In 1918 the world was already devastated by WW1, then further devastated by the influenza pandemic “Spanish flu”. It affected ~ 500 million people globally, leaving a death toll of 30-50 million. Unlike most influenza, which kill the weak, young and elderly, the H1N1 strain was claiming the lives of young healthy adults. The death toll was higher than the total casualties of the war. Towns banned visitors, some places even banned hand shaking. Churches and schools were overrun with the sick, undertakers were turning people away, telling people they had to take care of burying their loved ones themselves. This was a highly infectious disease, so one can understand the panic that people were experiencing. It was so prevalent that remote islands in the Pacific were affected. Fast forward almost 100 years to 2014. The world again is in a panic over the Ebola virus. Individuals outside the White House are holding placards reading, “Stop the Flights”. However this time, panic is spreading through misinformation and constant media sensationalism. Ebola is a low transmittable disease. Therefore have we learnt nothing in the last 100 years? We are more informed, medically superior, yet panic more in regards to a spread of a deadly virus in a remote part of the world. So are we ready for the next pandemic?
I attended a lecture entitled, “Pandemics: Can We Learn from History” at the Imperial War Museum London. The lecturer was Michael Baker, Professor of Public Health at the University of Otago, Wellington. Professor Baker is a world renowned scientist of infectious diseases, epidemiology and environmental health. He has worked internationally with the World Health Organisation (WHO) and the US Centres for Disease Control and Prevention (CDC). The aim of this talk according to Professor Baker, was to move beyond the epidemiology of pandemic diseases and consider what can be learnt. Scientific knowledge, enhanced visibility, social justice and global governance in helping us respond effectively to these major health challenges.
The evening started with a clip from New Zealand’s own, Peter Jackson’s 1992 B-movie Brain Dead. A film where an individual is bitten by a Sumatran rat monkey, gets sick and dies. The character then comes back to life to kill and eat dogs, neighbours and friends. If one gets bitten, the only way to beat the disease is to cut off the limbs of the infected. Much blood and gore follows. Of course this is a silly movie, but it does almost reflect some of our thoughts of what might happen if such a disease were to occur. Later movies such as 1995’s Outbreak and 2001’s Contagion do nothing to calm our nerves. These movies coincide with the interest at that time in emerging infectious diseases.
Professor Baker explained that Australia has some truly nasty emerging infectious diseases, which if you are an epidemiologist is very interesting. One of the diseases, the Hendra virus (HeV), is a particularly horrid zoonotic (infections that spread from animals to humans) disease affecting horses and humans. It has a 50% mortality rate in humans. It is still a relatively rare disease, but this an example of the kind of outbreak that Professor Baker tracks and reports. He looks at diseases that have the potential to become pandemics, diseases that cross borders to become a worldwide phenomenon as opposed to epidemics that are localised to countries or specific areas. The idea of a localised epidemic becoming pandemic. Mathematicians are able to predict the behaviour on a scale of how infectious a disease is, such as highly infectious Measles, to low infectious Ebola.
Problems arise when agents are submitted without being symptomatic. They will not be vulnerable to being controlled. This is why HIV is not easily controlled as individuals are able to live many years with no symptoms. Whereas diseases such as SARS are easily controlled and contained because symptoms occur rapidly. The critical element in worrying about the likelihood of a pandemic is the fatality risk. It is worth noting however that the term pandemic is still quite imprecise, many people have different dimensions as to what equates to a pandemic in regards to severity of a pandemic or whether it is asymptomatic. An epidemic may be more devastating in severity to a particular region than a pandemic. Asia is experiencing devastating epidemics in regards to the H5N1 virus. H5 viruses are avian influenza that effect the digestive symptoms of birds compared to H1 viruses in humans affecting the respiratory system. Now H5 viruses have mutated in such a way that they can affect humans with devastating effects, causing high mortality rates.
International health regulations have now been established, which is a global agreement of all 193 members of the WHO in understanding new diseases, and what we should be concerned about. They will look at what is an ‘extraordinary event’, and decide if it is a risk to other states and need a coordinated response. All countries signed up for this and use a decision tree, which is a risk assessment of a particular outbreak, such as an outbreak of H5N1, the pandemic that everyone has been awaiting for over a decade.
Another category that has the potential of pandemic are the synthetic, or weaponised infectious diseases. As the science in molecular techniques and understanding of genetics has become so sophisticated, so has the potential to synthesize new genetic material, able to mimic the most devastating effects of some of the worst infectious pathogens. The fact that it is now possible to exhume old influenza viruses and experiment with them is a very scary thought. Every year the United States releases security threats of this nature, the intentional release of pathogens or the use of weaponised agents.
Then there are the exotic infectious diseases from developed countries that can clearly have pandemic potential carried by vectors such as flies and mosquitoes, such as the Zika virus that has had a resurgence in the Pacific. Additionally there is the reintroduction of diseases such as polio and measles. It is now showing that a human factor, especially with measles as to how easy an outbreak can occur. The fact that there are vaccines available and children are not being vaccinated due to misinformation about possible side effects.
Imported food and drinks with contaminants is one area that they are not just thinking about infectious agents but the full spectrum of hazards such as chemical, microbiological and radiologic. The way these affect people behave in the same way as infectious agents in how they are transmitted. An example of this was the botulism found in New Zealand baby formula which had effects similar to a pandemic.
So by looking into the history of pandemics, are we able to predict the future? One of the goals is to look at what might work. For instance would closing schools make a difference through past observational studies? One can look to the First World War were extensive records exist. In New Zealand 5% of mortality rates were due to the Spanish flu, which added to the burden of warfare. The highest mortality rate were soldiers stationed in military camps and troop ships, usually in cramped conditions were it was difficult to quarantine and isolate the infected. Research has been done into the factors to help determine the likelihood of survival or mortality if such an influenza pandemic were to occur using a case controlled study. The 1918 pandemic showed that determining factors of mortality was age, chest diameter and other well defined features. The positive relationship link between mortality and chest diameter, indicating that larger men were more vulnerable, raising the likelihood of a cytokine storm causing very swift death upon catching influenza. Further research is being done to confirm this possible factor.
Professor Baker put forward that there are 5 major lessons we can learn from the last 100 years of pandemic diseases.
High Impact, they generally increase in inequality in effect and driven by inequality, high level of unpredictability, often highly controllable and will generally cause panic and outrage. Literature from the past really shows how pandemics shaped the world at that time but how can we use these for modern times? Through sophisticated modelling, if the Spanish flu were to occur, we would likely see >60 million fatalities. These kind of events will also have an extensive economic impact. When SARS occurred, even though only ~10,000 cases were documented, it had a multi-billion dollar impact, especially in Asia. As for inequality, pandemics are far more likely to occur in poorer societies and poorer populations in a differential way, how much more likely are you to die in a poorer country as opposed to Europe. This kind of effect can be seen in the mortality rates from Aids in Africa compared to the United States and Europe. Obviously there are other factors involved, such as likelihood of testing, unknown transmission and to availability to medication. However it is a prime example of mortality rate due to inequality. Pandemics that start in poorer countries due to inequality, it is more difficult to predict the outcome of a disease from a smaller sample as they are not representative of the larger population in general. Optimistically it shows that controllability of a pandemic is good as long as the disease is not asymptomatic. When looking at SARS, it had a high transmission rate but was highly symptomatic and very little asymptomatic transmission making it highly controllable. Influenza pandemics however are a lot less controllable and airport screening has proved ineffective with low sensitivity and specificity. Panic and fear which normally leads to prejudice and xenophobia usually arises due to how an outbreak is managed and is usually elevated due to miscommunication and misinformation.
Professor Baker and the NZ-UK Link foundation Visiting Professorship lecture programme 2015 can be seen at the following events.
4th June 2015 12-3pm The Wellcome Trust.
2nd July 2015 6-8.30pm London School of Hygiene & Tropical Medicine.
15th July 2015 6-8.30pm City of London, Guildhall.
By Darren Carty, second year student, BSc Honours Biological Sciences (Molecular Biology & Genetics)
On Tuesday 17th March 2015 I attended the Oxford London Lecture at The Assembly Hall, Church House in Westminster, London for a lecture on “Knowledge, nudge and nanny: opportunities to improve the nation’s diet”. Now in its fifth year, the Oxford London lecture is run annually by the University of Oxford and aims to connect with a wider audience, providing them the knowledge of Oxford’s latest research.
Professor Susan Jebb, the speaker for the evening is a member of the Diet and Population Health research team in the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Her research is based around public health nutrition issues, looking into cardiovascular diseases related to obesity and how this can be prevented through primary interventions within community and primary care.
The lecture was focused around two questions; what we are eating and what are we feeding to our children? And, are the problems big enough for change? Food has been a problem in recent years and there have been many arguments as to whether the problems lie with individual actions or just too many choices.
Professor Jebb discussed the question of whether the nation’s diet can be improved in the future. It is understood that the national healthcare system needs to be strengthened to focus on the prevention of avoidable diseases, as poor diet is a major cause of ill health. With over 12% of the population in ill health and 20% of the population obese nationally the population is generally eating too much of everything, especially food and drinks high in fats and sugar, and a diet lacking in fibre. Examples of studies were discussed to illustrate the dietary pattern and relationship between diets that are high in fat and sugar and excess weight gain. Results have shown the higher the risk of becoming obese, weight gain and a higher BMI with the risk of cardiovascular diseases.
Advertising and social media are a big factor, influencing the minds of people on what they eat. People should understand the metabolic information and the nutrients needed to have a healthy balanced diet; understating the patterns and proportions of food intake. The lecture continued to provide examples of studies of the relationship between over consuming of a higher fat and sugary diet and becoming more overweight.
One intervention model that Professor Jebb discussed was the 4Ps. It was found that more interventions should be carried out on the personal and population level. The 4Ps are: People, Products, Promotion and Places.
Recent campaigns such as Change 4 Life have increased the awareness of healthy eating with the aim of providing help for individuals to have targets, educating them on the understanding behind being healthy. Results have shown the behavioural changes by signposting healthier choices through labelling, causing people to think before consuming food and drink. Even though the effect of the campaign did alter a small population, the change was not large enough for the wider public to change their perspective when choosing food.
Over the years, products have changed to make them healthier on the shelves. There are now more and more products to provide the public with choices, reducing the trend of weight gain. Reformulation is the important strategy to reduce fat, saturated fat, sugar and salt and therefore also reduce intake consumptions to reduce calories by cutting portion sizes. As much as public acceptability is vital to maintain a momentum for the change, it is difficult for the food industry to continuously change due to the high cost.
Having the right promotion is important to provide healthy options, changing the population’s perspective on their food choices. Yet some examples provided by Professor Jebb shown no effects. The in-store environment changes the peoples’ choices. Whilst uplifting the sales with gondola-end promotions in supermarkets to increase their sales figures, the way supermarkets place their products in different positions restricts consumer choices, persuading them to buy the products that they might not want to in the first place.
Food is everywhere. Survey data provided by Professor Jebb shows a positive relationship between obesity and the places of where fast food shops are located. It was found that those live nearer the shops and food outlets have increased levels of obesity. Educating the public is important to send the message of being and eating healthy. It was suggested that perhaps using the planning law to develop healthy zoning policies near schools. Banning sugars and confectionary from near schools could have a positive influence on young people.
What do we need to do in terms of health? Professor Jebb discussed the interventions that can we apply to reduce the level of obesity. Information support, product renovation, out of home support, healthier options in all local food outlets, marketing controls, public procurement and provision, workplace incentives (for employees for choosing healthier options) and fiscal measures were just some examples listed.
In conclusion, poor diet is a major concern for the UK population with two thirds of adults being overweight in the current climate. Top level measures are needed to promote a healthier diet as it is an essential complement to the individual lifestyle interventions. Education is useful to provide information to the public but it was rarely sufficient and not always necessary. Therefore, actions from the industry are crucial to transform the food environment preventing the increase of obesity and over consumption. There is a subtle balance of power between policy makers, industry and the public, which needs to be understood and managed if effective policies are to be successfully adopted. However, some argue that foods are often consumed below the level of conscious decision making, implying that nudges in the environment change what we put in our mouth. Is this enough to help make the change? Or do we need strong policy actions acting as a nanny to help change the perspective of food and the opportunity to improve diet?
After Professor Susan Jebb’s lecture, a panel discussion was held with:
Chair: Alice Thomson, a columnist from The Times
• Professor Susan Jebb
• Lord Krebs (House of Lords, Chair of the Food Standards Agency, Science and Technology Committee, Principal of Jesus College, Oxford)
• Mr Joshua Hardie (Director of Group Corporate Responsibility at Tesco)
• Lady Young (CEO of Diabetes UK and previously Chair of the Environment Agency and Deputy Director of the BBC)
By Kiu Sum, first year student, BSc Honours Human Nutrition
On 4 July 2012 CERN announced to the world that they had found what they believe to be the elusive ‘God Particle’, the Higgs boson. A day now known to physicists as Higgserpendance Day. The following day the front covers of newspapers did not have the usual politics, banking scandals or Kim Kardashian’s latest exploits, they were completely dedicated to this subatomic particle. What is the importance of this? Why would anyone care? What does it do?
I recently attended The Bakerian Medal and Lecture at The Royal Society, an award which started in 1775 by Henry Baker. It is the premier lecture in the physical sciences which is awarded yearly. This year it would be given by Professor John Ellis CBE FRS of Kings College London on his work at CERN and the Higgs boson, entitled, ‘The Long Road to the Higgs boson – and beyond’.
I had seen photos of John Ellis with Stephen Hawking, wearing t- shirts and chinos, long silver hair and big silver bushy beard and I thought ‘cool dude’. In person he does not disappoint, a larger-than-life character.
Professor Ellis received his PhD in theoretical particle physics from King’s College, Cambridge in 1971. His areas of interest focus on particle physics, astrophysics, cosmology, quantum gravity and lately the interface between particle physics and cosmology (particle astrophysics). He has held positions at the Stanford Linear Accelerator Centre and California Institute of Technology. He then moved to CERN, where he remains and maintains a joint position as the Clerk Maxwell Professor of Theoretical Physics at King’s College London. He has received awards including the Maxwell Medal and the Paul Dirac Prize, in 2012 he was awarded a CBE. He was awarded the 2015 Bakerian Medal and Lecture for his ground breaking work in the physics of the Higgs boson and his attempts at unifying the fundamental forces of nature through his work at the Large Hadron Collider (LHC).
After decades of searching, starting in 1964 by Peter Higgs, the discovery of the Higgs boson occurred at CERN’s LHC in 2012. This unique particle which is the signature of the origin of the masses of elementary particles. It completes the Standard Model describing all physical matter in the Universe.
After taking to the stage Professor Ellis thanked the audience for attending, and that it was his pleasure to be giving this lecture to us. Being humble with success is such a redeeming quality. He attempted to share what Higgs is telling us and what is beyond in the Universe and how one would go about finding it?
We know that matter contains molecules, these molecules contain atoms and atoms contain nuclei, which at the centre have electrons whizzing around, protons and neutrons, up or down quarks defining the protons and neutrons. What they are trying to achieve at the LHC is not only the physical properties of visible matter, but also of what the physical properties of the invisible, like Dark Matter, believed to having played a pivotal role in the formation of the galaxies.
During the 20th century experiments were carried out on cosmic rays, which contained charged particles with extremely high energies. It was through the experiments on these particles that phenomena such as anti-matter were discovered. As techniques progressed during the 20th century, if one were to work with these particles, they would need to be done so in a controlled manner using known beams of particles and known energies. Hence, particle accelerators were constructed. The experiments carried out revealed what is known as the Standard Model of particle physics. Experiments began to find new physical phenomena of the type that had been predicted with the Standard Model. During the 1980’s and 1990’s more detailed experiments were carried out, confirming predictions made by the Standard Model with extreme accuracy.
So what does this Standard Model consist of? It describes visible matter known in the universe. The nuclei of the visible matter, the quarks, electrons and heavier electron like particles such as muons. These particles are the basic building blocks of matter. Therefore, to build something, you have to stick these building blocks together. To understand the fundamental forces, such as gravitation, electro magnetism and the two other forces that act within the nuclei, the strong nuclear force that holds the nuclei together and the weak nuclear force that is responsible for radioactivity. These are what John Ellis likes to call the Cosmic DNA, encoding all information needed to make all the visible stuff in the universe.
One has to know where particle mass comes from? We know that weight is proportional to mass as told by Newton, Einstein told us that energy is related to mass in his famous equation. But unfortunately they did not tell us where this mass came from in the first place? They did not explain the origin of mass? This is where Peter Higgs comes in, his theory of where particle masses may come from. In his 1964 paper, he would predict the existence of the particle known as the Higgs boson. The basic idea was to postulate what physicists call a field, a sort of universal medium that extends throughout all of space. To be able to travel through the Higgs field, one would imagine that a massless photon would travel through this field at the speed of light without really interacting, just skimming through the field. Particles containing mass, such as an electron move more slowly, it will interact with the field, it is moving slower than the speed of light. A heavier particle with a large mass will move very slowly through the field and interact deeply.
The Higgs field is said to be similar to the electromagnetic field, always being constant and everywhere. It is this field in particular that may explain why particles have mass. It has been difficult to confirm that this field really exists, this being of importance to finding the Higgs boson particle. If one imagines this field as snow, quantum of this snow would be a snowflake. The quantum of this field is the Higgs boson particle. Of course not all snowflakes are the same, each one will have different composites of water molecules. Subsequently, will there be other formations of the Higgs boson particles? Having found one Higgs boson particle, the search now is to find others. The importance of finding this particle can confirm that the Standard Model was correct. What they discovered at CERN, was that the particle did behave, interact and decay in the manner that the Standard Model predicted.
In a pre-published paper John Ellis sent to a science publication, they said that they had, “without a doubt found the Higgs boson particle”. Of course the scientific journal replied with, no, no, no, you cannot claim that you have without a doubt found the Higgs boson particle. On 10 December 2013, Peter Higgs and Francois Englert won the Nobel Prize, with the Nobel Prize headline, that they had, “without a doubt found the Higgs boson particle”. It seems what was a no for a science journal, was fine for the Nobel Prize Committee.
Professor Ellis continues to work at CERN on the physics of the Higgs boson particle, and Dark Matter. However his primary work is Supersymmetry, which is an extension of the Standard Model that may predict a partner particle for each particle in the Standard Model, explaining why particles have mass.
By Darren Carty, second year student, BSc Honours Biological Sciences (Molecular Biology & Genetics)
The Westminster Nutrition Society (WNS) had an annual Careers and Employability event on Wednesday 25 February 2015, in the Pavilion at Cavendish Campus. The event was well attended by students studying on nutrition courses. Five external guest speakers were invited for the afternoon to speak about their experiences, their careers and the opportunities available for students.
The afternoon started off with the Human Nutrition BSc Honours Course Leader, Dr Ihab Tewik introducing the event and welcoming both guests, students and staff. Leonie Milliner, the Chief Executive from Association for Nutrition (AfN) started the afternoon off speaking about the AfN, what is it, the process of being a registered nutritionist after graduating and how students can become involved in a variety of opportunities. As a registered charity, the AfN was launched in June 2010 with the prime purpose of protecting the public and at the same time to collectively influence inter-professional relations with other professionals. Since the Human Nutrition course at Westminster is accredited by the AfN, students automatically become Associated Nutritionists (ANutr) after graduating by registering within two years. Not every university gives this opportunity to their students and this is an example of how the University prepares students to become health professionals upon graduating.
Dr Margaret Ashwell OBE annually gives lectures to Human Nutrition students on one of the modules. Having done a lot in her science career, Dr Ashwell spoke about her scientific research and the importance of scientific communications to the students. Inspiring us with her vast knowledge of science over the years, Dr Ashwell ended the talk by giving some advice to students on how to succeed “if your results don’t make physiological sense, think: you may have made a mistake or you may have made a discovery”.
The event welcomed another speaker, Dr Linda Thomas, Science Director from Yakult UK Ltd. It was interesting to hear how Dr Thomas started off as a microbiologist and eventually became a Science Director. Speaking about her career experiences and the challenges she went through, it was fascinating to know how knowing people working in the industry has led her to find opportunities and giving her the experience to seek what is out there. As well as sharing her challenges, she gave advice to students on what employers look for during the recruitment process. Standing out from the crowd, being enthusiastic and demonstrating relevant skills are just a few good examples.
Helena Gibson-Moore, a Nutrition Scientist from the British Nutrition Foundation (BNF) was the next speaker after a break. From a small charity based in London, she spoke introduced the charity and how the BNF offers opportunities for students to expand their knowledge and skills through conferences, internships and membership. The last speaker of the day was Mark Hollingsworth, CEO of The Nutrition Society. It was interesting to hear he came from Air Force and how his career has progressed to end up in his current role.
Attendees were given an explanation of The Nutrition Society and how becoming a member of the society gives members four different types of opportunity: knowledge, support, development and networking. It was inspiring to know that for only £20 a year, student members can have access to these opportunities.
The afternoon ended with a session of networking between staff, students and guest speakers. The event was a success and all students enjoyed the afternoon, knowing that there are opportunities for students to expand their networks, knowledge and skills whilst studying at the University of Westminster.
“A great opportunity to hear and learn from key professionals in the field of nutrition at what was a well attended event” (Colette Hurst, President of Westminster Nutrition Society).
For more information about the Westminster Nutrition Society or would like to join (membership is free), please contact them at firstname.lastname@example.org or follow them on Twitter: @NutSocUWSU (During the afternoon, there was LIVE tweeting using hashtag #UoWNutrition)
By Kiu Sum, first year student, BSc Honours Human Nutrition
Over 380 people filled the Little Titchfield Street lecture theatre on Thursday 12 February for the final Plug In Your Brain talk of 2015 – ‘Our Strange Thoughts’. All the excitement and commotion was for Journalist David Adam, here to discuss (among other things) OCD, blood and HIV.
What is OCD?
Obsessive Compulsive Disorder (OCD) is an anxiety disorder that causes the sufferer to experience unwanted and obsessional thoughts. These thoughts are then followed by compulsions or sudden urges. A classic example of OCD is people who have an obsessive fear of getting infected from the bacteria they come into contact with on a daily basis from touching handles and using public transport. This then causes the individual to act in certain ways to prevent any chance of this happening, for example, constant washing and cleaning of the hands, time consuming hand washing rituals, wearing gloves to prevent skin coming into contact with any surfaces and not touching anyone else such as a high five or handshake. OCD affects as many twelve out of every one thousand and furthermore, the World Health Organisation (WHO) has ranked OCD in the top ten of the most disabling illnesses of any kind, and this is because of the large negative impact it has on the sufferers and how it can completely turn their lives upside down.
In David Adam’s book ‘The Man Who Couldn’t Stop’, he talks about his history of OCD and his lifelong personal battle with it. He tells readers how OCD can be managed and even overcome in some cases, all without coming across as a self-help book, but rather as a narrator sharing his personal story with the intention of helping other OCD sufferers. David’s OCD is based on the extreme fear of catching HIV and being infected. He has suffered from this since 1981 when he was aged 19. His OCD stems from watching a television advert back in 1981 which told viewers all about the risks of HIV, the course of the infection and the future of HIV.
During the Plug In Your Brain talk (‘Our Strange Thoughts’) Psychology Reader Dr Viren Swami kept things flowing by asking David a series of interesting questions that really got him talking and allowed the audience to gain an insight into his life as someone who suffers from OCD. David informed the audience that whatever he would be doing, he would always be thinking about HIV and the possibilities of him catching it. David then goes on to talk about treatments for OCD and how it all started off back in the middle ages when OCD was seen purely as demonic possession and therefore, treatments were either exorcism or burning the sufferers alive in hope of driving out the evil demons and spirits. However, it is safe to say that treatments have changed quite drastically since then and now one of the most popular and effective treatments of OCD is Cognitive Behavioural Therapy (CBT). CBT includes exposing the individual to his/her obsession in order to reduce the anxiety and compulsion with every exposure.
During the talk, David told audience members that after the birth of his baby daughter, his OCD increased and this time he had obtained a new fear – fear of passing on HIV to his daughter. David was then told by his psychiatrist during his CBT session to do one particular rather weird thing – whenever he found himself bleeding, to smear his blood on his baby daughter! His psychiatrist believed that this was one technique that would remove his fear of passing on HIV to his daughter. David still suffers from OCD but he states that he now lives resisting acting upon his fear of HIV and that he learnt to control it because regardless of everything he knows that it is an irrational fear.
The insightful and interesting event was then wrapped up after a buzzing Q&A session between David and the audience, in which people asked about many different things regarding OCD. We also heard experiences and stories of audience members who also suffer from OCD themselves.
By Ferial Yahi, final year student, BSc Honours Cognitive Neuroscience.