Thursday 29 May 2014

52 weeks in public health research, part 21

Posted by Jenni Remnant and Jean Adams

From Jenni Remnant: Durham Cathedral taken on the walk back to the station after an excellent panel discussion on 'Communicating and Understanding pain'.

From Jenni Remnant: Just in case there is an unexpected outbreak of hygiene.

From Jenni Remnant: a reasonably healthy summer lunch all  ready to go.

From Jean Adams: outdoor office all set up. Luckily it's pretty easy to dismantle when the electrical storms arrive. That pink elephant bean bag was made on commission for my littlest step-girl when she was about 10. Now she's wrapping up a foundation course in textiles herself.


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

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.

Tuesday 27 May 2014

Life is pain

Posted by Jenni Remnant

To avoid only writing (read complaining) about the difficulties of care, and in contradiction to the misleading title, I thought I’d write something uplifting-ish about a couple of events I’ve attended over the last couple of weeks.

The first was ‘Communicating and understanding pain; a multidisciplinary approach’ and the other was ‘Applied qualitative research in health; where now?’.

Both, I’m glad to say, were great.

I’m a bit of a pessimist about these events, not because I think they’ll be naff, but because I don’t have a lot of faith in my ability to maintain my mojo and absorb/impart any quality information over an entire day, especially post-lunch. I also get pre-event guilt about having inconvenient dietary requirements, and pre-event nerves that I will have to make small talk. I’m even worse at small talk than I am at big talk.

And....sometimes I worry that events will be as boring as hell and exercises in back patting, navel gazing and academic out-rankery.

Fortunately these two were totally great. The one on pain was split across two days; first an evening event at Durham University with three speakers Clare Roques, Suzannah Biernoff and Rachael Gooberman-Hill, and then panel discussion. The three talks were totally different, but all really engaging – totally outside of my area of study, but at the same time useful and relevant in terms of ordering thoughts, and seeing the wider picture. It was followed with a day of discussion, discussion and more discussion, with a free lunch lobbed in the middle (thumbs up to a free lunch). The basic premise of the day was to find an ‘answer’ (or at least more questions) in response to the ‘problem’ that in the north east the prescription of analgesics is 5x that of the national average.

I was sat in a room discussing this with neuro-scientists, clinicians, pharmacists, students, social scientists and an art historian. How fantastic is that? I don’t know if it was a lucky collection of people, or whether my expectations had been unfairly low, but the collaborative aim of the process was totally achieved; the discussions were varied, as were the ontologies of the attendees – but somehow it worked.

One group discussion I was in did travel further into philosophical thinking than my brain usually lets me travel; whether representation is representation, or whether representation is reality...etc, but mostly we kept on task and kept it real – we talked about GP consultation, hospital treatment, where pain came from and what relationship un/employment has with pain.

We talked about the dehumanisation of patients, and then over lunch with a pharmacist and clinician, about the potential necessity of that practice sometimes to avoid dehumanising clinicians; for example, if someone witnesses a lot of pain and death in their line of work, there may be utility in being a ‘body mechanic’, rather than engaging in the reality of all that sadness.

By the end of the day I got the impression we all felt energised rather thant comatose, and had truly given our brains some exercise, while also beginning to contend with a pressing public health issue.

The second of the two events was the British Sociological Association applied qualitative research in health symposium. Back on home turf in the Research Beehive in Newcastle, which was a good start.

This one was predominantly presentations, but included break out groups in the afternoon and a key note talk by Carl May. Also, to my delight, tweeting was encouraged with the hashtag; #AQHR.

The presentations were fantastic, a moving presentation was delivered using videos of patient narratives, one on the use of qualitative research to support randomised controlled trials, in addition to fascinating presentations on linked-up interviews, researching sensitive and distressing topics and various ways in which applied qualitative research in health has filled in the gaps left by more traditional health research styles.

The day was also, at times, very funny, certainly the quotes from research conducted in Glasgow around sexually transmitted infections in middle-aged adults had most of the room smiling.

The hashtag was well used – and the keynote speech was fantastic. Though I lost track a couple of times, on winding, but ultimately entertaining tangents, it was a pleasantly natural and informal talk from Carl.

In the break out groups I joined a group that focused on PhD student specific issues and was reminded of all the challenging parts of completing a PhD, though our group was fairly pragmatic – we identified that things that we thought were huge and bowled us over (criticism from supervisors…etc) were likely to be forgotten instantly by busy academics who probably have to rush off to another meeting or to teach…etc. We also highlighted the excellent use of a managerial tool used in academia and no doubt more widely in public health; ‘the sh*t sandwich’, whereby your criticism is sandwiched by positives, only we decided that it was more akin to a ‘sh*t pitta’, in that the bread is very thin, and the filling fairly substantial.


Rather typically – having spent both events listening and scribbling down notes as I’d realised they were going to overflow my brain’s capacity – on beginning to type them up, I gestured slightly too emphatically when describing what a great week I’d had and sent my full cup of coffee cascading across said notes rendering them illegible (see image above).

So can we do them again please? ;)

Thursday 22 May 2014

52 weeks in public health research, part 20

Posted by Jean Adams, Martin White and Jenni Remnant

From Jean Adams: some days I look up from desk and am startled to find the whole office (of about 40 desks) suddenly empty. Can you guess which desk is mine? Hint: it's the one with the crochet bunting ;)

From Martin White: askFuse, our responsive research facility, is now almost 1 year old. We celebrated at a recent Fuse members' meeting with this cake featuring a still from the animation we commissioned to launch the service last year.

From Martin White: This stunning portrait of Charles Darwin is in the National Portrait Gallery in London. Sometimes when you've done three hours of work on the train down (starting at 7am), delivered two hours of teaching, and know you'll do another three hours of work on the train home it's okay to spend an hour in a gallery.

From Jenni Remnant: this hedgehog followed me home the other day. Again: not particularly public health-y, but still damn cute.

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

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.

Tuesday 20 May 2014

Using social media for building an academic & professional network

Posted by Lynne Forrest

As part of a general session within our Institute on using social media for research, I was recently asked to talk about using social media for building a professional network. It was a good chance to reflect on why I think Twitter is such a good tool for doing this, particularly for those at the start of their academic career, who are lacking in publications, a wide academic network and an established reputation.

I first joined Twitter at the beginning of the second year of my PhD and, initially, I really couldn’t quite see the point. It wasn’t until I wrote a couple of posts for the Fuseblog and starting picking up some followers that I began to realise what a useful tool it could be. Now, over two years later, post-PhD I have a twitter network of around 600 people (large enough, but not too big as to be unmanageable), am on 23 Twitter lists ranging from Women in Science to Academics at Newcastle and Tweeting Epidemiologists, contribute regularly to the Fuseblog, and am a total social media convert.


Twitter has been a brilliant medium for connecting with other PhD students (and now early career researchers) in order to ask questions, get advice and generally provide moral support during what can be quite an isolating experience. It’s also been of practical support in highlighting interesting epidemiological and public health research I might never have found myself (the fabulous @SCPHRP is great for this), advertising jobs and conferences, sharing resources (a list of viva questions has done the rounds of my twitter network), raising my profile, and connecting me with a wide network of like-minded people in public health and beyond.

As someone who can come across as quite reserved in real life (despite the fact I am actually fairly stroppy and opinionated), I do find the whole networking thing quite stressful. I realise it’s a necessary part of academia and I need to get better at speaking up more, but in the early stages of academia it’s easy to think you’ve got nothing useful to contribute, as well as the worry of saying the wrong thing and looking stupid. But Twitter has again been an excellent tool for this sort of thing. Blogging has given me an academic voice and Twitter has allowed me to interact with senior academics that I’d be far too terrified to approach blind at a conference. As a recent member of my Twitter network said ‘Twitter is networking for people who hate networking’ (thanks @PhDGeek for allowing me to pinch this for my talk!).

So, if you do plan to use twitter to build an academic network what should you do? I’d advise keeping your personal and professional identities mostly separate. I do tweet non-work related stuff but decided fairly early on to stop following David Tennant, various members of Duran Duran and the cast of Merlin (no-one needs to know about my love for dodgy 80s bands and kids’ tv programmes). Use your profile to detail your research interests and help others find you. And use a sensible twitter name. I initially just planned to lurk so chose a daft name that I’ve now changed. Also, if you’re using other academic resources such as Researchgate and google scholar citations it seems sensible to have a consistent professional online identity.

The best way to build up a twitter presence is to start interacting and not just re-tweeting. If you are going to re-tweet then occasionally add some comment or opinion. Tweet from a conference or seminar. If your Institute or department has a blog then contribute to this. There’s only so much you can say in 140 characters and a blog post allows you to talk about your research or other aspects of the research process in a lot more detail. Reply to interesting tweets, start conversations and, most importantly, engage. There’s a great network of academics out there, you just need to find them.

Thursday 15 May 2014

52 weeks in public health research, part 19

Posted by Dominika Kwasnicka, Jenni Remnant and Jean Adams

From Dominika Kwasnicka: Respect. No litter please.

From Dominika Kwasnicka: This 'smokefree' bin and its cigarette butts are outside the antenatal care and delivery suite at our local hospital.

From Jean Adams: Fuse duck and I went on a little road trip over the bank holiday weekend. Here he is enjoying all the many healthy (not) options at the MandS at Weatherby Services. Is there a word that describes massive heaps of unhealthy stuff at the entrance to shops?

From Jenni Remnant: on the way to and from uni there are currently baby geeses (aka goslings). Not particularly public health-y, but damn cute.

-------------------
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.

Tuesday 13 May 2014

The ‘C’ Word IV: Challenging (behaviour)

Posted by Jenni Remnant and Libby Morrison

So, the word ‘challenging’ is used primarily to describe aggression in learning disability and mental health settings. It keeps the focus on the service user, as is standard (see ‘Person centred planning'). But I would like to consider ‘challenging behaviour’ in terms of being a carer, and in terms of public health and public health research.

Though ‘challenging behaviour’ tends to describe a certain type of behaviour, personally I find a lot of behaviours challenging as a carer – and I expect that others sometimes find my behaviour challenging.

In 9 years of caring for people I have had excrement thrown at me (once an absolute money shot got me square in the face), I have had my hair pulled with such force my scalp ripped, my car has been attacked with a plastic tennis racket, I have been threatened with a kettle of boiling water and a hammer, in addition to being spat at, chased and verbally abused. In many of these roles I was paid a higher hourly rate (one motivation for working in these services) of up to a couple of pounds over national minimum wage. Peanuts to cashews if you will.

This of course is challenging, but I knew exactly what I was signing up to, and if I’m honest, I like it. I imagine this is wrong on a number of levels, but I liked it when people were angry, because a lot of the time I felt they were justified in it. What an oppressive system they live in and are forced to submit to. Admittedly, I like it less when the anger is directed at me, but personally, I find it easier to feel genuine respect for those who fight.

There are two levels to what I personally find challenging. One is a collection of behaviours from service users. The other challenge comes from being angry at myself and feeling guilty that though I can understand and rationalise on a theoretical level that I shouldn’t judge or feel negatively towards people, I can’t feel it. I get so frustrated when I’ve suggested someone goes to the toilet and they say that they have when they haven’t, defecate instead on their bedroom floor and laugh while you clean it up. I feel humiliated when someone starts to masturbate when I try to give them support cleaning their bedroom, go to the supermarket or cook their breakfast. I feel disgusted when someone accesses porn that simulates rape. I feel scared when I’m lone working and a service user follows me around a service. I feel angry when I get a service absolutely spotless and someone tips instant coffee all over the side and doesn’t wipe it up and it goes into those horrible rock hard little lumps on the side… the list, I’m sorry to say is endless.

I worry that it is obvious when I am getting frustrated. A service user once announced to me “I have rights” when I asked, for the fifth or sixth time that day, to use the toilet as he hadn’t been for over 8 hours. He spent around 30-45 minutes in the loo each time, but didn’t use the toilet, with me outside the toilet issuing instructions. I agreed with him – I told him about Maslow’s hierarchy of need, and took from my pocket a summary of the universal declaration of human rights (I always have it on me at work), and in that tired, frustrated, trying-to-maintain-the-appearance-of-calm way, that absolutely patronised him and highlighted that in this situation I ultimately held the balance of power – went through them and explained how trying to support him in hygiene was not relieving him of his rights. I was angry at him, I was angry at myself.

The other challenge is where to go with the above information; who wants to hear that carers are human and get challenged? Which local authority wants to hear that a *free* informal carer finds it challenging to look after a husband who no longer recognises them? What manager wants to hear that you were woken up 6-7 times through the night on your sleep in shift and so feel too tired and drained to work through the following day? Your mental health as a carer is under strain. I currently do less than one shift a week and still sometimes struggle.

Then there’s your physical health – despite meticulously clean staff teams where I have worked, I have often worked with people that for whatever reason do not wash. People that I have worked with have often not washed their hands, don’t shower, and don’t do their dishes. Sometimes when they do their dishes, they don’t do an amazing job. It is patronising and disempowering to re-wash people’s dishes for them. I take in my own cutlery and crockery – and have been pulled up on it a number of times because it’s insulting and stigmatising.

There is a huge amount of surveillance around caring, in addition to judgement. Sometimes it feels so hopelessly fruitless – permanently rolling a stone up a hill for it to roll back down again a la Sisyphus.


What does this mean for public health and public health research? To me it means a necessary interrogation of the homogenising of service users, and the black and white dichotomy between informal and paid carers. An interrogation of the system that removes power and control from a huge number of people – and that’s not even starting on the lack of decent union representation and zero hour contracts – but how?

What are the right questions? I don’t know what the desired outcome is other than that beautiful idea of health equality and social equality for service users and carers – or how as public health researchers we would approach this messy and difficult area and do it justice – but we probably should.

I was very excited to see that Fuse has been advertising a PhD studentship that focuses on carers, and will be fascinated to see what is learnt from that.

Thursday 8 May 2014

52 weeks in public health research, part 18

Posted by Catt Turney and Jean Adams

From Catt Turney: One of the things I like about the DECIPHer's Cardiff office is that pretty much everyone, staff and students alike, is based in the same building. This means the dark alleys of email can often be avoided in favour of face-to-face talking, and the PhD students feel just as much a part of the centre as the staff. This tomato plant is one of eight brought in by a PhD student at DECIPHer, all of which (plants, not PhD students) were quickly adopted and are now accessorising various windowsills. I'm now facing the dilemma: take it home and protect it from the sub-zero conditions of the office over the weekend, or leave it open to the elements and allow it compete with the others in the Great DECIPHer Tomato Plant Competition 2014?

From Jean Adams: after convincing myself there was absolutely no way to explain the concept of an escalating financial incentive to research participants, I came across this perfectly simple example of how it could be done at the supermarket. Thanks for the advice, Waitrose.

From Jean Adams: I rarely meet real-life research participants. When I was early enough in my career that that would have been my bread-and-butter, I was entirely involved in secondary data analysis. Now that I'm doing more research involving primary data collection, I have 'people' who do the actual work. So it was nice to meet the members of our Parent Advisory Group the other day on a rare field-trip out of the office to a local Sure Start Centre.

From Jean Adams: It was great to welcome two new members to the most recent meeting of the Fuse Communications Group last week: Peter van der Graaf, and the #fuseduck. I think they'll both make really valuable contributions.

-------------------
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.

Tuesday 6 May 2014

10 top tips for getting published (tips 6-10)

Posted by Jean Adams

A little while back I wrote about a presentation I gave to the Institute of Health & Society’s new Early Career Researcher group on getting published. I only managed to cover tips 1-5 in that post. As promised, here are tips 6-10.

6. Do unto other as you would have them do to you


Tip number 5 was ‘review, review, review’. Tip number 6 is a direct follow up and really comes down to ‘be nice’. Everyone knows how crushing it is to receive a damning review of a piece of work that has taken years to complete. Don’t be fooled. These horrid reviews are blueprints in how not to do it – not templates for your next review. Reviews have to be critical to be useful, but they don’t have to be harsh, personal or unkind. There are ways and ways of saying your whole research programme is scientifically unsound and you need a wholesale re-think. 


7. Don’t make a rejection easy


Most assistant editors at most journals are unpaid volunteers. If they don’t do journal work in their ‘spare’ time, they do it in their ‘in-between’ time, around the edges of their real jobs. Online editorial management systems are good, but not great and it can sometimes be a bit of a struggle to keep track of all the documents associated with any one paper (original cover letter, original manuscript, two reviews of original manuscript, first response to author, revised cover letter, revised manuscript, two re-reviews of revised manuscript…). I am sure that most assistant editors have been tempted by the ‘reject’ button when they just can’t find what they’re looking for. You can reduce the chances of this happening by reading and following all the guidance provided. In particular, don't assume you know what the form letter inviting a revision says - read it carefully.

8. Expect rejection & find a (healthy) way to cope with it


A little while ago I was at a seminar delivered by a very well respected professor. The research they were presenting was just about to be published in The Lancet. During questions, the speaker told us about some follow-up work that was “currently doing the rounds of the journals”. This was a real reminder to me that everyone has papers that they struggle to get published: even important professors doing fantastic work that they think is really important. ‘Doing the rounds’ is normal. So you have to learn to deal with it – well. My personal preference is to ignore rejections for a few days. I see the email. I feel the sting. Then I let that dissipate before planning a time to read through the details and prepare the paper for the next place.

9. Don’t stop at publication


Getting published can be exhausting. After the research itself, the many rounds of drafting and redrafting, the formatting for endless different journals, by the time your paper is finally available for the world to see, the project has often long ended and the staff scattered. Despite this, publication in a peer-reviewed journal is just the start of the dissemination journey. If you really want people to read your paper, and find out about your results, you have to let them know about it. During your project you can keep a list of people who’ve said they’d be interested to read your results and send them the paper when it’s published. If your work might be of interest to the media, you can get in touch with your press office to talk about a press-release. You can present your results at academic conferences, and meetings of other people who you think might be interested. If you’re affiliated with Fuse, you might think about writing a blog post, or an evidence brief.

10. Enjoy the ride


If you work in university research, getting published is a core activity. Some people seem to be able to avoid winning grants, some people avoid much in the way of teaching, but you don’t come across many people who can wheedle their way out of getting published without attracting negative attention. If you’re going to do it, you might as well enjoy it. Enjoy the craft of writing, enjoy winning the battle with the reviewers, enjoy seeing your name at the top of the printed page, enjoy celebrating with your co-authors, enjoy how proud your grandma is of clever you.


As I said before, these might not be the toppest of top tips - just some things I thought worth thinking about. What are your top tips for getting published?

Thursday 1 May 2014

52 weeks in public health research, part 17

Posted by Jenni Remnant and Jean Adams

From Jenni Remnant: the contents of a cleaning cupboard in a community healthcare setting- where I was about to start cleaning.

From Jenni Remnant: giving blood.

From Jean Adams: once a month, IHS hosts a coffee morning to celebrate all the staff birthdays happening that month. The ratio of fruit:cake supplied seems to be slowly changing. Either way, there is never anything left by the time I get there. This month I got there early to take pics, but didn't want to disrupt the display by eating anything. By the time I got a chance to go back, there was a half eaten cookie and three blackberries left.

From Jean Adams: sometimes the best way to solve a tricky research design problem seems to be with a dry marker and a white board. After two hours with this particular problem and white board (and white board eraser), our conclusion was that our proposed solution was possible but probably wildly impractical. A lot of reading and talking later and it seems that the only real solution is to use a computer...


-------------------
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.