This year the festival, dubbed the ‘Glastonbury of science’, attracted 46,000 visitors and included exhibits, talks and interactive workshops on subjects as diverse as the botany of gin, the colour of music, and particle physics for beginners.

Dr Adler and Dr Eames’s session, ‘The truth about flu,’ discussed the School’s Flusurvey project findings and challenged commonly-held beliefs about how the virus is transmitted. Dr Dawn Harper from Channel 4’s Embarrassing Bodies also joined the panel to provide a GP’s perspective.

People used interactive voting buttons to share their opinions on whether taking public transport or owning pets increases the risk of infection. Over 80% of audience members thought that using public transport would increase the incidence of flu transmission, and they were very surprised to learn that Flusurvey data had shown this was not a significant risk factor. These findings were widely reported in the media, including in the Telegraph, Independent and Daily Mail.

The researchers also highlighted that school-age children often drive flu outbreaks, and Dr Harper emphasised that hand-washing is the best prevention measure.

Dr Logan, with support from Arctec researcher Dr Sophie Stewart, took his audience on a fascinating journey through insect anatomy and sense of smell during his ‘What makes insects tick?’ session. His special guests were live stick insects, mosquitoes and bedbugs, and children and adults alike got involved in the session to find out how they smelt to mosquitoes. One patient volunteer spent 10 minutes standing inside a thermal bag on stage to demonstrate how Dr Logan’s team harvest human body smell in order to analyse the chemicals that attract mosquitoes.

The audience heard how rooms infested with bedbugs have a distinctly ‘herby’ smell, sometimes likened to coriander, and the session was also attended by two bee-keepers, keen to learn more about how honey bees can be trained to detect smells that can aid police work.

We look forward to sharing more of our research at Cheltenham next year.

Image: James Logan and Sophie Stewart at the Cheltenham Science Festival. Credit: Vickie Bazalgette

Proportion of short trips taken by bus boosted, but overall distance walked remains the same

Free bus travel for young people benefits the environment and may help curb road traffic injuries, according to an analysis of the free bus scheme for young Londoners, published in the Journal of Epidemiology and Community Health. It has also boosted the proportion of short journeys taken by bus, but not reduced the overall amount walked, the findings show.

Researchers from the Transport and Health Group at the London School of Hygiene & Tropical Medicine wanted to assess the public health impact of giving teens in London free bus travel. The scheme, which all young Londoners are entitled to by registering for a Zip Oyster Card, was introduced for 12 to 16 year olds in 2005, and for 17 year olds in 2006.

Dr Phil Edwards and colleagues looked at data from the London Area Transport Survey and London Travel Demand Surveys to calculate the number of journeys made in London—as well as distance and principal mode of travel—before (2001-4) and after (2005-9) the scheme was introduced. They also looked at official data on traffic injuries and hospital admissions to see if the scheme had any noticeable effects on personal safety.

The analysis showed that the proportion of short journeys teens took by bus doubled from 2% to 5%, although the overall number of journeys they took did not increase.

The number of short trips walked also fell in tandem with an increase in this length of journey taken by bus, although there was no appreciable impact on total distance walked.

But there was clear evidence of a fall in the number of short journeys cycled and in distances cycled by young people, although this mode of travel was not hugely popular among this age group before the introduction of the scheme.

Rates of road traffic casualties had started falling before the introduction of the scheme, and continued to fall afterwards, but at a greater rate in young people, largely among passengers and cyclists. Pedestrian casualty rates remained the same.

Hospital admission rates for assaults had been rising among teens before 2005, but were higher among this age group after the scheme’s introduction. However, the authors caution that the data does not show whether the assaults occurred on buses or not, so increases in assaults cannot be directly attributed to free bus travel.

The number of daily car journeys taken by young people and adults fell, and the average distance travelled by car also shrank, suggesting that free bus travel prompts a shift away from car use and may therefore be a greener option.

There didn’t seem to be any fall in the use of buses by older people after the scheme’s introduction either.

Co-author of the paper, Professor Judith Green, said: “The introduction of free bus travel for young Londoners has been beneficial in a number of ways. Although the proportion of short journeys young people took by bus increased, it did not reduce the amount of walking they did overall because they were making extra trips and getting out and about more often.”

Lead author Dr Phil Edwards added: “Free bus travel has also led to a reduction in the use of cars; considering that all cities are facing increasing congestion and rising levels of traffic pollution, the introduction of free bus travel for young people is an example of a policy that has made hopping on the bus the norm while easing problems on the roads.”

• Phil Edwards, Rebecca Steinbach, Judith Green, Mark Petticrew, Anna Goodman, Alasdair Jones, Helen Roberts, Charlotte Kelly, John Nellthorp, Paul Wilkinson. Health impacts of free bus travel for young people: evaluation of a natural experiment in London. BMJ. doi 10.1136/jech-2012-202156

These findings suggest that encouraging more people to use physically active modes of transport could reduce rates of important risk factors for many chronic diseases, say the researchers from the London School of Hygiene & Tropical Medicine, Imperial College London and the Public Health Foundation of India.

Rates of diabetes and heart disease are projected to increase dramatically in India and other low and middle income countries over the next two decades.

The study analysed physical activity and health information collected from almost 4,000 participants in the Indian Migration Study.

It found that 68.3% of people in rural areas bicycled and 11.9% walked to work, compared with 15.9% cycling and 12.5% walking in towns and cities.

Half of people who travelled to work by private transport and 38% who took public transport were overweight, compared with only a quarter of people who walked or cycled to work. The study found similar patterns for rates of high blood pressure and diabetes.

The authors stress that getting more people to use active modes of travel should be integral to strategies to maintain healthy weight and prevent diabetes and heart disease in India. This should include improving the safety and convenience of walking and bicycling in Indian towns and cities, and also greater investment in public transport, since this travel generally involves walking to bus or train stops.

“India is facing an epidemic of obesity, high blood pressure and diabetes,” said Shah Ebrahim, Professor of public health and policy at the London School of Hygiene & Tropical Medicine and Director of the South Asia Network for Chronic Disease at the Public Health Foundation of India where this research was conducted.

“Our findings show that walking or cycling to work increases the chances of staying healthy. I cycle to work in London but I don’t in Delhi where I have been living for the last five years. The motorised traffic is just too dangerous for me. I have put on weight and my blood pressure is higher than it was five years ago. Investment in proper cycle lanes and pavements is essential for a healthy India.”

Publication:

• Millett C, Agrawal S, Sullivan R, Vaz M, Kurpad A, Bharathi A V, Prabhakaran D, Reddy S R, Kinra S, Davey Smith G, Ebrahim S, Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study. PLoS Medicine doi:10.1371/journal.pmed.1001459

The creation of HSJ Clinical Leaders provides an industry list of those who are making the greatest impact in the areas of health policy, service redesign, and research and innovation.

The list celebrates individuals who increase effectiveness in the NHS by leading innovation, driving policy change and aiming for continuous improvement in the quality of care delivered, not as a one-off task or project, but as a core part of their professional identity and role.

270 names were put before a judging panel that included Chief Executive and Registrar of the General Medical Council, Niall Dickson, and Editor in Chief of the BMJ, Dr Fiona Godlee. They selected one hundred individuals from all areas of healthcare for the final list, which was announced at a reception at the Royal College of Physicians.

Since 2008 Professor Black has been Chair of the National Advisory Group on Clinical Audit and Enquiries. His selection onto the Critical Leaders List recognises his ‘leading role in how audit is used to measure outcomes, prevent failure and re-establish trust in the post-Francis NHS.’

Professor Black is a key voice in debates around NHS reforms, and has spoken widely in the media on this topic, including recent interviews with Dr Norman Swan on ABC Radio’s Health Report (Australia) and in the Evening Standard.

His main current research interests focus on the assessment of the quality of healthcare and the performance of healthcare providers. Most of his work has been in the fields of surgery and critical care.  His recent publications include a study on how patient reported outcome measures could help transform healthcare.

Dr Ben Goldacre is author of the Bad Science blog and best-selling books Bad Pharma and Bad Science.

He was recognised by HSJ for doing ‘more than any other single individual to shine a light on how science and research gets distorted by the media, politicians, quacks, PR and the pharmaceutical industry’. His work has ‘changed the landscape of the public discourse on science and evidence based medicine, particularly around the importance of open publishing.’

The full list of Clinical Leaders is available online to registered users.

Image: Professor Nick Black. Credit: LSHTM

The Panel will be hosted by the London International Development Centre (LIDC) which includes the London School of Hygiene & Tropical Medicine, and supported by a Secretariat led by Jeff Waage, Director of the LIDC and Professor at the School. Professor Sir John Beddington, former UK Chief Scientific Adviser, and John Kufuor, former President of Ghana, will chair the Panel.

165 million children alive today will have their future potential stunted due to lack of adequate food. Providing better nutrition to mothers and infants in the first 1,000 days is essential to give these children a better start in life. The benefits of interventions that directly tackle nutrition are well documented, but broader measures are urgently needed to address the global burden of undernutrition and under-five mortality.

Agriculture is critical for improving livelihoods and tackling food and nutrition security.  It plays a key role in producing nutritious foods and making them available to consumers through the food value chain, resulting in better nutritional outcomes. It is also an important source of income for farmers and farm workers enabling them to provide their families with better quality nutrition.

“This initiative is coming at a critical time,” said Professor Waage. “With commitments made at the Nutrition for Growth event on 8 June, there are now more resources and more political will than ever to tackle malnutrition. Much of this effort is being directed at nutrition interventions, which we know work. But we also know that without other interventions that impact nutrition, particularly in agriculture, we will not achieve our goal.

“This is where the Panel can contribute, bringing the evidence for how agriculture can support improved nutrition to governments, civil society and industry, and encouraging commitment to this agenda. As a Secretariat for the Global Panel, LIDC will draw on the Bloomsbury Colleges’ developmental and disciplinary breadth, and in particular our cross-College Leverhulme Centre for Integrative Research on Agriculture and Health, to provide that evidence and strategic advice to the Panel.”

Image: A boy in Uganda carries a bowl stuffed with ears of corn on his head. Credit: Sarit Saliman, Courtesy of Photoshare.

Peter Piot reflects on the success and challenges of the AIDS pandemic, and how the response serves as a model for other global health threats

Great progress has been made in the global response to the AIDS epidemic, but these achievements are fragile because of ‘AIDS fatigue’ among funders, and public health and political leaders, according to Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine.

Writing in the New England Journal of Medicine, Prof Piot and co-author Professor Thomas Quinn, Director of the Johns Hopkins Center for Global Health, call for strategic targeting of prevention and care, and the implementation of creative combinations of behavioral, biomedical and structural interventions.

The authors say: “These programs will require universal access, large-scale implementation, careful monitoring and evaluation, financial and technical resources, and robust commitment. Only then may we begin to see a substantial effect on the global spread of HIV infection.”

2013 marks the 30^th year since researchers at France’s Pasteur Institute published their discovery of the retrovirus that causes AIDS. Reflecting on the success of the past 30 years, the authors highlight progress in the treatment of HIV infection, the evolution of prevention strategies, and biomedical advances in prevention.

They also argue that the unified and integrated response to AIDS invented the new global health approach and “can serve as a model for society’s future response to the growing epidemic of chronic diseases, obesity, and injuries, along with maternal and child health”.

Despite great progress, an estimated 34 million people are currently living with HIV infection and new infections continue to increase in Eastern Europe and several Asian countries. On Friday 7 June, the School will launch a report with the World Bank and World Health Organization reviewing HIV epidemics and vulnerability among key populations in Europe and Central Asia. Professor Piot will open the event and chair a panel discussion. Register online for further details.

Prof Piot was the founding Executive Director of UNAIDS and a pioneer in understanding the AIDS epidemic in Africa. He was recently awarded the Hideyo Noguchi Africa Prize for Medical Research for his work.

• Peter Piot and Thomas Quinn. Response to the AIDS Pandemic — A Global Health Model. New England Journal of Medicine. DOI: 10.1056/NEJMra1201533

Image: A Kenyan Girl Scout holding a poster showing Barack Obama and his wife taking an HIV Test on a visit to Kisumu, Western Kenya. Credit: Gemma Jones, Anthropologies of African Biosciences Research Group

The LIDC launched its Fellowship Scheme in February 2013 to support new collaborative research in international development.

You can read more about the successful projects and their teams on the LIDC website.

The report, Accountability for Maternal, Newborn and Child Survival, was launched at the Women Deliver conference in Kuala Lumpar. It highlights successes in improving maternal health and reducing child mortality in some countries, while pointing out where progress has been lagging in others.

Countdown to 2015 assesses progress in the 75 countries that together account for more than 95% of all maternal and child deaths, and the report includes one-page country profiles for these countries.

It  shows that the number of women who die each year from pregnancy or childbirth-related complications dropped significantly from 543,000 in 1990 to 287,000 in 2010. Thirty of the 75 Countdown countries showed reductions of 50% or more in their maternal mortality ratios between 1990 and 2010. However, nine countries in sub-Saharan Africa where HIV infections rates among women are typically high reported increases in maternal mortality.

Deaths among children under 5 years of age dropped from nearly 12 million in 1990 to about 6.9 million in 2011. Thirty countries cut child mortality by half or more from 1990 to 2011, and two-thirds of the Countdown countries accelerated their progress since 2000 compared with the previous decade.

Key findings where action is needed include:

• Declining global levels of maternal and child mortality, but slower progress in some countries, particularly in sub-Saharan Africa, where fertility levels typically remain high: These countries must be prioritised for collective global, regional, and national action.
• Newborn deaths now accounting for 40% or more of all child deaths in 35 of the Countdown countries:  Improving newborn survival, including reducing stillbirths, must be a major focus of policies and programmes.
• Unacceptably high levels of stunting, a form of growth failure resulting from chronic undernutrition, in virtually all 75 countries: Nutrition must be an essential ingredient of maternal, newborn, and child survival programmes.
• Wide inequities in coverage for key interventions, both across and within Countdown countries: Global and national efforts must focus on reaching the poorest and other vulnerable sub-groups of the population.
• High levels of fertility and unmet need for family planning highlight the need to broaden access to contraception: Growing political momentum around family planning must be translated into substantially increased resources.

The School’s Justine Hsu was lead author on a companion paper tracking the amount of official development assistance provided for reproductive health in 2009 and 2010. “Although the volume of aid for reproductive health is quite substantial, such funding is not balanced across activities – if international targets are going to be met for universal access to reproductive health, more balanced aid needs to go to essential reproductive health services such as family planning,”she said.

“We need to continue to analyse trends and breakdowns of data to understand what aspects of reproductive health are being supported, and to ensure donors are keeping to their commitments.”

Countdown will be working with country teams to undertake analyses to better understand and accelerate change for women’s and children’s health and coverage of care. The School will be working on several of these analyses, especially with partners in Tanzania.

Image: Countdown to 2015 Accountability for Maternal, Newborn and Child Survival report cover. Credit: UN Photo/John Isaac

Former Diploma in Tropical Nursing Lecturer at the School, Khalil Dale MBE, has been awarded the Florence Nightingale Medal.

Abducted and killed in Pakistan while working for the British Red Cross in 2012, Khalil Dale was posthumously awarded the prize by the International Committee of the Red Cross (ICRC) after three decades devoted to helping people in crisis around the world.

Since his first overseas mission for the Red Cross to Kenya in 1981, Khalil went on to work in Sudan, Somalia, Afghanistan and Iraq, before his posting to Pakistan with the ICRC.  He was given life-time membership of the Kenya Red Cross in recognition of his work during the famine, and was made a Member of the British Empire (MBE) in 1994.

The Florence Nightingale Medal is a medal instituted in 1912 by the International Committee of the Red Cross. It is the highest international distinction a nurse can achieve and is awarded to nurses or nursing aides for “exceptional courage and devotion to the wounded, sick or disabled or to civilian victims of a conflict or disaster” or “exemplary services or a creative and pioneering spirit in the areas of public health or nursing education”.

Dame Claire Bertschinger DBE DL said of Mr Dale: “Khalil highly deserves the Florence Nightingale Medal. He was an exceptional friend & colleague of mine, Alumnus of London School of Hygiene and Tropical Medicine, who lectured on the Diploma in Tropical Nursing course.  His devotion to his work was commendable and he will be greatly missed. “

Image: Khalil Dale MBE. Credit: British Red Cross

This is the second time we have awarded these fellowships, and as with last year’s awards  we received many very impressive applications from staff based both in London and overseas, across the breadth of disciplines, showing how much talent we have in the School.

The scheme aims to identify and support two research leaders of the future, and is open to staff at Lecturer, or exceptionally, Research Fellow, level to provide two years’ salary and a small sum for incidental expenses. The requirements for the awards included a strong CV, a research plan that fits with the School strategy and most importantly, a clear and ambitious plan for the future of their research careers. Working at Lecturer level is a critical time in any research career and we hope that this scheme has also helped applicants review their career strategy and plans.

The ideal applications for the fellowships included plans for securing further and future research funding, as we wanted to make sure applicants had a plan for salary support beyond the two years covered by the fellowships. Getting research funding is always a challenge, and it is particularly hard to write a grant as principal investigator that will also fund your own salary. Fellowships from for example the Wellcome Trust or the Medical Research Council can move researchers onto a more independent career track, but it is easy to wait too long to apply and then find too many years have elapsed since you completed your PhD and you lack any special circumstances such as breaks for maternity leave that might make you still be eligible to apply.

Once again, congratulations to Clare and to Lisa for their success in this round of awards.

Professor Hazel Dockrell, 24 May 2013