On 5th July was our second Student Panel meeting where we were fortunate enough to receive hands-on practical experience in the labs of the Chest Unit at King’s College Hospital! Our main point of interest today was to investigate measurements of inspiratory and expiratory muscle strength. The session started with all the members reintroducing ourselves to one another and speaking about what we study and what we would like to do in the future. It was great to catch up again and meet new members who I didn’t see at our last meeting! I made a load of new friends who gave me valuable tips regarding university and a career in medicine and science. These activities made us all feel very welcome again and very excited for the afternoon!
We were split into three groups depending on what we’d prefer to investigate and I chose to do respiratory muscle testing. My team’s practical was led by Brittany Best who is a current MSc student. Britt was extremely supportive and reassuring which made us find the practical easy and exciting to carry out. She started by teaching us the names and functions of the equipment which we were going to use; these included nose bungs, mouth pieces and a 3-chamber metal valve which we all used at some point of our practical. We also got to pop in to the other group’s rooms and see the cool stuff they were using such as an ECG! In my team, we performed measurements of inspiratory and expiratory muscle strength using the PImax, PEmax and SNIP technique. The PImax was much harder to carry out because we were not used to the equipment but also because it was so unusual to us! This made us think about how difficult a healthcare professional may find it to get accurate data from a patient’s results as patients can often be giggly or even find the unusual technique very awkward and hence will alter their breathing pattern, either purposefully or subconsciously. To obtain results, patients must suck air into their lungs through a mouth-piece. This may sound simple at first, however it quickly challenged our lung muscle ability when my partner was told to close one of the valves. It felt as though my lungs were about to burst because I couldn’t breathe in any air after a certain point due to the valve, but was generating a lot of pressure in my lungs! The SNIP test was much easier to do as it just involved sticking a nose-bung up your nose and breathing regularly with a little twist: give a powerful sniff after every third breath out. Although it isn’t the most fashionable way to gather results, it sure was easier!
Once we all had a chance to take on the roles of both a patient and the scientist, we each analysed our data to see if our values fell into the predicted range values. After a couple of attempts with Brittany reassuring us that it is tough when you’re new to it, we finally got the hang of it! Our values started looking normal as we got more used to the test.
Once we finished our practical, we then all discussed how these tests might be adapted to different patient populations including younger children or those on intensive care. We discussed about how someone on intensive care may not be able to breathe as they usually would and hence more invasive measures would be taken into consideration such as a technique which runs a tube through your nose and down the back of your throat which allows successful results to be collected. We also thought of the difficulties an individual may face due to weakened muscle strength such as those who suffer from motor neurone disease. The team spoke about how hard it must be for somebody’s biceps to always feel very painful and heavy as if a heavy bag was attached on to them! This made us reflect and contemplate about how difficult their home life could be, especially if they lived alone as simple everyday activities such as walking up the stairs could be a challenge to them.
The day was just as expected: very fun and factual! I always enjoy our student panel meetings as each meeting is different from the rest and always involves activities which I have never done before or even knew existed!
Huge thank you again to Dr Vicky MacBean and everybody else who works hard to make all our meetings amazing!
Sarah Ezzeddine, Year 12, Harris Academy Peckham
On the 7th of July, as part of the King’s College Muscle Lab Student Panel session, we looked at measuring lung function in two ways, Impulse Oscillometry and Spirometry.
Impulse Oscillometry involved measuring the patient’s tidal breathing over 90 seconds at a 5Hz resistance. We felt the procedure was simple, and once you get used to the noise of the machine, easy to get good readings from. We repeated the examination 3 times, layering the graphs to ensure our results were concordant. We saw a regular trace graph over a 90 second period.
Spirometry was a little more difficult to carry out; we recorded some tidal breathing first to ensure the patient was comfortable and ready, then the patient was asked to inhale as much air as possible into the lungs, then exhale as quickly as possible, all air from their lungs (we encouraged this through shouting as we found the first time round both patients didn’t expel as much air as they could!). This gave us a forced expiratory volume in 1 second value. We also repeated this examination to ensure out results agreed.
Both these tests are good in determining aspects of airway function, with Spirometry also giving FEV1 values and vital capacity, and Impulse Oscillometry giving tidal breathing patterns, however for patients with breathlessness which is a common symptom seen in the chest clinic, these tests could be difficult to carry out and gain accurate results, especially from Spirometry. Also young children may find this difficult to carry out, as it can take a while to get used to breathing with your mouth round the mouthpiece and with a nose clip. Overall it was a good experience to get some practical skills in the clinic and gain some valid result and values to analyse.
Estelle Thomas, Year 12, Harris Academy Crystal Palace
Students interested in the Science and Medicine field were recently granted the special opportunity to be a part of the King’s Muscle Lab advisory student panel which took place down the road from King’s College Hospital. Many of those were Year 12 and 13 students who like myself were from the ‘Harris Experience Advanced’ scheme along with some other students from JFS, Burntwood and Graveney schools who were lucky enough to be invited with us! This was the first gathering of the upcoming few for many of the students.
Upon arrival, we met 6 professionals in various fields including Doctors, Physiologists, Physiotherapists and Researchers. Each one gave a helpful presentation about their journeys into their professions and the various routes they took. Some were not as successful as others in their initial attempt. However, this broadened my insight into the very many similar pathways I could take other than Medicine including biomedical research. Our day was based around the broad topic of ‘Physiology’, the study of the functioning of the body, and specifically ‘Paediatrics’.
Soon after, we were assorted into groups with people we’d never met and each group was assigned a speaker to work with for 15 minutes. Here, we had the beneficial opportunity of asking questions that we were curious about. We discussed the differences between adults and children and their lung capacities. We then answered the question “Are children mini adults?” To my surprise, the answer was no. We also got the chance to share our future aspirations with them and gain useful tips and advice including upcoming work experience offers with the team which I am thrilled by!
As an aspiring neurologist, my favorite thing which we spoke about was the topic of brain diseases such as epilepsy, a neurological disorder which causes recurrent seizures in an individual. Also, learning about what causes the irregular brain wave signals which a sufferer experiences was fun. We deduced how factors such as other health conditions, race and age make developing epileptic seizures much more likely. Dr Harris also informed us about children he previously worked with in Uganda where the rate of death caused by open-fires is exceptionally high. Along with this, we brain-stormed the many difficulties a modern family with an epileptic child could face and the future issues which could arise.
Altogether, the experience was fascinating and a great success. Dr MacBean and her team organized it very well for us to feel welcomed and comfortable with one and other despite it being the first time seeing each other. (Side note: the snacks we munched on whilst being fascinated by the works of the respiratory system were lovely and a great aid for helping us absorb the new scientific content we learned.) It was not at all as difficult and fact-heavy as I initially expected it to be and turned out to be one of my favorite experiences so far this year. I will definitely be including this experience on my personal statement in future when I apply for Medicine, which I feel more content in doing after the Muscle Lab!
Special thanks to everybody who worked hard to provide us students with such an amazing experience!
Written by Sarah Ezzeddine, Year 12 Harris Academy Peckham
For those, like me, who love science it is natural to consider becoming a doctor. However, many students have very little idea what this involves and there are limited opportunities to find out more. So I was very grateful to be invited onto the King’s Muscle Lab panel. I went for the first time today and loved it. I have done the usual volunteering and work experience but this gave me a genuine insight into real life inside the NHS – how the moving parts all work together to produce better outcomes. Our panel were able to properly talk to the doctors and other healthcare professionals about their work which was a particularly valuable experience.
I’d never been on a student panel and had no idea what it involved but when I was sent the itinerary with a list of guest speakers I started to get excited! I arrived at King’s College London Institute of Psychiatry, Psychology & Neuroscience (is there anything they don’t do?!) with a few other keen scientists from my school. We were welcomed by Dr Vicky MacBean who introduced us to the ‘Muscle Lab’ and the visiting professionals and then we were off!
Each professional, a mixture of doctors, physiologists and physiotherapists, had fifteen minutes with their group of five to discuss a topic that incorporated everything from child physiology to ethics to care plans to early intervention. I was fascinated to see that so many professionals with such varied backgrounds were all working in the field of respiratory studies whether it was research or clinical. To see how all the healthcare professionals’ work fit together was particularly interesting and very reassuring for those on the panel who are trying to narrow down what they might want to do in the future. Whether you’re the person holding the spirometer measuring vital capacity or the person in the lab examining lung tissue you are part of a wider system that works with the primary focus of caring for patients. All the professionals that we met were at different stages of their career and yet all of them were genuinely enthused to be sharing their experiences with us.
The focus of the session was paediatrics and specifically how this differs to adult healthcare. It was emphasised that children are not just ‘mini adults’. Although all the students attending learnt a great deal it wasn’t like being in a class at school. The small group environment created an easy atmosphere for discussion where every idea was valued and we felt able suggest something that we weren’t necessarily sure was correct. We were guided by our experts but given the ability to be free thinkers.
I had an encouraging and inspiring experience at the ‘Muscle Lab’. It opened my eyes to the complexity of our comprehensive healthcare system which is particularly topical. Instead of leaving fearful for the future of the NHS I left energised by the passion and enthusiasm of those who are working to keep it going. Their desire to include the next generation in their work is admirable and I’m extremely lucky to have met such wonderful people with such passion for the respiratory system!
Post written by Tilly Roberts, Year 12 student at Graveney School, London
Recently, a group of ‘Harris Experience Advanced’ Year 12 Scientists, including myself, and some other students from Burntwood, JFS and Graveney Schools were lucky enough to be invited to attend a visit to the King’s Muscle Lab at King’s College London in Denmark Hill.
Upon arrival we were invited into one of the lecture rooms where we received a short introduction about what the King’s Muscle Lab does, and the research that takes place there. The main focus of their research is Physiology, involving studying the functions of body systems, then linking this to respiratory problems and other diseases among patients.
We were first given insightful presentations from researchers carrying out projects for their studies at or allied to the King’s Muscle Lab which was interesting and very beneficial to us, as it allowed us to see the wide variety of projects that can be included within different science degrees, and what type of research areas we may want to look into pursuing ourselves, in the future.
We were then split into groups of mixed students from different schools, to talk about a disease called COPD (Chronic Obstructive Pulmonary Disease) and the subject areas linked to it with the academics. The groups were rotated so that everyone had a chance to discuss each area surrounding the topic. This gave us a chance to voice our opinions within a group of students that we had not met before, and it was fascinating to listen to others’ opinions and consider them in addition to our own, to form valid points for discussion.
Firstly, Ms Kylie Morgan (PhD student) lead a discussion on ‘the use of animal models for COPD research’ and we talked about the controversy of research into COPD and found that it is most commonly carried out on rats and mice, and discussed the ethics surrounding this. Following this, Dr Aish Sinha (Junior Doctor at King’s) encouraged discussion on how doctors and researchers are measuring and assessing the extent of the disease, and that it can be difficult to measure whether medication is successful for patients. COPD is heavily related to the issue of smoking, and in a discussion with Ms Basak Tas (PhD student) we explored the problem of addiction within COPD.
In the session with Ms Charlotte Cheadle (PhD student) we discussed pharmacological management of COPD and how medication is delivered. For people with COPD, the volume of air that can be exhaled is reduced however the volume of air that can be inhaled remains the same and this can affect patients in a variety of ways, both directly and indirectly. In a talk guided by Ms Arietta Spinou we came up with different ways a patient’s quality of life can be affected which we split into social impacts and physical impacts. Under the headline social, the anxiety the disease could cause for a patient was suggested, as they could become self-conscious of coughing in public which could lead to social isolation and loss of integration within their social circles. In terms of physical problems that COPD can cause, we discussed tiredness, which would limit the activities of their everyday lives, coughing which is heavily linked to social problems mentioned above, and having to turn down opportunities that cannot be adapted to fit with the disease. These short discussions were very insightful as the points that came up included some that I had not considered before.
Following the discussions, we then all met back in the lecture room to feed back. One person from each group was nominated to present their group’s views on each topic area and this allowed each group to build upon their opinions and bounce ideas off each other.
Overall the visit was a captivating experience, and as you can imagine, these events are very popular and we are very fortunate to have received such special treatment. On behalf of the Harris Federation and Harris Experience Advanced students, I can safely say that we all thoroughly enjoyed the visit and I would like to thank the members of staff that made it possible, with a special thanks to Dr Victoria MacBean and Dr Alan Lunt and the Academics that delivered and lead the group discussion sessions. We look forward to being involved in more of these fantastic opportunities in the future.
By Ashleigh Francis
Sixth Form Student at Harris City Academy Crystal Palace
A wintry Friday in June we came to SpaceUp UK, bright eyed and keen, and this is what we heard.
If we age in space like we do on earth, but quicker
then we can raise our healthspan by making muscles thicker.
So move your muscles frequently, don’t be a floatanaut.
If you want to keep your health in age train like an astronaut.
Your skeleton aint static
cos blood runs through your bones.
We need high-res schematics
to map resulting holes.
Cardiac stem cells will senesce in Microgravity.
But there are ways around it for they go stochastically.
Cardiovascular degradation; we can’t get round that fact.
So run in the Space Station, yes that is how you act.
Low gravity in space could cause disks to expand.
It makes your back quite painful, whether you sit or stand.
In Heavy G they could contract and this is painful too.
But we don’t know a lot of why this will happen to you.
Our children will be living in a very different world,
so they should be our focus from a very early age.
Don’t teach them hocus pocus
and don’t just teach them STEM
Add A for Art
and make it steam.
Engage imagination, enthusiasm, dreams.
For the skills they need are lifewide.
And what we show them now will shape the world we leave behind.
Increase their science capital by reaching out to schools.
Show them that there’s a reason why we do the science we do.
Put pictures of a person looking down a microscope.
Knit a set of lungs or hearts. Knit dreams. Knit joy. Knit hope.
But get them involved
in the work you do.
and making posters.
They can bridge the communication gap.
Our brains evolved through gravity.
If you take that away,
the water pressure then builds up
and gives our heads a pain.
And if this pain is constant
you could become depressed.
But space is quite exciting now
so astronauts feel it less.
Standing still on earth, in bright light, on a flat surface,
We balance using 10% visual, 20% vestibular system in the ears and 70% proprioception.
If one is affected we undertaking sensory reweighting.
In astronauts the vestibular system gets messed up.
In a few days this reweighs
increasing dependence on the visual.
But visual quality also decreases.
If your dreams of bein’ an astronaut you don’t get to fulfill,
then set up the biggest space life science centre in Brazil.
In the stratosphere there is a sweet spot
where the air is warm and the water is liquid.
Test for life.
Not on the ground.
in the sky.
Do it independently.
Send your project up there suspended on a string.
It might crash down,
but you would still have useful science.
On a flight to Mars, there’s greater risk of medical events.
And some are big so make sure the mission is medically capable.
How do you automate medicine, well an early warning system.
But beware, astronauts as soon as they get called astronauts believe they are infallible.
(To the tune of the Wombles’ theme)
Upstream market, downstream market, UK Space agency free.
They got involved in Tim’s mission to bring it back to you and me.
Making good use of experiment time they find.
Circadian rhythm the astronauts oft leave behind.
Two superpower worked apart on Soyuz and Apollo
with duplicating problems and duplicating science.
They had to come together, there were far too many mistakes,
an unprecedented international collaboration in the ISS.
But that’s a start, the next step is
to work with other areas and fields cooperatively.
Homeostasis maintains the status quo.
In temperature, pressure, light and gravity.
It goes from -100o to 260o in 45 minutes.
Phew, that’s hard.
We need to help these astronauts stay well.
Pushes on the eye
The axial length is shortened
It makes it hard to get to Mars
We need to look to tests
Bob, he wears a spacesuit, it keeps his pressure even.
It mimics the loading we get right here on Earth.
It works by increasing tension in the vertical elastic fibres.
The fitting was quite intimate.
You can simulate the gravity in a Micro-G lab.
Then put it on and take it off in parabolic flight.
Influence policy. Use space tech for food and water shortage.
We can get a lot of data but it needs to be shared.
For those that need it most don’t have the access to it.
In 2018 James Webb Space Telescope will hopefully unfurl.
We’ll bite our nails for then, there’s lots that can go wrong.
And later WFIRST and LUVOIR.
Space tourism. DEBATE!
Space entertainment. DEBATE!
Space law. DEBATE!
There is much we need to think about.
So do we go by rocket or do we take the lift?
An elevator could give us payload as long as it don’t drift.
The price is prob’ly cheaper so that will help with thrift.
And so it seems that this would be a most fantastic gift.
And then? What then? Where should we go?
Let’s reach for the stars.
Don’t limit our thoughts, think beyond our technology.
Tweak some laws of Physics and then you can set sail.
But it’s all about the money and so about the time.
And will we get there before humanity may fail.
XCor does commercial space.
Get to Sydney in 2 hours.
Now we should thank those that worked hard to get this done.
Cheers and be jolly.
For Charles and Phil and Stephanie and Kate and Vicky and Molly.
And all those that I’ve missed.
And you the people taking part.
Who talked and listened.
So off you go with lots of facts re-join the Human Race.
And go and do exciting things that have to do with Space.
June 2016 at SpaceUpUK
More space poems here: http://www.worldspaceweek.org/news/space-poem-day-world-space-week-day-1/
More Poems here http://athspoemaday.blogspot.co.uk/
On Monday 13th March several of the student panel members were privileged to have the opportunity to attend the annual King’s College London Halliburton lecture, given by Professor Moxham. Professor Moxham is known for his work involving respiratory physiology, including respiratory muscle weakness, neural respiratory drive, breathlessness, ventilatory failure, non-invasive ventilation, and pulmonary rehabilitation. The lecture we attended on Monday, titled, “Physiology to improve Patient Care,” centralised around the idea that through bed-side research, breathlessness has not only been better understood, but will be further understood in the future.
The lecture began with an introduction by the Professor, where he told us that his interest in physiology arose during his work with RF Armstrong. He had been continuously measuring the cardiac output and blood oxygen levels by the bed-side and he told us he had, “found this very fascinating”. Several years later, he began his work in the field of respiratory muscle with Professor Richard Edwards, described to us as “an inspirational man.” He also talked about his past trip to Montreal where people examined changes in the EMG power spectrum and this allowed him to learn how to assess diaphragm strength.
This led to his work in trying to discover, “How to measure respiratory muscle weakness?” And he informed us that it is bed-side research which is essential to understanding this. He reported to us that the methods currently available for doing this are assessing maximum mouth pressure and oesophageal pressure. Professor Moxham explained that it was essential to find non-invasive ways to do this because in the instances where patients are unable to express their symptoms of breathlessness, we must rely on the medical equipment available to us, to allow us to understand the condition of the patients and help these patients.
He later presented to us what seemed to be the key theme of the lecture. “Breathlessness is the drive, and the drive is breathlessness.” At this point, the majority of the panel members struggled to understand this, but after the lecture Vicky explained to us that Breathlessness is the symptom where a patient is struggling to breathe, and drive is the “short term for neural respiratory drive, which is the traffic that the brain sends down to the breathing muscles (mainly the diaphragm, but also the intercostals and some other muscles) to tell them to contract.” She helped us understand that throughout the lecture, the Professor had explained that they key causes of this symptom of breathlessness are various diseases such as COPD, obesity and asthma. He concluded the lecture with the idea that when patients described breathlessness, it is not that it is not present if a doctor cannot see/measure it, the problem is that we have not discovered a way to measure the breathlessness, and hopefully through bed-side research the future doctors will understand that “the patient is always right” and that when they describe the symptom of ‘breathlessness,’ this is able to be seen with advanced medical equipment.
Although this was a challenging lecture for the student panel members to understand, it was both intriguing and enjoyable. We were introduced to a concept by Professor Moxham that we are all excited to further hear about in the future.
By Neta Fibeesh and Ma’ayan Dee, Student Advisory Panel members, JFS School (Year 11)
On the 27th February, a handful of the student panel students, including myself, had the privilege of acting as ‘honorary researchers’ during a focus group for children with sickle cell disease and their families. For those of you who are slightly bewildered (don’t worry its nothing to be embarrassed of) ‘honorary researchers’ is the fancy way of saying: we helped out! In case you’re not sure, sickle cell disease essentially is a disease where people don’t produce enough red blood cells, and the ones that are produced can become ‘sickle’ shaped, blocking normal shaped red blood cells from passing through vessels. Such abnormality of the cells often results in tiredness, which as you can imagine isn’t fun…
Much to Vicky and Alan’s surprise, the day was rather mellow – with the exception of the hectic food run whereby the supposedly quick ‘2 minute’ wait ended up being 10, and the jerk chicken was too spicy leaving us running back and forth to the nearby food stalls for the last minute order of pork dumplings. However the pain of the biting cold was definitely nullified by the taste of warm cinnamon doughnuts.
… Anyways, while Vicky and Alan did all the grown up duties with the parents, Lily, Francesca, Abi, Reef and I had the tasks of getting creative with our participants (drawing, writing etc) which produced masterpieces such as the spectacular depictions of Abi and Reef by our wonderful artist Ekene. Somehow drawing, writing and surveying concluded in a sing along of Carly Rae Jepsen’s ‘call me maybe’ thanks to Reef’s ukulele skills.
Aside from all this, we essentially wanted an insight as to how life like with sickle cell disease actually is, in order to comprehend fully the difficulties experienced by these families. This ended up being beneficial as we not only got a grasp of how it was to be a guardian of the children for a short time, but how they felt about having the disease. Thankfully, it also happened to be a delightful experience meeting all these lovely families. Not too bad at all for a first attempt at an event like this!
The first student advisory panel meeting of 2016 commenced with new arrivals from JFS and Harris Academy (Morden) at Harris Academy Crystal Palace. Our discussion was centered around disordered systems with presentations from researchers hailing from Italy and Serbia.
We were joined by Dr Pierpaolo Vivo, Barbara Bravi ,Silvia Bartolucci and Aleksandra Aloric from the Faculty of Natural & Mathematical Sciences at King’s College London. Each researcher presented their international journey through academia and explained their current research including the Random Matrix theory and mathematical modelling of the immune system.
We had the privilege of having individual discussions with the researchers and were able to ask questions to further understand disordered systems. Disordered systems refers to a system in which there are multiple components involved. It includes variables that need to interact, an aspect of “randomness” and collective coordination.
We learnt how disordered systems are relevant in group behaviour. To my surprise, an example of disordered systems in group behaviour is the awkward dance with a stranger when passing each other on the street. The surprises didn’t end there with the movement of a flock of birds being another example of disordered systems. In Rome a team of researchers recorded starling flocks every day for 2 years to investigate collective coordination. There is not an established leader in the flock of birds that causes the sudden change of direction which is the random aspect of system at play. The aim of this research is to understand what causes the birds to make a sudden change of direction. Using the data collected from the birds, the researchers created a 3D model that conducted model simulations. These simulations were used by the researchers to analyse in a hope to understand the change of direction.
Afterwards, we considered how disordered systems are relevant in life sciences. Bravi’s research outlines the simplification of complicated networks of biochemical reactions using approximations. Disordered systems also helps the interpretation and analysis of data via mathematical modelling.
To make the concept of disordered systems comprehensible and widely accessible to people, Aleksandra Aloric, Silvia Bartolucci, Barbara Bravi, Sari Nusier and Anne Odling-Smee created the educational game “Random walks with pirate and parrot“. This game is available on the Play Store and it consists of different levels from helping a pirate walk to find his boat to the biological “walk” of molecules occurring within the parrot’s body.
In conclusion, the meeting was exceptionally engaging as it evoked curiosity in me alongside fellow members of the student panel about the function of disordered systems and its unexpected presence in nature and society. After this meeting I will not be able to simply admire the beauty of flying birds in the sky without thinking about the science behind it.
Bilan Ali-Abdishire, Burntwood School (Year 12)