Adaptable prosthetics for amputees

Approximately one in every 1,000 people in the UK is an amputee. Many lose their limbs as the result of tragic accidents or due to active military combat and for some amputees losing a limb is a loss of freedom.

Bryce Dyer (pictured) is part of a team of design engineers and clinicians studying prosthetics at BU’s Design Simulation Research Centre: “Many prosthetic limbs remain unused simply because they can be so uncomfortable over time,” he says.

Fitting a false limb is currently “a bit of a black art” says Dyer. Prosthetists traditionally require decades of experience to do their job successfully and are dependent upon the subjective feedback of patients, with no other method of measuring fit. Additionally, current technology does not allow for changes in volume – patients’ stumps may swell and contract. “It’s like having your feet change size on a daily basis and expecting your shoes to still fit comfortably,” says Dyer.

Led by Professor Siamak Noroozi, the BU team are turning an academic concept into a practical product that could lessen the misery of thousands of amputees.

They are creating a ‘smart socket’ – a lower-limb prosthetic which can adjust itself to fit the changing shape of the limb stump it connects with. The design team say the fit will be so comfortable that amputee servicemen may even be able to return to active combat.

Calling on combined expertise, BU’s School of Design, Engineering and Computing is using artificial intelligence to create a self-learning system that will measure interactions between socket and limb stump during the fitting and wear.

“It is very much at a research and development stage,” says Dyer. Currently the team are also attempting to miniaturise the technology to make it light and portable as well as incorporating wireless technology.

BU scientists have teamed with commercial partners at prosthetics and orthotics supplier Chas A Blatchford & Sons, who work with the Ministry of Defence Medical Rehabilitation Centre in Surrey, where injured soldiers are sent following service in Afghanistan and Iraq.

“One of the great things about this industrial partnership is that we will be able to get feedback from the very kind of people we are trying to help,” says Dyer.

With better fitting false limbs, medical costs will fall, say BU designers. Prosthetists will be able to get it right first time and will require less experience to be able to do their job properly. Being agile enough to return to active service is a huge bonus for the rising numbers of amputee soldiers. “It will get them back in the field rather than being retired early or restricted in what they can do,” says Dyer.

Understanding how elite sprinters perform with artificial limbs or “blades” and how different types of prostheses compare is central to another strand of Dyer’s research. “Paralympic running world records are still being set on a near annual basis – the sport hasn’t settled down yet. I’m looking at how individuals should be grouped together or separated – how to give the fairest possible race.”

As well as informing future Paralympic Committees, the research will apply to disability in sport in general. Should someone who’s lost both limbs compete against a runner missing just one limb, for example? And how should technology be categorised, when variations in quality of false limbs may create substantial differences among international athletes?

“Some 30 years ago, it was all about enabling disabled people to take part in sport,” says Dyer. “But now the quality of performances and the sums of money involved are so great, there’s much more at stake. We don’t want to restrict technology but we need to find a way to measure it.”

How group behaviour can affect decisions in the workplace

BU researchers within the Human Resources and Organisational Behaviour department at BU’s Business School are working on as many as 15 projects at a time. All are linked around a common theme – how individual employees, groups and structures have an impact upon behaviour within an organisation.

Dr Davide Secchi collaborates with colleague Dr Hong Bui on a number of projects in the UK and abroad.

One joint project investigates how group behaviour might affect individual attitudes towards social responsibility at work. Using questionnaires and group discussions, the BU team assessed how attitudes might change according to group opinion. For instance, is it acceptable for businesses to relax environmental responsibilities when confronted by harsh economic times?

When respondents changed their minds as to what was acceptable behaviour after group discussions, Drs Bui and Secchi started to look for patterns.

Contrary to popular research, respondents in this case who had a change of heart were not necessarily those judged to be intellectually open, nor did how well the group knew each other appear to have any effect.

“Research shows it is easier to change your mind when confronted by opinions with people you already know, but this did not happen in our case – that was interesting,” says Dr Secchi, who alongside Dr Bui now plans to investigate other factors such as group ‘climate’, size and gender balance.

By its very nature, organisational behaviour crosses into many disciplines, including applied psychology, cognitive science, organisational sociology and business management. Drs Bui and Secchi conduct their research among students fresh from internships as well as employees in the private and public sector and both actively seek out companies and organisations interested in collaboration or funding research.

Typically research draws data from questionnaires or existing studies and uses quantitative and some qualitative research. Inspiration comes from a mix of brainstorming, developing existing research or at the request of funding bodies. Dr Secchi, for instance, developed a project on ‘bandwagon thinking’ after reading an article arguing the US sub-prime mortgage crisis occurred due to a kind of ‘group think.’

“US bankers began overlooking important information about loans and mortgages because everyone was doing it,” he explains.

This led Dr Secchi to investigate how this pattern might be mirrored in the workplace: “If people do not critically evaluate advice and decisions from co-workers and managers, they might be subject to bandwagon thinking,” he says.

Dr Secchi has created a theoretical framework to test how mindful employees might be; he hopes results will eventually be used by businesses.

Dr Bui, who specialises in how learning organisations develop, is keen to expand her research into systems thinking – seeing patterns of change and interrelations, rather than static snapshots.

“This is a shift of mind from seeing ourselves as separate to connected to the world, from seeing problems as caused by someone or something ‘out there’ to seeing how our own actions create problems. It is very under-researched in management,” she says.

One emerging trend Dr Secchi intends to pursue examines theories of irresponsibility. “Traditionally organisational behaviour has focused on the positive – how people feel good, responsible and like to do their job. Now we are starting to look at the causes of unethical and irresponsible behaviour.”

Prosopagnosia

Imagine not being able to recognise your own child at nursery or even pick out your own face from a line-up of photos. This is just how severe face blindness or prosopagnosia can be. BU psychologist Dr Sarah Bate (pictured) says: “In extreme cases, people might withdraw socially – become depressed, leave their job, or just suffer endless embarrassment.”

Until the last decade or so, face blindness was virtually unknown, but now thousands of people, including children as young as four, have contacted BU; one of the largest research centres worldwide to investigate face blindness. Dr Bate estimates one in 50 suffers from prosopagnosia to some degree – some struggle to put a name to a face whereas others can’t recognise people they have known their whole lives.

Whether this condition is caused by nature or nurture is under debate and BU is working closely with Dartmouth College in the United States to investigate and develop training programmes to improve face recognition.

“We are seeing two types of developmental prosopagnosia (face blindness from birth),” says Dr Bate. “Those who have what we believe to be a genetic form and those who simply fail to develop the ability to recognise faces. Why is this? That is where the work needs to be done.”

Very rarely, individuals may develop prosopagnosia later in life, after a stroke or head injury. People with autism may also be unable to recognise faces. BU’s research may also provide new information about how readily the brain can adapt and change. “If the brain is very plastic, we would assume it could rewire itself and people will show great improvement in response to training. But if neural pathways are fixed, we will try and find out when it becomes reluctant to change.”

Some 10,000 people have taken BU’s online diagnostic test and 50 prosopagnosics have come in person for laboratory analysis. Researchers use a range of equipment to examine the condition: eye-tracking investigates how sufferers scan faces and researchers assess unconscious face recognition by measuring the skin conductance response.

Once diagnosed, prosopagnosics will undertake BU’s online training programme, involving an hour of visual training every day for 20 days. Participants are repeatedly shown images and learn to see differences between similar features. “We hope this will improve their ability to make fine-grained discrimination between faces, resulting in an improvement in everyday face recognition,” says Dr Bate.

“Face blindness may be influenced by factors such as not having glasses at a critical time when young or perhaps being deprived of enough social interaction as a baby,” she says. Early intervention could improve the condition.

In another significant study, researchers at BU are investigating whether the hormone oxytocin – commonly associated with creating bonds between mother and newborn – will improve face recognition in the longer term. Clinical trials at BU have already shownit brings about short-term improvement, and Dr Bate wants to see if it will work in conjunction with the training programme.

“Prosopagnosia can make life really difficult – we hope to make this training freely available to anyone who needs it,” she concludes.

Tracing the effects of  climate change on  prehistoric & future environments

Looking back at the earth’s geological record it is clear that past ecosystems were very different from those we see today. Over sixty five million years ago, for example, dinosaurs formed a key part of the earth’s ecosystem.

Dr John Stewart from BU’s School of Applied Sciences has studied the interaction between ancient ecosystems – paleoecology – and evolution of humans and other organisms over the last 100,000 years, undertaking everything from excavating cave sites in Belgium to exploring the desert of Abu Dhabi.

In one study Dr Stewart has taken existing knowledge of the geographical spread of plant and animal species throughout the warming and cooling of the Ice Ages to provide insights into human origins, including the evolution and extinction of Neanderthals.

He has also examined the rise of the ‘first Europeans’, along with the Denisovans – a newly discovered group – mysterious cousins of the Neanderthals, who occupied a vast realm stretching from the cold expanse of Siberia to the tropical forests of Indonesia.

The key insight in this work, conducted alongside Professor Chris Stringer of London’s Natural History Museum, came from understanding the important role of the refuge taken by a species from harsher conditions – known as a refugium – which has a tremendous influence on the evolutionary future of the species. Once the climate changes again, for instance as ice sheets melt, these refugia populations can expand or connect up again.

Evolution has also had a huge influence. The inhabitants are not the same as the original populations as a result of genetic mutations. The time spent apart in refuge generally serves to splinter a once unified species.

Previous research into hedgehogs, polar bears and other animals suggest that, even once an Ice Age ends and the different populations start intermingling again, they never really merge back together as a single group. This process drives important evolutionary changes, which can ultimately lead to the origins of a new species.

Ultimately, this explains why Homo sapiens are still here and other human species went extinct some 30,000 years ago: our ancestors chose the right refuge to wait out the Ice Age. Today, Dr Stewart’s work has shifted away from fossil remains to ancient DNA.

Traditionally insights into the evolution of species have come from fossils, but we now know that the genetic changes that underlie a major change in body shape can be minor.

“The most exciting development in my field has been the ability to analyse ancient DNA, which has begun to allow us to see evolution happening over the last several dozen thousand years,” explains Dr Stewart.

The claim that climate change caused the Neanderthals’ demise is supported by work by Love Dalén at the Swedish Museum of Natural History in Stockholm, who has looked at the genes in 13 Neanderthal fossils found in southern Europe and western Asia.

All Neanderthal fossils more than 48,000 years old, and those found in Asia, had a higher level of genetic diversity than later European fossils, suggesting that the Neanderthals probably went through an evolutionary ‘bottleneck’ where a significant percentage of them perished.

When a bottleneck occurs, the remaining individuals are a much less diverse group, which makes it more difficult for them to evolve and adapt to a changing environment.

Dr Stewart, who is doing DNA studies in collaboration with teams at the Natural History Museum in Stockholm and the Universities of York and Royal Holloway, is now focusing on using genetics to elucidate the evolution of a wide range of creatures.

He has conducted recent studies at the cave site of Trou Al’Wesse, a refugium once occupied by Neanderthals, in Belgium. He is studying how animal populations changed as a result of Ice Age climate change to understand the evolutionary processes that have taken place over the last 50,000 years.

Dr Stewart’s work is not confined to the past though. It informs the present too. Recently there had been a proposal to eradicate the Eagle Owl because it killed other birds, such as hen harriers, and was not thought to be a native species. But Dr Stewart’s studies of fossils and more recent archaeological records revealed the bird, or something like it, has been present in Britain for up to 700,000 years. The plan to cull the birds has now been abandoned.

Most importantly this research can help us predict the future. The fear is that our everexpanding impact on the planet will trigger ecological collapse. The only way to know for sure is to look back into the past.

“By studying how organisms have reacted to past climate change,” explains Dr Stewart, “we can learn lessons about what may take place due to human-caused global warming.”

How a virtual reality environment is the solution to researching this psychological phenomenon

Many people associate computer animation with the latest Hollywood blockbuster, but it can also be used to explore complex psychological and social interactions, especially where they involve violence. Researchers at the National Centre for Computer Animation (NCCA) at BU have been doing just that.

Most psychology students will be familiar with the bystander effect; a classic piece of research in behavioural psychology suggesting the more people who witness a violent incident, the less likely it is that someone will intervene. It was first identified in the 1960s, but conducting research on the phenomenon has been difficult. Most experiments rely on staging fake emergencies or violent encounters using actors, which makes it tricky to gauge how genuine a response is. Dr Richard Southern and a team of researchers at the NCCA have the answer:

“We realised that to conduct experiments we had to recreate reality as best we could,” he explains. “With virtual reality, if you can trick people into believing they are in a place and the responses that occur around them in that environment are believable, then people will respond in a realistic way.”

To create their virtual world, Dr Southern and Professor Zhang used a system based at University College London (UCL) called ‘ReaCToR.’ Stereo images were projected onto the walls and floor of a small room using high-resolution digital projectors.

Participants stepping into the room wore lightweight shutter glasses similar to those used on modern 3D TVs, producing a realistic 3D sports bar scene. Head-tracking technology ensured they saw the image from the right perspective while an eight-speaker system delivered directional sound.

In a series of experiments conducted with colleagues at UCL and Lancaster University, the team recruited Arsenal FC fans and asked them to enter the ‘ReaCToR’ to look out for football memorabilia. Once inside, the participants were faced with a confrontation between two men.

“We used different scenarios to see what factors can impede whether someone will intervene when the confrontation starts,” Dr Southern explains. “We varied whether the victim in the confrontation was a supporter of Arsenal and wore an Arsenal jersey or showed little interest in the team and wore a generic red shirt. The participants intervened significantly more if they were of the same group affiliation as the victim.”

A whole host of variables were considered, with victims pleading for help in some scenarios and virtual characters demonstrating a range of different reactions. All of this provides new insight into human behaviour in the face of confrontation.

The work demonstrates the potential virtual simulations can offer when exploring human responses to violent situations, crucially, without exposing anyone to harm. This project has already attracted attention from the police and the Ministry of Defence to help train their personnel in diffusing confrontational situations. The technology can also be used to help evaluate a prisoner’s likelihood of violent re-offending and a pilot study has already yielded promising results.

Dr Southern said: “This is an enabling technology. It paves the way towards using immersive scenarios for all kinds of uses.”

Research shows how huge  international sporting events  more than pay their way

During the Olympic and Paralympic Games the eyes of the world were fixed firmly on the UK. The question is how does a country continue to reap the benefits after such an event?

BU’s Dr Richard Shipway (pictured) is researching the longer term benefits that can be leveraged from the Games, with the aim of informing future policy for major sporting events. This has included working with organisations such as Visit Britain and Visit England to scrutinise their Games-related tourism activity, as well as looking to the past for inspiration.

“We are analysing everything that has worked in the past to take forward to future megaevents, such as the Sochi 2014 Winter Games, the 2014 Brazil Football World Cup and the 2016 Rio Olympics,” he confirms.

The state of Queensland, although distant from the 2000 Games host city Sydney, offers a good example. This region worked hard to capitalise on the tourism potential of hosting the Games with spin-off sports events, promoting itself as a destination for pre-Olympic and Paralympic Games training, identifying benefits for arts and cultural communities and working with local businesses to help them gain contracts and revenues associated with the Olympics.

All these activities were publicised on the global stage. As a result, Queensland won Olympic contracts worth AU $408 million (£262 million), hosted more than 2,500 Olympic and Paralympic athletes from 48 countries, and welcomed 80% of the 181 Olympic teams to train in the region, which brought a further AU $36 million (£23 million) to the economy.

Less quantifiable but equally significant benefits include heightened media exposure and new relationships with partners in the tourism industry.

International models like this will help devise recommendations for tourism legacy initiatives associated with global sports events, and with the London 2012 Olympic and Paralympic Games estimated to generate £2.34 billion over a ten year period, it is crucial research.

The potential benefits go beyond economics though. While it is harder to measure social impacts, much of the tourism legacy will hinge on these less tangible aspects. As Dr Shipway puts it: “How can you put a value on civic pride and public engagement? You cannot place a monetary value gained from Mrs Brown carrying the Olympic Torch or the impact of Mr Jones being a 2012 volunteer – but they have a huge societal tourism impact.”

These social impacts influence how the UK is portrayed globally in the media, or the warmth of the welcome that visitors receive when they get here. They can make or break our tourism industry.

With precious little research having previously been invested in the tourism legacies of major sporting events, and a paucity of analysis over successful initiatives in this area, the work produced at BU by Dr Shipway and his colleagues should prove crucial to host nations, both now and in the future. Applied to London 2012, this is research that could keep the eyes of the world focused on the UK for years after the closing ceremonies.

New BU Dementia institute discovers new ways of making tourist and leisure attractions dementia-friendly

Fear of getting lost, fear of not finding the toilets or being misunderstood; there are many reasons why people with dementia and the families who care for them stop going on holiday or day trips.

For people with dementia, even simple days out can pose a host of hazards. Often, families say, it is easier to just stay at home. But BU’s newly launched Dementia Institute hopes to change that.

“We have a vision,” says Professor Anthea Innes (pictured) of the newly launched BU Dementia Institute (BUDI), “that perhaps in the future, Bournemouth might become a dementia-friendly town and tourist destination.”

An expert in health and social care research, Professor Innes is collaborating with Professor Stephen Page of BU’s School of Tourism to launch pioneering research into dementia-friendly tourism – developing venues where people with dementia will feel safe and at ease to enjoy themselves.

Encouraged by a government pledge to create 20 dementia-friendly cities, towns and villages by 2015, Professor Innes is working closely with those who need these facilities most.

“Our aim is to see how tourism can respond to the needs of people with dementia and their carers and find out if and why they haven’t been able to access tourist attractions and leisure facilities,” she says. “We hope to increase their use of tourist attractions, accommodation and resorts in the South of England.”

While an exploratory pilot scheme will take place locally, Professor Innes hopes to expand the research to UK facilities. “Lots of work is currently going into dementia-friendly communities – safe cashpoints, trained staff and police for instance – but we are the only people looking specifically at leisure and tourism,” she says.

Her initial focus groups with people with dementia and their families will feed into further research with voluntary organisations, NHS services and businesses themselves. BUDI plans to develop training to shape professional dementia care in the region. In the course of its research, BUDI’s team will also interview the many tourist attractions that make up Bournemouth’s seaside resort, such as tearooms, galleries, theatres and museums.

Dorset is home to one of the largest ageing populations in England and is a good place to start. Dorset also has the lowest rate of dementia diagnosis in the country, but not because of a shortage of people with the disease. Professor Innes estimates just one in four people with dementia in Dorset have actually been diagnosed.

“That’s a shocking statistic. In other areas of the country about 4 in 10 people with dementia are diagnosed, and if you don’t have a diagnosis, you won’t be able to access services and support. You might end up in a crisis situation because you and your family have not been able to plan for the future,” she says.

Sometimes GPs are reluctant to give a diagnosis due to their perception of a lack of local services. A dementia label can also carry a stigma with families and communities – meaning people are reluctant to admit a problem, and might be unaware of the level of care available. Sometimes older people will already be in care homes, but labelled as ‘pleasantly muddled,’ rather than receiving a formal diagnosis.

A strong business case also exists for improving tourist facilities. Experts predict numbers of people with dementia will double over the next 30 years – currently the disease costs the UK economy an estimated £19 billion.

“If somewhere is labelled as dementia-friendly, it’s good for the industry and people involved. Staff will be better trained and more aware – and that’s good for levels of service provision overall,” says Professor Innes.

Modelling the impact of environmental changes

Every autumn 70,000 birds descend on the mudflats and salt marshes of the Severn Estuary to spend the winter refuelling before heading on to their spring breeding grounds.

The estuary is one of the largest in Europe and one of the most important wildlife habitats in the world.

While the squawking, fighting and feeding behaviour of the wildfowl and waders may appear random to onlookers, a small team at BU can predict exactly what the birds are up to.

Led by Professor Richard Stillman, they have created a computer program called MORPH that models the behaviour of birds and fish in response to a host of environmental changes.

“There is a lot of environmental change – from climate change to habitat loss – that puts pressure on plants and animals. Conservationists want to know what the effect will be on these creatures and how concerned they should be,” says Professor Stillman.

Much of the team’s work focuses on wading birds. “They occur in the winter in very large numbers around coastal sites and they have international protection. But these sites are important for people too – we use these coastal areas for recreation or shell fishing or port development,” Stillman says.

Overwintering birds are the easiest to model. They are not concerned with breeding or nest making, just survival, so their food supply is a key factor influencing their behaviour and population size.

To create the model, researchers divide a river or estuary into sections and collect information about the food, tidal and river behaviour from each. The characteristics of the birds are then added, including how quickly they feed, whether they are aggressive in close proximity and how much they need to eat.

“The model birds react in the same way as real birds. They are programmed to behave in ways that maximise their chances of survival. That means they avoid risky behaviour and always go for the best quality of food,” Professor Stillman explains.

Once the computer model has been constructed, it is run to see how well it compares to the real world. If it works, and the model birds feed in the same places on the same things and at the same times as their real-life counterparts, the programmers can start manipulating the simulated environment. This allows them to measure the potential impact of environmental changes on the birds.

MORPH has been used to assess the impact of the Severn Barrage – a current proposal to dam the estuary to generate renewable energy.

It showed that the internationally important colonies of wading birds such as redshank and curlew would have significantly less time to feed on the mudflats if the project went ahead.

In another project, BU researchers looked at how plans to build 80,000 coastal homes in the Solent would affect birds. Increased visitor numbers to the coast were shown to cut the bird’s survival rates.

Fish behaviour can also be studied. One model looks at the impact of brown trout in an English chalk stream after changes to river management and predator population size.

Other models look at the impact of changes in UK rivers on dace, pike and roach.

Professor Stillman believes the technique could be extended to farmland birds as well as ponies and deer in the New Forest. The researchers can even model the behaviour of shell-fisherman and the techniques are also being used to assess coastal construction and river management across Europe.

Some species and habitats, however, remain difficult to model, such as woodland birds where it is difficult to see how they are behaving.

“The ongoing challenge is to work out the limits of this approach with new species and habitats,” Professor Stillman concludes.

Reducing the carbon footprint of holidaymakers

Each year our desire to get away from it all contributes to around 5% of the world’s carbon dioxide emissions. Ignoring the impact of tourism on the environment would be equivalent to ignoring the carbon emissions of a developed industrialised nation.

This is why Dr Janet Dickinson and Dr Viachaslau Filimonau from BU’s School of Tourism are working on ways to reduce the carbon footprint of holidaymakers. Rather than developing punitive taxes or penalties, the research is looking at how to give people good incentives and strategies to cut down on unnecessary travel.

The BU team is starting close to home by studying the behaviour of holidaymakers at a Dorset campsite, where up to 300 people stay each week during the summer peak season. “The aim is to try to revolutionise the travel decision making process,” says Dr Janet Dickinson, senior lecturer in BU’s School of Tourism.

“The idea is to give people visibility of transport options in their immediate future through social networking and through smart phones so they can see there are opportunities to share transport, or opportunities to avoid making journeys,” she says.

The study is part of a wider Sixth Sense Transport Project – a collaboration between BU and colleagues from the Universities of Southampton, Lancaster, Edinburgh and Salford.

“We are looking at a campsite, but the same approach could be used in any holiday community – a hotel, group of cottages or caravan park,” Dr Dickinson explains.

“You have a community in the same place often all doing things at the same time and there’s a huge potential for people to make better use of travel resources. You have an awful lot of congestion in the areas linked to tourism.”

The idea is to use social networks so people can reveal anonymously to their fellow campers where they are and what they are doing. At the same time they can see what everyone else on the campsite is up to, what their immediate plans are, and what the weather and travel conditions are like.

“If you are heading to the beach tomorrow, and you know 50 other people are too, it allows you to make contact and share travel – or find out about bus routes – or warn of congestion. You might need just one item from the shops – and this could allow you to ask someone already at the shops or heading off there to pick it up for you,” suggests Dr Dickinson.

The project is first assessing holidaymaker’s attitudes to sharing. The team are finding out more about holidaymaker’s habits, what sort of information they are willing to share and how prepared they are to join forces. Then they will experiment with real life holidaymakers at the campsite, inviting them to try out smart phone applications designed to help them on their break.

Other parts of the project are looking at social networking in schools to help parents share transport and promote ‘walking buses’, which would see supervised groups of children walking to school on predetermined routes. Another is looking at reducing the carbon footprint of the logistics industry – the moving around of goods by lorry and train.

“The project is not about developing an application for a smart phone, but finding out about people’s travel decision making and whether their behaviour can be changed if they realise 200 other people living alongside them are about to make the same journey,” Dr Dickinson explains.

There are more than four million anglers in the UK and the sport generates an estimated £3.5 billion for the economy. But research by Dr Demetra Andreou and her colleagues at BU’s Centre for Conservation Ecology and Environmental Science has uncovered a new threat that could put many of the native fish species that UK anglers rely on at risk.

The culprit is a single celled parasite called Sphaerothecum destruens; also known as the Rosette Agent. Dr Andreou’s work has revealed that the parasite has the potential to cause widespread harm to many popular species of UK fish, including salmon, bream, carp and roach.

With her results suggesting mortality levels of up to 90% in native salmon and 53% in bream, it could prove a nightmare scenario for the angling community. If the parasite got into the UK’s aquaculture industry, the impact could be devastating. “Here we have a parasite that could cause massive decline in native fish,” says Dr Demetra Andreou. “Yet no one even knows which rivers it is in.”

The problem, she explains, is that the fish die in small numbers, just a few each day. Such small losses in a river can easily go unnoticed as the sick individuals get picked off by predators, or the bodies get washed away.

“These parasites looked like one that had been found before in salmon in the US aquaculture industry,” explains Dr Andreou. In the US the Rosette Agent had devastated salmon populations, causing up to 90% of salmon stocks to die.

Dr Andreou and her colleagues set about trying to determine whether the sub-type of the parasite found in the UK could cause similar harm to UK fish species.

By studying salmon, bream, carp and roach with the parasite, they were able to accurately determine the impact the parasite could have on the fish without having to account for other changes in environment such as temperature and food, which can complicate studies in the wild.

They found that UK Atlantic salmon are just as susceptible to the parasite as their American cousins and coarse fish like bream, carp and roach were also susceptible to the parasite.

Despite this, very little is known about how many UK lakes, rivers and fisheries the parasite is present in. It does not feature on a list of parasites that the Environment Agency routinely tests for, but Dr Andreou and her colleagues hope to change that.

“One of the things we are trying to do is to get it listed on the Environment Agency’s Novel and Category 2 parasites. This means that when fish are moved from one water body to another, they will check for this parasite as part of the health check.”

The Environment Agency is already attempting to eradicate topmouth gudgeon, an unaffected carrier of the Rosette Agent, from UK waterways. The agency has already removed hundreds of thousands of the three-inch long fish from English rivers.

“We are also developing a way of testing for the parasite in the water,” says Dr Andreou.

“By filtering the water we can extract DNA onto the filter paper and using polymerase chain reaction (PCR), we can detect whether the parasite’s genetic information is in the water. It can help to narrow down the places where we should look in the fish community for the parasite.”

Dr Andreou is also now focusing on understanding what conditions are needed for the Rosette Agent to cause an outbreak. She believes that as some species of fish are less affected than others, it is important to determine how different species compositions can influence disease emergence.

Do consumers really care?

When Dr Jeff Bray started his research into ethical clothing decisions, cheap ‘disposable’ fashion lines were growing rapidly, while many other chains were introducing organic and Fairtrade cotton lines.

“It struck me that the trend towards ultra cheap ‘disposable clothing’ was in opposition to the promotion of carefully sourced lines with ethical provenance,” he says.

His questionnaires went to 3,000 random addresses, with around 400 returned and analysed, making it the first to look at the attitudes of everyday people in the UK. “The big finding is that, although retailers are offering more ethical choices, for the majority of customers ethical considerations are not of primary concern,” he says.

The findings show consumers do not generally consider ethical issues initially. Instead, price, fit, colour and style are all more important. Ethics may still play an influencing role later down the line once they have a shortlist of a couple of items, but it is a later influence rather than a primary factor.

Interestingly received wisdom into the type of people who buy ethical clothing and who care about the issues, suggests it is the preserve of relatively high earners. This was not borne out by Dr Bray’s research, which showed as household income rises, people are less concerned.

The research also found that interest in ethical issues increases with age, with younger consumers (16-24 year olds) caring little about ethical considerations: “Price, style and look are simply so important to young people that it crowds out other considerations,” Dr Bray explained. “As you get older, your moral maturity rises and your knowledge of ethical issues and conscience develops. Ethical issues then become more interesting. However, as you age further, you shop less frequently, and as a consequence you become less aware of the issues, and thus care about them less.”

The study also shows consumers find some ethical issues are more important than others. Almost half of respondents indicated that Fairtrade labelling would make them more likely to buy an item.

“People are prepared to pay more for Fairtrade, they understand it better and they believe that it is more important overall than Organic,” says Dr Bray. Retailers wishing to introduce ethical clothing ranges may therefore be more successful if they favour Fairtrade certified cotton, over organic cotton.

Linked with the positive association with Fairtrade were the findings that consumers were most concerned about sweatshop production practices – with many boycotting or avoiding stores or brands because of highlighted sweatshop production practices.

“Media attention highlighting poor ethical standards within a supply chain is absorbed by consumers and led to some boycotting of the brand,” concludes Dr Bray.

This research has implications for both retailers and campaigners. Retailers could use these findings to help them target their ethical ranges, aiming them at a more mainstream audience, and positioning them adjacent to similar products. They might also follow recommendations to focus their ethical ranges on staples, such as socks, where style and fashion are less important to people.

Campaigners meanwhile can take Dr Bray’s research as encouragement at the effectiveness of media coverage and that it is successful in both planting the issues in people’s minds and in influencing some people’s behaviour. They could even go a step further and use this evidence as added leverage when in dialogue with a company. After all a tarnished image could remain tarnished for many years to come.

BU’s multi-disciplinary arts research bridges  the divide between  art and science

In hidden corners of the UK are locations most civilians know nothing about. These are places where bombs are made, experiments conducted and ethical boundaries stretched. Security is tight and access is restricted. These are not the sorts of places you would expect to find a group of art enthusiasts on a bus tour.

BU’s Associate Professor of Art and Media Practice, Neal White took a group of 60 people on a unique tour around covert areas of Wiltshire and Dorset for his project ‘Dark Places’: “We explored spaces of secrecy and technology,” he explains. “We visited the secret chemical and bio-chemical warfare research facility at Porton Down and had lunch at the Department of Homeland Security.”

‘Dark Places’ ended with a paper on art and covert culture given at Cambridge University, and attracted the donation of an enormous archive by an amateur enthusiast. The archive includes formerly classified records of experiments undertaken on the public and with US Military at Porton Down. Perhaps most tangibly, the project furthered the tour group’s understanding of digital photography, GPS technology, geomorphology, ethics, and the laws of land ownership.

This project is typical of White’s work. He co-founded the Office of Experiments (OOE) in 2004; an independent initiative bringing together individuals from a range of different backgrounds on projects that bridge the divide between art and science – often taking in geography, philosophy and politics along the way.

White and his colleagues’ multi-disciplinary approach is characterised by its use of new technologies. This type of research, with its undisciplined approach, sits uncomfortably – almost homelessly – in UK academia. “Arts research is a relatively new area,” says White. “We are trying to merge disciplines that have previously been kept apart in the UK.”

In other countries, universities are set up differently. The Massachusetts Institute of Technology (MIT) has a Department of Arts, Culture and Technology that funds and runs arts research. Stanford University also produces leading research in the field, as do universities in Sweden, Holland, Austria and Germany. “In the UK, the arts are seen separately from knowledge enquiry,” says White, “In most other cultures, the two things are related.”

UK education policy seems to be reluctantly and belatedly making efforts to catch up. While universities such as BU embrace the merging of art and science, there are now calls for this model to become the norm.

BU offers art researchers a place to hang their hat. “The research we’re doing merges new technologies, and I can do this kind of work at Bournemouth, embedded in digital media,” explains White.

Based within The Media School at BU, White and his team contribute their research in Art and Design through joint projects with the BU’s National Centre for Computer Animation (NCCA).

An interesting outcome of this collaborative approach is that BU is able to produce significant postgraduate arts research. “At Bournemouth, we have one of the highest research outputs in Art and Design in the country,” notes White.

White’s latest project seeks to engage those termed in social sciences as ‘functionally illiterate’ – “People who don’t know how to open a bank account, let alone have access to computers” – and teach them how to use a digital camera, create a database or upload information. It is another bus tour, this time enlisting people through the Arts Council and through community centres in central London.

Funded by the Heritage Lottery Fund, ‘Experimental Ruins: The London Orbital’ will visit improbable, underground or unremarkable suburban settings where ‘hidden’ scientific research has taken place since 1945.

White is looking to provide societal benefits as well as artistic and scientific ones. He deals with gritty subjects that have the potential to make a huge humanitarian impact – and he’s hoping to shine light on some of the world’s darkest places along the way.

Dr Melanie Klinkner explores the unique legal challenges surrounding forensic evidence from mass graves in international criminal trials

Dr Melanie Klinkner (pictured), lecturer in Law at BU’s Business School, has devoted recent years to exploring the use of forensic science – particularly forensic archaeology, anthropology, and pathology – in two international criminal proceedings: the International Criminal Tribunal for the former Yugoslavia (ICTY), and the Extraordinary Chamber in the Courts of Cambodia (ECCC), which is trying former members of the Khmer Rouge.

The nature of atrocity crimes prosecuted at an international level is such that the accused is often a senior ranking military or governmental figure, with no direct involvement in any given base crime. Forensic evidence is therefore called upon to show whether the scale and methodology of killings discovered supports the hypothesis of systematic activity; a point that often needs making for higher-order charges, such as crimes against humanity and genocide, to be proven.

Dr Klinkner’s work grapples with a key conceptual debate surrounding the trustworthiness of forensic science as evidence: “Challenges to forensic science are not so much rooted in rejections of scientific methods,” explains Dr Klinkner, “but in the problems of overcoming specific geographical and cultural variables. Ongoing hostilities, adverse weather conditions and cultural sensitivities towards the scientific examination of the dead are common in places where forensic science is not well-developed as a tool of the criminal justice system. With current practices of relying on third-party investigations at the International Criminal Court (ICC), there may also be questions about the integrity and effectiveness of outsourcing forensic fieldwork.”

Another challenge Dr Klinkner acknowledges in the excavation of mass graves is that many have been contaminated by previous attempts. The totemic ‘pyramid of skulls’ in Cambodian mass graves may be an iconoclastic image of the horrors of the Khmer Rouge, but they pose difficulties for forensic anthropologists due to the alienation of crania from skeletons, the contamination of evidence and divorce of evidence from the crime scene.

Indeed, the cultural, religious and political imperatives of the aftermath of genocide are often in conflict with the dispassionate task of forensic science – the need to remember, to bury and grieve, to immortalise, to forgive, to display in museums, to collect with a view to remembrance rather than to analyse: all these motivations and activities may sit uneasily with the requirements of a criminal investigation.

Dr Klinkner also examines the complex question of the rights of survivors and victims’ families. Clearly there is a humanitarian duty to try and identify victims and to verify and disclose the facts associated with the crimes from which they or their relatives suffered. The role this ‘right to truth’ might play at the ICC remains to be seen and, alongside her BU colleague Dr Howard Davis, Dr Klinkner is examining the impact it would have on the Court’s criminal justice provision.

Ultimately, the examination of forensic evidence in international criminal tribunals requires an interdisciplinary expertise – between legal scholarship, natural science and social science. Dr Klinkner and her colleagues in the Law Department, together with forensic archaeologists from BU’s School of Applied Sciences, are rare in being able to address so many aspects of forensic science in this evolving discipline.

What makes luxury goods luxury? BU’s unique in-house media consultancy enables students and researchers to work together on real business problems

While recession tightens its grip on the UK high street, sales of luxury goods are taking off. Top-end retailers at London Heathrow – among them Chanel, Hermès and a new Miu Miu store at Terminal 3 – recorded an 8.8% rise in gross turn over in 2011.

This is a story that BU’s in-house consultancy, the Creative Enterprise Bureau (CEB), knows well.

“The advertisers at Heathrow were looking to better understand why airport advertising might be a unique medium, particularly in the context of luxury goods for travellers,” explains Dr Mike Molesworth, Senior Lecturer in Consumer Behaviour and Online Marketing at BU.

“We’re looking at what makes luxury goods luxury. We’re looking at the importance of context in perceptions of advertising too. Also, because there are a number of interactive formats at the airport, we’re looking at why interactive media might work better than traditional advertising,” he explains.

The findings should help Heathrow’s luxury brands better target their advertising, enabling them to capitalise on recent strong sales.

This project is typical of the type the CEB takes on. Set up in 2010 with Higher Education Innovation Funding (HEIF), the idea for the Bureau was conceived by some academics in the Department of Marketing and Communications.

Now in its second year of operation, the academic base for CEB work consists of staff from the Emerging Consumer Cultures Group (ECCG) – a research group based in the Media School at BU. Consultancy draws from the group’s knowledge of consumer behaviour and culture and relevant research in these areas.

“We want to connect business problems with our academic research and expertise,” Molesworth elaborates.

Students are also involved, giving them the chance to add paid consultancy work for real clients to their CV. These students work under the supervision of BU academics and their names go on all the reports. For these reasons, they must apply to work on CEB projects and they are selected according to their area of specialism and suitability for the work.

For BU students, such projects can offer unique and exciting opportunities – and these may even extend to students who have no direct involvement in the CEB.

“The Bureau impacts on the work of the university through teaching,” says Molesworth. “Academics can talk about their research in class, but students find it very interesting to see how it can be applied to a specific problem. The CEB helps to dismantle the idea that theory and practice never meet: through these projects, students see that big companies are very interested in the latest academic research and want to use that to inform their business.”

ITV offers a good example. The broadcaster asked the CEB to explore whether advertisements shown during a commercial break work better when there is congruence between their tone or product and the programme. Students and academics looked at attitudes to advertising, and found that this type of matching has been shown to benefit both the programme and the advertiser. “That shows how theory and academic research can help clarify a business problem,” Molesworth concludes. His own work with fellow BU academic Janice Denegri-Knott informed this study.

It is early days, but so far, the Bureau has proved popular and successful. Its projects are engaging a range of businesses and academics and creating positive opportunities.

So as UK universities search for new ways to forge links with industry, and fight to increase their research output, perhaps the CEB sets a new trend. It is certainly a story worth following.

Large parts of our lives are now being monitored and analysed by computers. Log on to Amazon and intelligent data analysis software can recommend a selection of books you might like to read. Far from being a sinister intrusion into people’s privacy, the purpose of these systems is to improve our lives. Professor Bogdan Gabrys (pictured), chair in computational intelligence at BU’s Smart Technology Research Centre explains:

“There is a huge explosion in the amount and availability of data we are generating on a daily basis but unless you use it in the right way that information is not going to be very useful. We have been working with a number of companies who want to use the data they obtain during their daily business to make predictions about sales and model customer behaviour.”

Known as predictive analysis, the work by Professor Gabrys and his colleagues goes beyond simply crunching numbers. They are developing computer programs capable of learning. With this intelligent software, computers can make judgements about the quality and reliability of the data they gather. They look for patterns and adapt according to what the information will be used for.

“We are trying to design adaptive algorithms that learn on the basis of the data they receive,” says Professor Gabrys. This has led to the Centre’s work supporting businesses in the tourism and communications industries:

“We have been working with Lufthansa Systems so the airline can accurately forecast demand for different types of plane tickets. Customers going on holiday in economy class tend to book their tickets a few months in advance. If the planes fill up with economy customers, they have to turn away lucrative business and we’ve found first class customers tend to book late.”

“Communications companies like BT also want to be able to predict whether a customer is going to switch providers, as it costs BT between five to eight times more to get a new customer than to retain an existing one. So we have been helping them detect if someone is likely to change service provider. They can then be proactive, contact such customers with a good offer or just give them more of a personal touch.”

Building a learning computer system capable of adapting according to the information that is fed into it is no easy task. Most prediction software until recently has been tailor made to solve specific problems. This can make them expensive to maintain and hard to adapt.

For this, Professor Gabrys and his team have turned to one of the most successful problem solvers on the planet for inspiration – Mother Nature herself. They are building systems which process information in a similar way to the human brain, with networks of neurons that constantly rewire themselves as we learn.

They have also drawn inspiration from genetics and natural evolution seen in insects such as bees and ants, as well as flocking and swarming behaviour in birds and fish. These help to devise robust learning and optimisation algorithms.

Professor Gabrys says: “We are trying to build more flexible systems and push the boundaries of how intelligent these systems are.”

So will computers soon take the guesswork out of our everyday lives with accurate and reliable predictions?

Professor Gabrys is not so sure: “If someone tells you they can reliably predict really complex systems such as economies or financial markets one year ahead, do not believe them. Some things are predictable and some are not. The critical aspect in what we do is knowing the difference between them.”

Re-examining the evidence will minimise risk

Child murder in the UK is very rare, but when it happens it hits the headlines and child protection social workers usually get the blame.

Professor Colin Pritchard, Jill Davey and Richard Williams from BU’s Centre for Social Work and Social Policy say that high-profile child tragedies – such as that of Peter Connolly (Baby P) – have driven child protection policy for decades and led to an unhealthy bureaucratic defensiveness in child protection services, continually under siege from the media and politicians.

Their study suggests that to identify potential child murderers, researchers should focus on the killers and the key factors they have in common, rather than, as in past studies, on the levels of risk posed by the different types of assailants. This is still the focus of current Serious Case Reviews in the sector, which often rely on procedures and process.

“If we could pinpoint those people most likely to become child killers, maybe we could move towards a more effective assessment of extreme risk to a child, save lives, yet reduce defensive bureaucracy that overly fears the ‘worst case scenario’,” says the BU study.

While UK assessment models are not very reliable, they show that of all cases of children admitted to A&E (aged from birth to four years old) an estimated 1-2% (2,000 to 4,000 annually) are likely to be abuse-related.

The BU team re-examined hard data from a UK regional study that covered a decade of child homicide assailants – focusing on child mortality rates and child-abuse-related deaths in 19 Western nations. They correlated this data with four international measures of relative poverty, focusing on income inequality.

As expected, total child mortality (all causes of death, aged birth to 14) and poverty are strongly linked, but contrary to the researchers’ expectations, violence-related child deaths are not. This suggests that factors other than poverty are at work.

The research uncovered three distinct in-family risk factors: mentally ill parents; mothers on the Child Protection Register; and men with previous convictions for violence, often domestic violence. While mentally ill parents are the most frequent assailants, violent men – both within-family and stepfathers from outside the family – pose a far greater comparative risk.

Professor Colin Pritchard says: “If you have a previous conviction for violence we don’t normally have very encouraging results. Of course, it’s against natural justice to punish people twice for the same crime but we believe the sensible thing to do with these men with previous convictions for violence, is to monitor them if they’re going to be involved with children – particularly those under 30, living with women with children aged under five who are not biologically related. We could make a big difference to these children’s lives. The link there with domestic violence is enormous.

“Where you’ve got hard facts and figures you should follow them through, though it might be uncomfortable. We are saying, simply monitor these men and let them know they’re being monitored. That in itself might make a difference. We need to see where they are and who they’re living with and regularly, routinely check and see the child, though they might not like it. We’re keen to start a proper debate.”

The study’s results also indicated that child killers’ problems are fundamentally psycho-criminological rather than socio-economic.

The authors stress that child murders are very rare in the UK and emphasise the fact that ‘the vast majority’ of men with a history of serious violence do not go on to kill either children or adults and nor do people with mental illness. They warn of ‘false positives’ and are anxious not to stigmatise people with mental health problems. But the abuse-related figures indicate the very different nature of people who actually kill children, say the researchers.

Professor Pritchard feels that psychiatrists should stop looking at patients in isolation and start looking at them with their families, and says: “We should confront the reality of the impact of mental illness on the children – I don’t want them taken away from their mentally ill parents, I want parents and their children to have the optimum support they need and deserve.”

He adds: “Our real strength in social work is that we never write anyone off – we keep reaching out. But, of course, that’s our weakness too. We shouldn’t be afraid of looking at the criminological element. The difficulty is, when we see these people’s backgrounds you can understand why they’re failing as human beings in response to children in their care. Sometimes we see them as victims – as they were – but then we forget that there’s this new victim and don’t intervene. But we must.”

The BU research team go on to call for a new partnership between the psychiatric service and child protection, where each side recognises the other’s contribution. Adult psychiatrists should consider the implications for child protection where their patient, who is a parent, has a severe personality or psychotic disorder or a history of serious violence.

The social worker should ask if there is a history of serious violence and/or mental health problems and give far more weight to these two factors than previously in any risk-assessment tool. Child protection social workers should have training to ensure they understand the impact of violent criminality or mental illness on the child. The fear of seeming judgemental should not stop them making hard but evidence-based case-specific judgements: the potential child victim must take precedence, say the researchers.

Jill Davey says: “We explored these findings in the context of the implications for social work practice. Our aim is to assist social workers to refine the risk assessment process and ultimately make a difference to children’s well being. Our future work will be focused on a close collaboration with our agency partners to further disseminate these findings and to enhance their risk assessment procedures.”

Richard Williams adds: “What the paper does, for the first time, is make this evidence available to give renewed clarity in asking the right questions when social workers assess their families. It vindicates their decision because they can now say, ‘This is evidence-based.”

In the digital age, no issue is more contentious than copyright and intellectual property law. But beyond the battles waged against online and offline piracy, there is a more subtle conflict between the interests of creators and investors and the consumers’ tendency to alter and distribute copyrighted content widely, without permission.

How should businesses and legislators react to growing demands to permit private non-commercial copying and user-generated adaptations of other’s creative works? How does the copyright incentive affect artists’ labour markets?

These are some of the questions posed by BU’s Centre for Intellectual Property Policy & Management (CIPPM).

Too often when policy-makers consider intellectual property, there is a gulf between legal research and any sound empirical evidence or well-founded comparative research. This is a weakness that the CIPPM seeks to address, by combining BU legal academics and practitioners with those versed in economics and other social sciences. As Professor Martin Kretschmer, director of the CIPPM says, “It’s rare to find such fine-grained legal expertise combined with such a willingness to collaborate across the disciplines.”

The CIPPM’s reputation for generating scrupulously independent research in this contested policy arena has already allowed it to produce studies for rights holders, consumer organisations and, increasingly, for governments.

In 2011 and 2012 alone, the CIPPM has worked on studies for the UK IP Office on orphan works (works where the owner is unknown or cannot be traced), combining experimental economics and simulated rights clearing exercises in multiple jurisdictions. The project has been a collaboration between four BU Business School & CIPPM academics: Dr Fabian Homberg, Dr Marcella Favale, Dr Dinusha Mendis and Dr Davide Secchi.

Another CIPPM project has focused on the economic effects of introducing an exception for parodies into UK copyright law; a joint project between Dr Kris Erickson in the Media School at BU and the CIPPM’s comparative lawyer and expert in Digital Rights and Entertainment Law, Dr Dinusha Mendis.

The UK Cabinet Office has also sought the expertise of the CIPPM, through Head of Law and lecturer Sally Weston, regarding mandating open standards in the procurement of government IT.

Other CIPPM academics have focused on different areas of copyright law. Dr Ruth Trowse has addressed the effects copyright law has on artists’ labour markets in her 2010 book ‘Cultural Economics’, whilst Professor Paul Heald has examined why old out of print and ‘public domain’ books from the 1850’s are five times more available to readers than copyrighted books from the 1950’s onwards.

Professor Martin Kretschmer conducted a major review as part of a fellowship funded by the Economic & Social Research Council (ESRC) entitled Private Copying and Fair Compensation (2011), identifying a complete lack of coherent methodology for measuring rights holder losses from private copying. His report has been credited with persuading the UK government to introduce a copyright exception for private copying, and is now cited in policy circles around the globe – at Brussels, Washington and the World Intellectual Property Organization in Geneva.

Beyond the vagueness of loss calculations for artists, for which levies supposedly compensate, the principles underlying copyright law suggests a range of different approaches for understanding where the balance of justice lies. Does the consumer even have a right to make private copies, and if so, on what basis? Is this a right rooted in broad conceptions of privacy rights or in the implicit allowance made when rights holders build assumptions about private copying into their purchase prices? Is there a need for permission to be granted by statutory licence?

The CIPPM’s research will remain at the forefront in any future attempts to develop and harmonise policy as well as continuing to navigate the complex issues surrounding intellectual property and copyright law.

Professor Edwin Van Teijlingen describes how even limited resources can save lives. Picture credit to Sheetal Sharma

Picture credit to Sheetal Sharma.

While few women in the developed world die from childbirth, having a baby in poorer parts of the world carries far more risks. In Nepal, where one in 500 die from complications during pregnancy and birth –and many more in rural areas.

Academics at Bournemouth University (BU) have been striving to increase women’s chances of survival: “Far too many women in Nepal have died from complications such as infection, haemorrhage or from having no antenatal care,” says Professor Edwin van Teijlingen, a BU medical sociologist. For the last six years, he’s been working in rural Nepal alongside a UK-based charity to improve women’s health during pregnancy and childbirth.

“Our results have been extremely positive,” he says. BU’s recent evaluation of the charity’s project shows many more women have taken up antenatal care as a direct result of the Green Tara Trust’s work. “This is a Buddhist charity based on a principle of equality and very much in favour of research and intervention for the poorest in society,” he says. “In the areas where we’ve been working, we’ve seen a dramatic drop in women not receiving antenatal care from 15.5% to 3.2%, which is really rewarding.”

BU’s work in Nepal has to date encompassed many projects, from the wellbeing of orphans, the health of Nepalese sex workers and Maoist rebel health workers to young people’s changing attitudes to sex.

But it is in the area of maternal health that dramatic improvements can be achieved with limited resources, says Professor van Teijlingen, who’s collaborated on the project with Dr Padam Simkhada, a visiting fellow at BU from the University of Sheffield.

Some 4,500 Nepali women die each year because of limited access to medical care. As one of the world’s poorest countries, an estimated one in two people live in poverty. Ten years of civil war, which came to an end in 2006, have damaged health services – some 1000 rural health posts were destroyed – and also hindered the work of healthcare administered by non-governmental organisations.

“In spite of that, Nepal is doing remarkably well for a poor country. If you can make even minor improvements, you will save quite a few lives,” adds Professor van Teijlingen.

BU’s work began with asking the poorest Nepalese communities where help was most needed. In rural areas, maternal health seemed an obvious choice. Researchers selected two villages – one to receive the intervention and another to act as a ‘control’. “This was one of the greatest challenges,” says Professor van Teijlingen. “Explaining to a village that we were not directly supporting them but wanted to hassle them with questions because it was for the ‘greater good’ was hard. But we had a very high response rate.”

Another challenge was reaching the women themselves, as it was not the pregnant women who made choices over their own care, but their mothers-in-law, with whom they invariably lived.

“Some 40 to 50 years ago, literacy rates among women were six to seven percent. So now, fewer than half of 45 year-old Nepalese women can read or write. So written information is no good if you want to reach the people who make the decisions,” explains Professor Van Teijlingen.

A team of up to ten local researchers assisted the BU team, who in turn advised Green Tara Trust on how best to channel its aid. This has seen more women take advantage of antenatal care, reducing potential risks associated with having a baby. Now the team is seeking to offer similar support to more rural communities in the south of Nepal. An accurate evaluation of aid projects, before, during and after, is essential, say BU researchers, in preventing the kind of misguided spending which typified aid projects in the developing world in past decades.

Ultimately, researchers hope successful promotion of women’s antenatal care will be rolled out through rural Nepal – with potentially dramatic results. Out of the four to six weeks he spends in Nepal each year, Professor van Teijlingen passes some of it working with the Nepalese government to help improve the nursing curriculum, which in turn he hopes will boost areas such as health promotion and local empowerment. “We want to show that these policies work, though it’s quite a challenge – initially it requires short-term expense for a longer term gain.”

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