Tag: Research

A deep dive into 30 years of progress and challenges

Professor Jonathan Valabhji

Diabetes now affects over half a billion people globally, including 3.8 million people in England. Type 2 diabetes, which accounts for 90-95% of all cases, has obesity as its primary modifiable risk factor. Expanding waistlines, both nationally and globally, have driven a steady increase in type 2 diabetes rates in recent decades. To mark World Diabetes Day, Professor Jonathan Valabhji OBE, from the Department of Metabolism, Digestion and Reproduction, reflects on his 30 years of experience in the field, in clinical practice, in national leadership, and in clinical and epidemiological research.  

My background in Diabetes research and clinical practice 

I qualified as a doctor in 1990 from St Bartholomew’s Hospital Medical College, London. I undertook specialist training in diabetes, endocrinology, and general medicine in North-West London, and landed at Imperial College in 1997 to undertake my MD (Doctor of Medicine degree) as a British Heart Foundation Junior Research Fellow. In those early years, I was interested in cardiovascular disease in diabetes, which at that point was responsible for the majority of deaths in people with diabetes. My work centred on understanding the paradox in type 1 diabetes: although patients often displayed healthy cholesterol profiles, they were at elevated risk of heart attacks and strokes. I spent 3 years in a lipid laboratory, using ultracentrifugation (a technique used to separate and isolate particles based on their density) to isolate high-density lipoprotein (HDL) cholesterol particles from blood samples, to try to disentangle the paradox.  

Population-level progress in cardiovascular health  

While I like to think that some of that early research advanced the field a little, it was other epidemiological and societal factors that saw cardiovascular disease fall in people with diabetes over the next two decades. Public health initiatives, such as reduced smoking rates, and improved management of blood glucose, blood pressure, and cholesterol, have collectively driven a marked decrease in cardiovascular complications, resulting in longer lifespans for people with diabetes. However, with this success came new challenges, as other and multiple long-term conditions (MLTCs) have increasingly become leading causes of illness and death. This has complicated care for patients, healthcare professionals, and the NHS.  At the same time, obesity has driven younger onset of type 2 diabetes, contributing to accelerated development of MLTCs at younger ages. 

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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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Postcards from Kampala: Data and Dashboards in Uganda

Nina Zhu enjoying coffee and a chat with Dr Sanjeev Singh, CAMO-Net India lead
Nina Zhu enjoying coffee and a chat with Dr Sanjeev Singh, CAMO-Net India lead

The Centres for Antimicrobial Optimisation Network (CAMO-Net) recently convened an insightful meeting at Makerere University in Uganda. This international event brought together researchers dedicated to the critical challenge of antimicrobial resistance (AMR). Throughout the week, attendees engaged in a series of informative presentations exploring data-driven approaches to optimising antibiotic use. Hear first-hand from Dr Nina Zhu from the Department of Infectious Disease on what her experience at the event was like. 

I recently returned from Kampala, Uganda, where I spent an incredible week at Makerere University for the Centres for Antimicrobial Optimisation Network (CAMO-Net) event. Colleagues from around the world came together in Kampala to share knowledge, take part in workshops, and learn more about the work our Uganda National Hub does to address antimicrobial resistance (AMR) in Africa and beyond. 

Data and Dashboards for Optimising Antibiotic Use 

The event’s theme was ‘Data and Dashboards’. Harnessing the power of data through strategic and targeted studies to generate new knowledge related to optimising antimicrobial use is a key theme of CAMO-Net. As my work focuses on using data linkage and system dynamics modelling to understand healthcare-associated infections and AMR, it was a perfect week for me!  

I was joined in Kampala by CAMO-Net members from four other countries: Brazil, India, Malawi, and South Africa. We received such a warm welcome from our Ugandan hosts and started the week with a networking session at a local restaurant. At the reception, Dr Andrew Kambugu, CAMO-Net Uganda lead and head of Makerere’s Infectious Diseases Institute (IDI) gave a fascinating showcase of IDI’s history. It was a perfect blend of networking and getting to know more about the impressive strides IDI has made in infectious diseases, data, and AMR. 

Professor Umar Kakumba, the 1st Deputy Vice Chancellor of Makerere University, and Dr Andrew Kambugu, CAMO-Net Uganda lead, welcomed the whole CAMO-Net team

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Spotlighting Air Quality Researchers on Clean Air Day

Group photo of Aerosol Science Team at Imperial’s Environmental Research Group in front of an air quality monitoring site (Ian is fifth from the left)
Group photo of Aerosol Science Team at Imperial’s Environmental Research Group in front of an air quality monitoring site (Dr Ian Chen is fifth from the left)

Air pollution is linked to 43,000  deaths each year in the UK.  The World Health Organization and the UK Government recognise that air pollution is the largest environmental threat to our health. To mark Clean Air Day, we’re spotlighting Dr Ian (Gang) Chen and Dr Kayla Schulte from Imperial’s Environmental Research Group who are leading the charge in the fight against air pollution. 

Dr Ian (Gang) Chen 

As a kid growing up in China, I always thought the haze was just another humid day with fog. Only after watching the Chinese-made documentary, Under the Dome in 2015, did I realise how polluted our air was. I was shocked and determined to do something about it. To begin my research journey in air pollution, I pursued a two-year MPhil program at the University of Toronto. There, I focused on developing a low-cost sensor to detect soot particles in developing countries. After that, I became interested in identifying and quantifying sources of air pollutants for my PhD studies at ETH Zurich, since it’s the most straightforward way to target emission sources and mitigate air pollution. My research has focused on this topic ever since.  

Our team (Aerosol Science) at Imperial’s Environmental Research Group maintain two air quality supersites in London, where we use the latest technology to continuously monitor pollution. One site is located near Baker Street, central London, a traffic station, while the other is an urban background site located in Honor Oak Park in south London. On Clean Air Day 2023, we launched a particulate matter (PM) dashboard which shows the hourly chemical composition of the solid particles and liquid droplets found in our air.  Making this data open-access and interactive is crucial for public understanding of the air we breathe. The organic mass in PM often contains millions of compounds and my research focuses on identifying and quantifying its sources. In the coming years, we aim to provide near real-time source information for PM on this dashboard, so that both the public and policymakers can understand where the pollution is coming from.  

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Early onset Type 2 Diabetes: A growing concern

Dr Shivani Misra

While traditionally seen as a disease of older adults, type 2 diabetes is increasingly affecting younger people. This “early onset” form carries a higher risk of complications and earlier death. To mark Diabetes Awareness Week, Dr Shivani Misra from the Department of Metabolism, Digestion and Reproduction sheds light on her research which aims to tackle early onset type 2 diabetes in individuals from minority ethnic backgrounds.

When I was at medical school, I learned that type 2 diabetes was a condition that affected middle-aged or older adults often living with obesity. However, these days the demographics of who is affected by type 2 diabetes have drastically changed. More and more younger adults and children are affected with type 2 diabetes and we call this early onset type 2 diabetes, typically defined as a diagnosis before the age of 40 years.

What we do know from large analyses across the world, is that when you’re diagnosed with type 2 diabetes at earlier age, your diabetes can progress through to complications very rapidly and also reduce life expectancy. Of even greater concern is the impact on women living with early onset of type 2 diabetes, in whom pregnancy can be complicated because of  type 2 diabetes and there’s a higher risk of foetal death, sadly.

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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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Queer in the field: The unique challenges of LGBTQIA+ scientists conducting international research

LGBTQIA+ scientists can face nuanced challenges when travelling abroad to conduct research. Bethan Cracknell Daniels, Research Postgraduate in the School of Public Health, reflects on her time in Ghana supporting infectious disease control, and how the  LGBTQIA+  International Support Group are advocating for a more inclusive global scientific community.

While applying for my PhD in Infectious Disease Modelling at Imperial in 2019, I wanted to gain hands-on experience in infectious disease control. At the time, I was an undergraduate student studying Immunology at the University of Manchester. I applied for an internship with a laboratory on the edge of Accra, Ghana, providing infectious disease diagnosis to a local hospital. I was excited to be accepted and immediately went about booking flights and organising my visa.

It was only a week before my flight that I learned Ghana criminalises homosexuality, with physical homophobic attacks against LGBTQIA+ individuals being common. As a queer woman with a same-sex partner, I was nervous. Living in Manchester, with its famous gay village, I was very open about my sexuality and thought nothing of walking down the street holding hands with my girlfriend. Unsure of how to navigate being gay in Ghana, I eventually decided to tell people I didn’t have a partner, effectively returning myself to the closet.

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Unravelling the mystery of smaller lungs in low- and middle-income countries

Andre Amaral

In low- and middle-income countries (LMICs), a notable number of individuals have smaller lungs for their sex, age, and height, especially in South and East Asia, as well as sub-Saharan Africa. The key question: Why does this pattern persist in these regions?

This phenomenon extends beyond physiological concerns, and as indicated by recent studies, reveals a troubling link between smaller lungs and heightened risks of suffering from heart disease and diabetes. Dr André Amaral, an epidemiologist at the National Heart and Lung Institute (NHLI), explores this phenomenon.

The BOLD study

Chronic lung diseases affect millions of people of all ages worldwide. Approximately 20 years ago, the Burden of Obstructive Lung Disease (BOLD) study was set up by Imperial College London to find out more about the prevalence and determinants of chronic obstructive pulmonary disease (COPD), which back then, was already considered a leading cause of disability and death.

The BOLD study was conducted in 41 sites across Africa, Asia, Australia, Europe, the Caribbean and North America, and recruited more than 30,000 adults aged 40 years and over. The large coverage of world regions, and ethnic groups, as well as the large number of participants, all answering the same questions and undergoing the same measurements in a standardised manner, makes the BOLD study unique. Participants in this study provided information on several characteristics of their life. This included whether they had been diagnosed with lung disease, a heart disease, or diabetes, whether they smoke or ever smoked, their weight and height, and their highest level of education. The level of their lung function was measured through a medical test called spirometry, which measures how much air a person can breathe out in one forced breath.

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The Compressed Air Bath and its Therapeutic Uses in Mid-Victorian Britain

The Wharfedale hydropathic establishment and hotel (Ben Rhydding) with surrounding grounds. Etching, ca. 1860. Wellcome Collection. Source: Wellcome Collection.
The Wharfedale hydropathic establishment and hotel (Ben Rhydding) with surrounding grounds. Etching, ca. 1860. Wellcome Collection. Source: Wellcome Collection.

What happens when industrial technology meets nature? A French invention of the 1830s, the compressed air bath capitalised on the allure of ‘pure countryside air’ to treat a range of respiratory problems. Dr Jennifer Wallis, Medical Humanities Teaching Fellow, explores the fascinating history of these baths and their therapeutic uses in mid-Victorian Britain.

During the summer holiday season, many of us will have taken a break to recharge our batteries. Whether it’s gazing out over a clear blue sea or hiking through a forest, connecting with nature is often a key component of our holidays.

Tourists in the 19th century sought a similar experience. They yearned to escape the crowded city or the routines of home to immerse themselves in a new environment. The era is most associated with the seaside resort, which grew in popularity as the railway network expanded. But many Britons were also choosing to follow in the footsteps of their eighteenth-century ancestors by visiting spa towns like Malvern. Spa towns were renowned for their health benefits, from the freshness of the air to the energising effect of the mineral waters. Hotels and resorts sprung up in spa towns to cater for the health-seeking hordes.

One such resort was the Ben Rhydding Hydropathic Establishment in Ilkley, Yorkshire. It cashed in on a contemporary interest in hydropathy, a treatment regime based on baths and showers. Ben Rhydding offered its visitors a variety of activities to supplement these treatments: bowling greens, dances, and guided walks of local beauty spots. It also offered a rather unusual experience for the health-seeking tourist, one that used air rather than water: a compressed air bath.

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