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Law and Ethics and Medicine: How do they relate?

by YPU Admin on July 21, 2016, Comments. Tags: Law, medicine, Research, university, and UoM

Introduction

Hello, my name is Jessica Azmy and I am a medical student at the University of Manchester. This year I am taking a year away from my medical studies and studying for a Masters in Healthcare Law and Ethics, before returning to my final year of medical school. I will hopefully then graduate as a doctor!

In Depth

It may seem strange to be completing a Masters at this stage and I never imagined when I started Medicine that this is something I would do. During medical school I was intrigued by the relationship between the law and medical practice because it seemed to be relevant in all areas. I often found doctors referring to what the law does and does not allow and wanted to explore this further. I am really interested in certain areas such as the law determining whether children can or cannot refuse medical treatment that doctors feel is best for them. The main aim is to consider what the law currently says and what it should say, if we lived in an ideal world. Of course doctors need to know the law to avoid being taken to court, if something goes wrong!


What the law should say comes down to fundamental questions which are captured by the ethics part of my course. For example, the reason why doctors must always ask whether we agree (consent) to medical treatment is because we are human beings that have the ability to decide for ourselves what we want. The exploration of why doctors should act in certain ways and whether it is right or wrong to take a particular course of action is a constant source of debate and there is rarely one ‘correct’ answer. This is what I like most because it makes me consider my own views and learn to argue these in a way to persuade other people to agree with my argument. Some of the areas I have considered include organ donation and whether this should or should not be a choice, whether scientists should be able to experiment on humans, and the problems arising from creating human-animal hybrids (mixture of human and animal tissue).

What’s the point?

With constant advances in science and technology creating new possibilities in healthcare there is a need to consider what we should and shouldn’t allow. How would you feel if you could choose the characteristics of your future child – their hair colour, eye colour and even intelligence? Do you think everyone should be an organ donor? Should doctors be allowed to end the life of a patient who is suffering terribly? Should doctors ever keep information from patients to prevent upsetting them? These are some of the pressing questions that ethics aims to address! The issues are often on the news making what I am studying even more relevant and interesting.

I am not sure what type of doctor I want to be in the future but the best thing about law and ethics is that it is relevant to all areas of medical practice and will hopefully help me with whatever speciality I go into. I hope to also use my Masters to teach future medical students about the law and perhaps offer advice in legal cases involving doctors.

Going further

To explore a wide range of ethical dilemmas in science visit:

http://www.beep.ac.uk/content/1.0.html

For a greater look at the ethics surrounding gene technology:

http://www.beep.ac.uk/content/457.0.html

To look at what is involved in creating human-animal hybrids (mixing human and animal tissues):

http://www.bbc.co.uk/ethics/animals/using/hybridembryos_1.shtml

Watch this video for a general introduction to ethics (not specific to science):

https://www.youtube.com/watch?v=vAuv0HujFbc

Really interesting video comparing ethics in science and arts and giving more information on why we make decisions:

https://www.youtube.com/watch?v=NO4mgCDtMXs&ebc=ANyPxKo8q0_849gLcXpPdKXw1t5vLgBlb1B-7rnzhJTjbOldWhebYT-Dpg3N7M3YTrysw2s7y3aD9RB_99TdaFjtCfkamFPsOw


 

Following Social Change in Beirut

by YPU on July 7, 2016, Comments. Tags: Humanities, Research, Social Anthropology, and UoM

INTRODUCTION

My name is Alice Stefanelli and I am a third-year PhD student in Social Anthropology. I received my Bachelor degree in Ethno-Anthropological Sciences from the University of Bologna, Italy, which is my country of origin. In my third year I came to Britain as an exchange student and I studied for a year at Brunel University, in West London. I loved the experience and I highly recommend it! Spending a term or a full year abroad is a very valuable and enriching experience that you will not regret. Later I was accepted into Goldmiths College, University of London, to do a Master in Social Anthropology, which I did part-time while I worked in a bookshop. Three years ago, I joined the University of Manchester to research the connections between civil society and pro-public space campaigning in Beirut, Lebanon. What I ask myself is: what kind of change do people in Beirut seek? How are they trying to achieve it?


IN DEPTH

In my thesis I try to explore social change in Beirut. I have chosen to look at a group of civil society organisations that campaign against the privatisation of public parks and beaches in the city. These are associations of citizens who do not want their few green public spaces to be sold to real estate developers and turned into expensive resorts that the majority of the population will never be able to afford.

As all anthropologists do, I spent a year in Beirut conducting fieldwork and collecting first-hand data. This meant that I spent time with campaigners: I went to their meetings, I joined them at the protests and other events that they organised, trying to help them out but also listening carefully to what they had to say and trying to understand what kind of social change they desired. In anthropology, this is called “participant observation”. I also conducted a number of interviews with them in order to ask them direct questions about their work and clarify some of my doubts.

To complement my thesis, I am collecting material such as newspaper articles from the local press that discusses these campaigns as well as the history of civil society campaigning in Lebanon, so that I can have a better idea of how things have changed in time.

My thesis is that citizens in Beirut disagree with the local authorities over what the future of the city and its population should be. The local council, backed by the government, seems to give priority to the private interests of big businesses and real estate companies. Campaigners seem to rather think that the interest of the majority of the citizenry of Beirut should be rather privileged. For this reason, they are fighting against the closure of public beaches and parks.

GOING FURTHER

You can watch this great video made by some campaigners on how the Beirut seafront has changed over the decades: https://www.youtube.com/watch?v=Iwu49DxVsZk

For a general introduction to anthropology, visit the Anthropology Day’s website: https://londonanthropologyday.co.uk/

And as for Social Anthropology in Manchester: http://www.socialsciences.manchester.ac.uk/subjects/social-anthropology/

 

The Giants of the Universe

by YPU Admin on June 23, 2016, Comments. Tags: Galaxies, Physics, Research, Universe, and UoM

Introduction

My name is Monique Henson and I’m currently in the second year of my PhD in Astrophysics. I finished my A-levels in Maths, Physics and Further Maths in 2010 and went on to study Physics at the University of Manchester. After my first year, I realised that wanted to focus more on the theoretical aspects of Physics, so I switched to the Physics with Theoretical Physics course. For most of my degree, I wasn’t really sure what I wanted to do afterwards. To help me decide, I did a few different internships during my summer holidays. I tried teaching, working for an international technology firm, and finally I tried academic research.

Before that summer project, I hadn’t thought too much about doing research. If I’m honest, I didn’t realise what a researcher does on a day-to-day basis. I now know that the day-to-day work of a researcher depends a lot on what they are researching! But all researchers are united by one thing - curiosity. Doing that summer project reminded me why I wanted to study Physics in the first place, and made me realise that I wanted to pursue it further.

I started my PhD in 2014. My research involves studying the biggest objects in the Universe that are held together by gravity - galaxy clusters. These giants are made up of thousands of galaxies. Each of those galaxies is made up of hundreds of billions of stars. Some of those stars will be just like our Sun.

In Depth

Why should we study galaxy clusters?

Despite their name, galaxy clusters aren’t just made of galaxies. They also have two other key parts - hot gas and dark matter. Most of the visible mass in galaxy clusters actually exists in between the galaxies. It takes the form of gas that is so hot it emits X-rays. The galaxies around the cluster faster than bullets, and their interaction with this hot gas causes them to rapidly evolve. By studying the galaxies in galaxy clusters, we can learn more about how galaxies change over time.

Most of the mass in clusters is actually dark matter, which is the name we give the substance that makes up most of the mass in the Universe, even though we can’t see it. It doesn’t reflect, emit or absorb light, which means that we can only detect it by looking for its effect on other things. Since galaxy clusters are so massive and around 85% of their mass is in dark matter, then that means they’re great for studying dark matter.

On top of all of that, the number of galaxy clusters in the observable Universe at a given point in time tells us both about how the Universe has expanded over time and how structure forms in the Universe. This technique is called cluster counting as it involves counting the number of clusters with a particular mass within a given volume of the sky.

[The galaxy cluster MACSJ0717. The bright points in the image are galaxies, some of which are in the cluster, whilst others are behind it. The blue-purple material is hot, X-ray emitting gas. If you looked at the cluster with just your eyes then you wouldn’t see it. Instead you need an X-ray telescope, like the Chandra telescope. Credit: NASA, ESA, CXC, C. Ma, H. Ebeling and E. Barrett (University of Hawaii/IfA), et al. and STScI]

What am I trying to find out?

To use cluster counting you have to be able to measure the masses of galaxy clusters really well. It’s quite hard to figure out the mass of something just by looking at it, but there are a couple of different methods that we use. One of these is called gravitational lensing. When light passes by a massive object, such as a galaxy cluster, it can get bent around the object through gravity. When we look at clusters we see that galaxies behind the cluster can look smeared or distorted. This distortion effect is dependent on the mass of the cluster, and by measuring it we can figure out the cluster’s mass.

It’s widely thought that this technique is very accurate for measuring cluster masses. I’m testing this by using this technique on a set of model clusters ran by Dr David Barnes at the University of Manchester.

Going Further

To learn more about galaxy clusters, have a look at the website for the Chandra X-ray telescope. They have some great images of clusters and a blog with regular updates.

One Minute Astronomer has a great article on gravitational lensing here. Gravitational lensing isn’t just used to find out cluster masses; other researchers use it to find planets and to study distant supernovae.

If you’d like to stay updated with my research and outreach activities, follow me on Twitter: @monique_henson

 

Only a Matter of Time: Research into Circadian Rrhythms

by YPU Admin on June 9, 2016, Comments. Tags: Body Clocks, circadian rhythms, Research, Sleep, and UoM

Introduction


My name is Harriet Van Den Tooren and I’m studying a Masters of Research in Medical Sciences. I started studying medicine in the University of Manchester in 2011 and decided to take a year out to complete a Masters degree in 2015, which was after my fourth year of medicine.

My Masters degree focuses on understanding the changes in bodily functions that occur during the daily cycle, called circadian rhythms, and how they affect the health of the lungs.

In Depth

How does your body know what time it is?

A few things help our bodies to know what time it is, but the most important one is light. Light passes into our eyes, and is converted to an electrical message sent to the brain through the optic nerve. Most of it goes to the back of the brain, which makes sense of the light messages and allows us to understand what our eyes see. Some of it goes to a small part of the middle of the brain called the suprachiasmatic nucleus, which sends messages to the rest of the body using hormones or electrical messages through nerves, which are different depending on whether it is day or night. In most cells of the body, there is a clockwork mechanism that is adjusted by these messages from the suprachiasmatic nucleus, so the whole body is in synchrony. Jet lag occurs because it takes a few days to change re-synchronise the clockwork in all the cells of the body after changing time zones (1).

How does that affect your lungs?

Some diseases are worse at different times of day, such as asthma, which is usually worse during the night. Cells of the lungs and the immune system have the clockwork mechanism too, which help to regulate inflammation of the airways. Usually, cells of the immune system work differently during the day because people are most likely to encounter an infection when they are active, and they reserve energy during the night. It is thought that disruption to the clockwork of cells in the lung and immune system may be a cause of the chronic inflammation seen in asthma. Therefore, understanding how inflammation affects the cellular clockwork, and how the clockwork affects inflammation may help us understand why asthma happens and how we can treat it (1).

One of the hormone signals that synchronises cells clockwork is a steroid humans produce in their body called cortisol, a hormone that also regulates the immune system. There is more of this hormone in the blood during the early hours of the morning and less during the late evening. Doctors treat conditions caused by long-term inflammation, such as asthma, with steroids to reduce inflammation by preventing the immune cells from producing chemicals that cause the inflammation. Research has shown that using steroid treatment during the evening to avoid natural levels falling too low, is more affective that taking it in the morning for asthma. Other medications have been shown to work better when taken at one particular time in the day compared to another time of day (1).

What have I learnt about research in labs this year?

Before I begun this year in September, I was used to learning information from books, memorizing it, and then sitting an exam. Research is completely different to that. Trying to discover new information is a lot harder than learning from books, but it’s also a lot more exciting. I haven’t done much research yet because the first six months has focused on learning lab skills (see my picture of cells when I was learning to stain them) and how to read a scientific paper, but I’ve just started in the labs and I’m definitely looking forward to the next six months! One of the biggest things I’ve learnt is that science is about persistence, you may attempt it many times before you finally get the result you wanted. This applies to experiments but also when applying for funding, jobs and publications. However, if you stick at it and get lucky, you may discover something that makes thousands of lives better.

Going Further

Understanding circadian rhythms can be tough work, but this is a website that has made it easier to understand:

http://thebrain.mcgill.ca/flash/d/d_11/d_11_m/d_11_m_hor/d_11_m_hor.html

Use the buttons on the top left “level of explanation” to start with beginner, and the buttons on the top right “level of organization” to see how circadian rhythms affect molecules, cells and how we think and feel.

If you’re thinking about becoming a doctor, I’d recommend looking at this:

http://www.bma.org.uk/developing-your-career/medical-student/how-to-become-a-doctor. It’s a website that provides information about the qualities needed to be a doctor, what it is like being a medical student and doctor, and how to apply to medicine.

If you’re thinking about becoming a doctor, a great place to start learning about how the body works is here - http://kidshealth.org/kid/index.jsp?tracking=K_Home. Choose your level on the top right “kids” or “teens”

If you like science and you just want to read more, a great place to start is - http://www.bbc.co.uk/science

Similarly - https://publications.nigms.nih.gov/order/pubs_gateway.html has easily understandable news about science, and tips on how to become a scientist.

Papers I read whilst writing this blog:

1.  Durrington HJ, Farrow SN, Loudon AS, Ray DW. The circadian clock and asthma. Thorax. 2014;69(1):90-2.


 

The Muddy Waters of Medical Humanitarianism

by YPU Admin on May 26, 2016, Comments. Tags: Humanitarianism, medicine, postgraduate, Research, and UoM

Introduction

My name is Ciaran Clarke and I am studying a masters in Humanitarianism and Conflict Response (HCR). My background is far removed from the history, international relations, and sociology which forms a large part of my degree. In fact, despite studying a postgraduate degree, I am still an undergraduate! I am studying the Masters between my fourth and fifth year of undergraduate medicine.

This is known as intercalation and is traditionally pursued by medics who want to study one aspect of science in greater detail, such as physiology or pharmacology. Manchester Medical School is particularly unique in the breadth of options available for intercalation. However, the HCR Master’s degree stood out for me. I have always wanted to undertake medical humanitarian work, but the multitude of issues surrounding this field have always left me feeling uneasy. I felt that the HCR Masters would give me an opportunity to grapple with these issues and develop a better understanding of how medical aid can be delivered effectively.

In Depth

The Masters programme has been incredibly rewarding, particularly for someone coming from a science degree. The complexity of humanitarian aid has been unveiled to me, going to a depth of understanding which I never imagined reaching. This has included asking myself questions which have never before crossed my mind, such as – is providing aid always good? A year ago I would have likely said yes, but through studying disciplines such as history, ethics and public health I have come to realise that no straightforward answer exists. For instance, there are instances of aid being used to extend conflicts, when it has fallen into the ‘wrong’ hands and been sold on a black market and provided funds for armed forces.

One of the great things about the Masters is the wealth of experience I have been surrounded with. It is difficult not be inspired when you turn up on a Tuesday morning and your lecturer starts telling you about his recent United Nations meeting or her trips to war torn parts of northern Sri Lanka to provide medical assistance. As a postgraduate taught (PGT) degree, for two thirds of the year my days are a mix of lectures, seminars and private study. After handing in my essays in May, I will then have the remainder of my degree free for my dissertation.

My dissertation gives me the opportunity to study one aspect of humanitarianism in real depth. My current focus is on the development of sustainable healthcare systems following humanitarian crises. Medical aid has often been directed towards specific diseases such as HIV/AIDS, Polio, Malaria or Tuberculosis, this is known as a vertical approach. While this can tackle specific diseases, when the money dries up it is unlikely that a robust healthcare system will remain. But many of the countries that have require medical aid have limited infrastructure and trained personnel for developing an all-encompassing or ‘horizontal’ approach. The question remains, how do we approach healthcare development in a sustainable manner without spreading resources so thin that they don’t have any effect? It seems that a compromise between the two needs to be reached!

The greatest challenge for me has been learning to adapt to a completely novel set of disciplines. Getting my head around and then critiquing theories of learning, international relations and in depth history articles has been a very different challenge to memorising the signs of liver failure!

Going forward, I still hope to undertake medical aid work in the future, but the Masters has made me realise that I must wait until I am a relatively independent practitioner. Therefore, I will continue on my medical training, hopefully pass my finals and then start as a junior doctor in 2017!

Going Further

For those of you who want to find out more about the incredible staff at HCRI then click this link

Medicins Sans Frontieres (Doctors Without Borders) website http://www.msf.org.uk/

An overview on the current state of the ‘humanitarian system’ http://www.alnap.org/what-we-do/effectiveness/sohs

The full range of intercalation options open to medical students at UoM http://www.mms.manchester.ac.uk/study/why-study-medicine-manchester/intercalation/

For an insight into some of the problems with aid watch the film “The Trouble with Aid” (2012)