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:
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.
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:
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.
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.
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.
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.
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.
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.
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.
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.
‘Opening Up the Body’ is a Wellcome-funded project to conserve the Post Mortem Examinationsand 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.
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.
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.
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.
‘Opening Up the Body’ is a Wellcome-funded project to conserve the Post Mortem Examinationsand 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.
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.
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.
Patients at St George’s Hospital
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:
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.
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.
A few of the conditions covered in the advent calendar proved to be particularly interesting and unusual, such as glanders, leprosy, and malaria.
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.
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.
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.
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.
This is a guest post by the Careers team at St George’s.
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.
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.
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.
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.
Don’t hesitate to get in touch with us by emailing firstname.lastname@example.org 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.
The BNF and BNFC are key resources for all medical and pharmacology students.
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’.