Tag: Public health

Completing the jigsaw: can milk banks contribute to transformed perinatal health in the UK?

Dr Natalie Shenker MBE

This week marks World Breastfeeding Week, a global campaign dedicated to informing, engaging, and galvanising action on breastfeeding and related issues. Dr Natalie Shenker MBE from the Department of Surgery and Cancer reflects on the progress made in related maternal health research in 2024, and explores how milk banks can help in the much-needed transformation of perinatal healthcare in the UK.

2024 has already been a remarkable year for human milk and lactation science. As interest grows globally in the sector, our understanding of the complex and ancient evolutionary physiological strategies involved, and their impact on infant and maternal health, deepens. The maternal health impacts of lactation and how to best support families are the key focuses of my research, and like much of the work across women’s health, has been largely ignored by mainstream science.  

In partnership with The George Institute, the new Women’s Health Network at Imperial College London is seeking to correct these crucial gaps. Excitingly, our study into the mechanisms through which breastfeeding can reduce the risk of certain types of cancer has received further funding from Breast Cancer Now. Yet, there is still so much to discover. Just last month an entirely new hormonal response that explains how breastfeeding protects against osteoporosis was described by scientists at UC Davis. They found bone metabolism increases during lactation to keep up with the large amount of calcium required to produce milk, at the same time as levels of the protective hormone oestrogen fall. Scientists were therefore previously stumped as to how breastfeeding prevents rather than causes maternal osteoporosis. The work, published in Nature, found that during breastfeeding, certain neurons in the brain called KISS1 neurons release a protein called CCN3. This protein helps increase bone repair, boosts the activity of skeletal stem cell activity and even speeds up how quickly fractures repair.

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The importance of annual reviews for COPD care

Man at COPD review

Currently, there are considerable gaps in the care of people with chronic obstructive pulmonary disease (COPD). Parris Williams, PhD student at the National Heart and Lung Institute (NHLI), highlights why improving the access, delivery and quality of annual COPD reviews is crucial to supporting 1.4 million patients in the UK with the condition.

Chronic obstructive pulmonary disease (COPD), a chronic condition causing restricted airflow and breathing problems, is the second most common lung disease in the UK. Currently 1.4 million people in the UK have a COPD diagnosis. Recommended by the British Thoracic Society and NICE guidelines, annual COPD reviews are a key element in COPD care. These reviews are an opportunity for the patient to discuss their condition with their medical team, alongside inhaler/medication revisions and opportunities for onward referrals if needed. When delivered correctly, COPD annual reviews increase the health and reduce exacerbation risk for patients.

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Bladder problems: Can we be less shy about having a pee?

Prof Marcus Drake

Bladder problems affect millions of people around the world, yet they remain shrouded in silence and embarrassment. Professor Marcus Drake, Chair in Neurological Urology, explores why society continues to be shy about this topic, and highlights why more medical research is needed to improve bladder care.

People do not generally spend a lot of time thinking about their bladder. After all, each pee only takes about 20 seconds. Since we might go for a pee just six times a day, that means only a couple of minutes are given over to the bladder daily.

As well as not thinking about it much, we also seem to be reluctant to talk about it. This may be a reflection on society, since peeing is a vital function yet talking about it seems to be discouraged. Perhaps this does not matter so much for most people. But it does matter for anyone with a bladder problem. This reluctance means that people can leave it very late to get help. For many it makes the experience of getting help difficult too.

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Psychedelics – how modern neuroscience research is leading to new treatments for brain disorders

Psychedelic therapies have the potential to vastly improve the treatment of mental health disorders such as depression. The Imperial Centre for Psychedelic Research is paving the way in exploring these innovate treatments using psilocybin – the active ingredient in magic mushrooms. Here, Professor David Nutt from the Department of Brain Sciences discusses. 

When most people think of psychedelics, the first thing that comes to mind is LSD-inspired Flower Power during the 1967 Summer of Love in the USA, with its associated revolution in art and music. This explosion of use was seen to be fuelling the protests against the war in Vietnam and so rapidly led to LSD and related psychedelics such as psilocybin (the active ingredient in magic mushroom) being banned, first in the USA and then later globally. This ban still exists today and has effectively censored research for over 50 years. The ban is very unfortunate as prior to this there were hundreds of studies that showed psychedelics were effective treatments for a range of mental illnesses as well as some other brain disorders. Millions of patients may therefore been denied access to potentially life-saving treatments.

This situation is beginning to change with several universities setting up psychedelic research groups including the Centre for Psychedelic Research at Imperial, which was the first and is now five years old. The impetus to these new research centres is twofold. First, today we have much more powerful neuroimaging methods to examine the impact of psychedelics on the brain and second, these neuroimaging studies have revealed possible mechanisms underpinning the therapeutic activity of psychedelic drugs, so encouraging more clinical research. This research has revealed remarkable efficacy in a number of patients who have not responded to prior conventional treatments and may be the start of a whole new phase of novel therapies for mental illnesses.

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Closing the Gender Health Gap: A Call for Sex and Gender Equity in Biomedical Research Policies

When it comes to healthcare, there are clear and stark inequalities between women and men. Marina Politis, Alice Witt, and Kate Womersley explain how, at its root, this gender health gap derives from a research and data gap, and how the MESSAGE project is working to improve accounting of sex and gender dimensions in medical research.

Everyone aspires to receive gold standard treatment when seeking medical care. What if, however, this standard, was only ever set out to be gold for one group of people? Much of our medical evidence base has been based on a male norm, with women underrepresented at all stages of the research pipeline. Subsequently, when a woman suffers an out-of-hospital cardiac arrest, she is less likely to receive bystander CPR than a man. Once in the hospital, she continues to be less likely to receive optimal care than her male counterpart.

The gender health gap in cardiovascular disease – poorer outcomes women experience due to the “male default” in health research and healthcare – is just one of many conditions for which there are disparities between women and men. From dementia to diabetes, and osteoporosis to obesity, sex and gender differences and similarities remain neglected in UK and international research.

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The one with a Nobel prize winner

Hadi Sallah, PhD student in John Tregoning's lab, working on RNA vaccines.
Hadi Sallah, PhD student in John Tregoning’s lab, working on RNA vaccines.

Dr John Tregoning, Professor in Vaccine Immunology, recounts his experience of working with Dr Katalin Karikó, Nobel Prize winner and the tenacious force behind the mRNA vaccines that helped change the course of the COVID-19 pandemic. Their recently published study investigates how RNA modifications impact the body’s immune response to infection, with the hopes of aiding the development of more effective mRNA vaccines.

Science is collaborative, we work with lots of different people to understand the world around us. Working with other people is one of the joys of the job. In our recently published study, Reducing cell intrinsic immunity to mRNA vaccine alters adaptive immune responses in mice, we had the privilege of working with Dr Katalin Karikó, joint winner of the 2023 Nobel prize in Physiology or Medicine.

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Tackling syncope – a significant diagnostic challenge for many

Syncope–a transient loss of consciousness–occurs in 42% of people by the age of 70. Professor Richard Sutton, Emeritus Professor of Clinical Cardiology, discusses this common medical problem, and how he has pioneered a “true but still insufficiently small interest” in it.

I have been Emeritus Professor of Clinical Cardiology at Imperial since 2011. Prior to that, I had trained in Cardiology at St George’s Hospital, the University of North Carolina, and the National Heart Hospital in London, becoming Consultant Cardiologist at Westminster Hospital in 1976. There I focused on cardiac pacing as a subspecialty. From a clinical perspective, cardiac pacing eradicated syncope (transient loss of consciousness) in patients with conduction tissue disease of the heart. So, I sought to extend the role of pacing into related syncope conditions.

My primary interest therefore became the symptom of syncope. I began this in the late 1970s, and formed a close relationship with Worthing Hospital which carried a heavy load of older patients, many of whom presented syncope. I founded an outreach clinic at Worthing which led to the receipt of many challenging patients with syncope in whom there was no obvious cause.

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Imperial College researchers conducting national pilot on supporting return to work

Some of the EMBED study team.

Researchers at Imperial College London are spearheading a national pilot aimed at revolutionizing the way we approach work and health. With soaring levels of economic inactivity due to ill health in the UK, the team at The Self-Care Academic Research Unit has joined forces with occupational health clinicians and experts from the Department for Work and Pensions. Together, they are implementing a pioneering study that embeds job centre work coaches and disability employment advisors within GP surgeries. Dr Lara Shemtob, Academic Clinical Fellow in General Practice and Occupational Health Physician at Imperial College London writes more about this exciting initiative, the EMBED study, below.  

Researchers at Imperial College London are working on a solution to the high levels of economic inactivity due to ill health in the UK. Together, with occupational health clinicians and a team at the Department for Work and Pensions, researchers at The Self-Care Academic Research Unit (SCARU) are delivering and evaluating a pilot study that places job centre work coaches and disability employment advisors in GP surgeries, where people’s work and health needs can be addressed together. 

‘This project represents a watershed for work and health in the UK, and a first step to universal access to occupational health.’ - Dr Shriti Pattani, National Expert in Occupational Health & Wellbeing and Honorary Senior Lecturer, Imperial College, London 

This topic is high on the policy agenda as levels of economic inactivity due to ill health continue to rise. The challenge of helping people work through ill health will only get more prevalent as the population ages. This could have significant consequences on public sector services in the next future with less people contributing to government revenues through work, and instead becoming more reliant on state support.  

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Imperial College WHO Collaborating Centre for Public Health Education and Training (WHOCC) receives its 5th re-designation by the World Health Organization

Outside-WHO-building-Geneva.

The Imperial World Health Organization Collaborating Centre for Public Health Education & Training (WHOCC) was created in 2007 to support the work of the World Health Organization and its founding objective: ‘the attainment by all peoples of the highest possible level of health’. Established by the WHO Global Committee with the support of the British Government, the WHOCC has a special focus on global health issues and health services research, in addition to public health education and training.  This year, Imperial WHOCC was redesignated for another four years- a huge achievement. Hear from Rachel Barker, Support Officer, at the WHO Collaborating Centre and Department of Primary Care and Public Health, about the WHOCC’s work.  

Following an intensive and rigorous process, the World Health Organization Collaborating Centre of Public Health Education and Training (WHOCC) Imperial College London, has been re-designated for another four years, securing its vital work in improving global health and wellbeing until 2027.  During the previous designation period, Imperial WHOCC shared its expertise with Low-and-Middle-Income-Countries (LMIC)  to assist them with their endeavors towards meeting the UN Sustainable Development Goals (SDG). In respect to SDG 3, ‘Good Health and Well-Being’, Imperial WHOCC has collaborated with stakeholders, countries, and international organisations on improving access to Universal Health Coverage (UHC).  

Commenting on the news, Professor Salman Rawaf shared his congratulations to the Imperial WHOCC team, “The WHOCC re-designation is quite the feat – thank you to our team for their hard work. This is our fifth re-designation – a record achievement for any WHO CC at a global level. As a direct result of our work, the WHO and many member states have benefited from the excellence of Imperial College London and its affiliated NHS institutions in research, service development, education and training. A sincere thanks to Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, Azeem Majeed, Chair in Cancer Epidemiology and Prevention at the School of Public Health, Professor Elio Riboli, and Professor Deborah Ashby, Interim Dean of the Faculty of Medicine for their continued support over the years.” 

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Navigating the debate on prostate cancer screening in the UK: Balancing risks, resources, and outcomes

In the rapidly evolving landscape of healthcare, few topics have garnered as much attention and controversy as prostate cancer screening in the UK. With approximately one in six men destined to face this diagnosis in their lifetime, the urgency to address this issue is undeniable. To provide clarity amidst this complexity, Rebecca Wright, Honorary GP Teaching Fellow at the School of Public Health, and Azeem Majeed, Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, at Imperial College London, delve into the heart of this debate, seeking to balance the critical factors of risks, resources, and outcomes in prostate cancer screening in England. 

Prostate cancer screening in England has become very topical and attracted considerable recent news coverage. Around one in six men will get prostate cancer at some point in their lives with incidence increasing with age. Another major risk factor is ethnicity; black men are at highest risk of prostate cancer and Asian men are at lowest risk. Other risk factors include family history, obesity and genetics; for example, those with a fault in their BRCA 2 gene (genes that produce proteins that help repair damaged DNA) have a two times higher risk of developing prostate cancer. (1) 

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