History of the National Survey of Sexual Attitudes and Lifestyles

Annotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMUL. First published by Queen Mary, University of London, 2011. ©The Trustee of the Wellcome Trust, London, 2011. All volumes are freely available online at www.history.qmul.ac.uk/research/modbiomed/Annotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMULAnnotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMULAnnotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMULAnnotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMULAnnotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMULAnnotated and edited transcript of a Witness Seminar held on 14 December 2009. Introduction by Professor Clive Seale, QMULA National Survey of Sexual Attitudes and Lifestyles (NATSAL) was proposed in the mid-1980s. This was to provide data to help predict and prevent the transmission and spread of HIV, in response to the critical need for information on the AIDS epidemic. Set up by biomedical and social scientists, NATSAL-1 was carried out in 1990, and the results used for AIDS projections and the national HIV and sexual health strategy. Subsequent surveys (NATSAL-2 and -3) have followed in 2000 and 2010 extending the objectives to include other sexually transmitted infections such as Chlamydia and Human Papillomavirus. Introduced by Professor Clive Seale, this volume focusses primarily on NATSAL-1 and addresses the background to the survey, the methodology, the results, and the funding: its initial support by the Department of Health, the dramatic withdrawal of government funds and subsequent funding by the Wellcome Trust. Contributors include many of the key people involved in setting up the survey, experts in public and sexual health, individuals from the Wellcome Trust, interviewers, and the Sunday Times journalist who, in September 1989, reported Margaret Thatcher’s veto of Government support.The History of Modern Biomedicine Research Group is funded by the Wellcome Trust, which is a registered charity, no. 210183

History of British Intensive Care, c. 1950–c. 2000

Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Intensive care developed in the UK as a medical specialty as the result of some extraordinary circumstances and the involvement of some extraordinary people. In 1952, the polio epidemic in Copenhagen demonstrated that tracheostomy with intermittent positive pressure ventilation saved lives and those infected with tetanus (common in agricultural areas) soon benefited. War-time developments such as triage, monitoring, transfusion and teamwork, and different specialists such as respiratory physiologists, anaesthetists and manufacturers of respiratory equipment all improved emergency treatment. These advances were rapidly extended to the care of post-operative patients, particularly with developments in cardiac surgery. Dedicated units appeared in the early 1960s in Cambridge, London and Liverpool, and later specialist care units were created for prenatal, cardiac and dialysis patients. The importance of specialist nursing care led to the development of nurse training, education and the eventual appointment of nurse consultants in the NHS in 1999. The specialty of intensive care was granted Faculty status by the GMC in 2010. Introduced by Professor Sir Ian Gilmore, this transcript includes, inter alia, the development of cardiac catheters, monitoring equipment, data collection techniques and the rise of multidisciplinarity, national audit, and scoring systems

Development of Physics Applied to Medicine in the UK, 1945–90

Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2006.©The Trustee of the Wellcome Trust, London, 2006.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.Annotated and edited transcript of a Witness Seminar held on 5 July 2005. Introduction by Dr Jeff Hughes.Organized with the assistance of Professor John Clifton (UCL) and chaired by Professor Peter Williams (Manchester), this seminar examined the early developments of medical physics in the UK between 1945 and 1990. Participants discussed a range of themes including medical physics before and during the war, the role of the King's Fund and the formation of the Hospital Physicists' Association (HPA), expansion of medical physics outside radiotherapy and to non-radiation physics (ultrasound, medical instrumentation, bioengineering, use of digital computers), developing regional services and links with industry. The seminar finished with a discussion on the changing scene in the 1980s, covering topics such as funding, academic and undergraduate medical physics, imaging, CT, NMR and others. Participants included Mr Tom Ashton, Dr Barry Barber, Professors Roland Blackwell and Terence Burlin, Dr Joseph Blau, Mr Bob (John) Burns, Professors John Clifton, David Delpy, Philip Dendy and Jack Fowler, Dr Jean Guy, Mr John Haggith, Drs John Haybittle, Alan Jennings and John Law, Professors John Mallard and Joe McKie, Mr David Murnaghan, Professor Angela Newing, Dr Sydney Osborn, Professor Rodney Smallwood, Dr Adrian Thomas, Dr Peter Tothill, Mr Theodore Tulley, Professors Peter Wells and John West, and Mr John Wilkinson. Christie D A, Tansey E M. (eds) (2006) Development of physics applied to medicine in the UK, 1945–90, Wellcome Witnesses to Twentieth Century Medicine, vol. 28. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Environmental Toxicology: The legacy of Silent Spring

The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, London, on 12 March 2002. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2004.©The Trustee of the Wellcome Trust, London, 2004.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.The period immediately following the Second World War brought great hopes of continuing benefits from widespread use of organo-chlorine and organophosphorus insecticides and other pesticides whilst the health risks of pre-war and other later practices were largely ignored. Rachel Carson’s Silent Spring (1962) coincided with the adoption of a more cautious approach to the use of pesticides, and the ensuing decades have been characterized by continued identification of both natural and man-made hazards and consequent efforts to minimize risk. ‘Environmental toxicology’ has no firm boundaries, encompassing as it does such diverse areas as the health risks of passive smoking, asbestos, lead, radon, air-borne particles, and accidental release of toxic chemicals (‘chemical incidents’), some of which still await resolution. Chaired by Professor Tony Dayan, this Witness Seminar brought together many of those who helped shape understanding in this area – 40 years after the publication of Silent Spring. Christie D A, Tansey E M. (eds) (2004) Environmental toxicology: The legacy of Silent Spring, Wellcome Witnesses to Twentieth Century Medicine, vol. 19. London: The Wellcome Trust Centre for the History of Medicine at UCL. ISBN 978 085484 0915The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Short-Course Chemotherapy for Tuberculosis

Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2005. ©The Trustee of the Wellcome Trust, London, 2005. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.Annotated and edite transcript of a Witness Seminar held on 3 February 2004. Introduction by Dr Linda Bryder, University of Auckland.The introduction in 1952 of isoniazid established the standard treatment of streptomycin, isoniazid and either thiacetazone or para-aminosalicylic acid for pulmonary tuberculosis. To achieve good results, patients had to take treatment for 18 or even 24 months under supervision. By 1970 a move towards short-course chemotherapy was made, in part due to experimental work in mice at the Pasteur Institute (Paris) and in part to experiments in Professor Denny Mitchison's unit at the Hammersmith Hospital, along with the advent of rifampicin and reappraisal of pyrazinamide. Finally, a series of large controlled clinical trials were carried out by the MRC in East and Central Africa, India, Singapore, Hong Kong and elsewhere. The trials showed that a remarkable and quite unpredictable simplification of treatment could be made with a cost-benefit of major importance. Chaired by Dr David Girling this Witness Seminar brought together a group of experts who were involved in some of the major developments in the treatment of tuberculosis and included: Dr Joseph Angel, Dr Ian Campbell, Sir Iain Chalmers, Dr Kenneth Citron, Sir John Crofton, Professor Janet Darbyshire, Professor Alan Glynn, Dr Tony Jenkins, Dr Amina Jindani, Dr Jeanette Meadway, Professor Dennis Mitchison, Dr John Moore-Gillon, Professor Andrew Nunn, Professor Peter Ormerod and Dr Knut Øvreberg. Mrs Gaye Fox attended on behalf of Professor Wallace Fox. Christie D A, Tansey E M. (eds) (2005) Short-course chemotherapy for tuberculosis, Wellcome Witnesses to Twentieth Century Medicine, vol. 24. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at University College London is funded by the Wellcome Trust,which is a registered charity, no. 210183

Cystic Fibrosis

First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2004. ©The Trustee of the Wellcome Trust, London, 2004. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 11 June 2002. Introduction by Professor John Dodge.Annotated and edited transcript of a Witness Seminar held on 11 June 2002. Introduction by Professor John Dodge.Annotated and edited transcript of a Witness Seminar held on 11 June 2002. Introduction by Professor John Dodge.Annotated and edited transcript of a Witness Seminar held on 11 June 2002. Introduction by Professor John Dodge.Annotated and edited transcript of a Witness Seminar held on 11 June 2002. Introduction by Professor John Dodge.Annotated and edited transcript of a Witness Seminar held on 11 June 2002. Introduction by Professor John Dodge.In the 1930s, when cystic fibrosis (CF) was first clearly recognised, it was a disorder that inevitably led to death in early childhood from respiratory failure and malnutrition. Since that time, antibiotic treatment and improving nutrition have brought increasing hope to sufferers from the disorder, so that increasing numbers of children have lived on into adult life. Chaired by Professor John Walker-Smith, and attended by a group of leading experts in field at the time, this transcript discusses the history and development of treatment as a result of the establishment of multidisciplinary teams working at special CF centres. Participants also discussed the role of the Cystic Fibrosis Trust and the identification in 1989 of the defective gene, which made antenatal diagnosis possible and suggests that gene therapy might become feasible in the future. Christie D A, Tansey E M. (eds) (2004) Cystic fibrosis, Wellcome Witnesses to Twentieth Century Medicine, vol. 20. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at University College London is funded by the Wellcome Trust,which is a registered charity, no. 210183

Foot and Mouth Disease: The 1967 outbreak and its aftermath

The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 11 December 2001. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2003. ©The Trustee of the Wellcome Trust, London, 2003.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.In 1967–68 Britain experienced the worst foot and mouth disease (FMD) epidemic of the twentieth century. Attributed to pig swill containing infected Argentine lamb, 2,228 outbreaks were recorded during a nine-month period, resulting in the slaughter of nearly 450,000 animals, statistics only surpassed by the 2001 FMD epidemic. Lord Soulsby led the discussion among veterinarians, virologists, academics and farmers. The edited, annotated and illustrated transcript considers MAFF’s State Veterinary Service procedures and organization and the subsequent investigations for the 1968 Northumberland Committee, with some comparisons with the 2001 outbreak; the contribution of the Animal Virus Research Institute and the International Vaccine Bank for FMD at Pirbright, Surrey; the hardship endured by the farmers during the outbreak; and political aspects of the historic slaughter policy and the debate over vaccination, both in Westminster and in Europe. Reynolds L A, Tansey E M. (eds) (2003) Foot and Mouth Disease: The 1967 outbreak and its aftermath, Wellcome Witnesses to Twentieth Century Medicine, vol. 18. London: Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Cholesterol, Atherosclerosis and Coronary Disease in the UK, 1950–2000.

Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2006. ©The Trustee of the Wellcome Trust, London, 2006. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Cholesterol began to be accepted after the Second World War as a significant cause of atherosclerosis and associated conditions such as coronary heart disease (CHD). This Witness Seminar, chaired by Professor Michael Oliver, included a discussion of the basic research on cholesterol. Early epidemiological studies demonstrated the relationship between excess saturated fat consumption and elevated levels of cholesterol, although cholesterol alone did not explain all population differences. Work on lipoprotein metabolism pointed to hypercholesterolaemia as one of, if not the major, risk factors for CHD, culminating in the development of cholesterol-lowering drugs, particularly the successful statins, available in the UK from the 1980s, and confirmed by randomized controlled trials. The role of diet in heart disease had always been controversial in the UK, and although extreme diets could reduce cholesterol, patient conformity remains difficult. Later, recommended limits on the composition of dietary fat were agreed, assisted by the food industry's introduction of functional foods such as cholesterol-lowering margarine. An introduction by Dr Nick Myant and appendices, on the diet-heart hypothesis by Professor Gerry Shaper and the development of lovastatin by Dr Jonathan Tobert, compliment the transcript. Contributors include Professor David Barker, Professor John Betteridge, Professor Gustav Born, Professor Richard Bruckdorfer, Professor George Davey Smith, Professor Paul Durrington, Professor David Galton, Dr Arthur Hollman, Professor Steve Humphries Professor Gordon Lowe, Professor Vincent Marks, Dr Paul Miller, Professor Jerry Morris, Professor Chris Packard, Professor Stuart Pocock, Professor Kalevi Pyörälä, Professor Thomas Sanders, Professor James Scott, Dr Elspeth Smith, Professor Anne Soutar, Professor Gilbert Thompson, Professor Hugh Tunstall-Pedoe, Professor Neville Woolf and Professor John S Yudkin. Reynolds L A, Tansey E M. (eds) (2006) Cholesterol, atherosclerosis and coronary disease in the UK, 1950–2000, Wellcome Witnesses to Twentieth Century Medicine, vol. 27. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Prenatal Corticosteroids for Reducing Morbidity and mortality after Preterm Birth

Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2005.©The Trustee of the Wellcome Trust, London, 2005.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.In 1959 the New Zealand obstetrician Graham (Mont) Liggins began investigating mechanisms that triggered premature labour. Supported by the Wellcome Trust, he examined the effects of hormones on labour in sheep, and demonstrated coincidentally that in utero corticosteroids accelerated fetal lung maturation. A randomized controlled trial (RCT) of prenatal corticosteroids in humans by Liggins and pediatrician Ross Howie, showed a reduction of respiratory distress syndrome in preterm babies. This Witness Seminar, chaired by the late Dr Edmund Hey, discussed the influence of Liggins' and Howie's 1972 paper announcing these results, and subsequent work by Avery and Kotas on induction of pulmonary surfactant in lambs. Other subjects included Crowley's 1981 systematic review of four RCTs; the low uptake of corticosteroids in practice until the Royal College of Obstetricians and Gynaecologists issued usage guidelines in 1992; trials to determine optimum drug, dose and number of courses; potential adverse effects; and cost-benefit analysis. Participants included the late Dr Mel Avery, Sir Iain Chalmers, Dr Patricia Crowley, the late Professor Harold Gamsu, Professor Jane Harding, Professor Richard Lilford, Professor Miranda Mugford, Professor Ann Oakley, Professor Dafydd Walters and Mr John Williams. Appendices from Liggins and Howie; Liggins' Wellcome Trust grant; and the protocol of the 1975 UK trial of betamethasone, complete the volume. Reynolds L A, Tansey E M. (eds) (2005) Prenatal corticosteroids for reducing morbidity and mortality after preterm birth, Wellcome Witnesses to Twentieth Century Medicine, volume 25. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183