When faced with the challenge of finding work experience it can hard to know which way to look. There is no website to tell you where to go, who will take you or if you will enjoy it, but for me I lucked out.
TwinsUK is an organisation which does invaluable research, and I am so grateful to have been able to witness and grow an understanding for everything they do here. I have had the opportunity to explore many different departments and see the whole research process from preparing their pre-packs to shadowing a twin visit and then on to the labs to see the data storage and analysis. Being with the Department of Twin Research has allowed me to learn and grow in the knowledge that a career in science is what I want. It has been an amazing opportunity which I am so thankful to have had.
Monday was my day in the lab and it was the part of the week I was most excited for, and I was not disappointed – the team were welcoming and insightful into what lab life was like as well as courses and different approaches to get into different areas of science.
On Tuesday I spent a day in the clinic. I had never considered having a job in a clinic based environment but being able to see the different stages of testing and meeting the wonderful twins, has opened my eyes to a different angle of research which is sociable, exciting and practical.
During the rest of the week I also had the opportunity to chat and learn about different roles and be able to find out just how many people are involved with the studies that go on.
All throughout my week, everyone I met was friendly and was truly interested in the job they do, creating a warm, homely environment within the department and making my brief time at TwinsUK so enjoyable. It has been a fantastic week, filled with amazing experiences and an opportunity I would recommend to anyone thinking about going into the field.
TwinsUK is one of many population cohorts that form the National Core Studies Longitudinal Health and Well-being. The aim of the National Core Studies Longitudinal Health and Well-being programme is to understand the health, social and economic impacts of the COVID-19 pandemic by analysing established population cohorts, as well as national electronic health records to guide implementation of, and changes, to government policies.
One study looked at how mental health of the UK population has evolved across the COVID-19 pandemic. The study looked at how mental health changed since before the pandemic, how experiences of mental health varied under different lockdown measures, and how the pandemic impacted already existing mental health inequalities. To address these questions, a coordinated analysis of data was carried out from 11 longitudinal population-based studies, including data from TwinsUK’s regular COVID-19 questionnaires sent to twins (known as our COPE study). The team assessed the prevalence of poor mental health using measures of psychological distress within each cohort at 4 time periods: pre-pandemic (first lockdown Spring 2020); easing of lockdown (summer 2020) and then during a subsequent of lockdown at the end of 2020 and start of 2021.
The info-graphics below show the key results:
A nation in distress: There was a sustained increase in mental distress in the UK during the COVID-19 pandemic, according to results from 11 longitudinal studies.
The pandemic did not affect everyone equally: Age, sex, and education levels affected people’s experiences of the pandemic.
Age: Middle-aged people (35-44) and older people (65 and over) saw the highest increase in their distress levels.
We were delighted to join the I ♥ Research Academy to mentor students from local schools who were interested in science. We delivered 6 workshops with the students to teach them about how to communicate science with non-scientists. In their last workshop, the students were asked to write up a news story on one of our research articles. Below is a news story written by one of our students, Laarayb.
Research has found a link between bacteria and hypertension, or, in other words, high blood pressure. By targeting gut bacteria, researchers can find evidence that high blood pressure can be prevented and lead to solutions to make it less prevalent.
This remarkable research finding can help explain what makes high blood pressure more dangerous and risk-worthy, which can help treat the most complex of cases, including heart disease.
Why should we care about this? High blood pressure can lead to extreme cases of damaged arteries and is an enormous factor in causing kidney and heart disease. It is also known that high blood pressure can cause arteries to be less elastic, reducing the amount of oxygen intake.
Therefore, researchers conducted a study that can help us see how the amount of gut bacteria can affect levels of high blood pressure. As high blood pressure is quite common, this study is particularly important to help us understand how we can reduce the risks of disease.
Researchers studied blood pressure and the measurements of gut bacteria of over 800 female TwinsUK participants, discovering that there were fewer types of gut bacteria in women living with high blood pressure. There were also lower levels of Ruminiclostridium 6, a type of bacteria, and more levels of Erysipelotrichacea, another type of bacteria, in women with high blood pressure.
Due to this, the Ruminiclostridium 6 bacteria was further researched, and our innovative scientists learnt that the bacteria plays a significant role in 84 chemical processes, including ones that are linked to blood pressure.
The researchers supported the study by stating that it will ‘be a novel means to prevent or treat hypertension’ if the gut bacteria are further researched and targeted.
Further work should be done on participants from different ethnic groups and male participants as the majority were white, female twins, so the outcome of the study may not apply to other groups. Furthermore, more work should be done on the Ruminiclostridium 6 bacteria to find out more about its role linked to blood pressure.
We were delighted to join the I ♥ Research Academy to mentor students from local schools who were interested in science. We delivered 6 workshops with the students to teach them about how to communicate science with non-scientists. In their last workshop, the students were asked to write up a news story on one of our research articles. Below is a news story written by one of our students, Kira.
TwinsUK has found that consuming larger amounts of vegetables, which are high in fibre and vitamins, is linked to a lower risk of having slow, long-term inflammation that lasts for painful prolonged periods.
Those who suffer from joint issues, or have even been diagnosed with arthritis, can benefit from this research study, and could potentially have a significant impact on them because they will be more informed about the effects of not eating vegetables. There is no doubt that what you eat may also be contributing to your physical well-being. This is something everyone should consider if they want to live a healthier and happier life.
Chronic inflammation occurs when your body continues sending inflammatory cells for a prolonged period after a disease or injury. This has increased lately due to the COVID-19 outbreak and therefore more people are at risk of heart disease. If this were to happen, you would gain massive amounts of white blood cells, suffer severe infections, and, develop heart disease.
Recent research conducted by TwinsUK also considered age, gender, and BMI (Body Mass Index) when analysing 700 participants who took part in the PREDICT nutrition study found that consuming less vegetables correlates with higher white blood cell levels. The researchers did not find any correlation between fruit consumption and white blood cells; however, fruits are also healthy and a key component of your diet.
As a result of carrying out this study, researchers demonstrated that the consumption of vegetables has a greater positive impact than people may be aware of. Finally, identifying the specific nutrients and dietary patterns that influence gut bacteria and immune cells will provide us with solutions to help reduce inflammatory processes associated with diseases such as cancer, infections, and chronic heart disease.
In October 2020, the National Core Studies commenced as part of the UK’s response to the COVID-19 pandemic. The National Core Studies are using health data to rapidly inform policy to help us get through the pandemic.
TwinsUK is closely involved in the Longitudinal Health and Wellbeing National Core Study, which aims to understand the health, social and economic impacts of the pandemic. We are one of many UK longitudinal population cohorts taking part in the project.
This large, multi-institution team is working together to answer key questions across several different areas. Current priority research questions include: how was healthcare disrupted by the pandemic; did government schemes such as furlough help; how was mental health impacted by the pandemic; how well do vaccines work; and what are the short and long-term consequences of infection on health.
The team has prioritised questions that harness the unique aspects of cohorts like TwinsUK, such as extensive pre-pandemic data. By working together and triangulating analysis in longitudinal health cohorts and electronic health records, we can provide robust evidence to inform policy.
Findings are regularly reported to the government’s Scientific Advisory Group for Emergencies (SAGE) and the Cabinet and have influenced NICE guidelines, which dictate how to treat medical conditions.
Results and impact so far
Every day we are learning more about COVID-19 and its impact, thanks to our TwinsUK members taking part in studies and questionnaires and our researchers rapidly analysing all the data coming in. Below are some key examples to date that TwinsUK was involved in:
Society and Health: The coronavirus job retention scheme was associated with the preservation of health behaviours (eating, drinking, smoking, sleeping habits) similar to those remaining in employment, and more favourable to those who become unemployed. Also, while mental and social wellbeing declined in those furloughed, the effects were far less than those who lost their jobs. This suggests that social protection policies should be implemented in the post-pandemic recovery period and during future economic crises.
Healthcare Disruption: The pandemic led to unequal healthcare disruptions. Females, ethnic minorities, and disadvantaged people were most affected. Action is needed to prevent the widening of existing health inequalities, and efforts to ensure continuity of care during pandemic-related disruptions may need to be more clearly targeted to those who most need that care.
Mental Health: People with prior mental ill-health were hit harder by pandemic disruption. Inequality between those with and without mental health problems should be considered when provisioning current and post-pandemic health, economic, and well-being support. Also, a substantial deterioration in mental health seen during the first lockdown did not reverse when lockdown was lifted, suggesting that lockdown alone was not responsible for the decline in mental health. There is a need for investment in mental health support to address all underlying causes.
Long COVID: We found that long COVID is associated with women, middle age, and pre-existing health factors, including asthma. Understanding why different groups of people have different levels of risk could both identify high-risk groups and help us understand how best to prevent and treat long COVID.
What are we working on now?
We are currently working with collaborators at University College London (UCL) to carry out a detailed study of how COVID-19 affects the body. This will help us understand long Covid, which is when infected individuals continue to experience symptoms for many weeks and even months after infection.
This study will recruit people with a range of COVID-19 experiences, and participants will be invited to UCL’s clinic in London for a full day of checks and health tests, including an MRI scan. TwinsUK is the first cohort to recruit participants to CONVALESCENCE, which aims to recruit 800 participants in total. We have recruited more than 150 twins to take part, mainly in twin pairs.
A big thank you
We would like to take this opportunity to thank our twins for everything they have contributed to this vital research, both by taking part in sample collection and questionnaires during the pandemic, but also for all of the data they have previously provided to TwinsUK, which is essential to understand how the pandemic has affected health.
TwinsUK’s Dr. Claire Steves is a senior researcher working across the National Core Study and CONVALESCENCE. Dr. Steves explained:
“There is a wealth of data in the UK’s population cohort studies and linked health records. The pandemic has shown the importance of using these unique resources to answer key questions about public health and inform policy as quickly as possible.”
“I would like to thank each and every one of our twins for the vital role they are playing in defeating COVID-19.”
If you would like more information on our COVID-19 research, please click HERE.
We are looking for new members of our TwinsUK Volunteer Advisory Panel (VAP) and eVAP, to replace our outgoing panel.
The VAP meet twice a year, either in person or by video call, and the eVAP provide input by email only.
To apply to be a member, please complete the short online application below by Monday 7th March 2022 (extended from 14th February 2022).
What are the VAP and eVAP?
The VAP and eVAP provide feedback on new research protocols, pilot our questionnaires, review newsletters and participant information materials, discuss ethical issues, and provide advice on a variety of topics.
We set up the VAP and eVAP in 2009 to ensure that we take the opinions and views of our volunteers on board during the development and running of research programmes at TwinsUK.
Membership lasts for three years.
The panel consists of:
12 VAP members who meet twice a year, either in person at St Thomas’ Hospital, London, or over video call. We also email VAP members approximately 4-6 times a year for their views.
12 eVAP members who are consulted by email only (approximately 4-6 times a year).
How do I apply?
There are no qualifications needed and everyone can apply, although only one twin in a pair can be on the panel at any one time – so please discuss with your twin before you volunteer! We also ask that you do not apply if you have previously been a VAP or eVAP member.
Both panels will be selected to represent the diversity of TwinsUK in terms of zygosity, age and gender of the twins.
If you would like to apply to become a member of the VAP or the eVAP, please click on the link below to complete the short form by Monday 14th February 2022. We will email you the outcome of your application by within a month of the closing date.
Apply to join today
To apply, click on the link below and fill out the short form:
If you have any questions, please do get in touch with the Chair of the VAP, Paz García, on paz.garcia@kcl.ac.uk.
Feedback from 2018-2021 VAP members
“I’ll really miss being part of VAP. Throughout my time in lockdown, it really gave me a sense of purpose and a feeling that I was part of a team making a valuable contribution in the fight against Covid. The VAP enabled me to contribute some diverse and commercial risk management skills in a very different environment. Our VAP formed a great team where everyone was listened to and their views were respected.”
“I was wary that the level of scientific explanations might be beyond me at times but I always felt that things were pitched in an appropriate way for us…. so don’t let people be put off by this.”
“I am very grateful to you all at the DTR for making my three years as part of the panel such an enjoyable and worthwhile experience. It has been especially good to have been able to contribute to your vital work during the pandemic which was such a pressured time for you all. Thank you so much.”
Night falls across the creeping Thames, glass glitters under the clouded sky, a sliver of the moon breaks through, and stirring autumnal wind crosses the glimmering edifice of St Thomas’ Hospital. Approaching winter seems to hang in the air as shadows lengthen in the evening light. These shadows climb the walls of the hospital.
Some windows are lit, some are not. If ghosts walk the halls, Agnes Elizabeth Jones nods to Florence Nightingale, and William Cheselden wonders how much mercury Isaac Newton ingested.
In the Twin Research clinic, samples of all kinds have been collected. This includes around 300,000 aliquots of blood, stored as serum and plasma. From finger-prick bloods to phlebotomy blood draws, a prowling vampire would be fascinated. Blood and guts are the source from which discoveries spring.
Through corridors, through laboratories under fluorescent light, the penumbral night seeps. Every catalogue of Halloween costumes tends to include nurse’s scrubs – hospitals can be spooky, can be cinematic. So can twins—the unheimlich, or the uncanny, plays on the material of life. I’m reminded of Michael in Caryl Churchill’s play ‘A Number’ pointing out: ‘We’ve got thirty percent the same [DNA] as a lettuce. Does that cheer you up at all? What I love about the lettuce. It makes me feel I belong.’
The trees along the river quiver down below. Curtains flutter in the breeze, woodsmoke drifts from distant bonfires. Beyond the clinic windows, clouds swirl in the sky like a witch’s cauldron.
From the clinic and labs of TwinsUK: Happy Halloween!
Nearly 2.4 percent of babies are now born as twins, the highest of any point in history. In the UK this means that, on average, there is now at least one pair of twins per year group at school.
In some places this rate is much higher. For the past several years, the number of twins starting school in Inverclyde, Scotland, has been in the double digits, leading to the nickname ‘Twinverclyde’. There are now over two hundred twins attending the first seven years of school, and there are no signs of slowing down — this year thirty twins, or fifteen pairs, are starting school for the first time in Inverclyde. It is unknown why this area continues to have such a high density of twins, year after year.
Twins entering school or returning to
school face one of two scenarios: they are in class together or in different
classes. Sometimes they may even be enrolled in different schools.
Schools have different policies around twins going into the same classes. I remember in school rarely seeing both twins of a pair in class, and often I would only see them together at lunch or after school. Many times we would not realise classmates were twins until we saw them together.
If my classmates were identical twins, there would be tall tales of switching classes and estimating how long it would take teachers to notice. I recall three separate occasions of people assuming twins in different classes were one person and confusion when they did not recall events that had happened to their co-twin.
Some schools push strongly for twins to be separated from each other, while other schools are small and only have one class per year so there is no option for twins to be separated.
A 2018 study from Goldsmiths, University of London found ‘almost no sizeable positive or negative average effect of classroom separation’. This study indicates that schools’ push for twins to be separated is not backed by evidence of any benefit, but seems to be a net neutral.
Research suggests that 80% of schools in the UK give parents the choice of whether to keep twins together while 20% do not consult with parents and have strict policies. Individual family circumstances differ however, and schools maintaining one blanket policy may be less helpful than families making their own decisions.
In some cases, it may be better for twins to be kept together, especially if they have spent much of their lives in close contact with each other and it would be distressing for them to be separated. In other instances, it may be better for a pair of twins in school to be separated to avoid interpersonal conflict or encourage making connections with others.
Starting the school year is a unique experience for twins due to their relationship and bond with each other. Whether it brings out competitiveness or requires navigating new group dynamics, it brings new challenges and new experiences.
During the first UK lockdown in March 2020, two nurses and four research practitioners planned their days with military precision. They were under immense time pressure, for if they did not return in time, they would lose their window of opportunity. They had to receive special dispensation to drive across the country. With difficulty, they had managed to obtain PPE from a handful of suppliers and the NHS.
Their mission? Groundbreaking research on COVID-19, detectability, antibodies and immune response with six hundred twins.
New rules of engagement
TwinsUK, operating from the Department of Twin Research at King’s College London, was short-staffed during the first lockdown because some clinic team staff members were deployed elsewhere in St Thomas’ Hospital where they were needed more urgently.
“How would we do it? Would the twins be comfortable with us visiting them in their own environment?” asked Clinical Operations Manager Alyce Sheedy, of the daunting task.
It was both a mathematical puzzle and a tactical operation. Between the first blood draw and returning to the lab, there were only six hours before the samples would lose viability.
In an 85-mile radius from St Thomas’ Hospital, from Southampton to Suffolk to Northampton to Kent Downs, the team were seeing an average of 26 twins each day. They accomplished this by hiring three cars and travelling in pairs. The team went to the most distant household of the day first and then continued to homes closer to the hospital.
Each pair of practitioners averaged eight home visits per day, driving throughout London and the south of England every day. In six weeks they reached over 500 twins for the first antibody study.
The twins they visited were either asymptomatic or had previously reported symptoms and had completed their isolation period. The team did nose and throat swabs to test for COVID infection. The initial antibody study took blood for antibody and T-cell testing, stool to see if the virus was detectable in stool and long-term viral shedders, and they took urine and saliva samples. Twins who tested positive for antibodies were visited again 6-8 weeks later, as was their co-twin.
250 of the initial 512 were visited again, and 52 twins were seen for T-cell blood tests, some which were repeat visits, and others who were being visited for the first time. 32 of the T-cell group were seen yet another time, and in April of 2021, 150 of the original 512 were seen again.
Alyce Sheedy draws a blood sample from a TwinsUK member during a home visit
Working from home
Before the lockdown the twins participating in TwinsUK’s longitudinal cohort study had been coming in to St Thomas’ for medical examination and collection of samples, so the twins and practitioners were used to seeing each other in that context, but the home visits were different.
“Being used to seeing twins in clinic environment, it was nice to see them in their own environment – it added another dimension to everything,” Alyce Sheedy observed.
The twins were welcoming, excited to be a part of the research and to join in the collective effort of investigating and battling COVID 19. They offered snacks and drinks and bathroom usage, which was especially important during the first lockdown when businesses were closed, and toilets were far and few between. The nurses and research practitioners were able to answer questions the twins had and ‘reassure and alleviate fears, which was a good feeling’, Alyce Sheedy recalled.
For some twins, the nurses and research practitioners were the only physical contact from outside that they had during lockdown, so it allowed for some company in person.
Sheedy described a moment on a return visit in August of 2020 when a twin was having a cul-de-sac neighbourhood party, and as the visiting team left, kitted out in PPE, applause erupted across the neighbourhood.
“It really showed that the twins were really appreciative of all the work we were doing on the COVID frontline.”
The global improvement to tap water quality worldwide has been a public health success, with access to clean water for drinking, food preparation and cleaning being essential for health.
It’s understood that where there are contamination events – for
example, pollutants entering water bodies that feed into tap water treatment
works – drinking water can affect human health. How badly this might affect an
individual might in part be due to their microbiome.
Microbiome and health
Whilst diet is frequently researched, drinking water, and its ability to alter gut bacteria, has been surprisingly overlooked. So that’s what we set out to do.
We asked 90 of our amazing twins who have lived in the same house since they donated their microbiome samples to supply a much easier to acquire sample – tap water! We then looked for any associations between the tap water and the microbiota.
Because drinking water in the UK is extremely regulated, we were not looking to see if there was a health effect of the water. Unless there are very old pipes, it is not only safe to drink but indeed essential to drink tap water regularly.
What we found instead was that molecules that are commonly found in water (for example, minerals that are dissolved in the water), but differ from tap to tap and region to region, did associate with microbiome composition.
This was a small, preliminary study, and further work and experiments are needed to confirm our findings, but it does suggest that tap water could influence the microbiome.
This means that where there is a contamination event, one of the ways it might harm us is via the microbiome, and that in areas where this happens frequently, treatments targeted at the microbiome it might be one way of lessening its impact.
Thank you to our twins
We’d really like to thank the twins who participated in this project, who were extremely patient, engaged and a joy to speak to for the questionnaire part of the data collection. Every project is a constant reminder that all of the research we do would be impossible without our dedicated volunteers!
