How zebrafish could help unlock new approaches to treating human stress

In the thick of job hunting and her postdoc, Professor Soojin Ryu’s sleepless nights provided her first personal insight into the impact of stress on the brain and behaviour. The revelation would shape a research career that is transforming understanding of stress.

“One day it struck me – when I’m stressed I don’t sleep. I got to thinking about the impact of that on the body and on a person’s life, and the consequences are huge. If you’re stressed and not sleeping you can start behaving like an unpleasant human being – agitated and short-tempered, and ultimately you can become really sick. As a modern society, we’ve decided to ramp up our stress hormone to the point that it’s life-threatening. I find that fascinating.”

Now, Soojin has joined the University of Exeter as Mireille Gillings Professor of Neurobiology, heading up a group that studies zebrafish to examine how acute and chronic stress change behaviour and its longer term consequences on the body and brain.

In her early career, in Berkley, Soojin worked in cells, but found the research ultimately unsatisfying. “I spent a number of years working on cell culture, but then I’d ask myself – ‘ is that what’s really happening in the body’?”

She wanted to work in small vertebrate, in which changes in response to hormonal fluctuations occur quickly. She chose zebrafish as the best option, pioneering a new animal model to study stress by discovering important aspects of how they respond to stress.

“Of course, zebrafish are really very different from humans, but it’s important to recognise which aspects are similar,” Soojin said. “I realised that the evolutionarily ancient brain stress response is similar in both humans and zebrafish.”

At the Max Planck Institute in Germany, Soojin started her own research, creating a genetically-modified zebrafish in which scientists are able to manipulate stress hormone levels at will. Published in Nature Communications, the work helped address some of the difficulties researchers had encountered in studying stress. In her last post at the University of Mainz, Soojin was part of a network applying basic stress research to human resilience.

“Some level of stress hormone is beneficial, but once it hits a certain level, it becomes detrimental to the body and brain,” explained Soojin. “Stress can be life-saving. Our stress hormone levels rise shortly before we awake and it helps ensure our systems are ready to respond. The stress hormone is fundamental to animal survival. We need the right level of stress for the appropriate situation and our bodies need to be able to regulate that to be healthy. We know that depressed people have different patterns of stress hormone where that regulation can falter.

“For the first time, our zebrafish model allows us to precisely control both the stress hormone level and the duration which is necessary to understand different effects of stress. That’s why it’s so exciting for the future of stress research.”

One important aspect of securing the Gillings Fellowship was a commitment to promoting women in science, an issue close to the heart of philanthropist Mireille Gillings. Soojin has mentored a number of female scientists and has organised workshops and meetings for women in neuroscience, to discuss the issues they identified as important. Her interest also stems from a personal passion driven by her need to balance work with parenting her eight-year-old daughter Leia. “As a mother, I am deeply committed to helping women combine scientific career with family,” she said.

“I’m delighted to join Exeter. Having seen how successful our model is, I’m passionate about collaborating with people who are working on human health to form a translational network to ensure it benefits people as swiftly as possible. Exeter has a strong focus on mental health and has amazing growth potential. I’m looking forward to working with my new colleagues to explore new treatment targets.”

Mireille Gillings Fellow will innovate to improve lives of frail older people

Over her career, Professor Sallie Lamb has developed a huge respect for the older people she works with on her ground-breaking rehabilitation programmes.

Professor Lamb, Mireille Gillings Professor of Health Innovation, has recently joined Exeter, having worked with a wide range of patients over the years, and has a specialism in frailty.

“I really admire how tenacious so many older people are,” said Sallie, who joins Exeter from Oxford University. “They’re the most vulnerable, yet they’re the ones who try the hardest and complain the least. I think it’s because they already know what losing their mobility feels like. They want to do everything they can to prevent that further and to get better, and they’re willing to fight for it.”

Sallie’s Fellowship at Exeter will help her develop more tools for older people to combat frailty. She has already had huge success in other areas, developing a programme for the common and often debilitating issue of lower back pain that was acknowledged as one of the most successful innovations in the NHS. The programme uses a cognitive behavioural approach to promote appropriate physical activity, which can effectively reduce symptoms over the long term.

“If you’re in a lot of pain, you feel like you can’t move and that you should lie still in bed – but that creates a vicious cycle of making the symptoms worse. With back pain, you really need to move to relive the symptoms. Our programme teaches people how to pace themselves and what type of activities to select, plus what to do if you get a setback.”

As a marker of the success of the programme, thousands of health professionals have so far undertaken a free online learning course, known as a MOOC, to upskill in the programme.

At Exeter, Sallie’s research will focus on frailty, an area where the College of Medicine and Health has existing expertise including Professors Louise Allen and Vicki Goodwin. “It’s a really exciting opportunity,” said Sallie. “There’s a huge opportunity to drive forward innovation and improve the health and wellbeing of older people – and particularly to improve mobility, which is key to a healthy and active life.

“The funding from the Gillings Foundation is really going to accelerate the development of a strong research programme to complement the existing research going on at Exeter. It’s a huge boost and will really accelerate getting this research to a point where it benefits people in need.”

Sallie is known for her rigorous approach to research, previously leading the Oxford Clinical Trials Research Unit, and will contribute to expanding capacity and expertise in clinical trials and medical statistics in the South West. .

A key aspect of the Fellowship appointments is a commitment to promoting women, a passion shared by entrepreneur Mireille Gillings. Sallie said she found herself in a role model position by leading by example, and as mother to 7-year-old Emelia, she is passionate about promoting work-life balance while enabling career progression.

“I’m also really committed to promoting a culture of teamwork between academic and professional services staff,” said Sallie. “People in professional services roles are absolutely critical and it’s important that’s recognised and valued.

“I’m really excited to join so many excellent scholars at Exeter, at such a dynamic time of growth and development.”

New Fellowship will tackle overlap between cancer and diabetes

Around 415 million people worldwide have diabetes, while 100 million people have cancer. They are unequivocally two of today’s greatest global health challenges. In bringing her world-leading knowledge of cancer to Exeter’s renowned diabetes research team, Professor Chrissie Thirlwell aims to benefit people with both conditions.

The newly-appointed Mireille Gillings Professor of Cancer Genomics will investigate the increased risk of some cancers in type 2 diabetes and obesity.

“If you have type 2 diabetes, you have a 20 – 30 per cent increased risk of developing certain cancers including bowel, liver and pancreatic cancer. The potential mechanisms underlying this increased risk are complex and incorporate lifestyle, dietary and other known risk factors such as obesity. The first step will be to determine any specific mechanisms associated with type 2 diabetes or obesity individually.

“The Mireille Gillings Fellowship has given me the infrastructure and opportunity to bring together my experience of cancer genomics and the wealth of world class research in diabetes and obesity at Exeter. It will accelerate our understanding of the increased cancer risk through utilising genomic data that has already been generated while producing new epigenetic data which will inform us about the impact of lifestyle on cancer risk.”

Chrissie’s expertise neatly crosses over with several research strengths at Exeter’s College of Medicine and Health and the wider university. She has natural synergy with Professors Sian Ellard and Andrew Hattersley in genomics, including a shared involvement with Sian in the 100,000 Genomes Project. Chrissie will join the Genomic Medical Centre team bringing her cancer genomics experience at a pivotal time when the 100,000 genomes project is being completed and DNA sequencing is becoming a routine part of patient care through the delivery of the next 5 million genomes.

The research funded by the Mireille Gillings Fellowship dovetails with several other groups in the RILD allowing new and exciting collaborations including with Professor Tim Frayling in large-scale genome-wide association studies looking for patterns in genes, and Professors Jon Mill and Katie Lunnon in epigenetics, or the study of how genes are activated, and Prof Lorna Harries in how genes are transcribed. Like Professor Noel Morgan, she is also already looking at clusters of cells known as islets in the pancreas, and how they contribute to the development of pancreatic neuroendocrine tumours.

Chrissie plans to apply these burgeoning collaborations to her new research and her body of work studying neuroendocrine tumours – rare tumours that can grow in different body organs. The international collaborations she has established to aid understanding and improve treatment have made her a global authority.

A large aspect of the Gillings Fellowship, supported by entrepreneur Mireille Gillings, is a commitment to promoting women in leadership roles. Through her involvement in UCL Cancer Institute’s Athena SWAN team, where they secured a coveted silver award to recognise commitment to equality, Chrissie realised the extent of a problem that had been invisible to her. “I was at a stage in my career when I wasn’t even aware that so few senior roles were held by women. I naively thought a lot of it was down to personal choice around work-life balance and families. Through working with industry during the UCL Cancer Institute Athena SWAN process, I learned that there were many incredibly capable women who really wanted those opportunities – they just weren’t getting them. I was struck how the statistics are alarmingly similar across the public and private sectors in that only 20% of senior leadership roles are held by women.

“It has to be about the right person with the right skills to do the job, there’s so much evidence that having diversity across all areas in leadership roles and on executive boards, leads to a far more productive workforce.”

Now, the medical oncologist plans to continue her clinical work alongside her research, joining the Royal Devon & Exeter NHS Foundation Trust. She has bold ambitions for the region. “I’m really keen to link with other trusts and create a European Centre of Excellence for the management of neuroendocrine tumours in the South West. We have the expertise across the region and it would mean a huge benefit to patients.

“It always blows people away when I mention the statistic that one in two people born after 1960 will be diagnosed with cancer at some point in their lives. Yet I’ve seen through my working life that prognosis and treatments are continuously improving. We’re moving towards a time where cancer becomes a chronic disease that people live with, rather than die from. There have been recent improvements in early diagnosis, and Exeter’s research has contributed to that through Professor Willie Hamilton’s team, however there’s still more work to be done .
“We’ve also seen major advances in treatment, particularly through immunotherapy, which harnesses the patient’s own immune system to fight cancer cells. Being part of those advances make my job extremely rewarding. When a patient is referred to an oncologist, you generally look after them for life. You get to know them and their families really well, and these days, there’s so much more we can do to improve their prognosis and enable them to live as normal life as possible during and after treatment.”

Chrissie arrives at Exeter at an exciting time. The diabetes research team recently secured a major £6 million award as part of the Government’s modern industrial strategy. The award recognises excellence with capacity to grow, and aims to enable the research to reach the next level, through academic recruitment and investment in infrastructure and facilities.
A keen open water swimmer who swam the English Channel while completing her PhD, Chrissie is looking forward to exploring all that the South West can offer. “The lifestyle is the icing on the cake for me in moving to Exeter,” she said. “It’s such an amazing time to come here. I‘m passionate about education and the expanding Medical Sciences and Medicine programmes present some really exciting opportunities, alongside the many research opportunities. I’ve had an incredible welcome so far and I’m really looking forward to getting stuck in and making a difference.”

University of Exeter, University of Sanctuary Award Presentation, 20 November 2019

Welcome everyone, I’m Janice Kay, of the University of Exeter. It’s wonderful to see so many of you for this award ceremony. It is a moment of celebration, and one that has a very deep and important meaning. On behalf of the senior management team and our whole university community, we are absolutely delighted to have achieved University of Sanctuary status. This award is a clear marker of our commitment, our progress and our success in creating a welcoming and supportive environment for refugees and asylum seekers.

I quote directly from the Universities of Sanctuary organisation: Universities, as key institutions within our society, have a responsibility to support people from all walks of life to reach their potential. The notion of sanctuary fits with the values and strategic plans of most universities; it contributes towards progress in inclusivity, diversity, and sustainability. It means taking a practical, public step towards inclusion, and countering discourses of xenophobia and racism both within and outside university life.

The idea of Universities of Sanctuary has grown from the Cities of Sanctuary scheme. Exeter has had an active and engaged City of Sanctuary group since 2014 with a thriving network of supporters. I am extremely proud that our students and staff instrumental in setting up the City of Sanctuary group. Not only that, they have gone on take action here at the university to enable us to become a University of Sanctuary, a university that welcomes refugees into our community and actively supports them.

This award recognises the efforts of many members of our community. I would particularly like to  recognise the work of last year’s Guild and specifically the former Students’ Guild President Grace Frain and previous Vice-President for Welfare and Diversity Rose Ahier. They championed and drove forward our activities to become a University of Sanctuary. It is wonderful to see Grace here today. Working alongside them has been our Sanctuary Scholars, our academic lead Dr Nick Gill and our Head of Student Immigration Services Jim Price, as well as many others.  Our ongoing thanks go to all of our local partners who work with the university to provide advice, guidance and support to our scholars. I would especially like to thank Refugee Support Devon and our local City of Sanctuary group.

This is a moment for celebration but I want to reflect for a moment on how important it is that we provide a safe and welcoming university community for refugees and asylum seekers. Refugees come to our country to seek safety from fear and persecution, be it for reasons of race, religion, nationality, membership of a particular social group or political opinion. Latest government figures indicate that there have been over 32,000 applications for asylum in the last 12 months. These numbers include people for whom a higher education in their country of birth may have been an unattainable goal. For some, exploring and fulfilling their potential through academic exploration would never have been an option. Universities in our country can help. Higher education has a longstanding tradition of providing sanctuary to academics and students. We are proud to be able to continue this tradition. The University of Sanctuary status shows we are doing this, and our commitment to going further. Equal Access to Higher Education is of course a universal right under Article 26 of the Declaration of Human Rights.

We have very many initiatives at Exeter to support refugees either directly through education and training or indirectly through our research which contributes to the evidence base and body of knowledge about forced migration and frail and failed states. Our academics and students have set up language exchange programmes, they conduct outreach activities using drama as a medium of engagement and have set up new information resources. Dr Nick Gill will share more about these later.

One of our most fundamental initiatives is the Sanctuary Scholarship programme which started in 2017. The scholarships enable the cost of tuition to be waived and provide support for living costs. We have now supported nine studentships and we are fortunate to have one of our Sanctuary Scholars with us today.

One of our Sanctuary Scholars has taken part in a video project called Lost in the Noise, which has been pioneered by Harry Bishop, a former student and Vice President for Community and Welfare at our Cornwall campus and who is now a member of staff in Cornwall. This project has sought to profile individuals and students whose voices may otherwise indeed have become ‘lost in the noise’. It is vital that we hear these stories and that we start to understand the experiences of others. This is a powerful route to becoming a more diverse, compassionate, progressive and culturally competent community. Thank you to the scholar for sharing their experiences so candidly in this film and to Harry for your project which has enabled this to happen. This film extremely impactful and brings to life the importance of universities as a place of sanctuary.

So once again, thank you for joining us to mark our award as a University of Sanctuary. It is an important milestone for us as an institution and one from which we will continue to build.

The enemy of my enemy is my friend

The year is 2050, the stench of plague fills the air and 10 million people are dying from cuts and grazes due to an enemy that cannot be seen. You would be forgiven for believing that we had entered a dystopian, parallel future, but alas not. This is the current future of mankind if we do not address the ever-growing threat: antibiotic resistance.

Whether we want to face it or not, our antibiotics are failing. Drugs that we have relied upon to so effectively treat bacterial infections are no longer working due to these crafty bugs becoming resistant to them. Over time, bacteria have evolved to survive antibiotics, with this “survival of the fittest” process resulting in populations of menacing “superbugs”. No matter how many different antibiotics we throw at these resistant microbes, some can no longer be killed and so what were once minor infections become fatal.

So how can we fight back!?

One avenue is to discover and develop new antibiotics. However, this has proven to be extremely costly and difficult, so alternative options are being explored. Mankind’s possible saviour: bacteriophages.

Bacteriophages, or simply phages, are viruses that infect and kill bacteria. Just as humans get viruses like flu, bacteria suffer from their own invaders which hijack the bacterial cell and turn it into a virus making factory, before killing them. With their large bulbous head and spindly legs (think War of the Worlds alien invader fighting ships), they are perfectly adapted for attaching to bacteria. Phages are the optimal killing machines. Currently, phages are not widely used to treat infections in the Western world as not enough is known about them. If we want to be able to harness the power of these microscopic bacteria killers, then we need to know more about how they work.

Most research studying bacteria and phages use methods that involve growing billions of cells in a test tube, and looking at how fast the population grows and dies on average. But this is not always the most informative. Imagine you want to know how fast humans run 100m. Someone tells you the average time is 15 seconds. Although all humans, not everyone would take 15 seconds. Clearly if Usain Bolt ran the race he would be much quicker, and the man who decided to hop all the way much slower! This also applies to bacteria. Even though they should all be identical, individual bacteria can behave very differently.

My work lets us identify the Usain Bolts and the Hop-Alongs of the bacteria world, as well as many others in between. I want to know which responses occur when we expose bacteria to phages and how this may affect the killing ability of these viruses.

Erin Attrill, Living Systems Institute

I use technology called ‘microfluidics’ that allows me to isolate and experiment on individual bacteria. With ‘micro’ meaning small, and ‘fluidics’ relating to the movement of liquids, I perform experiments on bacteria with equipment no larger than a postage stamp. Using networks of thousands of tiny channels, I can trap single bacteria in their own tiny chamber under a microscope and watch what happens when I add phages. Over the course of a day, I can continually monitor and photograph the same cells and record whether they are growing, dividing and even the exact point at which they lyse – that is, when they burst open releasing hundreds more phages.

I have observed that although all identical, some bacteria die instantly, but others grow much faster and divide multiple times before finally lysing hours later. Perhaps most importantly, some bacteria in the experiments are not killed by the phages at all. These bacteria survive the exposure and fill their chambers with more bacteria offspring. What makes these cells special and able to survive is unclear, and one aim of my work is to use microfluidics to try and understand why.

It is important to understand these differences to be able to optimise how many phages would be needed to eradicate the bacteria in a human as a potential treatment. If most bacteria are killed with two hours of phage treatment, a person may begin to look healthy, but if the “Usain Bolt” variants survive, then they could cause the infection to return. A longer dose or a higher concentration of phages may be required to eradicate the entire population so we need to fully understand how the different cells behave.

There is no need to be afraid of the word ‘virus’ – the good news is that phages cannot infect human cells. These minuscule invaders are the enemy of bacteria and so we should harness their power to defeat our bacterial foes. As stated, the enemy of my enemy is my friend. So let’s welcome in the age of the phage.

Erin Attrill, Living Systems Institute, University of Exeter

This article was the runner up in Max Perutz Science Writing Competition 2019.
Read all the shortlisted articles here https://mrc.ukri.org/documents/pdf/max-p-shortlist-articles-2019/

Digital Transformation: how corporate culture responds to the internet

Prepaid business card provider, Soldo, spoke with Prof. Mark Thompson as part of a series, speaking to today’s most influential digital disruptors. Prof. Mark Thompson is Professor in Digital Economy at Exeter Business School, and Strategy Director at the Methods Group.  He is a leading contributor to Digital Leaders, the Digital transformation business intelligence network with over 110,000 subscribers in the UK. Mark was co-author of the 2014 book “Digitizing Government” and the “2018 Manifesto for Better Public Services”. He also serves on the board of TechUK. Previous roles include National Audit Office Digital Advisory Panel, Cabinet Office Data Steering Group and acting as senior adviser to the Cabinet Office on ICT Futures.

Professor Mark Thompson

Professor Mark Thompson, Professor in Digital Economy at The University of Exeter Business School

We hear a lot about digital transformation – what does it mean to you?

Everybody bangs on about digital transformation, but it’s often hugely misleading because these discussions are usually technology led. To me, Digital Leaders’ version of digital transformation comes down to one thing: the arrival of mature services that have been developed around the shared infrastructure of the internet.

This infrastructure element cannot be overstated. Imagine, for example, that we had electricity and understood how to make washing machines and TVs, but we had no National Grid. On every street, it would be completely rational to build our own washing machines and TVs, because there’s no market – people would be using different voltages, current and plugs. Indeed, the birth of electricity was very much like this.  It’s nobody’s fault – the absence of a common infrastructure means everyone’s on their own.

Add the National Grid, and suddenly it’s irrational to build your own appliances – someone else can profitably make devices because they’ll work for millions of people. So the game-changer is the shared infrastructure.

Four decades after the internet’s invention, we finally have online technologies that can meaningfully interact with each other and be joined up and used at scale. Digital transformation is nothing to do with websites or front ends (although they’re important of course); it’s about the shared plumbing.

But that is technology led, yet you said at the outset that a purely tech discussion is misleading…

Very true. What is transformational is what these new technologies mean for businesses and the way they operate – which is both exciting and hugely challenging.

To see why, instead of focusing on innovation, let’s look at what it means to be an incumbent, a legacy business.

A legacy business is any organisation – and the challenges are absolutely organisational –  which grew up in the last century with processes, infrastructure, services, an operating model and, most importantly, a value proposition, defined before the prevalence of the internet. They lived successfully through the online services revolution which created new opportunities to get closer to their customers, without challenging their fundamental value propositions.

Today, however, incumbents face Big Tech like Amazon on the one hand, and startups like regtech, fintech, proptech etc. on the other. Any legacy business in 2019 is surrounded on all sides by challengers to their traditional value proposition.

For example, I was speaking with a pharmaceuticals executive recently who advocated “sticking to the knitting”: he said “We make drugs, and the minute we take our eye of that, we’re dead in the water”. But we now live in a health data economy which focuses on keeping people well rather than curing them when they are ill. Businesses like Amazon are outspending pharma in the healthcare sector exponentially.

So digital transformation is actually the belated response of legacy organisations, in particular, to the arrival of the shared plumbing of the internet. It’s a dawning realisation in modern boardrooms that capitalising on new technology demands a wholesale review of business models and core value propositions based on what you can achieve with digital technology and services; and that the new wave of emerging technologies – AI, virtual reality etc. – will only accelerate the need to throw off the shackles of old practices.

How can boards do that?

Well, above all, don’t do everything yourself. In the old days, billions were spent on in-house development of services, especially back-office functions. That is simply no longer of any value, indeed it’s hugely costly.

Every business is different, but as a matter of general advice:

  • Reconfigure everything you do around the customer – learn from their activity and take datapoints from every interaction to feed back into responsive service design. A good acronym for this is “SMAC”: Social Media, Mobile, Analytics and the C
  • Use digital platforms for the heavy lifting of service delivery. There’s plenty of competition between all the major players – Salesforce, AWS, Microsoft etc. to handle the infrastructure of corporate service delivery.
  • And finally, but most importantly, it will require a dramatic transformation of culture.

Why is culture such a problem?

Because we all find comfort in the status quo, and modern digital businesses demand that we focus exclusively on outcomes and rip apart the comfortable architectures that prevent us achieving those outcomes. Plenty of core and back-office functions will be either removed completely or consumed as-a-service in the pursuit of leanness, efficiency and agility.

Take Transferwise, an upstart in the money transfer business but now a world-leading ‘unicorn’. It’s user-friendly and beautifully designed, it’s disruptively cheap, and yet underneath the hood, they didn’t build it. Much of the key functionality is a white-label version of a different company’s business, Currency Cloud. They have built a $1BN business without reinventing the wheel and minimising their infrastructure investment.

This applies to legacy businesses too, but they are weighed down by a century of baggage – that they themselves have built. Five years ago, boardrooms fought that realisation; they embraced a certain digital mindset of sorts – open standards, agile development, the Eric Ries doctrine of failing fast etc.; but I think there is now a readiness in some quarters to think the unthinkable in big corporates about the radical changes required to core value propositions and organisational structure.

Now, I say “in some quarters” because there’s also plenty standing in the way of larger legacy businesses. I like to look at the incentives which drive behaviours, and unfortunately many holders of the CXO roles ultimately empowered to upend their organisations to undergo this extremely painful transition are only a couple of years away from the golf course. They are often grotesquely disincentivised at an organisational level from driving change, so there’s a lot of kicking the can down the road.

Furthermore, there’s a marked lack of education for non-technical senior people about these issues. We’re awash with training in technology, and it’s full of buzzwords.  But there’s no safe space for senior executives to join up the buzzwords and assemble them meaningfully in order to consider the effect of digital on their industries, behaviours, cultures, value propositions and service architectures. They can pay exorbitant fees for the major consultancies to develop a strategy, but the consultancies themselves are often incentivised to produce outsource arrangements that don’t necessarily represent the best interests of the company – whose leaders can often shrug off responsibility for understanding it all themselves to ‘the experts’, rather than getting properly to grips with it and owning the change themselves.

What can executives do, then? Because they’re being pushed tactical product by tech firms, endorsed by the analysts, the Gartners and IDCs – and nobody is talking corporate strategy?

Exactly. But we can group the current crop of technologies into some useful groups which senior executives can think about.

  • We’ve already mentioned SMAC, a focus on the front-end, data-driven approach to continuous customer-centric service redesign. It seems to me that at the highest level, you can look at that cluster of social, mobile analytics and Cloud and ask fundamental, often very challenging questions about how a business can reconfigure itself around its customers.
  • Then there are technologies around the back office, for example we talk about Robotic Process Automation (RPA), which is for attacking process-heavy administration. Increasingly, the genie’s out of the bottle because cloud-based services and infrastructure are commoditised and cheap, and creating tools to shorten back-office functions or eliminate repetitive ones is becoming as simple as bolting Lego bricks together: if companies don’t keep up, their own people will start doing it for them – bypassing governance and risk management structures.
  • There’s a third, less sexy consideration. Many large enterprises have grown by acquisition. They find themselves with multiple CRMs or ERPs, a vast hinterland of slow and old-moving technologies. It’s less glamorous, but there’s a huge piece of work in identifying common capabilities and service patterns across large organisations and then executing on the heavy consolidation that needs to happen in order to remain competitive. Without re-architecting into the cloud, you won’t get the interoperability and scalability that makes all this worth while.

That feels like three good clusters of activity, but again they’re all pretty useless unless, as a board, you’ve got some handle on your value proposition; which is going to change because you’re not going to do everything yourself.

One last example to help explain: the Hollywood Studio of the 1930s. It’s a fantastic example of a fully vertically-integrated organisation: the movie mogul owned everybody from the scriptwriters to musicians to set designers, actors and even movie theatres. Move to today’s HBO-type model and you have a sea of niche providers, all sustained by digital infrastructure. Creatives, production teams, aggregators, portals and marketers all operate separately and optimally, focused on a core value proposition and depending on a network of other operators to monetise their own particular service.

It required upheaval to move from the 1930s to today, but the magnitude and velocity of change – and associated transformational challenges – facing today’s incumbents is unprecedented.

 

This article first appeared on Soldo, a solution providing multi-user business expense cards that empowers employees by automating their expenses. You can read more interviews from Soldo’s digital disruptor series here.

Gender equality : « See it to be it » – Professor Janice Kay, Provost

How many women head up the UK’s leading companies? Our research has found that of 350 CEOs, it was just 12, equal to the number of male CEOs called David. And Andrew. And John.

Our expert Professor Ruth Sealy analysed the names of the FTSE 350 CEOs. Of this powerful group, 18 were called David, 13 were named Andrew and 12 called John. Just 12 were women, representing only 3.4 per cent of the group. Are you surprised?

Professor Janice Kay

Professor Janice Kay, Provost

Today (March 8) is International Women’s Day  –a valuable opportunity to celebrate the achievements of women, and to call for gender balance in society. Some people think this job is done, but while we have made strides in equality, this example shows there’s still a long way to go.

Last year’s gender pay gap report exposed the grim realities of a national picture in which men are consistently paid more than women, and hold more of the most senior roles. In fact, more than three quarters of 10,000 companies paid men more than women. Just one in three have women among their highest paid earners. Males are paid higher bonuses than females, and earn more than women overall – in every single sector.

Universities are no exception. Undergraduate students are roughly 50/50 male and female, so this should be reflected all the way up the scale. Yet only 15 per cent of senior leaders are women. At the University of Exeter, we acknowledge this problem and we’re on the right track. .We’re really proud of our national Advance HE Athena SWAN silver award – awarded to only 17 universities in the UK to recognise this commitment.

To be clear, men and women who do the same work at Exeter are paid the same salary. The issue around our gender pay gap is career progression. We’re establishing a range of schemes to ensure women aren’t disadvantaged by taking maternity breaks or caring responsibilities – that they’re supported and their expertise is recognised when they return to work, or through flexible working schemes. As women, we all have a role to play in this, whatever our age and stage.  This might be through tangible support such as mentoring. We have to make sure that women have the right opportunities at the right time to progress, and that strong female talent is visibly nurtured. As Billie Jean King said, you’ve got to see it to be it.

At the University, we’ve taken a good look at how our academic career progression works.  The proportion of female Professors has increased from 17 per cent in 2012 to 27 per cent today. The percentage of women on the University’s Executive Group has risen to 29 per cent. It’s not enough, but we’re working on it. The importance of having a balanced senior leadership team is vital in decision-making and signalling our values.

I’m proud of our work to support women’s careers. Female staff were the main beneficiaries of our decision to introduce the Living Wage in 2014. Our policy on maternity and paternity leave and family-friendly benefits is best in sector. We allow new parents to take six months of leave at full pay, followed by a further 13 weeks of leave at statutory pay. The policies are available for employees as soon as they start and parents can choose to share their leave entitlement. Our new menopause policy resulted from consulting female staff members.

We want to do what we can to develop real cultural change that is embedded in the values of our organisation, that avoids tokenism, and in which people of all genders are committed to gender equality. Our policies are supported by outstanding research. Internationally respected work on the phenomenon of the ‘glass cliff’ for female leaders has taken place in Exeter by Professor Michelle Ryan and her colleagues.

Just last month, leading Medical research journal The Lancet published a special edition dedicated to advancing gender equity in science, medicine and global health. Their editorial highlights the fact that systems must change – not just to support women, but to avoid disproportionately privileging men. Executive editor Dr Jocalyn Clark summarised: “Gender equity is not only a matter of justice and rights, it is crucial for producing the best research and providing the best care to patients. If the fields of science, medicine, and global health are to hope to work towards improving human lives, they must be representative of the societies they serve.”

In the Westcountry, we’re working to inspire, inform and prepare young people to take the best decisions about their future. More than two thirds of the 900 year 9-13s from disadvantaged and under-represented groups who took part in our University of Exeter Scholars programme last year were female.

This article first appeared in the Western Morning News.

Wetsuits from wetsuits | update

A Knowledge Transfer Programme between Finisterre and the University of Exeter’s Centre for Alternative Materials and Remanufacturing are investigating remanufacturing and circular economy initiatives which address the problem of discarded wetsuits.

Full-time Wetsuit Recycler Jenny Banks gives us an update about what the programme has been up to.

This blog first appeared on Finisterre’s THE BROADCAST.

We’re now three months into the Wetsuits From Wetsuits Programme and have learnt an incredible amount about the potential recyclability of our own Nieuwland winter wetsuit. Our committed wetsuit tester community have been a huge help in providing us with some of our Original Tester suits back from 2014, allowing us to compare the performance of old suits that have had real-lives, with that of a new suit.

THE HURDLES

It actually wasn’t as easy as we thought it might be to get our original tester wetsuits back as nearly all of them are still going strong – which is of course fantastic news! Most wetsuits last around two years before they’re replaced so we’re really happy that our Nieuwland suit is still delivering!

WHERE YOU’LL FIND ME

Splitting my time between Exeter and Finisterre HQ provides me with the perfect balance of influences. Over the last two months in Exeter, I haven’t left the lab. From microscopic surface imaging to tensile (elasticity) and thermal testing, we’re building a vital understanding of how and where the Nieuwland wetsuit changes during its life.

When I’m at Finisterre, all that testing is put into context. Being at the Wheal Kitty workshops – by the sea and amongst the team – reminds me of the real needs of cold-water surfers and ensures that I’m not tackling this challenge inside a bubble. Everyone here is really engaged with the programme and the energy within the team keeps me going if I ever feel over-whelmed by the challenge that lies in front of us.

OUR UNDERSTANDINGS SO FAR

De-constructing the Nieuwland was our first step towards understanding what difficulties we may face when making the world’s first fully recyclable wetsuit.

WETSUITS ARE VERY COMPLEX: ONE SINGLE NIEUWLAND WETSUIT IS MADE UP OF FIVE DIFFERENT TYPES OF NEOPRENE FOAM FOR STRETCH, FIVE DIFFERENT THICKNESSES OF NEOPRENE FOR WARMTH AND FIVE DIFFERENT COMBINATIONS OF FABRICS FOR DURABILITY AND COMFORT.

That complexity potentially poses a challenge for us in terms of wetsuit recycling but it’s not a question of just simplifying the suit – why would we change a wetsuit that we know performs so well?

Thus far, we’ve had some surprising results in the lab. Under the microscope, we can see the difference between our original tester suits and our new suit very clearly. Three years of frigid waters and regular surfing causes the neoprene’s cells to start to buckle (see first image). This change in our neoprene’s cell structure, however, is having next to no effect on the flexibility of our suit, which we really didn’t expect. We will be continuing our testing to verify this but this finding is promising and means we may be able to recycle our neoprene rubber without needing expensive and energy-consuming re-processing techniques.

Now we’re working on finding out whether that same cell structure change is affecting the Nieuwland’s thermal properties.

WE’RE COMMITTED

We want to deliver the world’s first recyclable wetsuit for testing in Autumn this year. Progress is good and we’re now moving into the design phase of the programme. Right now, no idea is a bad idea. We’re being very open-minded and exploring ideas that are far-out as well as those that involve simple, minor tweaks to our current Nieuwland suit.  Watch this space! #wetsuitsfromwetsuits

The behaviour of fat and the impact on how easily obese people can lose weight

Dr Katarina Kos leads the adipose tissue biology group at the University of Exeter and researches obesity-related disorders.

Obesity is one of society’s most pressing concerns. Suggestions for diets and weight-loss regimes are on everyone’s news feed.

The role of psychology and human behaviour is recognised as a key factor for success, but little appreciation is given to the behaviour of fat itself.

This is something that my research at the University of Exeter has begun to address. Studies have found that the way fat behaves can have an impact on how easily obese people can lose weight.

In my role as a clinician working with people who are struggling to lose weight, I know how hard losing those extra pounds can be.

That is why I hope my research into the behaviour of fat will with time offer solutions to help make this easier.  In the first stage of a longer research project, we have identified the type of damage done to fat tissue when overworked and are now studying in more detail which molecules are involved.  Next we plan to explore which drugs might help people to reverse the damage.

The most recent study, Lysyl oxidase and adipose tissue dysfunction looked at a molecule which is impaired when fat is struggling and overloaded with excess calories.

Like human beings, overworked fat ‘complains’ and becomes distressed and struggles to do its job. As fat cells begin to struggle for oxygen and suffocate under the burden of storing more and more energy, the fat becomes inflamed and as a result scarred.

The research by the Exeter Adipose Tissue biology group that I lead examined the molecule LOX in fat tissue which causes this scarring. The paper, drew a good deal of media interest both in the UK and around the world.

Scarred fat tissue is fibrous and rigid and less able to store excess energy. To compensate, the body can drive this energy to other parts of the body including the muscle (see below) and vital organs, such as the liver and heart, which it can cause serious health complications.

Bacon

Above, a picture of bacon where we find fat in the muscle described as mottling.

The study showed that fat scarring may not resolve itself with weight loss. In fact, there is evidence that the more the fat tissue is scarred, the more difficult it can be to lose weight in the longer term.

But this does not mean that people who are obese should lose hope. Not all obese people have scarred fat and even those with scarred fat can shift excess pounds.

In my clinical work, I talk to obese people all the time have tried for years to shift those extra pounds, and, based on my experience, I can offer the following advice.

  • Almost everyone can lose weight. Most heavier people succeed in losing some weight, but many put it on again, some very quickly. Our previous research has shown that women with weight problems have managed to drop dress sizes on many occasions and that Yo-yo dieting, and weight regain after weight loss is very common.Research suggests that it may be more difficult for obese people with more scarring of their fat to be as successful with weight loss as those with less scarring. With established scarring and exposure to excess energy, these calories are increasingly stored in unhealthy places, including on the tummy and within vital organs. This can predispose people to health problems including diabetes, fatty liver, high blood pressure and heart disease. However, even people with scarring can lose weight, though not necessarily quite as much and most would not expect and want to become a size 0.
  • A person does not need to be clinically obese to have scarred fat tissue. We do not yet understand why some people are more prone to fat tissue scarring than others. Some may have a genetic predisposition similar to the increased risk of diabetes.  We find fat scarring in people with a more extreme but rare condition called lipodystrophy where people have very thin arms, buttocks and legs and a disproportionally large tummy. It could also be that certain foods make us more prone to fat scarring regardless of the amount of energy they contain.  We are embarking on further research to learn more about this.
  • Help your fat tissue by using muscle to cope with excess calories.  Even just a short walk after a meal helps. Any type of calorie, whether from a diet of surplus fat, sugar or protein can be stored as energy in fat tissue once the body has met its energy need. But with a growing amount of fat tissue, it struggles to take up blood sugar into the fat cells and requires more and more insulin to do so. This is known as insulin resistance which can progress to pre- diabetes.  Once the pancreas fails to supply sufficient amounts of insulin and the pancreas is overworked, this can progresses to diabetes Type 2. We are studying when best to use activity breaks in sedentary people to help unburden the fat tissue.  Preliminary research by my team now being pursued has found that a short walk after a meal can have a beneficial effect on lowering blood sugar.
  • Why eating the same amount of calories will not mean you will be of the same weight. Some people seem to eat a lot but never gain weight, while others appear to eat like birds and struggle.  Whether the calories are in excess depends among other things on our metabolism, our age and whether we are fidgety, sedentary or active. There are also big differences in energy needs between men and women. Generally, women require far fewer calories day to day.
  • A lot of the ‘Obesity damage’ can be reversed through weight loss.  Many obesity-related health problems are reversible, especially if their onset is of more recent duration. Studies have shown that even modest weight loss (5% of total body weight) can reduce blood pressure, cholesterol, blood sugar and with it also the risk of heart disease.  Fat tissue recovers from inflammation and fatty liver disease can also resolve. Recent studies show also that diabetes can improve or vanish with weight loss. The same type of operations used for weight loss surgery can also be very effective in managing Type 2 diabetes and are thus also called ‘metabolic surgery’.

So what should you do to keep fat happy and allow it not to be overworked?

My tips, based on my experience working with patients with weight problems, are:

  • For those who struggle with their weight, do not despair. Weight loss is possible.  Even for those whose fat tissue is scarred, you may not reach a size zero, but with determination and lifestyle change you can shift those pounds, but it will take commitment. In my experience, people, with the right commitment, manage to lose 5 per cent of their body weight or a stone in six months which is a realistic target.
  • Weight loss will be more easily sustained without the use of radical calorie restrictions, but with changes to well- rehearsed habits.  You can cut your calorie intake by 400-500 calories a day by eating from smaller plates, avoiding refined sugars and junk food and start eating more slowly.  You do not need to give up snacking altogether. Trade crisps and cakes with healthy options such as chopped vegetables and yoghurts, swap ice cream for sorbet and think twice about cream.  Consider also whether you are consuming many liquid calories from alcoholic and non-alcoholic drinks, as they also count.
  • Do not cut too many of your calories at once. It is the little changes that will become a new, healthy habit.  This is not about being on a diet for a period of time, it is rather about adjusting your lifestyle for a lifetime. This will require commitment and may not always be comfortable. People who find a buddy to join the efforts are more likely to be successful.
  • If your doctor has tested you for obesity- related health complications, or you have been told you have fatty liver disease or diabetes and have a much larger waist than hip circumference, weight loss can make a great difference to your health and turning your life around will make you a healthier person.
  • For those of average weight  – you are not immune from unhealthy fat.  One possible sign of this is if your waist is wider in circumference than your hips.  You may want to follow the advice above.  Regular activity will help you to a healthier body and better fat proportions. As exercise drives oxygen to all your tissues including the brain boosting concentration and decreasing the risk of dementia.
  • For the lucky lean ones: you may have a natural protection from disordered fat, however look at your parents and their health as this is likely to predict your future risk. We tend to increase in body weight as we age.
  • For anyone: avoid big meals to absolute fullness and always consider some light activity e.g. a walk after consuming large amounts of calories.
  • Have breakfast and do not teach your body to go into starvation mode as this will make it more energy efficient which will not help your weight. Smoking will decrease tissue oxygen levels which damages fat and causes scarring. It also increases the likelihood of wrinkles! If you sit at a desk all day, try to break up periods of sedentary work with short periods of activity – whether walking to the copy machine or up some stairs – especially after you just had a meal. Even small activity changes will help your fat tissue and stop it from becoming overworked.

Socialise with activity in mind. Loneliness and boredom does make us seek comfort in food. People who find a buddy to join weight loss efforts are more likely to be successful.  Consider options where you can socialise with sporty activities from a walking group to taking on a challenge of a run with your mates.

Being kind to yourself can help weight loss too. Stress increases the risk of overeating and comfort eating and disturbs sleep and we know that a disturbed body clock affects our weight negatively. Find calorie-free happiness instead (a bath, book, music to dance to, chat with a friend, a fun past time which could be anything from knitting to sculpting, from gardening to playing golf).  Do set yourself a realistic target. Having a target or a sporty challenge in mind with a date set will keep you focused. This could be anything from a 5km walk to running a marathon, from climbing the local hill to a mountain, from swimming a length in the pool to crossing the English channel.  And for those with mobility problems sitting exercises, including yoga, may be an alternative. Many people opt for swimming as it is gentler on the joints.

Do not judge yourself on the way you look or your body weight, leanness does not bring happiness. However, people with weight problems are more frequently depressed. Seek treatment which maybe in form of talking therapies or tablets as this will help you to be stronger and to take on the effort and commitment to look after your weight.

Be forgiving to yourself as setbacks are natural, life happens and distractions occur, allow them to pass and get back on track. You can do it!

Here at Exeter we are at the forefront of research into obesity. Our research is optimistic. We are looking into whether the timing of activity can aid weight loss, which types of foods predispose us to fat tissue scarring and which drugs could help improve scarred fat tissue. We are also looking at genes which are linked to healthy and unhealthy fat.

We think obesity is something that can be tackled. But we need the best science to help people fight that unhealthy fat and keep unwanted pounds off. That way we can help tackle diseases such as diabetes, heart disease and strokes. Let’s get moving.

By Dr Katarina Kos, Senior Lecturer at the University of Exeter’s Medical School

Reflections on oceans and human health

Professor Lora Fleming is the Director of the European Centre: Chair of Oceans, Epidemiology and Human Health.

This post originally appeared on the BlueHealth website

As humans slowly wake up to their dependence on a healthy natural environment, Professor Lora Fleming reflects on a research career spanning over 30 years, and ponders where we go next.

Whilst I trained and practiced as a physician in the US, I had always held a deep connection with the natural environment. This personal passion became professional after studying for a doctorate in environmental epidemiology, and I’ve never looked back.

Epidemiology is a discipline that tries to look for the patterns and causes of disease by using large sets of data. But early on in my career, I realised that when thinking about the natural environment, this implied a one-way relationship:

What was the environment doing to us?

The answer was often spreading disease through vectors like mosquitos, poisoning our food with toxins like ciguatera, or causing deaths through extreme weather events. The impacts were always negative, and often depicted the natural environment as a source of hazards that needed to be controlled and mitigated.

I knew there had to be more to this relationship and whilst working at the University of Miami, I began to refine my focus to look at the burgeoning area of oceans and health. The complexity was clear: Here was a huge natural resource that provided food, supported industry, facilitated recreational activities, yet could also kill.

These intricately intertwined connections demanded an interdisciplinary approach, and as a result, my work in the area of oceans and health has been constantly varied and fascinating.

I have learned about ‘pico bacteria’ and ‘marine snow’ – the tiniest organisms in the ocean. I’ve worked with colleagues who use remote sensing to measure ocean temperature from orbiting satellites, and studied how organisms and chemicals in the oceans cause sickness through contaminated seafood. But perhaps most significant of all, I’ve had the opportunity to listen to people describe their love for the ocean and its importance to their cultures, livelihoods, and families.

These experiences have shaped my research, and over the last ten years I’ve been part of a growing group of scientists who are uncovering evidence that suggests interacting with the oceans, coasts, and other ‘blue’ environments can lead to important benefits in physical and mental wellbeing.

Whilst this might sound obvious to those who regularly spend time near or in the water, until recently we had very little research which systematically identified the potential health benefits of these environments – and we’re only really getting started.

Thankfully, in the light of environmental and societal pressures, policy makers across Europe are now taking the area of oceans and human health seriously. My team and I are currently leading two large pan-European research projects, BlueHealth and SOPHIE, which are helping us to understand how to maximise the wellbeing benefits of ‘blue’ spaces across different cultures and societies – while still taking into account the risks. These kinds of projects are vital if we are to convince governments to protect, create and encourage the use of these spaces.

All that I have learned over the past 30 years of researching, teaching, and listening has changed my own relationship with blue environments. I value them more, I am more aware of how fragile and complex THEIR health is, and how bad we are at looking after them.

And so I also worry.

Worry that we will only realise the value of these spaces and the negative impacts of our actions when it is too late.

But I also have hope. For many years, I have regularly visited my family’s house in Maine in the US. Located right next to a tidal river, it is constantly changing. The flow of the water, the sounds and uses of the waterways, the flora, fauna and weather vary over the seasons and years, but the beauty and peace are a constant. Although there are many fewer fish and seals now, the bald eagle has actually returned to this area during my lifetime.

This gives me hope that humans can realise and understand the importance of the natural environment before it is too late. And I hope that the work of my group can help us to live better with the natural environment locally and globally, and appreciate not only their beauty but also our total interdependence.

Professor Lora Fleming is a board certified occupational and environmental health physician and epidemiologist. She is Chair of Oceans, Epidemiology and Human Health at the University of Exeter and Director of the European Centre for Environment and Human Health. Lora is also Emerita Professor at the Miller School of Medicine and the Rosenstiel School of Marine and Atmospheric Sciences. In 2015 she was awarded the UNESCO Anton Bruun medal for outstanding work in oceans and health.