Blog posts

How COPD patients can sing their way to better health this Christmas

Carol Singers (CC BY 2.0)

Singing carols is a big part of Christmas cheer, but not many people realise that singing can also be helpful for people with lung disease. COPD is an extremely common condition – there are 1.3 million people with this diagnosis in the UK. Existing treatments help to some extent, but do not reverse the underlying pathology, meaning that even with optimal care many patients remain breathless with activity limitation and poor quality of life. This symptom burden represents a major area of unmet need. Singing for Lung Health (SLH) groups are a potential way for patients to gain skills to improve control of their breathing and posture, reducing symptom burden and enhancing wellbeing.

What is singing for lung health?

Singing for lung health involves taking part in classes led by a specially trained singing teacher. Patients learn techniques to help control their breathing and posture as part of a group activity which is fun and sociable. The goal for the groups is to get better at singing, an artistic objective. By doing this individuals gain skills that help them to cope with their lung condition, a health improvement objective. The classes have a particular focus on activities and exercises that are helpful for people with lung disease and so differ from more generic “singing for well-being” groups.

Singing for lung health has grown from a few small clinical trials to more than 80 groups nationally. As well as the plausibility of an approach based on learning to control the breath in people with lung disease, singing is also a fun social activity. Results from the Royal College of Physicians COPD audit show that provision of pulmonary rehabilitation is still limited, so there is a need for activities to sustain the physical and social benefits that these produce once people have completed them. For some people, taking part in a singing group may be a useful stepping stone to agreeing to join a formal rehabilitation program. (more…)

World AIDS Day: Professor Robin Shattock on the elusive HIV vaccine

World AIDS Day takes place annually on 1 December as an opportunity for people worldwide to unite in the fight against HIV and to show support for people living with HIV/AIDS.

To mark World AIDS Day 2017, we have published a series of blog posts to highlight the important and varied research that takes places at Imperial. Three experts from Faculty of Medicine share their interest in HIV/AIDS which spans from the elusive vaccine to the economics of the epidemic.


Where are we in the battle against HIV/AIDS?

The past thirty years have seen enormous gains. We’ve seen the development of highly effective therapy that today can ensure the health of an HIV positive individual for rest of their natural lifespan. We used to speak of HIV/AIDS as if they were the same thing, now you can be HIV positive and never develop AIDS (Acquired Immunodeficiency Syndrome). Globally over 18 million people are now receiving life-saving drugs, preventing millions of deaths each year. Treatment also dramatically reduces the risk of passing on the infection. Excitingly, recent studies have shown that taking a daily pill (known as pre-exposure prophylaxis or PrEP) can prevent people from contracting HIV infection and this is now being made available in the UK.

However, significant challenges lie ahead

Treatment is for life and is not a cure; we are currently unable to eradicate the virus once someone has been infected. As many as a third of individuals infected with HIV are unaware that they have contracted the virus and late diagnosis significantly impacts on the benefit of available treatments. While great strides have been made to make global treatment accessible, only half of those currently infected are accessing treatment and for every individual starting treatment, one or two people are newly infected. This means that the population requiring life-long medication will continue to expand with associated pressure on global financial resources and already stretched health systems. (more…)

World AIDS Day: Dr Katharina Hauck on the health economics of fighting HIV

Katharina Hauck speaking at the Annual Meeting 2017 of the World Economic Forum in Davos (Copyright by World Economic Forum / Sikarin Thanachaiary)

World AIDS Day takes place annually on 1 December as an opportunity for people worldwide to unite in the fight against HIV and to show support for people living with HIV/AIDS.

To mark World AIDS Day 2017, we have published a series of blog posts to highlight the important and varied research that takes places at Imperial. Three experts from Faculty of Medicine share their interest in HIV/AIDS which spans from the elusive vaccine to the economics of the epidemic.


The role of an economist in the HIV epidemic

As an economist, my research on HIV takes a higher-level population view. We advise policy makers in governments and international organisations on the cost-effectiveness of preventive and treatment interventions in the countries most ravaged by HIV. By estimating the benefits and costs of interventions, we can identify the ones that promise greatest improvements in population health.

The largest community-randomised trial of the universal HIV test and treat strategy

For example, we are currently conducting an economic evaluation of HPTN071/PopART; the largest study on the impact of a package of testing and prevention interventions on new infections in Zambia and South Africa. We measure the benefits of treatment to HIV-infected individuals who are found and diagnosed earlier because of PopART, and we expect that the interventions will also prevent new infections. It’s tricky to estimate exactly how many individuals will be spared from getting infected in future, but we work with epidemiologists who use complex modelling to project the number of prevented infections into the future. (more…)

World AIDS Day: Professor Mark Bower on HIV-related cancers

World AIDS Day takes place annually on 1 December as an opportunity for people worldwide to unite in the fight against HIV and to show support for people living with HIV/AIDS.

To mark World AIDS Day 2017, we have published a series of blog posts to highlight the important and varied research that takes places at Imperial. Three experts from Faculty of Medicine share their interest in HIV/AIDS which spans from the elusive vaccine to the economics of the epidemic.


Oncologist turned HIV expert

As a medical oncologist at Chelsea and Westminster Hospital, I specialise in the treatment of HIV-related cancers at the National Centre for HIV Malignancy – Europe’s largest research and treatment institute for these cancers. Over the last 25 years, I have seen an astonishing improvement in the outcomes of people diagnosed with both HIV and cancer, so that patients under my care with most HIV associated cancers now have the same overall survival as HIV negative patients.

The population of people living with HIV is ageing

One less welcome finding in recent years is the rising number of non-AIDS defining cancers – cancers not previously associated with severe immunosuppression and AIDS – amongst people living with HIV. Overall, the risk of cancer rises with age, although the age-related risk of individual types of cancers varies. In the UK half of all cancers are diagnosed in people over the age of 70 years old. The combination of increasing age of people living with HIV and the rising rates of cancer with age, is reflected in the changing epidemiology of non-AIDS defining cancers amongst people living with HIV. This was first described in the US by Shiels in 2011 who reported a three-fold rise in the rates of non-AIDS defining cancers between 1991 and 2005, and by 2005, 60% of these cancers occurred in people over 50 years old. We have since described the same phenomenon at the National Centre for HIV Malignancy, Chelsea and Westminster Hospital and in a pan-European cohort. (more…)

How a little Mo effort can make a big difference

It’s that time of the year again, when men grow moustaches around the globe. It all started in 2003, when two guys in Australia had the idea to make moustache-growing fashionable again. For a greater cause, they made this campaign about men’s health and established the Movember Foundation. As you may know, the campaign became an international phenomenon, attracting over 300,000 participants in more than 20 countries in 2016.

The Movember Foundation is now a global charity with one mission: “Stop men dying too young”. To achieve this, they are raising awareness and funds for three issues affecting men’s health; prostate cancer, testicular cancer and mental health. Here in the UK, the Movember Foundation has been working together with Prostate Cancer UK – the only charity that exists solely for prostate cancer – investing over £21 million in prostate cancer research between 2012 and 2015.

The prostate is a male-specific organ that sits just beneath the bladder and surrounds the urethra – this location is the reason so many symptoms of prostate disease affect the ability to urinate. Prostate cancer occurs when cells in the prostate grow and divide out of control. In the UK, prostate cancer is the most common cancer amongst men and expected to affect 1 in 8 men during their lifetime. The word ‘cancer’ sounds frightening, but it needn’t be for all cases of prostate cancer. When diagnosed at the earliest stage, virtually all men survive beyond 5 years. However, when diagnosed at the latest stage (advanced prostate cancer) only 30% of men survive beyond 5 years, indicating early detection is key. (more…)

“Don’t you just get the summer off?”

“Don’t you just get the summer off?” – James Moss
Not quite a million-dollar question, but one I am often asked by students I bump into over the summer months, who seem perplexed to see me on College premises. “But there’s no teaching” they’ll say, which is a fair and accurate statement. My job title is Teaching Fellow, which means I’m employed to design and deliver teaching sessions for our students. Fortunately for me, variety is the spice of life, and there are lots of different ways I spend my time.

Exam marking

This summer I marked way over ten thousand marks worth of questions across five different exams, which is almost 37.5 hours in itself (technically a full week of work!), and these papers get turned around – marked, double-marked and ratified – within ten days in time for the exam board (a meeting with senior teaching staff and external examiners).

Research

This summer I’m working on different research projects, along with all of the other things. Several of these are collaborations with undergraduate students on medical education projects (like evaluating new teaching methods or software to support learning), which is an exciting way to work and provides students with a unique experience (and hopefully a taste of research that can inspire them in the future). (more…)

Give HIV the Finger – National HIV Testing Week 2017

HIV testing week

It is the time of year again for HIV Testing Week!

Coordinated by HIV Prevention England (HPE) since 2012, National HIV Testing week has focused on three main aims:

  • improving awareness of HIV testing, particularly among communities at high-risk
  • increasing opportunities to take the test in clinics and other community settings
  • reducing the number of people diagnosed with HIV at a late stage

This year’s theme is ‘Give HIV the Finger’ – a cheeky reference to the free finger-prick test that people can receive by post, to provide a blood sample for testing without attending a clinic.

HIV in the United Kingdom

According the latest surveillance from Public Health England (PHE), just over 5,000 people were diagnosed with HIV in 2016; this is an 18% drop compared with 2015.[i] 54% of diagnoses were among gay and bisexual men; 19% and 22% among heterosexual men and women respectively. Late diagnosis is an important predictor of morbidity and premature death in people with HIV. In 2016, 42% diagnoses were made at a late stage of infection when treatment is less effective. (more…)

Lung volume reduction – new hopes and missed opportunities in COPD


COPD, chronic obstructive pulmonary disease, has traditionally been thought of as an irreversible and somewhat hopeless condition. Many patients with COPD may be missing out on the possibility for a dramatic improvement in their condition. They deserve better.

COPD, is a common and important condition. There are 1.3 million people with a diagnosis of COPD in the UK and it’s now the third leading cause of death worldwide. The main symptoms are breathlessness, cough and sputum production.

The term COPD encompasses a range of pathological processes, usually caused by smoking or inhaling other noxious materials. It includes chronic bronchitis – inflammation and damage to airways as well as emphysema – destruction of the lung tissue itself and damage to the blood vessels in the lung. In emphysema the walls of the alveoli (air sacs) break down. The lung tissue loses its elasticity and becomes baggy, and air gets trapped in the lungs making breathing uncomfortable. In some people the condition is caused by alpha one antitrypsin (A1AT) deficiency; the inherited lack of a defensive enzyme, which makes their lungs much more vulnerable.

There are treatments including inhaled medication, pulmonary rehabilitation and flu vaccination, and for people who continue to smoke, smoking cessation is the most effective. Despite the best standard care the condition is progressive and conventional treatments cannot so far reverse the underlying process. (more…)

Alcohol Awareness Week: seeking a responsible alternative


Most of us are aware that chronic, heavy alcohol consumption and binge drinking leads to a plethora of health issues including liver damage and addiction. However, many of us are still unaware of the dangers associated with even moderate alcohol consumption or the cumulative effects that alcohol can have on our health. So just what are those regular trips to the pub, or the frequent cocktails after work really costing us?

Research into effects of alcohol provide a range of results. Some research (funded by the alcohol industry) has even been claimed to demonstrate that alcohol consumption is actually beneficial to our physiological health. Conversely the International Agency for Research into Cancer has demonstrated that the more alcohol you drink directly increases the risk of seven common cancers including: mouth, throat, oesophageal, larynx, breast, liver and bowel.

Similarly, new research published in the British Medical Journal has revealed a potential link between moderate drinking and shrinkage of the hippocampus, a brain region associated with memory. These results suggest a link between moderate alcohol consumption and a potentially permanent alteration in brain structure. (more…)

The Pathology Museum’s top treasures

Tucked away in Charing Cross Hospital is Imperial’s best-kept secret: The Pathology Museum. Housing a 2,500-strong collection of anatomical specimens, the Pathology Museum contains some rare and unique artefacts dating from 1888, including the first hysterectomy performed in England.

Carefully curated by the Human Anatomy Unit (HAU), the specimens are grouped together based on organ systems, creating a well-arranged display of human pathology. The museum’s primary function is to help educate medical and biomedical students to diagnose diseases. The museum also hosts a number of conference and short courses in pathology for experienced professionals.

The collection incorporates specimens from across the Faculty of Medicine’s founding medical schools, there are an astonishing 4,000 further specimens not on display. This vast archive provides a snapshot of the historical foundations of the medical school. (more…)