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Valentine’s 10K – care and share

Join our fun Virtual Valentine’s 10K with your loved one, be it a friend, brother/sister, mum/dad, partner or all your family bubble – a great excuse to get out (legally). Do it in your own way and in your own time.

All you need to do is register – here’s how:

  1. Register here – you will receive a confirmation email to log in to the Secure Charity Portal where you can pay your registration fee [£25 covers the cost of the place and medal only and does not go to the charity].
  2. Breathing Matters will get notification that you have signed up for your challenge and will contact you – or you can contact us directly at breathingmatters@ucl.ac.uk
  3. Set up a Breathing Matters personal fundraising page.  It is up to you how much you want to raise for Breathing Matters; there is no minimum sponsorship limit.
  4. Choose your partner and start training!!!

For more details, click here: https://bit.ly/3rDpJjd

Virtual Valentine's Day Run

Pay half now half later on amazing challenges

We know from talking to our amazing supporters that, no matter how motivated you are, it’s as tough a time as ever to commit to paying a challenge registration fee in one lump sum. To help those supporters that have a charity challenge in mind but who are struggling to get their registration fee together, the new scheme from our partners Global Adventure Challenges is here to help! 

The brand new Challenge Booster Scheme allows adventurers to secure their space on selected treks, cycles and sleds with a payment of just 50% of the registration fee. The remaining 50% will be due by the end of April 2021 – giving you a guaranteed dose of excitement, and something incredible to look forward to – and we all need that at the moment!

This offer ends at midnight on Sunday, 31 January 2021, so now’s the time to take the plunge and secure your space.

There are some truly dream challenges available for 2021 and 2022, including the stunning Northern Lights Trek, the beautiful Cycle Thailand/China/Mallorca, the historically scenic Inca Trail Trek and the woofable Husky Trail Dog Sled.

For a full list of the challenges included in this offer, please click here – please note, most UK & European cycling and trekking challenges are excluded.

 

 

 

 

 

ILD Clinical Trials Annual Report

Breathing Matters was established 10 years ago with the aim of finding better treatments for interstitial lung diseases (ILD) and lung infections. Since that time, we have raised money and awareness into these often neglected conditions. Looking back over the 10years, we have come much further than any of us would have anticipated in the beginning. We have established new theories on the development of ILD or lung fibrosis and the role of the immune system in particular the clotting cascade and neutrophils. We also have better ways of monitoring and diagnosing these conditions and our novel nuclear medicine imaging programme and relatively non-invasive lung biopsy service are the first in the UK. We are about to start to trial a novel therapy in IPF, C21, which we began working even before Breathing Matters was conceived. We could not have achieved any of this without the support of our funders and our patients, so thank you all. This review highlights our achievements to date and our future directions in ILD.

RELATIVELY NON-INVASIVE LUNG CRYOBIOPSY (2014-ONGOING):

Objective: To find a less invasive and better diagnostic tool for every patient with ILD

Main benefactors: Teresa Timberlake and family – equipment purchase; Lawrence Matz Memorial Fund – Clinical Fellow

Breathing Matters investment: £52,000 salary; £36,000 (total £88,000)

Leveraged funding: £347,000

Outcomes:

  1. Novel cryobiopsy service, first in the UK including training other centres; presentations at European Respiratory Society (2015 and 2018), British Thoracic Society (2014-6);
  2. Completed Lung-INHALE study Study (2019) to assess inhaled drug deposition using CLB.  This will allow drug companies to develop inhaled therapies for IPF and be sure that they are reaching the part of the lung where they are needed. The use of inhaled therapy will avoid some of the side-effects of anti-fibrotic drugs that are taken as tablets. Paper submitted 2021 and once accepted will be available on BM website

This project was developed in discussion with a family whose mother had had a surgical lung biopsy towards the end of her life. Her experience was such that her family felt that a less invasive alternative must be available. Dr Theresia Mikolasch, the Lawrence Matz Clinical Fellow, took this on for Breathing Matters to find out about and train in new techniques. Dr Mikolasch then returned to UCLH and established the first and only UK cryoscopic lung biopsy (CLB) service. CLB is a new way of obtaining larger lung biopsies using a flexible bronchoscope passed into the lungs through the mouth. The patient is sedated and surgery is avoided. This is not only better for the patient than a surgical lung biopsy, but also provides a solution to the lack of biopsy samples available for scientific research.  GSK were so excited by the technique that they awarded Dr Mikolasch and Dr Porter a grant of over £300,000 to carry on the service for an additional 3 years.

NOVEL FDG-PET IMAGING TO PREDICT PROGNOSIS AND RESPONSE TO TREATMENT IN ILD (2014-ONGOING):

Objective: To find a new test (biomarker) that will enable us to predict prognosis and response to treatment in each individual patient.

Breathing Matters investment: £34,766

Leveraged funding: £173,850

Funding from BLF for clinical trial of FDG-PET in post transplant bronchiolitis £40,000

Outcomes: Novel FDG-PET imaging programme in ILD – first in the UK; presentations at American Nuclear Medicine Society (2015), British Thoracic Society (2015-9); American Thoracic Society (2017 and 2019)

Publications:

  • Pulmonary 18F-FDG uptake helps refine current risk stratification in idiopathic pulmonary fibrosis (IPF). Win T, Screaton NJ, Porter JC, Ganeshan B, Maher TM, Fraioli F, Endozo R, Shortman RI, Hurrell L, Holman BF, Thielemans K, Rashidnasab A, Hutton BF, Lukey PT, Flynn A, Ell PJ, Groves AM.  Eur J Nucl Med Mol Imaging. 2018 May;45(5):806-815. doi: 10.1007/s00259-017-3917-8. Epub 2018 Jan 16.
  • Synergistic application of pulmonary 18F-FDG PET/HRCT and computer-based CT analysis with conventional severity measures to refine current risk stratification in idiopathic pulmonary fibrosis (IPF). Fraioli F, Lyasheva M, Porter JC, Bomanji J, Shortman RI, Endozo R, Wan S, Bertoletti L, Machado M, Ganeshan B, Win T, GroveEur J Nucl Med Mol Imaging. 2019 Sep;46(10):2023-2031s AM.

Next steps:

  1. FDG-PET will be used as a response biomarker to see if we can detect which patients benefit from anti-fibrotic therapy and which patients do not benefit. We are applying to the NIHR for a £400,000 grant to carry out this study:
  2. We and others have shown that patients with IPF are more prone to blood clots. We have some very exciting work looking at anticoagulation in IPF.  We have completed 2/3rds of the study before halting for COVID work, but hope to complete the study and then publish our findings later in 2021 (see below).

Interstitial lung disease (ILD) consists of a heterogeneous group of diseases with varying amounts of interstitial inflammation and fibrosis. Survival in the most severe form of lung fibrosis, idiopathic pulmonary fibrosis or IPF, is particularly poor; however, there is heterogeneity in outcome. Some patients gradually deteriorate; some undergo stepwise progression, whilst others decline rapidly. Moreover, much of the prognostic data heralds from an era when the criteria for diagnosing IPF were less well and differently defined than at present.  There is a definite need to find prognostic biomarkers to predict outcome in IPF patients

Positron emission tomography (PET) offers the ability to non-invasively investigate cellular metabolism in vivo. PET studies in animals have yielded valuable insights into the biology of IPF and ILD and there is potentially encouraging evidence that PET may aid the development of therapeutic interventions to treat these debilitating conditions. It has been recently demonstrated that 18F-Fluorodeoxyglucose (18F-FDG) PET signal is consistently raised and can be objectively measured in patients with IPF. Moreover, these PET signals are shown to be stable and reproducible.

We have shown over several years and imaging hundreds of patients with ILD that the baseline measures of pulmonary 18F-FDG PET signal to predict survival in patients with IPF compared to other more established prognostic data.  We have also shown that combing PET data with our clinical scoring system based on gender, age and physiology (GAP) data (“PET modified GAP score”) refined the ability to predict mortality.

Future studies are to investigate the role of FDG-PET scanning in other ILDs, such as Rheumatoid arthritis (see below) and systemic sclerosis.

RHEUMATOID ARTHRITIS (RA) ASSOCIATED ILD (2018-ONGOING):

Objective: To discover why 1:5 patients with RA will develop lung fibrosis and what novel treatment can prevent disease progression.

Breathing Matters investment: £34,766

Leveraged funding:  £102,766

Outcomes: Novel biomarker test for neutrophils extracellular traps (NETS) in ILD in discussion with UCL business for further development; presentations at American College of Rheumatology (2014-6); British Thoracic Society (2016); British Rheumatology Society (2014-6);

Publications:

  • The lung in a cohort of rheumatoid arthritis patients-an overview of different types of involvement and treatment. Duarte AC, Porter JC, Leandro MJ. Rheumatology (Oxford). 2019 Nov 1;58(11):2031-2038. doi: 10.1093/rheumatology/kez177.
  • Autoimmune rheumatic disease IgG has differential effects upon neutrophil integrin activation that is modulated by the endothelium. Khawaja AA, Pericleous C, Ripoll VM, Porter JC, Giles IP. Sci Rep. 2019 Feb 4;9(1):1283. doi: 10.1038/s41598-018-37852-5.
  • Identification of a novel HIF-1α-αMβ2 Integrin-NETosis axis in fibrotic interstitial lung disease. Khawaja AK, Chong DLW, Sahota J, Pericleous C, Ripoli VM, Booth HL, Khan S, Rodriguez-Justo M, Giles IP, Porter JC. Frontiers in Immunology; 2020

Next steps:

  1. To work with a group in Cold Spring Harbour, USA to see if inhibiting NET formation prevents fibrosis.
  2. To see if the presence of NETs in the blood can predict whether patients will develop lung fibrosis.

RA is a chronic debilitating disease estimated to afflict 13% of the world population. Around 10% of patients with RA will develop an ILD that is very similar to the lung fibrosis that we see with IPF. Dr Akif Khawaja was funded by Rosetrees and UCL to carry out a PhD into the aetiology of RA-ILD. His work proposed that RA is a disease that starts in the lung. That chronic lung damage caused by smoking, infection and other insults causes the immune response to recognize the lungs and joints as “foreign” and attack them causing chronic damage. His work implicated neutrophils in this process and, in particular, the p38 MAPkinase pathway.  We are hoping to develop a new test using blood or sputum to detect early activation of neutrophils in the lungs of patients at risk of ILD.  This same test may act as a biomarker for prognosis and to detect early response to novel therapies.

A TRIAL OF ANTICOAGULATION IN IPF (2016-ONGOING):

Objective: To assess the potential of anticoagulation as a treatment for IPF

Main benefactors: The Hulme Family – The Mark Hulme Clinical Fellow

Breathing Matters investment: £40,000

Leveraged funding:  £100,000 from UCL/H NIHR BRC

Next steps: A trial of anticoagulation with heparin in IPF using FDG-PET as a response biomarker

At present, we do not know the exact cause of idiopathic pulmonary fibrosis (IPF), although research has identified lots of processes that are likely to be involved. Currently, we believe that microscopic injury occurs in patients with IPF and then the body responds to repair this, but does so in a way that leads to more damage and scarring. One of the processes involved in repair pathway is coagulation, which minimises blood loss when tissues are damaged.  Patients with IPF are at increased risk of blood clots and this can reduce their already low life expectancy. We also think that these blood clots drive the worsening of their lung disease. Researchers have shown that clotting is over-activated in the lungs of IPF patients and we want to investigate how reducing this might improve the disease.  Based on work carried out at UCL, we believe that anticoagulation with heparin is safe and may even prevent disease progression in IPF. Patients will be asked if they would be willing to take the oral anticoagulant dabigitran for 3 weeks, to reduce clotting. We will perform blood tests and FDG-PET scans before and after taking the drug to judge response.  If we find that the heparin is safe and the patients report some improvement that we can confirm with questionnaires lung function and FDG-PET scans, then we will progress to leverage funding for a much bigger trial.  Unfortunately, the study had to be put on hold with the COVID pandemic – we have completed 2/3rds of this study and have analysed the results. We have found a small effect and the suggestion is that we look in a few more patients that we will recruit early in the New Year.

A TRIAL OF A NOVEL TREATMENT (COMPOUND X) IN IPF (2019-2022):

Objective: To assess the potential of Compound X as a treatment for IPF

Main benefactors: NIHR BRC £100,000

Breathing Matters investment: £40,000

Leveraged funding:  Application to British Thoracic Society, Wellcome Trust and NIHE.

Next steps: A trial of Compound 21 in patients with IPF

Assessing effectiveness of treatments for IPF is difficult as often they do not make patients feel better, despite decelerating disease. Currently, we are guided by regular breathing tests and special imaging of the lungs, which are insensitive to changes and may be unpleasant for patients. We need better tests like a simple blood test to predict the prognosis for individual patients, and their responses to treatment. Causes of IPF are unknown, but we have found that specific white blood cells, called neutrophils, are increased in the lungs of patients with IPF. We also found that the more neutrophils in the lungs, the faster the decline from IPF. This suggests that neutrophils are actively worsening IPF. Neutrophils produce a substance called X that we detect in the bloodstream of patients with IPF. No-one has investigated whether X causes or worsens IPF. We plan to quantify X in the blood and lungs of patients with IPF. By comparing X levels in patients with IPF against healthy individuals, this will establish whether X is increased in patients, whether high levels of X indicate more severe IPF and whether treatment for IPF reduces X levels in patients that respond. These results will ultimately help design future clinical trials testing Compound X that is able to block X as a treatment for IPF.

UNDERSTANDING MUCIN 5B AND ITS ROLE IN IPF (2019-2022):

Objective: To assess the role of Muc5B in IPF

Main benefactors: NIHR £300,000

Breathing Matters investment: £40,000

Next steps: Further investigations in patients with IPF of the effects of blocking neutrophil activation

Publications:

  • Mucins and their receptors in chronic lung disease. Denneny E, Sahota J, Beatson R, Thornton D, Burchell J, Porter JC. Clinical and Translational Immunology 2020

It is unclear what causes IPF, but it is thought to be a response to damage to the lining of the airways (epithelium) following an unidentified injury. This results in the

formation of excessive scar tissue which disrupts the delicate architecture of the lung and ultimately death follows from respiratory failure.  We have shown from research previously sponsored by The Rosetrees Trust that a certain type of white blood cell which is specialised in fighting infections called neutrophils may play a role in PF. We have found that neutrophils are increased in the blood and lungs of patients with PF and the more neutrophils you have, the worse the individual’s outcome.  In addition, it is recognised that you are more likely to develop IPF if you have a commonly occurring genetic mutation that causes increased mucus production by the lung epithelium, and in particular a protein called Mucin or MUC5B that gives sputum its stringy quality. We propose that the overproduction of MUC5B may stress the epithelium, making it more prone to damage and scarring. In addition, the increased MUC5B will attract and activate neutrophils from the blood and these white blood cells can cause further damage. We hope that, by identifying treatments that limit the number of neutrophils moving into the lung, we can protect patients from developing PF or from PF progressing. We will use neutrophils and epithelial samples form patients and healthy volunteers to compare differences and see how the MUC5B affects neutrophil activation in the lung. Lastly, we plan to block neutrophil activation and recruitment with a specific treatment that is already being developed for other indications and has an excellent safety profile. If our results are encouraging, we can take this medication into an early clinical trial for patients with IPF.

We have also shown that we can detect very early changes in the CT scans of patients that make too much Muc5B and this might be a very early sign, even before the scan looks abnormal, that these patients are at risk of lung disease.

REMOTE MONITORING OF PATIENTS WITH CHRONIC LUNG DISEASE INCLUDING IPF (2021-2024):

Objective: To assess how feasible it is to monitor patients with chronic lung disease remotely to pick up deterioration in a more timely fashion

Main benefactors: NIHR and overseas PhD sponsor ~£120,000

Breathing Matters investment: £20,000

Next steps: We hope to start the study in early 2021

Mr Malik Althobiani, a respiratory therapist, has been sponsored to undertake a PhD with Professor Jo Porter to investigate the potential of remote monitoring or patients with lung diseases including IPF.  As outpatient appointments have been disrupted because of COVID-19 and access to breathing tests is limited due to the risk of spreading the virus, it is increasingly important to be able to monitor people with lung problems at home.  For people who have developed COVID, monitoring their recovery at home is also important.  Our research is designed to understand if remote monitoring of lung health and disease using wearable sensors, spirometers and pulse oximeters is possible. If so, such wearable sensors could be used to detect worsening of an underlying condition without putting patients in situations with a high risk of exposure to COVID.

Our research will evaluate whether remote monitoring of signs (such as heart rate and oxygen saturation) and symptoms (such as shortness of breath or reduced exercise tolerance) and lung function (such as walk tests and spirometry using wearable sensors and questionnaires is feasible.

If you are a UCLH patient and want to get involved in any of the above studies, please discuss this with your consultant.

 

[Updated, January 2021, J Porter]

 

 

An Ode to 2020

To mark the end of this difficult year, one of our lovely supporters has written this poem:

 

Wishing all our family and friends a very Happy New Year!!

Goodbye 2020: farewell, adieu,

We’re so glad to see the back of you!

You’ve brought so much hardship, sorrow and pain,

We hope never to see your like again.

You ruined our Holidays and plans this year,

And caused our nation to live mostly in fear.

Tight restrictions and lockdowns made us all see

How important it is just to be free.

We will look back at you in years to come

As a time when we all had to stay at home.

At midnight tonight, when you depart,

Your legacy will be many a broken heart.

And so we rejoice this New Year’s Eve

As dastardly 2020 finally takes its leave!

Here’s to a Happy New Year everyone!!!

 

Our Christmas and New Year Message

We hope that you and your families are all well and have survived 2020.  Thank you all so much for supporting us during this tough time.

It has been a strange year and a very busy one.  In March, many of our research staff took up the call to work on the frontline and the rest of the team worked hard on COVID-19 clinical studies to find life-saving treatments.

COVID-19 is a Respiratory disease, one that especially affects the Respiratory tract, and we are beginning to learn more about the lungs through this research.

It is clear that the SARS-CoV-2 virus (that causes COVID) is unusual.  It can affect the blood vessels resulting in a constellation of symptoms. One of the startling findings is that we are seeing new pulmonary fibrosis develop in about 6 of every 100 COVID patients that are admitted to hospital, and in around 3 in 100 of those treated in the community with mild COVID. It also appears to worsen fibrosis in patients who already have lung fibrosis, so access to the vaccine for our patients with pulmonary fibrosis is vital.  We are particularly interested in why some people get fibrosis after COVID and others don’t and we hope this will provide crucial insights into the whole spectrum of pulmonary fibrosis. We are closely following nearly 1000 patients who were admitted to UCLH with COVID or who been referred to us with breathing problems after COVID infection. Understanding how many get better, and how many have progressive fibrosis is critical for patients and the NHS to plan ahead.

Unfortunately, even after getting rid of the virus, many patients will continue to have symptoms that can be very debilitating. Breathing Matters has supported the national Urgent Public Health study, PHOSP-COVID. This study will discover what the long-term effects on health might be after being hospitalised with COVID-19 infection.

We have of course also been deeply committed to helping in delivering trials of new vaccines at UCLH. It is wonderful that we have not only one, but maybe as many as three different effective vaccines. We are hopeful that widespread vaccination will bring us all a return to normality in 2021.

Of course through all this, the main thing that has kept Breathing Matters and the team going is your vital, continuous and unwavering support.  Many health charities have seen dramatic reductions in income over 2020 with little respite in 2021. We hope that by keeping our overheads as low as possible and bringing in funding from other sources, and with your help, we can weather this storm.

Fundraising has taken a back seat this year with fundraising events, including the London Marathon and the Prudential Ride London cancelled.  However, we do have plenty of virtual events to whet your fundraising appetite, including a Virtual Christmas Concert given by the excellent Holst Singers. If you want to plan a future challenge overseas in 2021/2022, we have plenty of amazing events including the Northern Lights Trek in Iceland, Yosemite to San Fran cycle and a trek around the Great Wall of China. For inspiration, take a look at our Events Page.

In January, Breathing Matters will be 10 years old.  We have come a long way in a decade.  Particular highlights have included the following:

  • Our development of relative non-invasive cryoscopic lung biopsy as an alternative to chest surgery to biopsy the lung, to make a confident diagnosis of fibrosis and rule out other conditions that would require different treatments.
  • Our findings that FDG-PET scans can detect the changes of early lung fibrosis before a regular CT scan and may provide a very sensitive way to measure response to therapy in patients with pulmonary fibrosis.
  • Our 10 year collaboration with Vicore which will see a new drug (C21) being tested in patients with IPF with a study set to start recruiting in early 2021.
  • Our understanding of the role of the white blood cells, neutrophils, in the development of pulmonary fibrosis which may lead to novel blood biomarkers to assess patients most at risk and help us develop novel approaches to therapy.
  • Participation in the multicentre Bronch UK research project which includes around ten hospitals across the UK. This is the first such study and will help us learn a lot more about bronchiectasis and how best to treat it.
  • Completion of two phase I trials of novel vaccines against Streptococcus pneumoniae, the commonest cause of pneumonia, partly or wholly developed by Professor Brown’s laboratory.
  • Published important data on how common bronchiectasis is in the UK, showing that, far from being a disease that is dying out, it is increasingly common and is associated with an increase in mortality including perhaps surprisingly from diseases of the heart and large blood vessels. These data are quoted by all the major guidelines for bronchiectasis and have helped promote awareness of the disease as well as shown the high need for further research.

In 2021, we will focus back on our pulmonary fibrosis and lung infection work with renewed vigour and with the firm belief that, as a community, we can overcome anything if we all do our bit.

If you would like to donate to support our research, you can do this via our JustGiving Page. Thank you to our regular donors that make such a difference to our research and enables us to plan our future projects.  If you are interesting in giving regularly, please read our article.

Thank you all for your vital support.  Together we have hope and together we are stronger.

We would like to wish you a Merry Christmas and here’s to a healthier New Year!

From Everyone at Breathing Matters

 

 

 

Christmas with the Holst Singers

Very sadly, we are unable to be all together this December for our annual Christmas Concert at St Pancras Church, but to bring us all together at this special time of year, our friends in the Holst Singers have very kindly donated a recording of a small selection of carols for us.

The recording begins with a presentation by Professor Brown and Jane Walker which gives an insight into life at UCLH this year during the pandemic with reference to its impact on patients with bronchiectasis and also on our fundraising activities.

Please click here to listen to our Christmas recording.

If you would like to make a donation towards research into bronchiectasis and pneumonia led by Professor Brown and his team at UCL Respiratory, please click here
(Please use Google search engine to download the recording link).

With our warm wishes for Christmas and New Year 2021.

From Breathing Matters

Our grateful thanks to the Holst Singers and to the Lord Taverners for supporting this recording.

Regular Donors Rock

Did you know, the average person in the UK will give nearly £30,000 to charitable causes throughout their lifetime.  The UK is in the Top 10 most generous countries of the world – almost 70% gave to charity in 2018!

We are so lucky at Breathing Matters to have some amazing supporters who give regular monthly donations to help our vital research.  A small donation goes a very long way at Breathing Matters as we have little overheads which enables your donations to go straight to where it counts – the research itself!  Regular giving provides us with much needed funds that we can rely on and this can help us plan our research projects for the future.

 

We would like to say a MASSIVE THANK YOU to our regular givers – you know who you are!  We depend on your regular gifts – you really do make a difference!

 

At a time when our lungs need help more than ever, if any of our community is interested in supporting Breathing Matters on a regular basis and don’t currently do so, we hope that you will consider pledging a monthly gift to support our research.

To set up a regular gift, all you need to do is:

  1. Download and complete the Standing Order Form here
  2. Hand this in to your bank so they can set up the Standing Order.
  3. Return a copy to Breathing Matters at breathingmatters@ucl.co.uk 

Have a look at our updated pulmonary fibrosis wish list:

£5 – For equipment to take blood from a patient with pulmonary fibrosis/IPF for research.

£10 – For a specialised test to look at novel biomarkers in the blood of IPF patients.

£20 – For staining 4 slides of lung tissue from IPF patients to study novel molecules and link these with molecular imaging scans.

£30 – For growing individual fibroblasts (cells that produce the scarring) in the lab from the lungs of patients with IPF.

£40 – For an hour of a clinical fellow.

£50 – For analysis of a novel molecular imaging (PET) scan in an IPF patient.

£100 – For a spirometer to use at home to track patients without needing them to come into hospital – our remote monitoring project.

£500 – For isolating the platelets from patients with IPF so that we can examine them in the laboratory and compare them to platelets from people with normal lungs.

£5,000 – For equipment and running costs for a ‘Western Bot’ which allows us to look at abnormal proteins in the lungs of IPF patients.

£50,000 – For pump priming a blue sky research proposal: Allows a senior clinician to undertake a substantial period of research (a year or more) as a named research fellow to develop an hypothesis that is then submitted for full funding (£300K+) from a medical research charity.

 

Autumn 2020 Newsletter – Out Now

 

For the Autumn 2020 newsletter, please click here

 

 

 

 

Autumn 2020 Newsletter – Survival Quiz Answers

What’s the most important thing you need to survive in the wild?

Answer: Water – the human body needs a minimum of 2 quarts (1.9 litres) of water per day for good health. One day without water is cause for serious concern, and three days without water will lead to almost certain death.

 

Why should you try to avoid sleeping directly on the ground?

Answer: To keep from losing body heat – sleeping on the ground can lead to loss of body heat. You’ll retain more warmth by piling grass or pine needles on the ground to sleep on.

 

Why should you melt snow or ice before drinking it?

Answer: To avoid dehydration – eating frozen snow and ice will reduce your core body temperature and lead to dehydration.

 

How can you determine the distance of an oncoming storm?

Answer: By the time between flashes of lightning and claps of thunder – count the number of seconds between flashes and claps and divide this number by five to estimate how many miles away an approaching storm is.

 

Which symptoms determine if you are experiencing severe dehydration?

Answer: Vomiting and diarrhoea

A Jump to the Frontline

Article by Louise Beitverda, Lead Respiratory Nurse

Prior to the COVID-19 pandemic, my role as the Lead Respiratory Nurse at UCLH involved leading a team of clinical and research nurses. The research work included inputting information into the national registry for Idiopathic Pulmonary Fibrosis (IPF), participating in audits and assisting those involved in individual research.

In March, as the numbers of hospital admissions for COVID-19 started increasing, it became clear that most non-COVID-19 research would temporarily stop, and our clinical responsibilities would change. Around this time, due to our experience with non-invasive ventilation, some of the nursing team became involved in helping to deliver an education programme for Continuous Positive Airway Pressure (CPAP). This is a type of ventilation used to support patients in respiratory failure and it was used for COVID-19 patients. We helped to train over 100 clinicians on many different devices in just a few weeks. One of the devices was the life-saving Ventura CPAP designed by UCL very early on in the pandemic and sent to 30 different countries worldwide.

Once training was completed, we worked on the Respiratory High Dependency Unit (RHDU). This unit was set up to support COVID-19 patients requiring CPAP. Other team members were able to cover clinical posts remotely, which enabled patients to be able to continue to have vital telephone support during this time. One of our research nurses was able to help support the emerging COVID trials. Our administration team were asked to work remotely, but continued to provide support by ensuring that the nurses’ emails were attended to, and urgent messages relayed. Everybody played a vital role.

Working on the wards again was an interesting experience. There were certainly some challenging aspects. Long shifts and night duties (after 16 years) took some getting used to. I re-discovered the energising effects of ‘red bull’ at 3am, although it didn’t quite give me wings! Working in full PPE had its challenges, although it was reassuring and we felt protected wearing it. It took some time to ‘don’ on and ‘doff’ off, but fortunately there were staff to support us with this dressing task. PPE was incredibly hot, and the masks could cause considerable discomfort when worn for long periods. PPE made it difficult to identify people and to be able to communicate effectively, especially to people working outside of the COVID area. However, the challenges were overcome. We quickly started writing names on our gowns, and some even attached photographs of themselves. Barrier cream was supplied for our sore noses, and regular refreshment breaks were provided to allow staff to rehydrate; 2 hours was really the maximum time it was comfortable to spend in full PPE.

Communication issues were addressed via technology with varying degrees of success. It took some skill to master the walkie talkies which connected us to outside areas and sometimes it was just easier to write a note on pen and paper and hold it up against the glass entrance door when a message was needed to be conveyed to the outside world. Technology was of course very useful in terms of keeping patients connected with their families and friends at a time when visitors were not routinely allowed on the wards. Although there were some very difficult situations, it is easy to imagine how much harder this would have been had the pandemic occurred a decade or two earlier.

As a team, we will all have our individual memories of our time in the RHDU. Some of these memories will be about the intensity of the situation, and the experience of caring for patients with severe breathlessness on CPAP. However, many of these memories will be of positive events. It was always a lovely moment when patients were discharged and we were able to clap and say farewell to them, especially to those who had been on the unit for a long and difficult time.  For me, a special moment was seeing a patient being interviewed on the BBC, discussing his recovery with the physiotherapy team. I had been on duty the night he had arrived from Intensive Care, with a tracheostomy. It was incredible to think of the journey he had been on, and so pleasing to see his progress. It’s rare that ward nurses find out what happens to patients after they have been discharged, so this was very uplifting.

Despite the difficult situation, there was a great sense of teamwork throughout our time on the RHDU. It was a privilege to work with so many other members of the multidisciplinary team, many of whom were also redeployed and were undertaking roles so different to their own. The psychology team were available to support staff and I know that they were valued. We were well looked after on the ward, with constant deliveries of donated hot meals, and refreshments. Things like this really were appreciated and gratefully received, taking the little stresses out of the day. Other things that made life easier were incentives such as free taxis and parking, to be able to drive to work and not have to consider getting the underground for a few weeks really made travel easier and safer.

Guiding the team through this uncharted territory could have been a very difficult experience, as it was an ever changing landscape and it was not clear how long the situation would continue. However, each and every one of the nursing team showed an enormous amount of flexibility, patience and resilience, and they should be very proud.

Whilst we cannot be sure what lies ahead, we will continue to contribute to the research agenda, as this is such a pivotal part of healthcare. Never has there been a time when research was more important.  Research can and will save us from this fatal virus – there are now better treatments for COVID-19 and there are new vaccines on the horizon, and very soon we will feel safe once more.