From the Norman Dott collection to the TB case notes...

     Six months have passed since I started my contract as a cataloguing archivist for the Norman Dott project and after cataloguing 4308 case notes, it is time for me to move on to another project involving medical records: ‘RVH v TB’, a project to catalogue LHSA’s Royal Victoria Hospital tuberculosis and diseases of the chest case notes and registers (c.1920-2000). I will be working alongside Becky and later Clair to catalogue the 25,000 cases files from the Royal Victoria Tuberculosis Trust and associated hospitals. 

Boxes containing the LHB41 CC/4 series.

     Last Monday I started working on the series LHB41 CC/4, which is composed of 71 boxes of case files from the Royal Victoria Dispensary for Diseases, plus 6 boxes of X-ray films and 6 boxes of miscellaneous papers. My target is to catalogue 40 case notes a day on the xml editor Oxygen. The transition from one project to another has been facilitated by the fact that the methodology used for cataloguing the tuberculosis (TB) case notes is based on the one created for the Norman Dott records. They contain the same kinds of documents, from roughly the same period: case summaries, correspondence, notes, charts, medical reports, sometimes X-rays, and forms and contact sheets. I record the same type of information: age, sex, geographical origin and name of the patient, medical conditions and symptoms, date at examination, covering dates, type of treatment given, and outcome for the patient. However, there are some differences between the Norman Dott case notes and the TB case notes – beyond the fact that pulmonary tuberculosis, pneumonia and bronchitis have now replaced brain aneurysms, cerebral tumours and head injuries.

An example of case note from the TB collection. PR4.72 (all personal details have been redacted)

     One of the most important differences is the fact that tuberculosis was a highly infectious disease, unlike most of the conditions in the Norman Dott records. The methodology created for the Dott project has been adapted to reflect this particularity: for example, the way locations are recorded in the RVH v TB project is slightly different. Most patients come from Edinburgh itself, so it was decided to use Westminster constituencies to locate the patients: it is precise enough to give an idea of the spread of the disease without risking disclosing the identity of an individual. We also record the family history of tuberculosis, indicating whether a member of the patient’s family had had tuberculosis or not. Tuberculosis was a matter of public health, and public authorities made everything in their power to stop the spread of the disease. It included keeping track of all the persons who had been in contact with an infected patient, mainly their family but also their landlord and neighbours when applicable. The persons deemed at risk were then called for examination; that’s why the case files sometimes contain contact sheets detailing the examination of the relatives of a patient suffering from TB. In these circumstances, children were often given the BCG vaccine (that is to say the Bacillus Calmette-Guérin vaccine, against tuberculosis).

     The Royal Victoria Dispensary case notes promise to be as fascinating as the Norman Dott records, with their own particularities and challenges. I am looking forward to learning more about the history of tuberculosis in Edinburgh and helping project cataloguing archivist Becky to complete the cataloguing of this impressive collection.  

Aline Brodin, project cataloguing archivist. 

Let's get digital...

For many heritage institutions, digitisation can a bit of a double-edged sword, and the question “why don’t you just put it all online?” has been known to cause a bit of eye-rolling and clenched fists amongst archivists. In this week's blog Alice considers the issues that surround digitisation, and introduces an exciting project that LHSA is involved in...

As much as many of us would love to digitise large parts of our holdings, there are practical issues that can stand in the way. Digitisation involves more than simply snapping away with a hand-held camera: to be a worthwhile endeavour, it should produce high-quality digital images that can then be used in a variety of ways. In order to capture such images, you need good equipment, and this can be expensive! Another option is to outsource the services of a good digitisation company, but again, the costs can rise and rise. When beginning a digitisation project, it’s important to consider what is within the means of your institution.

Another concern is what the material you’re looking to digitise can withstand in terms of the photographic or scanning process. With many older volumes, the bindings might make it difficult to produce a ‘flat’ image, as they can cause the pages to curve out of shape. Although a flat image is needed, care must be taken to minimise the amount of stress placed on the most vulnerable areas, and this might require the use of specially designed cradles to hold the volume. Some volumes might be robust enough to go through a scanner which automatically turns pages as it goes – for others, the delicate nature of the pages means this is out of the question. Similarly, exposure to high light levels can have damaging effects on some records, and it’s therefore important to have a carefully-monitored lighting set-up.

The binding of the volume has here caused the pages to 'curve', making capture difficult.

A further concern is about not the physical form of the records, but their actual content. Many of LHSA’s records concern individuals, and as we’ve discussed before, it’s very important that we bear in mind potential issues around privacy and sensitivity when providing access to these records. In a similar vein, it’s also important to consider how any digital surrogates of a record might be used in the future, and how far we are able to control this. While digitisation allows for new contexts to be brought to records, we have to be sure that these new contexts build on, rather than obscure, the original context of the records’ creation.

A recent digitisation venture that LHSA has recently been involved with is the Florence Nightingale Digitisation Project, hosted by Boston University’s Howard Gotlieb Archival Research Centre.  The project aims to create a comprehensive database of digitised correspondence written by the pioneering nurse, and so far they have been able to provide access to over 1900 items.

LHB1/111/3 - Bound volume of letters presented to the
Royal Infirmary of Edinburgh by Miss Angelique Lucille Pringle

Past readers of our blog will remember that we hold a volume of letters written by Nightingale. These were presented to the Royal Infirmary of Edinburgh in 1951 by Miss Angelique Lucille Pringle, who had trained under Nightingale. The two women established a long friendship, and in her letters Nightingale refers to the younger woman as ‘Little Sister’, a nickname bestowed on her for her short stature and kindly temperament.

As part of our contribution to the Florence Nightingale Digitisation Project, we’ve been looking at how to best go about preparing this, and the staff of the University of Edinburgh’s Digital Imaging Unit have been on hand to provide us with guidance. The volume is a tricky one – almost every page is a different size, and there are a number of sections where Miss Pringle has clipped out confidential or private details from the letters, meaning they don’t always ‘sit’ on the page in the order you might expect! Many of these pages are very delicate, and there are one or two where Nightingale has added corrections or clarifications in pencil to a typed letter. This means lighting levels have to be absolutely perfect in order to pick up all these small details without accidently picking up the typed text on the reverse of the page.

One of these letters is already digitised - you can see this in full over on our issuu page – and we’ll be adding more details here as the project progresses. It’s great to see such a wonderful resource for Florence Nightingale enthusiasts coming together, and even better that LHSA is able to contribute to it!

_____

Resources:

• This video from the University of Oxford is a great introduction to how digitisation can open up records to new audiences
• Find out more about the University of Edinburgh's Digital Imaging Unit and the work they do at their blog

Downton Abbey and fortune telling fish...

Around this time last year, Ruth helped deliver a training day on collection care basics. It was held in London and the teaching was shared with a Preventive Conservator colleague from the British Library, where the course was held. Earlier this month Ruth was back at the British Library to provide this ‘Essential Preservation’ training day to a fresh group of attendees….but how were one of the nation’s favourite TV shows and a Christmas cracker toy involved?

Last year’s ‘Essential Preservation’ training session had been a great success – library and archive professionals who were interested in learning more about the steps they might take to care for their collections spent the day looking at a range of issues from best practice handling to writing preservation policies. The feedback was good but I felt that some improvements could be made to make it even better!

The day was split up into six sessions: an introduction setting out terminology and referencing the relevant standards and then lectures on handling, storage, writing a preservation policy, risk management and disaster response, and finally communicating the conservation message and where collaborations and sources of help can be found. I was responsible for three of the sessions – handling, storage and policy writing.

There’s so much important information to pass on that it was difficult of think of any other way to convey it other than in a lecture format. But the first time I ran the sessions I felt that the PowerPoints I had produced were a bit text heavy and would benefit from some more pictures to illustrate my points, and that there needed to be a bit more participation from those attending to make it more engaging for them.

The handling session already had a strong practical element in the shape of demonstrations and the opportunity for delegates to have a go at applying best practice techniques themselves; and in the policy session I had a short practical exercise to start everyone thinking about what their own preservation policy might contain. So I concentrated on how to improve the storage session...

In this part of the ‘Essential Preservation’ day I was looking at the various different factors that can impact on the condition of collections while they’re in storage, from the structure of the building itself through to the environment in the stores and the shelving and boxing used. I also looked at the kind of maintenance programmes needed to keep high quality storage spaces, including putting a robust housekeeping regime of cleaning and monitoring in place. And this is where Downton Abbey came in – who better to illustrate the need for cleanliness than the redoubtable Mrs Hughes, the housekeeper in Downton Abbey, who now adorns one of my PowerPoint slides along with Mrs Doyle and Kim and Aggie!

I also wanted to introduce an exercise for the delegates so they had a chance to put the principles I covered into practice. With the help of a colleague who used to work for the National Trust for Scotland, we created graphs showing temperature and relative humidity over the course of one day for three fictional spaces – a conservation studio, a store built to the sector standard, PD5454:2012, and a room in a historic house. The delegates had to work out which graph related to which space and then discuss the conditions shown in the graph – were they suitable for collections, and were there any measures they would introduce to improve conditions? The exercise seemed to work really well, it certainly got everyone talking about collection care issues, and I think we could have expanded on this a bit more if it hadn’t then been lunchtime!

I promised fortune telling fish… well, everyone got one when I was describing the potential issues around relative humidity as an example of how warmth and moisture in the air (or in this case from your hand) can impact on materials in your collection. 

According to the fish, I’m fickle!