Save the date: Hippocrates Prize for Poetry and Medicine to be awarded at Harvard on 6th May 2017

In a joint launch in the UK and in the USA, the judges for the 2017 International Open and Health Professional Awards have been announced as Neal Baer, Harvard-trained American paediatrician and ER producer, Pulitzer-Prize winning poet Jorie Graham; Scottish Makar (national poet) Jackie Kay; and Professor Owen Lewis, New York, USA.  The 2017 Hippocrates Young Poets Judge will be judged by poet Maya Catherine Popa, New York City, USA (see details about the judges).

There have already been entries from 14 countries for the 2017 Hippocrates Prize for Poetry and Medicine - deadline 12mn local time on 14th February.

The Hippocrates Prize for Poetry and Medicine, has an awards fund of £5,500 (~USD 7,500). To find out more about the Hippocrates Prize and to enter online, see hippocratespoetry.wordpress.com

In the UK, clinical pharmacologist and prize co-founder Donald Singer said: “We are delighted to have such a distinguished panel of poets and health professionals as judges for the 2017 Hippocrates Prize.”

Harvard physician and poet Rafael Campo added: “ The Arts and Humanities Initiative of Harvard Medical School is very pleased to be supporting this major international prize, and to be hosting the awards ceremony, which will for the first time be presented in the USA.”

The 2017 Hippocrates Awards are being organised in partnership with the Arts and Humanities Initiative of Harvard Medical School. The Awards will announced by the judges at a ceremony at Harvard Medical School in Boston, USA, on Saturday 6th May 2017.

There will also be a pre-Symposium Poetry and Medicine Workshop at the Museum of Fine Art in Boston: Friday 5th May – 6.30pm.

Download flyer for Symposium, awards, and pre-Symposium Poetry Workshop at Boston Museum of Fine Art.

Now in its 8th year, the Hippocrates Prize has attracted over 8000 entries from around the world, from the Americas to Fiji and Finland to Australasia. All awards are for a single unpublished poem in English of up to 50 lines of verse on a medical theme.

The International Open category is open to anyone in the world to enter. There have been entries from over 60 countries since the Hippocrates Prize was launched in 2009, with winning poets from Australia, Canada, France, Germany, Israel, New Zealand, Norway, South Africa, the UK and the USA.

The International Health Professional category is open to any in the world who is a Health Professional  employees, a health student or working in a professional organisation or charity involved in education and training of health professional students and staff or in supporting the care of patients.

The international Young Poet category: anyone in the world may enter who is aged under 19 years and at least 14 years old on the date of the Awards (6th May 2017). This £500 (~690 USD) award was launched in 2012. The 2017 Hippocrates Young Poets Prize for Poetry and Medicine is supported by the healthy heart charity the Cardiovascular Research Trust.

Notes for editors
For more on the Hippocrates Prize and the 2017 judges, contact +44 7494 450 805 or email hippocrates.poetry@gmail.com

The 2017 Hippocrates Prize is supported by:
- UK philanthropist Anthony Fretwell-Downing.
- The Arts and Humanities Initiative of Harvard Medical School.
- Healthy Heart Charity the Cardiovascular Research Trust, founded in 1996, which promotes research and education  for the prevention and treatment of disorders of the heart and circulation.

More on the Judges for the 2017 Hippocrates Prize

Views of No Man's Land

Ian McKellen as Spooner (L), and Patrick Stewart as Hirst in No Man’s Land.

Photo: Johan Persson

On 15th December, a remarkable live broadcast of the National Theatre's production of Pinter's play. The close-ups showed fine acting business beyond the experience of all but the front rows at Wyndhams' Theatre - and the occasional well-disguised mishap.
Read no more if you plan to see the play and wish to form your own view.

A stark first half was followed by fine comic display by the cast of four, the play closing with a return to themes implied by the title of the play. The Guardian's Michael Billington notes that the "beauty of Pinter’s play is that it is open to many interpretations and concludes that No Man's Land is "both desolate and funny and conveys, without peddling any message, the never-ending contrast between the exuberance of memory and the imminence of extinction." His earlier view was that play may give insight into dark professional fears of Pinter: the successful but lonely Hirst (played by Sir Patrick Stewart) the mirror image of failed poet Spooner (played by shabbily dressed Sir Ian McKellan). It less clear whether there is any autobiographical - or biographical - relevance to wealthy Hirst's two manservants, played with alternating menace, humour and compassion by Damien Molony as Foster and Owen Teale as Briggs.

A further obvious reading is that Hirst's distress is exacerbated by just-preserved insight into advancing disintegration of his mind - this evolving dementia perhaps accelerated by intensive use of a well-stocked drinks cabinet. Worth contrasting Pinter's reading with the formal portrayal of dementia by Florian Zeller in "The Father".

As shown in this production, No Man's Land, particularly given the historical setting of the play (mid-1970s), could refer to many taboo or inaccessible areas, ranging from the unwanted realms of dementia, dying and death, and to sexual politics, from homosexuality to (at least for these characters) the inscrutable minds of women.

Chamber Choir perform at Worsted Weavers' concert in support of CLIC Sargent

The University of Warwick Chamber Choir performed at St James' Church on the Packington Estate in support of children and young people with cancer at the third charitable musical evening organised by the Worsted Weavers' Guild. The outstanding Chamber Choir, led by its Conductor Lucy Griffiths, performed Spiritual and Shakespeare song cycles and A Child of Our Time. The programme was enhanced by an impromptu series of solos and duets by scholarship students within the Choir. The performance was followed by a reception in the Pompeiian room at Packington Hall, with wine, soft drinks and canapes. Use of St James' Church and the Pompeiian Hall was by kind permission of Lord and Lady Aylesford.

CLIC Sargent Fundraising Manager Lydia Buckmaster said: "It's great that the Worsted Weavers supported CLIC Sargent again with this fantastic event. 

Concert organiser and Past Master of the Worsted Weavers Guild of Coventry Donald Singer said: “The Guild supported CLIC Sargent for a 3rd year because of its excellent clinical and practical work, both nationally and locally, to help the whole family deal with the impact of cancer and its treatment on children and young people.

“Our guest musicians – the University of Warwick Chamber Choir and their conductor Lucy Griffiths – provided an outstanding musical evening in the dramatic setting of St James’ Church on the Packington Estate, which was made available through the generosity of Earl and Lady Aylesford. We are very grateful to everyone who supported the charity, both by coming to the event and by donations to CLIC Sargent. We look forward to our fourth charity concert, to be held in the summer of 2017, once again in support of CLIC Sargent.”

To find out how you or your company could help support CLIC Sargent, please contact CLIC Sargent Fundraising Manager Lydia Buckmaster on 01509 673 881 or email: lydia.buckmaster@clicsargent.org.uk

St James' Church

St James’ Church is a red brick building with four domes topped by finials in neo-classical style. The church was built in 1789 to a design by architect Joseph Bonomi for the Earl of Aylesford as a private family chapel and to celebrate the return to sanity of King George III. Its design was inspired by the Baths of Diocletian in Rome. The church houses an organ built in 1749 by Thomas Parker to designs by Handel in 1749 for his librettist Charles Hennens, who was the cousin of the 4th Earl of Aylesford. There is evidence to suggest that Handel himself played the organ. The church does not belong to a parish – it is owned and maintained by the Aylesford family. The church is a Grade I listed building. 

Joseph Bonomi

The church’s architect Joseph Bonomi was born on 19th January 1739 in Rome. He was the first of five children born to Giovanni Giacomo Bonomi and his wife Teresa Corbi and was christened Giuseppe [portrait by John Francis Rigaud (see below) - Public Catalogue Foundation]. He was educated at the Collegio Romano and studied architecture with Girolamo Teodoloi, a nobleman and successful Roman Architect. Bomomi was clearly talented and impressed Robert and James Adam when they visited Rome. This resulted in an invitation for Bonomi to move to London in 1767. Joseph Bonomi worked as a draughtsman for the Adam brothers and later as an assistant to the Architect Thomas Leverton. In 1775 he married Rosa Florini a cousin of the painter Angelica Kauffman. In 1783 Angelica persuaded Bonomi to move back to Rome where she was then living but it was only a short stay and he returned to London in 1784 with his family, remaining there for the rest of his life. 

In 1784 his earliest known independent work was carried out. From this date he became a successful designer of country houses in England. In 1789 he was elected an associate of the Royal Academy with the help of his friend Joshua Reynolds, President of the Academy. He exhibited a number of perspective drawings at the Royal Academy exhibitions.He is also nationally known for the Pyramid Mausoleum at Bickling Park, Norfolk for the Earl of Buckinghamshire in 1794. In 1804 he was appointed Architect of St Peter’s Rome but this was probably an honorary post as no evidence has been found of him working there. In 1808 at the age of 69 he died in London and was buried in Marylebone Cemetery. His son Ignatius Bonomi also became a successful architect. His work in Warwickshire includes: • Design of the gallery at Packington Hall for the Earl of Aylesford in 1772. • St James Church in Packington Park for the Earl of Aylesford in 1789-92 • The redesign of Barrells Hall at Ullenhall for the Newton Family in 1792.

The Pompeiian room

The Pompeiian room, hall, music room, staircase, dining room, library and small dining room all have schemes designed by Bonomi. The music room originally housed the organ (now in the church) which was played by Handel. The Pompeian room was intended as a sculpture gallery but was remodelled by Bonomi as a setting for the Etruscan vases collected by the 4th Earl. The Roman wall paintings in the Pompeiian Room are by John Francis Rigaud, a history, portrait and decorative painter of French descent who studied painting in Florence and in Bologna. Rigaud was born in Turin, his father’s family having first fled from Lyon to Geneva after the revocation of the Edict of Nantes. Within a year of arriving to work in England, Rigaud was made a fellow of the Royal Academy and went on in London to decorate Somerset House, the Guildhall and Trinity House. His portraits included paintings of Sir Joshua Reynolds, Lord Nelson and St James’ Church architect John Bonomi. Rigaud was elected to the Royal Society in 1784.

Capability Brown

2016 is the 300th anniversary of the birth of Lancelot 'Capability' Brown, the most influential English landscape gardener in history. “He changed the face of eighteenth century England, designing country estates and mansions, moving hills and making flowing lakes and serpentine rivers …” [1]. As epitaph Horace Walpole wrote [2]: “Brown shall enjoy unsullied fame For many a Paradise he regained” Brown is associated with more than 250 landscapes across England and Wales. He often described landscapes as having “great capabilities”, hence “Capability”. By using the sunken fence or ‘ha-ha’ he gave the illusion that discrete areas of parkland, though managed quite differently, were one. The 300 acres of magnificent parkland surrounding Packington Hall were landscaped by Capability Brown in 1751, at the height of his career, when in his mid-thirties. Packington Hall is one of a group of sites in Warwickshire at which Brown advised in the mid and late 18th century. These include Charlecote Park, Compton Verney, Combe Abbey, Newnham Paddox, and Warwick Castle. Lancelot Brown [portrait (in public domain) by Nathaniel Dance (later Sir Nathaniel Dance-Holland, Bt)] was baptised on 30th Aug 1716 at Kirkharle in Northumberland. 

 He was the fifth of the six children of yeoman farmer William Brown, and Ursula who worked in the big house on the Kirkharle estate, where Brown began work as a gardener. It was while working at Stowe gardens that he first became responsible for executing architectural and landscaping works. While at Stowe, Brown also began working as an independent landscape designer, contractor and architect. In 1744, he married Bridget Wayet, with whom he went on to have 9 children. In autumn 1751, the year he worked on landscaping the Packington Estate, he was able to move with his family to Hammersmith in London. Brown offered a range of options to clients: a) for a round number of guineas, a survey and plans for buildings and landscape, leaving his client to do the work; b) a foreman to oversee the work, carried out by estate labour. c) overseeing and refining the work himself, by visits for a certain number of days each year. By 1753, he was employing four foremen and by the end of the decade he had over twenty foremen on his books. In 1764 he was appointed to the gardens of Hampton Court, Richmond and St James, allowing him to move home to live in style at Wilderness House, Hampton Court. Throughout his life, Brown suffered from asthma, the possible cause of his death in 1783. 

1. Find out more at capabilitybrown.org

2. “Capability Brown” by Dorothy Stroud. 1975, Faber and Faber. ISBN 0 571 10267 0 

CLIC Sargent – the Children’s Cancer Charity 

The children’s cancer charity CLIC Sargent is the UK’s leading cancer charity for children and young people, and their families. CLIC Sargent provides clinical, practical, financial and emotional support to help them cope with cancer and get the most out of life. Lydia Buckmaster, Fundraising Manager for CLIC Sargent for Herefordshire, Northamptonshire, Warwickshire and Worcestershire said: “ Last year CLIC Sargent helped to support over 1100 children and young people with cancer in the Midlands. It costs CLIC Sargent around £4,000 to support each child or young person through their cancer journey. To continue to do this we must raise a significant amount of money each year and we can currently only support 2 out of 3 of these children and young people.” “Today, 10 children and young people in the UK will hear the shocking news that they have cancer. 

Treatment normally starts immediately, is often given many miles from home and can last for up to three years. Being diagnosed with cancer is a frightening experience and the emotional, practical and financial implications of treatment are intensely challenging for the whole family.” CLIC Sargent is the UK’s leading charity for children and young people with cancer. CLIC Sargent’s mission is to change what it means to be diagnosed with cancer when you’re young. We believe that children and young people with cancer have the right to the best possible treatment, care, and support, throughout their cancer journey and beyond. And they deserve the best possible chance to make the most of their lives once cancer treatment has ended. CLIC Sargent provides vital emotional, practical and financial support to young cancer patients and families during and after treatment, and we take what they tell us about the impact of cancer on their lives to service providers and policy makers to help change things for the better. 

Worsted Weavers’ Guild of Coventry 

The history of merchant guilds in Coventry goes back at least to 1267. The original roles of the guilds included providing training for their professions and ensuring the quality of what was produced. The National Archives record a Company of Worsted Weavers, Coventry, from circa 1448; and a Company and Fellowship of Worsted Weavers and Silk Weavers, City of Coventry, from 1628. In 1703 the worsted weavers of Coventry, whose trade was then improving, were separated from the silk weavers to form their own company as a member of the guilds of the city. In modern times the Worsted Weavers and other guilds of the City of Coventry continue in a charitable role. 
 

More at worstedweavers.wordpress.com

 

Adaptive pathways: new ways to assess treatments for serious unmet medical need

The European Medicines Agency hosted a stakeholder workshop on 8th December 2016 on adaptive pathways at its Canary Wharf London headquarters: a hot topic with around 150 delegates from healthcare, patient and consumer organisations, academia, industry and regulatory bodies.
The European Medicines Agency organised this workshop in collaboration with the European Commission to gather views and proposals from stakeholders on the adaptive pathways approach, in light of the practical experience gained during the pilot project EMA ran between March 2014 and August 2016, and to plan the next steps in the exploration of this concept. 

The basis for considering adaptive pathways for evaluating medicines is to meet the challenges underlying how to resolve high unmet medical need with then aim of licensing products likely to have a major impact on patient morbidity and/or life expectancy.
The desire is to find ways to reduce unavoidable uncertainties as rapidly as possible for serious/rare debilitating and life-shortening illnesses. There are clear ethical and scientific challenges in using novel approaches to evaluate medicines without a decline in the quality of evidence on the effectiveness and safety of new treatments. 

Products which might be considered for use of adaptive evaluation pathways include both conventional medicines and advanced therapy medicinal products (ATMPs). ATMPs are medicinal product which involve either a gene therapy medicinal, a somatic cell therapy or a tissue engineered product [see more on ATMPs at Directive 2001/83/EC as amended by the ATMP Regulation 1394/2007].

Adaptive pathways contribute to an expanded  toolbox for evidence generation where conventional randomized controlled trials are not-appropriate or practical. Principles include using processes to allow rapid reaction to uncertainty by iterative development based on ongoing analysis of  pathway data [“rapid cycle analysis”]. As secondary end-points are welcomed, these pathways require pre-planning across the entire product life-span, including the post-marketing paths ie active monitoring and management of on-market use.

The adaptive pathway approach is dependent on earliest stage and ongoing multi-stakeholder networking, underpinned by risk management plans. 

Critical issues include
- resolving scientific trust in real world data and the need to develop mature, robust registries
- defining and prioritising unmet medical needs
- agreement on acceptable risks and benefits early access worth it (vs.
- maintaining safety standards
- ensuring that benefits outweigh risks
- avoiding unrealistic expectations
- establishing practical criteria for reimbursement, especially when secondary outcome measures form the basis for market authorization  

Safer Big Data for safer medicines?

14-15 November, 2016: The European Medicines Agency invited experts from the European Union and the USA to discuss 5 key perspectives to speak on Big Data at a workshop in London aimed at identifying opportunities from 'Real World and other "Big Data" to improve development of new medicines and surveillance of licensed medicines for safety, risk and effectiveness.

The 5 key 'stakeholder' perspectives? Patients and the public, health professionals, academia, regulators and policy makers, industry (both health sector and software/hardware) and payers (considering a change in strategy to payment for health impact rather than sales, as exemplified by the Health Impact Fund).

A pragmatic definition from Lu and his colleagues states that "Big data analytics (BDA) applications are a new category of software applications that process large amounts of data using scalable parallel processing infrastructure to obtain hidden value." There are many potential applications from planning for public transport flows to using large health record datasets to improve patient safety such as in the US FDA-Harvard Sentinel partnership.

The FAIR principles for Big Data, Finding, Accessing, Interoperability and Reuse of Big Data, have both general and special challenges and potential benefits when applied to healthcare.

For example, in a recent issue of Nature Reviews Cardiology, Rumsfeld and colleagues from Colorado and Boston outline 8 potential applications of big data analytics to improve cardiovascular care, including "predictive modelling for risk and resource use, population management, drug and medical device safety surveillance, disease and treatment heterogeneity, precision medicine and clinical decision support, quality of care and performance measurement, and public health and research applications".

The EMA note: "Rapid developments in technology have led to the generation of vast volumes of data, which have the capability to transform the way the benefit-risk of medicinal products is assessed over their entire life cycle. However, it is recognised there are multiple challenges in the exploitation of these data.

"These range from the fundamental need to establish methods to enable the access to, integration and analysis of heterogeneous datasets to understanding the limitations in its use. Importantly, robust and transparent mechanisms to protect patient confidentiality are key to secure patient trust. It is important for the European Medicines Agency and the European Union medicines regulatory network to gather information on the latest developments in big data from the perspective of all stakeholders in order to identity how and when the multitude of data sources may contribute to medicinal product development, authorisation and post-marketing surveillance."

Some key themes:
- Patrick Ryan on which patients chose which treatments
- Sophie Louveaux discussing new EU regulation of data, meaningful consent and processing sensitive health data
- David Martin addressing challenges in Big Data analytics from FDA and PPP perspectives
- Julian Isla from the Dravet patient charity on making the patient the centre in digital health
- Baroness Helene Hayman on ethics, governance and public confidence
- Ronald Brand from the University of Leiden on informed consent v. opt out
- Nicolas Tatonetti from Columbia University, NY on data mining for medical discovery
- Nico Gaviola from Google on cloud data for safer medicines

See more on key threads and discussion points including on the European Open Science Cloud, new EU General Data Protection Regulations - from May 2018, replacing Directive 95/46, machine-learning for chemogenomics, challenges to implementing applications to precision medicines, access to the OHDSI community, social media to find new adverse drug event signals, FDA case studies using then Sentinel-HMO-Harvard collaboration,  opening access to the 28 EU independent national health care systems and more in due course when talks are made available on the EMA website for public access.

Antimicrobial resistance - a global public health threat

"Proper infection control practices and antimicrobial stewardship will be important to address this emerging threat" is the conclusion of a new publication from Sub-Saharan Africa on trends and reasons why resistance to antibiotics is becoming an increasing international problem.

The study, just published in the latest issue of the American Journal of Tropical Medicine and Hygiene, looked at data collected over a 5 year period on sensitivity of bacterial cultures to a wide range of WHO essential list as well as newer antibiotic medicines.

The data were collected in Kigali, Rwanda, at King Faisal Hospital, a major teaching and referral hospital for patients from throughout
Rwanda and from neighbouring countries.

The research team comprised international researchers from the USA (Yale AIDS Programme and the Department of Public Health, Philadelphia), the UK (Fellowship of Postgraduate Medicine, London) and SMBT Institute of Medical Science and Research Center in Nashik, India, in collaboration with clinicians from the King Faisal Hospital in Kigali, Rwanda.

"Differences in antimicrobial susceptibility between the first and fifth year of the study for each bacterial species was assessed using 2 test. Of 5,296 isolates collected, 46.7% were Escherichia coli, 18.4% were Klebsiella spp., 5.9% were Acinetobacter spp., 7.1% were Pseudomonas spp.,
11.7% were Staphylococcus aureus, and 10.3% were Enterococcus spp. Colistin and imipenem had greatest activity against gram-negative bacteria. 
Acinetobacter spp. showed the greatest resistance profile to antimicrobials tested, relative to other gram-negative bacteria. Vancomycin retained excellent activity against S. aureus and Enterococcus species (average susceptibility was 100% and 99.4%, respectively). 
Trend analysis determined that resistance to imipenem increased significantly among Klebsiella, E. coli, Pseudomonas, and Acinetobacter isolates; there was also rising resistance to colistin among E. coli and Pseudomonas species. 
Only E. coli demonstrated increased resistance to gentamicin. For gram-positive pathogens, vancomycin susceptibility increased over time for Enterococcus species, but was unchanged for S. aureus. Our data suggest that resistance to imipenem and colistin are rising among gram-negative bacteria in Rwanda."

Read the full article

Safer medicines in children and adults: video discussions from the international 2016 EACPT Focus Meeting in Opatija

From the EACPT Focus Meeting on How to Assess Medicines, Opatija, 6-9 October 2016. 

In these videos, Donald Singer discusses with speaker Suzana Mimica Matanovic evaluation of drugs in the pediatric population with an update on the impact of recent initiatives from the European Medicines Agency and discusses with Janne Backman from Helsinki how to identify and minimise risk of drug-drug interactions.

 

Discussants

- Suzana Matanovic: Assistant Professor of Clinical Pharmacology, School of Medicine, University of Osijek, Croatia and PCO alternate delegate at the European Medicines Agency

- Janne Tapio Backman: Professor in Clinical Pharmacology and Individual Medicine, University of Helsinki, Finland

- Professor Donald Singer: member of the Executive Committee of the European Association for Clinical Pharmacology and Therapeutics and EACPT delegate on the European Medicines Agency Health Professionals Working Party. 

Here is a summary of the key points from Professor Backman's  talk at the EACPT Focus Meeting in Opatija: 

Drug-drug interactions can either markedly reduce or enhance the therapeutic or adverse effects of drugs by causing alterations in the pharmacokinetics or pharmacodynamics of drugs. If such interactions are not understood or accounted for in patient care, they can have harmful, even hazardous clinical consequences. 

Drug-drug interactions have been a major cause of drug withdrawals from the market. Regulatory agencies, including the European Medicines Agency (EMA) have therefore published guidance documents that are designed for the industry to guide their DDI studies during drug development. In particular, detailed scientific recommendations can be given concerning pharmacokinetic interactions, because such interactions can be mediated via mechanistic changes in absorption, distribution, metabolism and excretion of drugs. 

Specific approaches are suggested concerning cytochrome P450 enzymes (CYPs), non-CYP enzymes and membrane transporters. In addition, current guidance also recommends use of modelling approaches, such as physiologically based pharmacokinetic (PBPK) models to design and extend the interpretation of preclinical and clinical drug-drug interaction studies. For designing clinical drug-drug interactions studies, detailed preclinical in vitro and early clinical pharmacokinetic information is necessary. 

Despite detailed guidelines, there are many challenges in characterization of the interaction potential of a drug, both as a perpetrator and as a victim of the interaction. Such challenges arise from complex interaction mechanisms, eg, simultaneous involvement of transporters and drug metabolizing enzymes, autoinhibition and autoinduction of metabolism, time-dependent inhibition and involvement of major drug metabolites. 

Understanding the challenges and pitfalls of drug-drug interaction studies is thus necessary in interpretation of the results of studies. In this lecture, basic methods of clinical drug-drug interaction studies will be reviewed, with examples of potential pitfalls and basic principles of interpretation.

The next EACPT biennial congress will be held in Prague Congress from 24th - 27th June 2017. The programme will provide an international scientific and educational forum for discussion of clinical pharmacology and therapeutics, including personalised pharmacotherapy. See more on our website. 

Anyone from anywhere in the world with a professional interest in clinical pharmacology and therapeutics can now join the EACPT as an Individual Associate member.

Membership benefits include

* Access to videos of talks from EACPT Meetings

* Discounted registration fees for EACPT meetings

* Online access to the Official EACPT Journal - Clinical Therapeutics

* Access to the EACPT’s worldwide network of Individual Associate Members

* Active involvement in EACPT 

The EACPT was founded 24 years ago and now includes as members all national organisations for clinical pharmacology in Europe, as well as organisations from further afield internationally. The EACPT aims to provide educational and scientific support for the more than 4000 individual professionals interested in clinical pharmacology and therapeutics throughout the European region, with its congresses attended by a global audience. The EACPT also advises policy makers on how the specialty can contribute to human health and wealth.

Incubation - an ancient Egyptian sleep cure for medical ills

The British Museum is hosting until 27 November an outstanding exhibition on underwater

From the Ebers papyrus: US NLM/NIH

archaeology from sunken ancient cities on the Nile Delta (the lost cities of Thonis-Heracleion and Canopus).
The exhibition highlighted trade, cultural and religious exchange among old Mediterranean civilizations and in particular interchange between ancient Greece and ancient Egypt.  Examples  were featured of a major Hellenised Egyptian deities.
A fascinating element of the exhibition was discussion of a Temple for Incubation as a way to cure ills, the granite building long submerged in soft sands, its disappearance accelerated with the sands became liquid due to seismic activity. It is intriguing to note the siting of an important temple for incubation on the Nile delta, as the name for ancient Egypt was Kemet (‘km.t’) after black earth of the Nile Delta.
The aim of sleeping the night in the temple was to allow incubi - bad dreams - to carry away toxic humours as causes of illness and so heal the sufferers - in return for generous donations.
This practice reflected widespread tradition linking dreams to temples, and the release of dreams as a way to cure disease: the ancient culture of visits to oracular shrines (oracles) where a god could be consulted through an inspired priest – the most famous perhaps the Oracle at Delphi in Western mainland Greece. A common further method to consult a god was incubation: the inquirer would sleep in the temple holy place and be rewarded with an answer in a dream. This would then be interpreted by the priest with an often ambiguous answer.
Cures might also be delivered through a dream: for example at the oracle to Amphiaraus at Oropus in Attica, the temple to the god of medicine Asclepius at Epidaurus, the oracle of Dionysus at Amphicleia, and the oracle of Trophonius in Levadhia.
Ancient Egyptian medicine is considered to date at least to the 27th century B.C.E. to the time when the Old Kingdom physician and architect Imhotep was the Vizier of Djoser. Imhotep was later deified. A key belief was that disease could be caused by an angry god or an evil spirit. However the Egyptians of the time were pragmatic in formulated effective treatments.

Sources for ancient Egyptian scientific medical practices include the Papyrus on surgical trauma bought by Edwin Smith in 1862 and dating to ~1600 B.C.E and credited to the much earlier Imhotep; and the Papyrus dating to 1500 B.C bought by Georg Ebers in 1873 at Luxor. The latter papyrus includes more than 700 remedies and spells to be used to ward off disease-causing spirits.The ancient texts also describe dreams and how to interpret them.
Priests played a key role in prescription of how to live as a way to avoid disease.  There were healing sanctuaries affiliated to temples where physician-priests could prescribe for the healthy and treat patients.
Purification included special diets, ritualized bathing and removal of all body hair. The patient could also be required to maintain a specific diet including what were considered to be unclear fish and animals. Perhaps via or influencing Hippocratic sources, diet might include involving fava beans (now recognized now as a precipitate for anaemia in people deficient in the enzyme glucose-6-phosphate dehydrogenase, a genetic disorder common in the Eastern Mediterranean and in Sub-Saharan Africa).

More on sleep and the interpretation of dreams in Ancient Egypt. 
British Museum. The dream book.

Register for Updates on Cancer and Lifestyle on 29th September in London

Medical charity the FPM is organising a one-day meeting on Updates on Cancer on 29th September at the Royal Society of Medicine, 1 Wimpole Street, London. 

Register online

Abstract submission online

Consultant Oncologist Professor Robert Thomas will discuss the evidence on benefits of lifestyle and nutrition after cancer, at a one-day meeting on Updates on Cancer on 29th September at the Royal Society of Medicine, 1 Wimpole Street, London organised by the FPM.

He said: “With 1:3 getting cancer and 3 million people living with the consequences of this disease at any one time in the UK, and the cost of care increasing, the case for developing effective, self-help initiatives has never been stronger.”

His talk “summarises the international evidence, which shows that physical activity, nutrition and other lifestyle strategies can substantially reduce the risk of relapse and minimise numerous late effects ranging from fatigue, weight gain, anxiety, hot flushes, arthralgia.”

He added that his talk will “highlight the biological processes that take place in the body after a healthy lifestyle, which can have direct and indirect anti-cancer effects. By looking only at the scientific evidence, it breaks down the myths behind which foods to avoid and which to eat more of. It discusses the risks the benefits, of mineral and vitamin supplements and highlights the potential benefits of boosting the anti-cancer polyphenols in our diet. It summarises the results of the world’s largest double blind randomised study of a polyphenol rich food supplement Pomi-T, developed and tested with the help of the UK government’s National Cancer Research Network (NCRN).”

Professor Robert Thomas is a Consultant Oncologist at Bedford and Addenbrooke’s Hospitals, a Professor of applied biology and exercise science Coventry University, a senior clinical tutor at Cambridge University. He is editor of the lifestyle and cancer website (Cancernet.co.uk) and designed the 1^st UK approved qualification in cancer rehabilitation. He wrote the evidence review for the UK’s National Cancer Survivorship Initiative, chairs the Macmillan Cancer Support Exercise advisory committee and directs an dynamic research unit, which has designed numerous studies which been published across the world. For these, and other, efforts to improve the long term wellbeing of patients he was awarded the British Oncology Association Oncologist of the Year, the Hospital Doctor Magazine UK Doctor of the Year and the Royal College, Frank Ellis Medal.

Southampton researcher Dr Lisa Loughney will discuss the benefits of exercise for people undergoing cancer treatment. 

Neoadjuvant treatment is treatment given as a first step to shrink a tumor before the main treatment e.g. surgery or radiotherapy.

In her 2016 paper on this theme she noted that neoadjuvant cancer treatment decreases physical fitness and low levels of physical fitness are associated with poor surgical outcome. She added that exercise training can stimulate skeletal muscle adaptations, such as increased mitochondrial content and improved oxygen uptake capacity that may contribute to improving physical fitness. She has therefore evaluated the evidence in support of exercise training in people with cancer undergoing the “dual hit” of neoadjuvant cancer treatment and surgery.

Dr Loughney works in the National Institute of Health Research’s Respiratory Biomedical Research Unit at the University Hospital of Southampton’s  NHS Foundation Trust.

Wendy French will discuss her Poet-in-Residency year at the UCLH MacMillan Cancer Centre.

Working with patients, sharing in their hopes and fears, tracking the everyday endeavours of a vital medical hub, Wendy French found herself drawn into lives in which blood tests, diagnosis, chemotherapy and hope become as much part of the human experience as cappuccino and Vivaldi on the radio.

Her residency resulted in publication of ‘Thinks itself a Hawk’. In the collection, one life, that of Zipora, a Jewish woman whose origins lay in the darkest days of the twentieth century, is chosen for particular attention for its power to place everyday experience in large frames, but also for the brightness with which it reminds us that everyday life is unique and important.

Wendy French was Poet in Residence at the Macmillan Centre UCLH from April 2014-2015. Her collaboration with Jane Kirwan resulted in the book Born in the NHS, published in 2013. She won the inaugural 2010 Hippocrates Poetry and Medicine prize for the NHS section in 2010 and was awarded the Hippocrates NHS second prize in 2011. She has two chapbooks and two further collections of poetry published, Splintering the Dark (2005), and surely you know this (2009). She previously worked twenty years with children and adults with mental health problems and was head of the Maudsley and Bethlem Hospital School. She has also worked with people with aphasia/dysphasia, helping them to recover their use of language through poetry.

This one day symposium will include further sessions on:

• risk factors for cancer
• evidence for effective strategies aimed at preventing cancer
• medical humanities to support patients undergoing treatment for cancer

3rd annual charity concert evening for children’s cancer charity CLIC Sargent

The distinguished University of Warwick Chamber Choir are to perform Spiritual and Shakespeare Song Cycles and A Child of our Time on Wednesday 20th July, 2016 at the Packington Estate in North Warwickshire in support of the children’s cancer charity CLIC Sargent.

Order tickets for concert and reception

Contact the organisers

This is the third in an annual series of charity musical evenings organised by the Worsted Weavers Guild of Coventry in support of this national charity, which supports children and their families in the Coventry and Warwickshire area.

The musical performance will be in the St James’ Church on the Packington Estate in
Warwickshire (~ 20 minutes north of Kenilworth).

The performance will be followed by a reception in the Pompeiian Room at Packington Hall, with wine/soft drinks and canapés. TIckets for the concert and the reception are £35 per person.

St James’ Church and Packington Hall are not normally open to the public. The neo-classical St James’ Church was inspired by the Baths of Diocletian in Rome and has an organ designed by Handel for his librettist, who was a cousin of the Earl of Aylesbury of the time, owner of the church and the Packington Estate.


Programme
Leigh arr. Woods: Don’t It Make My Brown Eyes Blue
Trad. arr. Erb: Shenandoah
Tallis: If Ye Love Me
Mantyjarvi: Shakespeare Songs
Morley: It Was A Lover And His Lass
Bennett: Weep O Mine Eyes
Passereau: Il est bel et bon
Bruckner: Locus Iste
Tippett: Spirituals from A Child of Our Time
Shearing arr. Carter: Lullaby of Birdland
Porter arr. Blackwell: Let’s Do It

Map of Packington Hall
The children’s cancer charity CLIC Sargent is the UK’s leading cancer charity for children and young people, and their families. CLIC Sargent provides clinical, practical, financial and emotional support to help them cope with cancer and get the most out of life. CLIC Sargent aims to help the whole family deal with the impact of cancer and its treatment. CLIC Sargent is active nationally, and locally in the Warwickshire and Coventry area.

St James’ Church, Packington Estate

The University of Warwick Chamber Choir performs in Warwickshire and further afield, with annual tour destinations including Spain, Germany, the Republic of Ireland, Belgium and Switzerland, as well as regular performances in London. UWCC have appeared on BBC national television in the Sainsbury’s Choir of the Year competition, live television in Greece, and on Central Television with Caliche with whom a CD of Ariel Ramirez’ Latin American Misa Criolla and Navidad Nuestra was recorded (the British première recording). UWCC’s wide ranging repertoire spans sacred, secular and folk music. The UWCC have premiered works by Howard Skempton and Michael Nyman and have commissioned new works from Joe Cutler and Jonathan Dove for 2015/16.

The choir’s conductor Lucy Griffiths is the Assistant Director of Music at the University of Warwick. She studied for her undergraduate degree in Music at the University of Bristol, where she first discovered her passion for conducting. She went on to work as a lecturer in Music at Portsmouth University before being awarded the prestigious sinfonia ViVA conducting scholarship. This allowed her to complete her masters in conducting at Birmingham Conservatoire, where she was twice awarded the Sir Michael Beech conducting prize.