52 weeks of public health research, part 14

Posted by Michael Heasman, Martin White and Lynne Forrest

From Martin White: The MRC has this jigsaw-like object in its 13th floor stair lobby. I think it celebrates 100 years of the MRC (Centenary last year). I attended two meetings: the Population Health Sciences Research Network board, which has overseen ‘methodological knowledge exchange’, including the hugely cited MRC Guidance on the development and evaluation of complex interventions; and the Public Health Interventions Development panel, which funds competitive, small scale research.

From Martin White: At the Public Health intervention Development research funding panel we reviewed 29 applications in less than 3 hours. Two panel members per application. You do the maths. The applications are short (a couple of pages) and the stakes not high (maximum of £150k over 18 months). But, only few will get funded. The MRC assessment criteria demand a high level of rigour and innovation. Only an agreed score of 8 or more can be considered for funding. There is no room for error as an applicant.

From Michael Heasman: no description required.

From Lynne Forrest: This poster appeared in the 3rd floor coffee room at IHS recently, urging us all to take the stairs for health and fitness reasons and also to ‘avoid awkward silences’ in the lift! I do wonder if it might be more useful if the notice were stuck beside the lift on the ground floor? And, as public health evidence is what we’re all about, is anyone evaluating its effectiveness?
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Just to remind you:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in my life, I foresee problems compiling 208 images worth posting on my own. So this is going to have to be a group project. Send me an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and I’ll post them as soon as I can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Also, this doesn’t mean we wont also be posting words. You word-based posts are, as always, much appreciated.

10 top tips for getting publishing (tips 1-5)

Posted by Jean Adams

The Institute of Health & Society at Newcastle University has recently set up an Early Career Researchers group. I was invited to speak at their inaugural meeting on ‘publishing’. The brief was to speak for about 20 minutes and cover 10 top tips. I think I was an ECR just on the edge of the time when the phrase started being used, and the research community started to recognise ECRs as a group worthy of attention and nurturing. Sometimes the younger researchers at conferences were invited to pub crawls (not really my thing), but I don’t remember much in the way of encouragement to organise and support each other. The attendance at the IHS ECR meeting was huge and there was a definite buzz in the room. I felt quite excited, and flattered, to be there.

‘Publishing’ is a big topic and so much of how to do it seems to be about experience, working out what works in what situations, and a mixture of good luck and persistence. But I managed to come up with 10 things that felt worth saying – maybe not the toppest tips of all, but some things worth thinking about. The first five are here. I’ll cover the next five sometime in the next few weeks.

1. Know what your paper did (aims) and what it adds (message)

I think there are two sentences that almost all peer-reviewed papers hang on – the aims and the message. The introduction justifies the aims, the methods describe how the aims were achieved, and the results describe what the ‘answer’ to the aims were. You probably know what the aims were (perhaps you shouldn’t have started the research if were clear what you were trying to achieve?). The message might be harder. This is the one thing you want people to remember from your paper. The ‘what this study adds’ box; the ‘citable sentence’. The message is what drives much of the discussion and in some cases may be open to interpretation. So you might have to discuss it with your team to get it clear.

Knowing your aims and message are about knowing where your paper's come from and where it's going; map by Max Roberts

2. Write a detailed plan as a team

I think I have only written a paper plan as a team once in my career. So I can’t promise that this works. But I get the feeling that much drafting and re-drafting could be avoided if a detailed plan for each paper was agreed within the team before the real business of writing got underway. If we all agreed the general argument put forward in the introduction, the sub-headings required in the methods, the crucial tables/quotes/figures to include in the results, and the three or four main points under each sub-heading of the discussion, then perhaps there would be little more than re-wording required at the comments stage. Perhaps?

3. Pay attention to your laziness

We are all lazy. Different people just express it in different ways, and hit the point of can’t be bothered at different points. I’m sure we all do that thing of arguing there is a good scientific reason not to do something, when the truth is we just really cannot find the will to do it. There is a lot of self-discipline required in lots of areas of research, and sometimes you run out. This is okay, understandable, and expected. But it feels to me worth noticing and being truthful – at least to yourself – about when the real issue is laziness and when there is good scientific justification for stopping. Then at least you know what the problem is and how you should address or justify it.

4. Know when good enough is good enough

Which brings me to knowing when to stop. Because hardly any (no?) piece of research is perfect and there does come a point where you have to agree that what you have is good enough for what you are trying to achieve. This point might be different for different things. But you do have to be able to draw a line and move on or else you'll never get to the next project - which is always more exciting/interesting/likely to change the world than the current one.

5. Review, review, review

Papers in peer-reviewed journals are remarkably formulaic. I think the best way to learn to write them, is to read others. And the best way to make yourself pay attention to how other papers are written as you read them is to do so as a peer-reviewer. If you aren’t routinely asked to peer-review for journals (and generally you need a publication record for this to happen), the more senior people you work with probably are. It’s fairly normal either to pass reviews officially on to a colleague via the journal office, or to do a review together with a less experienced colleague. So ask if you want more experience of this. Informal peer-review can also be very valuable – to reviewer and reviewed. We all know that feeling of being too close to a piece of work and needing someone with fresh eyes to notice the glaring mistakes.


OK. That’s it for today. I promise to get around to writing up tips 6-10 in the next few weeks. In the meantime, what are your top tips for getting published?

52 weeks of public health research, part 13

Posted by Melanie Rimmer, Emily Henderson & Martin White

From Melanie Rimmer: Reminds me of the old days of searching journals by hand, card index files, the smell of old books, dusty shelves festooned with dead flies, and the volume you needed was always the one missing from the shelf. Without doubt computer searching is better, but somehow sterile. I miss the romance (but not the dead flies).

From Emily Henderson: Celebrating our new status as a WHO Collaborating Centre! The Centre for Public Policy and Health at Durham University is now a WHO CC on Complex Health Systems Research, Knowledge and Action, which links with Fuse’s new Complex Systems Research Programme.

From Martin White: It never ceases to amaze me how the irony of juxtaposing public health stories (this one courtesy of our very own Blog Editor) with junk food promotions entirely escapes newspaper editors. Nowhere more than in the free dailies that litter our public transport. This piece about a systematic review on financial incentives is rather good, which makes me think it may even have been written by Dr Adams.

From MartinWhite: When a small glass of coke contains 9 teaspoons of sugar, it is hardly surprising that the Coca Cola Corporation is investing heavily in ‘changing the conversation’. Coca Cola wants us to forget about the sugar and do exercise instead to burn it off. Their marketing is widespread in the Alps, as well as in professional sport, leisure and educational settings. Someone tell them why this isn’t the answer please…

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Just to remind you:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in my life, I foresee problems compiling 208 images worth posting on my own. So this is going to have to be a group project. Send me an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and I’ll post them as soon as I can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Also, this doesn’t mean we wont also be posting words. You word-based posts are, as always, much appreciated.

Today the ‘c’ word is – choice.

Posted by Libby Morrison & Jennifer Remnant

Choice is a buzz word, much favoured by politicians. We are continually being offered ‘real choices’! In learning disabilities, choice can be a difficult and complex thing, often linked to other ‘c’ words like ‘capacity’ and ‘consent’ These other ‘choices’ will be examined in further blog posts. But today I will be considering every day, common or garden choice.

When I first began working in the Health and Social Care sector 16 years ago, I very quickly became aware that many service users chose the same things. Of the nine residents in the first care home for adults with a learning disability that I worked in, ALL watched Coronation Street AND Emmerdale. In the next care home with three adults with a learning disability, again all watched Coronation Street and Emmerdale. In fact by the fourth and fifth place I worked in I had realised that it wasn’t just soap operas that all the service users watched, it was specifically ITV – unless it was Strictly on BBC1,  obviously! So despite the ‘choice’ word being used all the time – it was a key area in the 2001 Valuing People white paper – I began to suspect that television viewing might have been more to do with the carers' choice, rather than the service users.

Call me a cynic if you will.

It was the same with music, cinema, theatre and shows. If I look through my local theatre’s programme of events, I can tell you exactly which shows all the people in my area with a learning disabilities will be at. Because it is a FACT that adults with learning disabilities ALL love Elvis Presley and Abba tribute bands! Yes they do. Also all people with Down syndrome are very happy and smile all the time – especially when they are taken to see Abba tribute bands!

Call me a cynic if you like.

I worked for 10 years with a remarkable woman, who had a mild learning disability. I thought that I knew her quite well – her likes and dislikes etc. By chance one day in my car I put on a classical music programme. Almost immediately she began humming along to a Beethoven piece. I asked her how she knew it, and she said ‘oh my Dad used to play it on the piano. I love that sort of music’. I had had no idea. I began to take her to see some classical concerts – which she loved, especially pianists. She recognised a piece of music one time as coming from Swan Lake – I asked her if she had ever seen a ballet. She hadn’t, so we went – she loved that too. I asked another carer if she would like to accompany this service user to the ballet – ‘Ballet? – bally awful more like’ she said. 

Call me a cynic if you must.

I was guilty myself of limiting this service user’s choice. Not knowing a great deal about classical music myself, I generally suggested well known pieces of music, thinking that she would not enjoy more modern and perhaps challenging composers. In fact it was me that struggled with modern classical music. When at one concert there was some Benjamin Britten and Peter Maxwell Davies, she turned to me with shining eyes and said ‘I could have listened to that all night’.

Real Choice.

52 weeks of public health research, part 12

Posted by Lynne Forrest and Jean Adams

From Lynne Forrest: Whilst buying a coffee for taking on the train, I noticed that Costa now list the calories in each cup. My flat white had 145 calories, which meant that two cups contain the calorie-equivalent of a Mars bar. This seemed shockingly high to me and I’m sure I can’t be the only person who had no idea of the large ‘hidden’ calorie count in drinks. Apparently most of the big coffee retailers use full-fat milk as standard. Perhaps we need a public health campaign (similar to those that aim to reduce hidden salt and sugar in food) to get them to switch to semi-skimmed as default.

From Lynne Forrest: As very much a fair-weather cyclist, now that the weather has improved I’ve started cycling in to work again. I’m trying to embrace the idea of active transport and cycling has the added advantage of being quicker than the bus. Most of my cycle is across Newcastle town moor, which isn’t the most scenic of routes but is traffic-free. Later in the year there are usually lots of cows blocking the path (which scare me!) but it’s currently blissfully cow-free.

From Jean Adams: I love a bit of retro-branding-as-art, but was particularly struck by this image in a hotel room I stayed in recently. How did a soft drink brand manage to become part of popular culture? When will we work out how to do that for apples?

From Jean Adams: Last week was my last visit to Ashridge for NIHR Leadership Training. Despite my initial reservations, I've really enjoyed the experience and hope I've learnt some useful things. I will particularly miss the splendid early 19th century country house setting. And the fabulous food.


-------------------

Just to remind you:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in my life, I foresee problems compiling 208 images worth posting on my own. So this is going to have to be a group project. Send me an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and I’ll post them as soon as I can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Also, this doesn’t mean we wont also be posting words. You word-based posts are, as always, much appreciated.

Sometimes you know what the answer will be, sometimes you don’t

Posted by Jean Adams

Quite often, I’m pretty sure I know what the results of a piece of research will be before we start it. I’ve never written my pre-thoughts down, so who knows how good I am at predicting the results, and how good I am at gradually changing my mind as the results become available and convincing myself, post-hoc, that I knew that all along.

We have just finished a systematic review of the effectiveness of financial incentives for changing health-related behaviours. Before we started, the general chit-chat on incentives was that they work for short-term, simple behaviours, but not for long-term, complex ones; that the effects don’t last much beyond the period that you give the reward for; and that you probably need to give people quite a lot of money to have an effect. It wasn’t absolutely clear to me why people thought this, but some prominent people, who I respect a lot, said at least some of it in some high profile journals. So I assumed I was missing something.

Our review was justified because no-one had ever tried to bring evidence on financial incentives on all health-related behaviours together in one systematic review. But I was pretty sure it was going to be one of those worthy-but-not-earth-shattering bits of work that would just confirm what everyone says already.

Like all good (or maybe bad) systematic reviews, this one seemed to go on and on. And on. The whole ‘rule book’, register your protocol, approach to systematic reviewing makes me think that it should be a nice, clean, linear, no decisions made on the hoof, sort of research method. Maybe that’s how it is for you. But it never seems to be for me. I think I’ve been entirely explicit with my inclusion criteria, but then they don’t seem to be any use for screening the articles the search found. I think we’ve finally identified all the included articles. Then some inter-library loan we’d forgotten about turns up and the reference list identifies another five papers to screen.

I find all of this unexpected messiness a little unsettling. Obviously, the number of times I’ve experienced it means it shouldn’t really be that unexpected anymore. But it is. The messiness makes me think I’ve somehow done it wrong. At which point I start to enter the bad part of the creative cycle and it is way too easy to get stuck there. Especially when it takes a year and about 30 rejections to get your review published.

The creative process

I don’t know why it took so long to get our review published. I don’t think (by which I mean please tell me this wasn’t the reason, it took so long) it was that it was badly done. It seemed to be more that everyone thought that a systematic review on the effectiveness of financial incentives was not news. We know about them - they work for short-term, simple behaviours, but not for….see above.

But it turns out that that wasn’t what we found at all. Most of the evidence we found that met our criteria in terms of study design was on smoking - a long-term, complex behaviour. We found financial incentives to be more than twice effective as usual care or no intervention for helping people to quit smoking. Effect size for smoking cessation dropped off in those studies following up for more than six months after incentives had been withdrawn, but not entirely. The effects for short-term, simple behaviours, like coming for screening or vaccinations, was similar - about twice as effective as usual care. Effect didn’t seem to be vary massively with incentive size.

I still haven’t managed to convince myself I knew this all along.

52 weeks of public health research, part 11

Posted by Amelia Lake, Beki Langford & Jean Adams

From Amelia Lake: Recorder and earpiece at the ready for my first telephone interview after a relaxing week off. Next job: to tackle too many emails!

From Beki Langford: After a very busy week and far too many hours spent in the office working to a deadline, it was wonderful to get out into the sunshine at the weekend and see that spring had finally sprung.

From Jean Adams: preparing teaching materials on the office floor early one morning, I had a sudden flash back to the days when every grant application involved sending 22 hard copies, organising great piles of print outs on the floor, and a final sprint to the post office to catch the last post before the deadline.

From Jean Adams: some of this year's students on our MSc in Public Health and Health Services Research. I'm always taken by surprise when MSc teaching starts in September and then can't quite believe it can all be over so soon come March. Actually it isn't - there are still more classes, assignments, exams and dissertations to get out of the way. Just no more of me standing up in front of the class. This year's students were lots of fun and VERY opinionated - a great combination that makes a teacher's life so much easier.

-------------------

Just to remind you:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in my life, I foresee problems compiling 208 images worth posting on my own. So this is going to have to be a group project. Send me an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and I’ll post them as soon as I can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Also, this doesn’t mean we wont also be posting words. You word-based posts are, as always, much appreciated.