“The patient is always right”

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)

Maryam’s thoughts on our sickle cell focus group

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 Donuts low resrather 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 Abi & Ekene low rescreative 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 singReef & Ekene low res 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!

Spot Alan low resMaryam Waseem-Saeed, Burntwood School (Year 12)

A Student Panel member writes about our recent meeting

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)

Engage 2015

On 2nd and 3rd December, Vicky and Alan headed off to Bristol for ‘Engage 2015’, which is the annual conference of the National Coordinating Centre for Public Engagement.  The conference is attended by people from all sorts of areas of work:  many working within Universities and Colleges (both doing academic – teaching and research – jobs, and those in roles such as public engagement, outreach, marketing and diversity), but also people from funding councils, charities and social enterprises.  The conference was much more interactive and discussion-based than the scientific conferences we normally go to, so was a great opportunity to share ideas and opinions with people from really varied backgrounds.

We presented our poster about how we’ve developed our public engagement approach over the last year with the help of you – our audience!  Our main focus was the fact that we had started the blog as a means of reaching out but without really knowing who we wanted to reach.  Our Student Panel in particular has been absolutely vital in developing what we do, and we are so grateful to all the Panel members for their honest feedback.  We are particularly grateful to Kabilan Parameswaran from the Panel who worked with us to decide what were the key things to go on the poster.  Below is the poster we displayed, which has since been brought back and put up on the wall in our patient waiting area.  We also showed some of our videos on an iPad alongside the poster, which got people interested!

So here’s to further progress and collaboration with our most valuable assets – YOU!

Engage poster

A Panel member reports on our recent meeting

We recently gathered again at Guy’s Hospital for our third student advisory panel meeting.  The theme this time round was Extreme Physiology – the branch of physiology that focuses on mechanisms of living systems under extreme conditions.

We were joined by Ms Fleming, Ms Attias and Mr Carvil – PhD academics from the Centre of Human & Aerospace Physiological sciences at King’s.  Also with us was Dr Elliott, a lecturer in physiology at the University of Westminster.  We began with introductions from each of them where they outlined their journeys through science as well as some of their recent work.

They then joined us in our small group discussions.  Here we were presented with the following points which we subsequently discussed:

How to research extreme physiology:  We brainstormed the different ways in which research in this area can be done; evaluated the pros/cons of using simulators in comparison to real conditions and considered some ways to obtain accurate and reliable findings.  We also looked at some of the practical applications.  Common examples are with extreme conditions in space but others range from the post incident cooling of firefighters to the changes of body temperatures during prolonged swimming.

How the research should be funded:  Here we thought about the different ways to gain funding for the research, with common sources being charities and the government.  A key discussion was whether or not research in extreme physiology is worth funding at all.  Some argue that more funds should be going towards the arguably more beneficial areas of research like the development of pharmaceuticals.

The use of the research in other populations:  We discussed some potential applications of extreme physiology research to other fields.  For example, it could facilitate developments in nutrition and bone fracture healing.  Furthermore, some pointed out that the research could have applications that we are not yet aware of.  This links to the fact that many of the world-changing scientific discoveries were not deliberate. An example given was of Alexander Fleming who discovered penicillin.  If Fleming’s contaminated bacterial cultures led to the development of a widely used antibiotic, then perhaps research in extreme physiology could one day impact the world on a similar scale.

When the small group discussions ended, I bravely took to the stage to summarise the points that my group came up with.  I was shortly joined by the panel members from the other groups and we ended the meeting by bringing together all of our points.

All in all, the meeting was insightful and I found it interesting discussing what seems to be a rather exciting branch of physiology.  Even if research in extreme physiology doesn’t change the world, I think we should still continue with it just for the thrill of gaining knowledge.

Anthony Butale, Year 13, Harris Academy Falconwood

It’s Biology Week 2015!

This week is Biology Week, ending on Friday with Physiology Friday, so there will be a post each day throughout the week to keep your biological interest piqued!  Today’s post is a link to the radio programme that a colleague of ours featured on recently. Dr David Green is a senior lecturer in the Centre of Human & Aerospace Physiological Sciences at King’s College London.  Dr Green’s research is about how the body adapts to change, including in extreme environments, ageing, sport and disease, and what can be done to help this.  Dr Green does a lot of work related to space travel and what happens to astronauts both in space and when they return to earth.  He also runs the Space Physiology & Health Masters course – you will see the students from this course featuring in our Friday Physiology Facts throughout this term.  We think his research is pretty cool!  On this radio programme, he talks about what kind of people are physically and mentally suited to going into space.  If you’re a budding astronaut, make notes!

Speech and laughter research

Every month, The Physiological Society send an email with details of a senior physiology researcher.  This month it is Professor Sophie Scott, the Deputy Director of the Institute of Cognitive Neuroscience and Group Leader for the Speech Communication Neuroscience Group at University College London.  Even though she works in a completely different area to us, her research sounds really interesting and we thought you might like to read about it.  Professor Scott is also giving the Annual Public Lecture at the Physiology 2015 conference on the Science of Laughter on Monday 6 July at 6:30pm, which you can watch on the livestream and The Guardian’s website.

What is your research about?
I study the human brain, and the ways that it lets us communicate with each other, using our voices. I am interested in why we sound the way we do, how we have conversation and how we can decode information from other people’s voices – and I’m also interested in how this can go wrong!

How did you come to be working in this field and was this something you always wanted to do?
I really wanted to study the psychology of music when I was an undergraduate, and I’m still not entirely certain why that didn’t happen. In fact, the person on whose music psychology research I’d based my undergraduate project took me on to do a PhD, but his interests were more in speech by that time. I have no regrets – voices are amazing.

Why is your work important?
Humans voices – from speech to laughter – are at the centre of most of our social interactions, and being isolated from this can be devastating – both personally and in more clinical terms. When we talk to each other, we share information, but we also make and maintain social bonds, and we even regulate our emotions this way. I can’t think of anything more interesting!

Do you think your work can make a difference?
I hope so. Work from my lab has made a difference to how we conceptualise the processing of speech and voices in the brain, and I have been at the forefront of the push to try and situate vocal communication within the realm of social neuroscience. I’m also one of a handful of scientists trying to take laughter seriously – and I think we might manage to do this!

What does a typical day involve?
Writing, lab meetings, planning studies, discussing data, discussing papers. Without exception, what I enjoy most of all is planning studies and looking at data. I also travel quite a lot, to give talks and go to conferences.

What do you enjoy most in your job?
I always enjoy looking at data. “The pleasure of finding things out” as Feynman put it. One of my post-docs, Saloni Krishnan, has nearly finished a study looking at differences between beatboxers, electric guitar players, and non-expert controls when they listen to music and sounds. The results are so exciting that I can’t stop thinking about them! I literally want to tell everyone, and is so exciting when data really start to make you think.

What do you enjoy the least?
Admin.

Tell us something about you that might surprise us…
I have a secret life doing science-based stand-up comedy. Well, not very secret if you know me, as I bang on about it a lot.

What advice would you give to students/early career researchers?
Take the time to find the stuff you really enjoyed studying – it’s your life and your research career, so you should allow yourself to focus on what really grabs your interest. Also, there are lots of different ways of being a scientist and conducting research, so try and spend time in different places and lab and see what styles work for you. Never be afraid to make contact with people and ask to visit their labs – in my experience scientists are very open and inclusive. Also, life is too short to collaborate with people you don’t get on with. Collaborations are brilliant, and you should enjoy them, not suffer through them.

A Student Panel member writes about our second Panel meeting

Yesterday was one of the warmest days of the year so far, and also the second student advisory panel meeting. This time it was held in Guy’s Hospital, in London Bridge. I’ll be frank – I’ve never actually been into a hospital before, and the clinical hustle and bustle of Guy’s was totally new to me, and incredibly exciting. There were eighteen members of the panel at this meeting, as well as two teachers, and, of course, Mr Lunt and Dr MacBean. We all piled into the lift, and – on a boiling June afternoon – having twenty two people in a lift that held fifteen was sweltering.

We emerged, gasping, into a blissfully cool foyer. The meeting itself was really interesting – we had talks from Dr Rafferty, a Senior Lecturer at King’s College London, and Dr Howard, a junior Doctor at King’s College Hospital. They both gave a talk about their education, how they got their jobs and what they entail, and what they enjoy about their careers in science. Dr Rafferty regaled us with stories about his time as a helicopter Houdini – he worked for the Defence Research Agency, figuring out ways to escape from helicopters that have sunk and developing breathing equipment. As someone who has an irrational fear of being stranded in the ocean, escaping from a submerged helicopter sounds horrific. But Dr Rafferty made it sound quite the adventure.

Dr Howard put me off ever being a medical doctor – she’s just finishing her second year of training and, after having a year off to have a baby (cue “ahhhhs” from the panel) she has to do seven years more. SEVEN YEARS. Now, that’s dedication. But her talk was also interesting – she told us how everyone wants an academic training programme (which is one that has time for research) and about the things that junior doctors study in hospitals – such as general surgery and trauma, paediatrics and neonatal intensive care.

After a short break wherein we had the chance to ask any additional questions to Drs Howard and Rafferty, we commenced the second part of our meeting. It was a discussion about research into post-ICU syndrome, and whether rehabilitation was the right way to get patients up and about again. Often, patients lose muscle strength after being in intensive care for a long time, because they haven’t been moving around, or because they aren’t getting enough energy, so their body starts to attack the muscles to try to get some. There are also psychological issues, cognitive problems, and problems for families who find it hard to care for a patient, after they have been discharged.

Our discussion centred on research about whether rehab was the best way to treat these patients. There are many things to consider, such as different rates of recovery, different types of treatments for different critical illnesses, and how we can even conduct clinical trials to measure the effectiveness of rehab, given that it’s hard to monitor people before they have a critical illness, because it’s often very sudden. It was all very enlightening, and gave me an insight into how hard medical research can be.

Overall, the meeting was hugely thought-provoking – I hope not just for me, but for my fellow panel members. I learnt a lot about a range of things, none of which I will forget soon. But, despite the enjoyableness of the meeting, I am very glad I won’t have to get in that lift again!

Lily Groom, Year 12 Student Advisory Panel member, Burntwood School

Democracy time!

After our first Student Advisory Panel meeting, we mentioned that we were going to develop a logo for the blog and our Facebook and Twitter.  A brilliant guy called Lee Taniwha has designed these for us. Lee spent a bit of time a few years ago on the receiving end of Vicky’s physio talents (he might have called it bullying at the time – physios make people work pretty hard).  He’s now a graphic designer (https://www.behance.net/taniwhazdname) and has kindly donated his time and fantastic skills to help us out by designing this selection of logos.

We now need you to vote for your favourite!  Either leave a comment on here saying which number (1-5) you like best, or go onto Facebook and like the one you think is the best.  We will collect all of the votes from here, Facebook, Twitter and from asking around the less technically-literate people in the lab, and we will announce the winner at our next Student Advisory Panel meeting on 25th June.  The winning logo will be used at the top of the blog and as our banner photo on Facebook and Twitter.