Are we Working Ourselves to Death?

07 November 2017
Presented by Chris Smith, Georgia Mills.

We devote up to 50 years of our life to it, yet it might just be getting us down. This week The Naked Scientists programme examines work, hearing how our behaviour and our buildings can change to boost our health and productivity. Plus, news of how gut bacteria can control our response to cancer treatment and how a rare opportunity allowed scientists to ‘get inside’ the human mind.

In this episode

00:56 - Gut bacteria affect response to cancer therapy

Does your microbiome play a role in how well you respond to cancer treatment?

Gut bacteria affect response to cancer therapy
with Jennifer Wargo and Deepak Gopalakrishnan, University of Texas

Whether a cancer victim responds to certain treatments or not might be dictated by the bacteria they carry in their intestines,  according to a new study from researchers at the University of Texas. Jennifer Wargo and Deepak Gopalakrishnan looked at more than 100 patients with the skin cancer “melanoma”. Those that responded best to a therapy designed to make the immune system attack tumours had a very different spectrum of gut microbes compared with patients who responded less well. And the same bacteria produced similar outcomes in mice with tumours as well, as Chris Smith found out…

Jennifer - We wanted to focus on an area that there’s a growing interest in and that’s the microbiome. We know that in our bodies we have trillions of bacteria; they actually outnumber our own normal cells by up to ten to one. And it’s becoming quite apparent that these bacteria can actually influence how our body functions, not only from a digestion standpoint but they can actually influence our own immune system. So we studied a large group of patients with metastatic cancer, cancer that had spread throughout the body. In this case, metastatic melanoma which, again, is a form of skin cancer.

Chris - But Deepak, what did you actually do? How did you do the experiments?

Deepak - We started enrolling patients in our protocol about 2/2½ years ago. Before they started therapy we started to collect an oral and a gut microbiome sample from them in order to identify what bacteria are present and the diversity of the communities, as well as the component bacteria within each of the communities. We also looked at the response of these patients in order to correlate whatever microbiome characteristics we had identified with response.

Chris - Right, so you’ve got a group of patients; they’re united by having malignant melanoma, a kind of skin cancer that’s spread around their body and they’re receiving immunotherapy which encourages the immune system to hit their cancer, and you’re saying in these people who responded to this, are there any differences in the bugs they have in them compared to people who do less well?

Jennifer - That’s correct.

Chris - What did you find?

Jennifer - We didn’t see any substantial difference when we looked at the bacteria in the mouths of these patients, but we did find night and day differences in the gut microbiome of these patients - with patients who responded to the immunotherapy having higher diversity of bacteria within their gut, and also different bacteria, specifically more bacteria in something called the ruminococcus groups.

Chris - Why do you think, Deepak, that the difference in the bugs makes a difference to the response to therapy? What do you think’s going on?

Deepak - That’s a very fascinating question and we are also trying to better understand the mechanism that is driving these responses. One of the primary reasons is that the gut is a seat of high immune activity within the body, and there is plenty of scope for interaction between the microorganisms that inhabit the gut and the immune systems. There is a lot of interfacing between these two processes that takes place at the gut.

We also took our study into mice. What we did was we took germ free mice so these did not have any microbiota in their intestine and we transplanted them with a stool from either a patient who responded very well on therapy versus a patient who did not respond at all. And there we saw that mice that received the responder’s stool, they grew much smaller tumours and did much better on therapy compared to mice that received non-responder stool.

Chris - Would you speculate then that in a person with melanoma, if they have a certain spectrum of bacteria living in their intestines, these are in some way manipulating the immune system and putting it into a state that determines how well it will attack a tumour if given a chance?

Jennifer - That’s absolutely what we think. I think in our body there’s certainly the highest density of bacteria within our gut and they’re constantly interacting with the immune cells that are also in our gut and surround our gut. So it’s essentially shaping an immune response in normal healthy people as well as in patients with cancer.

Chris - Do you think that there might even be grounds, in the future, for carrying out a selective transfer of faecal bacteria into cancer victims in order to better stimulate their immune responses?

Jennifer - Absolutely. This approach is already being used for non-cancer states like clostridium difficile colitis, or infections of the colon, and also for inflammatory bowel disease where you can actually do as you say a transfusion or a faecal transplant. Certainly, I think the concept for treating patients with cancer using faecal transplant and other strategies to change the microbiome is very real. In fact, we’re planning a study to do just that, to try and change the microbiome and hopes to improve the responses to immunotherapy.

06:33 - What wiped out the dinosaurs?

New modelling of the catastrophic meteor impact has given us a clearer idea of what happened afterwards.

What wiped out the dinosaurs?
with Professor Joanna Morgan, Imperial College London

66 million years ago, a meteor collided with Earth and the aftermath was catastrophic: for a start, it wiped out the dinosaurs. Now, thanks to a new model of the event, scientists have a much clearer idea of how the climate conditions changed afterwards. Izzie Clarke heard what happened from the author of the study, Joanna Morgan…

Joanna - When it hit the Earth’s surface it pushed it down about 30 kilometres, making this enormous hole that was 100 kilometres wide and 30 kilometres deep, and that took only about a minute. And then it took about another nine minutes to collapse into it’s current crater; that’s 200 kilometres wide and a kilometre deep. It hit in Mexico; it hit what’s currently the Yucatan Peninsula. It was a particularly bad place; at that location there were sediments that were full of carbon and sulphur and those were ejected into our Earth’s atmosphere and that’s what caused some of the rapid climate change immediately after impact.

Izzie - What effect did that have at the time?

Joanna - Sulphur is quite bad for us. Sulphur forms an aerosol and that reflects sunlight  so what we can when we use what we call global climate models, is that sulphur injection into the atmosphere led to global cooling of more than 25 degrees centigrade for about a year. Actually, we had sub-freezing temperatures for 3 to 16 years after this impact.

Izzie - This happened 66 million years ago, so how on earth are you able to work all of this out?

Joanna - In terms of the climatic gases, we can run numerical simulations. When the asteroid hits we can simulate that, and the passage of a shock wave travelling through the rocks leads to this degassing, so that’s how we make our calculations of the sulphur. Then, what happens immediately afterwards, we can look at what’s called the fossil record, so the sediments that filled the crater after impact. We can look at the little tiny fossils and the chemistry of those layers to tell us about things like temperatures post-impact, and how life came back to the impact site.

Izzie - What effect did this have on the animals and plants on the planet?

Joanna - We had both global cooling and global blackout of light for at least three years. That seems to very dramatically affect the photosynthesising plants, both in the ocean and the marine world. We had something like 90% of the photosynthetic plankton at the top of the oceans going extinct so that had an affect on everything. So everything that feeds off that would have been affected by the loss of these primary producers.

Izzie - Is that what led to the extinction of the dinosaurs?

Joanna - We think so. This was the most dramatic effect that could have been global; that’s correct. Closer to the impact site you can see that there would have been more wildfires and there would have been a large pulse of radiation from the expanding plume, a little bit like a nuclear explosion. So, closer to the impact site, other things could have caused the death.

Izzier - Gosh! That doesn’t sound like a pleasant environment to be in. How sure are we that this is what wiped out the dinosaurs, because some have argued that volcanoes also played a large role?

Joanna - That’s true. We can see the extinction of the small things like the plankton I was just talking about, that happened exactly coincident with the impact. So you get the impact ejector in a layer all around the globe and that’s when the extinction of those small things occurred.

For dinosaurs it’s more difficult because the bones are bigger and there’s less fossils. But you have to say that, given it caused the catastrophe of the primary producers, it seems very likely that it also caused the death of the dinosaurs. Having said that, there were volcanic eruptions going on for quite a long time and they may have made things more ready for extinction, as in things might have been quite stressed already.

10:43 - Down to Earth: BioLab

How a space biology lab lead to speed diagnoses of illnesses.

Down to Earth: BioLab
with Dr Stuart Higgins

Stuart Higgins is on the case in this week's Down to Earth...

‘Biolab’ is a semi-automatic biology testing laboratory in the Columbus module of the International Space Station. Launched on board the Space Shuttle Atlantis in 2008, the lab allows both astronauts, and scientists back on earth, to understand how weightlessness affects living organisms. Once set going, the experiments are largely automated, freeing up the astronauts to do other things.

One of these tasks includes carefully measuring out liquid nutrients for samples. And  it turns out that the expertise used to develop the machine for doing this, has found other uses back down on earth.

A Belgian biomedical company was looking for help to develop a machine that could automatically run tests for infectious diseases such as HIV and Syphilis.

The types of tests they use are called immunoassays. The test detects disease molecules, known as antigens, which are found in the blood when somebody has an infection.

While the tests can work in lots of different ways, a common approach is to take a thin strip of a special paper, and selectively coat it with antibodies. These are molecules produced by the body as it responds to an infection, and attach strongly to the disease antigens.

A sample from a patient can then be washed over the paper strip. Any disease antigens present in the sample will stick to the antibodies on the surface of the paper. A second, different antibody is then washed over the strip again, which sticks to the other side of the antigen, forming a kind of sandwich.

Attached to this second antibody is an enzyme. The strip is finally washed in another chemical which is broken down by this enzyme producing a coloured dye, which is then visible to the human eye.

The end result is a paper strip with lines that change colour depending on whether the disease is present or not. It’s a similar principle to how pregnancy tests work.

However, the process of running the test can be pretty laborious – it relies upon washing precise quantities of different liquids at different times over the strips. The Belgian biomedical company was trying to work out how to build a machine that could run these tests automatically, a few at a time. It ended up working with the engineers responsible for developing part of the automated tests on the space station’s biolab, who used the same tech and know how to produce an automatic testing machine, freeing up lab scientists to do get more done.

So that’s how experiments designed to test the impact of microgravity on organisms in space, led to automated testing for infectious diseases back on earth.

what is memory?

14:34 - Spotting suicide risk in the brain

Can we work out who is at risk of suicide by peering into their mind?

Spotting suicide risk in the brain
with Professor Marcel Just, Carnegie-Mellon University

In many western countries, suicide is the leading cause of death in young men. One of the reasons for this is that spotting who’s really at risk - so doctors can prioritise helping them - is extremely difficult. But now a team in the US have discovered a telltale signature of suicide risk written into an individual’s brain activity, which they uncovered using machine learning. The technique could offer a way not only to find out who’s most at risk, but also to tailor therapies to reduce thoughts of suicide in the first place. Marcel Just told Georgia Mills what he’s found...

Marcel - It has to do with acquiring fMRI images of brain activity during a thought process. We ask people to think about some thought. We could ask them to think about a hammer or a chair, or whatever but, in this study, we asked them to think about concepts related to death, positive concepts in life, and some negative aspects of life. This allowed us to acquire the brain activation patterns associated with each of these concepts, and our machine learning techniques allowed us to determine the physical manifestation of an individual thought. We thought this approach might be useful in identifying people who are suicidal ideators.

Georgia - So you put people in a brain scanner - this fMRI. You get them to think about certain topics and then their brains light up in certain ways, depending on what they’re thinking about, and your machine learning is able to go through all the various different brains and find consistent patterns?

Marcel - Correct. Patterns, but not arbitrary patterns. Patterns corresponding to very specific thoughts and we see very specific alterations in the thought patterns, the neural signatures, of the people who are suicidal ideators.

Georgia - So you had people in your study who were people who had contemplated suicide and other people who hadn’t - is that right?

Marcel - That’s correct. We had a group of 17 people who were suicidal ideators and 17 who were neurotypical people who were matched in age and other demographics. At the first level, we just let a computer programme find any difference it could latch onto, and it could accurately distinguish the two groups. But, at a second level, we asked “can we specify what some of the differences are?”, and there we asked whether the emotional component of the neural signature differs between groups, and it did.

Now let me explain how this magic of discerning of the emotional signature came about. We’d previously done a study where people are asked to evoke in themselves various emotions and so we had this repository, this archive of emotion signatures. Then, in the current study of the people with suicidal ideation, we had their neural representations of various concepts such as death, and carefree, and funeral, and so on. We could ask how much of the neural signature of something like sadness that there was in each one. How much there was of shame. The neural representation of death in the people who are suicidal ideators has a larger component of sadness and of shame.

Georgia - What would you say is the significance of a finding like this?

Marcel - A lot of the significance is promissory - potential for the future. Imagine if we could use this to predict who’s going to make a suicide attempt, we could save lives with this if it works. It also has the potential for application to other psychiatric disorders. Many psychiatric disorders consist of an alteration of some kind of thinking. Maybe we can detect it and provide a complementary measure to conventional psychiatric diagnosis.

Georgia - If you are able to see then a difference in the brains of people who are contemplating suicide, could this give us any ideas of how to treat suicidal thoughts?

Marcel - Yes, and let me just say, we’re not just seeing differences in the brains, we’re seeing differences in the thought representations in the brains. I think that’s different, and it gives you an additional traction on potential therapy. If you just know that some area activates too much or too little - well, maybe you can do something to change that. But if you know the thought is altered in a particular way; if you know that death evokes an unusual amount of sadness, you could possibly direct your therapy at changing, eliminating, reducing that specific alteration. I think this gives, potentially, an extremely useful avenue to therapy.

19:57 - How we recognise faces

A lucky circumstance allowed scientists to get inside the human mind.

How we recognise faces
with Nancy Kanwisher, MIT

More than a third of the brain in a human is devoted just to decoding what we see, and although brain scans can show us the parts of the brain that switch on when we look at certain things, they can't tell us what tasks those active areas are actually carrying out. But, very rarely, an opportunity arises for scientists to literally get inside the human mind. Chris Smith heard how this happened recently to neuroscientist Nancy Kanwisher…

Nancy - I’ve been studying a region on the bottom of the back of the right hemisphere for about 20 years - it’s called the fusiform face area. It’s a little region that’s about the size of a penny and it responds quite strongly when you look at faces and we’ve known that for quite a while. The question is: what does it do with faces and does it also play a little bit of role in the perception of other things that aren't faces?

What I wanted to know is when that region of the brain is stimulated and a person is looking at something that isn’t a face, does it affect their perception of that other thing? We can’t do things to people’s brains. That’s not ethical, so what we have to do when we study humans is wait for clinical opportunities where a neurosurgeon is going to do something for clinical reasons.

This patient had intractable epilepsy and you can’t live a normal life that way. In these situations, what neurosurgeons do is first map out the brain, find out the focus of the epilepsy seizures, and take it out surgically. So the neurosurgeons placed tiny electrodes all over the surface of his brain, including a lot of electrodes right in an area I happen to be interested in. It was an opportunity to find out what happens when the patient looks at different things and when those electrodes are stimulated electrically.

Chris - Right. So you’re both eavesdropping on what’s going on in those areas natively and you can also then reverse the equation and put electricity, and therefore stimulus, into those areas and ask well, if I change the activity in that area, what does it do to the patient’s experience?

Nancy - Exactly. So we gave the neurosurgeons a bunch of pictures of faces, and words, and objects, and different kinds of things, both in colour and in grayscale. We said “please show these images to the patient and we think we’ll be able to find out what exactly each electrode responds to.” And, sure enough, there were ten electrodes right next to each other that responded nearly exclusively to faces.

Chris - What happened when you then stimulated those areas, so you know I’m recording from this particular area underneath at the back of the brain, and I’m seeing it becoming very excitable when this person looks at faces? But when you then put energy into that area, what does the patient see?

Nancy - What the person saw was he saw a face on top of whatever he was looking at. So, when he was looking at a box, he saw a face on top of the box. When he was looking at this orange soccer ball, he saw a face on top of the soccer ball. He reported that the face looked like an anime character; it wasn’t a person familiar to him. Now that may be because when you electrically stimulate the brain, you are essentially activating tens of thousands of neurons in that region. It may be that when you do that, what that codes for is a very general presence of a face, not a particular face which might require activating a subset of those neurons.

Chris - What is your interpretation: the fact that you see the face on top of the object you were looking at, and the object itself is not changed in your perception when you do this?

Nancy - My interpretation is that region is only involved in face perception. Not even a little bit in the perception of objects. So this is the strongest possible evidence that the kinds of minds we have are these very specialised minds that have special purpose machinery for solving very particular problems.

Chris - When the visual system is looking at things, can one sort of summarise by saying well, if you look at something and there is a face somewhere in it, then the right bit of the brain extracts the face shape, tell your consciousness ah, that must be a face by activating this area you’ve been looking at, so it’s like a trip switch? When you’re area you're interested in goes active that says the the brain yep, that’s a face?

Nancy - Exactly.

Chris - Does your findings suggest then that if you had done the opposite of stimulating that area and you deactivated it, that this person wouldn’t be able to recognise a fact for what it was; they would just see a shape like any other shape?

Nancy - Exactly. I think what would happen is the patient would probably know that the face was a face, but probably would not know which face it was. Actually, we didn’t have time or the neurosurgeons to test that in this patient, but my guess is that when the patient was looking at a face, if we had asked him which person is that while stimulating that region he would probably be disrupted with that function. He’s probably know it was a face, but not know which face either if you deactivated the region or if you stimulate a lot of neurons in that region. Both of those things are kinds of disruption that interfere with processing in that region.

Happy workplace

26:52 - Can humour get you ahead at work?

How psychology can impact our productivity and success at work.

Can humour get you ahead at work?
with Maurice Schweitzer, Wharton University

The evidence is that humour can be a powerful motivator. And so can “trash talking” - where people make purposefully challenging or disparaging remarks about performance, which can help to boost productivity. But both can also backfire. Michael Wheeler spoke with Maurice Schweitzer who studies these approaches. Please note that this item does refer to a real-life example of an unacceptable use of humour that some might find offensive...

Maurice - While some people are doing things just right and others are getting it flat wrong. I’ll give you one example from my research investigating humour: people view us as more confident, warmer, more likeable, and more competent when we engage with humour, and they’re more likely to be selected as a leader. Dick Costolo was the CEO of Twitter and he was a standup comic earlier in his career, and he credits his sense of humour for helping him rise to power.

But there are other people who’ve had a disastrous outcome. I can give you one example of that where there was a PR representative who became infamous for her tweets.

She was flying to New York to visit family in South Africa. Her first tweet on this trip read: “Wierd German dude you’re in first class. It’s 2014, get some deodorant enter monologue as I inhaled B.O., thank God for pharmaceuticals.”

She lands in London and then tweets: “Chilly, cucumber sandwiches, bad teeth, back in London.”

And then her next tweet that crosses the line reads: “Going to Africa, hope I don’t get AIDS - just kidding I’m white.”

By the time she landed in South Africa there were protests and her family were saying that we don’t abide by this sort of behaviour. They’d already been contacted by media and she ends up losing her job.

Michael - Is there anything that we can learn from experiments about how to try and employ humour in a professional setting?

Maurice - Yes. From my research, what I’ve found is that people are often afraid of telling jokes that fall flat, but it turns out that’s not so costly. If you’re really “on the fence” you could tell something really quite edgy, or not very edgy. Go with the one that’s not so edgy and you might get a chuckle and, if you don’t, it not that big a deal.

Michael - What would be some other examples of things that you have tried to understand by conducting experiments?

Maurice - I’ve some recent research investigating “trash talking” - competitive and incivil communication. We brought in 178 undergraduate students and they would sit at computer terminals and just text back and forth with a partner.

Then we described the effort based task. We tell them you’re going to compete and you’re going to have to do things like count the number of letters in a sentence, and whoever counts more letters accurately is going to win a dollar. We then had a confederate that took it over and said “hey, it looks like we’ll be competing against each other in the next task, so whoever wins gets the bonus money.” That’s the neutral confederate.

And the trash talking condition, we start off the same way. “Hey, it looks like we’ll be competing against each other in the next task.” But then it transitions to “I’m just taking that bonus money you’re definitely going to lose.” And then “I’m smarter than you, I’m faster than you, I’m going to beat you like a rented mule.” The participants who received that trash talking message end up performing much better. A lot of effort based tasks, you see performance go way up.

Michael - Yeah. I can imagine it’s the type of thing that wouldn’t suit everyone though. It might work for some people but not for others. Have you gained any insights into anything that might be a little bit more generalisable?

Maurice - I have related work looking at anxiety in the workplace. Anxiety is negative; over-focused on what happens if things go badly. One of the things that we found is that you can change how you feel by saying “I’m excited.” Excitement is also a high activation, a high arousal emotion, but it’s focused on the ways in which things could go well. We had people say “I am excited” before they would sing and we had a Wi karaoke machine that scores singing. We had them deliver a short presentation, we had them take math tests across different experiments and we found that when people convince themselves that they were excited in these high pressure moments, they actually performed demonstrably better.

Michael - I’ve always been given the advice if I’m doing something like a presentation or something that could provoke anxiety to calm down. Is that good advice to give people?

Maurice - Yeah, that’s a great question. That advice is not nearly as good as: get excited, think about how great things would be if that presentation goes really well. The heart rate will stay high but if we focus on those opportunities we’ll engage better and we’ll basically harness that energy in a way that’s going to give us a high energy, constructive, effective presentation, where calming down doesn’t seem to work at all.

32:49 - Smart Drugs: What's the deal?

How common are smart drugs, do they work and are they safe?

Smart Drugs: What's the deal?
with Professor Barbara Sahakian, University of Cambridge

There are many lengths that people go to in order to improve their performance in the workplace, and increasingly there amongst them are reports of ‘smart drugs’ being taken at work, but what are they and who is taking them? Chris Smith heard from Barbara Sahakian from the University of Cambridge where she studies these agents and how they work...

Barbara -  They’re cognitive enhancing drugs, so they improve the focusing of your attention and concentration, or maybe your memory, or maybe your planning problem solving. All the different forms of cognitive function that we have. In America, people frequently use adderall (amphetamine salts). In the UK and Europe, it tends to be more methylphenidate which is Ritalin or Modafinil.

Georgia - We actually put a call out for people’s experiences with smart drugs and were surprised by the number of responses we got. This one came to us from someone who works in a tech startup in London and this is what she wrote to us…

My current regime is that I will take half a tablet of Modafinil at around 8am once every two or three weeks as needed, and then I will go through phases of taking twelve micrograms of LSD every three days.
For me, Modafinil lowers my activation threshold, which means all those jobs I’ve been putting off because of doubt or anxiety become much easier.
The night before a planned Modafinil day I will write
ato do list of these kind of tasks, along with any menial work I just need to plough through. It will start to work after about 20 minutes and I will feel an active focus and interest in what I am doing, without the slightest desire to procrastinate. I find myself irritated by needing to go to the bathroom and break my flow.
Sometimes I might accidentally get sent down the wrong path and find myself spending an hour tidying my desktop and document files, which is why
theto do list is so important to keep on track. By early afternoon I’ll noticeably begin to run out of steam and develop a minor headache in the front of my skull. Focus will fade, and by around 3pm I’ll find it difficult to work. It  makes the day shorter and more intense, often achieving a huge bundle of things that have been mounting in a pile of procrastination.
However, you definitely feel like you’ve been on a drug, like a supercharged coffee followed by a daytime hangover. That feeling,
ofI’ve been ‘on’ a substance and made a trade-off for the instant problem fix, means that Modafinil isn’t something I do often or view in a particularly positive light.
Microdosing LSD is different. I’ll feel a general sense of positivity towards my colleagues and begin to see problems from their perspective, even when we’ve disagreed in the past. I’ll be focused on my work, and again feel less anxiety about difficult issues, but without that adrenalised focus of modafinil.

Chris - Barbara, am I alone in feeling mildly alarmed by hearing that?

Barbara - Well it is surprising that so many people are using these drugs but, actually, the two reports accord quite well. In our studies where we’ve looked at cognitive enhancing effects, we’ve found that the 200mg dose is most successful and that’s what one of the people commented on using. They also commented on using it “to get into the flow” to actually get focused and also with tasks often that they’re trying to avoid, or they don’t find very enjoyable, or they’ve been putting off.

We’ve shown in our studies that are double-blind placebo controlled that when we ask people to rate say how interesting they found doing a test, that under placebo the test is okay, but under modafinil they rated it as really pleasurable or enjoyable. So, somehow, it makes these tasks seem a lot easier to get through that you’ve been putting off for some reason.

Chris - You’ve been doing these studies for a long time where you put people in brain scanners, put them on these chemicals, and see what changes in their brains when they’re on the chemical and doing a task compared with when they’re not. So what does happen when you take a drug like ritalin or modafinil?

Barbara - For ritalin, what we found was that if they’re doing a working memory task, which is the type of thing we use all the time for what we call higher cognitive function. So planning, problem solving, all of that will have a component which is what we call “working memory” where you’ve got some things in your memory space and then you get rid of them when you don’t need them any more. What we found was that not only on ritalin, in healthy people, do they have a better performance than those people on placebo, but also the brain doesn’t need to act as strongly so there’s more efficacy in the brain activation, but they have a better performance. It seems that your brain doesn’t have to work as hard, but you have a better performance.

I did a study with Lord Ara Darzi at Imperial College, because he was concerned about his surgeons taking too much coffee (caffeine) at night to stay awake and alert. Of course then, you can get hand tremor which is a common side effect of taking caffeine and so he wanted to know whether the surgeons would do better under modafinil. So we sleep deprived doctors and then we gave them modafinil, a placebo in a double-blind placebo controlled study. And we find that the doctors on modafinil who were sleep deprived actually had better cognitive function in terms of their ability to be cognitively flexible when solving problems, so they could switch between problem solving very quickly. We also found that they were less impulsive, so it seems to have these benefits as well.

But it is worrying, as you say, because we don’t know the long term consequences of using these drugs, so there are not long term safety and efficacy studies in healthy people with these drugs. Also, a lot of people are buying it over the internet and you don’t really know what you’re getting.

Chris - I know you’ve said that we don’t actually know what the long term effects are yet. But could one envisage a situation where if you take these chemicals and they enable you to “burn the candle at both ends,” we know that robbing yourself of good restful sleep is is a risk factor for say Alzheimer's disease, do you think that we might encourage people to put themselves at increased risk of things like Alzheimer’s because they adopt a higher risk lifestyle?

Barbara - That’s a very interesting point that you make. And I often worry about students who are taking these drugs and they’re usually cramming for exams because they haven’t done the work consistently. What they do sometimes with ritalin, they might take a tablet and then, as it’s wearing off, take another tablet and then, of course, they don’t sleep at night. We consolidate our memories in our sleep and also we need  that obviously for rest as well. So it’s counterproductive really because you’re not consolidating what your were trying to learn during the day.

I think we do need to put this into perspective and I often say will people in the future use these drugs to have a better work/life balance and to get their work done, and enjoy themselves and go out and exercise and things like that. Or will they just work longer because they can work longer so they just get into a 24/7 cycle.

Chris - Is it habit forming because the initial contributor we heard from said “I did it a certain way because I didn’t want to become dependent”  -are all these drugs habit forming?

Barbara - So far, for modafinil, nobody's demonstrated any abuse potential. But we do know that classic stimulants like amphetamine and the methylphenidate do have potential for abuse, and so there could be a physical aspect to it. But with modafinil, it might be that you become psychologically wanting to use it all the time because it worked for you on one occasion so now you want to try it on another, but it doesn’t seem to have abuse potential.

Chris - You’ve surveyed this, how many people in your surveys in circles like silicon valley and academics are using these agents?

Barbara - We don’t really know about the silicon valley, but what we do know is the surveys they’ve done in the United States they often find some place between 13 and 20% of students using them at colleges. There was a Varsity survey in Cambridge some time ago and they found about 10% of students. In Germany, they’ve done surveys and they’ve found about - and these are insurance surveys so they’re looking at people in the workplace - they’ve found about 7% of people in the workplace were using these drugs because they felt they couldn’t do their jobs otherwise.

41:15 - Ergonomics: How design impacts our health

Why workplace design is important in keeping healthy and productive at work.

Ergonomics: How design impacts our health
with Alan Hedge, Cornell University

What about the workplace needs to be considered when thinking about health, and how will the world of work change in future? Georgia Mills spoke to Alan Hedge, who’s professor of ergonomics at Cornell University...

Alan - Ergonomics, literally, means the science of work. Most organisations don’t optimise the workplace. Often, equipment is not designed to give you the best performance and, often, people don’t work in the most efficient way.

Georgia - Okay. So could you give me an example of how, potentially, your environment or your equipment might negatively affect a worker?

Alan - We’re looking at the physical environment. We know that poor temperatures can actually lead to reductions in work performance. We know that poor spatial layouts can impact communication patterns between people and that can reduce productivity. We also know that sitting people down all day long is now not a great idea and neither is standing people up all day long.

Georgia - So why is sitting down such a problem?

Alan - Sitting for too long, undoubtedly, is a problem. We know that in terms of what happens to your circulatory system. We know that in terms of what happens to the way that you process the calories that you eat or drink. We know that in terms of what happens to muscles and muscle strength. Your body is really designed to move.

But, likewise, standing up is equally problematic. We know that standing for too long increases risks of varicose veins, increases risks of carotid artery disease. So the key is don’t sit all day, don’t stand all day - mix it up.

Georgia - What other ways are there we can think about the design of a workplace that can improve the health or productivity of a worker?

Alan - When you think about designing an optimal workplace, what you have to think about first of all is what are people doing and, secondly, what equipment are they using? Now these days, a lot of people can do work on portable devices so, if that’s the case, those individuals don’t necessarily need to have a dedicated desk; you can actually work in a much smaller footprint.

What that means is that people go to work and it’s like checking into a hotel. So the trend that we are seeing in workplaces, at least here in the States, is to take that individual space and to take a chunk of that and create what we call a “shared space” that allows you to put different kinds of experiences into the building.

So we’re seeing more use of things like relaxation rooms in buildings where you can just go for 5 or 10 minutes just to de-stress a little bit before going back to the job that you’re doing. What you end up with at the end of the day are significant improvements in the health of individuals and you also have significantly more movement.

Georgia - Now what about temperature? Obviously here in the UK it’s starting to get pretty cold, so how can that affect performance and what can we do about it?

Alan - We have done a lot of work looking at temperature in relation to how much work people do. And what we found is that often buildings are too cold for an optimal level of work for individuals. Ironically, here in the US, that’s related to air conditioning in summertime. We find that the optimal temperatures usually are in the range of 25-26 celsius, which is often 4-6 degrees higher than people set their thermostats to.

Georgia - Is it true as well that different people are comfortable at different temperatures?

Alan - It is true that different people are comfortable at different temperatures because the muscles generate a significant amount of body heat. Men, on average, have about 30% more muscle mass than women so men, typically, are going to generate more heat, and there’s also some evidence that it relates to the distribution of body fat. So, yes, you do see these functional differences.

Georgia - So if everyone’s running at different temperatures, how can we solve this - with design or something like that?

Alan - One way is to create environments in which individual work spaces have their own temperature control. And, indeed, at the moment we’re testing a small portable air conditioning unit that will provide about 4 to 6 degrees of cooling. The advantage of looking at some kind of personal air conditioning system is that you can locally heat or cool the air, and filter the air where the person’s actually breathing the air.

What we are working on at the moment are systems that use relatively little energy to actually achieve all of these things. Little more than the energy of just running a fan, whereas large cooling systems in buildings use a huge amount of energy. In the US, a third of all of our energy is expended just by cooling buildings.

Georgia - Could you paint me a picture of the office of the future?

Alan - Technology is going to become part of every object that’s in the office. We’re going to have what we call “intelligent walls” or “intelligent surfaces.” There are a lot of projection technologies that let you interact with the computer system simply by making movements. We’re definitely going to see more variety in the workspace; we’re going to see more flexible work schedules; more personal monitoring; more wearable technology.

If you just look at the growth in things like Apple watch or the Fitbits or the Polar monitors, or whatever it is, your activity tracker is giving you information about your health status. We’re definitely going to see more impact wearables in the future.

The bottom line here is to try and extend the working life of individuals and also maintain their health.

Georgia - Oh, good. So I’ll be able to keep working until I’m 95.

Alan - That’s very good for you; it’s healthy for you. In fact, nothing will speed up your atrophy like stopping working, and work doesn’t have to necessarily be physically incredibly difficult. But if you look at many highly productive individuals, they are still working and mentally, at least, into their 80s and 90s.

Worker bees

47:48 - Are we all working too hard?

Is there a culture of spending too long at our desks, and will it hurt our health?

Are we all working too hard?
with Courtney Landers, University of Cambridge

We’ve looked at the ways our health is impacted by our physical and our social environment in the workplace, but what if it's simply the time we spend at work that has the biggest impact? Chris Smith heard from Courtney Landers, a mental health researcher interested in the impact of work on our mental health, about how work is affecting our stress levels.

Courtney - More than you’d think. It was really interesting you mentioned gut bacteria before because there’s lots of studies coming out now that indicate that the chemicals that your gut bacteria produce can really affect your mental health. What people don't consider, I think, is that things like stress, diet, exercise all affect your gut bacteria. And so, of course, if you’re working too hard and you’re not looking after yourself, your gut bacteria will be affected and, thus, perhaps your mental health will be affected.

Chris - The other thing that’s changed in the workplace in the last 50 years is a dramatic reduction in the number of jobs which are physical. The number of people doing a physical has dropped from something like 50% down to about 5%. The number of people doing a sedentary role has gone from about 5% to 50%. Do you think that also is playing a role because people are less active, and activity also improves wellbeing? Do you think that could be part of the reason why people might be unhealthy?

Courtney - Absolutely! I think it’s a combination. You’ve seen the rise of people working longer hours in the interest of efficiency perhaps, or productivity - trying to get more done. Because lots of jobs are desk based these days it means that people are spending more time at their desk. Whereas I think before, perhaps, people would work nine to five and then go home and play with their families, go out, do other things. And I think it’s probably that factor, not so much what you’re doing at work, but how long you send and work and what you do afterwards.

Chris - Is there evidence that the problem is getting worse because we are working longer hours on average now than we did historically and that’s largely driven digitally, isn’t it?  Because, historically your inbox filled up at the rate the postman could pedal his bicycle. Nowadays your inbox fills up at the rate a computer can feed you more to do and so you could get this sense of an overwhelming workload that never ends.

Courtney - Yes. I think there was a 2014 study in Australia just recently, and they were looking at work/life balance and, historically, Australia's got one of the best work/life balances.

Chris - It certainly agreed with me when I lived in Sidney. It was fantastic.

Courtney - Yes but over the last five years of this study, they’ve found that 45% of people’s work/life balance had got worse rather than better. So, for some reason, even though it’s this Nirvana, this lovely sunshine country, people, for some reason, were just working more and enjoying themselves less.

Chris - What about this idea because there’s this saying that if you do a job you love, you’ll never do a day’s work in your life - does that hold? So if you take people that really love their job and are workaholics because they are really into it, do they still suffer the same ill effect of long hours as people who don’t have that control?

Courtney - I think it’s a dangerous way to think because it doesn’t really matter how much you love what you’re doing, you still need to sleep, you still need to eat. After a certain number of hours doing these things that you love, eventually everybody needs to take a break.So unless you’re looking after the physical machinery of your body, eventually the mental machinery will breakdown no matter how much you’re enjoying it in the first place.

Chris - What appears to be the duration of work which is most consistent with good health?

Courtney - The interesting thing is that in the age of automation and the iphone, we really haven't looked at how much this is affecting us. There was a study, I think, by the University of Melbourne last year that looked at over 40s, I think, and they established that after about working 30 hours a week, which is 6 hours a day over a five day week, people’s productivity vastly reduced so, essentially, people were already working too hard above the age of 40. And, of course, most people start to work at a very early age these days, but there’s no data for the younger generation at all.

Chris - So something we should probably look into isn’t it.

Georgia - Mindfulness has been one popular method of unwiding from work. If you have not yet tried this then listen up; we asked yoga instructor Sanjay James from CAMYOGA in Cambridge to make us more mindful.

Sanjay - Bring your attention to the physical sensation of breathing. The air moving through your nose, the rising and falling of your belly. Notice when your mind wanders from your breath. When you notice your mind wandering gently return your attention to the breath. Just keep repeating to yourself and breathing in, and breathing in, and breathing in.

Then hold your breath for a little moment and repeat in your mind I’m holding my breath, I’m holding my breath, I’m holding my breath. And then very slowly breath out through your nose and repeat in your mind I’m breathing out, I’m breathing out, I’m breathing out and just stay in this rhythm.

Instead of wrestling with your thoughts practice observing them without reacting to them, Just sit and pay attention.

Georgia - Mindfulness is a bit of buzz word at the moment so Babara, I was wondering, does it actually work? Is there any science behind this - is it a good idea to unwind?

Barbara - Yes, there is evidence based behind it and there is studies showing that it does help and I think it’s particularly good. There are other techniques: exercise, yoga, things that you can use, but some people find it difficult to clear their minds and actually be in the moment and mindfulness helps you do that.

You heard from that little clip that basically you have to focus in on your breathing and when your mind wanders away come back to that again. So it keeps you from thinking about all these other things that distract us during the day and make it difficult to relax and unwind and really have that beneficial effect of wellbeing.

Georgia - So is this “being in the moment” idea, is that beneficial for our actual mental health?

Barbara - It is a good idea to be in the moment because many people miss out on things. They don’t realise they’re missing out on things because they’re not actually focussing on what’s going on at the moment with them. You’ve probably been at restaurants where you see everybody looking at their phones instead of talking to each other, and really enjoying the dinner and talking to their friends, so everybody’s checking their phones. So you lose out on the enjoyment and the well being that you can get from that experience.

Car in storm

54:58 - Are cars safe during thunderstorms?

Would a car protect you from a lightning strike, and what would happen if you were driving?

Are cars safe during thunderstorms?

Izzie Clarke put this shocking query to the Naked Scientists forum...

Izzie - Alan said that the biggest risk would be reduced visibility in a storm and the likelihood of an uncontrolled skid.

Evan thought that it was all down to the design of the car’s electronics.

So to get to the bottom of this electrifying question, we asked Philip Garsed from the University of Cambridge to strike up an answer…

Philip - A lightning strike last a hundred millionths of a second. Tens of thousand of amps heat the air to 50,000 degrees and make it explode. Your questioner is right to wonder where the safest place to be in a lightning storm is, and the car is a pretty good bet, but you probably don’t really want to be struck whilst you’re driving one.

A car conducts electricity far, far better than the surrounding air and when lightning strikes a metal car with a metal roof, the enormous current flows easily through the body of the vehicle and so it goes around the occupants rather than through them. It’s kind of like the electrical equivalent of building a bypass. Traffic goes around a town rather than through the middle of it.

Izzie - This is what's known as a Faraday cage and you’ll be safe as long as you remain completely inside the vehicle and not disrupt the current flow. So whilst it’s good news for you, the lightning strike won’t be good news for your car…

Philip - Although the worst of a lightning strike will go through the chassis, modern cars use lots of sensitive electronics. In the best case, that sudden burst of interference from the lightning would cause a lot of them to develop faults. But, more likely, those circuits will see currents they were never designed for and be permanently damaged.

Izzie - Ahh. That doesn’t sound good. And, according to Philip, there are a few other threats if you’re on the road at the time…

Philip - The biggest problem is likely to be how you respond. Because we know that you’ll probably be unharmed by the actual strike, but the problem is everything else that might happen. The thunder will make you jump, the lightning will dazzle you, you'll lose your lights, trigger the airbags, or perhaps even have a nice little electrical fire on your dashboard and, also, probably some of your tyres have exploded.

Of course, it’s pretty unlikely that your car will get struck by lightning  in a thunderstorm unless you're in a very exposed place.

Izzie - But, perhaps little a bit of space behind the car in front just in case. Thanks Philip for clearing that up.

Next week we’re picking at this question from Patrick…

Why, oh why, am I unable to stop picking my nose? What is it that makes it so satisfying and addictive? Is there an evolutionary reason behind it? Also, why do some other people eat what comes out?

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