Blog posts

Involving critically ill children in research: Is that even possible?

When a young patient’s life hangs in the balance, the last thing on the minds of stressed parents, families and patients would be to get involved in research. Or is it? Despite the turmoil, some brave families and children have volunteered to support clinicians in their research by taking part. Dr Padmanabhan Ramnarayan, Clinical Reader in Paediatric Critical Care in the Department of Surgery and Cancer and Honorary Consultant in Paediatric Intensive Care at Imperial College Healthcare NHS Trust and West London Children’s Healthcare, explains why.  

I have been a children’s intensive care doctor for over 20 years, and for most of that time, I have been leading research that has involved critically ill children. My patients are young, their parents and families are super-stressed, and most of the treatments are given in an emergency – all of which seem like perfectly valid reasons to not involve sick children in research. Despite this, my experience is that parents and families are overwhelmingly in support of research. Why? 

The evidence gap 

Since children’s intensive care is a young speciality, much of our practice is ‘borrowed’ from adult intensive care or newborn intensive care. This is not ideal because our patients range from birth to 18 years of age, with diseases as diverse as asthma, respiratory infections, accidents and trauma, sepsis and brain injury. Without high-quality research to guide care, the treatments provided to sick children may not be the best or the most effective. Doctors and nurses, and parents and families, understand this. By agreeing to include their children in research studies, parents want to improve the care provided to future patients. 

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Professor Sir Peter Barnes knighted for excellence: Reflections on his career in respiratory science

Professor Sir Peter Barnes FRS FMedSci, from the National Heart and Lung Institute (NHLI), was made a Knight Bachelor in this year’s King’s Birthday Honours “for services to respiratory science.” Sir Peter is Professor of Thoracic Medicine at the NHLI and he was Head of Respiratory Medicine at Imperial until 2017. Here he writes about his reaction to his award and describes some of the current research projects in chronic obstructive pulmonary disease (COPD).

A surprise! 

My wife opened the letter “On His Majesty’s Service” as she thought it was a tax demand – I was absolutely shocked to see I had been offered a knighthood. Of course, I was and am delighted with the award. It is very good for respiratory science and medicine, which generally receives little public attention. This is surprising as chronic lung diseases are amongst the most common in the UK, affecting one in seven people and the third ranked cause of death. I would like to dedicate this award to all the brilliant students, post-docs, research fellows, visiting scientists and colleagues that I have worked with at Imperial College London over many decades.  

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From Paris to London, via The Gambia—my journey as a clinician scientist

Prof Maud Lemoine with key collaborators, including Dr Yusuke Shimakawa and Dr Gibril Ndow
Prof Maud Lemoine with key collaborators, including Dr Yusuke Shimakawa and Dr Gibril Ndow

On the national day of France—known as ‘Bastille Day’ in English—we hear from Prof Maud Lemoine, Professor and Honorary Consultant in Hepatology at Imperial’s Department of Metabolism, Digestion and Reproduction. She completed her medical degree and PhD in Paris, France, before working in The Gambia, and then the UK  

What brought you to London, and Imperial?

Initially I came a bit by chance. I was working in a teaching hospital in Paris as a full-time clinical consultant, having completed a PhD in physiopathology of non-alcoholic fatty liver disease. I wanted to work abroad and was very interested in working on viral hepatitis and liver cancer in sub-Saharan Africa. I wanted to work in a non-French speaking environment and meet other cultures. In 2011, by chance, I met Prof Mark Thursz who gave me the opportunity to join his team. I spent about 2 years and a half in The Gambia where I implemented a very ambitious research programme on liver diseases in West Africa. Then, in 2014, I moved to London. I hadn’t planned to move to London, but then I discovered a different culture—where I was given so many more opportunities than I’d have in the French system. I was extremely motivated but more importantly I felt really supported by Imperial and my department to develop my ambitions and create my own research group. I do still miss the French system from which I have learnt a lot.

I was initially going to spend a year or two as a lecturer at Imperial, but then I secured more funding to expand my research activities and really enjoyed the work environment and its management based on trust and creativity—especially as it’s much more diverse here. There are so many different nationalities represented in our department, it’s really nice.

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“Why am I depressed, doc?” Experiences of an HIV clinician and researcher

HIV Stop Stigma

Despite major progress in treatment and prevention, being diagnosed with HIV can have a big emotional impact on individuals. People with HIV have higher rates of mental health problems than those seen in the general population. One reason for this may be HIV-related stigma, explains Professor Alan Winston from the Department of Infectious Disease. 

Since the late 1990s, I have been treating people living with HIV and been involved in HIV clinical research. Many things we read about HIV are success stories, and quite rightly we should celebrate these tremendous scientific and medical advances. Life expectancy for someone with HIV is now similar to that of the general population. Antiretroviral therapy generally has manageable side effects and for most individuals, does not incur that many tablets per day. Indeed, many HIV treatments involve taking only one tablet per day. So, why then do so many people with HIV suffer from depression, other mental health conditions, and a poorer quality of life? 

Experience in clinic 

Most people living with HIV, once on a stable treatment, will attend their treatment centre twice per year. Often appointments rotate between a consultant or medical doctor once per year and a nurse specialist on the other occasion. As we can’t cure HIV, our patients attend for life, and we get to know them very well. At consultations, in addition to routine monitoring, we ask people how they are keeping. What stands out are the number of individuals who report symptoms of depression and other mental health conditions such as anxiety. Whilst many of us suffer from mental health complaints, the burden of these complaints in people living with HIV is very high. Thankfully, we do have help in clinic and have a specific clinic run by a psychiatry nurse specialist we can refer patients to. 

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Navigating digital health: a guide to data and artificial intelligence in healthcare

Kelly Gleason introduces a guide, Navigating Digital Health, co-produced with 20 local diverse public partners (aged between 18-78, ethnicity: White, Black & Asian, 60% women and 40% men) to help the public navigate data and artificial intelligence and wider resources. Kelly is Imperial CRUK Lead Nurse and leads the Public Involvement for the CRUK Convergence Centre and the NIHR Imperial BRC Surgery and Cancer Theme. The guide and supporting resources are part-funded by the NIHR Imperial BRC.

What the public need to know about the guide:

  1. It’s made for the public by the public (with a large and diverse group of public contributors) and supported by experts in the field.
  2. This is a gentle introduction to data science and AI to allow anyone to begin to learn about this field.
  3. It can be used by patients or family members to understand more about these issues generally or to contribute to public involvement programmes in research.
  4. It can help people make informed decisions about accessing new technologies to support their health.
  5. The guide is supported by various forms of media, including the written word, podcasts and animated videos (see links at the end of this blog). (more…)

Forming the LGBTQIA+ International Support Group

Map of the world made of circles of different sizes in colors of LGBT rainbow pride flag isolated on white

Lesbian, gay, bisexual, transgender, queer, questioning, intersex or aseaxual (LGBTQIA+) travellers can face unique challenges when travelling abroad. That’s why, Rosie Maddren, Lucy Okell, Beth Cracknell-Daniels, Joseph Hicks and Christina Aitchison from the School of Public Health set up the LGBTQIA+ International Support Group at Imperial to help improve the overall experience of going abroad for LGBTQIA+ staff and student travellers.

“So are you married?”

I freeze. How do I respond? It seems like a simple enough question, but I’m gay (and so is my spouse). The question is being asked by a taxi driver in a country where not only is same-sex marriage illegal, but so is homosexuality in general. And it’s not just something imposed by the government. A recent poll suggested that 90% of this country’s citizens have a negative view of LGBTQ people. So how do I respond? How would you?

Travelling abroad for work is a rewarding opportunity that can come with challenges for any student or staff member. For those identifying as part of the LGBTQIA+ community, such travel can be associated with further complications. Legal restrictions and societal norms of some countries may make LGBTQIA+ staff and students feel anxious, unwelcome or unsafe. Unfortunately, in certain environments being your true self can directly impact your safety. On the other hand, presenting a censored version of yourself may negatively impact your mental health and wellbeing. There is no single correct way to navigate such situations, and there is limited guidance on this topic provided not only by Imperial, but wider networks across the globe. Last year, a group of us started working together to help build support for LGBTQIA+ staff and student travellers at Imperial.

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Making Waves at the National Heart and Lung Institute

Helen Johnson, Communications and Marketing Manager at the National Heart and Lung Institute (NHLI) discusses her recent project ‘Making Waves’, which set out to update the Department’s imagery across their buildings to better reflect the diversity of NHLI’s community and inspire the next generation.

“Sometimes our stories make us stronger”

This is what one of our contributors said to me during her interview, and I couldn’t have summed up ‘Making Waves’ any better. This project set out to showcase the people behind the great science and teaching that the NHLI is known for. 

We don’t always think about it on a daily basis but when you actually look at who is celebrated in the imagery on our walls, it tends to be people who no longer work for the Department, and they tend to also share characteristics in terms of their age and race. But, then again, it is just a portrait of that person, so we don’t necessarily know their whole story by just looking at an image. Everyone has their own story. 

The founding premise of ‘Making Waves’ was that anyone should be able to look at these new portraits and see themselves. So that everyone can know they are welcome at NHLI  and in science – that they belong. I was tasked with this vision by my Head of Department, Professor Edwin Chilvers, who was keen we brought our imagery more up to date to represent who NHLI is today. The leaky pipeline in science for those holding protected characteristics has been much reported, and is easy to see when you look for instance at the number of Black Professors across not just NHLI, but across the whole of Imperial. One set of portraits will not solve this, but hopefully by showing a greater variety of successful people and their journeys, others will be inspired to continue their own scientific paths.

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“Research is very much a team effort and I see this award as a reflection of that.” – Dr Felicity Fitzgerald, 2023 Simon Newell Award winner

Dr Felicity Fitzgerald

Dr Felicity Fitzgerald (who volunteered clinically during the West African Ebola outbreak) has been selected as the winner of the 2023 Simon Newell Award for her work in Zimbabwe to improve recognition and outcomes of newborns with suspected sepsis. Dr Fitzgerald spoke to the Royal College of Paediatrics and Child Health (RCPCH) about her research and tips for aspiring researchers.

The Simon Newell Award Recognises an outstanding young medically qualified researcher in British paediatrics. Each year, with support from GOSH Charity and Sparks, RCPCH offer the prestigious award of £2,000 to one early independent researcher in paediatrics.

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Movement Foundations: How can digital tools help people to become more physically active?

Dr David Salman from the School of Public Health discusses how digital interventions could help people return to fitness following a period of illness.

I am a GP, researcher, and work at the Imperial College Healthcare NHS Trust sport and exercise medicine clinic. Part of my work is to help people become more physically active – important because it is one of the few interventions that can improve health in many different ways. If we had a similar drug or intervention that reduced the risk of heart disease, diabetes, dementia, depression, risk of falls, and several cancers, then everyone would probably be on it. The problem is that almost one-third of people in the UK are not physically active enough for good health. This is partly because barriers to being physically active exist across individual and cultural factors, such as illness, pain or different conceptions of what physical activity or exercise mean; infrastructure aspects such as safety, facilities and lighting, through to national and global policy. Therefore, this wonder medicine is not equally available to all.

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Covid-19 vaccination in the UK: What does the future hold?

Covid-19 vaccination centre sign

Recently, the UK Government announced that offers of first and second Covid-19 vaccinations will come to an end after 30 June. Ahead of World Immunisation Week, Professor Azeem Majeed from the School of Public Health discusses this major change in national vaccine policy, and why it’s important to stay up to date with Covid-19 booster vaccinations.

The announcement from NHS England that first and second doses of Covid-19 vaccines will no longer be offered to adults after 30 June 2023 signifies a significant change in national vaccine policy. We will all remember the start of the Covid-19 vaccination programme in December 2020, the rapid rollout of vaccines by the NHS, and the enthusiasm for vaccination amongst most sections of the population. Vaccination curbed the impact of Covid-19, leading to large falls in hospital admissions and deaths, and allowing the government to end Covid-19 restrictions.

We are now though entering a new phase in which Covid-19 vaccination will be restricted to older people and those in medical problems that place them at higher risk of adverse outcomes such as hospitalisation and death. The very highest risk groups – such as the immunocompromised and people aged 75 years and over – have been offered booster vaccines every six months for the past two years. Other population groups – such as NHS staff, those aged 50 and over, and people with significant medical problems – have been offered annual booster vaccines.

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