 4th January. The computer rooms will also close during this period, but you can still return books via the the return slot. Please note that the library team will be on holiday and will respond to your queries on their return in January. Should you have any questions about opening hours or book loans, email library@sgul.ac.uk. In January, our opening hours will be 8am to 11pm Monday to Friday, 9am to 9pm Saturday and Sunday.

From everyone at St George’s Library, we wish you a Merry Christmas and a Happy New Year!

‘Digits: For Good’: Vaccinating Harrods and Selfridges, or, (Digital) preservation of COVID-19 and influenza records

Digital Preservation Day 2020 celebrates the positive impact of digital preservation. The theme ‘Digits: For Good’ focuses this year on the creation and preservation of research and development data used in finding a vaccine for COVID-19. In this post we’ll look into the work we’ve been doing to preserve these records, and also what the archives can tell us of past pandemics. This blogpost has been written by St George’s Archivist Juulia Ahvensalmi, Records Manager Kirsten Hylan and Research Data Support Manager Michelle Harricharan. You can engage with the day and find out more about our work on Twitter at @CollectionsSgul and @sgullibrary and using the hashtags #WDPD2020 and #SGULWDPD2020.

Our COVID-19 story 

At St George’s, University of London (SGUL), a specialist health and medical sciences university in South-West London, the Archivist, Research Data Support Manager, and Records Manager have joined forces to advocate for digital preservation.   

When it comes to meeting the challenge of preserving our digital materials, we have found that by bringing together staff members from different areas of the University we can utilise different skills and internal networks to achieve our goals.   

As part of the work we are undertaking around digital preservation, the team aims to collect all Covid-19 related material produced by SGUL. This includes a variety of documents in a variety of formats, produced by different parts of the university, including 

  • Communications, such as emails, web pages, FAQs, video recordings and social media. These provide evidence of our response to the crisis and our management of it – something that will be both interesting and important to keep for the future. Communications sent out to students, staff, alumni as well as those externally available will tell the story of how St George’s reacted to the pandemic 
  • Governance records, including minutes of meetings. These provide evidence of the conversations and decision-making about the responses and management of the pandemic 
  • Research, including recording the range of Covid-19 research St George’s researchers have been involved in throughout the pandemic as well as our researchers’ incredible work in the national and international media. Research data from these studies are also important to collect and preserve for the long term.

To date we are curating and preserving the items that we aware of, and we have started conversations with departments such as External Relations, Communications and Marketing to identify material we may have missed.   

We are conscious of the need to collect the full complement of Covid-19 material as ultimately this material will be an important part of our Archive in years to come and support future research.   

Looking back 

The majority of the material related to COVID-19 is digital, but that is not the case for most of the material held in the archives (although in the future that is of course likely to change!). The one pandemic most often compared to COVID-19 is the 1918-1919 influenza pandemic, known most commonly (and misleadingly) as the ‘Spanish’ flu, or ‘the Grippe’. Estimates of the number of deaths caused by it vary anywhere from 17 to 100 million people worldwide

In order to understand more about the current pandemic, and our responses to it, and to learn from our past mistakes, we need to look into the past. How did St George’s, then, respond to this pandemic? Well – the answer is that we don’t really know. The minutes of the Medical School (later SGUL) committee and council make no reference to the pandemic. St George’s Hospital and Medical School Gazette, journal produced by St George’s staff and students between 1892 and 1974, notes in February 1919 that the out-patient department and many wards at the hospital had to be closed as so many nurses were off sick, but the medical school records don’t reveal much more (although St George’s Hospital records, which are held at the London Metropolitan Archives, may hold more information). 

A photo of a paragraph in the St George’s Hospital and Medical School Gazette, Feb 1919. Archives and Special Collections, St George’s, University of London.
St George’s Hospital and Medical School Gazette, Feb 1919. Archives and Special Collections, St George’s, University of London.

What we do have is historical post mortem examination records, which we are currently cataloguing and making available online. These records provide an incredible source for studying death and disease in 19th and early 20th century London. They chart, among other things, the 1854 cholera epidemic, show how prevalent tuberculosis was, and contain numerous fascinating and illuminating cases, such as that of the pastry chef murderer in 1908. 

Photo of book cover: Post mortem and case book 1846, PM/1846. Archives and Special Collections, St George’s, University of London.
Post mortem and case book 1846, PM/1846. Archives and Special Collections, St George’s, University of London.

When we started cataloguing the volumes for 1918 and 1919, we were expecting to find plenty of examples of influenza, and were surprised when, well, there just weren’t that many.  

There were, of course, some cases, and many that sound troubling, such as the case of Ada Bell, a soldier’s wife aged 32, who died at St George’s 31 Oct 1918. Her illness was initially diagnosed as pneumonia, but she was brought to the hospital delirious, coughing and suffering from diarrhoea, deafness and shortness of breath. Her cause of death was deemed to be typhoid fever and influenzal bronchopneumonia. 

Scan of Post mortem case of Ada Bell, [Wife of] Soldier, 32, PM/1918/240. Archives and Special Collections, St George’s, University of London.
Post mortem case of Ada Bell, [Wife of] Soldier, 32, PM/1918/240. Archives and Special Collections, St George’s, University of London.

As the symptoms were varied, cases were sometimes misdiagnosed as dengue, cholera or typhoid, for instance. Of the overall deaths in those two years at St George’s, influenza cases account for 5.5% of all the cases: the yellow line in the graph below shows cases where influenza was reported to be the cause of death (or, to be more specific, cases in which influenza is mentioned in the post mortem report). We don’t, however, have the admissions registers for the hospitals, so we cannot tell the number of cases overall, only the number of deaths. 

There is a relatively large number of ‘unknown’ causes of death during these years as well (shown in turquoise in the graph below) – these are cases for which the records enter no cause of death and no details on the medical case, and they may or may not include some further influenza cases. The graph also shows other respiratory tract diseases (in green) and digestive system diseases (in purple).  

Graph showing deaths at St George's hospital 1918-1919. Showing overall deaths, influenza, other respiratory tract diseases, digestive system diseases and unknown causes deaths.
Deaths at St George’s Hospital 1918-1919. Source: Post mortem examinations and casebooks, PM, Archives and Special Collections, St George’s, University of London.

The 1889 influenza 

Influenza was of course not confined to these years only. Every so often influenza cases would flare up, and the previous time this happened on a large scale in 1889-90. With our propensity for blaming single countries for viruses, this pandemic is sometimes referred to as Russian flu and, according to some theories, it may have played a part in immunising those who had it against the 1918 flu, which appeared to disproportionately strike the younger population. 

There were attempts at finding medicines to cure the disease, and there was a minor scandal when the name of the teacher of materia medica (the study of drugs to treat diseases) at St George’s was found printed on an advertisement for an influenza cure: despite denying his involvement, he had to resign. The advertisement does not actually tell us what the medication consisted of, but we can only assume it did not work. 

‘Woodland affaire’, 1890. Archives and Special Collections, St George’s, University of London.

Influenza also continued to be a concern even after the 1918-1919 pandemic had abated, and in the 1926 St George’s decided to get involved in researching vaccines for influenza. There was a public funding campaign for the project, and in February 1927, St George’s published a letter in The Times

‘following on the traditions established here by Jenner and Hunter in their historical work, we are […] engaged in special research with the object of ascertaining what causes influenza, how it can be controlled, how it can be prevented from spreading and, finally, whether a really effective treatment can be found for it’. 

Scan of article in newspaper about influenza epidemic, research at St George's Hospital. ‘Influenza epidemic: Research at St George’s Hospital’. The Times, 15 Feb 1927.
‘Influenza epidemic: Research at St George’s Hospital’. The Times, 15 Feb 1927.

The arguments found in the plea for funding sound familiar: the ‘heavy burden which this scourge places on the community by the dislocation of business and loss of working power’. Because the project was widely publicised, the public was eager to take part, and we have some wonderful letters from people writing in and suggesting their own cures and theories of the causes of influenza: we will be tweeting these, so look out for them on our Twitter feed! 

Records relating to influenza research. Archives and Special Collections, St George’s, University of London.

The money for the research was found, and the subject of the vaccinations was chosen to be the staff of Harrods and Selfridges on Oxford Street, as well as the staff at Quin & Axtens and Bon Marché in Brixton, department stores which had recently been acquired by Selfridges. Altogether 345 people were vaccinated.  

Photo of table 1, ‘Report on anti-catarrh inoculations (catarrh of respiratory mucous membranes)’, 1928. Archives and Special Collections, St George’s, University of London.
Table 1, ‘Report on anti-catarrh inoculations (catarrh of respiratory mucous membranes)’, 1928. Archives and Special Collections, St George’s, University of London.

The various reports, meetings minutes and correspondence held in the archives tell us how the research subject was decided on, issues to do with the research, space and equipment (including the building of a spiral staircase in the laboratory – obviously an essential architectural refinement) and, most importantly, how the research was conducted and what the results were. 

The report of the findings in 1928 shows the research was conducted using attenuated vaccine ‘obtained from pathological fluids or secretions or from a mucous surface of persons who exhibited clinical evidence of disease’, with the assumption that the disease was called by a bacterium called Pfeiffer’s bacillus, or Haemophilus influenzae (also known as h-flu). It was not until a few years later, in 1933, that it was definitely established that influenza was actually viral, and not bacterial.  

And the results? Well, it appears that 1927 was a disappointing year when it comes to influenza, at least from the researchers’ point of view. The vaccination campaign was, however, declared a success, and there were plans to repeat it the following winter (although if that did happen, the records have not survived). 

Photo of response to ‘Report on the work carried out in the Research Laboratory’, 11 Jul 1928. Archives and Special Collections, St George’s, University of London.
Response to ‘Report on the work carried out in the Research Laboratory’, 11 Jul 1928. Archives and Special Collections, St George’s, University of London.

The preserved documents reveal an on-going preoccupation with and interest in influenza, even though (given what we are currently going through) there does not appear to be much sense of urgency, certainly not at the time of the 1918 influenza. 

Although the research was not successful in finding a vaccine that worked, it was an important step on the way: you won’t know what works until you try it. Our knowledge is cumulative, and dead-ends are part of research – not everything can work out, but it all adds up. The first influenza vaccine was developed in the 1940s, and (soon, hopefully) we will see a COVID-19 vaccine. 

Looking forward

What does this all have to do with digital preservation, then? Compared to the 1918 and 1889 flu pandemics the records we are creating today are largely digital. The technology supporting these records change rapidly and may one day become obsolete. If this happens, we could lose access to valuable records, including our covid-19 records. St George’s has recognised this and is actively engaged in looking after our digital information for the long term. We’ve recently purchased a digital preservation system, Preservica, to help us to preserve our digital records. We are working to develop methods and processes that will allow us to preserve the records that are currently being created, and to do so in a meaningful way that will work for colleagues across the organisation. 

Rather than thinking of digital and physical something entirely separate, we should consider them as part of a continuum, as it were. Preserving digital material can be challenging, and we can’t always replicate the processes used for paper with digital material, but the gaps in the past records show the need to preserve evidence of the current pandemic, not only for historical interest but to provide evidence of what happened and how we dealt with it. 

If you are interested in learning more about digital preservation at St George’s, or would like to get involved, please contact archives@sgul.ac.uk.

A recipe for success: studying with your peers

This contribution from the Learning Development team at St George’s comes from Hauwa.

Hauwa Muhammad is a 2nd year Biomedical Sciences Student and Learning Development Assistant at CIDE (as part of her Placement Training Year).

There are many benefits to getting together with your peers to revise difficult content in your programme of study. A key one is being able to use each other as a learning resource, having those extra thinking heads to resolve problems and clarify doubts. Studying with your peers also allows for a less pressured environment, since you are all in the same boat and, probably, at the same level. Outside the more formal context of the classroom/ lecture, and without the presence of an expert (the teacher), you feel more comfortable asking questions and less worried about making mistakes. Another advantage of forming or joining an existing study group relates to accountability. Being accountable to others and not just to yourself, provides an incentive for studying as you won’t want to feel behind when meeting with your peers. 

You must now be wondering how relevant this post is to you, since all or most of the interactions on your course continue to happen online. Colleagues from CIDE (the Centre for the Innovation and Development in Education) have launched a peer-assisted learning initiative precisely to help with the possible negative impact of not being able to meet face-to-face to discuss the content of your programme. One of the key aspects of this initiative is the involvement of a second-year student in the organisation and facilitation of study groups. I was hired for this purpose and since mid-September I have been piloting online study groups for year 1 students from two of St George’s programs: Biomedical Sciences and Therapeutic Radiography. These study groups are attached to specific modules where students are required to learn vast amounts of new information. I have been using the Big Blue Button (BBB) platform in Canvas to hold the study groups. BBB allows the creation of breakout rooms so students can join others in small groups to engage with the module’s content.  

A group of three students talking and smiling.

Peer Assisted Learning (PAL) has existed since the beginning of education. It occurs all around you. It happens in schools between kids while they are painting, colouring, or learning rhymes together. It takes place during group work or when friends are teaching each other. However, the introduction of PAL into universities was developed by researchers at Vanderbilt University in 1973 (Tariq, 2005). They developed theories that conceptualised learning through participation in social interactions and activities (Chan et al., 2016). Since the official integration of PAL into the university curriculum, 55 universities have adopted it into their curriculum in the UK (Keenan, 2014). This is more than 50% of the universities in the UK and the prevalence of peer-led learning schemes is increasing across institutions in the UK and internationally (Keenan, 2014).

When I enrolled at university, the first advice I was given was to make friends on my course. As a social and outgoing person, it was easy for me to make acquaintances by attending almost every lecture and meeting different sets of people in the lecture hall. Out of the many acquaintances, I made two good friends during my second semester and we have studied together ever since. However, I didn’t really know about the importance of making friends on your course until, during the lockdown in semester 4 when I went back to Nigeria to stay with my family. Suddenly, my schedule was a disaster. I had daily revision sessions on WhatsApp with my two peers and subsequently, I was able to study 70% of the content. My average increased by 10% from my first year to my second year because I studied with these two strangers I met in the lecture theatre.

Decorative image

The importance of student engagement in the organisation of PAL can’t be emphasized enough, especially in a pandemic. You can’t form relationships with people easily because there are no face-to-face interactions. Now, this is where this initiative is of massive help to students. Every session allows you to meet random strangers that you’re in this struggle with. Every session gives you the opportunity to meet your course mates informally using Big Blue Button and revise the content together. These are the replacement for the group calls I had when I was in Nigeria during lockdown. Some of the session strategies we use to revise the content are peer lessons and informal quizzes. During an informal quiz, students are split into groups of 5 using the breakout rooms and asked to create multiple choice questions from the lectures allocated to each group. This is to create an informal environment to be able to discuss the content and increase individual confidence in learning. Questions are then shared with everyone in the main conference where answers are discussed as a group. Volunteers explain why the chosen answers are right. If there’s a disagreement in answers chosen, everyone provides a reason for why he/she chose a specific answer. These sessions are fun and depend on the engagement of everyone. The sessions are open to all and non-compulsory, although attendance is encouraged.

We’ve had mostly positive feedback from the piloted sessions although we’re still working on improving the PAL sessions.  Students have mentioned that these sessions have enabled them to clarify complex concepts and become more aware of course expectations. We hope reading this blog will encourage you to also form or join a study group with your peers.

References

  1. Chan, N., Phan, C., Aniyah Salihan, N. and Dipolog-Ubanan, G., (2016). (PDF) ‘Peer Assisted Learning In Higher Education: Roles, Perceptions And Efficacy’. Social Sciences & Humanities 24 (4): pp 1811 – 1822.
  2. Keenan, C., (2014). ‘Mapping Student-Led Peer Learning In The UK’. The Higher Education Academy.
  3. Tariq, V., (2005). ‘Introduction And Evaluation Of Peer-Assisted Learning In First-Year Undergraduate Bioscience’. Bioscience Education 6(1).

If you’d like to speak to somebody outside of your programme about preparing for writing assignments and preparing for exams, one-to-one appointments with the learning development team are available via Microsoft Teams. Click here to book, or visit Study+ on Canvas for more information.

Now is the time – Careers Service at St George’s

Banner for St George's Careers Service with the motto: explore / plan / apply

Whether you are just starting out at St George’s, about to complete your course this year, or anything in between; it is always the right time to work on your career management. For those graduating this year, the urgency is even greater to find the right next step, so do take advantage of the support on offer.

Here are some simple starting tips.

Explore, Plan and Apply are the stages to work through. We have a section on the Careers Canvas pages dedicated to each step, supporting you along the way.

Explore

Exploring is finding the direction that is right for you and inspires you! Take the time to identify your skills and strengths, see what graduate job opportunities and careers sectors interest you, and network to meet the right people that share your career interest.

Two students. one medical and one allied health, walking and talking in a university corridor

You may find that the St George’s alumni stories inspire you and open up a range of possibilities to explore. Alumni from different courses offered at St George’s give you an introduction to what their current role involves and how they got there. Get career advice from people who have been in your situation just a few years ago.

Plan

Planning is taking the time to plot your approach to reach your goal. For example, organising work experience to upskill and test out ideas, deciding where to apply for a placement, researching your next course of study. Perhaps you want to explore the Student Ambassador programme (opens October 2020) to work within St George’s and boost your CV. There are many ideas for CV boosting experience on the Careers Canvas pages. Don’t forget to give yourself the best advantage by completing the St George’s Skill and Recognition Award, an online skills portfolio to take you through from your current stage, all the way through your career.

Apply

Applying making a successful application, CV and pass recruitment processes. If you are looking for your next move now, and of course closing dates for many graduate schemes are coming to an end in November,  we have recently added some resources to help you at this particular time. Have a look at our Canvas page on job hunting in a Global Pandemic.


We hope you can find all you need. Contact us with any queries, worries or feedback at careers@sgul.ac.uk

Black History Month 2020

October is Black History Month and in the Library, we celebrate that with books of course. We have been promoting relevant events on our Twitter account throughout the month, but we also have our own contribution to make.

On Wakelet, we have put together a collection of fiction and non-fiction books for Black History Month, which includes physical books and e-books. You can access the list here. There is a range of classics, recent publications and texts around the Black Lives Matter movement. Recently, we added White privilege – The myth of a post-racial society by Kalwant Bhopal and Akala’s Natives – Race and class in the ruins of empire to our Black History Month Wakelet for example. We also have a Wakelet on Ethnic Diversity and Inclusion, which includes podcasts.

We are always looking for recommendations for what to add, so don’t hesitate to get in touch by emailing liaison@sgul.ac.uk.

In this blogpost, Library staff are sharing their thoughts on some of the books in the collection and their book recommendations for Black History Month.

Book reviews

Natives by Akala

Jenni Hughes (Research Publications Assistant)

This is an enlightening, powerful read on how race and class intersect and operate in today’s Britain. Akala’s choice to examine these in tandem deepens and enhances his analysis of both: his early observation that “we are trained to recognise the kinds of racism that tend to be engaged in by poorer people” rather than the larger, more damaging kinds perpetuated by the rich and powerful, for example, clarified a great deal for me about mainstream discourse around race and racism in this country.

Akala’s accounts of his personal experiences of classism and racism support and are supported by his deep knowledge of the history and sociology of race, and his prose slides easily between different registers (academic, vernacular etc), enabling him to communicate his points clearly and incisively. Overall, this is a compelling and very readable analysis drawing on a rich well of knowledge, research, experience and scholarship.

Book cover for Akala's Natives

Giovanni’s Room by James Baldwin

Andy Lacey (Information Assistant)

Reading James Baldwins Giovanni’s Room felt like a whole new world opening up when I first read it as a 17-year-old. A whole world filled with adult gay men, with complicated, messy but joyous lives.

The novel centres on David, an American in France who travels to Paris. He meets Giovanni, a bartender and the two become friends. We are then taken on a journey with them, but also their social sphere. We explore their experiences of social alienation, but also their passions, and attempts to construct a unique space for themselves in the world. This novel is so good at describing homosocial spaces, and exploring how gay men often had to construct new, alternate families. It is also great at examining modern ideas of masculinity, and spotlighting the problems with it. Having been written by a gay black man in 1956, this novel still seems powerful and contemporary even all these years later. Which maybe shows there is still a way to go. Brave, important and completely brilliant.

Book cover for Baldwin's Giovanni's Room

Brit(ish) by Afua Hirsch

Georgina Coles (Information Assistant)

I would highly recommend Brit(ish) by Afua Hirsch. It’s both a personal account of the author’s struggle with her identity as a British Ghanaian woman and an exploration of the place of racism in British history and identity, and how British society can’t claim to be ‘post-racial’ or ‘colour-blind’ until it confronts the racism inherent in both its imperial past and its present. A fascinating and important book.

Book cover for Brit(ish) by Afua Hirsch

A Small Island by Andrea Levy

Karen John-Pierre (NHS and Liaison Manager)

On June 22nd, 1948 the first wave of immigrants from Jamaica arrived at Tilbury Docks on the Empress Windrush. Dressed in their Sunday best and full of hope and pride at finally arriving in the ‘Mother country’, they, and other commonwealth immigrants who followed them, encountered a much more hostile and colder environment than they were expecting.

This is the real-life backdrop to the late Andrea Levy’s award-winning and popular novel, ‘A Small Island’, which charts the incohesive interplay between Hortense and Gilbert, originally from Jamaica, their English landlady, Queenie and her husband, Bernard. Levy gives voice to the different internal journeys they make in this new landscape at the birth of modern multicultural Britain, letting each main character in turn take the reins of the story to reveal different perspectives, hopping between past and present.

In this honest and important book, Levy exams themes such as the effects of Britain’s colonial rule in the Caribbean and India, post-war migration and racism, the framing of interracial relationships, the sadness and heartache of immigrant life as well as the universal themes of love, marriage and hope. As the daughter of a Windrush child, this book struck a huge chord with me: I revelled in the telling of stories largely untold and would urge you to do the same.

Book cover for Small Island by Andrea Levy.

Wide Sargasso Sea by Jean Rhys

Anne Binsfeld – Liaison Support Librarian (IMBE)

Wide Sargasso Sea by Jean Rhys is a poetic, raw and magical reading. The author highlights class and race issues, with a strong feminist and anti-colonial twist. Rhys uses the Victorian classic Jane Eyre by Charlotte Brontë and retells it from the point of view of Bertha, the “madwoman in the attic”. Set in Jamaica, Antoinette/Bertha’s story focuses on her youth as the heiress of a crumbling Creole family dynasty. She is married off to a stranger, Jane Eyre’s Mr. Rochester, who takes her to England and locks her away. As well as addressing patriarchal abuse, Antoinette’s story looks at the intersectionality of mental health issues and racism. A haunting, but beautiful book.

Book cover for Wide Sargasso Sea.

More recommendations

If you are looking for further recommendations for your Black History Month reading, Lawrence Jones (Content and Digital Infrastructure Manager) recommends Passing by Nella Larsen, a book about mixed race women in the US in the 1920s ‘passing’ as white & the stresses they suffer whilst trying to avoid being found out. Louise Davies (Circulation Desk Supervisor) recommends Half of a Yellow sun by Chimamanda Ngozi Adichie, which is also on our Black History Month Wakelet.

Brenda Cluffer (Information Assistant) really liked Andrea Levy’s Long Song. She says the following about the author’s latest book: “The Long Song talks about the months leading up to the abolition of Slavery in the Island of Jamaica. Andrea Levy manages to bring humour to a rather brutal and tragic time in British history. It tells the story of  a young girl called July and her son who through various events are torn apart by the horrors of this system and the journeys they take in order to survive. The book covers topics of colourism, class, race, landlord and tenant, slave uprisings, abolition of slavery, the role of clergy and rape. A very serious topic but Andrea has the knack of drawing you into the subject and providing the Caribbean old saying ‘take bad something and mek laugh’ into a compelling read.”


Don’t forget to email liaison@sgul.ac.uk with any recommendations around Black History Month you might have. Also, be sure to have a look at our Wakelet where you can find collections around mental wellbeing, LGBTQ+, women in leadership and many more.

Open Access Week 2020: Open with Purpose

This week, October 19th-25th, is Open Access Week, an annual, international event dedicated to celebrating and promoting Open Research.

This year’s theme is Open with Purpose: Taking Action to Build Structural Equity and Inclusion, acknowledging that current systems are often built on a past of historic injustices and that in building new systems, we need to be mindful of who we are and aren’t including, who we are prioritising and whether we are perpetuating a legacy of injustice.

To find out more, visit www.openaccessweek.org, or follow the official twitter hashtag, #OAWeek. We’ll also be tweeting and retweeting from the library account, @sgullibrary, and, if you’re in the library, look out for our poster on how to find open access material.

You can also find posts we’ve made in previous years under the Open Access Week tag on this blog.

Here at SGUL we support open research via our Research Publications Repository (SORA) and our Research Data Repository. We currently have over 4870 full text papers available via SORA, with an average 4180 downloads a month, and these numbers are rising every day. And, since its launch three years ago, we’ve had 17,163 downloads of public content in our Research Data Repository.

As well as supporting SGUL researchers to make their publications openly available via SORA, the Library is also signing up to Read and Publish deals, several of which are new in 2020. These deals work by giving SGUL patrons access to read journals, and giving SGUL corresponding authors the opportunity to publish original research articles on open access, as visualised below:

(from our blogpost on our Read and Publish deals)

Research outputs that aren’t traditional publications, such as research data, source code, poster presentations and so on, can be uploaded to our Research Data Repository, where they will be preserved and, where appropriate, made available for other researchers to explore and re-use. The Research Data Repository has been updated recently – have a look at our blog post from last week to find out more.

If you’d like to know more about SORA or about our Research Data Repository, please get in touch at sora@sgul.ac.uk (for SORA) or researchdata@sgul.ac.uk (for the Research Data Repository, or for general help managing your data throughout the research lifecycle).

Want to get involved?

Here are some ways to consider making your research practices more open:

  • Upload your author’s accepted manuscripts to a repository such as SORA: this means that, publisher copyright permitting, we will be able to make them available to people who might not otherwise have been able to access them. You can do this via your CRIS profile at http://cris.sgul.ac.uk/ – if you have any questions, you can contact us at sora@sgul.ac.uk
  • Get in touch with researchdata@sgul.ac.uk about making your other research outputs openly accessible via our Research Data Repository, or for ideas on where to find open data and other outputs you can use in your own research.
  • Think about uploading a preprint of your research to a preprint server. Posting papers to preprint platforms has increased greatly since the start of the pandemic – you can find out more about preprints, such as what they are and what to consider before posting, by reading our blogpost from last year on preprints in the medical, biological and health sciences.
  • Follow the conversation via the twitter hashtag #OAWeek – and add your own thoughts and reflections!

Any questions? Get in touch with us:

We look forward to hearing from you.

Michelle Harricharan, Research Data Support Manager

Jenni Hughes, Research Publications Assistant

Jennifer Smith, Research Publications Librarian

Health E-news Friday 9 October

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

Announcement of forthcoming guideline on persistent effects of COVID-19

NICE, and the Scottish Intercollegiate Guidelines Network (SIGN) have announced that they will work with the Royal College of General Practitioners (RCGP) to develop a guideline for the persistent effects of COVID-19, or long covid. The guideline will address, among other things, a formal definition of the disease, and how to identify on-going symptoms, which can include on-going shortness of breath, fatigue, heart, lung, kidney, neurological and musculoskeletal problems. It will also provide a definition of best practice investigation and treatment options to support the management of the condition. Publication is expected before the end of the year.

COVID-19 related news

Cochrane review on anticoagulants for people hospitalised with COVID-19

A recently published Cochrane review explores the use of prophylactic anticoagulants for those who are hospitalised with COVID-19, to see whether preventive use of anticoagulants reduced mortality or the need for respiratory support, compared with placebo or no anticoagulant treatment. The studies found for inclusion in the review were retrospective studies from hospitals in China, Italy, Spain and the USA, and the variance in reporting of results, along with incomplete reporting, means the review authors have low confidence in the current evidence. 22 ongoing studies on the topic, including 20 RCTs, were identified, and the review will be updated when results of these are published.

Other news

Cochrane brings together recent reviews relevant to nursing, midwifery and allied health

On the Evidently Cochrane blog this week, collections of recent Cochrane reviews have been brought together for several staff groups. The individual collections offer an overview of recent evidence relating to nursing, reviews relevant for allied health professionals, and for midwives. Each collection offers several different topics, provides a summary of the findings, and links to the full reviews.

Cancer Research UK publication on the early detection and diagnosis of cancer

Cancer Research UK have published the ‘Early Detection and Diagnosis of Cancer Roadmap’, a report which aims to help bring together the UK efforts in early detection and diagnosis of cancer. The document aims to define a shared vision amongst healthcare professionals, healthcare service commissioners, academia, research funders, patients and other stakeholder sectors, and makes recommendations for overcoming the existing challenges to progress in this area.

NHS Employers resources for World Mental Health Day

Ahead of World Mental Health Day on Saturday 10 October, NHS Employers have rounded up a range of resources relevant to mental health and wellbeing amongst the healthcare workforce. The resources include a toolkit developed in partnership with Mind, and a variety of resources relating to mental wellbeing throughout the ongoing pandemic, including some specific advice on mental health for those working from home.

International consensus statement on preventing opioid-related harm

An international multi-disciplinary consensus statement on the prevention of opioid-related harm in surgical patients has been published in Anaesthesia. The authors of the statement include anaesthetists, pain specialists, surgeons, a primary care physician, nurse and pharmacist from Australia, India, Italy, the Netherlands, the UK and the USA, selected on the basis of clinical or academic expertise. The statement offers guidance on the safe peri-operative use of opioids in adult surgical patients, and includes recommended strategies to reduce the potential harms of postoperative use of opioids.

Nuffield Trust report considers mental health nurse education

A report from the Nuffield Trust, commissioned by NHS Employers and the Mental Health Network, looks at ways more people might be attracted to apply to study mental health nursing, and considers the reasons why numbers are currently limited. ‘Laying foundations: Attitudes and access to mental health nurse education’, identifies five broad areas where efforts can be made to encourage and support an increased number of students in mental health nursing education. These include improving understanding of mental health nursing roles and mental health patients, and enabling access to courses across the country, from across the breadth of the population.

NICE guidance

Medtech innovation briefing

MIB229 AnaConDa-S for sedation with volatile anaesthetics in intensive care

NICE guideline

NG170 COVID-19 rapid guideline: cystic fibrosis Updated

NG183 Behaviour change: digital and mobile health interventions

Technology appraisal

TA652 Alpelisib with fulvestrant for treating hormone-receptor positive, HER2-negative, PIK3CA-positive advanced breast cancer (terminated appraisal)

NIHR alerts 

Working may improve quality of life for carers of people with dementia

A decision aid may help people with newly-diagnosed multiple sclerosis consider their options for treatment

People with anorectal melanoma may not benefit from radical surgery


Statistics

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Health E-news Friday 2 October

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 related news

Cochrane Review examines the accuracy of chest imaging for COVID-19 diagnosis

A recent Cochrane Review considers the evidence for thoracic imaging tests in the diagnosis of COVID-19. Noting the continuing challenges of accurate diagnosis by reverse transcriptase polymerase chain reaction (RT‐PCR) testing, the review assessed studies on the use of chest imaging tests, including CT, X-ray and ultrasound, to see how accurate these tests are in diagnosing cases of suspected or confirmed COVID-19. On the basis of the included studies, the review suggests that chest CT and chest X-ray may be useful for confirming COVID-19 diagnosis, but that CT scans may be less accurate in suspected cases.

Study findings show high prevalence of infection, but suggest growth rate may be slowing

Interim findings from the Real-time Assessment of Community Transmission (REACT) study have been published, offering a view of the levels of infection in the general population in England. The study, led by Imperial College Healthcare NHS Trust, tests over 150,000 participants each month over a 2-week period, and the published findings shows prevalence of infection increased across all age groups and regions. Infection was highest in those aged 18 to 24 with 1 in 100 people infected, and cases increased seven-fold in those aged over 65. The North West had the highest levels of infection and the number of infections in London increased five-fold. The current prevalence of infection is the highest recorded to date by the study team.

Other news

GMC publish updated guidance on Decision making and consent

The General Medical Council have published new guidance on Decision making and consent, effective from Monday 9 November. The guidance is intended to help doctors have meaningful conversations with patients about their treatment and care options, and is designed to be easy to follow, taking account of the work pressures faced by doctors. A single page summary with key principles doctors need to know, a focus on the importance of taking a proportionate approach, tailored to individual patients, and information on how healthcare colleagues can support decision making.

Professional bodies for radiology and cancer radiotherapy call for dedicated investment

The Royal College of Radiologists (RCR), Society and College of Radiographers (SCoR) and the Institute of Physics and Engineering in Medicine (IPEM) have each submitted cases to the Treasury, ahead of the forthcoming Comprehensive Spending Review. The organisations are united in their calls to the Government to combat staff shortages and inadequate and outdated equipment and IT, the primary obstacles that slow down care for cancer and imaging patients. The full submissions of each organisation can be accessed from this page.

RCoA and Association of Anaesthetists publish guidance on safe drug management

The Royal College of Anaesthetists (RCoA) and the Association of Anaesthetists have published guidance on the Safe Drug Management in Anaesthetic Practice. This guidance has been endorsed by the Royal Pharmaceutical Society (RPS), the Faculty of Intensive Care Medicine and the College of Operating Department Practitioners. The guidance builds upon 2016 guidance, ‘Storage of drugs in anaesthetic rooms’, extending its scope to include other areas where anaesthesia is routinely administered, such as emergency departments and labour wards.

King’s Fund considers the trade-offs between digital and face-to-face care

With the move from face-to-face to digital provision of some health care services during the first stages of the pandemic, there is a need to consider the gains, the losses and the balance between the two options, ahead of lasting decisions being made, suggests the King’s Fund. Noting some of the benefits that digital solutions offer patients and staff, and highlighting some of the obstacles preventing access to digital solutions, the argument is made for a balance which draws on the strengths of both face-to-face and digital, taking proper account of the needs and preferences of patients and healthcare professionals.

Resources, events and celebrations for Black History Month

As Black History Month begins, with restrictions limiting face-to-face events, NHS Employers is keen for staff to engage with celebrations, and share stories and resources online. Their website lists some events that NHS trusts have planned throughout the month, links to further information and resources on Black History Month specifically, as well as resources on inclusion and diversity more broadly. They also offer some key facts, figures and information about the current NHS workforce.

NHS Confederation report calls for ‘re-imagining’ of the NHS

Bringing together NHS Confederation members and partners, the NHS Reset campaign has convened the health and care system to reflect on the learning from the last six months and what it means for the future. The report reflects the views of the NHS Confederation, and highlights five factors which are central to helping reset the way health and care is planned, commissioned and delivered.


NICE guidance

Technology appraisal

TA650 Pembrolizumab with axitinib for untreated advanced renal cell carcinoma

TA651 Naldemedine for treating opioid-induced constipation


NIHR alerts 

Tackling fear and misinformation may help increase hepatitis C testing in prison

Tranexamic acid should not be used for patients with severe gastrointestinal bleeding


Statistics

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Health E-News Friday 25 September

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

New guidance on preparing anaesthesia and critical care for a second COVID-19 surge

New joint guidance produced by the Faculty of Intensive Care Medicine, the Intensive Care Society, the Association of Anaesthetists and the Royal College of Anaesthetists, outlines key principles for clinical directors to consider when planning service changes. The guidance aims to enable services to increase the availability of critical care facilities for COVID-19, while also protecting planned surgery, preserving training, and protecting the health and wellbeing of healthcare staff.

COVID-19 related news

New discovery in structure of Coronavirus could offer way of stopping virus

A new discovery in the structure of the SARS-CoV-2 Spike protein could offer a potentially significant means of eliminating the COVID-19 virus. An international team led by the University of Bristol, who have been examining the molecular composition of the virus, have made a finding that suggests that it might be possible to develop anti-viral drugs to target a particular part of the virus spike, thereby stopping its infectivity. The full findings are available in an article published in Science.

Cochrane blog offers summary of existing evidence on COVID-19

A piece on the Cochrane blog offers a summary of the existing Cochrane Reviews and Special Collections on various aspects of the virus. These include reviews on detecting COVID-19, testing and screening options, measures for controlling the spread – which include PPE, quarantine and travel-based measures – and treatment options for patients with COVID-19. The piece also considers the impact of the pandemic on other areas of health and wellbeing, and links to relevant reviews. Keep up to date with Cochrane news and reviews on COVID-19 at their page dedicated to Coronavirus resources.

Other news

Healthcare regulators publish annual joint report on whistleblowing disclosures

The GMC, NMC and the six other UK healthcare regulators have published their joint ‘Whistleblowing disclosures report 2020’. The report covers any disclosures made between 1 April 2019 and 31 March 2020, and outlines the number of disclosures received by each of the regulating bodies, as well as summarising the actions taken as a result of these disclosures.

Latest evidence from Cochrane on psychological therapies for chronic pain

A recently published Cochrane review investigates the use of three common psychological therapies for chronic pain in adults: cognitive behavioural therapy (CBT), behavioural therapy (BT) and acceptance and commitment therapy (ACT). The review is based upon studies of face to face treatment delivered by trained psychological therapists, and found that CBT offers small benefits on pain, disability and distress, while the evidence for ACT and BT was uncertain.

King’s Fund report examines the workplace needs of nurses and midwives

A report from the King’s Fund, ‘The courage of compassion: Supporting nurses and midwives to deliver high-quality care’, examines the pressures faced by nursing and midwifery staff, and investigates the workplace transformations that could contribute to improved health and wellbeing, decreased stress, and increased motivation. The report suggests that three core needs of autonomy, belonging and contribution must be met, and provides recommendations for how these can be achieved.

Flu vaccination programme aiming to reach 30 million people

This year’s flu vaccination programme will be expanded in an attempt to provide the vaccine to 30 million people, as findings from Public Health England (PHE) research earlier this year suggests that the risk of death more than doubled for people who tested positive for both flu and COVID-19, compared to those with COVID-19 alone. The vaccine will first be offered to all primary school children, two and three year olds, and the most at-risk groups, including adults over 65 and those with long term health conditions, before being rolled out to others later in the season. All staff at St George’s can, of course get their flu jab from the daily flu clinic.

Evidence review on the influences of improvement processes in healthcare

An evidence review commissioned by The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge, and carried out by the RAND Corporation, explores the key influences affecting the implementation of improvement processes in healthcare. Based upon a review of publications covering a range of improvement approaches, six factors were found to be key influences on the successful implementation of improvement. These include leadership, patient and public involvement, and the use of data. The review is intended to highlight the issues that need to be considered when designing improvement initiatives.

NICE guidance

Clinical guideline

CG173 Neuropathic pain in adults: pharmacological management in non-specialist settings Updated

Interventional procedures guidance

IPG680 Transcranial magnetic stimulation for auditory hallucinations

Medtech innovation briefing

MIB227 t:slim X2 insulin pump for managing blood glucose levels in type 1 diabetes

MIB228 Novii Wireless Patch System for maternal and fetal monitoring

NICE guideline

NG59 Low back pain and sciatica in over 16s: assessment and management Updated

NG182 Insect bites and stings: antimicrobial prescribing

Technology appraisal

TA649 Polatuzumab vedotin with rituximab and bendamustine for treating relapsed or refractory diffuse large B-cell lymphoma


NIHR alerts 

New research provides insights into the distress experienced by transgender adults

More precise classification of risk in prostate cancer reveals a huge variation in treatment

Terminally ill patients and their families often need more help to manage their medicines

More health research should take place in the areas and populations with most disease

Cultural and language barriers need to be addressed for British-Pakistani women to benefit fully from breast screening

Community-based medicine collection improves access to lifesaving HIV treatment in South Africa

Statistics

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Health E-news Friday 4 September

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 related news

Further evidence for benefits of corticosteroids in COVID-19 treatment

Findings in papers published this week in Journal of the American Medical Association (JAMA), have reinforced evidence that outcomes for patients severely affected by COVID-19 can be significantly improved by corticosteroids. The first of the papers examines the effect of hydrocortisone on mortality and organ support, finding more rapid recovery and better survival rates in treatment with the steroid. The second paper looked at mortality over a 28-day period after the start of treatment with corticosteroids, estimating a 20 percent reduction in risk of death.

Government announce funding of increased testing capacity

The government has announced funding for increasing the current capacity for existing polymerase chain reaction (PCR) COVID-19 testing, with the aim of enabling large-scale repeat population testing. In addition, funds will go to expanding pilot trials of new testing techniques and technology, including a rapid test that could provide results in as little as 20 minutes.

New findings add to picture of COVID-19 risks in pregnancy

A systematic review published in the BMJ offers further detail to the known risk factors, clinical manifestations, and outcomes in pregnant and recently pregnant women with COVID-19. The key findings of the review are: that increasing maternal age, existing co-morbidities or high BMI are risk factors for severe COVID-19 in pregnancy; that women with the virus are more likely to experience preterm birth; and pregnant women are less likely to manifest symptoms of fever and myalgia than non-pregnant women with COVID-19.

Nuffield Trust briefing on impact of COVID-19 on use of technology in NHS

A briefing from the Nuffield Trust explores how the pandemic has pushed the adoption of technology in the delivery of NHS services and notes the increased usage of digital health services by patients. The report examines what has enabled these changes, considers possible risks of the move to remote service delivery alongside the positive outcomes, and calls for the balancing of change with evidence of its benefit. Finally, the funding, infrastructure and workforce requirements of sustaining any lasting technological adoptions is highlighted.

Other news

RCPCH statement on paediatrician role in supporting mental health

The Royal College of Paediatrics and Child Health (RCPCH) has published a statement on the role of paediatricians in supporting the mental health of children and young people. Noting the increasing incidence of mental health issues among children and young people, the heightened risks for those in vulnerable groups, and the anticipated increase in support needs resulting from COVID-19, the statement makes a series of recommendations relating to training for paediatricians, and also for service developments.

NICE guidance

Diagnostics guidance

DG41 Implantable cardiac monitors to detect atrial fibrillation after cryptogenic stroke

Medtech innovation briefing

MIB225 Helge for detecting haemolysis

Medical technologies guidance

MTG50 Axonics sacral neuromodulation system for treating refractory overactive bladder

NICE guideline

NG159 COVID-19 rapid guideline: critical care in adults Updated

Technology appraisal

TA645 Avelumab with axitinib for untreated advanced renal cell carcinoma

TA646 Glasdegib with chemotherapy for untreated acute myeloid leukaemia (terminated appraisal)

TA647 Eculizumab for treating relapsing neuromyelitis optica (terminated appraisal)


NIHR alerts 

Male prisoners develop unhealthy hearts at younger ages than people on the outside

Teams of healthcare professionals from a wide range of disciplines and pay grades are most effective at delivering improvements in patients’ experiences

Psychiatric drugs given to children and adolescents have been ranked in order of safety

Anti-inflammatory drugs do not lift depression in bipolar disorder


Statistics

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St George’s Archives – The Pastry Chef Murderer

Opening Up the Body’ is a project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946. Our Archive team have been cataloguing and digitising records dating from 1841-1917 – that’s about 27,132 cases across 76 volumes. The comprehensive reports contained within these volumes reveal some fascinating stories, which we’ll be sharing with you via the Library blog. Today’s post comes from Natasha Shillingford, Project Archivist.

On 27th July 1908 a patient called Ferdinand Alletrie was admitted to St George’s Hospital with a stab wound in the left chest which was penetrating the heart. The medical case notes say that ‘He was a waiter at the Bath Club. He had quarrelled with a colleague who waited for him outside and stabbed him in the chest.’ On admission he was observed to be in articulo mortis, or at the point of death. There was a stab wound in the third left intercostal space just to the left of the sternum. His clothes were noted to be soaked in blood. Ferdinand died five minutes after his admission.

Post Mortem Case Book 1908 (Ferdinand Alletrie, PM/1908/221)

The morbid appearances listed during the post mortem examination note that on the left side of the chest in the third interspace was a ‘punctured wound pointed at either end and gaping in the middle. It measured 1” long and ½” wide in the middle.’ The Post Mortem includes an illustration of the murder weapon as shown below.

Post Mortem Case Book 1908 (Ferdinand Alletrie, PM/1908/221)

But what led to the death of Ferdinand at St George’s Hospital? A search through historic newspapers uncovered an article called ‘Foreigners’ Fight at the Bath Club’ in the Leicester Daily Post dated 1st August 1908. The article details the tragic events that took place at the Bath Club that evening as well as the resulting inquest at Westminster Coroner’s Court ‘on the body of a cook named Pierre Auguste Ferdinand Alletree, employed at the Bath Club, who died from the effects of a wound said to have been inflicted by another employee of the club, who was in consequences arrested.’ The accused man was named as Georges Backenstrass.

Pierre Souleyne, chef at the Bath Club, said that he had engaged Alletree as sauce cook at the beginning of June, and later employed Backenstrass as a pastry chef at the club. One evening Backenstrass approached the chef and said ‘Chef. I am very sorry. I want to leave at the end of the week.’ When asked why he wanted to leave, he said that he was not friendly with the sauce chef. Souleyne said to him, ‘You have nothing to do with the sauce cook, and he has nothing to do with you. You must work friendly together.’ The chef also spoke to the sauce cook, no doubt to diffuse the situation, and Alletree responded, ‘You know me. He is silly. Don’t take any notice of him.’ No doubt the chef thought the issue was resolved, but he soon received news that the two chefs were fighting.

Louis Ayrand, another sauce cook, gave evidence as to the relationship between the two chefs. He said that Backenstrass ‘was a quiet and reserved man. He had some malady, and for that reason he was avoided by the other men.’ He said that ‘we never ate any of his pastry’, because of this unnamed illness. Continuing, the witness said that Backenstrass and Alletree did not agree about their work, and they had previously quarrelled when Backenstrass would not send up the sauce. On the night of the murder Ayrand heard the two chefs quarrelling in the vegetable pantry, and they decided to settle matters outside in Berkeley Street. Soon another chef by the name of Griffin called out ‘The pastry cook has stabbed your chef.’ Soon after Alletree ran back to the club, his hand over his heart, pointed to the pastry chef and said ‘Arrest him, he has stabbed me with a knife.’

Griffin, a vegetable cook at the Bath Club, said that he had quarrelled with Backenstrass the same night, when he took a biscuit off the pastry chef’s plate and Backenstrass objected. Alletree then began arguing with Backenstrass, and the latter said ‘I will wait for you outside.’ Griffin followed the two men outside and saw Alletree put his hand to Backenstrass’ neck and push him back. Backenstrass retaliated by hitting Alletree in the chest with something, after which the sauce chef exclaimed ‘he has stabbed me.’

Another chef stated that he saw the cook with a knife after the quarrel and said to him ‘You ought not to use a knife when you have quarrelled.’ Backenstrass replied ‘Well, there are two waiting for me downstairs.’

When Backenstrass was taken to Marlborough Street Police Station he made a statement in which he said that the sauce cook had called him a sneak for talking to the chef about him, and that the sauce chef and Griffin had approached him in the pantry, the latter threatening to break his nose. Describing the affair in the street, Backenstrass said ‘I took my knife out of my right trousers pocket and struck him in the chest. The knife is very sharp. It is the one I used for pastry. I never carried it before that night. I took it because of the pastry cook and the vegetable cook. If they had left me alone this would not have happened. The sauce cook told me I had too many pans in the fire. He told me I ate too much and he would come and watch me out. I asked him several times to leave me alone, and he would not.’

Backenstrass was held at Brixton Prison prior to the inquest. However the Governor of the prison informed the Coroner that Backenstrass had committed suicide in prison by hanging himself in his cell. The Coroner pointed out to the Jury that although Alletree had started the quarrel, if Backenstrass was still alive they would have to commit him on the capital charge. The jury returned a verdict of wilful murder against Backenstrass.

A further search of the historic newspapers revealed the article ‘The Bath Club Tragedy. The Brixton Prison Suicide’ in the Faringdon Advertiser and Vale of the White Horse, 8th August 1908. The article discusses the inquest into the death of Backenstrass. A medical officer testified that the prisoner, apparently a German, had suffered from a nervous affection. There were marks of two wounds of an operation in the abdomen, ‘but the man was in fairly good health, and behaved himself quite rationally, though he shewed that he was naturally worried about the crime.’ On the prisoner’s slate was found words written to the effect that ‘he had not been in good health, that he felt the disgrace, that his conscience was quite clear, and that he was guiltless of the offence with which he was charged.’ The jury returned a verdict of suicide whilst of unsound mind.


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Health e-news Friday 28 August

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

Joint vision for eye care services during and beyond COVID-19

The College of Optometrists and The Royal College of Ophthalmologists (RCOphth) have developed a joint vision for the two professions to continue to work together to support the delivery of safe and sustainable eye care services in England. The vision sets out three key principles and recommendations for the development and governance of high quality eye care service. The three principles are: balancing visual loss due to delays against the risk of acquiring COVID-19; decisions about the most effective patient care being made by the appropriate clinician, and; all pathways to be underpinned by the highest standards of joint optometry and ophthalmology clinical governance.

COVID-19 related news

Study offers more detailed picture of COVID-19 risk factors and outcomes in children

Findings, published in the BMJ, of an observational study of 651 children and young people (aged less than 19 years) with COVID-19 admitted to hospitals across England, Wales and Scotland between 17 January and 3 July 2020, offer further details of the symptoms, risks and outcomes of the virus in children. The nationwide study highlights that a very small number of children (six) died, and that those children most at risk of requiring intensive care are babies under one month old, and children aged 10 to 14 years. In common with adults, the study found that obesity, and black ethnicity were factors that increased the risk of requiring intensive care.

New measures to support development and rollout of COVID-19 vaccines announced

The government has outlined a number of measures that will allow the safe future mass rollout of a COVID-19 vaccine. These include an expansion of the trained workforce that can administer vaccines, in order to increase access; and giving the Medicines and Healthcare products Regulatory Agency (MHRA) powers to consider approving use of a vaccine ahead of a full product licence; providing that robust clinical trials demonstrate its safety and effectiveness. Linked with these proposals, a consultation is seeking views on the safe distribution of potential COVID-19 vaccines and treatments.

Other news

RCN launches fresh campaign for nursing pay rise

The Royal College of Nursing (RCN) has launched a new ‘Fair pay for nursing’ campaign, seeking an immediate pay rise of 12.5% for all NHS nursing staff. The RCN highlight that the pay rise is needed to: provide safe and effective patient care for all people of the UK by addressing the staffing crisis within nursing; recognise the skill, accountability and expertise of a safety critical profession; and recognise that the salaries of nursing staff have not kept pace with increases in the cost of living. The campaign page also notes the political nature of health care funding in its call for action to address the years of inadequate support for nurses.

RCPCH on declining vaccination rates in the UK

The Royal College of Paediatrics and Child Health (RCPCH) considers some of the factors that are contributing to the ongoing trend of declining vaccination rates in the UK. The piece highlights some of the potential barriers that prevent access to vaccines; considers the significant role of misconceptions, misinformation and belief; and in light of the pandemic, also discusses the impact of disruption to routines and the development and distribution of new vaccines.

NHS Confederation calls for inspections to be paused until after winter

The NHS Confederation has written to the Secretary of State for Health and Social Care, calling for the routine inspections of hospitals and other health care providers to be put on hold until after winter. Pausing inspections, the organisation says, will enable hospitals and other providers to focus on the backlog of treatment that has built up, as well as address issues like staff exhaustion, while also managing the ongoing threat from coronavirus. A recent report by the NHS Confederation makes the case for learning from the present moment, and asks questions of what governance and regulation of healthcare could look like if bureaucracy were reduced.

NHS Providers report on meeting the needs of everyone

A report from NHS Providers, ‘Getting it right for everyone: Meeting the needs of people with a learning disability and autistic people in NHS services’ looks at the longstanding structural inequities faced by people with a learning disability and autistic people, and the further  impact of the pandemic upon these inequalities. Drawing upon interviews with leaders in trusts providing good and outstanding learning disabilities and autism services, the report sets out in detail the common themes behind high quality care, offering detailed case studies of how they have succeeded.

NICE guidance

Clinical guideline

CG134 Anaphylaxis: assessment and referral after emergency treatment Updated

Diagnostics guidance

DG40 High-sensitivity troponin tests for the early rule out of NSTEMI

Medtech innovation briefing

MIB224 FebriDx for C-reactive protein and myxovirus resistance protein A testing

Quality standard

QS196 Community pharmacies: promoting health and wellbeing

QS197 Faltering growth

NIHR alerts

Screening for lymphoedema after breast cancer surgery could identify women likely to benefit from compression sleeves

The weekly break from dialysis is harmful to patients with kidney failure

Statistics

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Health E-news 21 August

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 related news

Joint letter urges recruitment of COVID-19 patients onto RECOVERY trial

In a joint letter sent to every NHS trust in the country, the UK’s four Chief Medical Officers and NHS England and Improvements’ National Medical Director have urged continued recruitment of high numbers of patients onto the RECOVERY trial, which is exploring potential treatments for the virus. The letter also discusses the next phase of the research response, which includes preparation to support a number of large-scale COVID-19 vaccine studies and driving forward the studies on convalescent plasma.

Considering the evidence on the efficacy of masks

Researchers at the University of Edinburgh, exploring the effectiveness of surgical and single-layer cotton masks on mitigating dispersion of large respiratory droplets (i.e. non aerosol), have made their findings available as a pre-print, non peer reviewed paper on medRxiv. The authors estimate that wearing even a basic, single layer mask decreases the number of projected droplets by over 1000 times in comparison to not wearing any face covering. The authors note that their research explores respiratory droplets, warning that any emerging evidence on aerosol transmission could impact the findings. Related to this, a separate paper in the BMJ calls for further research on the airborne transmission of COVID-19, and the measurement of viral aerosol outputs during respiratory activity and medical procedures. The authors in this case suggest that the infection risk associated with deep breathing, talking, and singing indoors is underappreciated and urgently needs attention.

Other news

Government announces creation of new public health protection organisation

The government announced the creation of a new organisation, with a primary focus on public health protection and infectious disease capability. The National Institute for Health Protection (NIHP), which will bring together Public Health England (PHE) and NHS Test and Trace, as well as the analytical capability of the Joint Biosecurity Centre (JBC) under a single leadership team, will start work immediately. Responses from a range of organisations, including the BMA, the AOMRC, the Academy of Medical Sciences, the Health Foundation and The King’s Fund raise a number of concerns. Primary amongst these are the timing of the reorganisation, the degree of independence that the body will have from government, and what will happen to the broader, prevention focused elements of PHE’s work.

Draft guidance makes new recommendation for lymphoma treatment

In new draft guidance, NICE has recommended use of combination treatment involving polatuzumab vedotin for adults with diffuse large B-cell lymphoma (DLBCL). The combination treatment will be available from today for patients whose cancer has relapsed or not responded to primary treatment, and who cannot have a haematopoietic stem cell transplant.

Findings from international study suggest efficacy of single-dose radiotherapy for breast cancer treatment

A study involving 32 centres in 10 countries, including the UK, has published findings in the BMJ. The TARGIT-A study examined the effectiveness of Targeted Intraoperative Radiotherapy (TARGIT-IORT), which uses just one shot of radiotherapy, compared to conventional external beam radiotherapy (EBRT), which requires daily treatment sessions over three to six weeks. The trial showed TARGIT-IORT  had comparable long-term efficacy for cancer control and lower non-breast cancer mortality.


NICE guidance

NICE guideline

NG125 Surgical site infections: prevention and treatment Updated

NG172 COVID-19 rapid guideline: gastrointestinal and liver conditions treated with drugs affecting the immune response Updated

NG178 COVID 19 rapid guideline: renal transplantation Updated

NG180 Perioperative care in adults

NG181 Rehabilitation for adults with complex psychosis


NIHR alerts 


Statistics

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Former students of St George’s: Assaad Y. Kayat (1843-1846)

To welcome new and old students to St George’s, our Archive team will be exploring the stories of some of our alumni. Today’s post comes from Archivist Juulia Ahvensalmi.

Image of Assaad Y. Kayat
Image of Assaad Y. Kayat. Source: ‘A Voice from Lebanon with the Life and Travels of Assaad Y. Kayat’ (1847).

Going through student records recently in the archives, I came across the name Assaad y Kayat in the list of students enrolled at St George’s in 1843. There was not much information in this list: his student number was 4093, he had attended the medical school for three seasons and he ‘appears not to have paid his fees’. His name stood out from the list of predominantly British names (the students at St George’s were until relatively recently primarily white, middle or upper class and male – you can read about our first female students in 1915 here), but the brief description was also intriguing. Who was Assaad, where did he come from and what happened to him?

As luck would have it, it turns out that Assaad, helpfully for us, published a book with his life story. He spelled his name As’ad Yakub Khayyat or Assaad Y. Kayat, and the book he wrote was called ‘A Voice from Lebanon, with the Life and Travels of Assaad Y. Kayat’. It was originally published by Madden & Co on Leadenhall Street, London, in 1847, and the front page includes a (rather dashing) portrait of him (see above).

The book appears to have been written specifically for a British audience. He had spent time in England on three occasions: it was on his third trip that he became a student at St George’s. At the age of 32 when he began his studies, he would have been considerably older than most of his fellow students – Henry Gray, for instance, was only 16 when he began his studies the previous year. Assaad was also married and had two small children, and had to earn money to cover his studies, so he presumably did not have much time for student activities. In his book, however, he only has words of praise for his time as a student:

‘I … entered as a medical student at St George’s Hospital … I shall be for ever indebted to them for the instruction I have received from their high skill. It is indeed a glorious hospital, an exalted medical school; it is an honour to be taught at it’

Signature of Assaad Y. Kayat in the St George’s Hospital Medical School Register 1836-1902.
Signature of Assaad Y. Kayat in the St George’s Hospital Medical School Register 1836-1902. Archives and Special Collections of St George’s, University of London

Life and travels of Assaad Y. Kayat

Born in 1811 in Beirut, Assaad describes in vivid detail his childhood and upbringing, through epidemics, wars and revolutions. He learns to read and write at the age of four, first in Arabic, his mother tongue, as his father wants to give him a good education (‘from the fear of my growing to manhood in a state of wretchedness and oppression’). Showing great promise and inclination for learning languages (he subsequently learns both ancient and modern Greek, Italian, English and Persian) as well as an astute business sense, Assaad soon progresses from selling rag papers to interpreting for sailors and merchants and is eventually employed as an interpreter by the British consul and representative of the East India Company in Syria. He travels widely around Middle East and Europe. Keeping in mind his audience, there is a lot of name-dropping of British dignitaries, officials and other people he meets on the way – his skills at networking are clearly second to none.

Although his focus is on Christian missionary activities, his account comes across as strikingly liberal for its time: he talks of ‘native agency’ and the importance of having native teachers and preachers, as well as of learning local languages and customs. He is a keen advocate of education, and in particular women’s education and equality.

Medical education

Throughout the account, he emphasises his journey to become a doctor ‘in order to benefit my fellow creatures’. On his second visit to England in the later 1830s, he attends some medical lectures at Cambridge, as well as at St George’s, where his first connection appears to have been the hospital chaplain, Rev William Niven. He regards medical education as an essential:

‘It requires no miracle to heal, but only to attend a medical course for a diploma or degree. A dose or two of sulphate of quinine often cures your patient of ague; vaccination prevents his taking the small-pox; the use of certain precautions prevents your catching the plague.’

In 1843 he returns to England, accompanied by his wife and toddler, as well as a group of young men with the view of obtaining an education for them, and to study medicine at St George’s. It is not all plain sailing, however, His wife Martha struggles to settle in; she has a toddler and a small baby to care for, she is sick herself, cannot get used to the miserable weather and the famous London fogs (or smogs caused by pollution in the dirty and overcrowded city), she doesn’t speak English and is largely confined to their small rented rooms, instead of their lovely house and garden and the company of her family and friends in Beirut (so despite his advocacy for women’s education, his own wife is stuck with a very traditional role at home). They are struggling with money; the committee (‘Committee of the Syrian Society’) Assaad had set up to enable the education for his ‘Syrian youths’ is slow to help, and Assaad attempts to raise money by giving public lectures on Syria and Christianity and by setting up a small importing and exporting business.

He is also keenly aware of his status as an immigrant in Britain and encounters prejudices and racism. He cites a journalist, who ‘came to my lectures twice, and all she could observe was my handsome appearance – her ears tickled by my foreign accent’ and talks at length about the difficulties in trying to expel these prejudices:

‘Some take me for a prince, or at least a chief; others, for a Chinese ambassador, a merchant, or an interpreter. Some think I am a Jew; others, a Turk, a missionary, a philosopher, or a lecturer; Christians of every denomination appointing to me a station or an office according to their own preconceived notions.’

Entry for Assaad Y Kayat (student number 4093). St George’s student records Vol 5. SGHMS/4/1/7.
Entry for Assaad Y Kayat (student number 4093). St George’s student records Vol 5. SGHMS/4/1/7. Archives and Special Collections of St George’s, University of London.

The student records show that Assaad studied for three seasons. One of the records notes that he ‘appears not to have paid his fees’, but according to his own account he finishes his studies in 1846, obtains his diploma and is admitted as a member of the Royal College of Surgeons, before returning to Beirut. It is unclear which account is true; maybe some more research in the archives will shed more light on the matter.


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Health E-news Friday 14 August

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

NHS publishes guidance for phase three response to COVID-19

The NHS has published a guidance document offering recommended actions across several key areas, including: addressing inequalities in provision and outcomes; mental health planning; and the restoration of community health services. Responding to the publication of the guidance, the NHS Confederation welcomed the emphasis on tackling the health equalities exposed by the pandemic.

COVID-19 related news

Briefing from NHS Providers explores trusts’ experiences of COVID testing regime

A new report from NHS Providers, drawing on the responses from 112 trusts to a survey conducted during June and July, explores the experiences that trusts have had with the national testing strategy so far. The report examines levels of confidence in the government’s approach and strategy, and trust leaders’ confidence in being able to meet testing requirements; considers issues relating to variable turnaround time for test results, and the implications of these; and calls for greater local involvement and control in testing in order to manage routine testing of staff and patients as services resume.

REACT study publishes first findings

The REACT (REal Time Assessment of Community Transmission) study, which has been using antibody finger-prick tests to track past infections and monitor the progress of the pandemic, has published pre-print findings on antibody prevalence based on 100,000 study participants. The findings indicate that 3.4 million people – 6% of the population – had been infected by COVID-19 by 13 July 2020. People living in London were most likely to have been infected, as were those working in care homes and health care, and people from Black, Asian and other minority ethnic groups and people living in larger households. All findings from the study can be found on the group’s page on the Imperial website.

COVID-19 pay protection FAQs

The NHS Staff Council Executive has published FAQs on pay protection relating to workforce issues arising from COVID-19. The document is an addition to existing guidance from the Department of Health and Social Care, and answers questions relating to staff who are redeployed to help service and patient needs, or in cases of redeployment following a risk assessment.

Study reveals extent of symptoms or infection of healthcare staff resulting from intubation

A new study published in Anaesthesia, explores the extent to which healthcare staff involved in procedures such as intubation might be exposed to elevated risk of acquiring COVID-19. The study of 1,718 healthcare workers from 503 hospitals in 17 countries shows that overall, 1 in 10 healthcare workers involved in intubating seriously ill patients with COVID-19 later reported symptoms, or had lab-confirmed COVID-19 themselves. The study authors recommend use of the findings to inform service planning, and suggest future work should aim at identifying interventions to reduce risks to healthcare professionals.

Other news

Research finds breast screening women aged 40-49 reduces cancer mortality

Research published in The Lancet Oncology, from a trial involving 23 breast screening units across Great Britain, suggests that yearly mammography commencing at age 40 or 41 years could lead to reductions in breast cancer mortality. The trial involved over 160 thousand women, recruited between October 1990 and September 1997, and the publication offers analysis of the data at 23 years of follow-up.

BMA report on disability in the medical profession

A new report from the BMA examines the experiences of disabled people studying, training and working in medicine, and offers recommendations for improving the support on offer. The report, based upon responses to a BMA survey, shows that just over half of respondents receive adjustments that they need, and which are a legal duty to provide. Over three quarters of respondents also expressed concerns over being treated unfavourably if disclosing a disability or long-term health condition.

NICE guidance

Interventional procedures guidance

IPG678 Deep brain stimulation for refractory epilepsy in adults

IPG679 Implanted vagus nerve stimulation for treatment-resistant depression

Medtech innovation briefing

MIB221 Healthy.io test for home testing of urine albumin to creatinine ratio

MIB222 pCONUS2 Bifurcation Aneurysm Implant for complex intracranial aneurysms

MIB223 Spartan RX point-of-care CYP2C19 test to guide treatment in acute coronary syndrome

Quality standard

QS194 Decision making and mental capacity

NICE Guideline

NG160 COVID-19 rapid guideline: dialysis service delivery Updated

NG174 COVID-19 rapid guideline: children and young people who are immunocompromised Updated

Technology appraisal

TA641 Brentuximab vedotin in combination for untreated systemic anaplastic large cell lymphoma

TA642 Gilteritinib for treating relapsed or refractory acute myeloid leukaemia

TA643 Entrectinib for treating ROS1-positive advanced non-small-cell lung cancer

TA644 Entrectinib for treating NTRK fusion-positive solid tumours

NIHR alerts 

Early warning scores used in hospitals must be based on sound science

High rates of delirium, persistent fatigue and post-traumatic stress disorder were common after severe infection in previous coronavirus outbreaks

Fluoxetine does not improve outcomes after stroke

Statistics

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Welcome to St George’s

We would like to welcome all new doctors who have recently joined us at St George’s. Below are some key things to help get you started.

Register with the library

To register with the library, simply complete the online registration form here.

Self-register for an OpenAthens account

If you need to set up a new OpenAthens account, use the self-registration form; if you already have an existing account with another organisation, you can transfer it to St George’s. If you have any questions, or need any help, contact our OpenAthens administrator, Stephen Reid.

Key resources

BMJ Best Practice

BMJ BestPractice is an online point of care tool that gives healthcare professionals fast and easy access to the latest information when making diagnosis and treatment decisions. Access via your OpenAthens account.

UpToDate

UpToDate is an online evidence-based medicine resource providing point-of-care clinical information. Access via your OpenAthens account, or from the trust intranet.

Databases

The library website has a list of databases available to all NHS staff. This inlcudes a version of PubMed which links to OpenAthens full-text content, Medline, Embase and additional resources including Aclands Video Atlas of Anatomy.

BMJ OnExamination

Designed to assist doctors in training to prepare for membership examinations with current and relevant online revision courses. Voucher codes providing 2 months access to the site are available from the library. Contact liaison@sgul.ac.uk for further information, or to request a voucher.

Journals

OpenAthens journals A-Z

To see which journals are available to access with your OpenAthens account, visit the NICE journals A-Z. Login to see full details.

University journals A-Z

Further titles are available from the St George’s, University of London collections; see the searchable A-Z list. All university journals are accessible from the computer rooms adjacent to the library; visit the library helpdesk to obtain a login.

Article request service

Articles from the university collections can also be requested online, using the form on the library website.

E-books

Our e-book collection can be found using Hunter, the library search tool. Filter results to ‘Online Resources’ for e-books, and login with your OpenAthens account.

Library guides

The library has produced a range of guides, designed to support clinical practice, research, and professional and service development. These include a guide to COVID-19 resources and research, quality improvement, and a guide on carrying out systematic reviews. The full list of guides can be found here.

Literature searching service

CARES is our literature searching service, available to all NHS staff. The service supports clinical practice, service development, research and teaching by providing librarian-run literature and evidence searches on your behalf.

Contact

For help, or for further information on library services, support and training, and the resources that are available to you, contact us on liaison@sgul.ac.uk

Health E-news, 31 July

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

Latest guidance updates from NHS Employers

NHS Employers have information on the latest COVID-19 guidance updates. Updates include: details on the government announcement confirming that registered health and care professionals travelling to the UK from high-risk countries will be required to self-isolate for 14 days; revised guidance on quarantine, including leave and pay options for staff required to quarantine; and guidance relating to the pausing of shielding, which is effective 1 August.

COVID-19 related news

NHS Confederation on ONS excess mortality statistics and test and trace figures

In a response to the publication of Office for National Statistics (ONS) comparison of all-cause mortality between European countries, and the latest figures for the test and trace programme, Dr Layla McCay, a director at NHS Confederation, expressed concerns over the week-on-week decreases in the percentage of close contacts being reached by tracing system, and stressed the importance of this system to the ability to identify and manage any surges in infections.

Chief executives of NHS trusts voice concerns over staff wellbeing

In a report published by the NHS Confederation this week, chief executives from NHS trusts across England revealed concerns about the impacts of COVID-19 on their staff. Executives voiced serious concerns over: the increasing levels of anxiety and fatigue reported by staff during the pandemic; the safety of BME staff, in light of the disparities of COVID-19 impacts; and protecting the safety of patients and staff as routine services are resumed.

NIHR announce funding of projects to investigate higher COVID-19 risk among certain ethnic groups

The National Institute for Health Research (NIHR) has announced joint funding with UK Research and Innovation (UKRI) of six new research projects to eek to explain and mitigate the disproportionate death rate from COVID-19 among people from Black, Asian and minority ethnic (BAME) backgrounds. One of the studies, UK-REACH, led by the University of Leicester, will establish a unique partnership between national healthcare organisations to specifically address the prevalence of COVID-19 amongst BAME healthcare workers.

NHS England launch online portal to support COVID-19 rehabilitation

A new website from NHS England has been launched, offering an ‘online portal’ to help the rehabilitation of patients discharged from hospital post COVID-19 and those managing their illness at home. The site has been developed with the support and input of several royal colleges, professional bodies and charities. The site offers support for managing a variety of common physical effects those recovering from the virus may experience, as well as for supporting mental health and wellbeing.

PHE report confirms increased COVID-19 risks of being obese or excessively overweight

A report from Public Health England (PHE), which summaries findings from recent publications examining he effects of excess weight and obesity on COVID-19, confirms that the data show that obese people are significantly more likely to become seriously ill and be admitted to intensive care with COVID-19 compared to those with a healthy BMI. The report also summarises evidence regarding the nation’s eating and exercise habits during the COVID-19 pandemic. While some data suggests that more people have exercised during lockdown, evidence indicates that the nation’s exercise levels have not increased overall since before the pandemic.

Other news

NHS England sets out plan to roll out new A&E standards before winter

NHS England is planning to roll out new emergency care standards, designed to replace the four-hour A&E target, before this winter. The new standards have not been published or consulted on and do not have official sign-off from ministers, though the plans have the backing of the Royal College of Emergency Medicine and other royal colleges. Details of the proposed changes are outlined in a paper discussed at an NHSE and NHS Improvement board meeting.

Induction of labour: if, and when, to induce

Evidently Cochrane discusses a recently updated Cochrane review, ‘Induction of labour at or beyond 37 weeks’ gestation, looking at the effects for women and their babies of inducing labour towards the end of pregnancy. The review found evidence that induction later in pregnancy, when compared to waiting for birth to happen, reduced the number of perinatal deaths, led to fewer babies requiring intensive care, and a probable reduction in the number of caesareans required. The review does highlight the variation in values and preferences, and reiterates the need for collaborative discussion and shared decision-making.

New e-learning resource for those working with people with dysphagia

A new Dysphagia Guide, developed in conjunction between Health Education England (HEE), Sheffield Teaching Hospitals NHS Foundation Trust, and the Royal College of Speech and Language Therapists has been made available to access without registration on the HEE e-Learning for Healthcare website. The guide is intended as a resource for health and care professionals working with people with dysphagia, as well as carers and those living with dysphagia themselves.

NHS People Plan published

The NHS People Plan has today (30 July) been published, outlining actions that organisations, employers and staff will need to take in the coming months.
We are the NHS: People Plan 2020/21 sets out guidelines for employers and systems within the NHS, as well as actions for NHS England and NHS Improvement and Health Education England throughout the coming months and year. While welcomed by royal colleges and professional bodies representing health professionals, there was widespread comment on the need for action on staff shortages and a commitment to funding. This was echoed by the Health Foundation in it’s response.


NICE guidance

Medtech innovation briefing

MIB220 Prontosan for acute and chronic wounds

NICE Guideline

NG164 COVID-19 rapid guideline: haematopoietic stem cell transplantation Updated

NG179 COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services

Quality standard

QS195 Renal and ureteric stones


NIHR alerts


Statistics

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Health e-news Friday 24 July

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

Click here to sign up to this bulletin via email.

COVID-19 related news

Resuming health services during COVID-19 – learning from other countries

The Nuffield Trust have published a briefing examining how other countries are handling issues relating to health service resources and capacity, and the resumption of services as lockdown measures are eased. The report, drawing upon data from the WHO, the European Commission, the European Observatory on Health Systems and Policies, and the OECD, also considers what lessons the NHS might learn from the experiences of other countries.

ONS bulletin examines COVID-19 mortality rates by area and deprivation

The Office for National Statistics (ONS) have published a bulletin on deaths involving COVID-19 by local area and socioeconomic deprivation. Presenting figures at national, regional and local authority level, the bulletin offers provisional analysis of deaths between March 1 and 30 June, focusing on differences between local areas. The analysis also shows the differences between proportion of COVID-19 related deaths as they relate to an area’s level of deprivation. Mortality rates in the most deprived areas of both England and Wales were around twice those of the least deprived areas.

UKRI funded vaccine trial publishes results from early trial stages

The team of scientists at Oxford University’s Jenner Institute and Oxford Vaccine Group have published results from Phase I/II trials in The Lancet this week. The study, which involves researchers from St George’s, has found that the vaccine candidate produces both T-cell and antibody responses against the SARS-CoV-2 virus, including robust neutralising antibody responses. No safety concerns were noted.

Other news

Pay rise for doctors and dentists in England announced

The government has accepted the recommendations in the latest Review Body on Doctors’ and Dentists’ Remuneration (DDRB) report, which will see pay for NHS doctors and dentists in England rise by 2.8%. The rise will be backdated to April 2020.

Partial update to back pain and sciatica guidelines out for consultation

A draft partial update of the National Institute for Health and Care Excellence (NICE) 2016 guideline on the assessment of low back pain and sciatica has been published for consultation. The draft guideline says that people with acute or chronic sciatica should not be offered gabapentinoids, other antiepileptics, oral corticosteroids or benzodiazepines. It also recommends that people with chronic sciatica should not be offered opioids, and states that no evidence recommends the use of antidepressants for sciatica. The Chartered Society of Physiotherapy intends to respond to the consultation, and recommends that individual members also contribute.

 
NICE guidance

Evidence summary

ES29 Remsima (infliximab biosimilar) for subcutaneous injection for managing rheumatoid arthritis

Interventional procedures guidance

IPG674 Artificial iris insertion for acquired aniridia

IPG675 Artificial iris insertion for congenital aniridia


NIHR alerts 

Drug users who lack access to clean water use dangerous alternatives to prepare injections

Most patients leaving hospital in India are given inadequate medical information

Loneliness in people with dementia is linked to social isolation and depression

Most people caring for relatives with dementia experience loneliness


Statistics

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Summer Holiday Library Update

While this summer is certainly different from any we have experienced before, we still hope you are making the most of the nice weather and enjoying a well-deserved break. For those of you who are continuing with university work, catching up on last year’s content or preparing for what’s to come, we have put together a short blog post around how to make the most of the Library resources. Our online services mean you can get the information and help you need, no matter where you currently find yourself.

1. Discover e-books in Hunter

We’ve added a large number of titles to our e-book collection in the last few months, so it’s now more likely than ever that you’ll find a range of online books to help with your topic.

You can find all our e-books in Hunter. Search under Books and more, then select Online Resources in the menu on the left. To access a book, use the SGUL users log in here link and enter your SGUL username and password.

See our short video on finding and accessing e-books in Hunter.

The Oxford Medical Handbooks have been some of our most popular e-books. You can find them by searching in Hunter, or view the full collection at Oxford Medicine Online – along with over 1000 other Oxford Medicine books available in full text and searchable by specialty and series.

Oxford Medical Handbooks

Please note we’ll be transferring part of our e-book collection to a new platform in the coming months due to the closure of DawsonERA. We hope disruption will be minimal, but if you’re unable to view an e-book you previously used, email us at library@sgul.ac.uk and we’ll try to restore access.

2. Explore online learning resources

As well as e-books and e-journals, your SGUL login gives you access to online teaching and learning resources, many featuring multimedia and quiz elements to help keep your study interactive. We’ve highlighted two popular resources below, but you can browse a full list here.

BMJ Learning offers hundreds of text and multimedia learning modules across 70+ medical specialties.

Access BMJ Learning here. On your first visit you’ll need to sign in with Shibboleth (use your SGUL login), then create a BMJ personal account with a unique password. On your next visit, just sign in with Shibboleth; your BMJ Learning homepage will now be personalised to your interests and previous learning

Sign in to BMJ Learning with Shibboleth then create your personal account. After this, just sign in with Shibboleth each time.

JoVE (Journal of Visualised Experiment) is an extensive collection of videos illustrating scientific concepts and laboratory techniques. SGUL students can view all content in the Biology, Immunology and Infection, Medicine and Neuroscience sections. Click here to sign in to JoVE.

Until 30th Sept 2020 we also have access to key sections in JoVE Science Education – so you have time to review topics in Basic and Advanced Biology, Clinical Skills and other areas over the summer. Click here for more information.

3. Contact the Library for help

The Library team remain available throughout summer to answer any questions you might have. For general enquiries, for example about loans and opening hours, please email library@sgul.ac.uk.

Your Liaison team is busy this summer preparing for next academic year as we transition all of our teaching and 1-2-1 support online. We have already delivered some online training sessions which went well. Additionally, we are working on some Canvas tutorials and are expanding our video collection. We remain available for help via email (liaison@sgul.ac.uk) and can set up an appointment with you if you need help with your research or referencing.

Your ‘On-Call Librarian’ is at hand…

Image of a black female student writing at a desk

Today, we are pleased to announce the launch of our new ‘On-Call Librarian service’ where library users can get on the spot help with finding information and using library resources. No need to book, just come to the library helpdesk between the hours of 10am and 2pm, Monday to Friday and ask to speak to a librarian for help with literature searching, referencing and more. This service replaces our now closed Research Enquiries desk – we hope you like it- email your feedback to library@sgul.ac.uk