Is There a Biological Relationship Between Autism and Suicide?

By Abbie Storan 

This article may be distressing for some readers due to its themes of suicide. If you are feeling suicidal, please visit here for help.

Around 800,000 people lose their lives to suicide each year. The World Health Organisation propose that for every person lost to suicide, there will be 20 more attempting suicide. Autistic people are 7.55 times more likely to die by suicide than the general population. Approximately 1% of the population is Autistic, but many will remain undiagnosed¹. 

When you consider a relationship between Autistic Spectrum Disorder, Mental Illness, and Suicide you will not fall short for evidence relating to the psychological nature of their connection, such as the JAMA network report published this January, which states that Autistic people have a “more than 3-fold higher rate of suicide attempt and suicide than neurotypical individuals, and that over 90% of people with ASD who attempted or died by suicide had another comorbid mental health condition². But what if we want to go deeper? Can we establish a biological explanation for why Autistic people are at such an exaggerated risk of mental illness, suicidal ideation, and death from suicide compared to the Neurotypical population? 

What is Autism? 

Autistic Spectrum Disorder [ASD] is a neurodevelopmental condition which affects how a person experiences the world around them, how they perceive others, and the way in which they communicate. With ASD, everything is different, and everyone is different. Due to the phenotypic heterogeneity as well as the accompanying differences in things like brain connectivity, it has been extremely hard for research to completely describe ASD neurobiology.  However, promising progress is being made with identifying the molecular pathways underpinning ASD³. With the increasing success in neuroimaging data and genetic analysis, it is likely we could see breakthroughs in the diagnosis and treatment of ASD and co-morbidities in the future.  

Before exploring the biology of ASD and Suicide, we should make note of the psychiatric evidence for relationships between ASD and Mental Illness. In 2017 AUTISTICA – the UK’s leading Autism research charity – partnered with the National Suicide Prevention Alliance. They produced a report wherein it was mentioned that depression is present in 30-50% of adults with Autism⁴. Meanwhile in a meta-analysis of 21,797 Autistic participants, 11.8% of were also diagnosed with Schizophrenia Spectrum Disorders⁵. Another large-scale meta-analysis of 26,070 people with ASD reported that the prevalence of co-morbid Anxiety Disorders was 42%. This same study also reported the lifetime prevalence of OCD within participants was 22%⁶.  

In the UK there are approximately 500,000 adults with Autistic Spectrum Disorder (ASD). Eight in ten of these adults will also suffer from mental illness⁷. From a study of 374 adults with ASD researchers found that 66% had experienced suicidal thoughts, and 35% had attempted suicide¹. 

Genetic links between Mental illness and Autism 

Thanks to a fascinating review of genetic associations with psychiatric disorders, from Andrade et al, we can now outline a direct biological relationship between ASD, Depression and Anxiety. This connection is facilitated by the dysfunction of genes encoding voltage-gated calcium channels (CaVs). CaV1.2 and CaV1.3 encourage neuronal firing and also couple excitation to gene expression; studies show this activity is linked to a number of psychiatric disorders. In particular CaV1.3 is encoded by CACNA1D genes, which have been associated with conditions such as ASD, Major Depressive Disorder, Schizophrenia, ADHD, and Bipolar Disorder. Andrade et al report that, “The non-coding SNP rs893363, located in the 3’ UTR of CACNA1D and the putative promoter region of the choline dehydrogenase gene was found in a genome-wide analysis of these five major psychiatric disorders”⁸. 

We can go on to consider the roles of Cortisol and the Hypothalamus-Pituitary-Adrenal axis (HPA) in relation to Autism and Suicide. Cortisol is colloquially referred to as the ‘stress hormone’, stress is a known biological and psychological response to experiencing threatening stimuli. The effect of acute stress is the Fight or Flight response, wherein the Hypothalamus stimulates the adrenal medulla to secrete adrenaline – which decreases activity of the parasympathetic nervous system while increasing activity of the sympathetic nervous system. Meanwhile chronic stress is regulated by the HPA axis⁹. Secretion of cortisol is controlled by actions of the paraventricular nuclei in the hypothalamus. Those nuclei secrete Corticotrophin-Releasing Factor to the pituitary, leading to the release of Adrenocorticotropic hormone into the bloodstream which stimulates cortisol synthesis and release from the adrenal glands. The HPA axis is under direct circadian regulation by the hypothalamic body clock, leading to diurnal rhythms in all components including cortisol¹⁰.  

Many studies on post-mortem brain samples from neurotypical people who died by suicide, and those who died by other means have highlighted higher concentrations  of corticotropin-releasing hormone¹²; suggesting that people who commit suicide biologically possess higher levels of cortisol, thus higher levels of stress. This has been supported by a particularly interesting study by McGowan et al in 2009, outlining the direct role of the HPA axis in suicide. From observations of the hypothalamus  in people who died from suicide they found evidence of hypermyelination as well as reduced expression of the NR3C1 gene – a glucocorticoid receptor responsible for weakening cortisol signalling – compared to their control group of people who had died by other means. Their work also revealed that early-life adversity can have lifelong detrimental effects on function of the HPA axis¹³. Autistic children are 63% more likely to suffer from bullying than neurotypical children; wider research confirms that 16.6-18% of Autistic children are physically or sexually abused¹⁴, and that autistic children are over 2.5 times more likely to be reported to child protection services for abuse¹⁵. So how is this relevant to ASD? The Diurnal Fluctuation of the HPA axis leads to a maximum concentration of salivary cortisol during the first half hour of waking, which decreases throughout the day¹⁰. We know that an increase in cortisol synthesis can dysregulate the HPA axis, and research states that children with ASD have elevated plasma and salivary cortisol concentrations, which we know to be associated with suicide. 

The Role of Serotonin 

We can now consider how serotonin plays a part in Autism and suicide. Hyperserotonaemia – elevated levels of whole blood serotonin – was the first biomarker identified from ASD in 1961, and it is present in more than 25% of autistic people. We can also note that elevated whole blood serotonin has been attributed to OCD too. Although we still do not completely understand how the serotonergic system contributes to ASD pathophysiology, neuroimaging and genetic research has concluded that the following clinical findings are related to both ASD and the serotonergic system: 

• Reduced platelet 5-HT binding, and reduced brain 5-HT binding. Since 5-HT is degraded by aromatic acid decarboxylase into 5-hydroxyindoleacetic acid (5-HIAA), this means reduced 5-HIAA levels are characteristic too.  
• Intensified by tryptophan depletion 
• A genetic linkage to chromosome 17q in males 
• Rare SLC6A4 amino acid variants leading to low expressions of the Serotonin Transport (SERT) receptor – associated with increase in cerebral cortex grey matter volume¹⁶ 

Post-mortem studies of people who died by suicide have revealed low levels of 5-HIAA in the brainstem, as well as in the prefrontal cortex. These low levels are also observed in suicide victims known to have depression and schizophrenia. Dysregulation of the serotonergic system predisposes individuals to suicidal and other self-injurious acts – The amount of 5-HIAA metabolite in the cerebrospinal fluid (CSF) is strongly correlated to current and future suicidal behaviour. So, we know that not only do low levels of CSF 5-HIAA predict a higher rate of suicidal acts, but also indicate more lethal suicide attempts. Most serotonin receptor studies focus on SERT, with results showing reduced amounts of SERT binding sites in suicide victims¹⁷. This information highlights more neurochemical evidence for the biological relationship between Autism and Suicide.  

Hope For The Future 

There is a lot of work to be done to further our understandings of both Autism biology and the biological basis of suicide respectively. Therefore, primary research into the direct biological relationship of suicide and Autism is understandably lacking. From past investigations discussed here, we can be positive this work is underway, and remain hopeful that in the future we may have answers that could keep more autistic people alive. Unfortunately, Autistic people are more prone to experience discrimination throughout their lives from other individuals and even from services expected to keep people safe – undoubtedly having a severe impact on their mental health. There is also still not even enough resources or support specifically for Autistic individuals with mental health issues, which tells us that equally as much progress is desperately needed on a societal basis to reduce Autistic suicides.  

 

References 

1.  Cassidy S, Bradley P, Robinson J, Allison C, McHugh M, Baron-Cohen S. Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: a clinical cohort study. The Lancet Psychiatry. 2014;1(2):142-147. doi:10.1016/S2215-0366(14)70248-2 
2.  Kõlves K, Fitzgerald C, Nordentoft M, Wood SJ, Erlangsen A. Assessment of Suicidal Behaviors Among Individuals With Autism Spectrum Disorder in Denmark. JAMA Netw Open. 2021;4(1):e2033565. doi:10.1001/jamanetworkopen.2020.33565 
3.  Ecker C. The neuroanatomy of autism spectrum disorder: An overview of structural neuroimaging findings and their translatability to the clinical setting. Autism. 2017;21(1):18-28. doi:10.1177/1362361315627136 
4.  Cusack J, Cassidy S, Spiers J. Suicide and autism. Published online 2017. Accessed March 23, 2021. http://www.nspa.org.uk/wp-content/uploads/2017/02/1b.-Suicide-in-autism.pdf 
5.  Lugo-Marín J, Magán-Maganto M, Rivero-Santana A, et al. Prevalence of psychiatric disorders in adults with autism spectrum disorder: A systematic review and meta-analysis. Res Autism Spectr Disord. 2019;59:22-33. doi:10.1016/j.rasd.2018.12.004 
6.  Hollocks MJ, Lerh JW, Magiati I, Meiser-Stedman R, Brugha TS. Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis. Psychol Med. 2019;49(4):559-572. doi:10.1017/S0033291718002283 
7.  Baron-Cohen S. Vulnerability – Autism. Autistica. Published 2020. Accessed March 23, 2021. https://www.autistica.org.uk/our-research/research-projects/why-are-autistic-people-more-vulnerable 
8.  Andrade A, Brennecke A, Mallat S, et al. Genetic Associations between Voltage-Gated Calcium Channels and Psychiatric Disorders. Int J Mol Sci. 2019;20(14):3537. doi:10.3390/ijms20143537 
9.  McLeod S. What is the Stress Response. Simply Psychology. Published 2010. Accessed March 23, 2021. https://www.simplypsychology.org/stress-biology.html 
10.  Sharpley CF, Bitsika V, Andronicos NM, Agnew LL. Further evidence of HPA-axis dysregulation and its correlation with depression in Autism Spectrum Disorders: Data from girls. Physiol Behav. 2016;167:110-117. doi:10.1016/j.physbeh.2016.09.003 
11.  Knapp S. HPA Axis – The Definitive Guide. Biology Dictionary. Published 2020. Accessed March 23, 2021. https://biologydictionary.net/hpa-axis/ 
12.  Offord C. What Neurobiology Can Tell Us About Suicide. Sci Mag. Published online 2020. Accessed March 23, 2021. https://www.the-scientist.com/features/what-neurobiology-can-tellus-about-suicide-66922 
13.  McGowan PO, Sasaki A, D’Alessio AC, et al. Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nat Neurosci. 2009;12(3):342-348. doi:10.1038/nn.2270 
14.  Mandell DS, Walrath CM, Manteuffel B, Sgro G, Pinto-Martin JA. The prevalence and correlates of abuse among children with autism served in comprehensive community-based mental health settings. Child Abuse Negl. 2005;29(12):1359-1372. doi:10.1016/j.chiabu.2005.06.006 
15.  ScienceDaily. Children with autism more likely to face maltreatment, study finds. Published 2019. Accessed March 23, 2021. https://www.sciencedaily.com/releases/2019/02/190215135837.htm 
16.  Muller CL, Anacker AMJ, Veenstra-VanderWeele J. The serotonin system in autism spectrum disorder: From biomarker to animal models. Neuroscience. 2016;321:24-41. doi:10.1016/j.neuroscience.2015.11.010 
17.  Wassink TH, Hazlett HC, Epping EA, et al. Cerebral Cortical Gray Matter Overgrowth and Functional Variation of the Serotonin Transporter Gene in Autism. Arch Gen Psychiatry. 2007;64(6):709. doi:10.1001/archpsyc.64.6.709 

Tahmina Hussain on the IBMS and Securing Placements

By Tahmina Hussain

Tahmina shares her tips as a BMS Team Manager and Blood Sciences Training Officer at Christie Pathology Partnership, for securing IBMS placements and getting involved with the IBMS as a student.

About me

I completed a degree in Applied Biomedical Science at Manchester Metropolitan University, which involved a 12-month sandwich year placement in my third year which was an amazing opportunity to complete my IBMS Registration Portfolio to gain the IBMS Certificate of Competence, and also opened up the pathway for me to secure a job. Since then, I have completed the IBMS Specialist Diploma in Haematology and Hospital Transfusion Practice, and a Master’s degree in Haematology and Transfusion Science. Completing these qualifications has enabled me to expand my skills, knowledge and experience and have contributed massively towards my professional development and career progression. I have also completed the IBMS Certificate of Expert Practice qualifications in Training and in Quality Management. My particular interest is within Training and Education and developing students, trainees and colleagues and help them to grow in confidence.  

Advice on placements 

Based on my experience, the uptake of placements is highly competitive, therefore it is extremely important to apply for a placement if the opportunity is available. Without this, I would not have been able to complete my training and become a HCPC-registered Biomedical Scientist. The benefits of undertaking a placement are huge, as you will gain experience working in a laboratory while developing your knowledge and skills, as well as significantly improving your opportunities for employability. If you are unable to secure a placement via university, try and contact local laboratories to ask whether there are any work experience opportunities, connect with your local IBMS Branch and search for vacancies advertised for medical laboratory assistants or assistant practitioners.  

When you are searching for a placement or applying for a position as a Biomedical Scientist, you should include key points in your CV that stand out to the employer. Your CV should be about selling yourself and increasing your chances at being shortlisted for an interview. Include your qualifications, how many years’ experience you have, what skills you have developed and what training you have previously completed. Make sure you include your roles and responsibilities in a particular job and relate them to the position you are applying for. Employers will be looking for skills that relate to Biomedical Science so keep your CV clear and concise and make sure it flows well. If you have attended other courses such as mentorship or been involved in other extracurricular activities that add to your skills, make sure you include it in your CV. If you take part in or contribute to any conferences or events as a speaker or write articles, these are all valuable skills and experience to add.  

If you have been shortlisted for an interview, make sure you prepare well. Remember to sell yourself with the qualities and skills that you have highlighted in your CV and relate it to how it would fit the job criteria. Think about your strengths and weaknesses and how these can be used to your advantage. Most importantly, employers will want to know why you want the job but also what benefits you will bring.

For Biomedical Scientist jobs, most employers will ask specific competency-based questions, so be prepared to answer using past experiences. Examples of questions can be talking about your biggest achievement and why you are proud of this or how you might have handled a difficult situation. You may also be asked questions that are very specific to the discipline. For example, you may be given a scenario where a sample has been processed and an abnormal result is detected, what might the cause of this be? What condition might it be related to and what would you do? By preparing well and researching the common tests performed in the laboratory you will have a better chance at answering the questions well.

Don’t forget, although you may not have worked in a laboratory before, you can still demonstrate your knowledge in the interview, this will indicate your eagerness to learn. Take your time to answer the questions and don’t be afraid to ask your own questions. Examples of questions might include shift patterns or opportunities for career progression. When the interview has ended, thank the interviewers for their time, ask when you are likely to hear back from them and ask if they are prepared to provide feedback at the end of the process. 

Tahmina’s advice on getting involved with the IBMS 

There are other ways of getting involved with the IBMS which will help you develop new skills. Biomedical Science Day (24th June 2021) is the IBMS annual celebration of biomedical science. This day celebrates our profession and the work we do. You can get involved by promoting Biomedical Science and raising awareness to the public of our role in healthcare.

Prior to COVID-19 many of us celebrated by hosting events and exhibitions so that patients and staff in the hospital were able to come and ask questions; we also gave a tour of the laboratories! However, since the global pandemic, we were not able to celebrate in the usual way. But that did not stop us! The social media platform has become increasingly popular for promoting our profession so there’s always an opportunity to get involved and take part in increasing awareness.

National Pathology Week (4th-9th November 2021) is also an annual celebration of pathology to highlight the important roles we play and the contributions we make to healthcare. Again, there’s lot of ways to get involved! Public engagement activities such as delivering careers talks to schools and universities are great opportunities to engage people of all ages.  

The IBMS Chats also take place on Twitter on the first Wednesday of every month at 8-9pm. You can join in the chat and ask questions and network with other professionals. The IBMS Support Hub also deliver free online sessions on various topics such as completing CPD, portfolios and professional development.  

The IBMS mentoring program has been launched recently and is available for any IBMS member who would like some support in gaining skills and knowledge for career development.  

If you are looking to connect with the IBMS, there are plenty of resources available on their website which are useful for obtaining information on the different qualifications, CPD and networking with other members. For more information, visit https://www.ibms.org/home/

Being a Biomedical Scientist: Danny Gaskin

In conversation with Dimtrios Bitas

Danny Gaskin is a 28-year-old University of Salford alumnus from Accrington and an HCPC registered Biomedical Scientist. He completed his BSc Biomedical Science degree in 2018 and is currently employed as a Patient Blood Management Practitioner by NHS Blood and Transplant. In this interview Danny shares his career path and useful advice to current Biomedical Science Students.

Could you describe your career path as a Biomedical Scientist? What were your steps after completing your degree?   

Between the second and the third year of my degree, I applied and successfully completed a placement year in the Haematology department at Manchester Royal Infirmary. I graduated with a first-class honour’s degree and the IBMS Certificate of Competency, which meant that I could go straight into work as a Biomedical Scientist. My career path started up in the lake district at Furness General Hospital, however, I didn’t spend long there. An opportunity came up, and I moved down to the southwest and joined the haematology and transfusion team at Milton Keynes University Hospital. I absolutely loved my time there. I worked independently, got involved with all aspects of the quality management system, started my MSc degree, and overall, grew quickly as a scientist. Being an ambitious person, my time in Milton Keynes didn’t last long either. A new challenge to join the Pathology team at Spire Manchester Hospital came up. This was my first post as a Senior Biomedical Scientist, and I learned so much very quickly. I left Spire roughly a year later to join NHS Blood and Transplant. I’ve learned something from the positives and negatives of everywhere I have worked. I look for a learning opportunity in every experience and I believe that’s made me a better scientist and probably a better person. 

I’ve learned something from the positives and negatives of everywhere I have worked. I look for a learning opportunity in every experience and I believe that’s made me a better scientist and probably a better person. 

After having a look at your CV, someone can notice that you switched courses and went from studying Adult Nursing to Biomedical Science. What changed your mind?   

Before my biomedical science days, I studied Adult Nursing. The original plan was to train as an A&E nurse, but this only lasted about 18 months. During my first placement as a student nurse at the Haematology Day Unit at Manchester Royal Infirmary, I became fascinated by blood cells. I took up independent study on the different blood cells and the mechanisms that influence their production, replication, and destruction. I soon realised that a career in biomedical science was more suited to my interests.  

Can you tell us about your current job? 

I am currently employed as a Patient Blood Management Practitioner by NHS Blood and Transplant. My job involves work on activities designed to support Patient Blood Management in hospitals across London. This includes provision of an on-going programme of support, education, audit, research, and specialist transfusion advice. One of the most important elements of my job is building relationships with other healthcare professionals involved in blood transfusion, to ensure a co-ordinated approach to improving transfusion laboratory and clinical practice locally, regionally, and nationally. It’s a job that I really enjoy and get huge satisfaction from. I work with the most talented team of scientists, nurses, administrators and doctors and we really make a positive difference every day. 

It’s a job that I really enjoy and get huge satisfaction from. I work with the most talented team of scientists, nurses, administrators and doctors and we really make a positive difference every day.

What was your role as a Biomedical Scientist in Haematology and Blood Transfusion like? Can you describe a typical week at work?   

On a Monday, you might observe the presence of immature cells on a patient’s peripheral blood smear that you’re concerned might be indicative of a serious problem with the bone marrow, so you get in touch with the haematologist to escalate it. On Tuesday, you might be responding to major haemorrhage bleep to provide replacement blood for a patient that has been involved in an accident and lost a lot of blood. Wednesday might see you have to get the tools out and replace one of the probes on your analyser. Thursday might be a quiet day until you get the call from theatres to say that there had been some complications during childbirth and now a new mother is in desperate need of blood components. Thankfully, Friday is rest day. 

What advice would you give to current Biomedical Science students? What steps would you recommend them to take?   

Besides the obvious advice of working hard and putting the hours in, I would advise them to get involved with the university societies and the IBMS. Take advantage of as many opportunities as you can whilst you’re a student. Some voluntary opportunities might first appear to be a lot of hard work for very little return, but there are transferable skills you can pull from any experience. Networking has had such a positive influence on my career to date. I’d suggest attending events, meetings and discussion groups. Build a social media presence. Make professional contacts and friends. Have fun and enjoy the process. Don’t let these three or four years pass you by without having fun. I miss university so much. 

Don’t let these three or four years pass you by without having fun. I miss university so much. 

What skills, abilities, and personal attributes are essential to succeed as a Biomedical Scientist?  

Often when I see this question, I go on to read about how one must be bright, have attention to detail, be data driven etc. which are all true, but actually I think first a foremost you need to be compassionate. You need to be able to always keep at the forefront of your mind that every single sample belongs to a person with a family that loves them and that are probably worried about the results you’re about to produce and report. You need to remember that every single task you perform in the laboratory, whether it’s analytical or administrative, is essential to uphold the high quality necessary to provide the minimum level of care we should all be striving for. If you’ve got that, and a passion for biomedical science, everything else can be taught.  

How can other people help or affect someone’s career? Were there any people who had a positive impact in your career development? 

My career path has been enjoyable but very fast paced. I’ve been lucky enough to meet some fantastic people in my career so far who have given me every opportunity to progress, and whether they have realised or not, they have helped me grow professionally and personally. Being surrounded by good people in a positive environment for learning is really important to me. I’ll be forever grateful to Dr Lucy Smyth and the University of Salford for the help and support required to switch and join the Biomedical science programme. At Furness General Hospital I met Stephen McDonald, Ola Yahaya, and Shehz Abdullah, three really talented scientists who supported me through the haematology and transfusion basics. Stephen, Ola, and I still work closely together on a few different projects and Shehz and I speak most days. All three became friends for life. At Milton Keynes University Hospital I met some of the most knowledgeable and humble biomedical scientists and I learned so much so quickly. 

You often talk about the value of networking, particularly through social media and what significant role it has played in your own career. What would be your advice to a biomedical science student looking to start networking through Twitter for example? 

There is a huge biomedical science community on Twitter. You can get involved with #IBMSChat and @WEBMScienitsts. Twitter is an immensely valuable tool for networking. I have met so many scientists on Twitter who have positively influenced my career in one way or another. Twitter and other social media platforms make the world so much more accessible. One thing I will say about Twitter is that it can sometimes feel like work from work. This is particularly true if you only follow biomedical science accounts and only engage with other scientists. Shutting off from work is important. Don’t be afraid to be yourself on Twitter too. I don’t believe that you should separate your personal and ‘science’ accounts. Not unless you want to, or your employer insists you should.  I like that I can get to know the people behind the science, and I hope that people can get to know me too.  

You can follow Danny on Twitter (@NHSDanny) for some useful blood transfusion content, real time football, and boxing punditry. Use the #AskinGaskin hashtag for any questions. Danny is approachable and would love to hear from students and early career scientists. 

Prophage-host interactions: lifting the curtain on Pseudomonas’ puppet masters

Dr Chloe James in conversation with Prathyusha Vishwanthan

Humans have been aware of bacteriophages as major players in the microbial world for over 100 years. Their most widely recognized feature is their ability to infect and kill specific bacteria, but they are also known to provide some beneficial characteristics to their bacterial host. Apart from a few famous examples, this aspect of phage biology has been largely neglected and the temperate phage-bacteria relationships are not fully understood. Dr Chloe James, a senior lecturer in Medical Microbiology at the University of Salford, has been very curious about this dynamic and has been working on this for a while.

Recently, Dr  James  started a new project funded by the BBSRC, which aims to observe how bacteriophages affect the behaviour of their bacterial host. It  will focus on a notorious opportunistic bacterium, Pseudomonas aeruginosa, a common cause of respiratory infection in cystic fibrosis patients.

Prathyusha Viswanathan interviews Dr Chloe James about her unique and interesting project:

It is quite a different yet interesting topic. How did it all start?

A few years back, I worked on a project examining cases of cystic fibrosis patients who were chronically infected with the Liverpool Epidemic Strain of Pseudomonas aeruginosa. The team had previously found this stain to cause much more severe disease than other strains and to spread from patient to patient, which seemed very unusual.

After sequencing the genome, they found several never-seen-before co-existing prophages. This is where I came in. I regularly monitored phage and bacteria in the patient’s sputum samples for over 2 years. The most notable finding was that these phages were always active and present in abundance. But we could not find any association between the phages and patient condition or antibiotic treatment.

So, this got me extremely curious, like wow, even though the phages are actively killing their bacterial host, the bacteria are still keeping hold of them which means that they must be helping the bacteria in some manner and this point made me determined to find out what they are actually doing. So, I worked with colleagues [Dr. Ian Goodhead and Dr. Heather Allison] to design a project that would better understand how the phages and bacteria affect eachother’s biology, the hypothesis being that temperate bacteriophages do so much more than what we know and at the moment. I think that they pull all kinds of strings and regulate bacterial behavior in different ways.

The BBSRC awarded us funding for 2 postdoctoral researchers to work full time on the project, but we also have some linked projects that are being explored by research students at Salford and Liverpool University.

What achievements have you made so far?

Some key findings of our work are that for one, each of the LES phages seems to be affecting the fitness of the P. aeruginosa host differently and depending on environmental conditions; secondly, together, these temperate phages seem to facilitate rapid evolution of their bacterial host contributing to their adaptation to the CF lung environment; lastly, we think that phages may have an important role in the competitiveness of the LES in CF lungs by acting as anti-competitor weapons (killing other P. aeruginosa strains). But this new project will delve much deeper into the mechanisms of interaction between these intriguing microbial partners. We have published a lot of this work.

These are two complex creatures; you may have noticed many  interactions – have any been particularly unexpected or peculiar?

Yes, that’s true. We are uncovering all kinds of interesting nuggets to follow up on. So far, the most striking discovery is the evidence that the phages are interacting with each-other. This means that the bacteria behave differently depending on which phage they are infected with, and in cases when multiple prophages co-exist together, we observe a completely different behavior. Of course, we also suspect that the bacteria is affecting the biology of the phages. Seeing how the phage infection progresses differently in other P. aeruginosa host strains has helped me direct my thinking in more broader dimensions.

What have been the most recent outputs from the project?

Grace Plahe, a Salford MRes student, presented her work on how LES phages affect bacterial growth and virulence at three different conferences last year. One of her abstracts has been published, and some of her preliminary data helped us to secure the bigger project funding we have now. Since then, two postdoc researchers have been employed on the project, and they will present their preliminary findings on phage-phage interactions and phage genome annotation at the next Microbiology Society annual conference.

What are the upcoming stages of research?

So, our latest funding is to run for 3 years and there are plenty of upcoming tasks on our list. Firstly, our aim is to thoroughly profile the infection cycles of each phage under a range of environmental conditions, and monitor changes in the expression of genes that reports the key stages of the process. We will then conduct a huge transcriptomics experiment which will map global gene expression of bacteria with and without their phage partners. This will show which phages  are regulating which bacterial genes and vice-versa.

We will also perform experiments by exposing the bacteria to both favourable as well as challenging conditions, so that this will help us to identify why the bacteria is keeping hold of so many elements that could so easily kill it and most importantly, we will also construct a series of mutants and perform functional assays to confirm our theories about how these phage puppet masters are pulling the strings.

it seems that your findings have a wide scope in research and  could help thought processes in other fields, leading to new  technologies; yet temperate phage research is rare and has not yet been given much importance. What do you have to say about this?

Very true, I agree. This aspect of phage research has not been given much attention. Most of the research is concentrated on the destructive nature of bacteriophages towards specific bacteria for developing antibacterial treatments. There is a lot of renewed excitement in that area at the moment, with real potential to improve treatment of infections caused by antibiotic resistant bacteria. Whilst the beneficial effects of prophages on bacteria have not been ignored, the scale of this has been grossly underestimated. There is so much more left undiscovered. There are relatively few published findings on the regulatory properties of temperate phages and yet there is a huge amount of genome evidence to show us that ~60% of the sequenced bacterial strains carry prophages in their genomes, and even more  tantalisingly, over 70% of most prophage genes are of unknown function. We know they are present everywhere, and that bacteria are keeping hold of them even though they can present a considerable cost, but we don’t know what they are doing!

I am sure there are many exciting crossroads for this type of research, and you were absolutely correct, this type of research would also help other research fields to understand the pathology of disease better and could inform completely novel approaches to patient treatment and management. In fact, CRISPR systems were actually invented by bacteria, in order to protect them against bacteriophage attack! So, studying phage-bacteria interactions can indeed trigger revolutionary new fields of research and I hope that some of our findings will lead to new thinking in all kinds of areas that I haven’t even considered.

The Emerging Role of a Physician Associate: Interview with a PA

BY PATRICIA MEDEIROS

Dr Eugene Stead (the US chairman of the Department of Medicine) founded the physician associate (PA) profession in 1965. There was a prominent shortage of physicians and other medical providers, resulting in a higher demand for healthcare professionals¹. As a response to this, Dr Stead initiated the PA course; a 2-year medical masters with a fast-paced curriculum, similar to the 3-year medical curriculum used to train doctors in World War II². However, due to the knowledge required, potential candidates could only matriculate if they had previous health-related training. Following the graduation of the first PA cohort, other US universities incorporated the PA course in their medical schools. Numerous countries around the world have since developed their own versions of the course, including the UK.

The UK formally introduced the PA profession in 2003. The Faculty of Physician Associates (FPA) defines PAs as medically qualified professionals with a generalist healthcare background³. PAs are an emerging role in the NHS and an integral part of the multidisciplinary team. They are dependent practitioners, working in liaison with medical supervisors, these commonly being consultants and surgeons. However, with the appropriate training, PAs can work autonomously.

During the course, PA students attend a series of clinical placements in primary care (GPs) and secondary care (hospitals). These placements include a variety of medical specialties, such as, paediatrics, GP, general surgery, obstetrics and gynaecology, mental health and more. After qualifying, PAs can choose to reside in a single area of medicine, but they also have the option to move between specialties. As part of the multidisciplinary team, PAs have become increasingly prevalent within the world of medicine and more widely recognised in the healthcare sector. PAs are not doctors; the PA role was designed to develop generalist clinicians as opposed to a specialised healthcare professional. For example, Drs commonly train to become ‘specialists’ in one area of medicine and PAs train to become ‘generalists’ in many areas of medicine. PAs have obtained a previous health-related degree, whereby certain areas of that degree incorporate key components of medicine. Therefore, providing them with a subsequent generalist medical education, develops competent individuals with the ability to work in varying areas.  

There are, approximately, 30 universities in the UK offering the physician associate course. To become a qualified PA, applicants are firstly required to achieve a 1^st class (or a 2.1 honours) in a 3 to 4 year undergraduate degree. This degree has to be in a science or health-related subject. Examples of these include, biomedicine, pharmacology and medical sciences. Following this, an additional 2 years of the PA masters (MSc) or the postgraduate diploma (PGdip) is required (or alternatively, a 4 to 5 year MPAS). PAs are also required to complete a series of university exams, a national exam, assessments, OSCEs, and more in order to qualify⁴. After qualifying, PAs are then further trained in a specialty of their choosing, with many completing internship years or, alternatively, rotational posts. As with many other medical professionals, PAs must also sit a recertification exam every 6 years. This exam encompasses all areas of medicine, regardless of the area the PA is currently working in. This ensures that all PAs maintain a general knowledge of medicine for patient care and safety.   

As physician associates study postgraduate level medicine, once they qualify, they are able to: diagnose and treat their own patients; formulate management plans; perform surgical procedures; run clinics; take medical histories; carry out physical examinations and more. Currently, PAs in the UK do not; sign off prescriptions, request ionising radiation or have licenses to work in certain countries. However, PAs in other countries, such as the US, do not have these limitations. This is mainly because the PA role in the UK is newly established and currently not regulated. However, in 2022, the General Medical Council (GMC) will become the official new statutory regulator for PAs. This means that the current limitations are being re-evaluated with plans for prescribing rights, licenses to work abroad and a clear progression pathway for the role⁵. 

AN INSIGHT INTO THE PA PROFESSION: 
PA THOMAS SMYTH IN CONVERSATION WITH PATRICIA MEDEIROS 

With guest editing by Afnan Housein and Nabiha Ahmed

WHAT DID YOU DO YOUR DEGREE IN?    

“I did my undergraduate degree in sports rehabilitation at the University of Salford and graduated in 2015. Then, I completed the PA course at the University of Manchester and I did the PGdip, not the MSc, so I didn’t need to do an additional thesis at the end of the course.”  

DID YOU HAVE ANY WORK EXPERIENCE BEFORE APPLYING?

“I was in the very first cohort, in the northwest, back in 2016. As the course was quite new, I didn’t know what experiences were applicable, so I tried to make everything as relevant to healthcare as possible. Luckily, with my sports rehabilitation degree, I already had placements in the NHS setting, like working with orthopaedic surgeons in hospital. Unfortunately, a lot of students now won’t have as much experience due to COVID-19, so universities are being slightly more lenient. We do have a mentor scheme at Salford Royal called the PA Academy and there’s also the North West PA Forum so people can get in touch for an insight into the role. We understand that students are doing their best under the current circumstances.”   

WHAT TIPS WOULD YOU GIVE ON WRITING A STRONG PERSONAL STATEMENT?    

“A useful tip that I was told, was using a ‘SEE’ approach, which is a ‘skill’, then an ‘experience’ relating to that skill, then an ‘elaboration’ on that and how it applies to everyday needs. Also, always link experiences to healthcare, even if they are not directly in a healthcare setting.  Try not to waffle – whoever is reading your personal statement is trying to gain an understanding of your knowledge and experiences from a short-written piece.”

WHAT WAS YOUR INTERVIEW LIKE AND WHAT ARE INTERVIEW PANELS LOOKING FOR WHEN SELECTING A PA?

“I actually interview applicants at Manchester and the process now is different from when I applied. Back then, we had to go to Hayfield Racecourse because I think there were 500 of us and only 140 places, spread between 3 universities. We had MMI (multiple mini interview) stations and if you got through, then you got a place at one of the 3 universities based on what you scored. It was very intense, but I think interviewers are looking for students that can understand and distinguish the PA role from other allied professions. It is also good to be knowledgeable on the NHS and its core values, data protection and more.”   

WHAT MADE YOU CHOOSE THE PA ROLE, AND DID YOU EVER CONSIDER MEDICINE?

“Yes, I always wanted to study medicine and I did a lot of research into it and found the PA course which, honestly, really resonated with me. I did a sports rehabilitation degree, so I already knew a lot about the human body and how it functions, but I wanted to know more. I think that a key factor in studying medicine to be a Dr. and studying medicine to be a PA, is that the course itself is 2 years, but it’s a postgraduate masters, so you need knowledge from another 3-4 year degree. After that, you can then still go into any specialty whilst maintaining a generalist approach. So because we are generalists, we can transition between specialties, without restarting our training, so I really liked that flexibility.”  

WHAT SPECIALTY ARE YOU CURRENTLY WORKING IN AND WHAT WAS YOUR MOST INTERESTING CASE ?

“The apple didn’t fall too far from the tree; I went back and did trauma and orthopaedics and I just fell in love with the role at Salford Royal hospital, especially the surgical element to it. So, I think the most interesting case I’ve had was a bone transportation surgery. Unfortunately, a patient had a high trauma road-traffic accident and a large portion of the bone in their leg was missing. We have a phenomenal team of specialist surgeons called the limb recon team. So, we did a bone transportation where we physically cut a segment of the bone and transported it millimetre by millimetre each day, and you could actually see the bone regrowing, it was amazing.”

Physician Associate, Thomas Smyth (Instagram-@Thomasthepa) 

WHAT IS YOUR FAVOURITE PART OF BEING A PA AND ONE THING THAT YOU WOULD POTENTIALLY IMPROVE?   

“For me personally, it would have to be the flexibility and the work-life balance. I’m in many different places throughout the week. I’m a PA ambassador and a guest lecturer too. I’m also in theatre for surgery a lot and I run my own clinics, so I enjoy that. But I think if I was to improve anything, it would be the recognition of PAs. There are a few misconceptions about the role and it’s undervalued at the moment because it’s quite new in the UK and people don’t always know what we can do.”  

WHAT DO OTHER HEALTH CARE PROFESSIONALS THINK OF YOUR ROLE AS A PA?

“When I first started, they weren’t quite sure on what the role was, so I was often having to explain. I was also trying to fit in this huge, already well-established, medical team. But as soon as I got past that, there was a huge gap to be filled. Me and the other PAs don’t really rotate around; we’re there to offer patient continuity so we know the system. Since we’ve been there for 3 years, we’re able to teach the junior doctors that come in and get them into the system very quickly.  We can free up the ward time for the juniors, so that they can go into theatre and into clinics and get all these extra experiences, so actually, we do work very well together.” 

WHAT DO YOU THINK THE GMC REGULATION MEANS FOR PAs?

“GMC doesn’t really change my role, but it would make it slightly easier. I work in a profession where I need both ionising imaging and to prescribe, but the doctors are there for support and vice versa.  But equally, I am a bit sceptical because with the GMC regulation, PAs may become more prevalent on the wards without much support from the doctors. But overall, I think it’s a great thing because PAs can expand their scope of practice.”   

WHAT ADVICE WOULD YOU GIVE TO PROSPECTIVE STUDENTS?  

“Personally, I had a great experience, so choosing to be a PA was a success story in itself, I definitely recommend it. I would say though, students need a clear distinction as to which medical model they want to study, whether that’s a PA medical model or a Dr. medical model.  Any aspiring PAs are welcome to look at our mentor scheme or contact me on social media with any other questions!”

Find Thomas on Instagram:
@ThomasthePA
To find out more about the mentor scheme, visit thepaacademy.co.uk

Students at the University of Salford can join the Graduate Entry Medicine, Dentistry and Physician Associate Mentoring Scheme for guidance and mentoring with PA applications. For more information on this, please contact S.Namvar@salford.ac.uk.

References

1.        Longmire D. The Use of Physician Assistants for Health and Wellness in Aging Population.; 2020. Accessed February 18, 2021. https://scholarscompass.vcu.edu/uresposters/325/
2.        Brady MI. A Survey Assessing Patient Satisfaction with Physician Assistant Care at the Maple Street Clinic.; 2004. Accessed February 18, 2021. https://core.ac.uk/download/pdf/48843937.pdf
3.        Reynard K, Brown R. A clinical analysis of the emergency medicine workforce crisis. Br J Hosp Med. 2014;75(11):612-616. doi:10.12968/hmed.2014.75.11.612
4.        Murphy DC, Harvey A. Jeannine Watkins is a physician associate. BMJ. 2020;371:m3858. doi:10.1136/bmj.m3858
5.        Ghadiri SJ. Physician associates: an asset for physician training and a 21st-century NHS? Futur Healthc J. 2020;7(3):e9-e10. doi:10.7861/fhj.teale-7-3

Is animal agriculture increasing the risk of disease and pandemics?

By Caitlin Owen

Zoonoses are diseases transmitted between humans and vertebrates. These are relatively rare but potentially devastating events. About 60% of human infections are estimated to have originated from animals¹, and this phenomenon is becoming more frequent². 75% of new and emerging diseases are zoonotic³, and most pandemics are caused by zoonoses⁴.

Zoonotic diseases can emerge when a genetic change happens which allows pathogens to ‘jump’ from animals to humans. Some pathogens may even combine genetic material with each other, allowing them to transfer advantageous mutations and the ability to infect animals and humans. This is thought to have occurred for the 2006 ‘swine flu’ pandemic, caused by an H1N1 virus which features a mix of genetic sequences from various human, avian and swine influenza viruses⁵.

Increasing demand for animal agriculture may be increasing the risk of new zoonoses forming.

Tens of billions of animals are killed every year for human consumption⁶. How does this industry meet our excessive demand for animal products and profits? How do its practices impact on global disease spread?

Disease becomes more likely when large numbers of genetically similar animals of the same species are kept extremely close together⁴.
Even “free-range” hens may  be kept with ~13 birds per square metre in the UK⁷. In the US, they simply have to be outside⁸. Livestock are prevented from moving around to prevent wasting of energy that could be spent on growth. Animals have also been selectively bred with genes that make them better products, causing much of livestock to be genetically similar in favour of bigger chicken breasts, or increased milk production⁴. Low genetic diversity in any population increases its overall susceptibility to certain diseases⁹, and when animals are kept close together¹⁰, especially in poor welfare conditions where they cannot escape the waste of other animals¹¹, or are frequently injured, an ideal breeding ground is presented for pathogens to spread and mutate quickly.

One way that the industry has compensated for this is through mixing antibiotics into animal feed and water supplies, leading to overuse^4;12.
Antibiotics are antimicrobial agents produced naturally by bacteria to reduce the competition presented by other bacteria and it is natural for bacteria to develop resistance through genetic changes for this reason⁴. However, our use of antibiotics in modern medicine presents the need to prevent this from happening too often. We are now accustomed to the various campaigns to reduce antibiotic abuse in human healthcare, yet animal agriculture accounted for a third of UK antibiotic use in 2016¹³. Fortunately, many measures are now being taken to reduce the overuse of antibiotics in animals, but while global demand for animal products continues to rise⁴, the demand for antibiotics will too.

_{SARS-SoV-2, the viral cause of COVID-19, the zoonotic origin of which is yet to be confirmed. Source: CDC}

Domesticated animals now account for 60% of the land vertebrate biomass of the planet, while wild animals only make up 4%¹⁴.  
Humans are the other 36%. This loss of bio-diversity is thought to increase the risk of new zoonoses in a few ways, though this concept is not yet fully understood⁴. One such example is in the spread of zoonotic viruses by mosquitos and ticks – where native vertebrate diversity is high, they feed from a greater variety of hosts, of which only a few are good reservoirs for the virus, leading to fewer infections¹⁵.
 
Paradoxically, the Increasing demand for land for resource-intensive livestock is in turn increasing wild animal-human interface, which also increases the risk of zoonoses jumping species to humans⁴.
Our growing demand for land and resources forces us to further encroach on wild habitats. Cattle in particular require vast amounts of land and crops, which is driving deforestation in places like the Amazon¹⁶. While habitats decline, wild animals are forced closer to human and livestock populations. This increases contact between livestock, wild animals, and humans.

Many zoonoses are already found in animal agriculture as foodborne diseases, such as salmonella, listeria and campylobacter.
Animals are a major source of foodborne pathogens, even in plants after contamination with animal waste⁴. Animal-sourced foods formed 35% of the global burden of foodborne disease in 2010¹⁷, and 2018-19 saw the largest-ever outbreak of listeriosis after 1000 laboratory-confirmed cases in South Africa and over 200 deaths as a consequence.

The number of outbreaks caused by zoonoses is rising, including relative to outbreaks caused by human-specific pathogens.
The total height of the bars represents the total number of outbreaks of disease; red area show the proportion of outbreaks that were caused by zoonoses as opposed to pathogens limited to humans (blue area). Adapted from Smith et al., 2014¹⁸ .

So is animal agriculture increasing the risk of disease and pandemics? The UN seems to think so⁴. In their 2020 report, ‘preventing the next pandemic’, increasing human demand for animal protein was listed as the first of 7 drivers of pandemics and as a contributing factor to other drivers listed,  such as unsustainable agricultural intensification and climate change.

It should be noted that in in lesser-economically developed regions with poor food security, animal products serve as an important source of nutrition that goes some way towards maintaining a healthy immune system and thus reducing the burden of disease⁴. Therefore, the answer is not as simple as everyone simply dropping animal products from the diet right now.

However we are now well aware, diseases do not respect borders and pandemics are worldwide. If we hope to prevent them in future, it will take global change in practices, and when both farming livestock and interacting with wild animals appears to increase the risk of disease, it seems ever-more likely that this will have to involve reducing our consumption of animal products.

References

1. Host range and emerging and reemerging pathogens. Woolhouse, MEJ and Gowtage-Sequeria, S. 2005, Emerging Infectious Diseases, Vol. 11, pp. 1842–1847. Doi: 10.3201/eid1112.050997.
2. Emerging diseases go global. Woolhouse, Mark E. J. 2008, Nature, Vol. 451, pp. 898–899. Doi.org/10.1038/451898a.
3. Risk factors for human disease emergence. Taylor, LH, Latham, SM and Woolhouse, MEJ. 1411, s.l. : 2001, Philosophical Transactions of the Royal Society B: Biological Sciences, Vol. 356, pp. 983–989. Doi: 10.1098/ rstb.2001.0888.
4. United Nations Environment Programme and International Livestock Research Institute. Preventing the Next Pandemic: Zoonotic diseases and how to break the chain of transmission. Nairobi, Kenya. : United Nations Environment Programme, 2020. ISBN No: 978-92-807-3792-9.
5. Origins of the 2009 H1N1 influenza pandemic in swine in Mexico. Mena, Ignacio, et al. 2016, eLife, Vol. 5, p. e16777. Doi: 10.7554/eLife.16777.
6. Food and Agriculture Organization of the United Nations. FAOSTAT: Data. [Online] http://www.fao.org/faostat/en/#data.
7. Department for Environment, Food and Rural Affairs. Code of practice for the welfare of meat chickens and meat breeding chickens. [Online] 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/694013/meat-chicken-code-march2018.pdf.
8. United States Department of Agriculture. Meat and Poultry Labeling Terms. [Online] 2015. https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/food-labeling/meat-and-poultry-labeling-terms/meat-and-poultry-labeling-terms/!ut/p/a1/jZFRb4IwEMc_DY-lx3AG90ZIFmUTZsxm5WUpehSS0pK2jrhPP9wyExed9p569.
9. Does genetic diversity limit disease spread in natural host populations? King, K. C. and Lively, C. M. 4, 2012, Heredity, Vol. 109, pp. 199–203. Doi: 10.1038/hdy.2012.33.
10. Investigation of risk factors for Salmonella on commercial egg-laying farms in Great Britain, 2004-2005. Snow, L C, et al. 19, 2010, British Veterinary Association, Vol. 166, pp. 579-86. Doi: 10.1136/vr.b4801.
11. The animal-human interface and infectious disease in industrial food animal production: rethinking biosecurity and biocontainment. Graham, J. P., et al. 3, 2008, Public Health Reports, Vol. 123, pp. 282–299. Doi: 10.1177/003335490812300309
12. Antibiotic Abuse in Animal Agriculture: Exacerbating Drug Resistance in Human Pathogens. Goldman, Emanuel. 1, 2004, Human and Ecological Risk Assessment: An International Journal, Vol. 10, pp. 121-134. Doi: 10.1080/10807030490281016.
13. The Parliamentary Office of Science and Technology. Reducing UK Antibiotic Use in Animals. [Online] 2018. researchbriefings.files.parliament.uk%2Fdocuments%2FPOST-PN-0588%2FPOST-PN-0588.pdf&usg=AOvVaw2I1wEWBrrsqTAVI2.
14. The biomass distribution on Earth. Bar-On, Yinon M., Phillips, Rob and Milo, Ron. 25, 2018, PNAS, Vol. 115, pp. 6506-6511. Doi: 10.1073/pnas.1711842115.
15. Biodiversity loss and the rise of zoonotic pathogens. Ostfeld, RS. Suppl 1, 2009, Clinical microbiology and infection, Vol. 15, pp. 40-43. Doi: 10.1111/j.1469-0691.2008.02691.x.
16. Persistence of cattle ranching in the Brazilian Amazon: A spatial analysis of the rationale for beef production. Bowman, Maria S., et al. 3, 2012, Land Use Policy, Vol. 29, pp. 558-568. Doi: 10.1016/j.landusepol.2011.09.009.
17. Global disease burden of pathogens in animal source foods, 2010. Li, Min, et al. 6, 2019, Plos One, Vol. 14, p. e0216545. Doi: 10.1371/journal.pone.0216545.
18. Global rise in human infectious disease outbreaks. Smith, Katherine F., et al. 2014, Journal of the Royal Society, Vol. 11, p. 20140950. Doi: 10.1098/rsif.2014.0950.19.

Phoenix from the ashes: Lung tissue damaged by tobacco smoking may be able to regenerate

By Bruce Veloso

What if lung tissue could regenerate after smoking damage and become healthy again – like a phoenix rising from the ashes?

Surprising new research published by Nature¹ suggests that this may be the case. It has been found that cells which escape damage have the ability to repair smoking-related damage inflicted on other cells in the lungs – but only if you stop smoking.

Hundreds of carcinogens are present in tobacco, which cause changes in DNA sequences of cells, resulting in the formation of cancerous cells over time. For years, it was thought that damage in the lungs caused by smoking was irreversible. and life-long with an unspoken rule which stated that lung cancer was soon to chase after and find ex-smokers. New research suggests that this may not necessarily be true. The results of quitting tobacco cause lungs to self-repair, noted in people who smoked at least a pack of cigarettes continuously for more than 30 years.

“MAGICAL”

– Dr Campbell, of the Wellcome Sanger Institute, involved in the research¹

It was also observed that the lungs of past smokers were comparable to people who had never smoked before, because the healthy cells that were able to avoid tobacco-related mutations could replace the damaged cells. It was noted that the majority of cells taken from a smoker’s airway had suffered mutations, with cells displaying up to 10,000 genetic alterations. But to the researchers’ surprise, a few cells managed to avoid damage to their DNA. How exactly, is as yet unknown. Nonetheless, after an individual stops smoking tobacco, those are the cells that repair the lungs by replacing the damaged cells.

Need a reason to quit smoking?

According to this paper, after you quit, your heart rate drops. In less than 12 hours, carbon monoxide level in your blood drops to normal. In 2-12 weeks, your circulation and lung function improve. Within 1-9 months Coughing and shortness of breath decrease. After only 5-15 years, your stroke risk is reduced to that of a non-smoker, lung cancer death rate is about half of a smoker and risk of heart disease is that of a non-smoker. The longer you stay away from tobacco the more your health can improve – quitting can be challenging but it is possible.

NHS Stop Smoking Services are free, local services providing a range of techniques to help you stop smoking. You can gain access to a stop smoking adviser via a GP referral or by contacting an adviser directly. To contact a stop smoking service in England, please call the free smoke-free national helpline: 0300 123 1044

References

1. Tobacco smoking and somatic mutations in human bronchial epithelium. Yoshida, K., et al. 7794, 2020, Nature, Vol. 578, pp. 266-272. Doi: 10.1038/s41586-020-1961-1.

The Steps You Can Take at University to Prepare for a Career

By Prathyusha Viswanathan and Anna-Marie Grayson

The  achievement of completing a university degree is especially felt when you secure a good job. Even a small opportunity, especially as an undergraduate, can be considered valuable, as work experience will boost your career. Initially, career planning can make you feel daunted, but just as building the foundation is crucial for constructing a building, taking the essential correct steps at university plays an incredibly significant role in your journey to a career. You will be able to feel yourself developing and progressing with each of these steps you take. To start, our university’s experienced Careers and Enterprise Leader, Anna-Marie Grayson, has detailed some of the important steps students should aim to take at each level of their study. Question? Email SEE-Placements-Industry@salford.ac.uk 

• Learn to develop a good rapport with your tutors or lecturers, their wide career network can help and guide you well.
• Join societies related to your field – this will allow you to interact with other students and volunteering here will develop teamwork and leadership skills.
• Draft a substantive CV and cover letter which can be updated when required.

• Consider joining a placement to gain work experience – apply with placement providers who would be essential to your programme of study and research the placement providers you are applying for.
• Make sure to attend the career fairs and workshops conducted on campus.
• Create and update your LinkedIn profile.

• Ensure you have a planner for the year.
• Focus on applying for graduate/postgraduate schemes applicable to your course and make sure you note deadlines.
• Update your CV.
• Apply for Postgraduate or PhD courses in good time, if you don’t wish to bring an interruption to your studies.
• Ensure you rebalancing your University workload with applications.

“Apart from these useful tips, I must definitely stress that our university not only conducts career fairs and workshops on campus, but also provides students with exceptional support and guidance in approaching their career goals. A CV is the tool to start your career search, a document which must be perfectly presented to employers. Our careers and employability team ensures students have an impressive CV if you consult with them. Students can also book mock interviews with our career team experts via the platform Advantage, to help prepare them to exhibit a confident, professional attitude and overcome fear to ace any interview.

“It is highly advisable students take the utmost advantage of such accessible support services set up for them. Remaining focused and vigilant always whilst pursuing your goals counts the most! I hope all of you ensure to adopt the right steps in your career search and wish you all the best to attain success in your desired career!”

– Anna-Marie Grayson; School of Science, Environment and Engineering Careers and Enterprise Leader at the University of Salford

Where can I start looking for graduate opportunities?

Use these resources to find opportunities for work experience or work after you graduate. You may also find it useful to contact relevant people in your network and keep an eye on LinkedIn and social media for any, such as for job adverts. Don’t be afraid to get in contact with opportunity providers like hospitals about how they specifically advertise opportunities and what they might have available.

AAAS Science Careers

Known to provide excellent job opportunties in Biomedicine, translational research, preclinical development and health sciences in countries such as the UK, US, Europe and Asia

NHS Jobs

Main provider of Biomedical Scientist jobs and Medical Laboratory or Associate Practitioner jobs in Pathology departments in NHS hospitals.

Salford Students: Salford Advantage

If you are a Salford Student ensure you have signed up with the relevant mailing lists for placements and opportunities.

The Biomedical Scientist Jobs

Official job board of the Institute of Biomedical Science and exceptionally certified platform providing opportunities for all biomedical science disciplines as well as veterinary science and research. Featured recruiters include Spire Healthcare, NHS, Pure Healthcare Group

Student Circus

Provides handpicked jobs, placements and internships in all UK sectors. Some jobs and employers referred by student circus also provides a Tier 2 VISA, which may be useful for international students

Student Employment Services (SES)

A well-established platform and excellent guide for student internships or placements, if you want to gain work experience while studying. Also provides some graduate opportunities